Electromagnetic field exposure and leukemia mortality in the United States.
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Cross-Sectional Studies↗
Biomedical subjects
L J Fine
Publications and source records attributed to L J Fine.
National estimates of occupational exposure to animal bladder tumorigens.
A prevention program for occupational bladder cancer should be based on an estimate of the number of workers previously and currently exposed to bladder carcinogens. The National Occupational Exposure Survey (NOES), which identified potential occupational exposures in approximately 5000 private sector firms in 1981 to 1983, is the best available source for recent hazard estimates; the National Occupational Hazard Survey (NOHS), conducted in 1972 and 1974, for past exposure estimates. The National Institute for Occupational Safety and Health Registry of Toxic Effects of Chemical Substances (RTECS) identified nearly 200 substances associated with animal bladder tumors. From NOES and NOHS, the numbers of workers with full time (greater than or equal to 4 hours/day) or any potential occupational exposure were estimated for the United States. About 60,000 workers were potentially exposed in the early 1970s and about 700,000 in the early 1980s on a full-time basis to the compounds on the RTECS list also appearing in NOES, and about 1.8 million workers in the 1970s and almost 3.5 million in the 1980s had some occupational exposure. Because matches were not found for many compounds and because NOES covers only part of the US work force, these are probably underestimates. The estimates for the number of exposed workers do not imply that these workers all have increased risk of developing bladder cancer, because some animal tumorigens may not be human carcinogens and our estimates are based on potential rather than measured exposures. The risk would depend on the potency, duration, and intensity of the actual exposures. Nevertheless these estimates are useful in estimating the approximate magnitude of the potential occupational exposure to animal bladder tumorigens.
Animals↗
Occupational health in the 1990s.
Where have we come since the Occupational Safety and Health Act was passed in 1970? Have we made progress in this country toward "safe and healthful working conditions for working men and women?" Many hazardous exposures that were prevalent before the creation of NIOSH, OSHA, and MSHA have been reduced. Exposure to asbestos, coal dust, silica, lead, and cotton dust are common examples. Through OSHA's Hazard Communication Standard and state Right to Know laws as well as an increase in the dissemination of information, the average employer and worker today is better informed of specific hazards on the job, and more attentive to safety measures. However, the high toll of work related disease and injuries continues today.
Accidents, Occupational↗
Occupational mercury exposure and male reproductive health.
This retrospective cohort study was designed to investigate the relationship of male occupational exposure to elemental mercury and several reproductive outcomes. All subjects worked at least 4 months between 1953 and 1966 at a plant that used elemental mercury; 247 white male employees who had the highest exposures were compared to 255 matched nonexposed employees. Individual exposure to mercury was estimated from urinary mercury measurement records. Information on reproductive history and potential confounding variables was obtained through personal interview with each of the employees and with a subset of their wives. No associations were demonstrated between mercury exposure and decreased fertility or increased rates of major malformations or serious childhood illnesses. After controlling for previous miscarriage history, mercury exposure was not a significant risk factor for miscarriage. Because of this study's potential problems with long-term recall, further studies of the effect of mercury on pregnancy outcome are warranted in other populations.
Abortion, Spontaneous↗
Surveillance in occupational illness and injury: concepts and content.
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Death Certificates↗
Neurological abnormalities associated with remote occupational elemental mercury exposure.
We examined 502 subjects, 247 of whom had occupational elemental mercury exposures 20 to 35 years previously, to identify potential exposure-related neurological abnormalities. Few significant (p less than 0.05) differences existed between exposed and unexposed subjects. However, multiple linear regression analysis demonstrated several significant correlations between declining neurological function and increasing exposure as determined by urine mercury measurements from the exposure interval. Subjects with urine mercury peak levels above 0.6 mg/L demonstrated significantly decreased strength, decreased coordination, increased tremor, decreased sensation, and increased prevalence of Babinski and snout reflexes when compared with the remaining subjects. Furthermore, subjects with clinical polyneuropathy had significantly higher peak levels than normal subjects (0.85 vs 0.61 mg/L; p = 0.04), but not increased exposure duration (20.1 vs 20.8 quarters; p = 0.34), and 28% of subjects with peak levels above 0.85 mg/L had clinical evidence of polyneuropathy, compared with 10% of remaining subjects (p = 0.005). Although exposure was not age dependent, several neurological measures showed significant age-mercury interaction, suggesting that natural neuronal attrition may unmask prior exposure-related subclinical abnormalities.
Aging↗
Respiratory symptoms associated with the use of azodicarbonamide foaming agent in a plastics injection molding facility.
