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Evaluation of workers' exposure to methylene diphenyl diisocyanate (MDI) in an automobile manufacturing company, Iran.

Evaluation of personal inhalation exposure to methylene diphenyl diisocyanate (MDI) among 39 employees, working in the window fixation and window glue processes in an automobile manufacturing company was performed. This study was conducted for both case and control groups. After sampling and sample preparation processes, MDI was determined with a UV-VIS spectrophotometer at 590 nm; the lung function was assessed with a digital spirometer, too. The average concentration of MDI in the window fixation, and window glue workplaces were 34.53 and 27.37 micro g/m3, respectively, which was lower than the threshold limit value (TLV) recommended by the American Conference of Governmental Industrial Hygienists (ACGIH) (51 micro g/m3). Respiratory symptoms in the exposed group were significantly different compared to the unexposed group (p < .05). Lung capacities in the case group were lower than in the control group (p < .05). Therefore, MDI can be easily measured making it possible to evaluate the adverse effects caused by occupational exposure.

Air Pollutants, Occupational↗

Estimation of cumulative exposures to naphtha at an automobile fuel-injector manufacturing plant.

As part of an epidemiologic study of neuropsychological and renal effects of occupational exposure to organic solvents, estimates of cumulative exposure to naphtha were derived for workers at an automobile fuel-injector manufacturing plant. The approach to exposure estimation was relatively unusual in three respects: (1) a marked association between indoor naphtha air concentration and outdoor temperature was modeled and applied to detailed historical temperature data to calculate cumulative exposure estimates; (2) the large number of investigator-generated air samples allowed the use of analyses of variance to compare alternative job-grouping schemes; and (3) the young age of the plant and few process changes allowed for historical exposure estimates with a high degree of confidence. The derived estimates of cumulative exposure appear to offer a firm basis for epidemiologic analyses of exposure-health outcome relationships.

Air Pollutants, Occupational↗

Changes over time in audiometric thresholds in a group of automobile stamping and assembly workers with a hearing conservation program.

Noise induced hearing loss (NIHL) is among the 10 leading occupational diseases, afflicting between 7.4 and 10.2 million people who work in noise above 85 dBA. Although mandatory hearing conservation programs (HCPs) have been in effect since 1972, this problem persists, as hearing protectors are not consistently used by workers, or may not attenuate to manufacturer's estimates in real world conditions. In this study, information from noise and hearing protection use measurements taken at an automobile assembly plant were used to construct average lifetime noise exposure and hearing protection compliance estimates for use in modeling to predict both total hearing loss and onset of two accepted definitions of hearing loss. There were 301 males and females in this cohort; their mean age was 42.6 (7.2) years, and mean tenure was 14.3 (3.5) years. Average length of follow-up was 14.0 years. There were 16 members of this cohort who had hearing loss at the speech frequencies (defined as an average hearing level > or = 25 dB at 500, 1000, and 2000 Hz). In cross-sectional multivariate analyses, years of employment, male gender, and proportion of time wearing hearing protection were the factors most associated with hearing loss at the average of 2000, 3000, and 4000 Hz (p < 0.0001) controlling for age, transfer status (as a surrogate for previous noise exposure), race, and lifetime average noise exposure. The most consistent predictor of hearing loss in both univariate and multivariate analyses was percentage of time having used hearing protection during the workers' tenure.

Adult↗

The use of heteroduplex analysis of polymerase chain reaction products to support the possible transmission of Legionella pneumophila from a malfunctioning automobile air conditioner.

Air conditioner condensates have not been previously associated with cases of Legionnaires' disease. We report the possible transmission of Legionella pneumophila serogroup 1 from a malfunctioning automobile air conditioning system's leaking water onto the floorboard of a car driven for a long distance by the patient. Heteroduplex analysis of polymerase chain reaction products was used to help establish an epidemiologic link between the water specimen and the patient.

Air Conditioning↗

A polysomnographically documented case of adult somnambulism with long-distance automobile driving and frequent nocturnal violence: parasomnia with continuing danger as a noninsane automatism?

