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PubMed1994

Evaluation of chemical releases and worker exposures from filter press operations.

The exposures (inhalation and dermal) and releases (air, water, solids, and process streams) associated with the filtration of industrial wastewater sludge from an electronics manufacturing plant were characterized. Chemical releases and worker exposures for a target chemical (total copper) were measured over four operational cycles. Various aspects of the filtration operation believed to influence the measurement values were documented. Worker exposures associated with the discreet stages of the filter operation were measured. Ventilation patterns around the filter press were also monitored. The workers' time-weighted average exposures to total copper during the 113-minute operational cycle ranged from 3.1 to 25 micrograms/m3 (2.2 geometric standard deviation, 6.4 micrograms/m3 geometric mean concentration). The manual removal of filter cake comprised only 15% of the time in an average filtration cycle, but produced 72% of the workers' inhalation exposure. During this cake-removal stage, inhalation exposures ranged from 11 micrograms/m3 to 130 micrograms/m3 (2.5 geometric standard deviation, 30 micrograms/m3 geometric mean concentration). Differences in worker technique may account for the large range of inhalation exposures during the cake-removal stage. Exposures and releases were successfully determined for a single unit operation, as well as for the discreet stages of operation. The data generated will enable EPA to more accurately estimate worker exposures and chemical releases for new chemicals as required by the Toxic Substances Control Act. The approach utilized will benefit industrial hygienists in providing estimates of worker exposures and aid in the targeting of survey sampling.

Air Pollution↗
PubMed2004

Incidence of acute low-back injury among older workers in a cohort of material handlers.

Injuries to the low back are the most common cause for injury claims among material handlers. Previous studies have shown conflicting results about how age affects risk of low-back injury. This study describes the incidence of acute low-back injury by age, gender, length of employment, and lifting intensity measured by job classification in a cohort of material handlers. The cohort included all material handlers employed at a large home improvement retail chain in California from 1989 through 1994. The cohort accrued approximately 50,000 full time equivalents over the study period. A total of 2152 low-back injuries were reported during the study period. Compared to workers aged younger than 45, the crude rate ratio for workers aged 45 to 54 was 0.78, and for workers aged 55 and above was 0.84. However, this age difference was not apparent among length of employment strata or among jobs with low or medium lifting intensity. A higher proportion of workers over the age of 55 missed work time because of their injury, and workers over 45 had a higher average number of lost workdays per injury. This research indicates that workers over age 55 had similar injury rates to workers younger than age 55, even when considering lifting intensity and length of employment. However, their injuries may cause a longer period of disability.

Acute Disease↗
PubMed2004

Industries in the United States with airborne beryllium exposure and estimates of the number of current workers potentially exposed.

Estimates of the number of workers in the United States occupationally exposed to beryllium were published in the 1970s and 1980s and ranged from 21,200 to 800,000. We obtained information from several sources to identify specific industries with beryllium exposure and to estimate the number of current workers potentially exposed to beryllium. We spoke with representatives from the primary beryllium industry and government agencies about the number of exposed workers in their facilities. To identify industries in the private sector but outside the primary industry, we used data from the Integrated Management Information System (IMIS), which is managed by the Occupational Safety and Health Administration, and the Health Hazard Evaluation program of the National Institute for Occupational Safety and Health. We used IMIS data from OSHA inspections with a previously developed algorithm to estimate the number of potentially exposed workers in nonprimary industries. Workers potentially exposed to beryllium included 1500 current employees in the primary beryllium industry and 26,500 individuals currently working for the Department of Energy or the Department of Defense. We identified 108 four-digit Standard Industrial Classification (SIC) categories in which at least one measurement of airborne beryllium was > or = 0.1 microg/m3. Based on the subset of 94 SIC categories with beryllium > or = 0.1 microg/m3, we estimated 26,400 to 106,000 workers may be exposed in the private sector (outside the primary industry). In total, there are as many as 134,000 current workers in government and private industry potentially exposed to beryllium in the United States. We recommend that the results of this study be used to target at-risk audiences for hazard communications intended to prevent beryllium sensitization and chronic beryllium disease.

