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PubMed2003

DOTS for temporary workers in the agricultural sector. An exploratory study in tuberculosis case detection.

INTRODUCTION: This study was conducted in the Boland health district of the Cape Winelands of South Africa where there is a high tuberculosis incidence and prevalence. A survey conducted on 211 farms in the study district during 1998, reported that 65% (n = 9042) of all workers on these farms, were temporarily employed. Temporary farm workers live in communities either within or the outskirts of the boundaries of the Boland health district, from where they are transported to work daily. RESEARCH OBJECTIVE: To estimate the point prevalence of sputum smear-positive tuberculosis among temporary farm workers in the Boland health district, and to determine whether temporary farm workers diagnosed with tuberculosis, have access to anti-tuberculosis treatment. STUDY DESIGN: The study took the form of a cross-sectional active case finding survey amongst adult temporary farm workers (not living on farms) on the four study farms in the Boland health district. RESULTS: Data was analysed using the Epi Info Version 6 computer programme. Four (4) existing (self-reported) tuberculosis cases were identified and six (6) previously undiagnosed new sputum smear-positive cases of tuberculosis were detected. The total point prevalence was 10 cases of tuberculosis in the cohort of temporary farm workers, resulting in a point prevalence rate of 2,809 cases per 100,000 temporary farm workers (95% CI 1,090-4,527). If the four (4) self-reported cases of tuberculosis are excluded in the calculation, the point prevalence of new sputum smear-positive tuberculosis cases is six (6) and the prevalence rate 1,685 cases per (95% CI 468-2909). Of the four self-reported tuberculosis cases, one indicated that their supply of medication was depleted, whereas the other three indicated that they had the required treatment at home. DISCUSSION: Tuberculosis is a major health problem in this region of South Africa and the incidence is projected to increase in correlation with the increasing prevalence of HIV/AIDS. Recent legislative changes in South Africa have resulted in a trend where farmers decrease their permanent work force and increase their use of a temporary work force. The nature of temporary employment in the agricultural industry creates potential difficulties for farm workers to access tuberculosis health care. The early detection and effective case management of this high-risk group presents a special challenge to the South African health community.

Agricultural Workers' Diseases↗
PubMed1992

Airway injury in swine confinement workers.

OBJECTIVE: To determine whether work-related respiratory symptoms are indicative of underlying lung disease among swine confinement workers and, if so, to identify whether respiratory changes were more indicative of airway or of interstitial lung injury. DESIGN: Nested case-control study within a population-based longitudinal study. SETTING: University hospital. PARTICIPANTS: Study participants were randomly selected from a group of 207 swine confinement workers followed longitudinally. Of these, 43 workers with respiratory symptoms were identified, and 31 were randomly selected for inclusion in this study. Three control groups (swine confinement workers, neighbor farmers, and blue collar workers) without work-related respiratory symptoms were frequency-matched by age, sex, and smoking status to the symptomatic swine confinement workers. MEASUREMENTS: Spirometry and lung volumes, diffusing capacity of carbon monoxide, chest radiograph, methacholine airway challenge, and bronchoalveolar lavage were done. An endobronchial biopsy was done in the last 27 participants evaluated. RESULTS: Although spirometric measures of airflow were similar between the symptomatic swine confinement workers and the three control groups, swine confinement cases were found to have significant elevations in residual volume (126.5 +/- 28.2 L) when compared to swine confinement controls (115.4 +/- 38.4 L; P less than or equal to 0.05), neighborhood farmer controls (101.1 +/- 29.4 L; P less than or equal to 0.005), and blue collar controls (106.4 +/- 30.4 L; P less than or equal to 0.05). Swine confinement cases also had an enhanced airway response to inhaled methacholine and had thickening of the epithelial basement membrane of the lobar bronchi. No parenchymal injury was observed in the swine confinement cases. CONCLUSIONS: Our findings suggest that swine confinement workers who have work-related respiratory symptoms are at risk for airway, but not parenchymal, lung injury, and that spirometry may not accurately reflect the extent of airway injury.

Adult↗
PubMed1998

Device evaluation and coverage policy in workers' compensation: examples from Washington State.

