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Respiratory health of cigar factory workers.

OBJECTIVES: To determine whether occupational exposure to raw tobacco causes respiratory or allergic diseases, an excess of respiratory symptoms, a decrease in lung function, or parenchymal changes in chest radiography among Finnish cigar workers. METHODS: This cross sectional study included all Finnish cigar workers (n = 106) exposed to raw tobacco and also a group of unexposed matched referents. Data were collected with a self administered questionnaire, flow volume spirometry, measurements of diffusing capacity of the lung for carbon monoxide, chest radiography and skin prick tests. A questionnaire was also sent to former workers of the factory. RESULTS: There were no significant differences between the groups in the prevalence of respiratory symptoms and chest radiography findings. Nine of 102 tobacco workers had pulmonary fibrosis of at least 1/0 (according to the International Labour Organisation (ILO) 1980 classification) and the corresponding figure was five for the referents. The tobacco workers tended to have a low forced vital capacity (FVC), and they had impaired forced expiratory volume in 1 second and lower means of the maximal expiratory flow at 25% of the FVC significantly more often than the referents. Diffusing capacity tended to be lower among the referents. The referents more often had atopy and earlier atopic diseases than the exposed workers. These results indicate the possibility of selection among the exposed workers. CONCLUSIONS: No excess of prevalence of respiratory symptoms in the tobacco workers was found. According to the questionnaire episodes of allergic alveolitis may have occurred in the cigar factory workers. However, in the absence of impairments in lung function and radiological changes it was not possible to distinguish humidifier fever and allergic alveolitis. In exposure conditions that include humidification of the air humidifier, fever and allergic alveolitis constitute a risk for tobacco workers. No effects were shown of exposure to tobacco dust on lung function.

Adult↗

Decreased white blood cell counts in semiconductor manufacturing workers in Taiwan.

OBJECTIVES: To assess the systematic health effects on the liver, kidney, and haematological function tests of workers in semiconductors in Taiwan. METHODS: 926 workers of a semiconductor plant in Taiwan in July 1995 were investigated. Complete blood tests including liver, kidney, and haematological functions were available from 227 workers. RESULTS: There was a significantly lower mean (SD) white blood cell (WBC) count in male workers of photolithography (5870 (1190)/mm(3), p=0.003) and implantation (6190 (1150)/mm(3), p=0.018) than that of male control workers (7350 (1660)/mm(3)). There was a significantly higher prevalence of leukopenia in male photolithography workers (6 of 20; 30%) than in male control workers (1 of 18; 5.6%), the crude odds ratio (OR) was 7.3 (95% confidence interval (95% CI) 1 to 55.6), and the multivariate adjusted OR was 8.1 (95% CI 0.83 to 78.3). The tests for serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), gamma glutamyl transferase (RGT), and creatinine were not significant among male workers. Female workers in photolithography had abnormal SGPT and RGT of borderline significance, the multivariate adjusted ORs were 9.6 (95% CI 0.86 to 107) and 6.35 (95% CI 0.53 to 75.8), respectively. CONCLUSIONS: This study suggests that leukopenia is a potential health effect in male fabrication workers of the semiconductor industry. The tasks of the process, maintenance, and equipment engineers which consisted mostly of men put them at risk for intermittent short term peak exposure to glycol ethers, ionising radiation, arsenic, or other toxins. The findings of this medical surveillance are significant; however, a further investigation of the aetiological factors and the subsequent health effects is necessary.

Adult↗

Increased risk of obstructive pulmonary disease in tunnel workers.

BACKGROUND: Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure. METHODS: Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy. RESULTS: Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV(1)) % predicted when related to years of exposure. Adjusted FEV(1) decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects. CONCLUSION: Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV(1), respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.

Adult↗

Respiratory disease among workers exposed to man-made mineral fibers.

