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Studies of respiratory morbidity in rubber workers. Part III. Respiratory morbidity in processing workers.

Respiratory questionnaires and pulmonary function tests were administered to sixty-five men exposed to dust in the processing are from three rubber tire manufacturing plants. Similar tests were done on 189 "control" workers. Compared with the controls, the processing workers had a higher prevalence of chronic productive cough. Overall, the processing group showed a decrease in the ratio of FEV to FVC. The processing workers with more than ten years of exposure showed a significant decrease in the ratio of FEV1.0/FVC, the FEV1.0, the residual FEV1.0, and the flow rates at 50% and 25% of the forced vital capacity. None of the pulmonary function effects could be solely explained on the basis of smoking, age, ethnic, or socioeconomic factors: all were related to the length of exposure. Based on these results we conclude that exposure in the processing area produces pulmonary disease.

Adult↗

Monitoring exposure of brewery workers to CO2: a study of cellar workers and controls.

Carbon dioxide exposure of nineteen cellar workers and twenty nonexposed controls in a medium size brewery was assessed by determining base excess and standard bicarbonate of the plasma before work on Monday and after work on Monday and Friday. Standard bicarbonate averaged 0.6mEq/L higher in the cellar workers than the controls when samples taken at the same time were compared. This difference was not statistically significant. Standard bicarbonate and hemoglobin concentration declined significantly in both groups between Monday before work and Friday after work, suggesting that hemodilution had occurred. This may have been related to the comsumption of large amounts of beer or other fluid. The air breathed by three cellar workers was monitored continuously during working hours for one wk. Carbon dioxide concentrations varied widely, but yielded a time-weighted average of 1.08% carbon dioxide. The time-weighted average was inordinately difficult to establish under the working conditions in the brewery and was irrelevant with respect to acutely hazardous exposures.

Adult↗

Prevalence of measles susceptibility among health care workers in a UK hospital. Does the UK need to introduce a measles policy for its health care workers?

OBJECTIVES: First, to determine the prevalence of measles non-immunity in a group of health care workers (HCW), and secondly, to investigate what pre-employment screening for measles is carried out by NHS occupational health departments. METHODS: Two hundred and eighteen HCWs with patient contact on the medical wards at Addenbrooke's hospital provided an oral fluid sample and answered a questionnaire. A postal survey of Association of National Health Occupational Physicians Society (ANHOPS) members was conducted to assess whether UK NHS Trusts identify measles non-immune individuals. RESULTS: Of the HCWs tested, 3.3% of were found to be non-immune to measles (both oral fluid and confirmatory serum sample were measles IgG negative). Less than one third of a sample of 80 NHS occupational health departments enquired about measles immunity. CONCLUSION: The prevalence of measles non-immune health care workers is low, but with a fall in uptake of MMR immunization and increased likelihood of measles outbreaks, it is important to identify these at-risk individuals. Serum testing is the most reliable method to use. Oral fluid testing and history of measles disease or vaccination are unreliable methods of identifying non-immune individuals. To achieve complete immunity, it is cost-effective to screen and then offer immunization. NHS trusts vary greatly in their measles policies for health care workers.

Adult↗

Long-term mortality study of oil refinery workers. I. Mortality of hourly and salaried workers.

This longitudinal study examined the mortality and cancer experience of workers at the Gulf Oil refinery located in Port Arthur, Texas. The cohort was studied over a period of 41 years, from 1937 to 1978, and consisted of 16,880 employees, with an accumulation of 406,198 person-years; 4361 deaths were observed. Emphasis of this study was placed on the experience of the hourly and salaried male workers employed one day or more and those with a minimum of one year employment. The standardized mortality ratio analysis revealed generally favorable mortality experience of the refinery workers, including that of overall cancer. Statistically significant deficits in mortality were found for several cancer sites including bladder, liver, and esophageal cancer. Many of the increased cancer risks suggested in the literature were not confirmed in this study. Although bone cancer was found to be increased significantly, review of those death certificates raises questions as to the accuracy of the recording and coding of this cancer. Sample size of this study is capable of providing sufficient statistical power for the detection of a twofold increase in mortality risk for many cancers, if such risk exists.

Adult↗

Higher birth weight and lower prevalence of low birth weight in children of agricultural workers than in those of workers in other occupations.

