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Biomedical subjects

H Checkoway

Publications and source records attributed to H Checkoway.

124 records · Page 7Linked to original sources

Mortality among workers in the Florida phosphate industry. II. Cause-specific mortality relationships with work areas and exposures.

Small excesses of lung cancer and emphysema mortality had been detected among an historical cohort of 17,601 white and 4,722 nonwhite Florida phosphate industry workers. Internal mortality rate comparisons were made between worker subcohorts classified according to length of employment in 16 work areas and according to employment duration in jobs grouped by potential exposures to 10 agents, including alpha radiation. The only consistent associations seen were increased lung cancer mortality rates among long-term workers in plant-wide services and skilled crafts jobs. There was no evidence to support causal associations with exposures characteristic of the phosphate industry.

Adult↗

An evaluation of the associations of leukemia and rubber industry solvent exposures.

Excessive leukemia mortality has appeared consistently in epidemiological studies of British and U.S. rubber industry workers. Attempts to identify causative factors have focused on exposure to benzene and other solvents. Interpretations of findings from these studies have often been influenced by expectations of a benzene/nonlymphocytic leukemia association, seen from previous work in other settings. However, data from the rubber industry studies have not been consistent with this expectation, as lymphocytic and nonlymphocytic leukemia have shown similar mortality excesses. Data from a small case-control study of lymphocytic leukemia are presented to illustrate an approach that considers multiple solvent exposures. The associations with lymphocytic leukemia risk observed for a number of solvents, most notably carbon tetrachloride and carbon disulfide, were stronger than those detected for benzene.

Adult↗

Cancer mortality and solvent exposures in the rubber industry.

Some evidence suggests that solvent exposures to rubber industry workers may be associated with excess cancer mortality, but most studies of rubber workers lack information about specific chemical exposures. In one large rubber and tire-manufacturing plant, however, historical documents allowed a classification of jobs based on potential exposures to all solvents that were authorized for use in the plant. A case-control analysis of a 6678 member cohort compared the solvent exposure histories of a 20% age-stratified random sample of the cohort with those of cohort members who died during 1964-1973 from stomach cancer, respiratory system cancer, prostate cancer, lymphosarcoma, or lymphatic leukemia. Of these cancers, only lymphosarcoma and lymphatic leukemia showed significant positive associations with any of the potential solvent exposures. Lymphatic leukemia was especially strongly related to carbon tetrachloride (OR = 15.3, p less than .0001) and carbon disulfide (OR = 8.9, p = .0003). Lymphosarcoma showed similar, but weaker, associations with these two solvents. Benzene, a suspected carcinogen, was not significantly associated with any of the cancers.

Adult↗

Lymphocytic leukemia and exposures to benzene and other solvents in the rubber industry.

Previous epidemiological studies on one cohort of rubber industry workers indicated that observed mortality excesses from lymphocytic leukemia were related to solvent exposures. The results of a detailed examination of the solvent exposure histories of 15 cases of lymphocytic leukemia from this cohort and 30 matched industry controls are presented. Extensive review of historical solvent use, raw materials specifications and job description records were used to reconstruct exposures to specific agents. Cases were 4.5 times as likely as controls to have had direct exposures to both benzene and other solvents. Analysis by manufacturing production source of solvent revealed that cases spent greater proportions of their work experience in jobs with potential exposures to coal tar-based benzene and xylene. No differences were seen for petroleum-derived solvents.

Adult↗

A hematology survey of workers at a styrene-butadiene synthetic rubber manufacturing plant.

A previous epidemiologic study of the U.S. rubber industry indicated that there has been an excess of leukemia and lymphoma mortality among hourly workers at one styrene-butadiene rubber manufacturing plant. This investigation was a combined industrial hygiene and hematology cross-sectional survey at the same plant. The objectives of the survey were to quantify exposure levels for styrene, butadiene, benzene and toluene, and to relate these levels to hematologic variation. Personal air samples and blood specimens were obtained from 157 production workers. All exposure levels for the four chemicals assayed were well below recommended standards. The higher mean styrene (13.67 ppm) and butadiene (20.03 ppm) concentrations were found in the Tank Farm area; in all other departments the mean levels for the four chemicals were less than 2 ppm. The Tank Farm workers had slightly lower levels of circulating erythrocytes, hemoglobin, platelets and neutrophils, and slightly higher mean corpuscular red cell volumes and neutrophil band counts than the other workers. Overall, in this population there was no pronounced evidence of hematologic abnormality, as determined from examination of peripheral blood.

