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[A study of the relationship between job type and/or position to life style and health of male white-collar workers].

The relationship between the type of job and/or position of male white-collar workers to their working life, life style, health behavior, and health condition was examined based on data obtained from a survey of 1129 male workers in a major computer manufacturing company in 1988. The results were as follows: 1. Work, life style, health behavior, and health condition of male white-collar workers are strongly affected by type of job and position when adjusted for education, income, and age. 2. Workers in the sales department and engineering department appeared to have the most problems associated with working life, life style, health behavior, and health condition. Workers in sales, especially, displayed Type A behavior and their job was characterized by a lot of business transactions in a working environment that requires them to work until late at night. This leads to an irregular diet, late bed time, and makes their family relationships worse. Workers in the engineering department had work loads that were heavy because they have the longest working hours, and the content of their jobs is a mixture of both research and sales. Consequently their health is not good. On the other hands, workers in the laboratory had the best situation, and with general workers about average in terms of working life, life style, health behavior, and the state of health. 3. The department heads have the best conditions of life and health over all, except for their diet. The chiefs of sections are generally in the middle between the department heads and ordinary workers in terms of life and health. They drink and smoke heavily and show Type A behavior characteristics. Ordinary workers appear to have the most problems in working life, life style, health behavior, and health condition. From these results it may be concluded that this is associated with the difference in work type and position of these workers compared to managerial class and also with a low level of morale.

Adult↗

[Latex allergy in health care workers: frequency, exposure quantification, efficacy of criteria used for job fitness assessment].

BACKGROUND: The main purpose of this study was to evaluate the latex allergy prevalence in a large population of health care workers, to quantify latex exposure deriving from use of gloves and to verify the efficacy of job fitness evaluations in allergic workers. METHODS: In the period 2001-2002, latex allergy prevalence was evaluated in 1962 health care workers by means of a self-administered questionnaire, clinical evaluation and specific allergological tests. Also, the total protein content (by means of Lowry method modified EN455-3: 1996) and the antigenic latex proteins (by means of RAST inhibition) in 4 different types of gloves were measured. Job fitness assessments for latex allergic workers were made in accordance with the criteria established by the Italian Association of Preventive Medicine for Health Care Workers criteria. The efficacy was verified one year later. RESULTS: 1557 questionnaires out of 1962 (79.35%) were completed; 504 (32.4%) reported work-related symptoms, in particular 283 subjects had probable irritant contact dermatitis, 66 allergic contact dermatitis and 118 reported irregular non-specific symptoms related to the use of both vinyl and latex gloves; 20 subjects out of the remaining 37 had a latex allergy (1.3% out of the 1557 workers responding to the questionnaire), 8 subjects had only urticaria while 12 subjects had urticaria associated with respiratory symptoms and/or angioedema. The measurement of total protein and antigenic protein content showed the highest levels in powdered latex examination gloves, the lowest levels in surgical powder-free latex gloves. Low concentrations of antigenic proteins were also found in nitrile gloves. Job fitness evaluations were efficacious in 11 out of 20 workers, and inefficacious in 3 cases (6 workers had resigned). CONCLUSIONS: This study revealed a very low prevalence of latex allergy probably due to the fact that we examined an unselected population, and only symptomatic subjects were considered; moreover, in our hospital, vinyl examination gloves had been prevalently used during the last ten years. The criteria followed for job fitness assessment seem to be efficacious on the whole. In spite of a low prevalence of latex allergy, we found a high frequency of irritant contact dermatitis in the examined workers, mainly due to the lubricant powder in both synthetic and natural rubber gloves. Most workers made a complete recovery when they started using powder-free gloves. The high biocompatibility of powder-free gloves was confirmed by the measurement of total protein and latex antigenic protein content in the gloves used in the hospital. Moreover, it should be noted that latex antigenic proteins were also demonstrated in nitrile gloves, this is a relevant information since nitrile gloves are often used as an alternative in latex allergic workers.

Adult↗

HIV/AIDS prevalence among South African health workers.

