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Biomedical subjects

R A Etzel

Publications and source records attributed to R A Etzel.

At least 37 records · Page 2Linked to original sources
PubMed1996

Mercury exposure in high school chemistry teachers.

To assess whether high school chemistry teachers had higher urinary mercury concentrations than other high school teachers, 24 high school teachers from nine schools in northeastern Ohio were studied. First morning voided urine samples and air samples from the teachers' classrooms were analyzed for total mercury content by cold vapor atomic absorption. The median adjusted urinary mercury concentration in the 12 chemistry teachers was 4.6 microg/g creatinine (range 2.2-8.2 microg/g creatinine) and it was 6.3 microg/g creatinine in the 12 non-chemistry teachers. All classroom air samples contained mercury levels below detection limits. No evidence was provided that high school chemistry teachers are at increased risk of chronic mercury exposure from their teaching activities compared to other high school teachers.

Adult↗
PubMed1996

Toxigenic molds in water-damaged buildings: dechlorogriseofulvins from Memnoniella echinata.

An investigation of a cluster of cases of pulmonary hemosiderosis in infants in Cleveland, OH, led to the isolation of many isolates of Stachybotrys atra and two isolates of a related toxigenic fungus, Memnoniella echinata. M. echinata produces two cytotoxic trichothecene mycotoxins, trichodermol (1a) and trichodermin (1b), as well as several griseofulvins. Dechlorogriseofulvin (2a) and epidechlorogriseofulvin (2b) were the major compounds isolated. This is the first report of a fungus outside the Penicillium genus producing griseofulvins.

Griseofulvin↗
PubMed1996

Pulmonary fibrosis deaths in the United States, 1979-1991. An analysis of multiple-cause mortality data.

We sought to describe pulmonary fibrosis mortality in the United States from 1979 through 1991 by analyzing death certificate reports compiled by the National Center for Health Statistics. Of the 26,866,600 people who died during the study period, 107,292 had a diagnosis of pulmonary fibrosis listed on their death certificates. Among men, age-adjusted mortality rates increased from 48.6 per 1,000,000 in 1979 to 50.9 per 1,000,000 in 1991 and, among women, these rates increased from 21.4 per 1,000,000 in 1979 to 27.2 per 1,000,000 in 1991. Among both men and women rates were higher in older age strata than in younger age strata. Age-adjusted mortality rates were consistently higher among whites and people of races than blacks. The frequency with which pulmonary fibrosis was listed as the underlying cause of death increased from 40% in 1979 to 56% in 1991. Age-adjusted mortality rates varied by state, with lowest rates in the Midwest and Northeast, and the highest rates in the West and Southeast. We conclude that the age-adjusted rate of pulmonary fibrosis among decedents in the United States increased, and pulmonary fibrosis was listed as the underlying cause of death with increasing frequency, over the study period. We cannot determine whether the differences we detected between regions, sexes, and races are related to characteristics of the disease or problems in death certification and coding.

Adolescent↗
PubMed1996

Effects of air pollution on the respiratory health of asthmatic children living in Mexico City.

The relation between air pollution and the exacerbation of childhood asthma was studied in a panel of 71 children (aged 5 to 7 yr) with mild asthma who resided in the northern part of mexico City. During the follow-up, ambient measures of particulate matter less than 10 microns (PM10, 24-h average) and ozone (1-h maximum) frequently exceeded the Mexican standards for these contaminants. The peak expiratory flow rate (PEFR) was strongly associated with PM10 levels and marginally with ozone levels. Respiratory symptoms (coughing, phlegm production, wheezing, and difficulty breathing) were associated with both PM10 and ozone levels. An increase of 20 micrograms/m3 of PM10 was related to an 8% increase in lower respiratory illness (LRI) among children on the same day (95% confidence interval [CI] = 1.04-1.15), and an increase of 10 micrograms/m3 in the weekly mean of particulate matter less than 2.5 microns (PM2.5) was related to a 21% increase in LRI (95% CI = 1.08-1.35). A 50 parts per billion (ppb) increase in ozone was associated with a 9% increase in LRI (95% CI = 1.03-1.15) on the same day. We concluded that children with mild asthma are affected by the high ambient levels of particulate matter and ozone observed in the northern part of Mexico City.

Air Pollutants↗
PubMed1995

Effects of urban air pollutants on emergency visits for childhood asthma in Mexico City.

