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PubMed2006

Airway disease in highway and tunnel construction workers exposed to silica.

BACKGROUND: Construction workers employed in a unique type of tunnel construction known as tunnel jacking were exposed over an 18-month period to respirable crystalline silica at concentrations that exceeded the OSHA permissible exposure limit. The present study examines workplace exposures and occurrence of airway disease in these workers. METHODS: Medical and occupational histories and chest radiographs were obtained on 343 active construction workers who had worked on the site during the period in question. Chest radiographs were interpreted according to the ILO-1980 system of classification. Standardized questions were used to develop an algorithm to define symptoms consistent with asthma (SCA) and to determine these respiratory outcomes: chronic bronchitis, shortness of breath (SOB), and physician-diagnosed asthma (current vs. not current). Relationships with each of three work activities were examined: slurry wall breakthrough (SWB), chipping caisson overpour, and tunneling/mining. RESULTS: Participants included laborers, carpenters, tunnel workers, ironworkers, operating engineers, and electricians. No cases of silicosis were found on chest X-ray. Overall prevalence of chronic bronchitis, SCA, SOB, and physician-diagnosed asthma was 10.7%, 25%, 29%, and 6.6%, respectively. Odds ratios (OR) for carpenters compared to laborers were significantly elevated for chronic bronchitis, SCA, and SOB. SWB was associated with chronic bronchitis and SCA (OR 4.93, 95% CI = 1.01, 24.17; OR 3.32, 95% CI = 1.25, 8.84, respectively). The interaction between SWB, SCA, and trade was significant for carpenters (OR 6.87, 95% CI = 1.66, 28.39). Inverse trends were observed for months on the site and chronic bronchitis, SCA, and SOB (P = 0.0374, 0.0006, and 0.0307, respectively). CONCLUSIONS: Tunnel construction workers exposed to respirable crystalline silica and cement dust are at increased risk for airway disease. Extent of risk varies by trade and work activity. Our data indicate the importance of bystander exposures and suggest that tunnel jacking may be associated with greater risk compared to more traditional methods of tunnel construction. A healthy worker effect is suggested.

Adult↗
PubMed1980

Mortality studies of smelter workers.

In view of the historic importance of smelter workers in the field of occupational medicine, it is surprising that until very recently little data was available on the mortality experience of these workers. The problem in most studies lies in identifying the smelter workers, because smelting, strictly speaking, refers to the melting of ores for the purposes of recovering metals, whereas smelters sometimes perform the operations of roasting, calcining, sintering, converting, and refining. These distinctions are not made in most mortality studies. Most mortality studies of smelter workers conducted to date have shown some excess in lung cancer. For lead, copper, cadmium, and nickel smelters a different etiologic agent has been proposed for each. These different explanations arise partly from different initial perspectives in conducting the studies. In this paper, data are presented on a current historical-prospective study of males who worked a year or more during the period January 1, 1940 to December 31, 1964 at a copper smelter in Tacoma, Washington. This smelter (and refinery) handled a copper ore with a relatively high arsenic content and produced arsenic trioxide as a by-product. Overall 97.2% of the original study population was traced through 1976. Of the 1,061 who were found to have died, death certificates were obtained for 1,018, or 96%. For all causes of death, the mortality rates in this cohort, expressed as a Standardized Mortality Ratio (SMR), were 3.5% higher than that expected based on the United States white male mortality experience. A total of 104 respiratory system cancers were observed compared to 54.6 expected (SMR = 190.5, p less than .05). Respiratory cancer rates were found to be elevated in both smokers and nonsmokers. Overall, a gradual rise in SMR's for respiratory cancer was observed with increasing duration of exposure but not with an increasing interval from onset of exposure. This observation is consistent with the notion that the effects of arsenic on cancer incidence disappear with time. This phenomenon has also been observed for cigarette smokers and chromate workers. Additional analyses are planned for the Tacoma cohort, which will examine mortality according to process as well as by exposure to arsenic and other contaminants. The importance of studies of workers at other kinds of smelters and refineries is stressed.

Aged↗
PubMed1985

Mortality of a municipal worker cohort: I. Males.