Workers' compensation health benefits are broader than general health benefits and include payment for medical and rehabilitation costs, associated indemnity (lost time) costs, and vocational rehabilitation (return-to-work) costs. In addition, cost liability is for the life of the claim (injury), rather than for each plan year. We examined device evaluation and coverage policy in workers' compensation over a 10-year period in Washington State. Most requests for device coverage in workers' compensation relate to the diagnosis, prognosis, or treatment of chronic musculoskeletal conditions. A number of specific problems have been recognized in making device coverage decisions within workers' compensation: (1) invasive devices with a high adverse event profile and history of poor outcomes could significantly increase both indemnity and medical costs; (2) many noninvasive devices, while having a low adverse event profile, have not proved effective for managing chronic musculoskeletal conditions relevant to injured workers; (3) some devices are marketed and billed as surrogate diagnostic tests for generally accepted, and more clearly proven, standard tests; (4) quality oversight of technology use among physicians may be inadequate; and (5) insurers' access to efficacy data adequate to make timely and appropriate coverage decisions in workers' compensation is often lacking. Emerging technology may substantially increase the costs of workers' compensation without significant evidence of health benefit for injured workers. To prevent ever-rising costs, we need to increase provider education and patient education and consent, involve the state medical society in coverage policy, and collect relevant outcomes data from healthcare providers.

Cost Sharing↗
PubMed1999

Injured workers' perceptions of case management services. A descriptive study.

This article describes the findings from a study of injured workers conducted as part of a multifaceted evaluation study of a case management program. The sample consisted of workers who filed a workers' compensation claim between January 1 and September 30, 1995. Data collection consisted of written surveys (n = 45), personal interviews (n = 27), and telephone interviews (n = 16). The findings from this study provided many insights into the injured workers' personal and work experiences, and, in particular, their perceptions of their experience with the nurse case management program. Workers satisfied with services described the nurse case manager (NCM) as having the ability to see the "big picture," to develop appropriate goals, and to anticipate client needs. Dissatisfied workers reported feeling unimportant in terms of service provision. They reported feeling that "the system" did not respond to their needs, and that the NCM was uninterested and disrespectful. This vivid portrayal of workers' experiences and perceptions of case management services provides valuable information about the world view of the injured worker.

Accidents, Occupational↗
PubMed2000

Bronchopulmonary pathology in workers exposed to organic fodder dust.

The purpose of this study was to investigate work-related respiratory symptoms, the prevalence of chronic lung diseases and ODTS, and to study the lung function and bronchial hyperresponsiveness in the workers of Ukrainian fodder production facilities. 240 workers of two Ukrainian fodder production plants have been examined. Dust concentrations in the air of working zone were different, reaching 48.2 mg/m(3) in the first plant and 16.8 mg/m(3) in the second. Endotoxin levels were 240.0 ng/m(3) and 1.8 ng/m(3) respectively. The length of service at the first plant exceeded 2 times that at the second. In the actual research the investigation of respiratory symptoms, lung function and bronchial reactivity was carried out. A comparison between animal feed workers and internal controls revealed work-related symptoms. The predominant symptomatic and lung function effects indicate a clinical picture related to chronic bronchitis. The prevalence of chronic bronchitis was 26.4 +/- 4.0% at the first plant and 8.8 +/- 4.8% at the second one (p < 0.01). The prevalence of respiratory troubles was related to dust exposure more strongly that to smoking. 39.7 +/- 4.4% of exposed workers at the first plant and 14.7 +/- 6.0% at the second one revealed organic dust toxic syndrome (ODTS). In 47.9 +/- 7.2% of workers with ODTS, this syndrome was associated with chronic bronchitis. Examination of lung function revealed obstructive changes which were more expressed in exposed workers of the first plant. Lung function clearly decreased with increasing duration of employment. Obstruction of small bronchi and bronchial hyperresponsiveness (registered in 74.7% of workers) were the early signs of respiratory troubles in exposed workers.

Adult↗
PubMed1992

Workers' compensation: 1984-88 benchmark revisions.