The metropolitan area of Mexico City, Mexico, has serious air pollution problems. Although air contaminants may contribute to clinical asthma, there are at present no data on the relation between air pollution exposure and childhood asthma in Mexico City. The authors reviewed data on emergency visits from January to June 1990 at one major pediatric hospital in Mexico City. They used a Poisson regression model to study the relation between the number of daily emergency visits for asthma and air pollutant levels. The levels of ozone and sulfur dioxide-exposure were significantly associated with the number of emergency visits for asthma. After adjustment for potential confounding factors, the multivariate regression model predicted that an increase of 50 ppb in the 1-hour maximum ozone level would lead to a 43% increase in the number of emergency visits for asthma on the following day. Exposure to high ozone levels (> 110 ppb) for 2 consecutive days increased the number of asthma-related emergency visits by 68 percent. The results of this study suggest that ozone exposure is positively associated with the number of children's emergency visits for asthma in Mexico City.

Adolescent↗
PubMed1995

Indoor air pollution and childhood asthma: effective environmental interventions.

Exposure to indoor air pollutants such as tobacco smoke and dust mites may exacerbate childhood asthma. Environmental interventions to reduce exposures to these pollutants can help prevent exacerbations of the disease. Among the most important interventions is the elimination of environmental tobacco smoke from the environments of children with asthma. However, the effectiveness of reducing asthmatic children's exposure to environmental tobacco smoke on the severity of their symptoms has not yet been systematically evaluated. Dust mite reduction is another helpful environmental intervention. This can be achieved by enclosing the child's mattresses, blankets, and pillows in zippered polyurethane-coated casings. Primary prevention of asthma is not as well understood. It is anticipated that efforts to reduce smoking during pregnancy could reduce the incidence of asthma in children. European studies have suggested that reducing exposure to food and house dust mite antigens during lactation and for the first 12 months of life diminishes the development of allergic disorders in infants with high total IgE in the cord blood and a family history of atopy. Many children with asthma and their families are not receiving adequate counseling about environmental interventions from health care providers or other sources.

Air Pollution, Indoor↗
PubMed1995

Indoor air pollution.

Explore the source record for details and available documents.

Air Pollutants, Radioactive↗
PubMed1995

Unintentional deaths from carbon monoxide poisoning in New Mexico, 1980 to 1988. A comparison of medical examiner and national mortality data.

Carbon monoxide was the number 1 cause of poisoning deaths in the United States from 1980 through 1988, with the highest rates reported in the western states. We studied unintentional deaths from carbon monoxide poisoning in New Mexico during this period using the multiple-cause mortality files from the National Center for Health Statistics (NCHS) and data from the New Mexico Office of the Medical Investigator (OMI). We compared the nationally available NCHS data with the more detailed OMI data to determine the sensitivity of NCHS data for the surveillance of this preventable cause of death. The NCHS data were 88% sensitive in identifying deaths from unintentional carbon monoxide poisoning and had a positive predictive value of 81% when compared with OMI data. Half of the unintentional carbon monoxide-related deaths were attributable to a home heating mechanism of some sort, 46% involved motor vehicle exhaust, and at least 42% were associated with alcohol use. We conclude that available NCHS data are a sensitive source of surveillance information about unintentional deaths from carbon monoxide poisoning. Additional details about specific deaths can be obtained from medical examiner files when needed.

Accidents↗
PubMed1994

Exacerbations of childhood asthma and ozone pollution in Atlanta.

Asthma prevalence and mortality due to asthma have been increasing during the last decade, and both the rates and the increases in rates have been higher for blacks than whites and higher for children than adults. Whether environmental factors such as air pollution contribute to these increases is unknown. The purpose of this study was to examine the relationship between emergency visits to a hospital for childhood asthma and exposure to ozone in an indigent, predominantly black population. Data were collected by abstracting clinical records for all children with asthma or reactive airway disease in one public hospital during the summer of 1990. From June 1, 1990, to August 31, 1990, 609 visits were made by children aged 1 to 16 years to an emergency clinic for treatment of asthma or reactive airway disease. Monitoring data indicated that maximum ozone levels equalled or exceeded 0.11 ppm on 6 days during the study period. The average number of visits for asthma or reactive airway disease was 37% higher on the days after those 6 days (from 6:00 PM to 6:00 PM the next day) than on other days (95% CI, RR = 1.02-1.73). The results of the study suggest that among black children from low-income families, asthma may be exacerbated following periods of high ozone pollution.

Adolescent↗
PubMed1994

An evaluation of the relationship between self-report and biochemical measures of environmental tobacco smoke exposure.

