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PubMed2006

[Levels and clinic significance of serum soluble Fas and soluble Fas ligand in coal workers' pneumoconiosis].

OBJECTIVE: To investigate the changes of levels and clinic significance of serum soluble Fas (sFas) and soluble FasL (sFasL) in coal workers' pneumonoconiosis. METHODS: Serum levels of sFas and sFasL were determined in 52 patients with silicosis, 57 coal workers' pneumonoconiosis, 46 healthy underground coal workers' (the underground control group) and 40 healthy volunteers working on the ground (the ground control group) with a sandwich ELISA. RESULTS: Compared to the underground control and the ground control group, the serum levels of sFas and sFasL in the patients with silicosis and the coal workers' pneumonoconiosis were significantly higher (P < 0.01). Serum levels of sFas and sFasL in the underground control group were significantly higher than those in the ground control group (P < 0.01); Serum sFas levels in coal workers' pneumonoconiosis was significantly higher than those in the patients with silicosis (P < 0.01). Although the serum sFasL levels was also increased, there was no significant difference (P > 0.05). In the patients with silicosis and the coal workers' pneumonoconiosis patients, the serum sFas levels in Phase I patients combined with emphysema and simple Phase II + III patients were significantly higher than those in simple Phase I patients (P < 0.01). There was no significant difference in the serum sFasL levels among various groups with different parameters of pneumonoconiosis. In the patients with silicosis and the coal workers' pneumonoconiosis, serum levels of sFas and sFasL were not significantly altered among different duration of exposure to dusts. There was no correlation between serum levels of sFas and sFasL in the patients with silicosis while there was a slightly positive correlation between sFas and sFasL levels in the coal workers' pneumonoconiosis (r = 0.479, P < 0.05). CONCLUSION: In the patients with silicosis and the coal workers' pneumonoconiosis, the serum levels of sFas and sFasL are abnormal and associated with the development of the pneumonoconiosis. The changes of serum sFas levels may indicate the development and progression of the pneumonoconiosis. The detection of the serum sFas level may be used in the differential diagnosis for the silicosis and the coal worker's pneumonoconiosis.

Adult↗
PubMedDate not supplied

[Malingering among workers seeking disability insurance].

OBJECTIVE: Describe the frequency and characteristics of Mexican Social Security workers with malingering disorder that request disability pension. MATERIAL AND METHODS: Comparative survey made among 136 workers seen during 2001, which were divided into three groups: malingering workers (MW), workers without disability (WOD), and workers with disability (WWD). We administered the Z Test for scaled variables and Z2 Test for nominal variables to identify group differences RESULTS: The incidence ofmalingering was of 2.2/100,000 workers. Mean age was 41.9 +/- 10.1 years, 440 was the average number of days of labor disability; 51 (37%) workers were malingerers. 35 (26%) workers were work disabled and 50 (37%) without disability. Malingerers had higher level of schooling compared with WOD and WWD (p < 0.02); most worked at the Social Security (p < 0.05), with lower number of previous jobs (p < 0.05), presented longer work disability (p < 0.05). Depressive symptoms were not frequently noted (p < 0.025) and all had normal electroencephalogram and brain computed tomography studies. CONCLUSIONS: Malingering workers who request work disability pensions follow a particular pattern that differs from other workers that request disability assessment at the Social Security Institute of Mexico.

Adult↗
PubMed2006

Developing research capacity building for Aboriginal & Torres Strait Islander health workers in health service settings.

