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At least 109 records · Page 6Linked to original sources

Demonstration of the healthy worker survivor effect in a cohort of workers in the construction industry.

OBJECTIVES: To assess the potential of a healthy worker survivor effect due to differential occupational mobility in a cohort of construction workers. METHODS: A cohort of 10 809 male employees in the German construction industry aged 15-64 years was followed up for occupational mobility, early retirement due to permanent disability, and total mortality from 1986 to 1994. Using the Cox's proportional hazards model of relative rates (RRs) with 95% confidence intervals (95% CIs) of occupational mobility, early retirement and total mortality were estimated according to medical diagnoses at baseline after adjustment for various covariates. RESULTS: During follow up, 2472 subjects changed employment, 359 employees were granted a disability pension for health reasons and 188 subjects died. A wide range of chronic diseases was associated with increased rates of early retirement and total mortality but not occupational mobility. However, a healthy worker survivor effect was identified related to disorders of the back and spine (ninth revision of the international classification of diseases, ICD-9, code 720-4), a common predictor of both occupational mobility (RR 1.17, 95% CI 1.04 to 1.32) and early retirement (RR 1.50, 95% CI 1.20 to 1.88). In total, there were about as many events of occupational changes (n = 41) as events of early retirement due to permanent disability (n = 39) significantly attributable to disorders of the back and spine. Differential occupational mobility preceded differential early retirement due to permanent disability by more than one decade. CONCLUSIONS: These findings show the need to consider a healthy worker survivor effect due to occupational mobility in occupational epidemiological research. Furthermore these results underline the necessity of further health promotion targeting work related conditions in the construction industry.

Adolescent↗

Action on worksite health and safety problems: a follow-up survey of workers participating in a hazardous waste worker training program.

In it's worker health and safety training program, the California-Arizona Consortium aims to promote worker action to improve health and safety conditions. To assess action on worker-identified health and safety problems, 278 trainees were interviewed 3-8 months after training. Associations with three outcomes were analyzed: (1) attempted action, (2) problem correction, and (3) trainee participation. Perceived management support was associated with all three outcomes, pointing to its key role in maximizing the impact of training. Odds of attempted action were 2-5 times greater with support than without. Trainees for whom English was not the primary language (mostly Spanish speakers) attempted action as often as English speakers. However, the odds of their correcting problems were half that of the English-speaking workers. It is suggested this was due to a perceived lack of control over organizational resources for change, not simply due to communication barriers.

Arizona↗

Mortality among rubber workers: VII. Aerospace workers.

This study evaluated cause-specific mortality among 3,161 men who were employed in the aerospace division of a rubber manufacturing company. Compared to other production workers at the plant, aerospace workers in deicer and fuel cell manufacturing jobs experienced a 60% excess of deaths from lung cancer. Deicer and fuel cell workers who were under 65 years of age had lung cancer rates that were approximately twice those of other rubber workers of comparable age. Aerospace division employees also had elevated rates of bladder cancer, leukemia, lymphoma, and multiple myeloma. However, detailed analyses suggested that, with the exception of lung cancer, these cancer excesses were not likely to be attributable to employment in the aerospace division.

Adult↗

Mortality among rubber workers: VIII. Industrial products workers.

This report compares the mortality experience of 6,533 men employed in the industrial products division of a rubber manufacturing company with that of U.S. males and of other rubber workers. For most causes of death the mortality rates of industrial products workers were lower than those of U.S. males and similar to those of other rubber workers. Relative to other rubber workers, men in the industrial products division had a 50% excess of deaths from lymphoma, a 90% excess of deaths from multiple myeloma, and a 20% excess of deaths from bladder cancer during the study period. The excesses of lymphoma and multiple myeloma were strongest during recent follow-up in 1970-78 (observed/expected deaths: 10/4.3 for lymphoma; 10/4.4 for multiple myeloma), whereas bladder cancer mortality was not excessive during this calendar period.

Aged↗

Asbestos disease in sheet metal workers: II. Radiologic signs of asbestosis among active workers.

