Tetrahydrofuran poisoning after occupational exposure.
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OBJECTIVES: A cross sectional study was undertaken to assess lung health among plumbers and pipefitters. Respiratory symptoms, lung function, and radiographic changes among 99 actively employed plumbers and pipefitters with > or = 20 years of union membership were compared with 100 telephone workers. METHODS: A respiratory symptom questionnaire was administered, including smoking and occupational histories. Spirometry was conducted according to standard criteria. Posteroanterior chest radiographs were evaluated by two experienced chest physicians, with a third arbitrating disagreed films. Members of the union were categorised as pipefitters (n = 57), plumbers (n = 16), or welders (n = 26), based on longest service, and compared with the telephone workers and internally (between groups). Lung health was also compared with employment in several work sectors common to Alberta for time, and for time weighted by exposure to dust and fumes. RESULTS: Compared with the telephone workers, plumbers and pipefitters had more cough and phlegm, lower forced vital capacity, and more radiographic changes (20% with any change), including circumscribed (10%) and diffuse pleural thickening (9%). None of the plumbers and pipefitters had small radiographic opacities. Among the three subgroups of workers, plumbers had the highest prevalence of radiographic changes. Both plumbers and pipefitters showed higher odds ratios for cough and phlegm than the welders. No differences between groups were found for lung function. Indicators of lung health were not related to work in any sector. CONCLUSIONS: Plumbers and pipefitters had increased prevalence of symptoms suggestive of an irritant effect with no evidence of bronchial responsiveness. The chest radiographs showed evidence of asbestos exposure, especially in the plumbers, but at lower levels than previously reported. Health screening programmes for these workers should be considered, although the logistical problems associated with screening in this group would be considerable.
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A sampling device (Robbins device) was used to expose brass, copper, and polyvinyl chloride plugs to potable water contaminated by Legionella pneumophila serogroup 1. Plugs were removed at approximately 1-week intervals and cultured. The colonization rates were polyvinyl chloride, 70; copper, 31; and brass, 25%. Quantitative cultures revealed that polyvinyl chloride was most heavily colonized, whereas brass was least colonized. We conclude that materials used in plumbing systems are readily colonized by Legionella and that the Robbins device provides a means for testing such materials in an in situ setting.
A low nutrient medium, dilute peptone, and reduced incubation temperatures (25 or 30 degrees C) were used to recover bacteria from dental unit water supply. Significantly greater numbers of bacterial colony-forming units were recovered on the dilute peptone medium than on the enriched media, blood agar or trypticase soy agar. Lower incubation temperatures yielded greater numbers of colony-forming units on all media. The bacterial population in dental unit water supply following stagnation in the supply lines and flushing of the lines was studied using dilute peptone incubated at 25 degrees C. No significant differences in the numbers of colony-forming units were found in stagnant water versus fresh water. Flushing the water lines for 10 min did not significantly reduce the numbers of colony-forming units.
In this paper we describe a simple method, noncorrosive to pipes, for the eradication of Legionella pneumophila from potable water systems. This method is based on the systematic purging of the pipe networks with cold water containing 1-1.5 mg residual chlorine/L. In the hot water system, a new pipe bypassing the water heater was installed, whereas in the air conditioning system, the circuit is purged with water from the tap water system. The feasibility of this method was studied in two hotels in which the presence of Legionella was detected despite treatment of the water by the hyperchlorination method. The evolution of the presence of Legionella was studied by culture and polymerase chain reaction. Eighty samples from hotel A and sixty-seven samples from hotel B were analyzed during the time that the eradication method was applied. Our results showed that this method permitted the effective elimination of L. pneumophila after 5 months in hotel A and 7 months in hotel B.