INTRODUCTION: Aboriginal and Torres Strait Islander health workers (hereafter called health workers) can play a major role in facilitating culturally appropriate health care delivery and program development through the acquisition of improved skills in the planning, monitoring and evaluation of these programs (RCB). However, many Aboriginal and Torres Strait Islander people and communities remain concerned about research and related activities. Health workers are well placed to assist communities to not only embrace research, but to be active players and promoters of relevant, appropriate and acceptable research. One means of achieving the twin goals of RCB and community acceptance and involvement in research, is through health workers undertaking research of health priority issues and evaluation of activities, such as program delivery, that are of direct relevance to their community's aim of improving or enhancing service delivery. This article outlines the development and content of a community-based RCB framework for health workers. The focus is on the major issues that enhance a proactive service delivery model using culturally appropriate research methods. Development process: The RCB framework described here was developed, over a period of time, through community workshops and consultations aimed at deriving general consensus on the key issues and components of a culturally-appropriate, community-based training process. The framework has subsequently been reviewed by Aboriginal and Torres Strait Islander community representatives from across Australia. The overall aim of the framework is to supplement current (institutionally-based) education and training resources for health workers with community-based research training modules. These modules can be tailored to provide research and evaluation skills relevant to health workers taking a more proactive role in facilitating health and wellbeing programs in their own communities. The use of collaborative consultation and participatory methods are intended to be a two-way education process. Course content: A visual pathway is used that encompasses the impact of health and practice in the community for health workers at a grass-roots level. This enables elements of the RCB process to be divided into a series of connected modules. These are: (i 'assessing' Existing Services; (ii) methods and measures for Identifying Need at various levels; (iii) important issues in Program Development; (iv) how the former contributes to Service Improvement; (v) resultant Outcomes that will impact on community and service provision; and (vi) Evaluation Methods and applying findings to service delivery. CONCLUSIONS: Active participation by the Aboriginal and Torres Strait Islander community is fundamental for effective research practices and outcomes. The aim is to provide health workers and community members with a working knowledge of research ethics and methods so that they can assist, monitor and steer the development of culturally appropriate research activities that will lead to provision of the highest quality services 'back' to the community. This RCB framework will enable health workers to be more proactive, self-reliant and self-sufficient within their community and healthcare settings.

Community Health Planning↗
PubMed1991

A comparative study of lung functions in rice mill and saw mill workers.

A lung function study was carried out to determine the relative effect of rice husk and saw dust on mill workers. The study consisted of 195 subjects of which 56 rice mill workers, 71 saw mill workers and 68 controls of similar age, sex and socio-economic condition. FVC was significantly reduced in saw-mill workers compared to both the controls and rice mill workers. Both FEV1 and PEFR/min were significantly reduced in both mill workers compared to controls. The fall in PEFR/min in saw mill workers was also significant when compared to rice mill workers. FVC was reduced after 5 years of exposure only in saw mill workers. FEV1 was reduced within a year which was further reduced after 5 years in both mill workers. PEFR/min was highly reduced within a year remained so even after 5 years.

Adult↗
PubMed1984

Changing the method for calculating quarters of coverage: the impact on workers' insured status.

The 1977 Social Security Amendments specified that, beginning in 1978, a worker would be credited with one quarter of coverage for a designated amount of annual earnings. For 1978, a worker received one quarter of coverage (up to a total of four) for each $250 in annual earnings from employment or self-employment. Before 1978, a worker who was paid $50 in wages in a calendar quarter was credited with a quarter of coverage. A person who had $400 or more in self-employment income in a year was credited with four quarters of coverage. Some workers received more quarters of coverage under the new provisions than they would have under the old, and other workers received less. Since a worker's receipt of benefits depends on his or her insured status, which is based on quarters of coverage, this change can affect a worker's eligibility for benefits. This study indicates that if $250 in annual earnings had been required for one quarter of coverage in 1977, more than 2.1 million workers would have had a change in their insured status for disabled worker benefits, and about 700,000 workers would have had a change in their insured status for survivor benefits. Those whose insured status was affected were most likely to have had marginal earnings records--for example, they had four to seven quarters of coverage when six were needed. (This effect was expected when the legislation was passed.) This article examines those whose eligibility for benefits was most likely to have been affected.

Adolescent↗
PubMed1984

Four-year evaluation of workers exposed to trimellitic anhydride. A brief report.

In a four-year clinical, immunologic, and environmental study of trimellitic anhydride (TMA) exposure in a single plant, 20 workers exposed to TMA powder were evaluated in 1979 and a total of 32 workers were evaluated from 1979 to 1983. Two distinct groups emerged before and after workplace control improvements were made in 1979. Seventeen of the original 20 workers were available for longitudinal study through 1983. Annual clinical evaluations and serum radioimmunoassays for total antibody binding and specific IgE binding to 125I TM-HSA (human serum albumin) were performed on all 32 workers. In 1979, six workers had antibody against TM-HSA, three had the late respiratory systemic syndrome, and two had TMA-induced allergic rhinitis or allergic rhinitis and asthma. One worker had antibody against TM-HSA without illness. Fifteen additional workers were evaluated longitudinally after institution of several workplace control measures. Four of these 15 workers had TMA exposure prior to environmental improvement and joined the study in 1982. The remaining 11 workers joined the study in 1982 and had at least two years of TMA exposure in the modified workplace. None of these 11 workers developed a TMA-induced immunologic syndrome or significant total or specific IgE antibody binding to 125I TM-HSA.