A review of chest x-rays of 707 currently employed New York metropolitan area sheet metal workers found that 29.3% of the workers with 20 years or more of union membership (a surrogate for years of exposure) had radiologic abnormalities characteristic of parenchymal and/or pleural asbestosis, with 18.6% having abnormalities characteristic of parenchymal asbestosis (International Labor Organization [ILO] classification 1/0 or higher) and 17.4% of pleural asbestosis. The prevalence of abnormalities characteristic of either parenchymal and/or pleural asbestosis in the group as a whole was 16.4%, with 10.9% exhibiting signs of parenchymal asbestosis and 9.2% of pleural asbestosis. There was a strong, statistically significant relationship between years in the trade and the prevalence of radiologic abnormalities. These findings underscore the need for medical surveillance of all asbestos-exposed construction workers, including retirees and workers who have had past exposure but who are no longer exposed.

Adult↗

Drake Chemical Workers' Health Registry Study: I. Notification and medical surveillance of a group of workers at high risk of developing bladder cancer.

A medical surveillance program and epidemiologic study of 408 former workers of the Drake Chemical Company (now a Superfund waste site) was established in 1986. The Drake Health Registry Study was initiated because these workers had probable past exposures to beta-naphthylamine (BNA), a potent bladder carcinogen. The registry is widely viewed as a model for notification of workers at high risk of disease due to past occupational exposures. By the 40th month, 90% of the 366 living workers had been notified of the existence of the registry; 262 had been enrolled in the annual or semi-annual screening for bladder cancer. Among these, 27 persons have had abnormal screening results indicating moderate to high risk of bladder cancer and have been made eligible for further diagnostic tests. While no invasive bladder tumors were found among 18 persons completing the extended diagnostic evaluation, two diagnoses of moderate to severe dysplasia have been made. The registry has also identified three living and three deceased cases of bladder cancer in the cohort; a mortality analysis showed a 20- to 30-fold excess of bladder cancer. An incidence projection, based on the six identified cases, reveals that between six and ten new bladder cancer cases are likely to occur among the Drake cohort over the next 20 year period.

2-Naphthylamine↗

Biological monitoring of workers exposed to 4,4'-methylene-bis-(2-orthochloroaniline) (MOCA). II. Comparative interest of "free" and "total" MOCA in the urine of exposed workers.

OBJECTIVES: The objectives of the study were to investigate the best urinary marker of exposure to MOCA in urine samples of exposed workers and to study its applicability in exposure evaluation in polyurethane resin production plants. In addition, our intention was to contribute to the question of biological target value in order to reduce exposure levels. METHODS: Urinary MOCA markers were measured in urine samples collected at the end of the workshifts. 40 workers from four factories were observed for three consecutive days in the same week. "Free" MOCA in non-acid-stabilized urines, "total" MOCA in urines after alkaline hydrolysis, "acid-labile" MOCA in sulfamic or citric acid-protected urines were measured in all urine samples. MOCA liberated by heating the non-acid-stabilized urines ("heat-labile" MOCA) was also measured in 17 urine samples of exposed workers. RESULTS: The median value of "free" MOCA was lower than that of "sulfamic acid-labile" MOCA: 6.0 and 12.5 micrograms/l respectively. The difference between "free" and "total" MOCA was statistically significant (Mann-Whitney test, P = 0.023) for the urine samples collected without acid. Correlations between urinary MOCA concentrations in hydrolysed and non-hydrolysed urine samples were high (r = 0.984, 0.966 and 0.950; P < 0.001) for urine samples with sulfamic acid, with citric acid and without acid respectively. For all the factories, the postshift urinary MOCA concentrations ranged between 1 microgram/l (detection limit) and 570 micrograms/l; 25% of "sulfamic acid-labile" MOCA concentrations exceeded 50 micrograms/l. Workers handling crystallized MOCA excreted the highest amounts of MOCA in urine. The urinary MOCA concentrations (median) were: 84.0 micrograms/l (mixer), 15.5 micrograms/l (moulder). 59.0 micrograms/l (maintenance) and 3.0 micrograms/l (others). CONCLUSIONS: MOCA measured in sulfamic acid-protected urine samples without hydrolysis provides a more practical and reliable biomarker than "total" MOCA (after hydrolysis) or "free" MOCA. A biological guiding value of 20 micrograms/l expressed as "sulfamic acid-labile" MOCA is proposed.

Chemical Industry↗

The Ray Alexander Workers Clinic--a model for worker-based health services in South Africa?

