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Biomedical subjects

S Hernberg

Publications and source records attributed to S Hernberg.

At least 73 records · Page 4Linked to original sources
PubMed1979

Mortality among Finnish doctors, 1953-1972.

The mortality with respect to the total population of Finnish physicians during the period 1953 to 1972 has been analysed and compared with the corresponding statistics for the general Finnish population, for Finnish foundry workers, and for American physicians. It was found that the overall mortality was lower for male physicians than that for the general population or for foundry workers, but was clearly higher than that for American physicians. Male physicians did not exhibit any major differences from the general population with regard to cardiovascular diseases and suicide, but had a lower mortality from malignant neoplasms, accidents and "other diseases" (including infectious diseases). The explanation of cancer mortality being lower than expected among male physicians was mainly to be found in a deficit in lung cancer. Although female physicians had higher life expectancy than male physicians and the female general Finnish population, they did not show any clear deficit for cancer. In respect of all specialists, surgical specialists had the lowest mortality; general practitioners had the highest mortality. Most of these variations were attributable to differences in coronary mortality, but mortality from lung cancer was also remarkably low among surgeons. Differences of a similar type were also found between occupational sub-categories; private practitioners had the highest, and research workers and central hospital physicians the lowest mortality figures. The lower cancer mortality among male physicians, as contrasted with the general population, is probably attributable to differences in smoking habits; about 22% of male physicians smoked in 1973, whereas earlier studies by others have indicated that the corresponding proportion was about 50% in the general population. In contrast, the differences in mortality between different specialist categories probably arises from other factors, since Finnish physicians reportedly display a relatively homogeneous smoking pattern.

Adult↗
PubMed1979

The battle against occupational lead poisoning in Finland. Experiences during the 15-year period 1964--1978.

Occupational lead poisoning has been greatly reduced as a problem in Finland during the 1970s. Case-finding efforts and increased awareness of plant physicians first caused an increase of the incidence with a peak of 89 reported cases in 1974. A sharp decline followed, and, although about 30 mild cases are still reported annually, classical clinical poisoning hardly exists anymore. An extensive regular monitoring program covering 8,000--10,000 blood lead (PbB) analyses a year also shows that exposure levels have been reduced. In 1977 only 70 PbB values, or 1%, were in excess of 70 micrograms/100 ml, and 243 values (4%) exceeded 60 micrograms/100 ml. All such values came from workers employed by less than 30 workplaces, and several of them belonged to workers monitored more than once a year. It is proposed that the general development of occupational health in Finland is to a great extent reflected in this favorable development; however, since special research, educational and informative efforts have been devoted to the lead problem, it may well be that these measures have also influenced the outcome. The results show that, on a nationwide scale, the lead problem can be coped with much more effectively than one has been apt to think. Hence the nonfeasibility of lowering maximum permissible exposure levels has been put in serious doubt. There is no reason to allow unnecessarily high exposure in the vast majority of workplaces only because a small minority has technical difficulties.

Environmental Exposure↗
PubMed1979

Congenital defects and occupational factors. A comparison of different methodological approaches.

In a previous study of children with congenital CNS (central nervous system) defects (N = 120), it was shown that exposure had occurred more often among the study mothers than among their referents. In the present study this population, extended with a one-year material of parents of children with oral clefts (N = 102) and their referents, was analyzed in a conventional way concerning occupational factors. This procedure was carried out in order to determine whether information on occupational factors only would provide enough hints to confirm known information concerning exposure, which had been acquired with the more-detailed but laborious interview method. No significant differences were observed in a comparison between the study groups and their referents when work of the mothers outside the home during pregnancy was considered. According to the social class grouping, classes 3 and 4 appeared more often among parents of children with congenital CNS defects than among their referents. With respect to industrial classification, manufacturing and different community services occurred more often among mothers of children with congenital CNS defects and oral clefts than among their referents. Some clustering could be observed with regard to the occupations of the parents in the two study groups as compared to their referents. When the material was methodologically processed in the conventional way described, no obvious conclusions could be drawn about exposure.