Agricultural occupation has been associated with different reproductive outcomes. This study examined the relation between mean birth weight (MBW) and the prevalence of low birth weight (LBW) and paternal occupation in 1995-1998. Births and late fetal deaths were analyzed (n = 1,097,817). Paternal occupation was grouped into four categories: professionals and managerial; clerical, sales and service; manual; and agricultural workers. We estimated the difference between the MBW and the prevalence ratio of LBW in each occupational group as compared to the group of professionals and managerial workers. The adjusted difference in the MBW of the children of each occupational category was -8.9 g, -17.2 g, and 16.9 g, respectively. The adjusted prevalence ratio for LBW was 1.04, 1.08, and 0.91. Our results suggest a higher birth weight and lower prevalence of LBW in children of fathers who are agricultural workers.

Adult↗

Terrorism-preparedness training for non-clinical hospital workers: tailoring content and presentation to meet workers' needs.

Clinicians have been the primary focus of health care worker training in response to the 2001 terrorist and anthrax attacks. However, many nonclinical hospital workers also are critical in providing medical care during any large-scale emergency. We designed a training program, guided by focus groups, to provide them with information to recognize unusual events and to protect themselves. We compared four different training methods: workbook, video, lecture, and a small-group discussion. One hundred and ninety-one workers participated. After the training, they were more confident in their employer's preparedness to respond to a terrorist attack but specific knowledge did not change substantially. Fortunately, the self-directed workbook (the more economical and least disruptive method) was as effective as the other methods. Our experience may be useful to others who are planning terrorism-preparedness training programs.

Adult↗

Employment and diabetes: a survey of the prevalence of diabetic workers known by occupational physicians, and the restrictions placed on diabetic workers in employment.

A postal survey of occupational physicians identified a prevalence of known diabetes among workers of 7.5 per 1000. The prevalence of insulin-treated diabetes was 2.6 per 1000 and of other diabetes was 4.9 per 1000. The figure for insulin-treated diabetes is lower than expected from population studies. The restrictions placed on diabetic workers in employment include shift-work, heights, dangerous areas, driving, civil aviation, emergency teams, offshore oil work, and work overseas. Certain companies within the chemical, oil, steel, confectionery, and drinks industries had lower than expected numbers of diabetic workers and merit further detailed study.

Diabetes Mellitus↗

Healthy and unhealthy life styles of female brothel workers and call girls (private sex workers) in Sydney.

Two groups of female sex workers were compared with respect to their healthy or unhealthy life styles. Both 'call girls' (private sex workers) and brothel workers were infected with sexually transmitted diseases as often in their noncommercial sexual relations as in their work, smoking was a serious problem for both, and each group endured problems from clients specific to their work sites. However, overall, the call girls had healthier life styles, but were more vulnerable to pressures from clients for unsafe sex and to potential violence.

Adolescent↗

Survey of construction workers repeatedly exposed to chlorine over a three to six month period in a pulpmill: II. Follow up of affected workers by questionnaire, spirometry, and assessment of bronchial responsiveness 18 to 24 months after exposure ended.

OBJECTIVE: The aim was to determine the prevalence of persistent respiratory symptoms and bronchial hyper-responsiveness due to reactive airways dysfunction syndrome in a population of construction workers at moderate to high risk of developing the syndrome, at an interval of 18 to 24 months after multiple exposures to chlorine gas during renovations to a pulp and paper mill. DESIGN AND PARTICIPANTS: 71 of 289 exposed workers (25%) were identified on the basis of an exposure and the onset of respiratory symptoms shortly after this event (moderate to high risk). A standardised respiratory questionnaire was first presented, followed by spirometry and a methacholine inhalation test on those whose questionnaire suggested the persistence of respiratory symptoms. RESULTS: 64 of 71 (90%) subjects completed the respiratory questionnaire at the time of the follow up. The questionnaire suggested a persistence of respiratory symptoms in 58 of the 64 workers (91%). Of the 58 subjects, 51 underwent spirometry and assessment of bronchial responsiveness. All of them used bronchodilators as required (not regularly) and four required inhaled anti-inflammatory preparations. Sixteen had bronchial obstruction (forced expiratory volume in one second) (FEV1 < 80% predicted) and 29 showed significant bronchial hyper-responsiveness. CONCLUSION: Of the subjects (n = 71) who were at moderate to high risk of developing reactive airways dysfunction syndrome after being exposed to chlorine and were seen 18 to 24 months after exposure ended, 58 (82%) still had respiratory symptoms, 16 (23%) had evidence of bronchial obstruction, and 29 (41%) had bronchial hyper-responsiveness.

Adult↗

Coal worker's pneumoconiosis: CT assessment in exposed workers and correlation with radiographic findings.