A case of childhood-onset somnambulism is reported in which a 43-year-old man presented with repeated sleep-related injuries incurred during violent nocturnal activity, which included frenzied running, throwing punches and wielding knives. He had also driven an automobile a long distance during a presumed somnambulistic state. His wife had been repeatedly injured, and she felt that her life was threatened by his nocturnal violence 2-3 times yearly. Polysomnography (PSG) documented multiple episodes of complex and violent behaviors arising exclusively from stage 3/4 sleep, thus confirming the diagnosis of somnambulism. Other causes of sleep-related violence were excluded. The patient responded promptly to treatment with bedtime clonazepam, and benefit was maintained at 5-year follow-up. Although this strictly clinical case did not have any legal repercussions, it does carry forensic implications, particularly when placed in the context of the published medical literature on PSG-documented parasomnias (somnambulism, rapid eye movement sleep behavior disorder) containing explicit examples of recurrent violence, at times life-threatening, directed toward the bed partner and others. Thus, a new medical-legal concept is proposed, consisting of "parasomnia with continuing danger" as a noninsane automatism. Treatment guidelines, within the context of forensic medicine, are presented.

Adult↗

Temperature variations in automobiles in various weather conditions. An experimental contribution to the determination of time of death.

From January 1995 through March 2000, temperatures in the passenger compartment of automobiles of different sizes were measured under varying weather conditions (sunshine, cloudy skies, rain) at two locations in eastern Switzerland. During the cold season, the interior temperature rose to 21 degrees C when cars were exposed to sunshine, whereas in summer interior temperature extremes of up to 89 degrees C were recorded. Make, model, and color of the vehicles were of only minor influence.

Automobiles↗

Automobile carburetor- and radiator-related burns.

Seventy-nine persons who had sustained automobile engine carburetor- and radiator-related burns were admitted to Grady Memorial Hospital Burn Unit between June 1, 1984 and September 30, 1990. Forty patients with carburetor-priming flame burns had a mean age of 31.5 years, a mean burn size of 13.4% total body surface area, and a mean length of stay of 13.8 days. There were 37 male patients. Four patients had an inhalation injury. Twenty-two surgical procedures were performed on 13 patients. One patient was an innocent bystander, and one patient died. The clothing of 16 patients had ignited, which resulted in larger, deeper burns and in one death. Burns predominantly involved the right sides of the face, head, and torso; the right upper extremity; and the right hand. Thirty-nine patients had scald burns that were associated with uncapping a radiator. These patients had a mean age of 29.6 years, a mean burn size of 8.9% total body surface area, and a mean length of stay of 6.4 days. There were 36 male patients and three innocent bystanders. One autografting procedure was performed, and there were no deaths in this group of patients. The burn-prone person is the young adult male. The circumstances that result in such dangerous behavior are predictable, and resultant burn injuries are preventable.

Accidents, Occupational↗

Should motorcycles be operated within the legal alcohol limits for automobiles.

A motorcycle simulator was used to assess operating performance of 14 experienced motorcyclists with varying breath alcohol concentrations. Riding error scores in three defensive and evasive maneuvers plus distance traveled in a standard time period were documented at baseline and at predetermined intervals following controlled alcohol consumption. The results revealed a positive correlation between total errors and breath alcohol concentrations within a range well below the commonly accepted legal limit of intoxication of 0.10 mg/dL. There was a highly significant increase (p < 0.0055) in an operator's tendency to leave the roadway (an error that is frequently fatal for motorcyclists), as well as a reduction in ability to complete a timed course. Moreover, performance errors increased while operators were "sobering up," a dramatic finding not heretofore established in previous studies. Since the present definition of the legal limit of intoxication for motorcyclists is based on automobile studies, noted increases in reaction time and performance errors support the hypothesis that "legal alcohol levels" should be lowered for motorcycle operators.

Adult↗

Myoelectric analysis of the paraspinal musculature in relation to automobile driving.

In this study, the myoelectric activity of 12 paraspinal muscles of ten men aged 18-24 was recorded to examine the effects of backrest inclination and lumbar support in relation to driving. In total, 24 test conditions were evaluated over a 3.5-hour period in a single day. These tests were then repeated, changing the sequence over the next 4 days. The results indicate a complex interaction between the thoracic and lumbar regions of the back with the lowest myoelectric activity position of 120 degrees backrest inclination, 5 cm of lumbar support, and 13.5-18.5 degrees of seat inclination. Electromyogramatic (EMG) evidence of fatigue was not identified over a 3.5-hour period. The generally low levels of EMG activity and, presumably, disc pressure present in any seating position suggest that the paraspinal muscle activity may not play the predominant role in disc herniation as it relates to automobile driving.

Adolescent↗

Mortality among automobile assembly workers. I. Spray painters.