Adult↗
PubMed1984

A retrospective cohort mortality study among workers occupationally exposed to metallic nickel powder at the Oak Ridge Gaseous Diffusion Plant.

The Oak Ridge Gaseous Diffusion Plant (ORGDP) employed over 800 white male workers between 1 January 1948, and 31 December 1953, in the manufacture of "barrier" material that required metallic nickel powder in its production. A retrospective cohort study was conducted to determine whether persons working with metallic nickel powder have a higher mortality from cancers of the respiratory tract than non-nickel workers. A comparison group was defined as all white males employed at ORGDP sometime between 1 January 1948, and 31 December 1953, who had no indications of occupational involvement in barrier production. This group comprised over 7 500 workers. Vital status determination has been completed up to 31 December 1977, allowing at least 24 years of follow-up for all persons in the study. Death certificates were available for 97% of the deaths among the nickel workers and non-nickel worker groups. End-points of interest were selected site-specific cancers and the general overall pattern of disease-specific mortality. Mortality rates in the nickel workers and non-nickel worker groups were compared with those for the white male population of the United States and with each other. There was no evidence of increased mortality due to lung cancers or nasal sinus cancers in nickel workers. Increases (not statistically significant) in mortality due to cancers of the buccal cavity and pharynx, and of the digestive system were observed in the nickel worker group, compared with the non-nickel worker group.

Adolescent↗
PubMed1994

Immunologic findings in confectionary workers.

BACKGROUND: Food allergies are frequent in the general population. There are however, few studies of immunologic responses among workers in the confectionary industry. OBJECTIVE: To assess immunologic and clinical findings of workers in a confectionary plant. METHODS: Immunologic (skin tests and serum IgE) and respiratory findings (symptoms and lung function) were studied in a group of 71 confectionary workers (mean age: 35 years and mean exposure: 11 years). RESULTS: Skin prick testing with food extracts used in the manufacturing of candies and pastries demonstrated that the most frequent positive skin reaction occurred with extracts of cacao (31%), followed by reactions to chocolate (9%), cocoa (6%), hazelnut (6%), and sugar (2%). Increased serum IgE levels were found in 13.0% and increased IgM serum levels in 52.1% of these confectionary workers. The prevalence of asthma (26.1%) and dyspnea (26.1%) in workers with positive skin tests was significantly higher than in workers with negative skin tests (asthma: 2.0%, P = .004; dyspnea: 4.1%, P = .001). There was a high prevalence of acute respiratory symptoms during the work shift, but no significant association with immunologic tests was found. Similarly, both skin test positive and skin test negative workers exhibited significant across shift changes in lung function; however, no significant differences in baseline lung function or across-shift changes were noted between skin test positive and negative workers. Pre-shift administration of disodium cromoglycate (DSCG) significantly diminished across-shift reductions in FEF50 and FEF25 for both skin test positive and skin test negative workers. CONCLUSIONS: These data suggest that exposure to environmental factors in confectionary plants is associated with frequent respiratory symptoms of an irritative nature. Specific skin testing may be useful in characterizing confectionary workers at risk for the development of occupational asthma.

Adult↗
PubMed1993

Neurobehavioural effects on workers in a video tape manufacturing factory in Singapore.

This study was carried out in a video tape manufacturing factory in Singapore where workers were exposed to mixed solvents consisting of methyl ethyl ketone (MEK), cyclohexanone (CHE), tetrahydrofuran (THF), and toluene (TOL). The objectives were to quantify workers' exposure to the various solvents and to evaluate if there were any neurobehavioural changes among the workers compared to controls. Nineteen exposed workers out of the workforce of forty-five were studied. Twenty-six workers (with no exposure) matched for ethnic group, age, and years of education served as controls. Eight-hour personal environmental samples were analyzed for the 19 workers along with symptom questionnaires, clinical examinations, and neurobehavioural tests including the Santa Ana Dexterity, Finger Tapping, Digit Span, and Visual Reproduction tests. The mean TWA concentrations for MEK, THF, CHE, and TOL were all below the current American Conference of Governmental Industrial Hygienists Threshold Limit Values (TLV). However, the total solvents concentration index exceed unity in one of the work areas. Significant differences were observed for prevalence of headache, and eyes and nose irritation among the exposed workers. There were also significant differences for the Santa Ana test for both-hands, Digit Span test and Visual Reproduction test. However, no dose-effect relation between behavioral scores and airborne solvent exposure was noted. The study suggests that solvent-exposed workers in video tape manufacturing plants may have poorer visual motor control and recent memory impairment (visual and verbal) than unexposed workers. Dermal absorption of solvents may have played a role in these results by increasing workers exposure.

