Risk Of Occupational Diseases Research Articles

T AXONOMIC CHARACTERISATION OF ACTINOBACTERIA ISOLATED FROM THE ATMOSPHERE SURROUNDING CHAMOMILE PLANTS

Many different microbes, including actinobacteria thrive in the conditions offered by moisture nutrient materials, which are needed for microbial growth. The actinobacteria isolated and identified from the atmosphere surrounding chamomile plants cultivated at El-Fayoum Governorate, Egypt reached a maximum concentration during harvesting period of chamomile plants. The main components of the air- borne bacteria in the atmosphere of the studied area were Streptomyces, Micrococcus , Rhodococcus, Arthrobacter, Microbacterium, Cellulomonas and Nocardia. These bacteria have an important role in the spreading of allergic diseases among the population during the harvesting of the chamomile plants and indicate a potential risk of occupational respiratory disease.

Evaluación de los efectos de la rotación en operadores de motosierras

El presente trabajo fue desarrollado en bosques naturales de Pinus caribaea, en la provincia de Pinar del Río-Cuba, para evaluar diferentes métodos en el corte raso con motosierra, empleando sistema de madera corta. Se experimentó la rotación del trabajo de un método de alternancia controlada de los operadores por el reabastecimiento de combustible de la motosierra (MAC) y un método con alternancia libre (MAL). En ambos métodos se utilizaron dos operadores en parejas, la palanca de empuje y la ejecución de la muesca direccional en árboles con diámetros superiores a 30 cm. Los métodos fueron comparados entre si y a su vez, con el que se aplica tradicionalmente en estas áreas (T), que consta de un operador y un ayudante que mantienen sus funciones durante la jornada, no usan la palanca de empuje, no efectúan la muesca direccional y toman descanso espontáneos. De acuerdo con los resultados el MAC es el más apropiado pues, redujo los riesgos de accidentes y enfermedades ocupacionales en los operadores de motosierras, al equilibrar y disminuir la carga fisiológica de trabajo en un 13,69%, redujo el tiempo de exposición a posturas incomodas, así como los efectos nocivos de la motosierra en un 52,08%, la productividad del tiempo efectivo se elevó en un 27,32% respecto al método (T), con la disminución de los costos de la operación, que justifican salarios básicos correspondiente al nivel del operador para ambos integrantes de las parejas.

Development of a medical examination program for former workers at a Department of Energy national laboratory.

As a part of the U.S. Department of Energy (DOE) Former Workers' Medical Surveillance Program, a Needs Assessment was conducted at Los Alamos National Laboratory (LANL). The objective was to identify former LANL employees who may be at significant risk for occupational disease and determine whether a medical examination program could reduce morbidity or mortality. We describe the needs assessment approach used at LANL. An algorithm was developed to make needs determinations. Information on factors including exposure, health impacts, size of exposed populations, and LANL worker concerns and recommendations were obtained. Each of these factors was scored from 1 to 3. The resulting factor sum was then multiplied by a binary (1 or 0) intervention suitability factor which was 1 if both of the following were available: (1) a screening test with acceptable sensitivity and specificity for the health outcome of concern; and (2) an intervention that decreases morbidity or mortality. This resulted in an Intervention Needs Score that was used to set priorities for the medical examination program for the estimated 35,000 former LANL workers. Analysis of the algorithm output suggested that six exposure categories be recommended for consideration in a medical examination program. Beryllium, asbestos, and noise clearly warranted inclusion. Lead and ionizing radiation required careful consideration regarding availability of screening tests. Solvents were problematic due to the lack of screening tests and suitable intervention in formerly exposed workers. The algorithm approach to the needs assessment at LANL documented that six chemical and physical agents should be considered as candidates for inclusion in a medical examination program for former workers.

Imaging of nonmalignant occupational lung disease.

The radiologist plays an important partnership role in detecting presymptomatic disease in those at risk for occupational lung disease, contributing to the specificity of the diagnosis and recognizing sentinel events. Medicolegal roles for imaging include confirming the presence of a morphologic abnormality compatible with occupational lung disease, identifying other potential causes for disability, and determining the morphologic extent of disease. This article describes and illustrates the imaging appearance of a wide range of occupational lung diseases.

Health and safety in the catering industry.

There is evidence that the catering industry has high levels of work-related injury and disease. This study examined the incidence, nature and causes of work-related injury and disease among 315 catering students, at a large school of catering in the west of Ireland, over a 10 month academic year. A high incidence of accidents that caused injury was found. Cuts and lacerations, arising from accidents with knives, were the most common injuries seen, followed by burns and scalds from handling hot liquids. A significant level of work-related dermatitis was also recorded. Trainee chefs were identified as an occupational group with a high risk of occupational injury and disease. This group would benefit from vaccination against tetanus. Work-related injuries and disease generated a significant workload for the student health unit, which in itself is a good reason for catering establishments to make use of occupational health services. Health and safety procedures need to be audited and constantly reviewed at a local level. Further research is necessary to more accurately determine the incidence, nature and leading causes of work-related injury and disease in the catering industry in Ireland. This would help in the planning and implementation of an effective health and safety management system.