About 93.1 million workers were covered under workers' compensation laws in 1988--an increase of 11 percent from the 1984 total. Benefit amounts totaled $30.7 billion--an increase of about 56 percent since 1984. Of the total payments made under the workers' compensation program, $17.6 billion went to disabled workers, $1.6 billion to their survivors, and $11.5 billion for medical care. The Social Security Administration (SSA) is interested in measuring economic security in the United States, and workers' compensation plays a large role in that measurement. This article represents one part of our overall effort to determine the roles the various income-maintenance programs play in helping citizens of the United States achieve economic security. The figures presented here provide readers with an opportunity to review workers' compensation program operations during much of the 1980's. Workers' compensation is also important to SSA because that program is directly related to the Social Security Disability Insurance program. Since 1965, Social Security disability benefits have been subject to reduction if the beneficiary also receives workers' compensation and the combined benefits exceed 80 percent of previous earnings. In addition, SSA has been directly involved in providing income maintenance for disability from work-related diseases since 1969 when the Federal Black Lung benefits program was established.

Humans↗
PubMed1990

[Immunologic status, respiratory symptoms and ventilatory function in soybean-processing workers].

Immunological and respiratory findings were studied in a group of 19 male soy-bean workers. A group of 31 control workers were examined for the prevalence of respiratory symptoms and 20 control workers were included in the immunological study. All soy-bean workers had positive immediate skin reaction to soy-bean dust, 18 to soy antigen after separation from oil, three to lecithin antigen and only one to soy oil. Only three soy-bean workers had increased levels of specific IgE. Among 20 control workers, 19 reacted to soy-bean dust, 20 to soy after separation of oil and none to soy oil. One demonstrated increased specific IgE. The prevalence of chronic respiratory symptoms was considerably higher in exposed than in control workers, being statistically different for dyspnea (P less than 0.01). The statistically significant acute reductions in ventilatory capacity were particularly pronounced for FEF50 (-4.7%) and FEF25 (-9.4%). The mean ventilatory capacity values before shift on Monday were significantly lower than those on the following Friday for FVC, FEF50 and FEF25. There was no difference in ventilatory capacity between soy-bean workers with positive and those with negative skin tests to house dust or between those with increased and those with normal IgE serum levels. A water soluble extract of soy-bean dust was also assayed in organ bath containing guinea pig trachea. This model showed the extract to be highly reactive causing a dose-related constriction of airway smooth muscle. Our data suggest that immunologic sensitization to soy-bean products is very frequent. In addition to possible humoral contribution to respiratory disorders, soy dust seems to directly affect airway smooth muscle.

Adult↗
PubMed1993

[Immunologic and respiratory reactions in workers exposed to organic aerosols].

The relationship of skin reactivity and IgE serum level to the prevalence of chronic respiratory symptoms and ventilatory capacity in workers exposed to different organic aerosols and in control workers is presented. In general, the exposed workers had a higher prevalence of positive skin tests to occupational allergens than the controls, with the exception of soy-bean workers. The workers with positive skin tests to occupational allergens had a higher prevalence of almost all chronic respiratory symptoms although the differences did not always reach statistical significance. Among workers with positive skin reactions the prevalence of increased IgE serum level was significantly higher than among those with negative skin reactions. There were large mean relative acute across-shift reductions of ventilatory capacity in all groups of exposed workers, varying for FVC from 1.7 to 13.3%, for FEV1 from 0.4 to 21.9%, for FEF50 from 1.5 to 16.1% and for FEF25 from 0 to 24.9%. However, there was no correlation of acute and chronic lung function changes with skin reactivity or IgE serum level. Our data suggest that although exposure to organic aerosols may cause immunological reactions, it appears that such changes are not caused by allergic mechanisms. On the basis of positive skin reactivity or IgE serum level the workers who are prone to the development of chronic respiratory impairment cannot be predicted with certainty.

Agricultural Workers' Diseases↗
PubMed1997

[Respiratory function in vineyard and orchard workers].