INTRODUCTION: Studies on HIV prevalence among health workers usually focus on occupational exposure to HIV. Little is known about HIV prevalence in this group. However, it is expected that HIV prevalence among health workers will reflect prevalence in their society. OBJECTIVE: To determine HIV prevalence among South African health workers. METHOD: A stratified cluster sample was drawn of 5% of health facilities in South Africa (N = 222) representative of the public and private health sectors in South Africa. The sample was designed to obtain a nationwide representative sample of medical professionals and non-professional health workers. A subsample comprising health workers in four provinces was tested for HIV status. The Orasure HIV-1 device in combination with the Vironostika HIV UNI-Form II plus O enzyme-linked immunosorbent assay (ELISA) kits were used to collect oral fluid specimens for HIV testing. RESULTS: Based on a sample of 721 health workers and a response rate of 82.5% (or 595 respondents), the study found that an estimated 15.7% (95% confidence interval (CI): 12.2-19.9%) of health workers employed in the public and private health facilities located in four South African provinces, were living with HIV/AIDS in 2002. Among younger health workers, the risk is much higher. This group (aged 18-35 years) had an estimated HIV prevalence of 20% (95% CI: 14.1-27.6%). Non-professionals had an HIV prevalence of 20.3%, while professionals had a prevalence of 13.7%. CONCLUSION: HIV prevalence among health workers in South Africa is high; this calls for the introduction of antiretroviral programmes targeting them. In addition, there is a need for the development of new policy regarding placement of infected health workers in tuberculosis (TB) wards, coupled with vigorous human resource planning to replace the health workers likely to die from AIDS. Infection control procedures also need to be reviewed.

Adult↗

A test of worker policing theory in an advanced eusocial wasp, Vespula rufa.

Mutual policing is an important mechanism for maintaining social harmony in group-living organisms. In some ants, bees, and wasps, workers police male eggs laid by other workers in order to maintain the reproductive primacy of the queen. Kin selection theory predicts that multiple mating by the queen is one factor that can selectively favor worker policing. This is because when the queen is mated to multiple males, workers are more closely related to queen's sons than to the sons of other workers. Here we provide an additional test of worker policing theory in Vespinae wasps. We show that the yellowjacket Vespula rufa is characterized by low mating frequency, and that a significant percentage of the males are workers' sons. This supports theoretical predictions for paternities below 2, and contrasts with other Vespula species, in which paternities are higher and few or no adult males are worker produced, probably due to worker policing, which has been shown in one species, Vespula vulgaris. Behavioral observations support the hypothesis that V. rufa has much reduced worker policing compared to other Vespula. In addition, a significant proportion of worker-laid eggs were policed by the queen.

Animals↗

[Early genetic effects on workers occupationally exposed to formaldehyde].

OBJECTIVE: To investigate the DNA and chromosome damage in peripheral blood lymphocyte of workers occupationally exposed to formaldehyde (FA). METHODS: All 151 workers occupationally exposed to FA from two plywood factories and 112 workers without occupational FA exposure working in a machine manufactory were recruited into this study. Comet assay and cytokinesis-block micronucleus technique was used to evaluate the DNA and chromosomal damage of peripheral blood lymphocyte. The air FA samples were collected with SKC 224-PCXR8 air samplers. Gas chromatography was used to analyze the FA level. Personal information including occupational history, age, sex, smoking and drinking status was collected by the questionnaire. RESULTS: The time weighted average concentration (TWA) of FA in the working environment of FA-exposed workers (range 0.10 - 7.88 mg/m(3)) was higher than those in controls (< 0.01 mg/m(3)). The olive tail moment (Olive TM) in low FA-exposed workers [3.03 (2.49 - 3.67)] was lower than that in high FA-exposed workers [3.95 (3.53 - 4.43)], but higher than that in controls [0.93 (0.78 - 1.10)], the differences were statistical significant (P < 0.05). Comet trail length in FA-exposed workers were significantly higher than that in controls [6.78 (6.05 - 7.60)], but no significant differences ware found between the high FA-exposed workers [12.59 (11.80 - 13.43)] and the low FA-exposed workers [11.25 (10.12 - 12.50)]. The frequency of micronuclei per 100 binucleated cells in low FA-exposed workers (0.41 +/- 0.25) was lower than that in high FA-exposed workers (0.65 +/- 0.36), but higher than that in controls (0.27 +/- 0.13), the differences were statistical significant (P < 0.05). The increased tendencies with the exposure levels were found in those three indices. In stratification analysis, the same results were found. CONCLUSION: In the current FA exposure levels, the DNA and chromosomal damage in peripheral blood lymphocyte might be induced by FA exposure, and be increased with the levels of exposure.

