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Mortality of workers in an automobile engine and parts manufacturing complex.

A proportionate mortality ratio (PMR) study was conducted using data on workers from three local unions representing an integrated automobile factory composed of forge, foundry, and engine (machine and assembly) plants. Ninety four percent of the death certificates were obtained for all active and non-active workers who died during the period 1 January 1970 to 31 December 1979 and were vested in union and company benefit programmes. Observed numbers of deaths were compared with expected numbers based on two standards, the proportionate mortality among men in the United States 1970-9 and among men in Erie County 1975. There was close agreement between the number of observed and expected deaths by either standard of comparison among white auto workers in the forge and foundry plants. Valid analyses of cause specific mortality among non-whites could be conducted for the foundry plant only. Although there was raised PMR for deaths due to diseases of the circulatory system using the Erie County standard, none of the other cause specific PMRs was significant. Although based on small numbers, the risk of cancer of the lung was significantly high in non-whites under age 50 in the foundry (PMR = 2.6; p less than 0.05). The cause specific PMRs for whites in the engine plant were statistically significant for malignant neoplasms (1.2) and all external causes (0.62) based on the US white male standard. Analysis of cancer specific mortality among white men in the machining/assembly plant showed significant excesses for cancer of the digestive system (PMR=1.5), particularly of the liver (PMR=2.6) and pancreas (PMR=1.9); cancers of the respiratory system (PMR=1.4 using the Erie County standard); and cancer of the urinary bladder (PMR=2.3). Workers employed for more than 20 years showed statistically increased mortality ratios for cancers of the digestive system (1.9), particularly cancer of the pancreas (2.3) and cancer of the rectum (2.8). Individuals whose employment began during or before 1950 exhibited increased PMRs for cancers of the digestive organs (1.8), particularly of the pancreas (2.5) and of the bladder (3.4). Workers whose employment began after 1950, on the other hand, exhibited raised PMRs for cancers of the respiratory system (1.5) and of the kidney (3.2). Since the foundry and forge plants did not start production until 1955, mortality associated with those work settings may be greater in the future.

Adult↗

A case-control study of chronic neuropsychiatric disease and organic solvent exposure in automobile assembly plant workers.

A case-control study of chronic neurological and psychiatric disease and occupational exposure to solvents was carried out in eight automobile assembly plants. Cases included 299 subjects who were granted medical disability retirement in 1980-8. Two control groups were selected, the first from those granted retirement in the same period because of medical disability from causes unrelated to solvent exposure. The second included hourly employees from the plant population. In these facilities, solvent exposures tended to be short term and low level, although common: the average duration of exposure was 2.3 years; about 41% experienced at least one day of exposure. Of those exposed, 46% had less than one year of exposure. Results for all psychiatric disease combined (273 cases) suggested that cases had lower exposures than either control group, regardless of how exposure was expressed. Results could not be explained by conventional confounding exposures or characteristics or by usual manifestations of the healthy worker effect. By contrast, chronic neurological disease, and multiple sclerosis in particular, seemed to be associated with exposure, although few cases were identified and observed increases in risk were not statistically significant.

Adult↗

Abuse of epidemiology: automobile manufacturers manufacture a defense to asbestos liability.

Much of the "debate" about the relationship between asbestos exposure from automobile brake work and asbestos-induced cancer has been fueled by studies that have been funded by corporations with billions at stake in tort litigation. The authors explore how asbestos-lined brake manufacturers have corrupted medical literature to escape liability, analyzing studies funded by these companies to enable them to claim that work with asbestos brake linings never causes mesothelioma. They reveal how the companies have redefined scientific criteria for the determination of cause-effect relationships and manipulated scientific data to give the impression of an absence of effect. But the absence of evidence is not evidence of the absence of an effect.

Asbestos↗

The risk of automobile accidents with seizures occurring while driving: relation to seizure type.

Automobile accidents occurred with 55% of seizures in epileptic drivers with both well-described seizures at the wheel and a well-classified epilepsy diagnosis. A further 38% of seizures would have led to accidents in less fortunate settings. Complex partial seizures occurred in 81% of patients and were responsible for 88% of accidents. Immediate alterations of consciousness were significantly more likely to lead to accidents than were seizures beginning with an aura. Motor activity during simple partial seizures was also responsible for some accidents. Differences in seizure frequency may account for different crude accident rates among studies of epileptic drivers. We suggest guidelines for licensing restrictions that seem safe and reasonable.

Accidents, Traffic↗

Bags, buckles, and belts: the debate over mandatory passive restraints in automobiles.