The prevalence of acute and chronic respiratory symptoms and diseases and ventilatory capacity were studied in 174 vineyard and orchard workers. In addition, 115 nonexposed workers were studied as a control group. In vineyard and orchard workers, there was significantly higher prevalence of chronic cough, chronic phlegm, dyspnea and chest tightness in comparison to the control group. Smokers, vineyard and orchard workers employed for more than 10 years showed significantly higher prevalence of chronic cough, chronic phlegm, chronic bronchitis and chest tightness than smokers with shorter employment. In vineyard and orchard workers employed for more than 10 years there was higher prevalence of acute symptoms during work shift than in those with shorter employment, although the differences were statistically significant only for cough (p < 0.05). Most of the measured ventilatory capacity tests in vineyard and orchard workers were lower than predicted in smokers and nonsmokers. Values lower than 70% of predicted were found in 5.2% workers for FVC, in 6.3% for FEV1, in 27.6% for FEF50 and in 40.2% for FEF25. These data indicate that workers employed in vineyards and orchards may develop acute and chronic respiratory symptoms and diseases along with lung function changes which are partly related to environmental factors and partly to smoking habit.

Adolescent↗
PubMed1997

Respiratory function in shoe manufacturing workers.

A study of respiratory findings was performed on 376 female workers employed in a shoe manufacturing plant. The mean age of the workers was 32 years and the mean duration of their employment was 12 years. These workers were predominantly nonsmokers. Acute and chronic respiratory symptoms were recorded for each worker, and lung function was measured before and after the work shift. Maximum expiratory flow-volume (MEFV) curves were performed on which forced vital capacity (FVC), 1-second forced expiratory volume (FEV1), and flow rates at 50% and the last 25% (FEF50, FEF25) were measured. Significantly higher prevalences of all chronic respiratory symptoms were recorded in exposed compared to control workers; in particular, chest tightness (exposed: 44.7%; control: 0%), dyspnea (exposed: 42.6%; control: 2.0%), and rhinitis (exposed: 46.3%; control: 2.4%) were far more prevalent in workers than in controls. Among the shoe workers, there was also a high prevalence of acute symptoms that developed during the work shift, being most pronounced for nose and throat irritation (61.4%). The prevalence of acute and chronic respiratory symptoms increased with duration of employment. Statistically significant across-shift reductions were recorded for all ventilatory capacity tests for the group as a whole. In comparison to predicted, the measured ventilatory capacity parameters were significantly lower for all workers (p < 0.01). Lung function abnormalities increased with duration of employment. Environmental measurements demonstrated that benzene, fur, and synthetic fibers were found at higher than allowable maximal concentrations (Croatian standards). The data suggest that work in the shoe manufacturing industry may be responsible for the development of acute and chronic respiratory impairment.

Acute Disease↗
PubMed1997

Respiratory function of textile workers employed in dyeing cotton and wool fibers.

A group of 135 textile dyeing workers (97 male and 38 female) was studied for the prevalence of acute and chronic respiratory symptoms and lung function changes. Respiratory symptoms were elicited by a standardized questionnaire, and lung function testing was performed before and after the morning shift by recording maximum expiratory flow-volume (MEFV) curves. In addition, 103 nonexposed control workers were studied. The prevalence of all chronic respiratory symptoms was significantly higher in the exposed than in the control workers; in particular, the prevalence of occupational asthma was 6%. The exposed nonsmoking workers had more complaints than the controls who were nonsmokers. As expected, most of the symptoms were more prevalent in smokers than in nonsmokers. Nonsmokers with both long- and short-term work exposure had higher prevalences of dyspnea and rhinitis than control workers. Smokers exposed for 10 years or less had significantly higher prevalences of chronic phlegm than nonsmokers with the same duration of exposure (p < 0.05). In workers exposed for > 10 years, there were significantly higher prevalences of chronic cough, chronic phlegm, and chronic bronchitis in smokers than in nonsmokers (p < 0.01). A high prevalence of shift-related symptoms was found in exposed workers. Significant across-shift reductions of ventilatory capacity tests were documented in this cohort and varied from an average of 4.0% for FVC to 14.2% for FEF25. Preshift values of ventilatory capacity were significantly lower in this exposed population compared to predicted values suggesting a chromic effect. Our data suggest that textile dyeing workers develop acute and chronic respiratory impairment as a result of their exposures. These findings are exacerbated by cigarette smoking.

Animals↗
PubMed1997

Respiratory impairments due to dust exposure: a comparative study among workers exposed to silica, asbestos, and coalmine dust.

