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PubMed1993

Randomized telephone smoking-intervention trial initially directed at blue-collar workers.

Although smoking prevalence in the United States has declined markedly in recent years, prevalence among blue-collar workers remains high and few successful methods of reaching this group have been identified. The present study was designed to test the relative efficacy of two different approaches to telephone smoking-cessation counseling for blue-collar workers. Our study built on the experience of the National Cancer Institute's Cancer Information Service (CIS) and compared the past CIS smoking-cessation counseling procedure and a modified version of the present procedure. In our trial, callers to a special telephone hotline who asked for information on smoking cessation were randomly assigned to receive counseling under one of two protocols: 1) the past CIS procedure, in which general information was given and cessation materials were sent to the callers, and 2) a version of the present CIS stage-model procedure, adapted by us for use with blue-collar workers, in which callers were given counseling specific to their stage in the smoking-cessation process. The general-information group contained 185 subjects; the stage-model group contained 197. Despite extensive efforts in the present study, it was not possible to recruit the number of blue-collar workers planned for our statistical analysis. Consequently, of a total of 382 subjects recruited, 93 (24.3%) were blue-collar workers, 181 (47.4%) were white-collar workers, and 108 (28.3%) were retired persons who worked part time, student workers, or the unemployed. Our results show no statistically significant differences in either short-term or long-term nonsmoking rates between the general-information group and the stage-model group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Evolution of radiologic changes in lungs of workers occupationally exposed to asbestos dust].

The dynamic of radiological changes in lungs of 458 workers exposed to chrysotile asbestos dust and in 65 retired workers previously exposed to the same dust was assessed. There was a 5-year interval between initial and control examinations in the group of acting workers and an 8-year interval in the group of retired workers. The control examination of workers with employment below 10 years did not reveal radiological changes which could indicate asbestosis. In the group of 400 workers with employment over 10 years new cases of asbestosis were diagnosed in 34 persons (8.5%) during the control examination. During the control examination progress of pleural changes was observed in 4% of males and 3.8% of females. As the period of exposure to asbestos had expanded the occurrence of small, irregular shadows, especially in persons working longer than 15 years, was more often noticed. The aforesaid aberrations have progressed in 11.7% of males and 9.5% of females when compared with the results of the initial examination. In the group of retired workers 15 (23.1%) new cases of asbestosis were detected 8 years after the termination of occupational exposure. Small, irregular shadows, limited in number as well as pleural changes have progressed in approximately 22% of retired males and females.

Asbestos↗
PubMed1993

[Immunologic reactions, respiratory symptoms and ventilatory capacity in jute and sisal textile workers].

Allergic reactions in relation to respiratory symptoms and ventilatory capacity were studied in 41 textile workers employed in the processing of jute and sisal. Only 5.0% of the jute workers and 9.5% of the sisal workers demonstrated positive skin reactions to jute or sisal allergens. Increased IgE was found in 9.8% of the textile workers. Among 35 control workers 11.4% reacted with a positive skin reaction to the jute or sisal allergen and 2.9% had increased IgE. Chronic respiratory symptoms as well as changes in ventilatory capacity were found in textile workers with positive and negative skin tests. Our data suggest that immunological reactions are not likely to be responsible for the development of respiratory impairment in textile workers exposed to jute and sisal dust.

Adult↗
PubMed1993

Excess hepatobiliary cancer mortality among munitions workers exposed to dinitrotoluene.

An analysis of the mortality experience of workers exposed to dinitrotoluene (DNT) was conducted to test the hypothesis that DNT exposure is associated with an increased risk of cancers of the liver and biliary tract. A total of 4,989 workers exposed to DNT and 7,436 unexposed workers who had worked for at least 5 months at the study facility between January 1, 1949 and January 21, 1980, were included in this investigation. Workers were considered exposed if they had worked at least 1 day on a job with probable exposure to DNT. The vital status as of December 31, 1982, was successfully ascertained for approximately 97% of these workers. Standardized mortality ratios (SMRs) were estimated based upon comparisons with the US population using a modified life-table program. In addition, standardized rate ratios (SRRs) were computed based upon direct comparisons between the DNT and the internal unexposed cohort. An excess of hepatobiliary cancer was observed among workers exposed to DNT in this study. The rate ratio for hepatobiliary cancer was 2.67 (six cases observed) based upon comparison with the US population (SMR = 2.67, 95% CI = 0.98, 5.83), and 3.88 based upon comparison using the internal unexposed referent group (SRR = 3.88, 95% CI = 1.04, 14.41). This study failed to demonstrate an exposure-response relationship between duration of DNT exposure and hepatobiliary cancer mortality. Our study was limited by the small number of workers with long duration of exposure to DNT, and by the lack of quantitative information on exposure to DNT and other chemicals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Socioeconomic status and risk of HIV-1, syphilis and hepatitis B infection among sex workers in São Paulo State, Brazil. Instituto Adolfo Lutz Study Group.

