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Biomedical subjects

H Frumkin

Publications and source records attributed to H Frumkin.

70 records · Page 4Linked to original sources
PubMedDate not supplied

Interim results of the study of particulates and health in Atlanta (SOPHIA).

Substantial evidence supports an association of particulate matter (PM) with cardiorespiratory illnesses, but little is known regarding characteristics of PM that might contribute to this association and the mechanisms of action. The Atlanta superstation sponsored by the Electric Power Research Institute as part of the Aerosol Research and Inhalation Epidemiology Study (ARIES) study is monitoring chemical composition of ambient particles by size fraction, as well as a comprehensive suite of other pollutants, at a site in downtown Atlanta during the 25-month period, August 1, 1998-August 31, 2000. Our investigative team is making use of this unique resource in several morbidity studies, called the "Study of Particulates and Health in Atlanta (SOPHIA)". The study includes the following components: (1) a time series investigation of emergency department (ED) visits for the period during which the superstation is operating; (2) a time series investigation of ED visits during the 5 years prior to implementation of the superstation; and (3) a study of arrhythmic events in patients equipped with automatic implantable cardioverter defibrillators (AICDs) for the period January 1, 1993-August 31, 2000. Thirty-three of 39 Atlanta area EDs are participating in the ED studies, comprising over a million annual ED visits. In this paper, we present initial analyses of data from 18 of the 33 participating EDs. The preliminary data set includes 1,662,713 ED visits during the pre-superstation time period and 559,480 visits during the superstation time period. Visits for four case groupings--asthma, chronic obstructive pulmonary disease (COPD), dysrhythmia, and all cardiovascular diseases (CVDs) combined--have been assessed relative to daily air quality indices, controlling for long-term temporal trends and meteorologic variables, using general linear models, generalized estimating equations and generalized additive models. Single-pollutant models predicting case visitation rates using moving averages of 0-, 1-, and 2-day lagged air quality variables were run. For the pre-superstation period, PM10 (24-h), ozone (8-h), SO2 (1-h), NO2 (1-h) and CO (1-h) were studied. For the first 12 months of superstation operation, the following air quality variables of a priori interest were available: ozone (8-h), NO2 (1-h), SO2 (1-h), CO (1-h), and 24-h measurements of PM10, coarse PM (PM 2.5-10 microm), PM2.5, polar VOCs, 10-100 nm particulate count and surface area, and in the PM2.5 fraction: sulfates, acidity, water-soluble metals, organic matter (OM), and elemental carbon (EC). During the pre-superstation time period, statistically significant, positive associations were observed for adult asthma with ozone, and for COPD with ozone, NO2 and PM10. During the superstation time period, the following statistically significant, positive associations were observed: dysrhythmia with CO, coarse PM, and PM2.5 EC; and all CVDs with CO, PM2.5 EC and PM2.5 OM. While covariation of many of the air quality indices limits the informativeness of this analysis, the study provides one of the first assessments of PM components in relation to ED visits.

Adult↗
PubMedDate not supplied

Investigation of a reported cluster of bladder cancer cases in the Pottstown/Phoenixville area of Pennsylvania.

A urologist in Phoenixville, Pennsylvania, noted an apparent excess of invasive bladder cancer cases in his practice area during 1988 and 1989. Background incidence data for the local area were derived from state Cancer Registry statistics. Seventeen additional cases were noted during review of local hospital tumor registry data. Exposure evaluation included complete occupational histories for 15 index cases and correlation of residential histories with a review of local industries, water quality data, and toxic waste sites. The data were compared with incidence data from 1984 and 1985, and no increase in bladder cancer incidence for this area in 1988 and 1989 was evident. There was, however, a higher bladder cancer incidence among white males in the study area and Chester County, compared with Pennsylvania as a whole. Residential histories and environmental analysis did not reveal a common environmental carcinogen. A high incidence of occupational exposure to suspected bladder carcinogens was noted. In addition, all but 4 of the index cases smoked cigarettes. The study was limited by an extreme paucity of water supply analysis data. Effective environmental monitoring would promote more effective research into environmental carcinogenesis.

Aged↗
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Systemic lupus erythematosus in relation to environmental pollution: an investigation in an African-American community in North Georgia.

