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PubMed2004

Immunomodulatory effects of mineral fibres in occupationally exposed workers.

In the context of a large-scale molecular epidemiology study, the possible immunomodulatory effects of mineral fibres, in workers occupationally exposed to asbestos, rockwool and glass fibres, were examined. In each plant, 61, 98 and 80 exposed workers and 21, 43 or 36 control clerical subjects, respectively, were recruited. In the case of the asbestos-exposed subjects, an additional town-control group of 49 people was included. Evidence of pulmonary fibrosis was found in 42% of the asbestos-exposed workers, while evidence of pleural fibrosis was found in 24%. The asbestos-exposed cohort had significantly decreased forced vital capacity of lungs as well as forced expiratory volume per first second. Our findings indicate that exposure to all three types of fibres examined modulates to different degrees the immune response. Suppression of T-cell immunity and to a lesser extent, B-cell immunity was found in the case of workers from a former asbestos cement plant, while stimulation of T-cell response was observed in rockwool workers, and stimulation of T- and B-cell response was seen in glass fibre workers. Depression of the percentage of lymphocyte subpopulation of CD 16+56 (natural killer cells) in peripheral blood was found in glass fibre workers. Statistical analysis showed increased levels of proinflammatory cytokines (IL-6 asbestos; IL-8 all three fibres), expression of adhesion molecule L-selectin on granulocytes and monocytes (asbestos), levels of soluble adhesion molecules (SAMs) in sera (ICAM-1 all three fibres; E-selectin glass fibres), increased levels of immunoglobulin E (asbestos and rockwool) and elevated expression of activation markers on eosinophils (CD66b asbestos, glass fibres; CD69 asbestos). Significant correlations were observed between lymphocyte proliferation and markers of DNA damage and repair. Increased levels of proinflammatory cytokines, SAMs, immunoglobulin E and elevated expression of activation markers on eosinophils was found in people with symptoms of hypersensitivity and an elevated inflammatory status.

B-Lymphocytes↗
PubMed2004

Non-smoking coke oven workers show an occupational PAH exposure-related increase in urinary mutagens.

We examined the urinary mutagenicity in the YG1024 Salmonella typhimurium strain in the presence of S9 mix, of 31 male non-smoking coke oven workers and an equal number of controls matched for gender and dietary habits. Occupational PAH exposure to the workers was assessed by means of the individual urinary post-shift excretion of 1-pyrenol (mean +/- S.D.: 5.41 +/- 6.06 micromole/mol creatinine). Eleven urinary extracts of workers (35.5%) were clearly mutagenic (with at least a doubling of the number of spontaneous revertants), against only two samples in the control group (6.5%) (chi2-test; chi2 = 7.883; P < 0.01). Moreover, the mean mutagenic activity level corrected for dilution/concentration of the urine was about three times higher in coke oven workers than in matched controls (mean +/- S.D. (range) 495 +/- 407 (89.7-1603) versus 186 +/- 113 (14.2-524) net revertants/mmol creatinine; Mann-Whitney U-test, z = 3.86, P < 0.001). Simple linear regression analysis showed that the coke workers' urinary mutagenic activity is associated with the PAH occupation-related urinary excretion of 1-pyrenol (r = 0.41, P = 0.0215). This study definitely demonstrates an occupation-related exposure of coke oven workers' bladder epithelium to mutagenic PAH metabolites. This factor, mainly in the case of high exposure studied here, may account for a higher bladder cancer risk in coke oven workers.

Coke↗
PubMed2006

Analysis of chromosome damage in circulating lymphocytes of radiological workers affected by thyroid nodules.

The aim of our study was to assess whether or not thyroid nodularity in combination with occupational exposure to low levels of ionising radiation would be correlated with chromosome damage in peripheral lymphocytes. Conventional chromosome-aberration analysis was performed on a group of 92 hospital workers with or without thyroid nodules. On the basis of measurements of their exposure levels, the workers were classified into a low (mean total level=0.03 mSv), medium (mean total level=1.04 mSv) or high (mean total level=8.60 mSv) exposure category. Our results indicate that among workers with thyroid nodules, the high-exposed workers showed significantly higher levels of both total (2.35+/-0.34 per 100 cells) and chromosome-type aberrations (1.46+/-0.20 per 100 cells) than medium-exposed (0.98+/-0.42 and 0.68+/-0.25 per 100 cells, respectively) or low-exposed workers (1.11+/-0.29 and 0.58+/-0.17 per 100 cells, respectively). Workers without thyroid nodules had comparable frequencies of chromosome aberrations among the three exposure categories. To our knowledge, this is the first study revealing a slight, but significant increase of chromosome damage in peripheral lymphocytes from hospital workers who developed thyroid nodules under conditions of occupational exposure to radiation well below the threshold limit for the workplace. The existence of a possible association between chromosome aberrations and development of thyroid nodularity will be discussed.