Air Pollution, Indoor↗
PubMed2005

The effectiveness of hearing protection among construction workers.

Effective hearing conservation programs in the construction industry are rare. Where programs are present, they often rely on workers' use of hearing protection devices (HPDs) rather than on exposure controls to reduce noise exposure levels. Dependence on HPDs for protection from high noise is problematic, as the protection provided by the HPD depends on both the HPD's attenuation level and the time the HPD is used. This article presents an analysis of data on noise exposure and hearing protection among construction workers drawn from several large datasets covering nine construction trades. A unique combination of 1-min dosimetry noise exposure levels and simultaneous self-reported use of HPDs was evaluated, as were occupational and nonoccupational HPD use data collected by questionnaire as part of a longitudinal study of noise exposure and hearing loss among apprentices. Direct measurements of HPD attenuation were also made on workers at their work site. The workers assessed in this study were found to use hearing protection less than one-quarter of the time that they were exposed above 85 dBA. Workers who reported always using HPDs in high noise on questionnaires were found to wear them only one-third of the time their exposures exceeded 85 dBA. Workers' self-reported use of HPDs during most noisy nonoccupational activities was also found to be low. Direct attenuation measurements found that workers were able to achieve more than 50% of the rated attenuation of their HPD on average, but that the variability in achieved attenuation was large. When the measured HPD attenuation levels and use time data were combined, the effective protection afforded by HPDs was less than 3 dB, a negligible amount given the high exposure levels associated with construction work. However, there was substantial variation in effective protection among the different trades assessed. These results demonstrate the need for better hearing conservation programs and expanded noise control efforts in the construction industry.

Cohort Studies↗
PubMed2000

Social workers and subbstance-abusing clients: caseload composition and competency self-ratings.

Past research and reports from the field have described social workers as having a host of negative responses to alcohol- and drug-abusing clients. Some found that substance abuse training increased social workers' sense of security and legitimacy in the therapeutic role with such clients. We report on 23 master's level social workers (MSWs) who completed an intensive 9-month substance abuse training program (trainees) and 22 MSW comparison subjects (comparisons). Both trainees and comparisons completed caseload forms identifying their clients by diagnosis and self-rated their competence to assess and treat each client. We predicted that workers trained in substance abuse, when compared with workers who lacked such intensive training, would (a) assess and treat more substance-abusing clients, (b) work with more complex substance-abusing clients (i.e., dually diagnosed clients), and (c) perceive themselves to be more competent to assess and treat substance-abusing clients. No significant differences were found between trainees and comparisons on relevant background variables. Using the t-test statistic to compare groups, we found that social workers trained in substance abuse had more substance abuse cases, with and without additional diagnoses, and rated themselves higher on two of six competency measures: in intervening with clients when all diagnoses were combined and in intervening when substance abuse only diagnoses were combined. This study takes the work a step further in demonstrating how social workers translate substance abuse training into practice. However, findings must be interpreted cautiously since training participants were not assigned randomly and selection bias may have been operating. The study is relevant for other health, mental health, and human service professionals for whom negative attitudes and behavior toward substance-abusing clients may be influenced by education and training.

Adult↗
PubMed2004

Health care workers and the initiation of treatment for latent tuberculosis infection.