The etiology of systemic lupus erythematosus is not well understood, although gender, race, genetic predisposition, and certain drugs are risk factors. Several environmental exposures have been implicated. In this study, we examined the prevalence and incidence of lupus in an African-American community that experienced long-standing exposures to industrial emissions. We hypothesized that lupus was elevated among residents of a specific community in Gainesville, Georgia. We included both a retrospective cohort study and a cross-sectional study designed to assess the incidence and prevalence, respectively, of lupus. The prevalence of lupus was 3 cases/300 persons (1000/100,000). Compared with the highest reported prevalence, this represents a 6-fold increase. The incidence of lupus was 3 cases/4709 person-years (63.7 cases/100,000 person-years). Compared with the highest reported incidence, this represents a 9-fold increase. The hypothesis that environmental toxins may induce lupus is consistent with the known ability of certain medications to do the same. The results suggest that long-standing exposure to industrial emissions may be associated with an increased risk of lupus.

Black or African American↗
PubMedDate not supplied

Blood lead in children and its determinants in Nagpur, India.

In a community-based cross-sectional study of 297 children aged 6 months to 6 years in an Indian city, the authors assessed the prevalence of elevated (> or = 10 microg/dL) blood lead (PbB) levels, their risk factors, and the lead contents in potential environmental sources. Mean PbB was 18.4 microg/dL +/- 16.5. The prevalence of elevated PbB was 67%. Anticipated risk factors for elevated PbB were living in houses painted with lead-based paint, odds ratio (OR) 6.42 (1.75, 23.6; p = 0.005), recent exposures to lead-based paint, OR 2.61 (1.07, 6.66; p = 0.03), and the use of the eye cosmetic ma," OR 2.63 (1.24, 5.56; p = 0.01). Unanticipated results were effect of upper caste as a risk factor, OR (adjusted) 1.85 (95% CI = 0.96, 3.57; p = 0.06), and the lack of effect of traffic, parental occupational exposure, or nutritional status. Analysis of various environmental sources such as paint, pencils, crayons, and clay revealed high lead levels. These results demonstrate the existence of a major environmental health problem in Indian children, with risk factors that differ from those in other countries.

Child↗
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Salud Ocupacional.

Explore the source record for details and available documents.

Academies and Institutes↗
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The international trade in toxic waste: the case of Sihanoukville, Cambodia.

In December 1998, 2,700 metric tons of industrial waste containing high levels of mercury and other metals and possibly other toxic compounds were shipped illegally from Taiwan to Sihanoukville, Cambodia. There the waste was unloaded and transferred to a nearby inland dumpsite. An estimated 2,000 Sihanoukville residents were exposed to the waste occupationally or environmentally, and at least six deaths and hundreds of injuries have been associated with the incident. The authors describe the human exposures and associated morbidity and mortality, recount the medical and public health response, and consider the issues complicating epidemiologic analysis of the incident. They also consider the major issues highlighted by the incident, including the trade in toxic waste between developed and less developed countries, the factors that shape emergency public health responses in resource-poor environments, and the importance of prevention and preparedness in containing emergencies in developing countries.

Adult↗
PubMedDate not supplied

Cancer epidemiology and the workplace.

Occupational exposure occurs most frequently through direct contact with carcinogenic agents, with any of their active metabolites during absorption (skin, respiratory tract); or during excretion (urinary tract). In the USA, from 2-8% of cancer are attributed to this circumstance. In developing countries emphasis should be made on prevention measures of possible carcinogenic exposure factors, with three basic premises: a) identify exposure markers (biological monitoring); b) identification of high risk subjects, presumable before exposure occurs, and c) early identification of signs of sickness (medical surveillance). This article proposes that, in theory, all occupational cancer can be prevented.

Carcinogens↗
PubMedDate not supplied

Cellular phones and risk of brain tumors.