Adult↗
PubMed1998

Cytochrome P450 1A1 MspI polymorphism and urinary 1-hydroxypyrene concentrations in coke-oven workers.

Coke-oven workers are regularly exposed to a high concentration of the benzene-soluble fraction (BSF) of total particulates, which are comprised mainly of polycyclic aromatic hydrocarbons (PAHs). A metabolite of pyrene, 1-hydroxpyrene (1-OHP), is readily measured in the urine of exposed individuals. Epidemiological studies have shown that P4501A1 (CYP1A1) genotypes are associated with PAH-related lung cancer risk. The purpose of this study was to investigate whether CYP1A1 MspI genotypes modulate the relationship of individual occupational exposure to air BSF to urinary 1-OHP concentrations among coke-oven workers. We monitored individual breathing zone air BSF over 3 consecutive days in 80 coke-oven workers in Taiwan from August 1995 to February 1996. Exposure was also dichotomized by work area (topside oven workers and sideoven workers). Preshift urine on the morning of day 1 and postshift urine on the afternoon of day 3 were measured by fluorescent spectrophotometry, and blood samples were analyzed to determine the relative distributions of CYP1A1 MspI polymorphisms. The frequency of the MspI homozygous variant genotypes of CYP1A1 was 15%. Multiple linear regression showed significant effects of individual occupational exposure to air BSF and preshift 1-OHP on postshift urinary 1-OHP concentrations (P = 0.002 and P < 0.001, respectively). After adjusting for preshift 1-OHP concentrations and air BSF, subjects with the homozygous variant genotype have a 2-fold higher postshift 1-OHP levels than the combined wild-type and heterozygous (P = 0.04). In addition, a positive trend was found in postshift 1-OHP and across-shift change of 1-OHP (postshift 1-OHP - preshift 1-OHP) in decreasing order, as follows: topside oven workers with the homozygous variant trait, topside oven workers with the heterozygous variant trait, sideoven workers with the homozygous variant trait, and sideoven workers with the heterozygous trait (P < 0.001). We conclude that CYP1A1 MspI variant genotype can modify the metabolism of PAHs in coke-oven workers.

Adult↗
PubMed2006

A 5-year follow-up study on respiratory disorders and lung function in workers exposed to organic dust from composting plants.

OBJECTIVES: To evaluate acute and chronic effects of long-term exposure to organic dust on respiratory disorders and lung function among employees at 41 composting facilities in Germany. METHODS: A total of 218 compost workers and 66 control subjects were enrolled in the cohort. They were evaluated using a standardized questionnaire, a clinical examination, and spirometric measurements. Changes of symptoms, respiratory disorders, and lung function were determined in a first survey after 5 years of exposure in 123 compost workers and 48 controls. Exposure measurements were performed at six composting facilities for respirable dust, cultivable microorganisms, and endotoxins. RESULTS: Exposure measurements revealed high concentrations of thermo-tolerant/thermophilic actinomycetes and filamentous fungi in the bio-aerosols at the composting sites. A significantly higher job fluctuation was observed among the compost workers compared to control subjects (95 vs. 18; p < 0.05). Compost workers reported a significantly higher prevalence of mucosal membrane irritation (MMI) of the eyes and upper airways than control subjects. Conjunctivitis was diagnosed significantly more often in compost workers. Forced vital capacity in percent of predicted (FVC%) of the non-smoking compost workers declined significantly (-5.4%) during the observation period compared to control subjects. The decline of FVC% in 16 compost workers exceeded 10% of initial values. A significant increase was observed in the number of compost workers suffering from chronic bronchitis (RR = 1.41; 95% CI = 1.28-1.55). Allergic alveolitis was diagnosed clinically in two compost workers. CONCLUSIONS: The exposure to organic dust at workplaces of composting facilities is associated with adverse acute and chronic respiratory health effects, including MMI, chronic bronchitis, and an accelerated decline of FVC%. The pattern of health effects differs from those at other workplaces with exposures to organic dust possibly due to high concentrations of thermo-tolerant/thermophilic actinomycetes and filamentous fungi at composting plants.

Agricultural Workers' Diseases↗
PubMed2004

Workers' compensation costs: still a challenge.