BACKGROUND: Despite strong evidence and recommendations supporting the treatment of latent tuberculosis infection, many affected health care workers at risk of acquiring tuberculosis from and potentially transmitting tuberculosis to their patients do not receive treatment. The objective of this study was to determine whether health care workers were less likely than non-health care workers to initiate treatment for latent tuberculosis infection. METHODS: In this retrospective cohort study that used the disease management database from a specialized downtown Toronto tuberculosis clinic, patients with latent tuberculosis infection were included if they had risk factors for progression of disease and were excluded if they had contraindications to treatment. RESULTS: Our final cohort consisted of 308 patients with latent tuberculosis infection. The overall treatment initiation rate was 58%. We found that, when a number of confounding variables, including age, foreign birth, contact with persons with active tuberculosis, tuberculosis skin test conversion, bacille Calmette-Guérin vaccination, abnormal chest radiograph findings, comorbidities, and income, were considered and/or controlled for, the odds of a health care worker initiating treatment were approximately one-half of those of a non-health care worker (adjusted odds ratio, 0.55; 95% confidence interval, 0.32-0.93). CONCLUSION: We conclude that, in our clinic, health care workers are less likely than non-health care workers to initiate treatment for latent tuberculosis infection.

Adult↗
PubMed2000

The mortality and cancer morbidity experience of workers at the Capenhurst uranium enrichment facility 1946-95.

The results presented here contain the follow-up of the cohort of workers ever employed at the Capenhurst site of British Nuclear Fuels plc or its predecessors between 1946 and 1995. The main activity of the plant is isotopic, 235U, enrichment of uranium. The study cohort consists of 12,540 employees and contains 334,473 person-years of follow up. This is a relatively mature cohort, with a mean follow-up period of 26.7 years, that has been exposed to low levels of radiation. The collective external radiation dose received by the 3244 radiation workers was 31.95 person-sieverts, with mean cumulative dose 9.85 mSv. To the end of 1995 there have been 3841 deaths recorded for this cohort, 585 of which were amongst radiation workers. The standardised mortality ratios (SMRs) for all causes were significantly low, 83 and 91 respectively, for radiation and non-radiation workers, indicating the usual 'healthy worker' effect. The cancer mortality was less than that expected, though not significantly so, with SMRs for all cancers of 88 and 97, for radiation and non-radiation workers respectively. The cancer registration rates were significantly low, with standardised registration ratios (SRRs) for all cancers of 82 and 88, for radiation and non-radiation workers respectively. An association between bladder cancer registrations and cumulative external radiation exposure was noted when the cumulative external dose was lagged by 20 years.

Adult↗
PubMed2004

Identifying workers at risk for high health care expenditures: a short questionnaire.

The objective of this study was to create and measure the predictive accuracy of a brief questionnaire for screening new workers to identify those at increased risk for generating high health care insurance expenditures during the following year. Such an instrument could help health plans and providers intervene to mitigate the health risks of identified high-risk workers. We mailed a 53-item questionnaire to members of a "derivation cohort" (adult food processing workers, n = 15496) and obtained records of the eligible respondents' health insurance expenditures during the following year. Using multiple linear regression, we identified eight of the questions that predicted future expenditures most accurately, and created a formula to predict total expenditures from answers to these questions. To validate the formula's predictive accuracy, we used the eight-item questionnaire to survey two "validation cohorts" (transportation workers, n = 7445; and their dependents, n = 5562), inserted responses into the scoring formula, classified respondents into high-risk (top 10%) or low-risk (lower 90%) groupings, and then compared health insurance expenditures generated by the high- and low-risk groups during the following year. In the derivation cohort, age, sex, regular use of medications, frequent visits to physicians, and having arthritis, diabetes, cancer, or high cholesterol predicted future health care expenditures. In the worker and dependent validation cohorts, the respondents classified by the formula as high-risk generated insurance expenditures during the following year that were 2.4 and 1.8 times greater than those generated by the members of the low-risk groups (p < 0.001). An eight-item questionnaire and its scoring formula can identify high-risk groups of workers that will generate high health care expenditures during the following year. Healthcare organizations could use this questionnaire to help target new workers for care management and disease management interventions.

Adult↗
PubMed2005

Are public health workers aware of what they don't know?