The primary objective of this study was to determine whether there was an increased mortality, especially with respect to cancer of the lung, among spray painters in the automobile manufacturing industry. The study was carried out at ten assembly plants from five participating companies and utilized both proportionate mortality ratio (PMR) and case-control analyses. Among workers with spray-painting experience, there were no statistically significant PMRs for lung cancer, either for all companies combined or for any company individually. In addition, the case-control analyses did not demonstrate a statistically significant excess risk for lung cancer mortality, adjusting for length of employment and duration in spray painting. The case-control analysis was large enough to detect approximately a two-fold increase if, in fact, an increase that large actually existed.

Aerosols↗

Follow-up study among model and pattern makers in a German automobile company. Results of a second follow-up.

An historical follow-up study of 528 model makers in a German automobile company found an unusual pattern of mortality among these workers that included an increased risk of total cancer and tumors of the stomach, genitourinary organs, and the brain (Becker et al, 1992). Because of small numbers of cases and problems with the validity of causes of death, we carried out a second follow-up using data from the official mortality statistics and extending the observation period by five years. The new results did not confirm the previous observations of an increased risk of total cancer, cancer of the genitourinary organs, and tumors of the brain but confirmed indications of an increased risk of stomach cancer and suggested for the first time that there may be an increased risk of cancer of the intestine. Though the small numbers of cases did not allow statistical confirmation of these findings, they are consistent with the results of other studies recently conducted in the United States and published in this journal.

Automobiles↗

Investigation of pulmonary function among employees exposed to low levels of monomeric isocyanates and solvents at an automobile finishings plant.

There have been reports in the literature of decrements in pulmonary function associated with long-term, low-level monomeric isocyanate exposure combined with solvent exposure. This cross-sectional study examines the relationship between these exposures and pulmonary function in an automobile paint and coating (finishes) plant. A job exposure matrix was developed for isocyanate and solvent exposure; years in a work task were used as a surrogate for exposure. Recent pulmonary function tests were used as the outcome variables; specifically the difference between predicted and actual FEV1 and FVC. The results of the analysis demonstrated no statistically significant relationship between combined isocyanate and solvent exposure and decline in pulmonary function. There was a statistically significant negative correlation between solvent exposure and FEV1 and FVC.

Adult↗

Analysis of burn injuries in frontal automobile crashes.

The purpose of this study was to investigate burn injuries resulting from frontal automobile crashes and to determine the effects of frontal airbags on the incidence of burn injuries. The study included 25,464 individual cases from the National Automotive Sampling System database files for the years 1993 to 2000. Occupants were at a significantly higher risk to sustain a burn injury when exposed to an airbag deployment (1.54%) compared with those who received a burn injury when not exposed to an airbag deployment (0.02%; P = 0.02). In contrast to previous publications, this study found that 1.53% of front seat occupants exposed to an airbag deployment sustained an airbag-induced burn injury. The vast majority of airbag-induced burn injuries were minor (98.7%); however, in cases with no airbag deployment, the burns were often much more serious, including fatal burns (29.6%). Occupant weight, height, sex, seatbelt use, and seat position were all found not to be significant in predicting the risk of airbag induced burn injury, whereas age and crash velocity were found to be significant.

Accidents, Traffic↗

Incidence of carpal tunnel syndrome among automobile assembly workers and assessment of risk factors.

OBJECTIVES: This study defined the incidence rate of carpal tunnel syndrome (CTS) among active assembly workers and evaluated risk factors. METHODS: This study followed 189 automobile assembly workers over 1 year. Incident cases were defined as workers who had no current or prior history of CTS and were subsequently diagnosed with CTS by means of active surveillance during the study. RESULTS: The estimated annual incidence rate ranged from 1% to 10%, depending on the case definition. Significant predictors for CTS include a higher baseline median-ulnar peak latency difference, history of wrist/hand/finger tendonitis, history of diabetes, nonneutral wrist and elbow postures, and a lower self-reported social support. CONCLUSIONS: This is similar to other prospective studies that demonstrate both ergonomic and medical history are independent risk factors for development of CTS.

Automobiles↗

Gordonia polyisoprenivorans sp. nov., a rubber-degrading actinomycete isolated from an automobile tyre.

