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Biomedical subjects

R Bowler

Publications and source records attributed to R Bowler.

7 recordsLinked to original sources

Contrast-sensitivity loss in a group of former microelectronics workers with normal visual acuity.

The measurement of contrast sensitivity at varying grating frequencies is used increasingly to study visual and neural disorders. It provides more information than conventional acuity measures. Refractive errors initially affect high spatial frequencies, whereas lower spatial frequencies are affected only when these errors are pronounced. Neurophysiological alterations are reflected by depressed sensitivity to coarse gratings. Visual dysfunction has been associated with workplace exposures to a wide range of organic solvents. In microelectronics assembly where large quantities of organic solvents are used in many aspects of the work processes, visual deficits have been observed. The objective of the present study was to compare contrast sensitivity among former microelectronics assembly workers, with normal far and near visual acuity, and a reference group from the same region, with similar acuity. No significant differences were observed between scores at the two ends of the contrast sensitivity curves; however, at the intermediate spatial frequencies, the former microelectronics workers' scores were significantly lower (Student's t-test; p less than 0.05). For the microelectronics workers, no relation was observed between age and contrast sensitivity at any spatial frequency, whereas for the reference group, contrast sensitivity scores were progressively lower with age at spatial frequencies greater than or equal to 6.0 cpd (r2 = 0.15 at 6 cpd to r2 = 0.45 at 18.0 cpd), suggesting that for the former there is some form of interference with the expected contrast sensitivity loss with age. Lower contrast sensitivity scores in intermediate spatial frequencies, observed among the former microelectronics workers, possibly reflect neural alterations, which may have resulted from exposure to neurotoxic substances. These findings suggest the need for further studies on visual functions in microelectronics workers.

Adult

Evidence for adverse reproductive outcomes among women microelectronic assembly workers.

Microelectronics assembly entails complex processes where several potentially fetotoxic chemical compounds are used extensively. This study was undertaken to assess the potential adverse reproductive outcomes among former women workers in a microelectronics assembly plant in New Mexico with respect to a comparable population from the same geographical region and to examine the relation between these outcomes and employment history in this plant. After matching a pool of 143 former microelectronic female workers and 105 referents, 90 former microelectronic female worker-referent pairs were constituted (representing 302 and 324 pregnancies in former workers and referents respectively). The odds ratio (for pair matching design) of spontaneous abortion among women workers, before beginning to assemble microelectronic components, was 0.9 (chi 2 = 0.04; NS). After the beginning of employment this odds ratio became 5.6 (chi 2 = 9.8; p less than 1%). This estimated odds ratio decreased to 4.0, taking into account the increased risk for spontaneous abortion in previous pregnancies before employment (chi 2 = 5.4; p less than 5%). It was not possible to determine if this effect was reversible owing to the small number of pairs available after employment. The findings of this study corroborate the results of former studies that suggest a potential association between electronic manufacturing activity and risk of spontaneous abortion. Although the organic solvents were suspected of being the potential risk factor, this study was inconclusive from this point of view. Nevertheless, these investigations may provide some insight into reproductive outcomes among female workers exposed to solvents.

Abortion, Incomplete

Prolongation of the P-300 latency associated with hydrogen sulfide exposure.

Three patients exposed to hydrogen sulfide developed persistent cognitive impairment, as suggested by the P-300 event-related potential and measured by neuropsychological testing. Routine neurological and physical examinations were unremarkable, although the patients were sufficiently impaired so as to be unable to work. The P-300 event-related potential and neuropsychological testing proved to be important in the detection of cognitive dysfunction following acute hydrogen sulfide exposure. The three patients with neurocognitive dysfunction were acutely exposed to hydrogen sulfide. The incidents occurred independently and under different circumstances. Each patient was evaluated at the Northern California Occupational Health Clinic, San Francisco, examined neurologically and neuropsychologically, and evaluated with a P-300 event-related potential. Each patient had persistent neurological symptoms, neuropsychological deficit, and abnormally prolonged P-300 latencies.

Accidents, Occupational

Cross-sectional neurotoxicology study of lead-exposed cohort.