OBJECTIVES: Training of public health workers is an important part of preparedness. Self-assessment is often used to measure how well workers are trained and whether they are ready to respond to an emergency event. The current study assessed how well self-assessment predicts actual knowledge. METHODS: Public health workers at a Public Health Ready pilot site self-assessed their general level of confidence, answered objective knowledge items about their local response plan, and self-assessed whether they were correct on the objective knowledge items. Correlational analysis was used to assess how well workers could assess what they knew and did not know. RESULTS: In the first analysis, for 15 objective knowledge items, the median correlation between self-assessment and actual performance was 0.18. When the average self-assessment on the core competencies was correlated with the number of correct answers to the objective knowledge items, the correlation was 0.34. CONCLUSIONS: The modest sizes of the correlations suggest that workers are weak judges of what they know and do not know. To prepare public workers for emergency events, it is suggested that two steps are important: (1) using the core competencies, develop a local response plan, and (2) develop an objective knowledge test to assess workers' knowledge of the local response plan.

Attitude of Health Personnel↗
PubMed2006

Reducing urinary tract infections among female clean room workers.

OBJECTIVES: A higher prevalence of urinary tract infection (UTI) was observed among clean room workers than among others in our previous study in 2001. We implemented intervention programs for reducing UTI and evaluated their effects 2 years later. METHODS: We conducted an intervention study in four factories in the industrial park where the previous study was conducted and recruited participants from women workers who received annual health examinations at the clinic of the park. The intervention included health education programs during the new employee orientation and seasonal on-the-job training. We also implemented other measures, including placing posters in the workplace and disseminating knowledge of UTI prevention through e-mail and oral communications. One-on-one education was provided to workers who were found to have UTI in the previous study. RESULTS: All the 1666 qualified workers, including 1414 clean room workers and 252 nonclean room workers, agreed to participate. We found a similar prevalence (both 0.8%) of symptomatic UTIs (patients with clinical symptoms, such as voiding frequency, urgency, and burning sensation during voiding) in clean room and nonclean room workers. In the 366 participants who also participated in the previous study, we found a significant decrease in the prevalence of UTI (from 9.8% to 1.6%) and significant increases in the prevalence of water intake and urine voiding, three times or more during a shift (p < 0.001 for all McNemar tests). CONCLUSIONS: The interventions had achieved behavior modification and decreases in the prevalence of UTI.

Adult↗
PubMed1993

A comprehensive evaluation of within- and between-worker components of occupational exposure to chemical agents.

A database of approximately 20,000 chemical exposures has been constructed in close co-operation between the School of Public Health of the University of North Carolina at Chapel Hill and the Department of Air Pollution of the Wageningen Agricultural University. A special feature of this database is that only multiple measurements of exposure from the same workers were included. This enabled estimation of within- and between-worker variance components of occupational exposure to chemical agents throughout industry. Most of the groups were not uniformly exposed as is generally assumed by occupational hygienists. In fact only 42 out of a total of 165 groups (25%), based on job title and factory, had 95% of individual mean exposures within a two-fold range. On the contrary, about 30% of the groups had 95% of individual mean exposures in a range which was greater than 10-fold. Environmental and production factors were shown to have distinct influences on the within-worker (day-to-day) variability, but not on the between-worker variability. Groups working outdoors and those working without local exhaust ventilation showed more day-to-day variability than groups working indoors and those working with local exhaust ventilation. Groups consisting of mobile workers, those working with an intermittent process and those where the source of contamination was either local or mobile also showed great day-to-day variability. In a multivariate regression model, environment (indoors-outdoors) and type of process (continuous-intermittent) explained 41% of the variability in the within-worker component of variance. Another model, in which only type of process (continuous-intermittent) had a significant effect, explained only 13% of the variability in the between-worker component of variance.

Air Pollutants, Occupational↗
PubMed2004

Urinary 1-hydroxypyrene and polycyclic aromatic hydrocarbon exposure among asphalt paving workers.