The workers' compensation system in the United States, comprised of independent state based and national programs for federal workers, covers approximately 127 million workers and has evolved and grown since its inception in 1911. Coverage has significantly broadened in scope to allow for the inclusion of most occupational injuries and illnesses. The cost of workers' compensation care has also increased. Some of the cost drivers have been identified,and various approaches have been taken to address medical cost containment. There is a need to balance cost control with ensuring benefit adequacy and quality of medical care. It is likely that managing workers' compensation costs will continue to be a challenge in the foreseeable future. The cost of workers' compensation care affects all stakeholders including workers, employers,providers, state workers' compensation regulators, legislatures,and insurers. A continued commitment to quality, accessibility to care, and cost containment, and being alert to emerging issues that can affect these elements, will help ensure that workers are afforded accessible, high quality, and cost-effective care.

Cost Control↗
PubMed2003

Management of return-to-work programs for workers with musculoskeletal disorders: a qualitative study in three Canadian provinces.

In this qualitative research project, researchers in three Canadian provinces explored the perceptions of many different actors involved in return-to-work (RTW) programs for injured workers, studying their views on successful RTW strategies and barriers to/facilitators of the RTW process, then analyzing the underlying dynamics driving their different experiences. Each research team recruited actors in a variety of different workplaces and key informants in the RTW system, and used a combination of in-depth, semi-structured interviews and focus groups to collect data, which were coded using an open coding system. Analysis took a social constructionist perspective. The roles and mandates of the different groups of actors (injured workers; other workplace actors; actors outside the workplace), while sometimes complementary, could also differ, leading to tension and conflict. Characteristics of injured workers described as influencing RTW success included personal and sociodemographic factors, beliefs and attitudes, and motivation. Human resources managers and health care professionals tended to attribute workers' motivation to their individual characteristics, whereas injured workers, worker representatives and health and safety managers described workplace culture and the degree to which workers' well-being was considered as having a strong influence on workers' motivation. Some supervisors experienced role conflict when responsible for both production quotas and RTW programs, but difficulties were alleviated by innovations such as consideration of RTW program responsibilities in the determination of production quotas and in performance evaluations. RTW program success seemed related to labor-management relations and top management commitment to Health and Safety. Non-workplace issues included confusion stemming from the compensation system itself, communication difficulties with some treating physicians, and role conflict on the part of physicians wishing to advocate for patients whose problems were non-compensable. Several common themes emerged from the experiences related by the wide range of actors including the importance of trust, respect, communication and labor relations in the failure or success of RTW programs for injured workers.

Accidents, Occupational↗
PubMed1992

Workers' disability and return to work.

A severe injury on the job often results in a medical recovery period requiring either a temporary or long-term absence from work. Rehabilitation interventions emphasizing return to work may facilitate recovery and prevent workers from becoming unemployed. A review of the current literature suggests a direct relationship between workers' demographic and disability-related characteristics, early referral to rehabilitation and successful return to work. This article describes findings from a research study designed to investigate factors associated with the return to work of injured workers. Data from 200 workers' compensation cases from a large automobile manufacturing employer in the state of Michigan were analyzed in terms of workers' demographics and other characteristics including type and severity of injury, cause of injury, type of medical intervention received, disability status, worker's job experience and wages before injury; disability costs to employer; the provision of vocational rehabilitation services; and return-to-work outcomes. Variables found to be significantly related to return to work outcomes included workers' age, education, wages before injury, job seniority and severity of the injury. Workers who successfully returned to work had higher seniority in their jobs, more education and were paid higher wages. Workers whose injuries were more severe and longer lasting, were less likely to return to work. Back impairments appeared to be a particular risk factor for return to work regardless of vocational rehabilitation intervention.

Accidents, Occupational↗
PubMed1998

Perceived efficacy of pain clinics in the rehabilitation of injured workers.

OBJECTIVE: To assess the perceived efficacy of pain clinics in the rehabilitation of injured workers among four groups of professionals. DESIGN: A questionnaire was given to 351 subjects representing four professional groups: physicians, vocational rehabilitation counselors, staff at pain clinics, and employees of a workers compensation program. Subjects rated the effectiveness of pain clinics in eight specific functions, estimated the percentage of workers who return to work after pain clinic treatment, and indicated how soon after injury a worker should be referred to a pain clinic. RESULTS: Pain clinic staff consistently gave the most favorable ratings and workers compensation employees the least favorable ones. There was good agreement across professional groups regarding the need for early referral of injured workers to pain clinics and the specific functions that pain clinics carry out relatively well. Clinics were ranked as most effective in reducing workers' use of opiates, and as least effective in reducing workers' pain. Return-to-work estimates varied significantly across professional groups. Within professional groups, subjects with high estimates gave more favorable overall ratings to pain clinics. CONCLUSIONS: The results provide a profile of the perceived effectiveness of pain clinics in various functions and highlight the importance of getting accurate information about return to work rates following pain clinic treatment. They suggest that workers are not referred to pain clinics early enough.