Adult↗

A case-control study of bladder cancer in the United States rubber and tyre industry.

A case-control study of bladder cancer was conducted in five United States rubber and tyre companies to determine if there were high-risk jobs and work areas within the industry. The study included 220 male cases of bladder cancer, of whom 107 were identified from hospital record reviews and 113 from death certificates. Each case was matched individually with two industry controls by sex, race, year of birth, and company. One control was matched additionally by year of hire and duration of employment. Comparisons of cases and controls not matched by year of hire and age of hire showed no differences for those variables, which suggests that age and calendar period of first exposure to the industry were not risk determinants. When the work histories of both cases and controls were contrasted it was found that cases were more likely than controls to have worked in milling (odds ratio (OR) = 1.91) and calender operation (OR = 2.21) jobs. The relative risk estimates for milling and calender operation both exhibited linear trends of increase with duration of exposure. Milling and calender operation jobs entail potential exposures to volatilised reaction products from heated rubber stock. A better understanding of aetiological associations with job type will require more detailed characterisation of the work environment with regard to the sources and levels of aromatic amines and other suspected bladder carcinogens.

Adult↗

Bias due to misclassification in the estimation of relative risk.

Lack of bias in the estimation of relative effect in epidemiologic studies depends on the internal validity of the study. This paper conveys in graphic and tabular form the direction and magnitude of bias due to misclassification of study subjects. A series of computer-generated graphs shows that the departure of the estimate of effect (relative risk or odds ratio) from its true value is a function of sensitivity and specificity (measures of classification validity), disease frequency, and exposure frequency. The discussion of bias emphasizes misclassification of the "outcome" variable; i.e., disease occurrence in a cohort study and exposure rate in a case-control study. Examples are used to illustrate that the magnitude of the bias can be large under circumstances which occur readily in epidemiologic research. When misclassification is equal for the two compared groups, the estimate is biased toward the null value, and in some instances beyond; when differential misclassification occurs (as in selective recall in case-control studies) the bias can be in either direction, and may be great. Formulas are derived to estimate the underlying true value of the relative risk or odds ratio using the investigator's observations together with the estimated sensitivity and specificity of the classification procedure.

Classification↗

Correcting for the effects of location and atmospheric conditions on air pollution exposures in a case-crossover study.

A limitation of most air pollution health effects studies is that they rely on monitoring data averaged over one or more ambient monitors to represent daily air pollution exposures for individuals. Such data analyses therefore implicitly require the assumption of a homogeneous spatial distribution for particulate matter (PM). This assumption may be suspected in the Pacific Northwest because of its hilly topography and local variations in wood burning. To examine the bias from substituting regional PM (i.e., the average of three ambient monitor measurements) for individual PM exposure, we conducted an exposure substudy to identify the influence of location factors, specifically urban versus suburban classification and topographic features ("upstream" versus "downstream"), on local ambient measurements. Using nephelometer measurements collected over 1 year in four locations, we developed regression models to predict local PM as a function of regional PM, atmospheric stagnation, temperature, and location. We found a significant interaction between atmospheric stagnation and topography, with the most upstream site having reduced PM levels on high stagnation days after controlling for regional PM. We also found a significant interaction with temperature at one downstream site thought to be heavily exposed to wood smoke in the winter. These results are consistent with the physics of surface radiation inversions. The interactions reordered the index versus referent exposures in a case-crossover analysis of out-of-hospital primary cardiac arrest for subjects living in specific locations, but did not meaningfully change the associations with PM from the analysis using regional PM as the exposure. The lack of change in these results may be due to limitations in the data used to correct the exposure estimates or to the absence of a PM effect among persons without prior heart disease who experienced a primary cardiac arrest.

Adult↗

Validity study of self-reported pesticide exposure among orchardists.