Fibrous glass and mineral wool workers exposed to airborne man-made mineral fibers prior to 1964 were identified and followed for deaths caused by respiratory disease. Fiber exposure levels were estimated for each worker. Average fiber concentrations were very low in relation to a National Institute of Occupational Safety and Health recommendation that exposure to man-made mineral fibers less than 3.5 microns in diameter be limited to 3 fibers per cubic centimeter of air. Fibrous glass workers were exposed to about one hundredth and mineral wool workers to about one tenth of that amount. Respiratory cancer death rates were not excessive for the fibrous glass workers, but they were significantly elevated for the mineral wool workers. When respiratory cancer deaths were compared with fiber exposure levels, however, there was in no instance a strong positive correlation. There was a significant excess in nonmalignant respiratory disease deaths (excluding influenza and pneumonia) for fibrous glass workers and for the total cohort. When these nonmalignant respiratory disease deaths were compared with fiber exposure levels, however, there was in no instance a strong positive association. A special study was made of workers exposed to small diameter fibers. Respiratory cancer deaths were not in excess; however, there was an excess in nonmalignant respiratory disease deaths. This study provided no consistent evidence of a respiratory disease hazard related to exposure to man-made mineral fibers among the workers who produce these fibers. Results must be interpreted in relation to the relatively low exposure levels for these workers.

Adult↗

Musculoskeletal disorders in industrial workers of Delhi.

To study the musculoskeletal disorders in industrial workers in Delhi, 631 workers from 60 factories representing small and medium-sized enterprises located in Delhi were interviewed. Many (59.4%) of the workers had musculoskeletal disorders. Tailors, those working near furnaces, cooks, workers in buffing, checking and assembly work, and those working with chemicals had the most joint complaints. Cervical pain was more frequent in tailoring and packing work, whereas lumbar pain was more common in buffing, operators working on presses, those using hand and power tools, and those lifting heavy manual loads. Contract workers had less musculoskeletal morbidity than regular and temporary workers. Skilled workers also had less morbidity. Workers experiencing more job satisfaction reported fewer musculoskeletal disorders. The high prevalence of musculoskeletal disorders in workers needs urgent attention from the health and labor sectors. An ergonomic approach to prevention should be considered. The current manual load handling limits prescribed in the Indian Factory Rules potentially expose workers to back stress. It is also inappropriate to have separate load-lifting limits for men and women. Research is urgently required to determine the safe load handling limits for the Indian working population based on ergonomic principles. Until internationally acceptable safe limits are established, back pain should be a notifiable disease in India.

Adolescent↗

[A study on stressful life events of workers in Japan].

The experience rates of eighteen life events of Japanese workers were surveyed and the strength of each of the events was evaluated by a self-reported questionnaire. The fifteen professions surveyed included construction, transport, mailing, chemical production, banking, newspaper, TV services, commercial publishing, advertising, teaching and civil service. The number of workers who answered was 18,657 males and 4,443 females, aged 20 to 59 years. The male workers were divided and analysed in six job groups: clerical workers (n = 5,866), professionals (n = 3,696), blue collar day workers (n = 1,623), blue collar night or shift workers (n = 3,191), drivers (n = 1,663) and construction workers (n = 2,466). They were divided into groups and compared according to job, sex and five different age groups. The highest experience rate in each of the life events such as family trouble for both sexes, death of a family member, financial trouble and anxiety, death of a close friend, dissatisfactory transport to workplace or job, respectively. Comparing the experience rates between males and females we found no significant difference for five items. However, other items had higher experience rates for males than for females with the exception of family trouble. In regard to the age characteristics of each of the life events, as the age increased the experience rates of health-related life events such as the death of a spouse, child, family member or close friend and one's own illness or injury became higher. In contrast, the experience rates of items such as moving to a worse residence and failure in a school or training program became lower as the age increased for both sexes. Among job groups, construction workers had the highest experience rates of most life events except for the item of dissatisfactory transport to the workplace or job. Among other job groups, drivers had higher experience rates in the following four items: re-employment, death of spouse, divorce and financial trouble and anxiety. Blue collar day workers had higher rates for failure in school or training program and family trouble. The blue collar night or shift workers had higher rates for failure in school or training program and dissatisfactory transport to the workplace or job. The mean values of strength in six life events: re-employment, death of a family member, death of a close friend, serious physical illness, dissatisfactory transport to the workplace or job and family trouble were stronger in females than in males.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Cancer in thirty-nine nuclear industry workers: a preliminary report.