OBJECTIVES: To determine how HIV risk behavior and the prevalences of sexually transmitted diseases vary according to socioeconomic status and city among sex workers in São Paulo State, Brazil. SUBJECTS AND METHODS: A cross-sectional study of 600 female sex workers (100 of a higher socioeconomic status and 100 of a lower socioeconomic status in each city) was conducted in the cities of São Paulo, Campinas and Santos. HIV risk behavior was assessed by questionnaire; serological tests were administered to assess prior exposure to HIV-1, syphilis and hepatitis B. RESULTS: Only statistically significant (P < 0.05) findings are reported here. Compared to those with a higher socioeconomic status, sex workers with a lower socioeconomic status worked longer hours each day (9.6 versus 7.9), had more clients per day (5.4 versus 2.6) and had fewer episodes of intercourse per client per encounter (1.1 versus 1.4). Levels of condom use for vaginal, anal and oral sex were significantly higher in Santos than in São Paulo or Campinas. Twenty-three per cent of the women said they feared violence if they insisted that their clients wear condoms; 74% voiced similar fears regarding their non-client sexual partners. Overall, 11% of sex workers were positive for exposure to HIV-1, 45% for syphilis and 39% for hepatitis B. Those with a lower socioeconomic status were more likely than those with a higher socioeconomic status to be infected with HIV-1 (17 versus 4%), syphilis (66 versus 24%) and hepatitis B (52 versus 26%), but there were no differences in prevalence rates by city. CONCLUSIONS: These data demonstrate substantial heterogeneity in HIV risk behavior and the prevalence of HIV-1 and other sexually transmitted diseases among sex workers in São Paulo State, many of which were related to differences in socioeconomic status. Interventions to prevent HIV transmission among sex workers must be tailored to the local environment and, in particular, to the socioeconomic status of these workers.

Adolescent↗
PubMed1995

Prevalence of sexually transmitted diseases among commercial sex workers in Singapore from 1977 to 1993: the effects of screening measures.

This paper discusses the trend of sexually transmitted diseases (STDs) among commercial sex workers in Singapore. Various STD control measures were introduced in Singapore since 1976 to control STDs among commercial sex workers. Under a Medical Surveillance Scheme introduced in 1976, all commercial sex workers were encouraged to undergo regular STD screening and received treatment when found to be infected. As a result, the infection rates of various STDs among commercial sex workers have declined over the years. The infection rate for gonorrhoea has declined from 9% in 1977 to 1.7% in 1993. The chlamydia infection rate declined from 8% in 1992 to 4% in 1993. The human immunodeficiency virus (HIV) infection rate among commercial sex workers under the Medical Scheme was less than 0.1%. The STD infection rate of commercial sex workers who did not participate in the Medical Scheme was much higher than those enrolled in the Medical Scheme. Our findings indicated the effectiveness of the Medical Scheme in controlling STDs among commercial sex workers.

Chlamydia Infections↗
PubMed1996

Presence of antibodies to heat stress proteins and its possible significance in workers exposed to high temperature and carbon monoxide.