Analysis of Variance↗
PubMed2004

Mushroom body structural change is associated with division of labor in eusocial wasp workers (Polybia aequatorialis, Hymenoptera: Vespidae).

Highly eusocial insect workers exhibit age-related division of labor. Adults begin working inside the nest, moving to the nest periphery and later to foraging. Passage through this task sequence is associated with neuroanatomical changes in the mushroom bodies (MB) of honey bee (Apis) and ant (Camponotus) workers. We asked whether eusocial wasp workers (Polybia aequatorialis) exhibit similar changes in adult neuroanatomy. Wasps were identified as working in-nest, on-nest, or foraging. The volumes of the somata of workers' MB intrinsic neurons (Kenyon cells), and of the neuropils containing the Kenyon cell dendritic arbors (calyces), were estimated using stereological methods. In-nest workers had significantly smaller calyx to Kenyon cell volume ratios than on-nest and foraging workers. Age-related task specializations in Polybia workers are associated with major neuroanatomical reorganization in the mushroom bodies.

Aging↗
PubMed2004

The influence of milk intake on the lead toxicity to the sensory nervous system in lead workers.

The dietary calcium supplement has been suggested to children and pregnant women for prevention of lead toxicity, because of lead-calcium interaction. Lead workers were supplied free milk in Taiwan; however, part of workers did not drink milk due to lactose intolerance. The goal of this study is to evaluate the effects of milk-intake on the peripheral nervous system in workers with long-term lead exposure. We measured 181 workers' current perception thresholds (CPT) as neurological outcomes. The outcome variables were then correlated to the subject's milk intake, blood lead levels, and index of long-term lead exposure that was calculated by the subject's serial blood lead data in a period of working duration. The potential confounders, including age, gender, body height, smoking and alcohol consumption, were also collected and analyzed in multiple regressions. 23 workers who reported never or rarely drinking milk, which meant that they have suffered from diarrhea or abdomen discomfort after drinking milk since childhood, had higher blood lead parameters but not statistically significant, and higher thresholds in sensory nerve tests, especially, statistically significance on 5 and 250 Hz of hand CPTs, which represent C fiber and A-delta fiber. In multiple regression models with control of potential confounders, significant protective effects of milk intake were found on reducing hand CPTs, but not on foot CPTs. Our study, using measurement of sensory nerve CPTs, revealed that drinking milk (two bottles a day, about 700 g per day) might have an effect to protect lead peripheral neurotoxicity. The detail biochemical mechanisms need further investigations. However, reduction of occupational lead exposure is the essential way to protect lead neuropathy. The authors did not emphasize that offers of milk to workers could be instead of occupational hygiene efforts. Furthermore, lead workers with lactose intolerance might be more susceptible, and need more industrial hygiene interventions.

Adult↗
PubMed2005

Lung health in workers exposed to reed dust.

We conducted a cross-sectional survey in a cellulose plant among 109 reed workers, exposed to reed dust and 78 unexposed office workers, to investigate respiratory health effects of reed dust exposure. Investigations included dust measurements, serum total IgE, skin prick test, pulmonary function testing and questionnaire on respiratory symptoms. Total dust level in the reed processing unit was higher than the office (9.7 and 0.02 mg/m3, respectively). Reed workers had a higher rate of current smoking (67% and 46%, respectively). After the adjustment for smoking status and age, reed dust exposure was significantly associated with wheezing, chronic cough, dyspnea, itching eyes and itching nose. Chest tightness and ODTS symptoms were only reported by reed workers (27.5% and 23.9%, respectively). After the adjustment for pack-years of smoking, percentage of predicted FEV1, FVC, FEV1/FVC and FEF25-75 in reed workers were significantly lower than office workers. Among reed workers, wheezing was associated with older age (>40 years) and ever smoking, and cross-shift decline in FVC and FEV1 with shorter duration of work. Reed dust exposure in the workplace could provoke respiratory symptoms, possibly due to an irritating effect. Health selection bias is likely, and could have underestimated the health effects of reed dust exposure.

Adult↗
PubMed2006

Lipid peroxidation and antioxidant status in workers exposed to PCDD/Fs of metal recovery plants.