We conducted a comparative study of pulmonary dysfunction among workers who were exposed to silica, asbestos, or coalmine dust. The results showed that all three groups of dust-exposed workers, even those without radiographic signs of pneumoconiosis, had decreased spirometric parameters and diffusing capacity (DLco) in both nonsmokers and smokers. Pulmonary function was further decreased when pneumoconioses were present in the three groups. In accord with increasing radiographic categories, pulmonary function in the workers with either silicosis or asbestosis was even lower, whereas in those with coal workers' pneumoconiosis (CWP), it changed relatively little. Workers with mild to moderate (radiographic category I-II) silicosis or asbestosis showed similarly decreased DLco, but those with silicosis showed lower FEV1/FVC than those with abestosis. The workers with CWP also showed a lower FEV1/FVC than those with asbestosis. The major impairment patterns for silica workers, asbestos workers, and coal miners were mixed, restrictive and mixed, and obstructive, respectively. Smoking obviously increased the prevalence of obstruction for all the groups. We conclude from the present study that all the three dusts cause functional abnormalities that precede radiographic changes of pneumoconiosis. We should pay more attention to respiratory impairment in the initial stage of silicosis and CWP.

Adult↗
PubMed1997

Serum liver function profiles in coking workers.

Coking workers are regularly exposed to coke oven emissions (COE), which consist mainly of polycyclic aromatic hydrocarbons and volatile organic compounds. In a previous cross-sectional study, we found that coking and by-product workers with heavy exposure to COE in the older of two coke operation areas in Taiwan had higher serum activities of hepatic aminotransferase than the controls. In this study, we further examine the relationship of exposure to COE with liver function profiles in coking workers. Liver function profiles included serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (BIL). The exposed group included 88 workers working 3 months or more in the older coke oven plant. Fifty-nine referents, not visiting the coke operation areas in the last 3 months, came from the administrative area in the same company. Each participant wore a personal monitor that was used to measure benzene soluble fraction (BSF) of total particulates, as a surrogate of COE, for 3 consecutive days between August 1995 and February 1996. Serum liver function profiles, hepatitis B surface antigens, and anti-hepatitis C antibodies were examined in the morning following the exposure measurements. Exposure levels were categorized by exposure situations (high, medium, low) among coking workers. The high exposure group (n = 23) worked topside of the oven. The medium exposure group (n = 44) worked at the sideoven for more than 4 hr/day, whereas the low exposure group (n = 21) worked at the sideoven for less than 4 hr/day and mostly remained in the control rooms. The low exposure group was used as an internal comparison group. The median BSF concentrations for various exposure situations were as follows, high exposure group: 372 micrograms/m3, medium exposure group: 61 micrograms/m3, low exposure group: 49 micrograms/m3, and referents: 10 micrograms/m3. The coking workers (n = 88) did not significantly differ from the referents (n = 59) in any of the liver function profiles. Excluding the referents, workers in the high exposure group had a mean AST level that was 31% higher (95% confidence interval (CI) = 9-57%) and a mean ALT level that was 46% higher (95% CI = 7-98%) than those in the low exposure group after adjusting for appropriate confounders in multivariate models. The prevalence of an abnormal hepatocellular pattern (AST > 37 IU/L or ALT > 39 IU/L) was more common in the high exposure group than in the low exposure group (adjusted odds ratio = 4.4; 95% CI = 0.9-22.6). However, these associations were not found in GGT, ALP, or BIL. After controlling for the possible effects of nonoccupational factors on serum activity of AST and ALT, we conclude that increased AST and ALT levels among topside coking workers may be caused by heavy inhalation exposure to COE. Additionally, the adverse hepatic effect seems to be caused by a mixture of hazards, rather than a unique identifiable chemical.

Adult↗
PubMed1998

Respiratory function and immunological status in workers employed in a latex glove manufacturing plant.