OBJECTIVES: Using urinary 1-hydroxypyrene (1-OHP) as a measure of total absorbed dose, the primary objective of this study was to evaluate the total effect of inhalation and dermal PAH exposures while considering other factors such as age, body mass index and smoking that may also have a significant effect on urinary 1-OHP. METHODS: The study population included two groups of highway construction workers: 20 paving workers and 6 milling workers. During multiple consecutive workshifts, personal air and dermal samples were collected from each worker and analyzed for pyrene. During the same work week, urine samples were collected pre-shift, post-shift and at bedtime each day and analyzed for 1-OHP. Distributed lag models were used to evaluate the independent effect of inhalation and dermal exposures that occurred at each of several preceding exposure periods and were used to identify the relevant period of influence for each pathway. RESULTS: The paving workers had inhalation (mean 0.3 micro g/m(3)) and dermal (5.7 ng/cm(2)) exposures to pyrene that were significantly higher than the milling workers. At pre-shift on Monday morning, following a weekend away from work, the pavers and millers had the same mean baseline urinary 1-OHP level of 0.4 micro g/g creatinine. The mean urinary 1-OHP levels among pavers increased significantly from pre-shift to post-shift during each work day, while the mean urinary 1-OHP levels among millers varied little and remained near the baseline level throughout the study period. Among pavers there was a clear increase in the pre-shift data during the work week, such that the average pre-shift level on day 4 (1.4 micro g/g creatinine) was 3.5 times higher than the average pre-shift results on day 1 (0.4 micro g/g creatinine). The results of the distributed lag model indicated that the impact of dermal exposure was approximately eight times the impact of inhalation exposure. Furthermore, dermal exposure that occurred during the preceding 32 h had a statistically significant effect on urinary 1-OHP, while the effect of inhalation exposure was not significant. CONCLUSIONS: We found that distributed lag models are a valuable tool for analyzing longitudinal biomarker data and our results indicate that dermal contact is the primary route of exposure to PAHs among asphalt paving workers. An exposure assessment of PAHs that does not consider dermal exposure may considerably underestimate cumulative exposure and control strategies aimed at reducing occupational exposure to asphalt-related PAHs should include an effort to reduce dermal exposure.

Air Pollutants, Occupational↗
PubMed2004

Reduced nucleotide excision repair and GSTM1-null genotypes influence anti-B[a]PDE-DNA adduct levels in mononuclear white blood cells of highly PAH-exposed coke oven workers.