We constructed job-exposure profiles and assessed quality of health care in 39 of 47 current and former workers from a nuclear installation in the Negev whose files were referred to us for assessment of a possible work-related aspect of their tumors. The workers, all male except one, began employment at various times from the reactor construction and were engaged in different tasks in laboratory research, construction, maintenance, and service. Of those workers still living the average age was 57.9 years, with a range from 42 to 77 years of age. The average age at the time of death for the deceased workers was 57.3 years, with a range from 41 to 69 years of age, Information on past exposures to radiation and chemical agents came from employee records dosimetry, and interviews. Personal monitoring (urine assays) in 29 workers indicated the presence of various radionuclides, with higher levels found in persons with work histories in laboratory/research and development and technical/inspector job categories compared to those in administrative/service job categories. Among the 39 workers, latency between onset of exposure and first appearance of illness from tumor was 24.2 years, with a range of 5 to 34 years. Tumor distribution for these workers was as follows: hematolymphatic (n = 11 workers), gastrointestinal (n = 9), breast (n = 1 [male]), renal-urogenital (n = 8), skin (n = 1), and pulmonary (n = 8 [5 known smokers]). For all tumors except those of the respiratory tract, the first diagnosis was made more frequently in those patients under the age of 55. Observed/expected comparisons for tumor proportional incidence showed excess fractions of blood tumors in persons < 55 and > 55 years of age. Ratios were greater than unity for blood, breast (n = 1), gastrointestinal, and urogenital tumors in patients < 55 years of age and pulmonary tumors in persons > 55 years of age. The odds ratio for smoking history in patients with lung tumors compared to those with other tumors was 4.8. Nonmalignant conditions appeared at relatively younger ages. After the exposure episodes two children with major congenital anomalies were born to wives of the workers; one anomaly was fatal. Not all patients were first diagnosed for cancer following referral from the plant medical service, and delays between warning signs and symptoms and medical evaluation occurred in some. Although we lacked data on cancer incidence and population at risk, our findings suggest that earlier official assessments of risk should be reconsidered. There is a need for population-based monitoring of risk to nuclear industry workers, external quality control of their medical surveillance and care, and improvements in information delivery.

Adult↗

Occupational and longitudinal differences in health-care and non-health-care worker attitudes concerning AIDS exposure and work: evidence of professional dedication.

To assess changes in occupational preferences of health-care workers in response to the AIDS epidemic, attitudes for nine issues concerning AIDS in the workplace were gathered in 1990 and 1992. AIDS-aversive patterns strengthened for both health-care and non-health-care workers over time as AIDS incidence rose. Compared to non-health-care workers, significantly more health-care workers showed greater concern over job related AIDS exposure, and over time they also reported more approval of testing and status disclosure for AIDS. Despite these concerns, significantly more health-care workers than non-health-care workers were willing to work with an AIDS-infected coworker or boss, and significantly fewer health-care workers than non-health-care workers believed they had a right to refuse work with an AIDS-infected coworker. Training had little effect on AIDS-aversive preferences among health-care workers. But significantly more non-health-care workers with AIDS-related "protective" training reported a self-protective rejection of AIDS-infected coworkers. Implications for health-care management are explored.

Acquired Immunodeficiency Syndrome↗

Training methods and association with worker injury on Colorado dairies: a survey.