A study was performed in 17 female workers employed in a latex glove manufacturing plant. The mean age of these workers was 42 years and the mean duration of their employment was 19 years. The employees were primarily nonsmokers or light smokers. The presence of chronic respiratory symptoms and acute work-related symptoms was recorded for these workers. Ventilatory capacity was measured during the morning work shift by recording maximum expiratory flow-volume curves from which forced vital capacity (FVC), 1-second forced expiratory volume (FEV1) and maximum expiratory flow at 50%, and the last 25% of the vital capacity (FEF50, FEF75) were measured. A control group of 17 nonexposed women workers was also studied. The prevalence of chronic respiratory symptoms was greater among latex workers than among control confectionary packer workers, varying from 5.9% (vs. 0% in controls) for occupational asthma to 58.8% (vs. 0% in controls) for dyspnea grades 3 or 4. There was also a high prevalence of acute work-related symptoms in this industry, in particular, eye irritation (76.5%), dryness of the nose (70.6%), throat burning (70.6%), dryness of the throat (64.7%), and cough (58.8%). Among exposed workers, measured ventilatory capacity data were significantly lower than among controls, particularly FEF75 (75.1% +/- 10.5%). One of the 17 studied workers (5.9%) had a positive skin reaction to latex and had symptoms compatible with occupational asthma. Our data suggest that in addition to occupational asthma, the manufacture of latex gloves is associated with frequent, nonspecific respiratory findings.

Adult↗
PubMed1999

The effects of economic reform on health insurance and the financial burden for urban workers in China.

Since 1980, Chinese enterprises have been undergoing reforms in employment practice, taxation, and workers' health/welfare benefits coverage. In particular, Chinese businesses have been facing a major challenge with respect to the financial burden of providing medical benefits to their workers. The purpose of this paper is to analyse the impact of enterprise reform on workers' health care benefits and their financial burden due to medical expenses. This study is based on a 1992 survey conducted in 22 cities, and included 406 enterprises and 5920 workers. It was found that there were wide variations of coverage for health care benefits among urban Chinese workers. It was also found that workers with partial coverage were as likely to incur out-of-pocket medical expenditures as workers without coverage. These out-of-pocket medical expenditures could reach as high as 25% of a worker's annual income. Policy recommendations are discussed at the end of the paper.

Adult↗
PubMedDate not supplied

Chromium status of tannery workers in relation to metabolic disorders.

Chromium (Cr), being an excellent tanning agent, is widely used in the leather industry. In the process of leather production, tannery workers are exposed to either inorganic Cr(III) compounds or Cr bound to proteins (leather dust). The total Cr content in tannery air (1-54 microg m(-3)) is rather high in comparison to ambient air (4-6 ng m(-3)) but the amount of Cr in inhalable particles (<10 microm) is two to three orders of magnitude less (20-60 ng m(-3)). The total daily intake of Cr was estimated by the analysis of diet (24.3 +/- 4.0 microg Cr day(-1)), drinking water (0.3 +/- 0.1 microg Cr dm(-3)) and ambient air. The contribution of the latter was dominant for tannery workers and almost negligible (8%) for the unexposed population. Chromium is an essential nutrient required for sugar and fat metabolism. The normal dietary intake of Cr for the occupationally unexposed population is found to be suboptimal (<30 microg Cr day(-1)) whereas tannery workers receive on average 150-325 microg of supplemental Cr day(-1). Assessment of the Cr status of both populations was made on the basis of the Cr contents of their scalp hair, pre-shift urine and thermally induced sweat. The median Cr contents in these tissues and fluids were significantly higher (P<0.01) in tannery workers (hair: 4 microg Cr g (-1), urine: Cr/creatinine 1.7 microg Cr g(-1), sweat: 25 microg Cr dm(-3)) in comparison with the control group (hair: 0.16 microg Cr g(-1), urine: Cr/creatinine 0.13 microg Cr g (-1), sweat: 0.7 microg Cr dm(-3)). Tannery workers absorbed up to 13 times more Cr in comparison to controls, the amount varying considerably depending on the workplace and duration of exposure. The main route of Cr absorption appears to be through the gastrointestinal tract, where medium to large particles play a dominant role. The absorption of Cr from leather dust may be more efficient in comparison to inorganic Cr(III) compounds. Under normal circumstances sweat Cr losses represent at least 20% of urinary Cr excretion. The incidence of glucose intolerance and disturbed lipid metabolism was compared between the unexposed (control) population (n=150) and a population of tannery workers (n=138) from the same residential area. The percentage of glucose-intolerant subjects was significantly (P<0.01) lower in the older subgroup (age>48 years), who were even more obese, but not in the whole tannery population in comparison to controls. In the group of subjects displaying glucose intolerance, those from the control population showed a significantly higher body mass index (BMI) of 32.3 and a considerably larger proportion of females (86%) in comparison to subjects from the tannery population (28.2 and 60%, respectively). There was no significant difference in total serum cholesterol levels between the groups. Results of other lipid variables, such as high-density lipid (HDL) cholesterol, low-density lipid (LDL) cholesterol and triglycerides, are controversial: namely, the HDL/LDL ratio was higher for the controls, who showed in contrast significantly higher serum triglyceride levels in comparison to the older subgroup of tannery workers. The possible effects of other parameters on serum HDL-cholesterol level are outlined but the influence of Cr on lipid metabolism in tannery workers remains unclear.