A retrospective cohort mortality study was conducted on 11,499 full-time municipal employees of the City of Buffalo, New York, who were employed at least one day between January 1, 1950 and October 1, 1979 and worked a minimum of five years. This paper outlines the method of the study and presents the all cause and cause-specific mortality for the male cohort of 10,128. Statistically significant deficits in mortality are seen for infectious diseases, diseases of the circulatory system, diseases of the respiratory system, and all external causes. Statistically significant increased mortality is seen for both malignant and benign neoplasms. All cause mortality was significantly lower than expected for professional, manager, and clerical workers. White-collar workers exhibit a decreased risk of mortality from all diseases of the circulatory system, all diseases of the respiratory system, and all external causes of death. No statistically significant increased or decreased risk of mortality from specific cancer sites is seen for white-collar workers. Blue-collar workers show statistically significant deficits in mortality from infectious diseases, all diseases of the circulatory system, all respiratory diseases, and all external causes. Blue-collar workers exhibit statistically significant increases for benign and malignant neoplasms and in particular, malignant neoplasms of the esophagus, large intestine, and rectum. The meaning of these findings will be clarified through analyses of specific worker groups.

Adult↗
PubMed1985

Clinical features to stage alveolitis in asbestos workers.

To analyze the clinical features of asbestos-induced alveolitis and stage its activity, we evaluated 217 asbestos workers by the usual clinical, radiological, and functional parameters and computerized gallium 67(Ga) lung scan; we obtained bronchoalveolar lavage (BAL) in 33 and lung biopsy in 6. In addition, we scored the profusion of lung rales and correlated it with other parameters of severity of asbestosis. In the 55 workers without asbestosis and normal 67Ga scan, BAL analyses were comparable to those of controls. Of the 56 without asbestosis but increased 67Ga lung uptake, BAL analyses in 8 documented a predominantly macrophagic alveolitis (confirmed on lung biopsy in 3), with the highest levels of BAL fibronectin. In the 106 workers with asbestosis, 67Ga lung uptake was increased in 75; BAL in 17 demonstrated a macrophagic and neutrophilic alveolitis with elevated fibronectin levels. Lung biopsy in 3 of the latter workers documented peribronchiolar fibrosing alveolitis. Rale scores in all workers or in those without asbestosis did not correlate with 67Ga scores; they correlated fairly well with profusion of parenchymal opacities (Rs = 0.42) and rigidity of the lung pressure-volume curve (Rs = 0.39). Thus, 67Ga lung uptake is an early indicator of chronic macrophagic alveolitis in asbestos workers, which usually progresses to asbestosis. In the disease, profusion of lung rales constitutes a simple clinical mode of assessment of disease severity that correlates better with radiological and functional parameters than with parameters of alveolitis.

Adult↗
PubMed1986

An outbreak of N-hexane induced polyneuropathy among press proofing workers in Taipei.

The objective of this study was to determine the prevalence and the etiology of polyneuropathy observed among press proofing workers in Taipei. Neurological examinations of 59 workers, from 16 press proofing factories, were conducted. Fifty-four of those workers subsequently underwent studies of nerve conduction velocities. Samples of bulk solvent from the involved factories were analyzed for their contents using gas chromatography. Fifteen (25%) of the study group were found to have polyneuropathy. All 15 patients with polyneuropathy were from factories in which solvents containing n-hexane were regularly used, and there was a significant association between n-hexane concentration in the bulk samples and prevalence of polyneuropathy. The air concentration of n-hexane in one factory in which all six employees developed polyneuropathy was 190 ppm. Workers who were exposed to n-hexane at air levels of less than 100 ppm but who frequently worked overtime showed a significant slowing of motor nerve conduction velocities on median, ulnar, and peroneal nerves. Of 13 workers who regularly slept in the factory, 12 (92%) had polyneuropathy compared to three (7%) of 46 workers who did not sleep in the factory. The outbreak of polyneuropathy was attributed to a combination of the use of solvents with high contents of n-hexane, poor ventilation, and the practice of sleeping in the factories between shifts.