An Exploratory Study of Meanings of Risk Control for Long Term and Acute Effect Occupational Health and Safety Risks in Small Business Construction Firms

A qualitative study of employers' and employees' meanings of occupational health and safety (OHS) risk control was conducted among a sample of small businesses engaged in the Australian construction industry. Two OHS risks relevant to the construction industry were selected for study. One risk (falls from height) represented an immediate consequence, whereas the other (occupational skin disease) represented a long-term health effect. Meanings of the sources and control for these risks were explored during in-depth interviews. Participants perceived the immediate effect, falls from height OHS risk, as being more important in their workplaces than the delayed effect, skin disease OHS risk. The risk of falls from height was perceived to be controllable but requiring a great deal of effort to prevent, whereas there was a fatalistic resignation to the risk of occupational skin disease. Meanings of risk control for both occupational skin disease and falls from height focused on individual rather than technological risk controls. Organizational barriers to the adoption of technological OHS risk controls in the construction industry were identified.

Is atopy and smoking important in the workplace?

The relationship between the respiratory system and the environment involves a complex dynamic interaction of genetic susceptibility, host defence and toxicity. The chance of an individual developing a respiratory disease is dependent on genetic susceptibility and subsequent hereditary risk factors, life-style risk factors and the amount and nature of the exposure that may be encountered in the working environment. Atopic status is an important pre-existing risk that a worker may bring to the workplace (occupational asthma/rhinitis to high molecular weight agents). Smoking is an avoidable additional risk for certain occupational diseases (occupational asthma/bronchitis/cancer) while it can be protective in other circumstances (allergic alvcolitis). More controversially, smoking in some workers may put at increased risk the health of colleagues (passive smoking). This article attempts to clarify the issues surrounding the interaction of atopy, smoking and the workplace.

Risks of Occupational Respiratory Diseases among U.S. Coal Miners

Abstract The excess (exposure-attributable) risks of certain respiratory diseases and outcomes were estimated for U.S. coal miners exposed to respirable coal mine dust for various durations and concentrations, including a 45-year working lifetime at the current 2-mg/m3 standard. Multiple linear and logistic regression models were used to compute predicted prevalence and excess risk of disease, using data and regression results from published epidemiological studies of U.S. coal miners. Disease outcomes evaluated include simple coal workers' pneumoconiosis, progressive massive fibrosis, and clinically significant deficits in lung function, measured as forced expiratory volume in 1 second of < 80% or < 65% of predicted normal values. Point estimates of excess risk of progressive massive fibrosis ranged from 1/1000 to 167/1000 among coal miners exposed to respirable coal mine dust at a mean concentration of 2 mg/m3 for 45 years. This range reflects coal rank and study differences. Point estimates for an exce...

Environmental and occupational lung diseases in Indonesia.

Indonesia as a developing country has air pollution which is mainly caused by motor vehicle emissions and industrial smoke. The most important indoor air pollution is cigarette smoke. The prevalence of smoking among Indonesian men is 45.7%. Of the population, 10.8% are ex-smokers and 43.5% are non-smokers. Among the female population, only 1.8% smoke. There are some important factors that influence the air pollution in Indonesia; this paper identifies the real problems and their impact. The paper reviews various studies that have been carried out in Indonesia which were related to ambient air quality, industrial air pollutants levels (SO2, NOx, Ox, Pb, CO, HC) in large cities in Indonesia have exceeded the acceptable level, especially in industrial trade and heavy traffic areas. The more cigarettes inhaled and the deeper the inhalation, especially the kretek cigarettes, the risk of ling function abnormality becomes greater. Smoking high dose kretek cigarettes, that is > or = 116 cigarettes/day x years, the risk of abnormal lung function is 13-fold that of a non-smoker; if added with the deep inhalation of smoke, the risk becomes 20-fold. Smoking increases the risk of occupational lung disease. The level of dust in some industrial areas exceeded the standard level and correlated with respiratory problems. The existence of industry caused by air pollution in the environment increased the incidence of obstructive airway diseases. We conclude that the main cause of air pollution in Indonesia is motor vehicle emissions, followed by industrial smoke. Cigarette smoke is also related to abnormal lung function.

A new risk of occupational disease: allergic asthma and rhinoconjunctivitis in persons working with beneficial arthropods

A new risk of occupational disease: allergic asthma and rhinoconjunctivitis in persons working with beneficial arthropods

A new risk of occupational disease: allergic asthma and rhinoconjunctivitis in persons working with beneficial arthropods.

