Cause Of Occupational Disease Research Articles

Prevention of disability at work

Prevention of disability at work

Asbestos consumption, asbestos exposure and asbestos-related occupational diseases in Germany

Like in most industrial countries, asbestos is a leading cause of occupational diseases, especially malignant diseases, in Germany. Following the increased consumption of asbestos after World War I, the recognition of asbestos related diseases developed. At the end of the 1930s, Germany was the first country to accept lung cancer in combination with asbestosis as an occupational disease and to initiate the endeavor for reduction of asbestos dust exposure. Nevertheless after World War II the usage of asbestos increased dramatically. The ban of asbestos first came into force in 1993. Until this time several hundreds of thousands of workers had inhaled asbestos and the number of asbestos related diseases increased. In this review the history and current status on asbestos consumption, asbestos exposure and asbestos related occupational diseases in Germany is presented.

Die Bestätigungsquote von Berufskrankheiten-Verdachtsanzeigen als Qualitätsmessparameter

To evaluate the notifications of suspected causes of occupational diseases (NSC) under quality assurance aspects. We retrospectively analysed the NSC assessed by the institutions for statutory accident insurance and prevention (Berufsgenossenschaft) between 1998 and 2002. Physicians were most frequently represented among the 357,050 notifications (60.2 %). The number of notifications dropped continually between 1998 and 2002. The number and quality of the notifications (NSC) depend on the knowledge of the occupational diseases as well as on the knowledge of the insured persons and on their respective occupational histories. The NSC are issued via the statutory social insurance bodies who are in contact with the patients, and the NSC also depend on the present scientific knowledge of the types of relevant diseases. Usually, the physicians were most frequently the notifiers of occupational diseases, with one exception, namely, incapacitating diseases due to damage to vertebral discs of the lumbar spine caused by many years of lifting of carrying heavy loads or of many years of work in an extremely bent position, in which cases the statutory insurance bodies themselves issued the notifications. Altogether 123,262 notifications were confirmed. The average quota of confirmations was > 40 % with physicians issuing the notifications, > 30 % with statutory pension insurance bodies and only approx. 12 % with notifying statutory sickness insurance bodies. The lowest quota of confirmations - namely, only 3 % - concerned the incapacitating vertebral disc disease of the lumbar spine mentioned above. Non-confirmed notifications of suspected occupational diseases involved an estimated cost of at least 58 million Euro. On-target improvement of the quality of notification of suspected occupational diseases is possible by exploring several avenues, including on-target assessment of evaluation criteria reporting by the statutory accident insurance bodies concerned and by regular advice rendered to the statutory social insurance bodies by occupational therapists.

Gene expression in rat skin induced by irritating chemicals.

Occupational skin disease is the second most significant cause of occupational disease, after accidents. Irritation from occupational chemicals such as solvents, hydrocarbons, and surfactants are one cause of this disease. Gene expression studies provide useful information about normal processes in the skin and responses of the skin to exogenous chemicals. We exposed rats, cutaneously, to sodium lauryl sulfate (SLS, 1% and 10% aqueous solution), m-xylene (pure liquid), and d-limonene (pure liquid) for 1 h and measured transcriptional responses at the end of the exposure and 3 h later for comparison with untreated skin samples. Total skin RNA was isolated and analyzed using the Affymetrix RatTox U34 array. Using the Affymetrix software, we found that 234 of approximately 850 genes were detected as present in at least 80% of the normal skin samples. The largest number of these genes was related to metabolism, oxidative/cellular stress, and signal transduction. Limonene caused the largest change in mRNA levels with a total of 34 increased transcripts and 4 decreased transcripts. Xylene treatment resulted in 6 increased transcripts and 14 decreased transcripts, while 10% SLS caused 5 transcripts to increase and 17 to decrease. Only two transcripts were observed to change in skin following a 1% SLS exposure. Sodium lauryl sulfate transcript changes increased with dose and were maximum at 4 h. Limonene transcript changes were more numerous at 1 h than at 4 h. The observed differences may reflect different mechanisms of irritation.

Disease and injury among veterinarians.

To identify occupational causes of disease and injury in veterinarians and their staff. A self-administered questionnaire was mailed to all of the 160 registered veterinary practices in Western Australia. Injuries accounted for most workers' compensation claims over a 12-month period with 31% of respondents losing a total of 360 work days with a mean of 13.3 days whereas non-occupational diseases such as influenza accounted for 408 work days lost. Over a 10-year period, 71% of respondents had been injured. The major physical injuries were dog and cat bites, cat scratches, scalpel blade cuts and back injuries from lifting heavy animals. Exposure to chemicals such as flea rinses, formalin, glutaraldehyde, x-ray developers and gaseous anaesthetics were reported to cause headache, nausea and allergies. Thirty percent of respondents did not have extractor fans for scavenging waste anaesthetic gases. The study showed high use of radiography (94%) for diagnostic purposes with 24% of respondents believing radiation exposure is a major occupational health and safety issue. Stress, drug abuse, suicide and burglary were also reported. Despite a high awareness of zoonotic diseases, there were very few reports of these. Injuries and other occupational hazards reported together with work days lost demonstrate a need for improving the working environment of veterinarians and their staff and the development of comprehensive health and safety programs.