Adolescent↗
PubMed1987

Study of noise exposure and high blood pressure in shipyard workers.

A cross-sectional and case-reference study of occupational noise exposure and blood pressure was conducted in a shipyard company. There were 158 male workers from the higher noise environment (greater than 85 dBA) and 158 matched workers from a lower noise environment (less than 80 dBA). The workers in the higher noise environment had higher systolic and diastolic blood pressure (p less than .05) after adjusting for confounding factors. Comparison of regression revealed that there is no different increase in blood pressure with age in different environmental noise exposure. Based on 63 matched hypertensive-normotensive pairs from 2,730 shipyard workers, the relative risk of hypertension among workers exposed to an over-85-dBA acoustic environment, compared to those under 80 dBA, was 2.38. It is suggested that there may be a population of noise-exposed workers at increased risk of high blood pressure.

Adult↗
PubMed1987

Sister chromatid exchanges and DNA repair capability in sanitary workers exposed to ethylene oxide: evaluation of the dose-effect relationship.

Determination of ethylene oxide (EtO) in the working environment and induction of sister chromatid exchanges (SCE) and unscheduled DNA synthesis (UDS) in peripheral lymphocytes of 10 exposed sanitary workers and 10 control subjects matched for sex, age, and smoking habits are reported. The relationship between the external dose of EtO and the frequency of SCE was determined in the above group and in a group of 41 sanitary workers previously studied. The 10 newly examined workers were exposed to EtO concentrations (1.84 ppm as time-weighted average) intermediate between the high (10.7 ppm) and low (0.35 ppm) levels of exposure of the two previously examined groups (19 and 22 workers, respectively). A statistically significant (p less than 0.002) increase of SCE frequency was observed between the present control and exposed groups. The inducibility of unscheduled DNA synthesis by gamma rays was lower in the lymphocytes of the exposed workers than in controls, but the difference was not statistically significant. A significant relationship between the frequency of SCE and the level of EtO exposure for the three exposed groups was demonstrated by two different statistical methods. It is suggested that the present Italian threshold limit value for EtO (3 ppm) may not protect the exposed workers against possible genotoxic effects and that even a chronic exposure to 1 ppm may not be devoid of genotoxic risk.

Chromosome Aberrations↗
PubMed1988

Effects of informing workers of their health risks from exposure to toxic materials.

This study compared the mental health, attitudes, and smoking behaviors of 133 workers who had been informed of health risks from exposure to toxic materials on the job with 137 workers who worked in similar conditions but who had not been told that their health was at risk because of exposure to toxic materials. The informed workers reported more health problems than controls, but there were no significant differences between the informed and uninformed groups in mental health, attitudes toward health hazards in or outside of the workplace, or in smoking rates. Ninety percent of all respondents felt that exposed workers definitely should be told of their health risks. These findings indicate little psychological risk from informing workers about their risks because of exposure to toxic substances and a strong desire on the part of workers to be informed.

Adult↗
PubMed1989

Acute pulmonary responses among automobile workers exposed to aerosols of machining fluids.

Previous investigations of workers exposed to machining fluids have shown increased rates of cough and phlegm and have shown that these exposures may cause occupational asthma. To examine acute responses to these agents, cross-shift lung function changes related to machining fluid aerosols among 89 machine operators at two factories producing automobile parts were measured and compared with the findings for 42 unexposed assembly workers studied similarly at the same factories. Workers wore a personal air-sampling device on a Monday and Friday of a working week, and spirometry was performed before and after the work shifts on both days. On Mondays, a 5% or greater decrease in the forced expiratory volume in 1-second (FEV1), regarded as an "FEV1-response," occurred in 23.6% of the machinists and in only 9.5% of the assembly workers (relative risk = 2.5, p less than .05). After adjusting statistically for a history of childhood asthma, for smoking prior to lung function testing, and for race, odds ratios for an FEV1-response of 4.4 among workers exposed to aerosols of straight mineral oils, 5.8 for oil emulsions, and 6.9 for synthetic fluids were found. The FEV1-responses on Fridays were similar to those on Mondays. There was no progressive decline in FEV1 over the work week. Personal air samples, collected with a two-stage impactor, allowed aerosol masses to be measured in three size fractions: less than 3.5 microns, 3.5-9.8 microns, and greater than 9.8 microns aerodynamic diameter. Exposure levels to each type of machining fluid were remarkably similar within each size fraction and for total aerosol levels. Total aerosol concentrations for assembly workers ranged from 0.07 to 0.44 mg/M3, and for machinists from 0.16 to 2.03 mg/m3. Inhalable particle (less than or equal to 9.8 microns) levels were derived from the sum of the air concentrations in the two smallest-size fractions, and significant cross-shift decrements in FEV1 on Mondays and Fridays were associated with inhalable aerosol levels greater than 0.20 mg/m3. These findings show that acute airflow obstruction is associated with exposures to aerosols of various machining fluids and that airway responses occur well below current recommended exposure limits.