Respiratory health variables were studied cross-sectionally in 227 employees of a plastics molding facility where numerous complaints had been apparently associated with the use of azodicarbonamide foaming agent in injection molding. Pre- and postshift respiratory status measures and azodicarbonamide concentrations were also obtained for 17 employees. Cross-sectional pulmonary function differences by injection molding status were not observed. Modest decrements in pulmonary function measures were observed between start and end of shift but with no dose-effect relationship. A strong association was observed for injection molding workers for eye/nose/throat irritation, cough, and wheezing. Additionally, wheezing, chest tightness, and symptoms of chronic bronchitis were strongly associated with work in injection molding during periods in which azodicarbonamide was in use. These results suggest respiratory symptom causation by some combination of azodicarbonamide itself, reaction products of azodicarbonamide formed during injection molding, or other unidentified agents uniquely associated with the process of injection molding with azodicarbonamide foaming agent.
Adult↗
Occupational factors and carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) is the most commonly reported nerve entrapment syndrome. The prevalence of CTS among 652 active workers in jobs with specific hand force and repetitiveness characteristics was estimated. The prevalence of CTS ranged from 0.6% among workers in low force-low repetitive jobs to 5.6% among workers in high force-high repetitive jobs. When controlling for potential confounders, the odds ratio for the high force-high repetitive jobs was more than 15 (p less than .001) compared to the low force-low repetitive jobs. High repetitiveness appears to be a greater risk factor than high force (odds ratio of 5.5 p less than .05 versus 2.9 and not statistically significant).
Adult↗
Ergonomics considerations in hand and wrist tendinitis.
The objectives of this article are to present (1) a historical perspective on hand and wrist tendinitis in workers, (2) new data that demonstrate a relationship between the repetitiveness and forcefulness of manual work and the prevalence of tendinitis, (3) possible biomechanical factors in tendinitis, and (4) possible job modifications for the prevention of tendinitis. Numerous studies during the last 100 years show that tendinitis is a major cause of worker suffering and workers' compensation in intensive hand work. Epidemiologic data show that the risk of hand and wrist tendinitis in persons who perform highly repetitive and forceful jobs is 29 times greater than in persons who perform jobs that are low in repetitiveness and force. A possible factor in this relationship is viscous deformation of the tendons and adjacent tissues. Although these data suggest that the risk of tendinitis among workers can be reduced by reduction of the repetitiveness and the forcefulness of the work, this hypothesis has not yet been fully tested.
Ergonomics↗
A neurological evaluation of workers exposed to mixtures of organic solvents.
Workers with long term exposure to mixtures of organic solvents below regulatory limits have been reported to experience mild, but clinically detectable, sensory or sensorimotor polyneuropathies. In conjuction with a cross sectional study of behavioural performance a clinical neurological evaluation was conducted among printers and spray painters to examine dose response relations. All 240 subjects completed an occupational history and symptom questionnaire and underwent a clinical neurological examination. On average, subjects had been employed on their current job for six years. Classification of solvent exposure for each subject was based on exposed versus non-exposed job titles and observations during an industrial hygiene walk-through or on the measured concentration of solvents in full shift personal air samples. The average full shift solvent concentration was 302 ppm for printing plant workers and 6-13 ppm for workers at other plants. Isopropanol and hexane were the major constituents. Neurological abnormalities consistent with mild polyneuropathy were found in 16% of subjects; none was clinically significant. Exposed/non-exposed comparisons showed slightly higher frequency of symptoms in the exposed subjects which was not related to solvent level. Subjects categorised as exposed during the walk- through survey also had poorer vibratory sensation measured at the foot and diminished ankle reflexes. In multiple linear regression models, however, controlling for age, sex, alcohol intake, and examiner, no significant (p less than 0.05) relation was found between solvent concentration and poor neurological function except for two point discrimination measured at the foot. This investigation has not provided evidence for dose related adverse neurological effects from exposure to moderately low levels of solvent mixtures for a relatively short duration, although this may be due to the shortness of exposure duration, the type of solvent exposure, or to selection factors.
Adult↗
Ergonomics and the effects of vibration in hand-intensive work.
Along with ergonomic factors, such as forceful and repeated exertion and certain postures, vibration has been cited as a factor of chronic nerve and tendon disorders such as carpal tunnel syndrome and tendinitis. The arguments for the contribution of vibration come from epidemiologic studies, clinical case analyses, and studies of short-term effects. It is well established that vibration stimulates muscle contraction, which is called the tonic vibration reflex. It is also known that vibration reduces tactility and that tactility affects the amount of force exerted to hold or manipulate a given object. For localized vibration exposure of the hand and arm to occur, the hand must grip a vibrating object. Vibration may increase the risk of chronic tendon and nerve disorders by increasing the force exerted in repetitive manual tasks. This close relationship between force and vibration, and difficulties in measuring force and vibration in manual work, makes it very difficult to determine their relative contributions in epidemiologic and clinical studies.
Carpal Tunnel Syndrome↗
Respiratory effects of work in retail food stores. III. Pulmonary function findings.