Seatbelt-wearing occupants of motor vehicles experience a death rate that is half that of nonbelted occupants, yet fewer than 10 percent of the population regularly wear their seatbelts. The potential of effective passenger-restraint systems to substantially reduce mortality and disability has led the federal government to consider requiring all new vehicles to come equipped with restraint systems that take effect without active participation from the passenger--airbags or automatic seatbelts. Since 1969, the government has issued several rulemakings to that effect, but each has been delayed or rescinded, the result of an ongoing debate about the policy's wisdom. Political and economic interests are at stake, as are matters of principle; and disputes over basic facts remain unresolved. Both advocates and opponents of a mandatory passive-restraint requirement agree that restraints can prevent deaths and disabilities, though there are differences of opinion as to the degree of protection afforded. Opponents of the requirement concentrate their substantive concerns on the propensity of the public to disconnect passive belts and the reluctance of prospective car buyers to pay the additional cost that airbags would entail. Cost-benefit analyses of a passive-restraint requirement find the requirement socially desirable; but they fail to take distributional issues into account, and several of their assumptions have been challenged by the automobile industry, the only major organized opposition to the requirement. This paper examines the central issues and evidence in the debate, including a consideration of alternative means of achieving effective, efficient passenger restraint.

Accidents, Traffic↗

Does uvulopalatopharyngoplasty inhibit automobile accidents?

Patients with rhonchopathy, which includes obstructive sleep apnea syndrome (OSAS), who report sleepy spells at the wheel do poorly on simulated monotonous driving tests and have a twofold to threefold increase in traffic accidents. To assess whether drivers with rhonchopathy (heavy snoring, sleep disturbances, and daytime sleepiness) cause fewer automobile accidents after uvulopalatopharyngoplasty (UPPP), the car accident rate for the first 5 years after surgery was compared to the rate of the 5 years immediately before the operation. Data were collected by means of a self-report questionnaire. Fifty-six patients with rhonchopathy were compared to 142 controls without rhonchopathy who had been subjected to nasal surgery. The response rates were 96% and 94%, respectively. The reported habitual sleepiness while driving had disappeared in 87% (P < .001) of drivers who had the problem preoperatively. The accident risk reduction (corrected for mileage) in patients was almost four times greater than the reduction in controls (P < .001) after surgery. The relative rate of patients involved in any single-car accident fell by 77% (P < .05), and the relative rate of single-car accidents fell by 83% (P < .001). It is concluded that drivers with rhonchopathy have an increased risk for car accidents, especially single-car accidents, but that this risk returns to normal after UPPP.

Accidents, Traffic↗

Vigilance and automobile accidents in patients with sleep apnea or narcolepsy.

Patients with obstructive sleep apnea or narcolepsy report difficulty remaining alert and attentive. To detect impaired vigilance, we designed Steer Clear, a computer program simulating a long and monotonous highway drive that presents 780 obstacles in 30 min. Sixty-two patients with sleep apnea hit a higher percentage of obstacles (4.3 +/- 0.6% [SEM]) than 12 age- and sex-matched subjects without sleep apnea (1.4 +/- 0.3%; p < 0.05) and 10 age- and sex-matched volunteers (1.2 +/- 0.3%; p < 0.05). Ten patients with untreated narcolepsy hit a higher percentage of obstacles while performing on Steer Clear (7.7 +/- 3.2%) than 10 age- and sex-matched subjects without narcolepsy (1.2 +/- 0.3%; p < 0.05). Poor performance on Steer Clear was associated with a higher auto accident rate in the patients with sleep apnea or narcolepsy (p < 0.01). Twenty-one patients who performed normally on Steer Clear had 1 accident in 5 years (0.05 accident/driver/5 yr), and in none of these accidents were they at fault as drivers. Twenty-five patients who performed poorly on Steer Clear had 5 auto accidents in 5 years (0.20 accident/driver/5 yr), and in 20% of these accidents they were at fault as drivers. Twenty-one patients who performed very poorly on Steer Clear had 8 auto accidents in 5 years (0.38 accident/driver/5 yr), and in 38% of these accidents they were at fault as drivers. These 21 patients who performed very poorly on Steer Clear (hitting > 4.5% of obstacles) had a significantly higher auto accident rate than the patients who performed normally (hitting < 1.8%). We conclude: (1) Patients with sleep apnea or narcolepsy performed more poorly on a test of vigilance, Steer Clear, than did control subjects; (2) Impaired vigilance as measured by Steer Clear is associated with a high automobile accident rate in patients with either sleep apnea or narcolepsy.

Accidents, Traffic↗

Health impacts of frequent heavy automobile traffic on children and adolescents.