Aerosols↗
PubMed1989

Levels of polychlorinated dibenzo-p-dioxins and dibenzofurans in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

Review of employment and chemical production records at a Missouri chemical plant and of questionnaires with self-reported occupational exposure to 2,3,7,8-tetrachloro-dibenzo-p-dioxin (2,3,7,8-TCDD) for 16 Missouri workers has explained the wide diversity of 2,3,7,8-TCDD levels previously reported in the workers' adipose tissue (3.5-750 ppt on whole-weight basis). We show that the highest exposures reported to date in the United States occurred in a group of nine production workers who made products contaminated with 2,3,7,8-TCDD. The nine workers had adipose tissue levels with a mean of 246 ppt and a range of 42 to 750 ppt. Seven persons who worked at the same chemical company, but not in the 2,3,7,8-TCDD-contaminated process, had a mean of 8.7 ppt and a range of 3.5 to 25.8 ppt. We also report serum levels of 2,3,7,8-TCDD in these individuals. The adipose tissue from a subset of four production workers with elevated levels of 2,3,7,8-TCDD and seven Missouri residents with normal 2,3,7,8-TCDD levels was also analyzed for other isomers of the PCDDs and PCDFs. The mean adipose tissue level of 2,3,7,8-TCDD in the subset of production workers was 45 times higher than the mean level in the unexposed Missouri residents, but similar levels of the other PCDDs and PCDFs were found in both groups.

Adipose Tissue↗
PubMed1991

First-aid reports of acute chlorine gassing among pulpmill workers as predictors of lung health consequences.

Workers in pulpmills can be exposed to a multitude of gases hazardous to respiratory function, the most common of which is chlorine gas. First-aid reports of acute gas overexposure incidents ("gassings") over an 8 year period were used to generate exposure data on a group of pulpmill workers whose respiratory function had been studied cross-sectionally in 1981 and 1988. Three hundred forty-eight incidents representing 174 workers were identified, 78% of these being treated solely by the first-aid attendant with the administration of O2 and cough suppression medication. Among 316 workers tested during a 1988 respiratory health survey, 78 had at least one chlorine or chlorine dioxide "gassing" incident. There was a significant decrease in the FEV1/FVC ratio (p less than .05) as well as increased risk for workplace associated chest symptoms in this group with at least one "gassing" incident. In an age- and smoking-matched analysis, among workers tested both in 1981 and 1988, there was a greater decline in FEV2/FVC ratio and MMF (p less than .05) in the "gassed" group than in the nonexposed group over the 7 year period of observation. These results emphasize the need for worker protection against accidental chlorine gas exposures.

Analysis of Variance↗
PubMed1992

Respiratory disorders and atopy in cotton, wool, and other textile mill workers in Denmark.