Adult↗
PubMed2000

Absence of significant genotoxicity in lymphocytes and urine from workers exposed to moderate levels of cobalt-containing dust: a cross-sectional study.

Mortality studies have shown that, in the past, lung cancer occurred after exposure to mixtures of cobalt metal and metallic carbide particles, the main constituents of hard metals, but apparently not when exposure was to cobalt alone. The major objective of this biomonitoring study was to assess genotoxic effects as a measure for carcinogenic risk in workers from cobalt refineries and hard metal plants currently exposed to the threshold limit value/time-weighted average (TLV-TWA) for cobalt-containing dust. The study comprised three groups of workers: 35 workers exposed to cobalt dust from three refineries, 29 workers exposed to hard metal dust from two producing plants, and 35 matched control subjects recruited from the respective plants. The study design integrated complementary methodologies to assess biomarkers of effects that represent both initial DNA damage (8-hydroxydeoxyguanosine [8-OHdG] in urine and comet assay on lymphocytes) and definitive chromosome breakage/loss (micronuclei in lymphocytes). Cobalt and cotinine were determined in urine as a measure for cobalt exposure and recent smoking, respectively. No significant increase of genotoxic effects was detected in workers exposed to cobalt-containing dust as compared to controls. No difference in any genotoxicity biomarker was found between workers exposed to cobalt and hard metal dusts. Multiple regression analysis indicated that workers who smoked and were exposed to hard metal dusts had elevated 8-OHdG and micronuclei values. Because this observation is in line with a previous epidemiological study of an increased risk of dying from lung cancer in workers from the hard metal industry who smoked, it is concluded that this specific occupational group needs closer medical surveillance.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2003

Mortality from non-malignant diseases among male Norwegian asphalt workers.

BACKGROUND: The possible associations between asphalt work and mortality from non-malignant diseases in a cohort of male Norwegian asphalt workers that formed part of the European asphalt worker mortality study are examined. METHODS: The mortality experience among 8,610 male workers ever employed in asphalt work was observed from 01.01.1970 until 12.31.1996, yielding 127,636 person years of observation. The cause-specific deaths observed in the study cohort were compared with the expected figures calculated from 5-year period- and age-specific national death rates. A study-specific job exposure matrix was used for individual-individual exposure estimates. RESULTS: Eight hundred and three workers died during the observation period (SMR = 0.92, 95% confidence intervals (CI) = 0.58, 1.40). The mortality from non-malignant respiratory diseases was elevated (SMR = 1.25, 95%CI = 0.97, 1.58) and was associated with years since first employment in the asphalt industry. Mortality from respiratory diseases was highest among the workers first employed in the 1960s. Among the different job types held by the workers the pavers and mastic asphalt workers had the highest mortality from respiratory diseases. A weak dose-response was found with cumulative exposure to PAH and bitumen fume and mortality from non-malignant respiratory diseases in analyses employing the job-exposure matrix. Overall mortality, the mortality from circulatory diseases (SMR = 0.93, 95%CI = 0.83, 1.03) and external causes (SMR = 0.90, 95%CI = 0.72, 1.11) was lower than expected. CONCLUSIONS: Mortality from respiratory diseases was found somewhat elevated among the asphalt workers. There was some evidence of exposure-response with both bitumen fume and PAH exposure. PAH from coal tar contributes to the PAH exposure.

Adult↗