This paper assesses the extent to which particulate, elemental and organic carbon emissions from heavy traffic in urban city roads affect the health of children and the adolescent health. Although the health effects of exposures may be cumulative, it is in the adolescence that the manifestations are realized. This paper therefore, assesses the best way forward for monitoring and preventing the environmental health impacts of heavy traffic on children and adolescents who live within the vicinity of urban city transportation systems. Major urban cities such as Houston, New York, and California are cited as examples of cities where health-related problems have already been reported. The particulate, elemental and organic carbon emissions are reviewed as the sources by which heavy traffic and the hazardous chemical emissions affect the health of the populace. The role of accessory loading and engine speed on idling emissions in direct health risks of children and adolescents is evaluated. The association of particulate, elemental, and organic carbon emission with respiratory effects (including, allergies and asthma), and the related behavior problems in children and the adolescents are discussed. The best strategies in preventing the effects of heavy traffic in the urban cities are suggested by introducing new effective monitoring techniques and exposure assessment methods. It is visualized that a more comprehensive research is needed to develop robust regulatory systems that would control the efficiency of automobiles and prevent the adverse health effects relating to heavy traffics in urban city roads. Strong city environmental health authorities-community partnerships relevant to exposure information should be encouraged.

Adolescent↗

A statistical method for predicting automobile driving posture.

A new model for predicting automobile driving posture is presented. The model, based on data from a study of 68 men and women in 18 vehicle package and seat conditions, is designed for use in posturing the human figure models that are increasingly used for vehicle interior design. The model uses a series of independent regression models, coupled with data-guided inverse kinematics, to fit a whole-body linkage. An important characteristic of the new model is that it places greatest importance on prediction accuracy for the body locations that are most important for vehicle interior design: eye location and hip location. The model predictions were compared with the driving postures of 120 men and women in five vehicles. Errors in mean eye location predictions in the vehicles were typically less than 10 mm. Prediction errors were largely independent of anthropometric variables and vehicle layout. Although the average posture of a group of people can be predicted accurately, individuals' postures cannot be predicted precisely because of interindividual posture variance that is unrelated to key anthropometric variables. The posture prediction models developed in this research can be applied to posturing computer-rendered human models to improve the accuracy of ergonomic assessments of vehicle interiors.

Adult↗

Automobile safety regulations and death reductions in the United States.

The effectiveness of federal automobile safety standards was examined using detailed data on 236,000 vehicles in fatal crashes in the United States during 1975-1978. Controlling statistically for type of regulation, types of vehicles, and ages of vehicles, the federal motor vehicle safety standards were associated with substantial reductions in car occupant death per 100 million vehicle miles travelled, and some reductions in fatal collisions of the federally regulated vehicles with pedestrians, motorcyclists, and bicyclists. Some 37,000 fewer deaths occurred in 1975-1978 than would have been expected without the federal standards.

Accident Prevention↗

Automobile color as a predictor of driving behavior.

Research on achievement motivation has shown that highly motivated people prefer cool or somber colors like blue and tend to be in a hurry, while less motivated people tend to choose warm or bright colors like red and are less time conscious. We applied these findings to automobile driving, hypothesizing that drivers of cars with high nACH colors would speed at greater velocities and run red lights and stop signs more. Unobtrusive observation in three studies of 193 highway speeders, 261 cars at stop lights, and 191 cars at stop signs showed that drivers of cars with high nACH colors did tend to speed at higher rates and to run red lights more, although they did not run stop signs more. The data partially support previous research on the behavioral correlates of color preference.

Accidents, Traffic↗

[A survey of the improvement of public transportation for the elderly. Reasons for giving up driving by retired automobile workers living in in Kanagawa Prefecture].

In order to improve the adequacy and safety of transportation for elderly people, the reasons for, and the after-effects of stopping driving by elderly people were analyzed. The subjects consisted of 500 car manufacturing retirees, aged 60 years old and over, living in Kanagawa prefecture. Of the 500 people questioned, 298 people (59.6%) responded. Of these 196 currently held licences. In this group, 149 still drove, 9 intended to stop driving soon, and 38 had already stopped. Of the 38 people who had already stopped driving, 7 quit before age 55. These people were omitted from analysis because factors other than aging possibly contributing to their stopping driving. We were interested in the 31 people older than 55 and the 9 people who intended to quit soon. The results were the following: I) The main reasons why they had stopped driving were the following: a) anxiety felt because of decreased driving ability and the feeling to need to walk in order to improve their health; b) the needlessness of driving because of availability of other means of transportation; II) The anxiety from decreased driving ability correlated with difficulty with narrow roads and imparied vision making it difficult to observed road signs; III) The reasons for stopping driving correlated with the effects: the needlessness of driving because of use of other means of transportation correlated with decreased frequency of going out for hobby and group activities. These results show that stopping driving also affects the social activities of the Japanese elderly. It was concluded that we should inform the elderly drivers of the effects of stopping driving as well as improving conditions on roads and comfort in automobiles.

Aged↗

Back disorders and nonneutral trunk postures of automobile assembly workers.