Although the toxic effects of lead have been known for centuries, lead intoxication is still widespread in the United States. Without baseline tests of neuropsychological, neurobehavioral and neurophysiological testing it may be difficult to detect subtle changes in neurological function after lead exposure. This may be further confounded by partial chelation treatment and exposure to neurotoxic mixtures or inability to quantitate alcohol consumption. We undertook a cross-sectional study to address these problems in 24 exposed and 29 control subjects in a plant that manufactured electrical components using fritted leaded glass to coat capacitors and transistors. Potentially exposed workers had blood lead levels ranging between 3 micrograms/dL to 135 micrograms/dL. Industrial hygiene monitoring revealed the plant's air lead levels ranged from 61 micrograms/m3 to 1,700 micrograms/m3 in excess of OSHA permissible exposure limits of 40 micrograms/m3/10 hr day. Using a specially designed battery of neurophysiological, neurobehavioral and neuropsychological screening tests, we demonstrated a significant difference from controls in measures of psychomotor speed, motor strength and verbal memory. Although limited by the cross-sectional design, these findings support the hypothesis that the battery of neurophysiological, neuropsychological and neurobehavioral tests can detect a significant inter-group differences between lead-exposed and control subjects.

Adult

Colour vision loss among disabled workers with neuropsychological impairment.

Test performance on a neurobehavioural battery was examined with respect to acquired colour vision loss among patients with a history of neurotoxin exposure. The study group included 14 men and 7 women with clinically diagnosed neuropsychological impairment (mean age: 41.3 +/- 8.1 years; mean educational level: 13.4 +/- 1.4 years). Verbal and visual ability, memory and psychomotor function were assessed with the California Neuropsychological Screening Battery. Colour vision was assessed with the Lanthony D-15 desaturated colour arrangement panel. Acquired dyschromatopsia was present in 17 patients (80.9%), 11 of whom manifested patterns of Type II colour vision loss. Simple regression analysis of neuropsychological test performance with respect to colour vision loss, using age-adjusted Z-scores, revealed significant relationships (p less than or equal to 0.05) solely for tests which rely heavily on the visual system. Significant differences in visual task test scores were also observed with the type of dyschromatopsia (Kruskal-Wallis, p less than or equal to 0.05). These findings suggest that poor performance on visual tasks and colour vision loss may both result from damage to neuro-ophthalmic pathways or that loss of integrity of the peripheral visual pathways may affect visual task performance. The authors propose that visual testing should be incorporated into neurobehavioural test batteries.

Adult

Visual dysfunction among former microelectronics assembly workers.

Although known neurotoxins with potential ophthalmotoxic properties are commonly used in microelectronics assembly, there has been no systematic study of visual disturbances among past or present workers in this industry. The objective of the present study was to compare visual functions, using a matched-pair design, between former workers from a microelectronics plant and a local reference population. From an initial population of 180 former workers and 157 potential referents, 54 pairs were matched for age (+/- 3 y), education (+/- 2 y), sex, ethnic origin, and number of children. Near and far visual acuity, chromatic discrimination, and near contrast sensitivity were assessed monocularly. Paired comparisons (Signed-rank Wilcoxon test) revealed that the former microelectronics workers had significantly lower contrast sensitivity, particularly in the intermediate frequencies, independently of near visual acuity loss. There were no differences for far visual acuity in both eyes. Even though near visual acuity and color vision were compromised among the former workers, the differences were only significant for one eye, as was the prevalence of acquired dyschromatopsia (chi-square for matched pairs, p less than .001). These findings suggest a pattern of contrast sensitivity deficits consistent with impairment to foveal and/or neuro-optic pathways among these former microelectronics workers. Exposure to ophthalmotoxic chemicals is proposed as the most probable risk factor.

Adult

Medical surveillance for neurologic endpoints.

Except for screening for noise-induced hearing loss, medical surveillance for neurologic disease in the workplace has not been done on a routine basis in the past. In the future, however, as occupational medicine focuses increasingly on the detection of preclinical effects of exposure and strategies to prevent such exposures, medical surveillance for neurologic disease will become a necessity.

Environmental Monitoring