During the period of current political transition, concern for the future of South Africa's health services have led to increased interest in different models for the provision and financing of health care. These debates have included an examination of the concept of Managed Care and the ideas of Health Maintainance Organization. Progressive trade unions, particularly, have been faced with the prospect of promoting private sector health care if they are directly to meet their members health needs, while at the same time seeking an equitable health care system for a future democratic South Africa. The Ray Alexander Workers Clinic is presented as a model of a worker-based health service which attempts to address this contradiction. Important lessons for a future National Health Service may be learnt. The role of worker control and cost containment are emphasized and implications for integration into State Services and relationships to social services for the broader community are explored. An argument is made that worker-based health services offer excellent possibilities for integration in a future National Health Service in South Africa that is centred on a Primary Health Care approach.

Ambulatory Care Facilities↗

Mortality study of workers employed in 1,3-butadiene production units identified from a large chemical workers cohort.

The IARC has given the designations of "sufficient evidence" of carcinogenicity of 1,3-butadiene in experimental animals and "limited evidence" of carcinogenicity in humans. To investigate the carcinogenic effect in humans, a cohort mortality study was conducted among 364 men who were assigned to any of three 1,3-butadiene production units located within several chemical plants in the Kanawha Valley of West Virginia, including 277 men employed in a U.S. Rubber Reserve Plant which operated during World War II. The butadiene production units included in this study were selected from an index developed by the Union Carbide Corporation which listed for each chemical production unit within their South Charleston and Institute plants all products, by-products and reactants. Departments included in the study were those where butadiene was a primary product and neither benzene nor ethylene oxide was present. A total of 185 deaths were observed; the standardized mortality ratio (SMR) for all causes of death was 91, reflecting lower mortality among the study population than the U.S. population. The study found a significantly elevated standardized mortality ratio (SMR) for lymphosarcoma and reticulosarcoma based on four observed cases (SMR = 577; 95% confidence interval (CI) = 157-1480), which persisted in an analysis using county referent rates. An excess of lymphosarcoma and reticulosarcoma among all workers and among workers with routine exposure to 1,3-butadiene was also observed in the only other cohort of 1,3-butadiene production workers previously studied. A statistically non-significant excess of stomach cancer was observed in the overall cohort (five cases; SMR = 243; CI = 79-568) that was most pronounced among workers employed in the Rubber Reserve plant for 2 or more years (five cases; SMR = 657; CI = 213-1530). We conclude that the results of this study add to the weight of evidence suggesting that butadiene is carcinogenic in humans.

Aged↗

Seroepidemiology of varicella-zoster virus antibodies among health-care workers and day-care-centre workers.

Inclusion of live varicella vaccine in the routine occupational health vaccination schedule requires knowledge of the natural immunity to varicella zoster virus (VZV) among high-risk occupations. This study aims were to evaluate VZV antibody positivity among health-care workers (HCWs) and day-care-centre workers (DCWs) and to assess its association with potential risk factors. Three groups of workers were tested for VZV antibody positivity: hospitals and community clinic HCWs (n = 335), DCWs (n = 117) and blue-collar workers as controls (n = 121). The total VZV antibody positivity was 94.4%. There was no significant difference in VZV antibody positivity among study groups. DCWs had the lowest VZV seroprevalence (90.9%, 95% CI 85.7-96.1) and controls the highest (96.6%, 95% CI 93.2-99.9). This high VZV antibody positivity suggests that no special occupational measures are indicated in health-care or day-care occupational settings in Israel. On-going monitoring of the natural immunity to VZV is necessary to detect trends over time.

Adult↗

Urinary mutagens in municipal sewage workers and water treatment workers.

In view of the potential exposure of sewage treatment workers to a multitude of mutagenic substances, the frequency of urinary mutagens was measured by the Ames test among a sample of 164 sewage treatment workers employed in 14 sewage treatment plants which processed between 3 and 10 million gallons of sewage daily in New York State between March and July, 1984. The frequency was compared to that observed in 72 water treatment employees in the same municipalities. Sewage workers had a significantly higher risk for urinary mutagens after controlling for smoking, using the Ames test, both with and without the addition of the liver microsomal homogenate, S-9. More precise methods of measuring exposure in epidemiologic studies, particularly in environmental and occupational epidemiology, are in various stages of development. The application of one of these methods, the Ames test, to an occupational group (sewage workers) with potentially high exposure to mutagenic substances is described and the strengths and limitations of this application are discussed.