The goals of this study were to define the current methods for training entry-level workers on Colorado dairies, to measure the relationship of training methods to the incidence of work-related injuries on those operations, and to characterize the nature and cause of injuries reported by participating workers. Seventy-two workers from 15 dairies from Weld, Morgan, Larimer and Yuma counties volunteered to be interviewed privately in the language of their choice. Training methods were classified by content (task training versus safety training), method of delivery (on-the-job verbal instruction, on-the-job demonstration, on-the-job supervision, classroom- based, and / or reading materials); and instructor (supervisor and/or co-worker). The majority (84.7%) of interviewed workers were Mexican-born, Spanish-speaking males. Most workers reported the training to be a combination of verbal instruction, demonstration and supervision. Twenty-nine of 72 (40.3%) of all participants suffered at least one work-related injury in the 12 months prior to the interview. Entry-level safety training had no protective effect (P = 0.463) on the reported incidence of injury in dairy workers in the previous year. However, workers that received task-related training were four times less likely to suffer a work-related injury (P = 0.008). Training conducted by a co-worker also had a significant protective effect against work-related injuries (P = 0.028). Dairy workers identified direct contact with livestock or machinery as the main cause for work-related injuries, and most injuries occurred while medicating sick cows and milking.

Accidents, Occupational↗

Use of commercial sex workers among Hispanic migrants in North Carolina: implications for the spread of HIV.

CONTEXT: Rates of HIV and AIDS have risen among U.S. Hispanics and in migrant-sending regions of Mexico and Central America, pointing to a link between migration and HIV. However, little is known about male migrants' sexual risk behaviors, such as the use of commercial sex workers. METHODS: The prevalence and frequency of commercial sex worker use was examined among 442 randomly selected Hispanic migrants in Durham, North Carolina. Logistic and Poisson regression techniques were used to model predictors of commercial sex worker use, and descriptive data on condom use with commercial sex workers were examined. RESULTS: Twenty-eight percent of respondents reported using the services of a commercial sex worker during the previous year; rates reached 46% among single men and 40% among married men living apart from their wives. Men with spouses in Durham were less likely than other men to use commercial sex workers (odds ratio, 0.1). Among men who used commercial sex workers, the frequency of visits declined with greater education (incidence rate ratio, 0.9) and increased with hourly wage (1.1). Frequency and use declined with years of residence, although the results were of borderline significance. Reported rates of condom use with commercial sex workers were high, but were likely to fall if familiarity with a commercial sex worker increased. CONCLUSIONS: Commercial sex workers represent an important potential source of HIV infection. Educational and behavioral interventions that take into account social context and target the most vulnerable migrants are needed to help migrants and their partners avoid HIV infection.

Adult↗

Induced sputum evaluation in microwave popcorn production workers.

OBJECTIVE: Severe airways obstruction and bronchiolitis obliterans have been reported in microwave popcorn production workers and attributed to inhalation of flavoring agents. We investigated whether exposure to flavoring agents is associated with airways inflammation in popcorn production workers. METHODS: Fifty-nine workers with high exposures and 22 patients with low exposures to flavoring vapors completed a questionnaire, spirometry, and sputum induction. Sputum cell counts were categorized as "high" if greater than (and "low" if less than or equal to) the median cell counts of a healthy external control group (n = 24). We compared high- and low-exposure groups as well as all workers with control subjects. RESULTS: Neutrophil concentrations in nonsmoking workers were significantly higher than those of the healthy nonsmoking control group (p < 0.05). The smoking-adjusted odds ratio for high neutrophil count (> 1.63 x 10(5)/mL) was 3.8 (95% confidence interval, 1.3 to 11.5) in the high-exposure group compared with the low-exposure group. Sputum interleukin-8 and eosinophil cationic protein levels were higher in high-exposure workers than in low-exposure workers (p < 0.05). For the worker group, mean values of FEV1 percentage of predicted and FEV1/FVC percentage of predicted were > 95%. There were no relationships between sputum characteristics and the presence of airways obstruction. CONCLUSIONS: High exposure to popcorn flavoring agents is associated with neutrophilic airway inflammation in popcorn production workers. These data provide further evidence that popcorn production workers face a significant occupational hazard through exposure to flavoring agents.