It is important to identify the potential genetic-susceptible factors that are able to modulate individual responses to exposure to carcinogenic polycyclic aromatic hydrocarbons (PAHs). In the present study we evaluated the influence of four polymorphisms of nucleotide excision repair (NER) genes [xeroderma pigmentosum-C (XPC)-PAT +/-, xeroderma pigmentosum-A (XPA) 5' non-coding region-A23G, XPD-exon 23 A35931C Lys751Gln, xeroderma pigmentosum-D (XPD)-exon 10 G23591A Asp312Asn] and that of glutathione S-transferase mu1 (GSTM1-active or -null) on benzo[a]pyrene diol epoxide (B[a]PDE)-DNA adduct levels from the lympho-monocyte fraction (LMF) of highly PAH benzo[a]pyrene (B[a]P)-exposed Polish coke oven workers (n = 67, 67% current smokers) with individual urinary post-shift excretion of 1-pyrenol exceeding the proposed biological exposure index (BEI) (2.28 micromol/mol creatinine). The bulky (+/-)-r-7,t-8-dihydroxy-t-9,10-oxy-7,8,9,10-tetrahydrobenzo[a]pyrene (anti-B[a]PDE)-DNA adduct levels were detected by high-performance liquid chromatography (HPLC)/fluorescence analysis and genotypes by polymerase chain reaction. We found that workers with the low DNA repair capacity of XPC-PAT+/+ and XPA-A23A genotypes had significantly increased anti-B[a]PDE-DNA adduct levels (Mann-Whitney U-test, z = 2.24, P = 0.02 and z = 2.65, P = 0.01). Moreover, DNA adducts were also raised in workers without GSTM1 activity (GSTM1-null genotype) (Mann-Whitney U-test, z = 2.25, P = 0.0246). Workers with unfavourable XPC-PAT+/+ and XPA-A23A NER genotypes, alone (approximately 65% of workers) or combined with GSTM1-null genotype (approximately 75% of workers) were in the tertile with the highest adduct level, i.e. >4.11 adducts/10(8) nt (chi2 = 5.85, P = 0.0156 and chi2 = 5.40, P = 0.01). The increase in anti-B[a]PDE-DNA adduct levels (ln values) was significantly related in a multiple linear regression analysis to PAH exposure (i.e. urinary post-shift excretion of 1-pyrenol) (t = 2.61, P = 0.0115), lack of GSTM1 activity (t = 2.41, P = 0.0192) and to low DNA repair capacity of the XPC-PAT+/+ genotype (t = 2.34, P = 0.0226). The influence of the XPA-A23A genotype was not evident in this statistical analysis, and no associations with XPD polymorphisms, dietary habits or tobacco smoking were found. The modulation of anti-B[a]PDE-DNA adducts in the LMF by GSTM1-null and some low-activity NER genotypes may be considered as a potential genetic susceptibility factor capable of modulating individual responses to PAH (B[a]P) genotoxic exposure and the consequent risk of cancer in coke oven workers.

Benzopyrenes↗
PubMed2006

Hemoglobin adducts in workers exposed to benzidine and azo dyes.

Benzidine (Bz) is a known human carcinogen. Several azo dyes have been synthesized with Bz. Bz can be metabolically released from azo dyes. In a group of Indian workers producing Bz and azo dyes the presence of hemoglobin (Hb) adducts was investigated. The following Hb adducts were identified and quantified by GC-MS: Bz, N-acetylbenzidine (AcBz), 4-aminobiphenyl (4ABP), aniline. 4ABP and aniline were quantitatively the major adducts. In the exposed workers (n = 33) all correlations between 4ABP, Bz and AcBz were r = 0.89 (P < 0.01) or greater. The group of workers exposed to Bz (Bz workers, n = 15) had 10-17-fold higher adduct levels than the workers exposed to dyes (dye workers, n = 18). 4ABP can be metabolically released from Bz and azo dyes. Aniline can be metabolically released from azo dyes. Therefore, the presence of 4ABP and aniline as Hb adducts is a consequence of exposure to the parent compounds or to the exposure of Bz and azo dyes and a consequent metabolical release of the arylamine moiety. The mean adduct ratios of 4ABP/(AcBz + Bz) varied up to 4-fold across all seven factories. Therefore, it is possible that 4ABP may have derived from general contamination in the work environment or endogenous metabolism, or a combination of the two. Since 4ABP is also a known human carcinogen, tumors observed in workers exposed to Bz or Bz dyes might be caused by both compounds. Further, these results suggest that understanding the role that genetic variants in NAT1 and NAT2 play in modifying the impact of Bz on bladder cancer risk may be complicated, as N-acetylation detoxifies 4ABP and activates Bz.

Adult↗
PubMed1989

Job-related stress and coping among home-care workers with elderly people.

Little is known about the job-related stress of home-care workers from the point of view of the workers themselves. Thirty-two home-care workers from six community-based, home-care programs sponsored by New York area Catholic Charities agencies were studied. The subjects predominantly were female, white, observant Christians, with a median age of 49 years. Test scores revealed little reported stress; however, interviews revealed significant stress that resulted primarily from interpersonal interactions, affective tasks, and insufficient pay. Coping strategies appeared to include denial, identification with clients, altruism. Low pay was the workers' primary dissatisfaction. The authors suggest ways that social workers, administrators, and supervisors can improve their work with home-care workers and encourage advocacy and social action on behalf of these workers.