Adult↗

Monitoring acrylic fiber workers for liver toxicity and exposure to dimethylacetamide. 2. Serum clinical chemistry results of dimethylacetamide-exposed workers.

Worker exposure to N,N-dimethylacetamide (DMAC) in an acrylic fiber manufacturing facility was measured, over a 1-year study period, by full-shift (12 hours) personal air monitoring for DMAC and biological monitoring for levels of DMAC, N-methylacetamide (MMAC) and acetamide in post-shift spot urine samples. Evidence of liver toxicity was assessed by serum clinical chemistry tests (serum levels of total bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptase) at least once during the study period for all 127 male workers in the two study departments and for 217 male in-plant controls with no previous or current exposure to DMAC. If a worker's biomonitoring results exceeded one of two "trigger" values established for the study (60 mg MMAC/g creatinine or 136 mg DMAC equivalent/g creatinine), additional serum clinical chemistry tests were conducted at weekly intervals for 3 weeks. DMAC-exposed workers were classified as either high exposure, if one or more biomonitoring result exceeded one of the trigger values, or unspecified exposure if none of them did. Control-group employees were classified as no-exposure. Mean DMAC in air levels for the high- and unspecified-exposure groups appeared to differ (geometric mean DMAC in air levels of 1.9 and 1.3 ppm 12-hour time-weighted average, respectively). No significant DMAC exposure-related trends in hepatic serum clinical chemistry results were detected. Neither transient increases in serum analyte levels after a "high" biomonitoring result (one that exceeded a trigger value) nor an elevated mean level over the study period when compared with in-plant controls were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

STI declines among sex workers and clients following outreach, one time presumptive treatment, and regular screening of sex workers in the Philippines.

OBJECTIVES: This intervention linked research aimed to reduce prevalence of Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct) among female sex workers by means of one round of presumptive treatment (PT), and improved prevention and screening services. METHODS: A single round of PT (azithromycin 1 g) was given to all female sex workers reached during a 1 month period of enhanced outreach activity. Routine sexually transmitted infection (STI) screening services were successfully introduced for two groups of unregistered sex workers who work in brothels (BSWs) and on the street (SSWs). No changes were made to existing screening methods for registered sex workers (RSWs) or lower risk guest relations officers (GROs). Cross sectional prevalence of Ng and Ct was measured by PCR on three occasions, and stratified by type of sex work. Ng/Ct prevalence was assessed twice in clients of BSWs. RESULTS: Prevalence of Ng and/or Ct at baseline, 1 month post-PT, and 7 months post-PT was BSWs: 52%, 27%, 23%; SSWs: 41%, 25%, 28%; RSWs: 36%, 26%, 34%; GROs: 20%, 6%, 24%, respectively. Ng/Ct declines 1 month post-PT were significant for all groups. 6 months later prevalence remained low for BSWs (p<0.001), and SSWs (p = 0.05), but had returned to pre-intervention levels for the other groups. Prevalence of Ng/Ct among clients of BSWs declined from 28% early in the intervention to 15% (p = 0.03) 6 months later. CONCLUSIONS: In this commercial sex setting, one round of PT had a short term impact on Ng/Ct prevalence. Longer term maintenance of STI control requires ongoing access to effective preventive and curative services.

Adolescent↗

Pulmonary fibrosis in aluminum oxide workers. Investigation of nine workers, with pathologic examination and microanalysis in three of them.

Epidemiologic surveys have indicated an excess of nonmalignant respiratory disease in workers exposed to aluminum oxide (Al2O3) during abrasives production. However, clinical, roentgenographic, histologic, and microanalytic description of these workers are lacking. This is a report of nine Al2O3-exposed workers with abnormal chest roentgenograms (profusion greater than or equal to 1/0, ILO/UC) from a plant engaged in the production of Al2O3 abrasives from alundum ore. Mean duration of exposure was 25 yr, and time since first exposure was 28 yr. in a subgroup of three, the severity of symptoms, reduction in the forced vital capacity (67% predicted) and diffusing capacity (51% predicted), and progressive roentgenographic changes (profusion greater than or equal to 2/2) prompted open lung biopsy. Lung tissue was analyzed by scanning electron microscopy and electron microprobe analysis. In each of the three biopsies, interstitial fibrosis with honeycombing was seen on routine section. In one biopsy, silica and asbestos fiber counts were at the low end of the range seen with silicosis and asbestosis; however, the absence of asbestos bodies and silicotic nodules suggested that the fibrosis was due to another cause. Metals occurred in amounts several orders of magnitude above background, and the majority was aluminum as Al2O3 and aluminum alloys. The findings in these nine workers suggests a common exposure as the possible cause. The nonspecific pathologic findings, absence of asbestos bodies and silicotic nodules, and the striking number of aluminum-containing particles suggest that Al2O3 is that common exposure. The possibility of "mixed dust" fibrosis should also be considered.