Antibodies to the ubiquitous group of stress proteins known as heat shock proteins (Hsps) have been found to be associated with a number of diseases in humans. Hsps are known to be induced by certain xenobiotics, some of which are common in the working environment. The biological significance of the presence of such autoantibodies is presently unclear. In the present study, we used immunoblotting to investigate the presence of antibodies against the different stress proteins, Hsp27, Hsp60, Hsp71, Hsc (heat shock cognate) 73 and Hsp89 alpha and beta in groups of workers exposed to high temperature or carbon monoxide. These data were related to a detailed clinical evaluation and to various laboratory measurements including electrocardiogram (ECG), B echogram, white blood cell counts and typing, the activity of alanine aminotransferase (ALT), acid phosphatase (ACP) and alkaline phosphatase (ALP) and lymphocyte DNA damage. Antibodies to Hsp27 and Hsp71 were found more frequently in the high temperature and carbon monoxide-exposed groups than in controls (P < 0.05). The carbon monoxide-exposed group showed the highest incidence of anti-Hsp antibodies. Anti-Hsp60 antibodies were only detected in workers exposed to high temperature or carbon monoxide. The percentage of workers with abnormal ECG, B echogram changes and displaying hepatitis B antigen (HBsAg) was higher in the carbon monoxide group than in the control group (P < 0.05). There was a significant increase in the activity of ALT in the high temperature and carbon monoxide groups and in the activities of ACP and ALP in the carbon monoxide group (P < 0.05). The extent of DNA damage measured in lymphocytes was higher in workers from the high temperature and carbon monoxide-exposed groups. We suggest that the increased frequency of antibodies to Hsps is the result of these damages of the release of denatured Hsps and of a decrease in the phagocytic ability of macrophages in these workers. The data gathered in the present study show a statistical relation between the occurrence of antibodies against Hsps and the frequency of health problems in workers and suggest a potential role for the antibodies as useful biomarkers to assess whether workers are experiencing environmental stress.

Antibodies↗
PubMed1996

Exposure-response relationship for vibration-induced white finger among forestry workers.

The relation between the occurrence of white finger and vibration exposure was investigated in a group of 222 forestry workers using chain saws. The forestry workers and 195 controls never exposed to hand-transmitted vibration were interviewed by occupational health physicians. The diagnosis of vibration-induced white finger (VWF) was made on the basis of subjective symptoms of finger blanching and the results of a cold test with plethysmographic measurement of finger systolic blood pressure. Vibration was measured on a representative sample of AV and non-AV chain saws. Daily vibration exposure was assessed in terms of 8 h energy-equivalent frequency-weighted acceleration [A(8)]. A lifetime vibration dose was estimated for each of the forestry workers. The overall prevalence of VWF among the forestry workers was 23.4%. Raynaud's phenomenon was discovered in 2.6% of the controls. In the forestry workers, the risk of VWF showed positive increments with each increment of vibration dose, suggesting a monotonic dose-response relationship. The responsiveness to cold in the digital arteries of the forestry workers was also found to increase with increasing vibration dose. The estimated relation between VWF and vibration exposure showed that the expected occurrence of VWF increased in approximately linear proportion to either A(8) (with exposure duration unchanged) or the number of years of exposure (with equivalent acceleration unchanged). In this study of VWF among forestry workers the estimated exposure-response relation showed that if the magnitude of vibration acceleration is doubled, the total duration of exposure should be halved to produce an equivalent effect. On the basis of the assessment of vibration exposure, the estimated risk for VWF in the study population was found to be lower than that predicted by the International Standard ISO 5349. The results of this study tend to support the vibration exposure levels currently under discussion within the European Union.

Adult↗
PubMed1997

Biodosimetry of Chernobyl cleanup workers from Estonia and Latvia using the glycophorin A in vivo somatic cell mutation assay.

The reactor accident at Chernobyl in 1986 necessitated a massive environmental cleanup that involved over 600,000 workers from all 15 Republics of the former Soviet Union. To determine whether the whole-body radiation received by workers in the course of these decontamination activities resulted in a detectable biological response, over 1,500 blood samples were obtained from cleanup workers sent from two Baltic countries, Estonia and Latvia. Here we report the results of studies of biodosimetry using the glycophorin A (GPA) locus in vivo somatic cell mutation assay applied to 734 blood samples from these workers, to 51 control samples from unexposed Baltic populations and to 94 samples from historical U.S. controls. The data reveal inconsistent evidence that the protracted radiation exposures received by these workers resulted in a significant dose-associated increase in GPA locus mutations compared with the controls. Taken together, these data suggest that the average radiation exposure to these workers does not greatly exceed 10 cGy, the minimum levels at which radiation effects might be detectable by the assay. Although the protracted nature of the exposure may have reduced the efficiency of induction of GPA locus mutations, it is likely that the estimated physical doses for these cleanup worker populations (median reported dose 9.5 cGy) were too low to result in radiation damage to erythroid stem cells that can be detected reliably by this method.