Secondary copper smelters, which primarily utilize the waste materials that contain organic impurities, and the zinc recovery plant, which handles mostly fly ash and slag from the iron and steel industry, are major emission sources of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in Taiwan. In this study, we compared the levels of erythrocyte glutathione (GSH), erythrocyte superoxide dismutase (SOD) and plasma malondialdehyde (MDA) in workers at a secondary copper smelting plant and a zinc recovery plant who may have been exposed to PCDD/Fs. Though the PCDD/F levels were higher in workers of zinc recovery plant than those of secondary copper smelting plant, no significant difference was found for serum PCDD/F levels between the two kinds of plants. We observed a significant difference in plasma MDA levels between workers at the zinc recovery plant (2.54 microM) and those at the copper smelting plant (1.79 microM). There was and a significant positive correlation between plasma MDA levels and the PCDD/Fs levels. In addition, we observed that the MDA levels were not affected by smoking and exercise status. Therefore, the data suggest that the MDA levels of the metal recovery workers are influenced by their PCDD/F exposure. The erythrocyte SOD activity in workers from the zinc recovery plant was marginally higher than that from the secondary copper plant (196 vs. 146 units/ml, p<0.06). In both plants, large variations in the MDA and SOD levels were found, especially in the high-PCDD/Fs-exposure group, which may be attributed, at least partially, to the differences in smoking status and the number of cigarettes smoked. Overall, our results indicate a higher oxidative stress in workers of the zinc recovery plant than in workers of the secondary copper smelting plant in Taiwan.

Adult↗
PubMed2005

Effects of web-based supervisor training on supervisor support and psychological distress among workers: a randomized controlled trial.

BACKGROUND: A randomized controlled trial was conducted to determine the effects of web-based supervisor training on worksite mental health on supervisor support and psychological distress among subordinate workers. METHODS: Section chiefs in a computer engineering company were randomly assigned to either a training group (n = 9) or a non-training group (n = 7). The section chiefs in the training group participated in web-based self-learning training on worksite mental health. A total of 92 subordinate workers under the trained section chiefs (the intervention group) and 84 subordinate workers under the untrained section chiefs (the control group) completed a questionnaire at baseline and a 3-month follow-up. RESULTS: The score of supervisor support greatly decreased in the control group during the follow-up period, and the score changed very little in the intervention group, with a significant intervention effect (P = 0.032). This pattern was more pronounced for one particular item dealing with the extent to which a supervisor listens to personal problems of subordinate workers (the intervention effect, P = 0.012). No intervention effect was observed for the score measuring co-worker support, psychological distress, or other job stressors among subordinate workers (P > 0.05). CONCLUSIONS: It is suggested that the web-based training of supervisors on worksite mental health is useful in improving, or at least maintaining, supervisor support among subordinate workers.

Adult↗
PubMed2000

Ecdysteroid titer, ovary status, and dominance in adult worker and queen bumble bees (Bombus terrestris).

The role of ecdysteroids in the regulation of dominance and reproduction in social Hymenoptera is little explored. In the current study we compared ecdysteroid titers in hemolymph of individual queen and worker bumble bees (Bombus terrestris) that differ in their behavior, reproductive status and social environment. Egg-laying queens that head colonies and have ovaries exhibiting all stages of follicle development, had a higher ecdysteroid titer than virgin queens whose ovaries contained only follicles at initial stages. In workers, the relationship between ecdysteroid titers and follicle development appears to be more complex and to be influenced by the bee's social status and social environment. Shortly after emergence, young workers had only follicles at the initial stages of oogenesis and they exhibited a low ecdysteroid titer. No significant correlation was detected between ovary status and ecdysteroid titer in workers, with some workers showing activated ovaries but low ecdysteroid titers. However, at six days of age, a trend towards higher ecdysteroid titer was observed for workers in queenless groups, a condition characterized by rapid follicle development relative to queenright conditions. In these queenless groups, high social status was associated with high ecdysteroid titers. By contrast, in queenright workers ecdysteroid titers were low, even for bees with presumably high social status that had activated ovaries and were observed performing oviposition behavior. This study suggests that ecdysteroids are involved in regulation of reproduction in B. terrestris.

Journal Article↗
PubMed2002

Prevalence and consequences of sleep disorders in a shift worker population.