Adult↗

Comparison of respiratory variables in grain elevator workers and civic outside workers of Thunder Bay, Canada.

We compared respiratory variables in 441 grain elevator workers with 180 civic outside laborers in Thunder Bay. The grain handlers had a lower frequency of both positive skin reactions to pollens and molds and a family history of asthma, which suggests that they may have been self-selected for a decreased tendency to develop allergic respiratory disease. There was a higher frequency of cough and rales and a small decrease in forced vital capacity and forced expiratory volume in one sec among the grain handlers, as compared to the civic workers matched for smoking. However, these differences between grain and nongrain workers were small in comparison to those between smokers and nonsmokers. There was no clear indication of a worsening of respiratory functions that could be attributed specifically to duration of employment as a grain elevator worker.

Adult↗

A Mailed-questionnaire Survey of Ex-workers: A Tool to Evaluate the Healthy-worker Effect in Cross-sectional Studies.

In order to evaluate a possible healthy-worker effect in a cross-sectional study in a viscose rayon plant, a survey of ex-workers was conducted. From the personnel records of this factory, 475 male, Caucasian, Dutch-speaking, carbon disulfide (CS&inf2;)-exposed workers who had been employed ten years prior to the cross-sectional study were selected for study. Of these, 142 were still employed in the same plant, and 64 were deceased. Retrieval of the causes of death proved impossible. A questionnaire was mailed to the remaining 269 men, of whom 149 completed and returned it. Eighty-nine subjects reported having left the plant for health reasons. Among the health reasons specified, eye-irritation complaints were most often mentioned (53.7%), followed by gastrointestinal complaints (32.8%), complaints concerning the central nervous system (19.4%) and the peripheral nerves (11.9%), heart or lung problems (14.9%), and problems affecting the skin (9.0%). The average duration of employment decreased significantly with the intensity of the exposure to CS&inf2;. The results suggest that the findings of a cross-sectional study of current workers in the same viscose rayon plant may represent underestimates of some conditions, in particular the acute eye-irritation complaints. Other complaints with high prevalences in the cross-sectional study, such as complaints consistent with polyneuropathy, seemed less, while others, such as impotence, seemed not at all, subject to underestimation.

Journal Article↗

What do petrochemical workers, healthcare workers, and truck drivers have in common? Evaluation of sleep and alertness in Brazilian shiftworkers.

The article reports briefly on some effects of shiftwork and the work environment on health and wellbeing of shiftworkers. Studies of Brazilian shiftworkers (healthcare workers, petrochemical workers, and truck drivers) are described. A similar methodology was used to evaluate sleep and alertness in all these studies. The evaluation of sleep duration and quality and alertness showed similar results in the three studies. Although the workers were in different work settings, performing different jobs, the results are similar: daytime sleep is reduced and perceived as having worse quality than nighttime sleep; alertness decreases as the night work progresses. The study highlights the importance of shiftwork schedules' features and work organization for workers' health, wellbeing, and safety.

Brazil↗

Raw deal for workers: why have U.S. workers experienced a long-term decline in pay, benefits, and working conditions?

Pay, opportunities, and job quality have worsened for most U.S. workers over the past 30 years, across most sectors of the economy. This decline is related to fundamental changes in the economy and society, including sluggish productivity growth and employer assaults on workers' rights and protections. Productivity growth has slowed as companies no longer invest as much in equipment and training. Businesses have attacked workers' protections; unionization is down, and the minimum wage is worth about two-thirds as much as at its high point in the late 1960s. The National Labor Relations Board, other federal agencies, and the courts are stacked with anti-labor appointees. And businesses have pushed more and more risk onto workers, with a growth in temporary work and much reduced work-related benefits.

Cost Sharing↗