Abnormalities, Drug-Induced↗
PubMed1979

Ten-year coronary mortality of workers exposed to carbon disulfide.

Two cohorts, one comprising 343 viscose rayon workers exposed for at least five years to carbon disulfide (CS2) and the other made up of 343 nonexposed men, were followed from 1967 to 1977 with respect to coronary heart disease (CHD) mortality. In the examination in 1967 known risk factors of CHD were controlled; only blood pressure was slightly higher in the exposed group. The difference was considered a result of exposure. Five exposed and eight nonexposed men had experienced a previous clinical myocardial infarction. The total mortality was 48 (14%) in the exposed group and 31 (9%) in the compeer group (p congruent to 0.05); 29 exposed and 11 nonexposed men had died from CHD (p less than 0.01), and 5 exposed and 1 nonexposed from other cardiovascular causes (p = 0.1). All coronary deaths occurred in the age interval 40 to 69 years. The estimated risk of death from CHD for this 30-year age span, assuming no competing risks of death, was 31.9% for the exposed cohort against 13.3% for the compeers. A multivariate analysis yielded age, raised blood pressure, and exposure to CS2 as prominent risk factors. The contributory risk caused by past occupational CS2 exposure seemed to increase the already notoriously high risk of CHD mortality among Finnish men.

Adult↗
PubMed1978

Exposure-response relationship between styrene exposure and central nervous functions.

For the study of the relationship between styrene exposure and symptoms and signs of central nervous dysfunctions, 98 male workers occupationally exposed to styrene were given clinical, neurophysiological and psychological examinations; also a symptom survey was made. Urinary mandelic acid concentrations, measured once a week during five consecutive weeks, were used to express the exposure intensity. Different unexposed groups were used for reference. No exposure-response relationship was observed between symptoms of ill health and the urinary mandelic acid concentration, although the exposed group as a whole expressed significantly more symptoms than the reference group. The occurrence of abnormal electroencephalograms was about 10% in the group of workers with mandelic acid concentrations below 700 mg/l, but it was 30% among those whose mandelic acid concentration exceeded 700 mg/l, a level corresponding to the 8-h time-weighted average (TWA) of styrene exposure of about 30 ppm. With regard to psychological functions, the first change in visuomotor accuracy became discernible when the urinary mandelic acid concentration exceeded 800 mg/l. A more pronounced decrement appeared in both visuomotor accuracy and psychomotor performance when the mandelic acid concentration exceeded 1,200 mg/l, which corresponds to an 8-h TWA of styrene exposure of about 55 ppm.

Adolescent↗
PubMed1978

Psychological performance of subjects with low exposure to lead.

In a study of the effects of low lead exposure on psychological performance, 49 exposed workers and 24 controls were given a psychological test battery. All the lead workers had been under regular monitoring during their entire exposure time, and only workers whose maximal blood lead concentration had never exceeded 70 microgram/100 ml were included in the study. At the time of the examination, the mean blood lead level of the exposed group was 32 +/- 11 microgram/100 ml. Comparisons were made both between exposed and nonexposed workers and within the exposed group. In the latter case, the maximal, the average and the actual blood lead concentrations were used as measures of uptake. The most important finding was a significant relationship between impaired psychological performance and lead uptake within the exposed group. The performances that were most affected by lead depended on visual intelligence and visual-motor functions. Age and neuroticism did not explain these relationships. The impairment of psychological performance correlated better with the average than with the maximal or actual blood lead concentration. Considering that no single blood lead concentration had ever exceeded 70 microgram/100 ml, these findings indicate that the threshold for impaired performance lies below that level.

Adult↗
PubMed1977

Clozapine-induced agranulocytosis. A genetic and epidemiologic study.