A case-referent study was conducted in an automobile assembly plant to evaluate the health effect of trunk postures, such as bending and twisting, that deviate from anatomically neutral. Cases of back disorders were all those of workers who reported back pain to the medical department in a ten-month period and met the severity criteria of an interview. The referents were randomly selected workers free of back pain according to medical department records, an interview, and an examination. For each of the final 95 cases and 124 referents, the job was analyzed for postural and lifting requirements with a video recording and software analysis system by analysts blinded to the case/referent status. Back disorders were associated with mild trunk flexion [odds ratio (OR) 4.9, 95% confidence interval (95% CI) 1.4-17.4], severe trunk flexion (OR 5.7, 95% CI 1.6-20.4), and trunk twist or lateral bend (OR 5.9, 95% CI 1.6-21.4). The risk increased with exposure to multiple postures and increasing duration of exposure.

Adult↗

Shoulder disorders and postural stress in automobile assembly work.

OBJECTIVES: A case-referent study was conducted in an automobile assembly plant to evaluate the risk of shoulder disorders associated with nonneutral postures. METHODS: The cases were workers who reported shoulder pain to the plant clinic during a 10-month period and met symptom criteria (pain frequency or duration in the past year) in an interview; more than one-half also had positive findings in a physical examination. The referents were randomly selected workers who were free of shoulder disorders according to the clinic records, the interview, and the physical examination. For each of the 79 cases and 124 referents, 1 job was analyzed for postural and biomechanical demands by an analyst blinded to the case-referent status. RESULTS: Forty-one percent of the subjects flexed or abducted the right arm "severely" (above 90 degrees) during the job cycle, and 35% did so with the left arm. The peak torques at the shoulder were rather low. Shoulder disorders were associated with severe flexion or abduction of the left [odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.5-6.5] and the right (OR 2.3, 95% CI 1.2-4.8) shoulder. The risk increased as the proportion of the work cycle exposed increased. The relationships were similar for the cases with and without physical findings. Use of hand-held tools increased the risk and also modified the association with postural stress, although the joint exposure distributions limited full analysis of this finding. CONCLUSIONS: The findings support the conclusion that severe shoulder flexion or abduction, especially for 10% or more of the work cycle, is predictive of chronic or recurrent shoulder disorders.

Adult↗

A new Legionella species, Legionella feeleii species nova, causes Pontiac fever in an automobile plant.

From 15 to 21 August 1981, Pontiac fever affected 317 automobile assembly plant workers. Results of serologic tests were negative for Mycoplasma, Chlamydia, respiratory tract viruses, and previously described legionellae. A gram-negative, rod-shaped organism (WO-44C) that did not grow on blood agar, required L-cysteine for growth, and contained large amounts of branched-chain fatty acids was isolated from a water-based coolant. The organism did not react with antisera against other legionellae, and on DNA hybridization the organism was less than 10% related to other Legionella species. Geometric mean titers found by indirect fluorescent antibody testing to WO-44C were significantly higher in ill employees than in controls (p = 0.0001). Attack rates by department decreased linearly with the department's distance from the implicated coolant system. The etiologic agent apparently was a new Legionella species; we propose the name Legionella feeleii species nova (AATC 35072). This is the first outbreak of nonpneumonic legionellosis in which the etiologic agent is not L. pneumophila, serogroup 1.

Aerosols↗

Environmental hazards of automobile mechanics in Ibadan, Nigeria.

A cross sectional survey was conducted among automobile mechanics and technicians in Ibadan to determine the socio-demographic characteristics and environmental hazards of these workers. Three hundred workers were interviewed. All respondents were males aged between 13 and 72 years of age. Educational attainment was poor, with only 20% of respondents having completed secondary education. Sanitation facilities were inadequate. Forty percent of workshops provided facilities for refuse disposal. Of the 33 workshops visited, only 1 provided toilet facilities. Most workers used facilities in neighbouring residential premises. Only three workshops (9%) had designated eating areas. Occupational exposure to petrol was common to all trades. Other occupational exposures were to petrochemicals such as engine oil and brake oil. Protective clothing was not used by the majority of workers. Only 25 (8%) respondents were wearing overalls at the time of our visit. This findings illustrate the typical work conditions of workers in small scale industries. There is a need for health education programmes about occupational and non-occupational diseases. This and other health promotion activities can be organized through the unions.

Adolescent↗

Biomechanics of minor automobile accidents: treatment implications for associated chronic spine symptoms.

Biomedical experimental data indicate that automobile accidents with no vehicle damage are unlikely to cause injury to the occupants. Soft tissue injuries heal in a few weeks. Chronic pain has never been produced by experimental injury and is much less common in countries without financial payments for accident victims. Chronic pain after no-damage collisions is probably caused by psychologic factors. Psychologic treatment should be added to conventional nonoperative treatment when no objective explanation for chronic symptoms is found.

Accidents, Traffic↗