Adult↗

Development of a decision model to identify workers at risk of long-term disability in the construction industry.

OBJECTIVE: This study presents a decision model that predicts long-term disability among construction workers. METHODS: Risk factors were identified in two cohort studies among construction workers and evaluated in validation samples of smaller cohort studies among Dutch construction workers. The risk estimates (odds ratios) were used in a logistic regression model to calculate the probability of long-term disability in the next 4 years for a particular construction worker, subject to a specific combination of risk factors. The a priori probability was set equal to the overall long-term disability risk among the youngest construction workers (< 30 years) with a relatively short exposure history. RESULTS: According to literature findings, the risk estimate for work ability was set with the odds ratio at 2.0 for good work ability, 5.0 for moderate work ability, and 10.0 for bad work ability. Age-dependent risks were set at odds ratios of 1.5, 2.0, and 3.0 for the age groups of 30-34 years, 35-44 years, and 45-54 years, respectively. A sickness absence period of > or = 3 months had an odds ratio of 2.0, and severe musculoskeletal complaints had an odds ratio of 3.0. Since the number of construction workers older than 55 years was rather small and heavily biased by a healthy worker effect, it was decided to limit the applicability of the decision model to workers aged 20-55 years. The decision model used four risk factors and predicted a 40-fold difference in disability risk between construction workers with all four risk factors present (0.79) and those without any risk factor (0.02). CONCLUSIONS: The decision model presented the combined effect of different risk factors on the risk of an individual worker becoming disabled within 4 years. Evaluation studies will need to demonstrate whether the application of this decision model is helpful in identifying workers at risk for long-term disability and will facilitate appropriate intervention at the individual level.

Adult↗

Sex-ratio conflict between queens and workers in eusocial Hymenoptera: mechanisms, costs, and the evolution of split colony sex ratios.

Because workers in the eusocial Hymenoptera are more closely related to sisters than to brothers, theory predicts that natural selection should act on them to bias (change) sex allocation to favor reproductive females over males. However, selection should also act on queens to prevent worker bias. We use a simulation approach to analyze the coevolution of this conflict in colonies with single, once-mated queens. We assume that queens bias the primary (egg) sex ratio and workers bias the secondary (adult) sex ratio, both at some cost to colony productivity. Workers can bias either by eliminating males or by directly increasing female caste determination. Although variation among colonies in kin structure is absent, simulations often result in bimodal (split) colony sex ratios. This occurs because of the evolution of two alternative queen or two alternative worker biasing strategies, one that biases strongly and another that does not bias at all. Alternative strategies evolve because the mechanisms of biasing result in accelerating benefits per unit cost with increasing bias, resulting in greater fitness for strategies that bias more and bias less than the population equilibrium. Strategies biasing more gain from increased biasing efficiency whereas strategies biasing less gain from decreased biasing cost. Our study predicts that whether queens or workers evolve alternative strategies depends upon the mechanisms that workers use to bias the sex ratio, the relative cost of queen and worker biasing, and the rates at which queen and worker strategies evolve. Our study also predicts that population and colony level sex allocation, as well as colony productivity, will differ diagnostically according to whether queens or workers evolve alternative biasing strategies and according to what mechanism workers use to bias sex allocation.

Animals↗

Occupational injuries among workers in the cleansing section of the City Council's Health Services Department--Bulawayo, Zimbabwe, 2001-2002.