Accidents, Occupational↗
PubMed2004

Use of attorneys and appeal filing in the Washington State workers' compensation program: does patient satisfaction matter?

LEARNING OBJECTIVES: Specify the frequency with which injured workers in Washington State's compensation system retained an attorney or filed an appeal, and the personal and job-related correlates of these actions. Analyze the relationship between workers' legal actions and their satisfaction in two domains: how well the claim was managed administratively, and how well the worker and claim manager communicated with one another. Characterize the relationship between retaining an attorney and long-term disability. ABSTRACT: Little is known about how often injured workers retain attorneys or file appeals in the workers' compensation system. We conducted a population-based study to examine the frequency of attorney retention and appeal filing in the Washington State workers' compensation program and the factors related to this event. Data for the study were provided by a survey conducted on 804 injured workers who were interviewed an average of 159 days after claim receipt. Attorney retention and appeal filing were examined up to 28 months later. Seven percent of the workers either retained an attorney or filed an appeal. Workers who were less satisfied with claims administration procedures were more likely to retain an attorney or file an appeal (P<0.05). The average length of time from claim receipt to attorney retention (368 days) suggests that retaining an attorney is a correlate rather than a predictor of long-term disability.

Adolescent↗
PubMed2002

Validity and utility of community health workers' estimation of kava use.

OBJECTIVE: Estimating illicit substance use in epidemiological studies is challenging, particularly across ethical, cultural and language barriers. While developing the methods for a case-control study of the effects of heavy kava consumption among Aboriginal people in remote Northern Territory (NT), we examined the validity and utility of alternative methods for estimating exposure. METHODS: We assessed the level of agreement between a consensus of Aboriginal health workers in two different communities using interviews conducted with community members and health workers and individuals' self-reported kava consumption. Exposure measures included history of kava use, current kava use and history of heavy use. Agreement between a health worker consensus classification and individuals' self-report was analysed and agreement among several health workers in a consensus classification without self-report was assessed. RESULTS: Health workers concurred about an individual's history of kava use (k=0.83), current use (k=0.43) and also level of use (k=0.33). There was very good agreement between health workers' consensus and self-reported history of use (k=0.77). Agreement among health workers about current kava use was poor (k=0.08), while there was fair agreement between health workers and self-reported heavy kava users (k=0.36). Data from review of clinic patient notes supported agreement between consensus classification and self-reported history and level of use (k=0.39). CONCLUSIONS: Self-reported kava use may be a poor estimate of current use especially when obtained from interviews away from a confidential clinic setting. Consensus classification by knowledgeable Aboriginal health workers provided comprehensive coverage, efficiently and with greater reliability and assisted to identify 'excessive' kava use.

Community Health Workers↗
PubMed1998

Evaluation of chronic respiratory effects in the potato processing industry: indications of a healthy worker effect?

OBJECTIVE: To investigate the occurrence of chronic respiratory effects of exposure to organic dust in the potato processing industry. METHODS: Self reported chronic respiratory symptoms and spirometric lung function were assessed in a cross sectional study among 135 potato processing workers. A comprehensive study of current exposure to dust, endotoxin, and potato antigens had been performed previously. Workers were grouped into low and high exposure categories for each of the three exposure indices. Relations between exposure concentrations and respiratory health variables were investigated either by calculating prevalence rate ratios or by performing linear regression analyses. Atopy was assessed by measuring total immunoglobulin E (IgE) and specific IgE to five common aeroallergens in serum samples of workers. RESULTS: Evident relations between current exposure indices and respiratory health in the entire group were not found. Workers employed < or = 5 years showed a two-fold higher prevalence of respiratory symptoms, lower lung function, and higher endotoxin exposure than workers employed for > 5 years. Also, atopy was more prevalent in workers employed < or = 5 years. After stratification for duration of employment, negative effects of endotoxin on lung function among workers employed < or = 5 years were suggested. CONCLUSIONS: This study does not show chronic respiratory effects of exposure to organic dust in the potato processing industry, despite the fact that the levels of exposure to endotoxin found in this industry have been reported to be associated with decreases in lung function in other occupational settings. A likely explanation for not detecting apparent effects might be that many symptomatic workers drop out of this industry a few years after starting the job, suggesting a healthy worker effect.

Adult↗