To study the signs of coal worker's pneumoconiosis (CWP) at computed tomography (CT), the authors obtained thoracic CT scans in 170 coal-dust-exposed workers who were concomitantly evaluated with conventional posteroanterior and lateral radiography. The profusion and extent of disease was assessed by means of CT in two groups of miners: group 1 (n = 86), miners with worker's compensation and radiographic evidence of CWP, and group 2(n = 84), miners who had applied for compensation without radiographic evidence of CWP. The CT signs of CWP consisted of micronodules, nodules, and progressive massive fibrosis. The comparative analysis demonstrates the superiority of an optimal CT technique over chest radiography in the evaluation of simple silicosis, with improved sensitivity in the detection of small parenchymal opacities. CT provides additional information on the stage of the disease but also clarifies some ambiguities of the ILO classification of small opacities. CT was equivalent to radiography for complicated silicosis, except in the identification of necrosis. CT evaluations are complementary to plain radiography in the assessment of CWP, and the addition of high-resolution CT is useful in achieving a more accurate evaluation of the small parenchymal opacities.

Adolescent↗

Back Pain among U.S. Workers: Comparison of Worker Attributes According to Self-reported Causes of Back Pain.

Back pain is a significant health problem, especially in industry. To gain a better understanding of back pain in light of its diverse causality, data for 29,322 working adults interviewed in the Occupational Health Supplement to the 1988 National Health Interview Survey were analyzed by self-reported cause of back pain. The 12-month prevalences of back pain for "injury or repeated activities at work," "injury or repeated activities not at work," and "other reasons," were 9.1%, 4.4%, and 4.0%, respectively. The worker attributes and work impacts associated with these self-reported causes were compared for this nationally representative sample. Results from multivariate logistic regressions indicated different profiles of worker attributes among the three cause-specific subgroups of back-pain sufferers. Work impact was substantial in all cases, but was highest for workers with work-related back pain.

Journal Article↗

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

The International Agency for Research on Cancer 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, we conducted a cohort mortality study 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, West Virginia and Institute, West Virginia, 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% 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.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Worker's health & outsourcing: worker's profile in a hospital cleaning service].

In the last two decades, service outsourcing has reduced companies' costs by the rationalization of their actions and the exploration of precarious work relations. This research aimed to outline the profile of outsourced workers in the cleaning service of a university hospital, identify their points of view about the health-illness process and future plans. This is a descriptive study from a quantitative approach, involving a random sample with 50 cleaning workers. Most of them started to work early, 74% were women and education level was low. In 36% of the cases, physicians diagnosed some kind of illness. In the analyzed period, 84% of the interviewees had realized medical consultations, resulting in an average of 3.6 consultations per worker, 56% of which involved general clinicians. Data analysis allowed for the identification of these professionals' perspectives in relation to the health/illness process and their future.

Adult↗

Blood lead survey of children, pregnant women, professional drivers, street workers, and office workers in Trujillo, Peru.

In this pilot study, conducted in summer 2002, the authors measured blood lead levels (BLLs) for 118 subjects in the city of Trujillo, Peru, where leaded gasoline is in the process of being phased out. Subjects included bus drivers, combi (minivan) drivers, street vendors, newspaper vendors, traffic police, taxi drivers, gas station attendants, children living both near and distant from gas stations, pregnant women, and office workers (controls). The highest BLLs were 9.2 microg/dl and 9.3 microg/dl from a child who lived near a gas station and from a traffic policeman, respectively; however, all BLLs were below the U.S. Centers for Disease Control and Prevention's advisory level of concern (10 microg/dl). Office workers (n = 8) and pregnant women (n = 36) had significantly lower BLLs (geometric mean +/- standard deviation = 2.1 +/- 0.7 microg/dl, p < 0.022; and 2.5 +/- 1.1 microg/dl, p < 0.008, respectively) than total traffic-exposed workers (n = 48; 3.2 +/- 1.8 microg/dl). BLLs of children living near gas stations (n = 17; 3.7 +/- 2.2 microg/dl) were marginally higher (p = 0.07) than for children not living near gas stations (n = 9; 2.9 +/- 1.1 microg/dl). The study was limited by small sample size and the fact that the data were based on a convenience sample not fully representative of the cohorts studied. Nevertheless, the authors' findings suggest that leaded gasoline use in Trujillo continues to affect BLLs in traffic-exposed populations.

Adult↗

A job analysis of selected health workers in a district health system in KwaZulu-Natal. Part three: Other categories of health workers.