INTRODUCTION: Irregular work schedules often results in a disruption of the normal circadian rhythm that can causes sleepiness when wakefulness is required and insomnia during the main sleep episode. METHOD: Two physicians using the Sleep-EVAL system interviewed 817 staff members of a psychiatric hospital. The interviews were done during the working hours. In addition to a series of questions to evaluate sleep and mental disorders, the evaluation included a standard questionnaire assessing work conditions, work schedule and their consequences. Three work schedules were assessed: (1) fixed daytime schedule (n=442), (2) rotating daytime shifts (n=323) and (3) shift or nighttime work (n=52). RESULTS: Subjects working on rotating daytime shifts were younger than the two other groups and had a higher proportion of women. Participants working on rotating daytime shifts reported more frequently than the fixed daytime schedule workers to have difficulty initiating sleep (20.1% vs. 12.0%). The sleep duration of shift or nighttime workers was shorter than that of the two other groups. Furthermore, subjects working rotating daytime schedule reported to have shorter sleep duration of about 20 min when they are assigned to the morning shift. Work-related accidents were two times more frequent among the rotating daytime workers (19.5%) compared with the fixed daytime schedule workers (8.8%) and the group of nighttime or shift workers (9.6%). Sick leaves in the previous 12 months were also more frequently reported in the rotating daytime schedule group (62.8%) as compared with the daytime group (38.5%, P<.001); 51.9% of nighttime or shift workers took sick leave. CONCLUSIONS: Working on a rotating daytime shifts causes significant sleep disturbances. As consequences, these workers are more likely to feel sleepy at work and are more likely to have work-related accidents and sick leaves.

Adult↗
PubMed2002

A survey of forest workers in New Zealand. Do hours of work, rest, and recovery play a role in accidents and injury?

PROBLEM: A number of structural and organizational changes have occurred recently within the New Zealand Forestry Industry, with concerns being raised about the impact of these changes on the forestry worker in terms of fatigue, sleepiness, and compromised safety. This study explored the relationship of fatigue, and some of its key determinants, with accidents and injuries in a group of forestry industry workers in New Zealand. METHOD: A total of 367 forestry workers responded to a self-administered questionnaire. RESULTS: Fatigue was found to be commonly experienced at work in the forest, with 78% of workers reporting that they experienced fatigue at least "sometimes." This study found that certain groups of workers reported long working hours, reduced sleep, compromised recovery time, and intensely paced work. The results of logistic regression analysis showed that recent sleep, number of breaks taken during the workday, and specific job/tasks were independently associated with reporting of high fatigue levels at work. Near-miss injury events were significantly more common among those reporting a high level of fatigue at work. Accidents and lost-time injury were associated with length of time at work, ethnicity, and having had near-miss injury events. DISCUSSION: Together, these results suggest that fatigue and aspects of work organization, which are likely to be fatiguing, may be associated with compromised safety for forest workers. IMPACT ON INDUSTRY: With an already slim margin of error present in forest operations, an impairment due to increased fatigue may constitute a significant risk factor for accidents and injuries in this workforce. The results indicate the need for further examination of shift and workload management among forestry workers, as well as a role for improving industry awareness about the causes and consequences of fatigue.

Accidents, Occupational↗
PubMed2003

Hospital workers' opinions on the predisposing factors to blood-related work accidents in Central Hospital, Benin City, Edo State, Nigeria.

INTRODUCTION: Hospital workers are prone to accidental injuries during their day-to-day activities at work. These accidental injuries are of importance because many of these predispose the workers to blood-borne infections. METHODS: A total of 242 hospital workers at Central Hospital, Benin City, Edo State participated in a cross-sectional study carried out between June and August 1999 aimed at finding out the predisposing factors to blood-related work accidents. The study group consisted of 53 doctors, 34 laboratory workers and 155 nurses. All doctors and laboratory workers at Central Hospital were involved in the study, while 50% of the nursing population were involved in the study. The nurses were selected using a stratified random sampling method. The respondents completed a pretested self-administered questionnaire. RESULTS: The results showed that the four main factors responsible for accidents among the hospital workers were: non-availability of protective measures; desire to hasten the procedure; type of procedure; and use of inadequate/inappropriate equipment. The major factor responsible for accidents at work among hospital workers was non-availability of protective measures. RECOMMENDATIONS: It is therefore recommended that adequate materials and equipment should be provided. This study could be further validated using a qualitative study design (focus group discussions).

Accidents, Occupational↗
PubMed2000

Venom alkaloids of fire ants in relation to worker size and age.