OBJECTIVE: The objective of this study was to examine the relationship between subjective perceptions of the quality of housing among mental health consumers and both client characteristics and objective measures of the client's neighborhood. METHODS: A cross-sectional survey of a random sample of 468 male clients who were recruited from three mental health centers in Connecticut was used to assess client characteristics, including sociodemographic and clinical status, and measures of subjective quality of housing that reflected perception of both the client's residence and the neighborhood. Data describing the objective characteristics of the 233 census-tract block-group neighborhoods in which clients lived were obtained from the 2000 decennial census, from which three measures were created by using principal components analysis: average household income, affordability, and availability of plumbing and cooking facilities. Ordinary-least-squares regression analyses were used to identify client and neighborhood correlates of subjective quality of housing. RESULTS: Neither psychiatric diagnosis nor substance abuse were found to be significantly associated with any of the subjective housing quality measures. Clients who were living in their own place with others, those who were less bothered by side effects of medications, and those who were living in higher-income neighborhoods were more satisfied with the overall quality of their housing. CONCLUSIONS: Client assessments of subjective quality of housing, both overall and along specific subdimensions, are largely independent of commonly used diagnostic and symptom measures of mental health status. Consumers' subjective experience of housing quality are significantly associated with objective measures of neighborhood characteristics, particularly the mean household income of the neighborhood.
Hydrogen sulfide poisoning is a rare but devastating injury. Four of 8 cases of toxic inhalation of hydrogen sulfide are presented with special attention to the life-threatening complications. Four patients died at the scene of the accident and the remaining 4 had been hospitalized in the Intensive Care Unit (ICU). One patient died in the hospital from cardiogenic pulmonary edema and circulatory failure (pulmonary wedge pressure > 30 mmHg) and 3 patients left the hospital in good health although they presented serious complications. One of them left the hospital with a temporary pacemaker, and 1 of the 2 others died after two months owing to myocardial infarction. The authors discuss in detail the clinical features of this condition and emphasize the need for urgent and appropriate therapy as well as the need for safe environmental conditions.
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This article discusses the issue of lead contamination of drinking water, noting the various regulatory-driven measures that have been adopted in the U.S. since 1986 to address this public health issue. The article summarizes the literature on the dynamics of tap water lead contamination and discusses this widespread source of lead exposure in the context of the latest research evidence.
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Municipal sewage treatment plant workers are potentially exposed to a multitude of industrial chemicals and pathogenic microorganisms. A questionnaire survey of working habits, lifestyle and symptoms of illness was conducted among 189 municipal sewage treatment plant workers processing between three and ten million gallons of wastewater daily in 16 plants in New York State between March and July of 1984. Water treatment plant workers in the same cities comprised the comparison group. Sewage workers reported a significantly higher frequency of headache, dizziness, sore throat, skin irritation and diarrhea within the month immediately preceding receipt of the questionnaire, after controlling for various possible confounders. Eye and skin irritation were significantly associated with exposure to mutagens. The health significance of these findings and possible sources of error in assessing risk are discussed.
Pleural thickening is the most common roentgenographic manifestation of past asbestos exposure. In addition to pleural thickening serving as a specific market of exposure, discrete (plaques) and diffuse pleural fibrosis are important abnormalities because they have been found to be associated with increased risk for other asbestos-related sequelae and to themselves have an adverse effect on pulmonary function. We review here the results of an evaluation of a cohort of asbestos-exposed workers, plumbers and pipefitters, who were consecutively enrolled in a large cross-sectional prevalence study. Among the 681 male participants, pleural abnormalities were associated with decreased values of forced vital capacity, an effect independent of ILO profusion grade. The risk for pleural disease was unexplained by smoking status. Diffuse pleural thickening was more common and was associated with greater decrements in function than was discrete thickening.
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Sanitary reform, especially that required by the Public Health Acts (1872, 1875) needed a well trained body of Sanitary Inspectors. The Sanitary Institute and other professional organisations set about improving the qualifications and standing of the people who were charged with creating a healthier urban environment on a day-to-day basis. The structures created at that time have changed much, but we can still recognise the posts, the professional associations and the journals that were created in late Victorian times. This is a testament to the quality and flexibility of the pioneering work done a century ago.
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