Adult↗

Reasons for not using condoms among female sex workers in Indonesia.

The aim of this study was to gather data on condom use among brothel-based female sex workers in Indonesia and to study the reasons for not using condoms in order to provide new and existing condom promotion programs with information to improve their performance. Quantitative data were gathered by KABP surveys (n = 1450) and a condom diary with a sample of 204 female sex workers. Qualitative data were collected by conducting focus group discussions and in-depth interviews among female sex workers and pimps. Around 53% of sexual intercourses were reported to be protected, and 12% of these protected intercourses were preceded by clients' argumentation against it. Only 5.8% of sex workers consistently used condoms for a 2-week period of observation, and this figure decreased to 1.4% for a 4-week period. Reasons for not using condoms from the clients' side, as mentioned by the sex workers, were perceived less pleasure due to the condom and the belief that clients that are acquainted with the sex workers do not need protection against sexually transmitted diseases (STDs) or AIDS. The main reasons of female sex workers for not using condoms were the beliefs that boyfriends, native Indonesians and healthy-looking clients cannot spread STDs. Another reason stated was that sex workers had already taken other preventive measures, like taking antibiotics. The research also showed that pimps were not very supportive of condom use programs in Indonesia. Condom unacceptability is an important reason for not using condoms for both clients and female sex workers, whereas pimps, who are in the best position to encourage condom use, unfortunately consider condom use as a threat to their business. For the successful introduction of consistent condom use, it is necessary to design interventions for both sex workers and clients and to provide appropriate educational materials and preferred brands of condoms. Also, pimps must be involved in intervention programs.

Adolescent↗

Subjective symptoms among female workers and winter working conditions in a consumer cooperative.

Subjective musculoskeletal symptoms are more frequently complained about in cold store work and in related conditions than in normal temperature work. This cross sectional study was undertaken (a) to explore the prevalence of subjective symptoms in winter among a group of female workers engaged in classification of cold storage goods, and in a group of female checkers in several supermarkets of a large consumer cooperative; and (b) to give recommendations for improving the winter working conditions of these workers. The subjects consisted of 46 workers engaged in classification of cold storage goods, 56 checkers operating a laser scanner in supermarkets and 59 office workers (control group). Work loads for the three groups were estimated according to the recommended criteria. A self-administered questionnaire covering age, occupational career, smoking, alcohol drinking and physical exercise, present or past history of diseases, individual protective measures against cold, and subjective symptoms (54 items) was used. The air temperature of the working site at the opening time for classification workers was 4.8 degrees C which was significantly lower than those measured for the other two work places (12.1 degrees C and 15.8 degrees C). About 70 to 80% of classification workers complained of cold sensation in different body regions, as well as shoulder stiffness, and problems related to the back. The supermarket checkers and office workers had a high prevalence of cold sensation in their feet. The frequencies of using warm clothes and foot heaters, as an individual measure to work comfortably in winter among the classification workers and the checkers were significantly higher than that among the office workers. We concluded that work difficulty due to moderate cold exposure among workers in the consumer cooperative could be reduced by some physical activity as well as proper clothes.

Adult↗

[Fluorine content in the urine and in the serum of hydrofluoric acid workers as an index of health administration (author's transl)].