An epidemic of agranulocytosis and granulocytopenia occurred in 1975 in conjunction with clozapine treatment of mental patients in Finland. An attempt was made to assess the epidemiologic and genetic factors contributing to the adverse drug effect. The estimated incidence rate in Finland was 2.1/1000 patient-months. This figure could not be compared with rates from other countries because of the inexact nature of the figures reported so far. All 16 cases occurred in seven hospitals in southwestern Finland, whereas the overall hospital net use of the drug was geographically evenly distributed. The difference between the observed and the proportionally expected incidence of cases amongst the hospitals where clozapine was used was statistically significant. The average consumption of the drug did not differ between the hospitals where cases occurred and those where no definite cases could be diagnosed. Six-generation pedigree analyses failed to reveal significant parental consanguinity or genetic kinship between probands. Neither did the birth places of the ancestors of the probands disclose a typical isolate pattern. In conclusion, the cases appeared to be confined to a few hospitals in southwestern Finland. Although a genetic factor is not excluded, we found no evidence in support of a genetic mechanism.

Agranulocytosis↗
PubMed1976

Disturbances in psychological functions of workers occupationally exposed to styrene.

The relationship between long-term occupational styrene exposure and disturbances in psychological functions was studied. The exposed group consisted of 98 male workers exposed to styrene in the manufacture of polyester plastic products, and the comparison group comprised 43 concrete reinforcement workers. The duration of exposure in years and the mean mandelic acid concentration in urine (five determinations during 5 weeks before the clinical examination) and the cumulative dose of exposure were used as the indicators of exposure. The psychological functions studied were intelligence, visuomotor speed, visuomotor accuracy, memory, vigilance, and psychomotor performance. Some personality test variables were also included. In a group comparison two variables (visuomotor inaccuracy and poor psychomotor performance) out of 20 showed statistically significant differences and characterized the styrene exposed group. These findings were confirmed when workers with low and high styrene exposure were compared. One variable measuring visuomotor speed and another measuring visual memory were related to the duration of exposure (R = 0.28, p less than 0.05). In a multiple regression analysis disturbances in visuomotor accuracy, poor psychomotor performance, and lowered vigilance proved to have some connection with a high mandelic acid concentration (R = 0.49, p less than 0.01). In addition workers with disturbances in visuomotor accuracy and slight disturbances in virumotor speed had higher mandelic acid concentrations when compared with those workers without any deterioration. The results indicate that disturbances in visuomotor accuracy and, to a lesser degree, in psychomotor performance are the main findings measured by test methods used in this study and related to one indicator of styrene exposure, mandelic acid concentration. The psychological methods used revealed subclinical symptoms related to exposure, and they should aid in making group diagnoses, e.g., when additional information is needed for the determination of the threshold limit value. The deterioration found in visuomotor accuracy could be related to lowered safety in work and traffic.

Adolescent↗
PubMed1976

Occupational lead exposure in Finland. VI. Final report.

Between 1970 and 1973, 2,209 workers representing 30 different types of work were studied in Finland for lead exposure. The indicator of lead exposure was the blood lead concentrations (Pb-B) of the workers. The highest recommended value for Pb-B in Finland, 70 mug/100 ml of blood, was exceeded in the following types of work: PVC plastic manufacturing, storage tank manufacturing and repairing, machine shop work, treating metal surfaces, paint manufacturing, car radiator repairing, spray painting, machine shop work (railway), and storage battery repair. The types of work with the highest average exposure were lead scrap smelting (Pb-B median 79 mug/100 ml, range 35--118), storage battery manufacturing (Pb-B median 66 mug/100 ml, range 19--101), metal founding, (Pb-B median 53 mug/100 ml, range 6--108) shipbreaking (Pb-B median 49 mug/100 ml, range 26--106) crystal glass manufacturing (Pb-B median 41 mug/100 ml, range 12--82), car radiator repairing (Pb-B median 38 mug/100 ml, range 17--83), and PVC plastic manufacturing (Pb-B median 37 mug/100 ml, range 10--126). During the past 5 years cases of clincial lead poisoning have occurred in all of these types of work, and the patients received workmen's compensation. The usefulness of the national poisoning register in predicting the relative hazard of lead exposure in the types of work studied was evaluated with the aid of rank order correlation statistics. The analysis showed that the poisoning register is a useful indicator of lead exposure in the most exposed types of work. However, the present survey also revealed work in which the hazard had escaped recognition in this country: metal founding, car repairing, and car radiator repairing, for example. Although it seems possible to predict the most heavily exposed work types from national poisoning registers only, the detection of workers with less severe manifestations of toxic effects, or somtimes even poisoning, in other types of work first requires a systematic survey of all types of work with possible lead exposure, and then regular monitoring of all exposed workers.