Piperidine alkaloids compose most of the venom of the red imported fire ant, Solenopsis invicta, and we examined how six of these alkaloids varied across worker size and age. In a colony sampled intensively, the relative abundance of each alkaloid was highly correlated with worker size with one exception, and ratios of saturated to unsaturated alkaloids were positively correlated with worker size. Similarly, both the abundance and ratios of alkaloids differed significantly between the small and large workers sampled from colonies across Texas, USA. Young and old workers produced less venom than ants of intermediate age (3-7 weeks), and ratios of saturated to unsaturated alkaloids increased significantly with worker age. The differences in venom composition correspond to the size- and age-based functional roles of workers.

Age Factors↗
PubMed1998

Aeroallergens and work-related respiratory symptoms among office workers.

OBJECTIVE: We sought to determine the association between office workers' respiratory tract symptoms and immediate skin test reactions with exposure to fungal and house dust mite aeroallergens at their work sites. METHODS: An initial prevalence survey was conducted among 1102 full-time workers in six mechanically ventilated, air-conditioned, nonindustrial buildings in downtown Montreal. Detailed environmental measures of 214 subjects' work sites were determined. Half of the workers reported frequent work-related respiratory tract symptoms on the initial survey. Participants simultaneously underwent allergy skin prick testing and completed a second self-administered questionnaire. RESULTS: Contaminant levels were low and not associated with symptoms in the great majority of workers. For approximately 17% of workers, symptoms were associated with exposure to total concentrations of house dust mite allergen greater than 1 microg/gm floor dust (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.3, 19.5]) or to detectable airborne Alternaria allergens in their offices (OR, 3.3; 95% CI, 1.2, 9.4 and in the ventilation system supplying their offices (OR, 3.9; 95% CI, 1.6, 9.6). Workers with positive skin test reactions to Alternaria extract were exposed at their work site to airborne Alternaria allergen (OR, 4.4; 95% CI, 1.4, 14.5) and cited significantly more respiratory symptoms on both questionnaires. Detection of airborne Alternaria allergen at work sites was significantly associated with detection in the ventilation system (OR, 4.0; 95% CI, 1.4,10.9); this was in turn associated with lower efficiency filters. CONCLUSIONS: Potentially avoidable exposure to aeroallergens accounted for symptoms in a small subgroup of office workers with frequent work-related respiratory tract symptoms.

Adult↗
PubMed1999

Exposure-response relationships for work-related sensitization in workers exposed to rat urinary allergens: results from a pooled study.

BACKGROUND: Recent studies in a few industries have shown that the likelihood of IgE-mediated sensitization increases with increasing exposure. The shape of the exposure-response relationships and modification by age, sex, and smoking habit has hardly been studied. OBJECTIVE: The purpose of this study was to determine exposure sensitization relationships for rat sensitization and to evaluate the influence of atopy, smoking habits, and sex. METHODS: Data from 3 cross-sectional studies in The Netherlands, the United Kingdom, and Sweden were used and involved 1062 animal laboratory workers. Selection criteria were harmonized, and this resulted in a study population of 650 animal laboratory workers (60.6% female) with less than 4 years of exposure. Air allergen levels were assessed previously and converted on the basis of an interlaboratory allergen analysis comparison. Available sera were analyzed for the presence of specific antibodies against common allergens (house dust mite, cat, dog, and grass and birch pollen) and work-related allergens (rat and mouse urinary proteins). Questionnaire items on work-related respiratory symptoms, hours worked with rats per week, job performed, smoking habits, and sex were used in this analysis RESULTS: The prevalence of work-related sensitization to rat urinary allergens (IgE >0.7 KU/L) was 9.7 % (n = 63). Thirty-six of the sensitized workers had work-related symptoms (asthma or rhinitis). Two hundred forty-eight workers (38.2%) were atopic (defined as specific IgE to 1 of the common allergens). The sensitization rate increased with increasing air allergen exposure. Atopic workers exposed to low levels of allergen had a more than 3-fold increased sensitization risk compared with nonexposed atopic workers. For atopic subjects, the risk increased little with increasing exposure, whereas for nonatopic subjects, a steadily increasing risk was observed. Smoking and sex did not modify the sensitization risk. CONCLUSION: Rat urinary allergen-sensitization risk increased with increasing exposure intensity. Workers who were atopic had a clearly elevated sensitization risk at low allergen exposure levels.

Allergens↗
PubMed1981

Ornithosis in poultry workers.