The behavior of fluoride ion level in the urine and in the serum was measured as an index for health care of workers exposed to hydrofluoric acid, the effect of fluorine-containing foodstuff intake by the workers being considered at the same time. For this study, 250 hydrofluoric acid workers and as a control group 1,600 non-hydrofluoric-acid workers were examined. All workers, ranging in age from 15 to 59 years old, came from the same electronics factory. Fluorides in the biological fluids were measured by using the fluoride ion-specific electrode method and the electrode potential recording method concurrently. The fluoride ion levels (geometric mean) in the urine and in the serum of the non-hydrofluoric-acid workers were determined to be 0.59 ppm and 12 ppb, respectively. Among the influences of fluorine-containing foodstuff on fluoride content in the biological fluids, the effect of black tea and/or green tea intake was particularly remarkable. In the case of the non-hydrofluoric-acid workers, the concentration increased to about double of the control value. Similarly in a diet test on volunteers, the concentration increased about six times. As for the response to tea intake with the lapse of time, the concentration in the urine specimen (spot urine, S.G. corrected: 1.024) reached the maximum value three hours after the intake. In the case of the serum specimen, the maximum value was recorded one hour after the intake, and the influence of the intake continued for several hours. These results suggest that, in the medical examination of hydrofluroic acid workers, restriction of intake of tea and in some cases even a fasting program would have to be introduced as necessary pre-conditions. Upon observation of fluorine concentration in the urine with the lapse of time of hydrofluoric acid workers restricting tea intake, it was confirmed that the trend of the day-to-day variation was small. But that of the in-a-day variation, namely, an increase in the concentration toward the end of daily working hours was obvious. By introduction of these well-regulated methods, it has become possible to properly evaluate even the influence of hydrofluoric acid on the workers irregularly exposed to a hydrofluoric acid environment having a lower concentration than that of the threshold limit value (3 ppm). However, in view of ease of collection and measurement of specimens, speed, and degree of response to the exposure, it can be concluded that the measurement of fluorine content in the urine is more advantageous as an index for the health care than that in the serum. For this reason it is desirable that the former method should be given priority from the view point of prevailing industrial hygiene laws and regulations.

Adolescent↗

Field conditions for agricultural workers in the El Paso, Texas region.

Agricultural workers labor long hours under difficult conditions in many of the nations fields and orchards. Agricultural workers are primarily minority populations, the most dominant group being Hispanic/Latino. The Rural Coalition and the Environmental and Occupational Health Sciences Institute were funded under the National Institute of Environmental Health Sciences (NIEHS) Environmental Justice Program, to investigate health and environmental issues that impact agricultural workers along the Texas-Mexican border area. A Spanish-language field conditions survey was developed and distributed to the workers entering the Sin Fronteras Organizing Project in El Paso, Texas. There were 841 valid surveys collected and analyzed for the calendar year 1998. Workers age mean was 51, with 18.6 years of work experience in agriculture. In the time period surveyed, workers labored for 7.2 hours per day. The primary crop in which they worked were chilies. Of particular concern were issues concerning food, water, and hygiene. Almost all workers stated they had access to fresh drinking water (97 percent), 20 percent did not have access to food, and 30 percent were offered alcohol for purchase. Almost one-third of the workers did not have water available for hand washing in the field. Only 8 percent of the workers reported pesticides used in the fields in which they were working; this number is lower and may be a reflection of the improved training and caution taken by the workers. Clearly additional research in the area of field conditions and the impact and enforcement of state and federal regulation needs to be carried out.

Journal Article↗

Attitudes towards co-workers affected by occupational hearing loss. II: Focus groups interviews.

This study was undertaken as a complement to a questionnaire inquiry on attitudes towards co-workers affected by occupational hearing loss (OHL). Four groups of 7 to 11 volunteer participants were recruited among respondents to the questionnaire inquiry. They were interviewed using a focus group technique. Scenarios were prepared to serve as a basis for asking questions aimed at three major objectives: (a) to characterize workers' perception of a co-worker who has an impairment involving no visible signs; (b) to identify the conditions that trigger social withdrawal and isolation behaviour among people affected by OHL, and the conditions that might make the latter decide to seek help; and (c) to define the type and methods of help that might minimize social withdrawal and isolation among hearing impaired workers. The interviews were taped and transcribed verbatim for content analysis using a phenomenological-interpretative framework. The findings can be summarized by the following description of the perception of the problem of OHL among industrial workers. The strong fear of being stigmatized leads those affected by OHL to conceal its manifestations and consequences in their everyday life. As a result, significant others, co-workers, employers and the general population are not aware of such manifestations. Within the workplace, the problem of OHL is generally seen as being inconsequential. In daily interactions among co-workers, its effects are ignored. Within the family, hearing difficulties are often not interpreted as such but they nevertheless affect the workers' significant others. People do not know how to facilitate communication with a person affected by OHL. A large scale multi-target awareness programme is proposed to demarginalize workers affected by OHL. Implications of the findings are drawn in such areas as characterization of attitudes toward workers with hearing impairment, rehabilitation for those affected by OHL, and prevention of OHL.