Automobiles↗
PubMed1976

Eight-year follow-up of viscose rayon workers exposed to carbon disulfide.

An 8-year follow-up of workers exposed for at least 5 years to carbon disulfide showed an excess of deaths due to coronary heart disease in reference to a comparison cohort. However, after effective preventive measures, e.g., leaving only 19% of the original group exposed and reducing the level of exposure to less than 10 ppm, had been undertaken after the 5th year of follow-up, coronary mortality decreased and no excess mortality during the last 3 years of follow-up occurred. These results, although only suggestive -- due to the small number of deaths and the short time of follow-up after the intervention -- seem promising from the point of view of improving the prognosis of workers who have already accumulated an excess risk for coronary death.

Adult↗
PubMed1976

Turnover and health selection among foundry workers.

The quantity, reasons, and health selection involved in labor turnover were studied with the use of questionnaires and employers' records. The basic material was the personnel of 20 representative foundries. The turnover in 1950--1972 was estimated from a sample of 588 workers. The causes and health selection were studied with questionnaires put to the 1,789 current employees (91% response), the 493 foundrymen who had left after at least 5 years of exposure (the 5-year-plus men, 71% response) and 424 of those who had left after less than 1 year of exposure (the 1-year-minus men, 55% response). The men were asked to describe their present and earlier work at the foundry, the nature and duration of their exposure, diagnosed lung and heart diseases, and chronic bronchitis and angina pectoris and to assess their present and former state of health and work capacity. The disability analysis was based on a sample of 2,834 men whose data were taken from the Social Insurance Register. The disability findings were compared to expected values based on the Finnish male population. Turnover proved to be rapid; short periods of employment predominated. The major reasons for leaving were poor work conditions, physically demanding work, low pay, and poor health. The turnover was fastest in dusty occupations. Relatively more exfoundrymen, both 5-year-plus and 1-year-minus, than current employees felt their health and/or work capacity to be poor. More of the older men in the 5-year-plus group than men of the same age in the current group had chronic bronchitis and diagnosed lung disorders. Both the 5-year-plus and the 1-year-minus exfoundrymen had relatively more diagnosed heart disorders than did the current employees. The disability prevalences of the foundrymen in any category of diseases did not exceed the expected values based on the male population. The overall findings indicate early health selection prior to pensionable disability and/or death.

Adolescent↗
PubMed1976

A mortality study of foundry workers.

The mortality of foundry workers was studied from a sample of all those men employed in 20 representative iron, steel, and nonferrous foundries for any period of time during 1950 through 1972. A statistical sample of 3,876 men from all those 15,401 workers with at least 3 months' exposure formed the cohort under study. The actual number of person-years of follow-up became 47,160. Total and cause-specific mortality was studied in the entire cohort and in different categories based on exposure time and occupation. The foundry workers' experience was compared to that expected on the basis of the general male population's death rates in Finland, and different categories of the cohort were compared to each other through direct standardization. During the period from 1950 through 1973, there had occurred 224 deaths. The mortality approached the expected value computed from the age-adjusted general male population, the standardized mortality ratio (SMR) being 90 for all foundry workers and 95 for workers in "typical" foundry occupations. The corresponding standard mortality ratios based on the estimated total number of person-years, after the application of corrections for sampling fractions, were 86 and 95, respectively. There was a slight shift of the age of death towards younger age groups among the casters, fettlers, and furnace tenders. Mortality from coronary heart disease showed a standardized mortality ratio of 80 for the whole cohort; no significant differences were found for any occupational category. Lung cancer mortality was higher than expected (SMR 150) in the entire cohort; closer analysis revealed that the excess was confined to iron foundries, and especially to molders with more than 5 years of exposure. There were no more violent deaths than expected, not even from work accidents. Because most occupational cohorts have standardized mortality ratios that are well below 90, the present results were interpreted as probably indicating slightly elevated mortality. The most important finding was the concentration of lung cancer among molders in iron foundries.