Artériopathies des maladies professionnelles

Arteriopathies of occupational diseases predominate in the upper limbs and are usually expressed as Raynaud's phenomenon ("white finger"), sometimes complicated by digital gangrene. Hand-arm vibration disease, hypothenar hammer syndrome, exposure to silica even without silicosis and vinyl chloride intoxication are the principal causes of occupational diseases acknowledged as such by the laws. In a personal series of 60 patients with complicated upper limb arteriopathies, 25% had a recognized occupational disease. Since December 1992, Erasmus' syndrome and systemic scleroderma due to silica without silicosis have been accepted in France as being occupational diseases. The therapeutic problems are discussed, notably the surgical indications in hypothenar hammer syndrome, the possible medical treatments of finger necrosis occurring in Erasmus' syndrome and, in particular, the role played by spinal cord neurostimulation.

Occupational asthma and rhinitis related to laboratory rats: Serum IgG and IgE antibodies to the rat urinary allergen

Allergic reactions to rat urinary proteins are an important cause of occupational asthma and rhinitis among laboratory workers. We have measured IgG and IgE antibodies to a purified rat urinary allergen in sera from 179 laboratory workers of whom 30 reported symptoms on exposure to rats. There was a very good correlation between IgE antibodies and positive skin tests. In addition, there was a close correlation between reported asthmatic reactions and serum IgE antibody to rat allergen: IgE ab was present in 12 18 of workers with asthmatic reactions but in only 2 135 of workers without symptoms ( p < 0.001). Serum IgG antibodies to rat allergen were present in all sera with IgE antibody but were also present in 30% of asymptomatic individuals. The incidence and quantity of IgG antibody correlated with the degree of exposure to animals (i.e., hours per day) but not with the length of exposure in years. Our results on rat allergy confirm that there is an increased incidence of asthma among individuals who were atopic as judged by positive skin tests to other allergens. However, this relationship did not apply to individuals with rhinitis alone, and excluding atopic individuals from employment would have been a very inefficient method of reducing asthma or rhinitis in this group. Our results confirm that IgE antibody responses to rat urinary allergen are an important cause of occupational disease. The results for IgG antibody suggest that their prevalence represents a marker for the degree of exposure to rat proteins.

Compensation for occupational disease with multiple causes: the case of coal miners' respiratory diseases.

Many diseases associated with occupational exposures are clinically indistinguishable from diseases with non-occupational causes. Given this, how are fair decisions made about eligibility for compensation? This problem is discussed in relation to the federal black lung program. Conflicting definitions of terms--coal workers' pneumoconiosis as defined by the medical profession, pneumoconiosis as defined by the United States Congress, and the popular term, black lung--are important considerations in this discussion. Each is embedded in different logical interpretations of the causes of occupational disease and of disability. Alternative views are presented and critically discussed.

A job-exposure matrix for use in population based studies in England and Wales.

The job-exposure matrix described has been developed for use in population based studies of occupational morbidity and mortality in England and Wales. The job axis of the matrix is based on the Registrar General's 1966 classification of occupations and 1968 classification of industries, and comprises 669 job categories. The exposure axis is made up of 49 chemical, physical, and biological agents, most of which are known or suspected causes of occupational disease. In the body of the matrix associations between jobs and exposures are graded to four levels. The matrix has been applied to data from a case-control study of lung cancer in which occupational histories were elicited by means of a postal questionnaire. Estimates of exposure to five known or suspected carcinogens (asbestos, chromates, cutting oils, formaldehyde, and inhaled polycyclic aromatic hydrocarbons were compared with those obtained by detailed review of individual occupational histories. When the matrix was used exposures were attributed to jobs more frequently than on the basis of individual histories. Lung cancer was significantly more common among subjects classed by the matrix as having potential exposure to chromates, but neither method of assigning exposures produced statistically significant associations with asbestos or polycyclic aromatic hydrocarbons. Possible explanations for the failure to show a clear effect of these known carcinogens are discussed. The greater accuracy of exposures inferred directly from individual histories was reflected in steeper dose response curves for asbestos, chromates, and polycyclic aromatic hydrocarbons. The improvement over results obtained with the matrix, however, was not great. For occupational data of the type examined in this study, direct exposure estimates offer little advantage over those provided at lower cost by a matrix.

Racial inequality and occupational health in the United States: the effect on white workers.

While a number of studies have shown that black workers in the United States face higher levels of occupation-related hazards to health and safety than do whites, even controlling for differences in education and experience, little attention has been paid to the implications of racial inequality for the overall level of hazard in the economy. Alternative theories of the causes of occupational diseases and injuries imply that greater inequality helps white workers, by assigning them to the safer jobs, or on the contrary hurts white workers, by weakening the unity and bargaining power of the workforce as a whole. This article analyzes the impact of racial inequality on the level of hazard reported by white workers. Consistent with the institutional and Marxian theories of the labor market, the statistical findings indicate that white workers employed in occupations and industries containing greater numbers of blacks report greater exposure to hazard than comparable white workers in occupations and industries employing fewer blacks.

Clinical Medicine for the Occupational Physician

The title of this book is somewhat misleading, as less than half of it is devoted to clinical topics. The other topics, however, such as ethics, epidemiology, and health of travelers are all pertinent. It is not a comprehensive text on occupational medicine, as many pertinent clinical and nonclinical topics are not discussed, eg, toxicology, industrial hygiene, exposure standards, ergonomics, role of the occupational health nurse, identification of occupational causes of disease, bladder carcinoma, ionizing radiation, shiftwork, and many harmful agents found in the workplace. The chapters on epidemiology, the health of working women, cancer, dermatoses, stress, and mental illness are good summaries that relate well to occupational problems. Most of the other clinical topics are limited to six organ systems: pulmonary, gastrointestinal, cardiovascular, musculoskeletal, nervous, and ear, nose, throat. These are good general reviews of the topics, but the occupational components are small. For example, noise and its effect