INTRODUCTION: During 2001-2002, a total of 97 occupational injuries occurred among workers in the cleansing section of the Bulawayo, Zimbabwe, City Council's Health Services Department. This report describes a study that was conducted to describe the nature of these injuries and determine the associated risk factors. METHODS: A retrospective, descriptive cross-sectional survey was conducted concerning occupational injuries incurred by workers in the cleansing section during 2001-2002. A total of 153 workers who had been in the section as of January 1, 2001, and 23 senior managers and section supervisors were interviewed, the occupational injury register was reviewed, and a walk-through survey was conducted to estimate risk factors. RESULTS: The occupational injury register indicated that during the study period, 62 workers sustained 67 injuries, including one that was fatal. Of these 67 injuries, 27 (40%) involved workers who sustained cuts inside a box-type refuse removal truck, and 11 (16%) involved workers who had sprained ankles and wrists as a result of improper lifting. Workers aged 18-25 years were more likely to incur an injury than workers aged >25 years. Working as a bin loader and not having received preemployment training were associated with injuries. None of the bin loaders had received preemployment training. Hazards identified during the walk-through survey included use of small jacks in workshops, contact with biologic and chemical materials on trucks and landfill sites, and poor use of protective clothing. Supervisors cited worker negligence as the main cause of injury, whereas 72 (84%) workers cited lack of adequate protective clothing as a source of injury, and eleven (7%) workers cited use of inappropriate equipment. CONCLUSION: On the basis of the modifiable risk factors for injury identified in this study, the Bulawayo City Council drafted a new health and safety training manual. New recruits now receive training before starting work on refuse collection trucks.

Accidents, Occupational↗

Issues with prescribed medications in Aboriginal communities: Aboriginal health workers' perspectives.

INTRODUCTION: The health of Indigenous Australians remains appalling. The causes of this situation are multi-factorial, however one contributing factor is poor medication compliance within Aboriginal populations. Anecdotal evidence provided by Aboriginal health workers in western New South Wales (NSW), Australia, has suggested that there are problems associated with the use of prescribed medications within the Aboriginal community. Aboriginal health workers form a core component of the Aboriginal health service sector and they have an in-depth knowledge of the community and its healthcare provision, as well as a familiarity with clinic patients and families. As such they are an important group whose opinions and beliefs about medication use in the Aboriginal population should be investigated. While there have been studies on the issues of prescribing in Aboriginal communities and access to medications, limited investigation into the use of prescribed medicines in Aboriginal communities and the role of the pharmacist in that process, has taken place. Therefore, this research aimed to identify the type of and reasons for inappropriate use of prescribed medications within Aboriginal communities serviced by the Mid Western Area Health Service (since incorporated into the Greater West Area Health Service) as perceived by the Aboriginal health workers in the area, and to explore strategies in conjunction with those Aboriginal health workers to address identified issues. METHODS: Qualitative, in-depth interviews were held with 11 Aboriginal health workers employed in Community Health Centres and hospitals in the Mid Western Area Health service of NSW. The interviews were audiotaped and transcribed verbatim. The transcripts were content analysed for emerging themes. The interviews explored the beliefs, perceptions and experiences of the Aboriginal health workers regarding prescribed medication use, the role of the pharmacist, and identification of future strategies to improve medication use in local Aboriginal communities. RESULTS: The Aboriginal health workers reported a general lack of access to medications and frequent inappropriate use of medications due to limited understanding, literacy and information all of which lead to non-compliance with instructions. Medication sharing was common in their communities. They reported that many Aboriginal people were uncomfortable seeking medicines advice, and the consumer medicine information provided was often difficult to understand, culturally inappropriate and unlikely to be utilised. Strategies suggested to improve pharmacist services and access to the services were a more 'Aboriginal friendly' environment, relationship development between pharmacists and Aboriginal health workers, cultural awareness programs for pharmacists and their staff, provision of disease state management services and medicine education programs by pharmacists for Aboriginal health workers. CONCLUSION: Medication misunderstandings and non-compliance within the Aboriginal community frequently occur. Suggestions to improve access, understanding and compliance, along with the education and training of Aboriginal health workers may provide tools for self-determination. Pharmacists may be well positioned to provide Aboriginal health workers with medicines information and patient education skills, and encourage the effective use of medicines within the Aboriginal community.

Attitude of Health Personnel↗

Comparison of measured and predicted ventilatory volumes in selected groups of industrial workers.

A follow-up study of ventilatory volumes [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0) and maximum expiratory flow at 50% of the FVC (MEF50)] was conducted for selected groups of workers from two plants involving the electrolytic extraction of aluminum (two groups with 95 and 38 workers, respectively), a cement industry (50 workers with chronic bronchitis and 96 healthy workers)and a shipyard (38 workers) during a period of 3 or 4 a. In the workers from the aluminum plant, particularly in those who were older and exposed longer to respiratory irritants, the fall in FVC was much higher than expected. Cement workers also showed a tendency towards more decreased FVC values than expected, and the fall in MEF50 was particularly pronounced. The cement workers with chronic bronchitis had a slightly higher annual fall in the ventilatory volumes than the healthy cement workers. The observed fall in the MEF50 of the shipyard workers without a specific occupational exposure to dusts or respiratory irritants was unexpectedly high. An analysis of the relative values of the ventilatory volumes within the groups indicated individual differences among the exposed workers in regard to a possible chronic effect of occupational exposure to respiratory irritants. A drop in the ventilatory volumes during the follow-up period was not found to be directly dependent on the initial volume values. In the evaluation of the results, selection factors and ambient exposure to irritants were taken into account.