Alleles↗
PubMed1996

Molecular detection of human immunodeficiency virus-1 infection among commercial sex workers using the polymerase chain reaction in Singapore.

We studied the sensitivity of polymerase chain reaction (PCR) for detecting early human immunodeficiency virus-1 (HIV-1) in sex workers. Blood samples of sex workers who attended our Sexually Transmitted Diseases clinic were tested for HIV infection by testing for the presence of HIV antibody and HIV-1 proviral DNA using PCR (with the Amplicor HIV-1 amplification kit, Roche) at 00 (when they first register to work as sex workers), 01 and 03 months after starting work. The objective was to detect HIV-1 using PCR in sex workers during the "window" period when their HIV antibody tests were still negative. Sixty-nine blood samples were PCR-tested at 00 month of which 8 were simultaneously positive for HIV antibody and PCR tests. Seventy-seven blood samples were tested at 03 month. We found that PCR test using the Amplicor HIV-1 amplification kit (Roche) to be sensitive in detecting HIV infection in sex workers but the test appeared not sensitive enough to detect HIV-1 infection during the "window" period. We were unable to detect any sex workers with PCR detectable HIV-1 before they seroconverted to become HIV antibody positive. The reason for the failure was attributed to the low infection rate among sex workers and possible lack of sensitivity of the Amplicor PCR/HIV-1 amplification kit to detect early HIV-1 infection. We are currently studying other PCR procedures to improve the sensitivity of the PCR test for HIV-1.

DNA, Viral↗
PubMed1997

High prevalence of mollusc shell hypersensitivity pneumonitis in nacre factory workers.

Following the discovery of hypersensitivity pneumonitis caused by the inhalation of mollusc shell dust in two workers from a nacre-button factory, the health status of 26 workers employed in sawing mollusc shells was investigated. The evaluation included the administration of two questionnaires and radiological, functional and immunological assessments of all workers at the outset and 1 year later, when hygienic and therapeutic measures had been taken. Six workers, in whom specific inhalation challenge test was positive, were diagnosed with mollusc shell hypersensitivity pneumonitis, thus yielding a prevalence of 23%. Evidence of diffuse lung disease and systemic symptoms was found in these patients. Nonspecific bronchial hyperreactivity was also found more frequently in patients with mollusc shell hypersensitivity pneumonitis. Specific immunoglobulin G (IgG) level and specific skin testing failed to differentiate patients with mollusc shell hypersensitivity pneumonitis from other exposed workers; whereas, nonspecific skin testing, which was impaired in the patients, did differentiate. Bronchoalveolar lavage and transbronchial biopsy performed in patients with mollusc shell hypersensitivity pneumonitis were consistent with the disease. Removal from an environment containing mollusc shell dust was followed by regression of clinical, radiological and functional changes. The clinical picture of the 20 workers who did not present mollusc shell hypersensitivity pneumonitis remained unchanged, but functional decline was observed despite improvement in the environmental conditions of the factory. This report describes the first series of patients with mollusc shell hypersensitivity pneumonitis studied, and underlines the importance of careful follow-up of workers occupationally-exposed to mollusc shell dust.

Adult↗
PubMed1996

[Investigation of health status in workers exposed to low-level benzene].

In order to know the health status in workers exposed to low-level benzene, 323 air samples were collected from five workshops of the Corporation, where low-level benzene was emitted from aromatic hydrocarbon devices. Results showed air benzene levels ranged from 0.05-29.25 mg/m3, with an average of 4.57 +/- 6.16 mg/m3, and the highest in the benzene-producing workshop. Four hundred and thirty-seven workers closely-exposed to benzene in five workshops and 150 controls were selected and their peripheral white blood cell count and micronucleus of lymphocytes were determined. Result showed that 1. peripheral white blood cell count of the exposed workers was within the normal range, but obviously lower than that of the controls; 2. proportion of lymphocytic micronucleus was higher in exposed workers than that in unexposed ones, and there was significant difference in it between workers in benzene-producing workshop than that in controls; 3. white blood cell count lowered and proportion of lymphocytic micronucleus increased in the workers, with the increase of air benzene level in the five workshops. All these demonstrate that low-level benzene is harmful to the exposed workers, especially to their genetic materials.