Adaptation, Psychological↗
PubMed1987

Mortality of aluminium reduction plant workers in France.

The mortality between 1950 and 1976 of 6455 French aluminium plant workers was analysed in order to assess occupational risks (especially lung cancer) associated with electrolysis, particularly with the Söderberg process. Mortality from all causes (SMR = 0.85), was lower in this cohort than in the French male population ('healthy worker effect'), and cancer mortality (SMR = 1.09) was only slightly higher. There was an excess of mortality from accidents (mainly non-occupational) in electrolysis workers (SMR = 1.38) and from cirrhosis of the liver in maintenance workers (SMR = 1.63). Among electrolysis workers, only those who had worked less than 10 years had a relative excess mortality from lung cancer (SMR = 1.94), but this did not seem to be associated with a particular electrolysis process. However a substantial underlying risk of lung cancer in Söderberg workers could not be excluded, although such a risk appeared unlikely for prebake workers.

Aluminum↗
PubMed2005

Effects of carbon dioxide narcosis on ovary activation and gene expression in worker honeybees, Apis mellifera.

In an effort to uncover genes associated with ovary activation in honey bee workers, the extent to which eight candidate genes co-varied in their expression with experimentally-induced changes in worker reproductive state was examined. Groups of caged, queenless workers narcotized with CO(2) on consecutive days early in adult life showed a significantly lower level of ovary activation than did groups of untreated workers. This same experimental treatment, by contrast, is known to accelerate ovary activation and induce egg laying in virgin honey bee queens--an observation that suggests that CO(2) narcosis has contrasting effects in queen versus worker ovary activation. Experimentally-induced changes to worker reproductive state were associated with changes in gene expression. Vitellogenin, an egg yolk precursor, and transferrin, an iron transporter, were two transcripts found to be significantly down-regulated as a function of the ovary-inhibiting treatment. CO(2) narcosis did not effect the expression of six other genes selected as putative markers for processes that may underlie ovary activation. The show that the expression of vitellogenin and transferrin is correlated with ovary activation in workers, and may therefore be part of the gene network involved in the regulatory control of functional sterility in honeybees.

Animals↗
PubMed1991

Excess number of bladder cancers in workers exposed to ortho-toluidine and aniline.

A retrospective cohort study of the incidence of bladder cancer was conducted in response to a union request for an evaluation of a possible excess number of cases of bladder cancer at a chemical plant in western New York State. Workers at the plant were exposed to two potential bladder carcinogens--ortho-toluidine (o-toluidine) and aniline. Incidence rates of bladder cancer among workers at the plant were compared with those of the population of New York State (excluding New York City). Among all 1749 workers at the plant, 13 cases of bladder cancer were observed versus 3.61 expected [standardized incidence ratio (SIR) = 3.60; 90% confidence interval (CI) = 2.13-5.73]. Among the 708 workers who worked in areas in which o-toluidine and aniline were used, 7 cases were observed versus 1.08 expected (SIR = 6.48; 90% CI = 3.04-12.2). Among the 288 maintenance, shipping, and janitorial workers thought to have been possibly exposed, 4 cases were observed versus 1.09 expected (SIR = 3.66; 90% CI = 1.25-8.37). Among the remaining 753 workers who were probably not exposed, 2 bladder cancers were observed versus 1.43 expected (SIR = 1.39; 90% CI = 0.25-4.39). Increased risk of bladder cancer was strongly associated with increased duration of employment in the department where o-toluidine and aniline were used (P less than .001). Among workers with 10 or more years of employment in the department, the SIR was 27.2 (90% CI = 11.8-53.7). o-Toluidine is an animal carcinogen more potent than aniline and is known to produce bladder tumors in rats; hence, it is more likely that o-toluidine is responsible for the observed excess number of cases of bladder cancer, although aniline may have played a role.

Adult↗