Adult↗

Altered circadian rhythm of blood pressure in shift workers.

The effect of shift work on the circadian rhythm of blood pressure (BP) was studied in male bakery workers. The study group consisted of 28 men, blue collar non-rotating shift workers, 20-60 years of age, and the control group comprised 30 men, blue collar, day workers in the same age group. BP was evaluated in all subjects by 24h BP monitoring. Day workers showed typical circadian rhythm with a drop in both systolic and diastolic BP at night. This pattern was reversed in night workers. The peak SBP for night workers was at 11 pm and among day workers at 4 pm. Peak DBP was recorded among night workers at 10 pm and among day workers at 3 pm. All subjects showed a highly significant cyclic variation in BP. Whereas the range for SBP was similar in these two age groups (P > 0.05), the amplitude of DBP tended to be smaller in young workers. Therapeutic decisions for night shift workers with hypertension should take into account their altered BP cycle.

Adult↗

Implementation of a hospital policy for health care workers exposed to hepatitis or the human immunodeficiency virus.

Implementation of a hospital policy for health care workers exposed to the human immunodeficiency virus (HIV) or hepatitis is discussed, using a model program established by San Francisco General Hospital (SFGH). Occupational Safety and Health Administration (OSHA) guidelines on blood-borne pathogens require a comprehensive program for management of occupationally exposed workers at all health care institutions. To meet the need of immediate assessment, SFGH has established a 24-hour hotline staffed by several clinicians. These clinicians provide risk assessment at the time of the call, and the 24-hour pharmacy service, using an anonymous system to protect the worker, can have zidovudine prophylaxis available within five minutes for workers potentially exposed to HIV. Hepatitis prophylaxis focuses on hepatitis B immunization and administration of hepatitis B immune globulin to workers who have been exposed. Ongoing medical management involves monitoring the adverse effects of zidovudine, ensuring that workers receive any workers' compensation benefits to which they are entitled, providing pretest and posttest counseling for exposed workers and their significant others and families, and supplying appropriate documentation. Confidentiality is essential for worker participation in the program. The costs of such a program are not insignificant but must be borne by the institution if it is to take care of its health care workers. Institutional policies and procedures must address all the components of postexposure management, as well as the issues related to HIV- and hepatitis B-infected health care workers. Sufficient staffing and funding, confidentiality, and prevention are the keys to a successful program.

Counseling↗

Injuries in home health care workers: an analysis of occupational morbidity from a state compensation database.

BACKGROUND: Home health services represent one of the fastest-growing segments of the US economy. Home health care workers (HHCWs) might be expected to have a high incidence and increased severity of injury because of inherent difficulty in control over their work environment, and the limited amount of research on injuries in home health care appears to support this hypothesis. METHODS: Using data on workers' compensation claims for 1995-1996 from a large state database, we calculated the incidence, frequency, and types of injuries occurring in this working population. Comparison data were drawn from nursing home (NH) and hospital-based nursing personnel. RESULTS: An incidence of 52 injuries per 1,000 workers per year was calculated; this rate lies between nursing home workers (132/1,000) and hospital-based workers (46/1,000). The percentage of indemnified (> 3 days lost-time) injuries was increased over those occurring in nursing home personnel. Mean number of days lost from work by home health workers was 44, significantly increased from the average 18 and 14 days lost by NH and hospital nursing workers, respectively. Mean indemnity payment was $1,523 and mean medical costs were $1,276 per injury. Permanent partial disability awards were made to 19 (4.9%) of the injured HHCWs during the 2-year study period; back injuries accounted for 63% (12) of these awards. Overexertion injuries and falls accounted for 63% of total injuries in this group of workers, while 13.5% occurred as a result of motor vehicle accidents. The incidence of injury attributed to motor vehicles in HHCWs was 7 per 1,000 workers per year, an order of magnitude greater than in NH and hospital workers. CONCLUSIONS: These data indicate that injuries to HHCWs, though less frequent than in their nursing home counterparts, result in greater lost time from work and accompanying costs, which may indicate greater severity of injury. Characteristics of home health work, including increased intensity and speed of work, adverse working conditions, and the necessity of motor vehicle transportation as a condition of work may be contributors to injury in this setting. Further investigation of determinants of accidents and injuries in home health care, both in the actual setting where the work takes place and in the way it is structured, is warranted.