Adult↗
PubMed1997

Practical and affordable measures for the protection of health care workers from tuberculosis in low-income countries.

With the global upsurge in tuberculosis (TB), fueled by the human immunodeficiency virus (HIV) pandemic, and the increase in multidrug-resistant TB, the condition has become a serious occupational hazard for health care workers worldwide. Much of the current understanding about nosocomial TB transmission stems from the USA; however, little is known about the risk of such transmission in low-income countries. The focus of this review is on sub-Saharan Africa, since this is the region with the highest TB incidence, the highest HIV incidence, the worst epidemic of HIV-related TB, and where the risk to health care workers is probably greatest. Measures used in industralized countries to control nosocomial TB transmission (ventilation systems, isolation rooms, personal protective equipment) are beyond the resources of low-income countries. Protecting health care workers in these settings involves practical measures relating to diagnosis and treatment of infectious cases; appropriate environmental control; and relevant personal protection and surveillance of health care workers. Research needs to be carried out to examine the feasibility and cost-effectiveness of measures such as voluntary HIV-testing of health care workers (to enable known HIV-positive health care workers to avoid high-risk settings) and isoniazid preventive therapy for workers in high-risk settings. More resources are also needed to ensure full implementation of currently recommended measures to decrease the risk of nosocomial and laboratory-acquired TB.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Mortality among workers in the pulp-paper industry. A successive follow up of the cohort].

After five successive years of observation the authors present a verified evaluation of the delayed health effects in the pulp and paper industry workers (with particular regard to mortality from malignant neoplasms). The cohort studied consisted of 10,460 workers employed for at least 12 months between 1967 and 1990 in the plants manufacturing sulfate pulp, paper, board and paper products. Subjects were assigned to three subcohorts according to the work areas: 1. pulp mill workers; 2. paper mill workers (paper and board as well as their products); 3. other workers. The workers were enrolled in the subcohort if they were employed for at least one year in one of these departments. One subject could be included in more than one subcohort. The vital status of the cohort was determined through a variety of sources over an observation period of 28 yrs (1967-95). Mortality data were analysed in terms of cause-specific standardized mortality ratios (SMRs) with expected deaths count based on the national mortality rates in Poland. The results of a twenty three-year cohort observation, published earlier, showed the lowered overall mortality (explained by a "healthy worker effect") and the excess of deaths from malignant neoplasms for some sites (peritoneum, prostate, brain). Due to a small number of deaths recorded, kind of exposure and its duration, were left out of the analysis. The results presented in this paper, obtained after five successive years of the male cohort observation, showed an excess of deaths from cancers of the respiratory tract and peritoneum. In the female cohort an excess of brain cancers was found. Only an excessive mortality from malignant neoplasms of the respiratory system was coherent with the exposure to higher concentrations of wood, paper and board dust. An excess mortality from diseases of the circulatory system was found in both males and females employed in paper production.

Adult↗
PubMed1998

Noise induced hearing loss among male airport workers in Korea.

The purposes of this study of airport workers were to a) determine the prevalence and symptoms of hearing loss, and b) identify compliance in using hearing protective devices (HPDs) and its relationship with hearing loss. This cross sectional epidemiological study was conducted with 255 noise exposed and 195 non-noise exposed, full time, male workers at a large metropolitan airport in Seoul, Korea. The three measures used were the self administered Occupational Hearing Questionnaire (OHQ), an audiological assessment, and a record review of baseline hearing and noise levels of locations in which the employee worked. The results showed a significant difference in prevalence of hearing loss (more than 25dB) between the noise and the non-noise exposed groups (p < .05). About 60.8% of noise exposed workers reported continuous use of the HPDs. The continuous HPD users had significantly lower rates of hearing loss than the occasional users or non-users. The major symptom for workers with low frequency hearing loss was trouble in communication, whereas tinnitus and fullness in the ear were the most common symptoms for the workers with high frequency hearing loss. The airport workers exposed to excessive noise had a great deal of high frequency hearing loss. The degree of hearing loss present reinforces the need for aggressive hearing conservation programs among airport workers exposed to noise.