A cross-sectional study of respiratory disorders and atopy in Danish textile industry workers was conducted to survey respiratory symptoms throughout the textile industry, to estimate the association of these disorders with atopy, and to study dose-response relationships within the cotton industry. Workers at cotton mills, a wool mill, and a man-made fiber (MMF) mill were examined. Four hundred nine (90%) of the 445 workers participated in this survey, i.e., 253, 62, and 94 workers at the cotton mills, the wool mill, and the MMF mill, respectively. An interview designed to assess the prevalence of common respiratory and allergic symptoms was given to all workers willing to participate, and blood samples were drawn. Lung function measurements determined a baseline FEV1, FVC and the change in FEV1 and FVC during work hours on a Monday. The working environment was examined for dust, bacteria, endotoxins, and molds, and the exposure was estimated for each participant. The mean personal samples of airborne respirable dust and respirable endotoxin were highest in the cotton industry, i.e., 0.17-0.50 mg/m3 and 9.0-126 ng/m3 respectively, whereas mold spores were found in the highest concentrations in the wool mill: 280-791 colony-forming units (cfu)/m3. Only small concentrations of microorganisms were found in the MMF mill. The mean change in FEV1% and FVC% was greatest among atopic individuals in both cotton and wool industry and other textile industries although the differences were not significant. FEV1% and FVC% in the cotton workers were significantly associated with the cumulative exposure to respirable endotoxin. Byssinosis was diagnosed only in the cotton industry. We found a dose-response relationship between endotoxin exposure and byssinosis, and a significant association between A-1-A serum concentrations less than or equal to 35 mumol/liter and byssinosis, a finding we are further evaluating in subsequent studies.

Animals↗
PubMed1993

Experiences of a state-sponsored notification and screening program for asbestos workers.

Worker notification can involve a broad range of activities including medical screening, personal and mass communications, cohort identification and tracing, and even litigation. The inclusion or exclusion of various supporting activities in a worker notification program may pose significant medical, public health, financial, logistical, and even legal implications for targeted individuals as well as for the agencies involved. This report describes some experiences in a state-sponsored notification and screening program of approximately 4,500 asbestos workers in Minnesota. In this program, a variety of factors led to the decision to provide medical screening to 1,101 workers and 451 spouses. It is anticipated that another 3,400 workers will be notified but not screened. A follow-up survey of notified workers showed overwhelming support for this program. It is estimated that this program will cost more than $650,000 by its completion. The decision to institute medical screening and other support activities should be made with careful consideration of the diverse implications of these activities to the individuals, communities, and agencies involved.

Asbestos↗
PubMed1994

Prevalence of depression among electrical workers.

To address the possible association between electric and magnetic field exposure and depression, we analyzed data from the Vietnam Experience Study. In order to compare the risk of diagnosed depression, depressive symptoms, and elevations in personality scales indicative of depression, we classified employed participants as electrical workers (N = 183) and nonelectrical workers (N = 3,861) and compared their scores on the Diagnostic Interview Survey (DIS) and the Minnesota Multiphasic Personality Inventory (MMPI). Electrical workers in the aggregate showed little evidence of increased risk, with the possible exception of an increase in elevated MMPI depression scores among short-term workers. Data on electricians yielded indications of increased risk for several markers of depression. Despite the limited number of electrical workers, uncertainty regarding exposure, and our inability to address other workplace exposures, these results suggest that electrical workers in general are not at increased risk for depression. However, our results encourage further evaluation of depression among electricians.

Adult↗
PubMed1994

Mortality from respiratory cancers (including lung cancer) among workers employed in formaldehyde industries.

A joint study on effects of formaldehyde exposure in industrial populations by the National Cancer Institute and the Formaldehyde Institute, Inc. (Blair et al. [1986]: J Natl Cancer Inst 76: 1071-1084; Blair and Stewart [1989]: J Occup Med 31: 881, Blair et al. [1990]: Am J Ind Med 17:683-700) reported no significant elevation in risk ratios standardized to the general population. Using the same data as Blair et al., we compared more exposed to less exposed workers to compute relative risk for respiratory and lung cancers using a multivariate, log-linear model incorporating factors for job type (hourly vs. salaried), cumulative exposure (0.1-0.5, 0.5-2, 2+ vs. < 0.1 ppm/years), length of exposure (1-5, 5-10, 10+ vs. < 1 years), and age. Models were fit for all workers, all males, all workers less than 65 years of age, and for all males less than 65 years of age. Hourly workers have a significantly elevated relative risk when compared to salaried workers. While only high levels of cumulative exposure show a significant elevation in relative lung cancer risk, trend analyses of the coefficients of a log-linear model show a significant trend of increasing risk with increasing formaldehyde exposure. The significantly elevated respiratory and lung cancer risk for workers younger than 65 may indicate a shift of respiratory cancer mortality towards younger ages among those occupationally exposed to formaldehyde.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Neuropsychological deficit among elderly workers in aluminum production.