Findings are reported from a prospective morbidity study which examined the effects on pulmonary function associated with the particulate and gaseous air contaminants to which retail food store workers are exposed. A total of 685 supermarket employees (including meat wrappers, meat cutters and store clerks) performed standard ventilatory function tests [forced expiratory volume in 1 s (FEV1.0) and forced vital capacity (FVC)] during a base-line survey. Those available four years later (305) were resurveyed in a similar manner. A suggestive chronic effect on pulmonary function was shown in those with high cumulative exposures and allergic history. Among those workers who had continuous exposure to air contaminants in settings with "hot-wire" plastic wrap film cutters the annual rates of change in FEV1.0 and FVC were twice as great as the changes found among comparable workers who were not exposed to fumes from wrapping film. Those who switched from the "hot-wire" to the "cool-rod" cutters during the course of the follow-up had intermediate rates of change in lung function.
Adult↗
Respiratory effects of work in retail food stores. II. Respiratory symptoms.
This study examined the relationships between the prevalence of respiratory tract symptoms and estimates of environmental exposures in retail food stores, in particular exposures to emissions from the cutting of polyvinyl chloride wrap. When respiratory symptoms were compared with a measure of cumulative exposure, there was evidence that the prevalence of symptoms of episodic airway narrowing was higher for workers who had been exposed directly or indirectly to meat wrapping operations independent of a significant association of these symptoms with allergic or asthmatic history. Whether this finding reflects a nonspecific irritant effect or allergic sensitization cannot be determined from these data. No single substance present in the work environment studied has, as yet, been identified as associated with these effects.
Adult↗
Respiratory effects of work in retail food stores. I. Methodology and exposure assignments.
This study was designed to examine whether retail food store employees have an unusual prevalence or incidence of respiratory symptoms or pulmonary function abnormalities attributable to their work environment. The methodology and development of exposure assignments are presented. Employees from 75 supermarkets (a total of 685 meat cutters, wrappers and store clerks) were tested in a base-line survey, and those still available (305) were resurveyed four years later. Each subject completed a standard questionnaire on job history, health history, cigarette smoking, and respiratory symptoms and also performed five forced expiratory efforts on a standardized spirometer. The major air contaminants were identified including the composition and levels of exposures associated with the different ways of cutting plastic film wrap. A cumulative exposure estimate for each subject was made. Parts II and III of this study present the association of these work environment factors with respiratory symptoms and ventilatory function.
Adult↗
Abnormalities of pulmonary function and pleural disease among titanium metal production workers.
The authors conducted a cross-sectional survey of respiratory disease among 209 titanium metal production workers. Work in areas where there was exposure to titanium tetrachloride and titanium dioxide particulates was associated with reductions in ventilatory capacity. Pleural disease (plaques and diffuse thickening) was present in the chest radiographs of 17% of the subjects and was associated with the duration of work in titanium manufacturing. It was also associated with past asbestos exposure. After control for asbestos exposure, it remained associated with titanium manufacturing. The findings are consistent with the hypothesis that titanium tetrachloride and titanium dioxide particulates may be associated with a reduction in ventilatory capacity and that the overall process of titanium manufacturing may be associated with unexpected pleural disease.
Adult↗
Drug screening: ethical guidelines.
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Drug Evaluation, Preclinical↗
Occupation and industry data obtained from death certificates: the effect and influence of case selection.
This study first examined the accuracy of death certificate diagnoses of 4,954 cases of cancer of the lung, liver, nasopharynx, and pleura/peritoneum, then compared usual occupation and industry based on case selection from the Metropolitan Detroit Cancer Surveillance System (MDCSS), a population-based cancer registry, with cases selected from death certificates for the above types of tumors to examine the effect of misclassification. Accuracy of death certificate cancer diagnoses ranged from 93.4% for lung cancer to 28.6% for malignancies of the pleura/peritoneum. The mix of usual occupation/industry titles obtained from death certificate cases and MDCSS cases was similar for lung cancer but not for malignancies of the pleura/peritoneum (35.7% of cases from the registry v 11.1% from death certificates for the automobile industry, P = .05). The effect of misclassification and utility of usual occupation/industry statements on death certificates is discussed.
Death Certificates↗
Detection of cumulative trauma disorders of upper extremities in the workplace.
Surveillance for musculoskeletal disorders of the upper extremity in industry is in its infancy. Research efforts to elucidate the causal factors of these disorders often rely on either the analysis of existing medical records, worker compensation records (passive surveillance), or the surveying of workers with questionnaire and physical examination (active surveillance). The use of either type of data for routine surveillance presents several difficulties illustrated with the results presented in this paper. The analysis of existing records is generally less costly but the reliability of the data is difficult to assess. Standardized questionnaire and physical examinations can be as sensitive as the use of unusually thorough existing occupational medical records; however, it is unclear whether the additional cost of an active surveillance system will deter the routine use of such systems.
Arm↗