As cellular telephones are a relatively new technology, we do not yet have long-term follow-up on their possible biological effects. However, the lack of ionizing radiation and the low energy level emitted from cell phones and absorbed by human tissues make it unlikely that these devices cause cancer. Moreover, several well-designed epidemiologic studies find no consistent association between cell phone use and brain cancer. It is impossible to prove that any product or exposure is absolutely safe, especially in the absence of very long-term follow-up. Accordingly, the following summary from the Food and Drug Administration Center for Devices and Radiological Health offers advice to people concerned about their risk: If there is a risk from these products--and at this point we do not know that there is--it is probably very small. But if people are concerned about avoiding even potential risks, there are simple steps they can take to do so. People who must conduct extended conversations in their cars every day could switch to a type of mobile phone that places more distance between their bodies and the source of the RF, since the exposure level drops off dramatically with distance. For example, they could switch to: a mobile phone in which the antenna is located outside the vehicle, a hand-held phone with a built-in antenna connected to a different antenna mounted on the outside of the car or built into a separate package, or a headset with a remote antenna to a mobile phone carried at the waist. Again the scientific data do not demonstrate that mobile phones are harmful. But if people are concerned about the radiofrequency energy from these products, taking the simple precautions outlined above can reduce any possible risk. In addition, people who are concerned might choose digital rather than analog telephones, since the former use lower RF levels.

Brain Neoplasms↗
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Diesel exhaust.

Explore the source record for details and available documents.

Animals↗
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Arsenic.

The toxicity and carcinogenicity of arsenic are well known, but vexing questions remain. The current controversy over the appropriate Federal limit for arsenic in drinking water highlights some of the difficult scientific, ethical, economic, and political issues that complicate standard-setting in occupational and environmental health. These include limitations in the scientific evidence concerning the risk at low doses, uncertainty about the appropriate mathematical models for estimating the risk at low-level exposures based on data from higher-level exposures, and controversies concerning the appropriate safety margin, level of evidence required for standard-setting, and costs of remediation.

Administration, Inhalation↗
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Radon.

Residential and occupational exposure to radon is the second leading cause of lung cancer after cigarette smoking. As many as eight million homes in the US have elevated radon levels according to Environmental Protection Agency estimates. High exposure levels in homes are largely a result of radon-contaminated gas rising from the soil. This makes it an unusual indoor air pollutant in that it has a natural source. This study examines the synergism between smoking and radon, what levels are considered safe, and what to do to safeguard against overexposure to radon.

Animals↗
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Special populations in occupational health.

This introductory chapter lays the groundwork for the in-depth examination of special populations that follows. Drs. Frumkin and Pransky discuss what makes a population special, health disparities over the generations, and the evolving recognition of special populations in occupational health.

Health Priorities↗
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Minority workers and communities.

Environmental and occupational hazards do not affect all communities equally. Members of ethnic and racial minorities, whether as working people or as community residents, sustain disproportionate risks from chemical, physical, and biological hazards. This paper reviews the nature of these disproportionate risks, focusing primarily on the workplace, but considering general environmental exposures as well. It discusses three principal mechanisms of increased risk: excessive hazardous exposures in both the workplace and the general environment, increased susceptibility, and inferior healthcare. It presents evidence that, as the result of these factors, members of minority groups display elevated rates of work-related illness, injury, fatality, and disability. Finally, it offers recommendations with regard to research, primary prevention, minority recruitment into the occupational health professions, and treatment and compensation for injured and ill minority workers.

Career Choice↗
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Across the water and down the ladder: occupational health in the global economy.

As the world economy becomes more integrated, and as industrial production expands in poor nations, workers in these nations face a range of occupational health and safety hazards. This article discusses the political economy of occupational health in developing nations by reference to multinational companies, free trade zones, free trade agreements, and the export of hazards. It reviews the special circumstances of occupational safety and health in developing nations and presents data on morbidity and mortality related to workplace exposures in these nations. Finally, it discusses approaches to improving workplace safety in developing nations, including policy initiatives, both mandated and voluntary, and public health initiatives, including training, technical assistance, collaborative research, and advocacy.

Developing Countries↗
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Decision-making in worker fitness and risk evaluation.

The information needed to determine fitness or risk and to make employment recommendations and decisions is reviewed. Four key questions are discussed: What are the risks and demands of a specific job? Is the worker capable of performing the job? Would the job place the worker at increased risk? What should the clinician do when there is a likelihood of increased risk or decreased capabilities?

Health Status Indicators↗