Self-reported work histories are often the only means of estimating occupational exposures in epidemiologic research. The objective of this study was to examine the accuracy of recall of historical pesticide use among orchardists. All 185 orchardists in this study had participated previously in a cohort study of men occupationally exposed to pesticides. In that study (1972 to 1976), subjects were interviewed annually and asked to list pesticides used since the last interview. In 1997, 265 of the 440 presumed-living orchardists from the original cohort were successfully recontacted and asked to complete a detailed questionnaire concerning their lifetime use of pesticides; 185 (69.8% of farmers successfully contacted) agreed. Considering the 1972-1976 data as the standard, sensitivity and specificity of recall were calculated for certain pesticides and pesticide categories. Sensitivity of recall was good to excellent (0.6-0.9) for the broad categories of insecticides, herbicides, and fungicides, for heavily used chemical classes, such as organophosphates and organochlorines, and for commonly used pesticides; it was lower and more variable (0.1-0.6) for specific pesticides. Recall specificity was greatest (0.7-0.9) for the least used pesticides and chemical classes, such as dithiocarbamates and manganese-containing pesticides, and was generally modest for the rest (0.5-0.6). There was no evidence of selection bias between study participants and nonparticipants. In conclusion, recall accuracy was good for commonly used pesticides and pesticide categories. This level of recall accuracy is probably adequate for epidemiologic analyses of broad categories of pesticides, but is a limitation for detecting more specific associations.

Aged↗

Latency analysis in occupational epidemiology.

Allowance for prolonged disease induction and latency times is an important consideration in occupational epidemiology studies of cancer and other delayed effects of exposure. Two useful approaches for assessing prolonged induction and latency periods are (1) exposure lagging and (2) considering exposures only within moving time windows. The exposure weighting scheme proposed by Jahr2 to assess exposure burdens is another method that accounts for induction and latency, although not explicitly. These three approaches, which are shown to be special cases of exposure weighting, are illustrated with an analysis of lung cancer mortality among a cohort of workers from an asbestos textile plant.

Adult↗

Neurophysiological function in farm workers exposed to organophosphate pesticides.

To investigate neurophysiological effects of low-level exposure to foliar organophosphate residues during one season among agricultural workers, the authors performed a cross-sectional study of 67 Hispanic farm workers and 68 age-, gender-, ethnicity-, and education-matched reference subjects. The neurophysiological examination included sensory and motor nerve conduction and neuromuscular junction testing. Erythrocyte cholinesterase activity was measured at the time of examination. No statistically significant neurophysiological differences between the exposed and reference groups were observed. Farm workers and reference subjects had similar sensory nerve latency and amplitude (sural), motor nerve conduction velocity (ulnar), and neuromuscular junction function (ulnar). No relationship between duration of exposure during the season and electrophysiological measures of nerve function was found. Exposure of farm workers to the low levels of organophosphate pesticides during one season experienced by farm workers in this study was not associated with impaired peripheral neurophysiological function.

Adolescent↗

Mesothelioma surveillance to locate sources of exposure to asbestos.

To determine whether there were previously unrecognized sources of asbestos exposure in British Columbia, incident mesothelioma cases (n = 51) and population-based controls (n = 154) were interviewed about their occupational histories and asbestos exposures. The following occupations were at elevated risk: sheet metal workers (OR = 9.6, 95% CI: 1.5-106), plumbers and pipefitters (OR = 8.3, 95% CI: 1.5-86), shipbuilding workers (OR = 5.0, 95% CI: 1.2-23), painters (OR = 4.5, 95% CI: 1.0-24), welders (OR = 3.9, 95% CI: 0.8-22), gardeners (OR = 3.9, 95% CI: 0.8-22), bricklayers (OR = 3.5, 95% CI: 0.9-14), miners (OR = 3.4, 95% CI: 0.9-13), machinists (OR = 3.2, 95% CI: 1.0-11), construction foremen (OR = 3.1, 95% CI: 0.9-11), and electricians (OR = 3.0, 95% CI: 0.8-12). In a reanalysis excluding subjects who worked in occupations or processes considered strongly a priori at risk, three groups remained of interest: non-asbestos miners (OR = 9.6, 95% CI: 1.8-53), bricklayers (OR = 5.4, 95% CI: 1.0-28), and construction labourers (OR = 2.8, 95% CI: 0.7-10.6).

Adult↗

Genetic polymorphisms in Parkinson's disease.

The search for genetic polymorphisms relevant to Parkinson's disease etiology and pathogenesis has been motivated by recent thinking emphasizing the potential significance of gene-environment interactions. Especially influential to this research have been the MPTP model of PD induction, hypotheses concerning oxidative stressor reactions, and epidemiological observations of an inverse relation between cigarette smoking and PD risk. This brief review summarizes trends in genetic polymorphism research, with examples provided by investigations of cytochrome P450 enzymes, monoamine oxidase, superoxide dismutase, and mitochondrial genes.

Animals↗