Accidents, Occupational↗

Acute and chronic health effects due to green tobacco exposure in agricultural workers.

BACKGROUND: An epidemiological study was undertaken in Gujarat, India to study the acute and chronic health effects of occupational exposure to green tobacco. METHODS: Non-Flue Cured Virginia (FCV) tobacco is the main crop in many districts of Central Gujarat. Three villages were selected from Anand district for the study and a random sample of 685 exposed workers were examined. Six hundred and fifty-five control workers with the same socio-economic status were examined from two villages where tobacco was not cultivated. RESULTS: The overall prevalence of green tobacco sickness (GTS) was 47.0% among tobacco workers. The prevalence in women workers was 55.7% while in men workers it was 42.66%. To detect the chronic health effects prevalence of hypertension, electrocardiogram (ECG) abnormalities, and eye problems in all the workers and reproductive abnormalities in women workers, all subjects received a medical examination. The data were compared in exposed and control group but they were non-significant statistically. No case of tobacco amblyopia was detected. CONCLUSION: The prevalence of GTS among non-FCV tobacco workers is high. However, from viewpoint of severity it can be considered as mild acute nicotine toxicity, which is relieved without medication. No significant difference is observed as regards to chronic health effects among tobacco workers and control workers.

Acute Disease↗

Village health workers in Java, Indonesia: coverage and equity.

Village health workers are often the main vehicle for promoting the primary health care approach in developing countries. Services provided by these workers are expected to be more appropriate to the health needs of populations than those of clinic-based services, to be less expensive and to foster self-reliance and local participation. Because village workers are more accessible and acceptable to clients in their communities, they are expected to improve the overall coverage of services as well as equity--increased service use by poorer individuals and households. This paper presents research on coverage and equity from village health worker programs in Java, Indonesia. Rural health and nutrition projects in Java using village-level volunteers with limited training have grown since the early 1970s to include large national programs managed by the government's rural health system. Volunteer village workers are now the most extensive link between the rural population and the formal health service structure. Previous research on coverage and equity of these village worker activities is reviewed and results from the author's own study are presented. Services provided by village health workers achieve significantly higher levels of population coverage than similar clinic-based services. In most cases, village workers show no bias towards better-off clients and they may favor poorer beneficiaries. These findings show that village workers are meeting the coverage and equity objectives of the primary health care approach. However, some of the research reviewed raises questions about the ability of village worker activities to maintain these results over a longer period. The rapid expansion of these programs requires continued research, not only on coverage and equity, but also on health outcomes, costs, and participation.

Adult↗

Respiratory symptoms and lung function in poultry confinement workers in Western Canada.

OBJECTIVE: To determine whether poultry production methods impact respiratory health, and whether poultry farmers have more respiratory symptoms and lower lung function than comparison control groups. DESIGN: Cross-sectional study. SETTING: Provinces of Saskatchewan, Alberta and Manitoba during the winters of 1997 to 1999. POPULATION: Three hundred three poultry workers, 241 grain farmers and 206 nonfarming control subjects were studied. Poultry workers were further classified according to the poultry housing type in which they worked, ie, workers who worked with poultry raised on the floor (floor-based operations), which included broiler/roaster, broiler/breeder and turkey operations (n=181), and workers who worked with poultry raised in a caged setting (cage-based operations), which included egg operations (n=122). INTERVENTIONS: Subjects completed a respiratory health questionnaire, which included questions on the poultry operation and work habits, and participated in lung function testing. MAIN RESULTS: Overall, this study indicated that poultry workers report greater prevalences of current and chronic respiratory symptoms than control populations, and that the type of production method (cage-based versus floor-based) appears to influence the prevalence of respiratory symptoms and lung function values. Workers from cage-based operations report greater prevalences of current cough and wheeze, as well as lower mean values for forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% to 75% of vital capacity (FEF25-75) and FEV1/FVC than workers from floor-based facilities. Workers from cage-based facilities also reported greater prevalences of current and chronic cough and phlegm, as well as significantly lower FEF25-75 and FEV1/FVC values than nonfarming control subjects. Furthermore, grain farmers had lower FVC and FEV1 values than nonfarmers. CONCLUSIONS: The results suggest that the type of poultry production system (ie, floor- versus cage-based) appears to have an effect on the respiratory response of workers from these facilities. Further studies are required to understand the physiological mechanisms of respiratory dysfunction and the relationships concerning workplace exposure among poultry workers.