Adult↗

Development of a questionnaire to assess worker knowledge, attitudes and perceptions underlying dermal exposure.

OBJECTIVES: Workers' behavior is identified as an important determinant of dermal exposure and is influenced by knowledge, attitudes, and risk perceptions. Because behavior may be a significant predictor of exposure, its assessment provides a means for examining exposure and designing strategies and incentives that encourage worker protective behavior. Currently, there are no psychosocial instruments examining worker knowledge, attitudes, and perceptions with respect to dermal hazards. Accordingly, a questionnaire was developed and tested to provide an instrument for measuring worker knowledge, attitudes, and perceptions. METHODS: The questionnaire was developed on the basis of a literature review and expert consultation. Scales were constructed based on standard methods. Two worker focus groups were used to evaluate worker understanding and content validity of the KAP (knowledge, attitudes, perceptions) questionnaire. The resulting 115-item questionnaire that included scales for knowledge (N=13), attitudes (N=27), perceptions (N=15), behavior (N=8), behavioral intentions (N=15), barriers (N=13), and facilitators (N=5) was tested on 89 workers from 19 facilities. RESULTS: The concepts identified in the focus groups included worker perception of higher risk due to a poor fit and replacement frequency for personal protective equipment and cross-contamination by workers moving into work zones. Field testing of the questionnaire (N=89) yielded Cronbach's alpha reliability scores ranging from 0.87 for the self-efficacy personal protective equipment scale to 0.92 for the overall belief scale, indicating high internal reliability. CONCLUSIONS: Although further testing and refinement is needed, this survey instrument provides an initial and conceptually unique means for evaluating behavioral determinants of worker dermal exposure.

Focus Groups↗

Chromosome aberrations in tunnel workers exposed to acrylamide and N-methylolacrylamide.

OBJECTIVES: The aim of this study was to examine chromosome aberrations in 25 tunnel workers exposed to acrylamide-containing grout in injection work. METHODS: Blood samples were collected from 25 exposed and 25 unexposed tunnel workers matched for age, gender, and smoking habits. Whole blood was cultured for 50-53 hours according to conventional methods. Chromosome damage was scored in 200 metaphases per person on coded slides. The distribution of glutathione S-transferase (GST) genotypes (M1 and T1) was examined for all the workers. Exposure assessment was performed with detailed interviews and questionnaires. RESULTS: The chromosome examinations showed no statistically significant differences between the 25 exposed and 25 unexposed workers for cells with chromosome aberrations or for chromatid breaks, chromosome breaks, and chromosome gaps. The exposed workers had a significantly higher number of chromatid gaps (mean 10.6, SD 5.6) than the unexposed workers (mean 6.4, SD 4.4, P=0.004), but there was no exposure-response relationship. The limited stratum-specific numbers showed that the exposed workers with the GSTM1-/GSTT1-genotype had nonsignificantly higher frequencies of all the effect parameters than the unexposed workers; this finding indicates that individual susceptibility related to the detoxification of acrylamide and N-methylolacrylamide may have played a role in the observed effect. CONCLUSIONS: No increase in chromosome breaks or aberrations was observed for 25 workers exposed to acrylamide-containing grout during tunnel work. The increased frequency of chromatid gaps in the exposed workers may indicate a slight genotoxic effect related to exposure to acrylamide or N-methylolacrylamide.

Acrylamide↗