A cross-sectional study was conducted at a Norwegian primary aluminum plant. All workers aged 61-66 years were offered early retirement benefits. Among the workers, 47 met the study criteria and 38 (81%), comprising 14 potroom workers, 8 foundry workers, and 16 controls, volunteered to participate. They were tested with a neuropsychological test battery. Workers in potrooms with Søderberg electrolytic cells were found to show signs of impairment of the nervous system. A test for tremor discriminated significantly between the potroom group and the controls. There was a suggestion of increased risk of impaired visuospatial organization and a tendency to a decline in psychomotor tempo in the potroom workers. We suggest that the above findings may be related to long-term occupational exposure in the potroom, and further to chronic low-dose exposure to aluminum.

Aged↗
PubMed1994

Exposure to magnetic fields among electrical workers in relation to leukemia risk in Los Angeles County.

To address the hypotheses that electrical workers are exposed to higher magnetic fields and are at higher risk of leukemia than nonelectrical workers, we performed a registry-based case-control study among men aged 20-64 years with known occupation who were diagnosed with cancer in Los Angeles County between 1972 and 1990. Controls were men with cancers other than those of the central nervous system or leukemia. Magnetic field measurements on workers in each electrical occupation and in a random sample of occupations presumed to be nonelectrical were used to estimate magnetic field exposures for each occupation. Among men in electrical occupations, 121 leukemias were diagnosed. With the exception of electrical engineers, magnetic field exposures were higher among workers in electrical occupations than in nonelectrical occupations. A weakly positive trend in leukemia risk across average occupational magnetic field exposure was observed (odds ratio [OR] per 10 milligauss increase in average magnetic field = 1.2, 95% confidence interval [CI] 1.0-1.5). A slightly stronger association was observed for chronic myloid leukemia, although only 28 cases occurred among electrical workers (OR 10 milligauss increase = 1.6, 95% CI = 1.2-2.0). The results were not materially altered by adjustment for exposure to several agents known or suspected to cause leukemia. Although not conclusive, these results are consistent with findings from studies based on job title alone that electrical workers may be at slightly increased risk of leukemia.

Adult↗
PubMed1994

Dust exposure indices and lung function changes in longshoremen and dock workers.

A group of Dutch harbor workers involved in loading and unloading bulk products from sea vessels such as coal, cokes, and some other products like alumina, borax, phosphate ore, and vermiculite was studied. Exposures were characterized by personal and environmental monitoring. This information was subsequently used to estimate several dust exposure indices and to study relationships with lung function variables and respiratory symptoms. Average respirable dust exposure levels ranged from 0.3-4.0 mg/m3. Workers involved in unloading products from sea vessels were exposed to the highest dust levels. Supervisors and workers with tasks in the dock had an intermediate to low exposure. Office workers had the lowest exposure to respirable dust. Inhalable dust levels were considerably higher and average exposures ranged from 0.3-80 mg/m3. The ranking of occupational titles by inhalable dust exposure was almost identical to the rank order of respirable dust levels. Workers with higher current and cumulative dust exposures tended to have a lower lung function, and only shortness of breath had a statistically significant relationship with current and cumulative inhalable dust exposure. In general, relationships between lung function and inhalable dust levels tended to be somewhat stronger in terms of statistical significance, because inhalable dust is an estimate of dust deposition in the upper airways and lung function is a measurable parameter of airway obstruction in that region. However, the differences with respirable dust were minimal, and variability in dust exposure levels was extremely large for this population. It was concluded that harbor workers involved in unloading ships containing coal and various kinds of ore can be exposed to high dust levels. Relationships between dust exposure and lung function illustrate that these exposures are a respiratory hazard. Our finding that inhalable dust levels have a somewhat stronger relationship with lung function level than respirable dust levels deserves further attention.

Adult↗