To evaluate the relationship between self-reported exposure to environmental tobacco smoke and saliva cotinine concentrations, we studied 186 nonsmokers. Each participant completed an exposure questionnaire, kept a daily exposure diary for 7 days, and provided a saliva sample for cotinine analysis. Salivary cotinine concentrations were measured using gas chromatography/mass spectrometry. Of the volunteers, 30% lived with one or more smokers, and 84% were regularly exposed to smokers at work. Eighty-three percent of the volunteers had detectable saliva cotinine concentrations (> or = 0.5 ng/ml) (median = 1.1; range = 0.5-7.4 ng/ml). Cotinine concentrations were related to exposure in the household and at the workplace. Volunteers who lived with smokers had significantly higher cotinine levels (median = 1.0; range = < 0.5-7.4 ng/ml) than those who did not (median = < 0.5; range = < 0.5-4.7 ng/ml). Volunteers who reported regular exposure at work had higher cotinine levels (median = 0.8; range = < 0.5-7.4 ng/ml) than those who did not (median = < 0.5; range = < 0.5-3.0 ng/ml). Cotinine concentrations were predicted by a regression equation that included the number of smokers at home and work and the number of minutes of exposure recorded in the daily diary (r2 = 0.29).

Adolescent↗
PubMed1994

Volatile organic compounds in the blood of persons in Kuwait during the oil fires.

Between March and November of 1991, approximately 9000 workers from 43 different countries battled the burning oil wells in Kuwait. To document the exposure of persons in Kuwait during the oil well fires to volatile organic compounds (VOCs), we obtained samples of blood from 14 U.S. personnel in Kuwait City in May of 1991 (group I) and 40 American firefighters working in the oil fields in October of 1991 (group II). Concentrations of VOCs in group I and group II were compared with those of a random sample of 114 persons in the United States (reference group). The median concentrations of VOCs in group I were equal to or lower than those in the reference group. We found significant differences between the median concentrations of several VOCs in group II and the reference group. Median levels of ethylbenzene were about 10 times higher among group II than among the reference group (0.53 microgram/l vs 0.052 microgram/l). Median levels of benzene, m-/p-xylene, o-xylene, styrene, and toluene among group II were more than double those of the reference group. Although firefighters had higher median concentrations of VOCs than the reference group, those American personnel in Kuwait not involved in fighting the oil fires had concentrations of VOCs comparable to those in the reference group. Blood VOC measurements indicate a significant increase in exposure to VOCs in firefighters, but do not demonstrate this in personnel in Kuwait City.

Adult↗
PubMed1993

Do the medical history and physical examination predict low lung function?

BACKGROUND: We sought to determine whether an abnormal respiratory history or chest physical examination could be used to identify men with low lung function. METHODS: We analyzed pulmonary function, physical examination, and questionnaire data from 4461 middle-aged male Vietnam-era army veterans. MAIN RESULTS: The study sample consisted of 1161 never smokers, 1292 former smokers, and 2008 current smokers. Clinical indicators of respiratory disease (respiratory symptoms, respiratory signs, or a history of respiratory disease), were present in 26.1% of the never smokers, 31.7% of the former smokers, and 47.2% of the current smokers. We defined low forced expiratory volume in 1 second as a value less than 81.2% of the predicted value. Seven percent of the never smokers, 8% of the former smokers, and 17.3% of the current smokers demonstrated low forced expiratory volume in 1 second. Among those with a clinical indicator for spirometry only 11% of the never smokers, 13% of the former smokers, and 21% of the current smokers actually had a low forced expiratory volume in 1 second. Among those without a clinical indicator 6% of the never smokers, 6% of the former smokers, and 14% of the current smokers actually had a low forced expiratory volume in 1 second. CONCLUSIONS: The use of clinical indicators as a basis for obtaining pulmonary function tests in middle-aged men misses many with low lung function, especially current smokers.

Adult↗
PubMed1993

Black spots on the scalps of schoolchildren. A recurrent condition in the windy west.

During the past 10 years, epidemics of black spots on the scalps of schoolchildren have caused considerable concern in at least 4 communities in the Rocky Mountain states. We describe the clinical presentation of "black spots" in a group of Wyoming elementary school students and the epidemiologic investigation that revealed the cause. Our study included a questionnaire survey of students' parents, examination of students at the affected school and at two other schools, observation of playground activity patterns, and laboratory analysis of specimens taken from affected children and from the school environment. The black material in the scalp spots was chemically identical to flakes of black material found on the playground and tar from the school roof. We concluded that the spots were caused by flakes of windblown tar from the school roof. Previous outbreaks of black spots may have had a similar cause.

Air Pollutants↗
PubMed1992

Respiratory disease surveillance in Hungary.