A rubber-degrading bacterium (strain Kd2T) was isolated from fouling tyre water inside a deteriorated automobile tyre. The strain was aerobic, Grampositive, produced elementary branching hyphae which fragmented into rod/coccus-like elements and showed chemotaxonomic markers which were consistent with the classification of Gordonia, i.e. meso-diaminopimelic acid, N-glycolyl muramic acid, arabinose and galactose as diagnostic sugars, a fatty acid pattern composed of unbranched saturated and monounsaturated fatty acids with a considerable amount of tuberculostearic acid, and mycolic acids comprising 58-66 carbon atoms with two principal mycolic acids C60 and C62 counting for over 60%. Results of 16S rDNA analyses as well as chemotaxonomic results, led to the conclusion that Gordonia sp. strain Kd2T (= DSM 44302T) represents a new species within the genus Gordonia for which the name Gordonia polyisoprenivorans is proposed.

Actinomycetales↗

Epilepsy and driving: a survey of automobile accidents attributed to seizure.

From results of a survey of 72 epileptic car drivers who had a mean driving history of 8.6 years, 18 (25%) had experienced one or more automobile accidents ascribed to a seizure while driving, with the total number of accidents of the surveyed group amounting to 35. All the drivers were known to have partial epilepsy, 13 of them having temporal lobe epilepsy. The main characteristics of these 35 accidents were as follows: (1) Fifty-seven percent were caused by complex partial seizure without an aura in which consciousness was immediately impaired at onset, while about 10% were attributed to simple partial seizure in which the conscious state was not altered. No accident was caused by a first seizure; (2) Fifty-one percent occurred on an empty road with little pedestrian and/or vehicular traffic; (3) In about half the accidents, the driver's vehicle collided against an immovable object, and only 20% involved crashing into another car; (4) Most accidents caused damage to only the driver's car and/or mild physical injury; and (5) Fifty-four percent of the accidents were not reported to the police, and many that were reported were ascribed to driving while asleep, to careless driving or to similar behavior.

Accidents, Traffic↗

A prospective study of the development of hand eczema in an automobile manufacturing industry.

We have not been able to find any prospective study of the risk of developing occupational dermatitis in the car manufacturing industry. To try to define individual predictive risk factors for the development of hand eczema and to determine the prevalence of hand eczema within 1 year in an automobile manufacturing industry, we investigated prospectively 1564 new employees during one year of employment. Only persons with previous atopic dermatitis or hand eczema were restricted to dry and clean workplaces. The employees were personally interviewed and examined before their employment. Written questionnaires were used at 3 and 12 months to obtain information on type of work, exposure, protection and hand dermatitis. All patients developing hand eczema were examined, patch tested and followed to determine the course and consequence of their eczema. The risk turned out to be only 4% on average, but significantly higher in females (6%). Certain sections within the factory such as wet work (canteen/kitchen and cleaning) and work in the paint shop with high exposure to organic solvents carried significantly higher risks. Heavy exposure to mineral oil, a known risk factor, was effectively counteracted by the extensive use of protective gloves to yield a lower than average prevalence in the press and body shop. Individual risk factors for the development of hand eczema were previous hand eczema, atopic dermatitis, but also wool intolerance and hay fever as isolated phenomena. Most cases of hand eczema were mild, of irritant contact type and only 1 employee developed an allergic contact dermatitis due to the working environment.(ABSTRACT TRUNCATED AT 250 WORDS)

Automobiles↗

Assessing automobile head restraint positioning in Portland, Oregon.

OBJECTIVE: Automobile head restraints, when used properly, have been shown to decrease the incidence and severity of whiplash injuries to the neck. Before the development of a public campaign on proper head restraint positioning, the authors assessed head restraint positioning and public understanding. DESIGN: Over a one month period, the position of the vehicle head restraint of drivers was observed in moving cars in the city of Portland, Oregon (population 530,000). Optimal position was defined as having the head restraint above the ears with the back of the head touching the head restraint. A questionnaire on head restraint understanding was administered to people during jury service. RESULTS: Of the 4287 drivers observed, 1% (n = 30) had no head restraint on their seat, 4% (n = 158) had a fixed head restraint, and 95% (n = 4099) had an adjustable head restraint. Among the fixed head restraints, 21% (33/158) were positioned optimally with no horizontal gap. Among the adjustable head restraints, only 7% (280/4099) had optimal head restraint positioning. Overall, 93% (3974/4287) of all head restraints observed were suboptimally positioned. Seventy five percent (38/51) of polled Portland residents identified safety as the primary head restraint function. CONCLUSION: Ninety three percent of all head restraints observed were suboptimally positioned. Fixed head restraints were three times more likely to be in optimal position than adjustable head restraints (21% v 7%). Most polled Portland residents understood the proper function and positioning of head restraints. This discrepancy between actual practice and understanding should be addressed with public education and manufacturer design changes.

Automobiles↗