Accidents, Occupational↗
PubMed1976

Prevalence of pneumoconiosis and chronic bronchitis in foundry workers.

The prevalence of pneumoconiosis, chronic bronchitis, and impaired lung function was studied among those 1,000 foundry workers (response rate 93.1%) with the longest exposure time (minimum 4.2, mean 17, SD 9 years) from a representative sample of 20 foundries. Pneumoconiosis was diagnosed from 100 x 100 mm radiographs, and the false positives and false negatives were evaluated from normal-size radiographs from all those with a positive finding and a sample of those with a negative finding. Chronic bronchitis was studied by means of a translation of the MRC Short Questionnarie on Respiratory Symptoms. Forced vital capacity and forced expiratory volume in 1 s were measured with a Vitalograph Single Breath Wedge Spirometer, and the FEV % was calculated from these variables. The subjects were grouped according to smoking habits and dust exposure, which could be fairly well evaluated from measurements performed in connection with the health survey. All comparisons were made between different subcategories. The overall prevalence of pneumoconiosis was 3.8%, when allowance had been made for false positive and false negative findings. Most cases were mild. Chronic bronchitis occurred more frequently among those occupied in jobs classified as dusty. Smoking also strongly increased its prevalence; a combination of both exposures produced the strongest effect. The effect of smoking was also evident as an impairment of lung function; however, no such effect of dust exposure could be shown in this material. Since this was a prevalence study, the selective removal of workers from dusty jobs probably led to underestimates of all the health effects studied. In spite of the effect of selection excess bronchitis could be demonstrated in workers from dusty environments. Therefore effective dust control must be initiated not only with regard to silica dust but also with respect to total dust.

Adult↗
PubMed1976

Angina pectoris, ECG findings and blood pressure of foundry workers in relation to carbon monoxide exposure.

A prevalence study on angina pectoris, ECG changes, and blood pressure was carried out with those 1,000 workers (response rate 93.1%) with the longest exposure time (minimum 4.2 years) from a statistical sample of 20 foundries. The history of angina was obtained from a questionnaire recommended by the World Health Organization, and the ECGs were coded according to the Minnesota code. On the basis of measurements of the concentration of carbon monoxide (CO) in the air, the workers were divided into three occupational exposure groups, one with definite CO exposure, one with slight or occasional CO exposure, and one without CO exposure. Allowance was also made for present and past smoking habits. All comparisons were made on an intrastudy basis between the different subcategories. The prevalence of angina showed a clear dose-response relationship with regard to CO exposure from either occupation, smoking, or both, but no such trend was found for ECG findings suggestive of CHD. These results may suggest a greater sensitivity in detecting CHD on the part of the angina questionnaire. The systolic and diastolic blood pressures of CO exposed workers were slightly higher than those of other workers when age and smoking habits were taken into consideration. However, exposure to heat was intermixed with exposure to CO. It could be shown that selection based on health had operated in the foundries. Hence, the prevalence found can be considered to be underestimates of the "true" occurrence of cardiac disorders. Nevertheless both angina and "coronary" ECG findings were more prevalent than in other methodologically comparable studies on the general population or industrial workers without toxic exposure.

Adult↗