In October 1989, the Hungarian National Institute of Hygiene initiated the Children's Acute Respiratory Morbidity (CHARM) Surveillance System to assess the association between nine reportable respiratory diseases and air pollution. The weekly number of physician-diagnosed, reportable respiratory diseases among four age groups of children (less than 1, 1-2, 3-5, and 6-14 years) was tabulated for Sopron, a city with 60,000 residents. We calculated the proportion of diseases occurring during weeks with low, moderate, and high sulfur dioxide (SO2) and nitrogen dioxide (NO2) concentrations. The weekly averages of the 24-hour median SO2 concentrations were divided into thirds at less than or equal to 17.6, greater than 17.6 to less than or equal to 26.3, and greater than 26.3 micrograms/m3 (range: 0.9-79.6 micrograms/m3), and the NO2 concentrations at less than or equal to 29.8, greater than 29.8 to less than or equal to 44.1, and greater than 44.1 micrograms/m3 (range: 4.2-90.1 micrograms/m3). During 1990, 11,474 respiratory disease cases occurred among the 4,020 children less than 15 years of age living in Sopron and monitored by the CHARM system. The two most frequently reported disease categories were rhinitis/tonsillitis/pharyngitis (71.5%) and acute bronchitis (8.5%). Sixty-seven percent of pneumonia cases occurred when SO2 concentrations were highest. We found no association between levels of NO2 and respiratory diseases. The CHARM Surveillance System may characterize more fully which groups of children develop particular respiratory diseases following exposure to air pollution.

Acute Disease↗
PubMed1992

An outbreak of a food-related illness resembling boric acid poisoning.

An outbreak of an illness suggestive of boric acid poisoning occurred among 51 persons who had eaten lunch at the cafeteria of the United States Agency for International Development in Islamabad, Pakistan, on February 11, 1990. Affected patients had headache and severe myalgias 2 to 4 hours after eating lunch. Fever, nausea and vomiting, red eyes, and photophobia were also reported. Among 25 patients (49%), a sunburn-like inflammation of the skin of the face developed, which subsequently desquamated. One patient required hospitalization for 1 day because of dehydration. Among all patients, the only symptoms remaining 72 hours after the meal were mild headache, fatigue, and peeling skin. Those persons who became ill were more likely to have eaten one particular food item (minestrone soup) for lunch than were those who did not become ill. A similar illness has been described following ingestion of boric acid. However, the results of an analysis of serum samples collected 3 days after the lunch from 24 patients did not show boron above normal background levels. Because of boron's short half-life, however, these data do not rule out the possibility that patients may have had higher boron levels at the onset of the illness.

Boric Acids↗
PubMed1992

Exposure to environmental tobacco smoke in naturalistic settings.

BACKGROUND: Exposure to environmental tobacco smoke (ETS) has been identified as a risk factor for chronic disease among nonsmokers. Results of epidemiological surveys suggest that the majority of nonsmokers have regular ETS exposure. However, little is known about the topography of exposure. METHODS: An exposure diary was used by 186 nonsmokers to self-monitor ETS exposure over a 7-day period. Subjects also completed a questionnaire that assessed their patterns of ETS exposure. RESULTS: The primary source of ETS exposure was the workplace, except when there was a smoker in the household, in which case the household was the primary source. The presence of a smoker in the household resulted in higher levels of exposure both at work and in other locations when compared with subjects without household exposure. Subjects' assessments of exposure on the questionnaire were consistently lower than their self-monitored levels. This finding suggests that general exposure ratings underestimate exposure. CONCLUSIONS: This study provides a new understanding of the patterns of ETS exposure and may help guide the development of policies and interventions designed to reduce ETS exposure.

Adult↗
PubMed1992

Restrictive workplace smoking policies: impact on nonsmokers' tobacco exposure.

The health consequences of exposure to environmental tobacco smoke (ETS) are well documented. Although nonsmokers are generally aware of the health risks of ETS exposure, the majority of nonsmokers are regularly exposed. The most common source of exposure is the workplace. Restrictive workplace smoking policies are being used as a primary means of reducing ETS exposure. However, few studies have focused on the relation between workplace policy and ETS exposure. We performed two studies which examined the relationship between smoking policy, self-reported ETS exposure, and salivary cotinine concentrations. Study I, a pilot study, focused on a workplace-based sample of 106 volunteers; Study 2 examined exposure among 881 nonsmokers in workplace settings. In both studies, more restrictive workplace smoking policies were associated with a lower proportion of nonsmoking volunteers with detectable salivary cotinine. In Study 2, the larger study, the only other variable found to be significantly related to cotinine detection was the presence of smokers in the home. These results suggest that restrictive workplace smoking policies may reduce employees' overall ETS exposure.

Adult↗