This article described the third part of a study aimed at doing a job analysis of nurses and non-professional health workers in a district health system. This article describes the tasks of five categories of workers, their training and their work-load over an ordinary week. Interviews were done with 52 workers from three hospitals and five clinics, of whom 14 were men and 38 women. The three PHC guards had a much more varied job than the hospital security staff (also three). All of them have had specific task related training. The six General Assistants in Primary Health Care settings were almost exclusively involved in cleaning, while the 23 in hospitals added food and drink management and running errands to their work. Only one had training pertaining to the specific tasks. All three clerks were found in the PHC setting, and their tasks were mainly that of receptionist. None had specific task related training. The three Ground's Men worked at gardening and cleaning at PHC clinics, but a range of other tasks were added from time to time. Porters, of whom ten were interviewed, did mainly transporting of patients and running errands. GA's and security staff were also used to control violent patients and visitors, something for which none of them have had training. Recommendations were made about training and work redesign in the district.

Adult↗

[Interindividual differences in tolerance to shift work and characteristics of shift workers: relation between the quality and duration of sleep and certain worker characteristics].

The investigation aimed at examining the relationship between the quality and duration of sleep on the one hand and various shift workers' characteristics on the other, as well as establishing whether sleep characteristics were congruent with some other indices of night shift tolerance. A total of 604 rotating shift workers working in a fast rotating shift system were administered a battery of questionnaires. The results showed that sleep quality was related to their many characteristics, especially to neuroticism, rigidity of sleeping habits, flexibility of habits, and relaxedness. Actually, the shift workers' characteristics accounted for a notable percentage (48%) of interindividual differences in sleep quality. However, there were fewer traits related to sleep duration than to sleep quality so that only a small percentage of interindividual differences in sleep duration could be explained (12-30%). Sleep quality proved to be a good indicator of night shift tolerance. The results concerning sleep duration indicated only sleep duration on the afternoon shift and days off, as well as average sleep duration in the complete shift cycle, to be relatively good indices of night shift tolerance.

Adult↗

The effect of airborne lead particle size on worker blood-lead levels: an empirical study of battery workers.

Theoretical models and experimental data suggest that the particle size distribution of lead aerosols should affect the lead dose absorbed by exposed workers. In the present study, 44 workers in five major operations in a high-volume, lead-acid battery plant were studied for the influence of lead aerosol size on lead-in-blood (PbB) levels. A multiple linear regression analysis based on particle size assumptions made in the model used by the Occupational Safety and Health Administration to help select the permissible exposure level (PEL) for lead showed no improvement in prediction of PbB over that already present without any consideration of particle size. The use of the American Conference of Governmental Industrial Hygienists (ACGIH) regional size-selective criteria also failed to improve the prediction of PbB. However, when deposition models developed by Heyder et al were used in which the lead aerosol was separated into alveolar and extra-alveolar fractions, corresponding to what is considered respirable and ingestible lead, the coefficient of determination (R2) associated with the fractionated lead particulate increased approximately 25% over that attributable to only the total lead concentration. In addition, the deposition model, which closely matched the ACGIH reference worker criteria, resulted in ratios of the coefficients for the respirable to ingestible lead contributions to PbB that appeared to agree with experimental data, suggesting approximately a 10 to 1 ratio in absorption efficiency of the lung versus the gastrointestinal tract.

Aerosols↗

Farm worker injuries on Western Cape fruit farms: the role of the lay health worker.

AIM AND METHOD: An exploratory and descriptive study to obtain basic data on the extent, nature, sources and severity of injuries sustained on fruit farms was conducted. The possibility of utilizing lay health workers (LHWs) on farms to document routine information on injuries was also investigated. Descriptive information of all injuries occurring on selected farms, both occupational and other, needing some form of treatment, were documented over a one-year period from June 1999 to May 2000. A purposive non-probability sampling method was used. Forty-eight fruit farms with a history of trained LHWs were purposefully selected. Injuries were documented using a one-page questionnaire. RESULTS: A total of 500 injuries were recorded, giving an average of 10.4 injuries per farm per year. Half of these injuries were work-related. Workers aged 20-39 were most at risk. Injuries sustained were related to routine activities of fruit farming, occurred mostly in the orchards and involved cuts, bruises and abrasions to the hands, including the fingers, and the eyes. Most of the non-work related injuries occurred in and around the home. A third of these injuries were sustained by persons < 20. A large percentage of the non-work related injuries were violence- and alcohol related. Most of the injuries required basic primary health care that could be managed by the LHW. Injury severity caused people to take time off for one third of the cases. CONCLUSION: A relatively high occupational injury rate in comparison to high-income countries. Occupational Health and Safety legislation needs to be institutionalized and adhered to. Alcohol and violence on farms is a serious public health problem. LHWs could potentially play an important role in documenting injury data.

Adolescent↗