Adult↗
PubMedDate not supplied

Airborne exposures to PAH and PM2.5 particles for road paving workers applying conventional asphalt and crumb rubber modified asphalt.

Personal exposure monitoring was conducted for road paving workers in three states. A research objective was to characterize and compare occupational exposures to fine respirable particles (< 2.5 microns) and particle-bound polycyclic aromatic hydrocarbons (PAHs) for road paving workers applying conventional (petroleum derived) asphalt and asphalt containing crumb rubber from shredded tires. Workers not exposed to asphalt fume were also included for comparison (to support the biomarker component of this study). The rubber content of the crumb rubber modified (CRM) asphalt at the three study sites was 12, 15, and 20%. A comparison of some specific job categories from two sites indicates greater potential carcinogenic PAH exposures during CRM asphalt work, however, the site with the greatest overall exposures did not indicate any differences for specific jobs. A statistical analysis of means for fine particle, pyrene and total carcinogenic PAH personal exposure shows, with two exceptions, there were no differences in exposures for these three measurement variables. One site shows significantly elevated pyrene exposure for CRM asphalt workers and another site similarly shows greater carcinogenic PAH exposure for CRM asphalt workers. Conventional and CRM asphalt worker airborne exposures to the PAH carcinogen marker, BaP, were very low with concentrations comparable to ambient air in many cities. However, this study demonstrates that asphalt road paving workers are exposed to elevated airborne concentrations of a group of unknown compounds that likely consist of the carcinogenic PAHs benz(a)anthracene, chrysene and methylated derivatives of both. The research described in this article has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.

Air Pollution↗
PubMed1995

[Peptic ulcer among workers in the engineering and chemical industries].

Incidence of peptic ulcer among workers employed in the engineering and chemical industries is presented in view of selected environmental factors. The study covered 157 workers with peptic ulcer who reported themselves to outpatient clinics at the Nitrogenous Fertilizers Plant in Pulawy and the Automobile Works in Lublin (5000 and 3252 employees, respectively). The study was conducted over a period of one year. It included: medical examinations, supplementary tests and a questionnaire survey. The questionnaire asked, among others, about working conditions, type of occupation performed and lifestyle. Peptic ulcer was diagnosed in 2.03% of workers engaged in the engineering industry and 1.82% of those working at the chemical plant. The incidence of peptic ulcer was higher among manual workers (2.18%) than in office workers (1.16%). The patients had been exposed to the following environmental factors: excessive noise--21%, vibration--17.2%, commuting--11.5%, extra work--14.5%, conflicts at work--13.5%, conflicts at home--15.3%, irregular meals--21.6%, alcohol intake--22.4%, cigarette smoking--62.4%. The study indicates that peptic ulcer is more often diagnosed in manual than in office workers and its incidence can be associated with working conditions and lifestyle. However, no significant variation in annual morbidity caused by peptic ulcer was observed among workers of the plants under study.

Chemical Industry↗
PubMed1998

The assessment of DNA damage in lymphocytes of wooden furniture workers.

Single-strand breaks (SSB) and DNA repair were detected in peripheral lymphocytes derived from workers of a furniture factory in a non-polluted region of Poland. The workers were exposed to wood dust (n = 19), or to the dust and varnishes or lacquers together (n = 5). Four groups were studied simultaneously: (a) exposed workers smokers of cigarettes (n = 14), (b) nonexposed smokers--control (n = 14), (c) exposed workers' nonsmokers (n = 14), (d) exposed nonsmokers (n = 10). In exposed workers DNA SSB and DNA repair were statistically significantly increased. DNA SSB was clearly higher in the smoking workers than in the smoking controls. Cigarette smoking itself has produced no evident increase in the frequency of DNA SSB in the control group. Occupational exposure had a significant effect on DNA repair in non stimulated lymphocytes both in smoking and nonsmoking workers.

DNA Damage↗