An outbreak of ornithosis in duck workers in the winter of 1979 and spring of 1980 was discovered by the investigation of a cluster of cases in Norfolk. A serological survey showed that 61% of duck workers but only 23% of control poultry workers had chlamydia group antibody titres of greater than or equal to 1:8. Altogether 9% of duck workers in the survey had antibody titres greater than or equal to 1:32 and a clinical illness suggestive of ornithosis. The proportions of seropositive tests and clinical attack rates were highest in workers eviscerating ducks and lowest in farm workers. It is suggested that a clinical history of contact with poultry should be considered relevant in the diagnosis of ornithosis and that clinicians caring for poultry workers should consider the possibility of ornithosis as an occupational disease.

Adult↗
PubMed2006

[Allergy to latex gloves among healthcare workers in Dakar].

BACKGROUND: The prevalence of latex allergy is high (to 17%) among groups at risk such healthcare workers. Our aim was to determine the prevalence and severity of allergy to latex gloves among health workers in Dakar. PATIENTS AND METHODS: The study was conducted in three of the five hospitals in Dakar (Senegal). A randomized sample was constituted. All healthcare workers required to use latex gloves in their work were included. A questionnaire was administered. The analysis was performed using the Epi-info software package (6.0). RESULTS: One hundred and forty cases were included. The median age was 39 years and the sex-ratio was 0.57. Sixty-six (47%) cases had familial atopic dermatitis, 13 (9.6%) had atopic dermatitis, and 4 (2.9%) indicated food allergy (banana, avocado). Irritant dermatitis was found in 40.7% of cases, 112 healthcare workers (81.2%) used bleach and water to clean their hands. Antiseptics were used frequently: 75.5% of those interviewed used them more than three times a day. None of the healthcare workers indicated any allergy to latex condoms. Otherwise surgical procedures and bladder/rectal catheters were noted respectively in 24% and 18% cases. Fifteen healthcare workers (10.7%), of whom 12 were women, indicated appearance of clinical signs when using latex gloves. The clinical manifestations were: contact urticaria or immediate pruritus (8 cases), combined contact dermatitis and contact urticaria (2 cases), allergic conjunctivitis (1 case), allergic rhinitis (2 cases) and asthma (2 cases). We also noted 6 cases of contact dermatitis. Rechallenge tests were performed in 7 cases and were positive, 2/3 prick-tests and 1/4 patch-tests (standard European battery). The statistical analysis shows that allergy to latex gloves was significantly associated with atopy and irritant dermatitis (p<0.03). DISCUSSION: We found a prevalence of allergy to latex gloves of 11% among healthcare workers in Dakar, reflecting reports in the literature. The classical risk factors such atopic dermatitis and irritant dermatitis were found. The correlation between irritant dermatitis and frequent use of bleach and water mean that these practices should be eradicated since they play an important role in the development of contact urticaria and anaphylactic reactions.

Adult↗
PubMed1998

Tuberculin skin test conversion rates in New York City Emergency Medical Service health care workers.

OBJECTIVE: To determine annual tuberculin skin test conversion (infection) rates for prehospital health care workers (EMTs and paramedics) in an urban environment with a high prevalence of Mycobacterium tuberculosis. METHODS: We conducted a prospective study of prehospital health care workers for the New York City EMS, EMS Employee Health Service, and the Fire Department Bureau of Health Service to determine the tuberculin skin test conversion rates. In 1992, all current and new EMS prehospital health care workers without a known history of a positive tuberculin reaction received a baseline tuberculin purified protein derivative (PPD) skin test. Thereafter, (January 1, 1993-December 31, 1996) all EMS health care workers who had negative PPD skin test results received annual tuberculin PPD skin tests. Tuberculin skin test conversion was defined as induration of 10 mm or greater in a worker with a documented prior negative test result. The PPD skin test reaction was measured by trained professional readers. RESULTS: A total of 7,290 PPD test results were read during this study. Compliance with annual testing was 75%. Annual tuberculin skin test conversion rates were 1.3% in 1993, .7% in 1994, .1% in 1995, and .2% in 1996 (average .5%). In a static subgroup with at least 15 years' seniority, compliance with annual testing was 100% and annual tuberculin skin test conversion rates were .5% in 1993, 0 in 1994, .5% in 1995, and 1.5% in 1996 (average .6%). CONCLUSION: Despite the high prevalence of M tuberculosis infection in New York City and the potential for difficulty in the use of respiratory precautions during emergency response operations, EMS prehospital health care workers have an annual tuberculin conversion rate that is relatively low compared with hospital-based health care workers.

Cohort Studies↗