Agricultural Workers' Diseases↗

Cotinine levels and green tobacco sickness among shade-tobacco workers.

STUDY OBJECTIVE: Symptoms consistent with Green Tobacco Sickness (GTS) were found in 4% (13/331) to 15% (45/303) of the migrant, mostly Latino, shade-tobacco workers who sought medical care at a Connecticut clinic. The objective of this study was to determine whether or not shade-tobacco farm workers absorb nicotine from the tobacco leaves and have a corresponding increase in both salivary cotinine levels (a breakdown product of nicotine) and symptoms consistent with GTS. METHODS: The study utilized a prospective cohort design to evaluate salivary cotinine and symptoms consistent with GTS in a population of shade tobacco farm workers compared to a control group of nursery workers. The workers were assessed at two points in time, the early tobacco planting season and the harvest season. RESULTS: There was not a significant increase in salivary cotinine levels among shade-tobacco workers. Salivary cotinine levels over the work season did not significantly increase in shade-tobacco workers when compared with nursery workers. During the harvest season, none of the tobacco workers reported symptoms consistent with GTS. CONCLUSIONS: Migrant workers in Connecticut who harvest shade-tobacco appear to have a low-risk of occupational nicotine dermal absorption and a low incidence of GTS. The work practices associated with harvesting shade-tobacco, in addition to the fact that shade tobacco may actually have a lower level of nicotine than either burley or flue cured tobacco, may explain these results. Our study appears to reinforce the GTS prevention recommendations made by investigators in other tobacco growing regions, specifically the importance of minimizing close skin contact with tobacco leaves and avoiding dermal contact with the plants when they are wet.

Adult↗

Response of herb processing workers to work-related airborne allergens.

A group of 51 herb processing workers employed in a big herb processing facility located in eastern Poland were examined by the skin and precipitin tests with, respectively, 4 and 17 extracts of microorganisms associated with organic dusts. Out of this number, 32 workers were examined by the skin test with 7 extracts of selected herbs processed in the facility. All the subjects were asked about the occurrence of work-related symptoms. 32 healthy office workers were examined with microbial extracts as a reference group. The herb processing workers showed a high proportion of early skin reactions (after 20 min) to the extract of Gram-negative bacterium Alcaligenes faecalis (41.2%), significantly higher compared to the reference group (p<0.01). At all time intervals (20 min, 8 hrs, 24 hrs), the workers responded with a high frequency to the extract of Bacillus subtilis (respectively 72.5%, 64.7%, and 15.7%), significantly greater compared to the reference group (respectively p<0.001, p<0.001, and p<0.05). No significant differences were found between the groups of herb processing workers and referents in skin response to the extracts of Streptomyces albus and Alternaria alternata and, except for the extract of Pantoea agglomerans, in the frequency of positive precipitin reactions to microbial antigens. In the skin test with herb extracts, the highest response among workers were caused by the extracts of chamomile flowers and nettle leaves which evoked 40-65% of positive skin reactions at all time intervals. 39 out of 51 interviewed herb processing workers (76.5%) reported the occurrence of work-related general, respiratory and skin symptoms. The positive skin reactions occurred more frequently among symptomatic workers which suggests that the specific immunologic response might be implicated in etiopathogenesis of work-related symptoms in examined workers. However, in most cases the differences did not attain a significance level which indicates that there is no direct relationship between a positive immunologic response and the appearance of symptoms caused by occupational exposure to herb dust, and that most probably a considerable part of these symptoms might be also due to non-specific immunologic and/or toxic mechanisms.

Adult↗