Allergic asthma and rhinoconjunctivitis have been reported in workers who are constantly in close contact with arthropods during the course of breeding and research. We investigated a group of ten people working with beneficial arthropods in a "bio-factory." The following tests were carried out: skin prick test with allergens present in the workplace, baseline pulmonary function test, aspecific bronchial provocation test with ultrasonically nebulized distilled water, and pulmonary function test after workplace exposure in two subjects. The results demonstrated a good correlation between skin prick test, previous RAST positive reactions, clinical symptoms, and exposure. Pulmonary function test after workplace exposure proved positive in one asthmatic subject and in one subject with rhinoconjunctivitis. It is concluded that the evidence supports the occupational nature of these allergic diseases and that there is a need for careful surveillance and environmental monitoring within the workplace.

Predictors of hepatitis B vaccine acceptance in health care workers.

This article examines the relative importance of occupational, epidemiologic, and attitudinal factors in hepatitis B vaccine acceptance. A stratified random sample of 1,018 health care workers at risk for occupational blood exposure at our university hospital were contacted in 1992 and 919 (90%) participated. Potential reasons for vaccine acceptance or refusal were evaluated with factor analysis. Logistic regression models were calibrated on a stratified random subsample to identify independent predictors of initiating and completing the series, then validated on the remaining subjects. Fifty-four percent (482 of 898) of previously nonimmune workers had completed the series, while 70% (626) had received one or more doses. Hepatitis B vaccine acceptance was related strongly to social influence (physicians, supervisors, role models, friends, and spouse) and knowledge of the disease and vaccine, whereas refusal was primarily related to concern about vaccine side effects and problems with vaccine access. Independent predictors of initiating the vaccine series included younger age (odds ratio [OR] 0.98 per year, 95% confidence interval [CI95] 0.96-0.997), occupation (housestaff: OR 2.9, CI95 1.1-7.9; nurses: OR 2.1, CI95 1.0-4.3 versus housekeepers), increased blood exposure frequency (OR 2.4, CI95 1.6-3.5 for 1-6 versus 0 exposures in past year), and increased frequency of recent influenza vaccination (OR 3.3, CI95 2.0-5.3 for 1 versus 0 doses in prior 3 years). Occupation (increased acceptance among housestaff, nurses, nursing assistants, laboratory technicians), increased frequency of blood exposure, and recent influenza vaccination also were predictors of series completion. Factors such as occupation, blood exposure frequency and acceptance of other preventive services may help identify health care worker groups with low vaccine acceptance most likely to benefit from targeted vaccine delivery. Hepatitis B vaccine should be offered routinely during evaluation for occupational blood exposure. Future vaccine implementation efforts should emphasize the involvement of physicians and supervisors and education about occupational disease risk, liability, and the safety of the vaccine.

HIV seroprevalence in emergency department patients: Portland, Oregon, 1988-1991.

In Portland, OR: 1) to determine the changes in HIV seroprevalence for ED patients from 1988 to 1991, 2) to define the characteristics of the HIV-positive ED patient, 3) to determine the hepatitis B seroprevalence of HIV-seropositive ED patients, and 4) to demonstrate the feasibility of an ED population-based surveillance investigation. A prospective, multiyear observational, cross-sectional, multicenter, population-based seroprevalence study was performed using seven urban hospital EDs. Serologic testing for HIV and hepatitis B was performed on excess blood obtained from ED patients. Four sampling periods were used at each hospital at 14-month intervals starting June 1988 and ending December 1991. The blood specimens were obtained concurrently at all the participating hospitals. Of 1,681 patients, 17 (1.0%) were HIV-positive. The HIV seroprevalence rate was relatively stable over time: 0.5% (2/444) in 1988, 1.7% (7/396) in 1989, 1% (3/296) in 1990, and 0.9% (5/545) in 1991. Most (94%) HIV patients were men, 100% were white, 81% were > or = 30 years old. Most (59%) of the HIV-positive patients also were positive for hepatitis B core antibody. Many (76%) of the HIV-positive patients were known to be positive by the emergency health care worker. HIV seroprevalence among the ED patients in Portland, OR, was generally stable from 1988 to 1991. Many HIV-positive patients also were hepatitis B-positive, thus representing a double occupational infectious disease risk to ED personnel. A significant minority (24%) of the HIV-positive patients were not known to be HIV-positive by the ED personnel. Universal precautions and hepatitis B immunization are paramount for reducing the risk of infectious disease due to exposure to body fluids.

A new risk of occupational disease: allergic asthma and rhinoconjunctivitis in persons working with beneficial arthropods. Preliminary data.

For some years, biological pest control has been re-evaluated as an alternative to the indiscriminate use of pesticides. The number of "bio-factories" in Europe has been constantly increasing and today more than 100 technicians work in mass rearing of arthropods. Seven cases of asthma and allergic rhinitis are reported in 13 workers engaged in the production of beneficial arthropods. The subjects suffered from attacks of asthma and rhinitis when they came into contact with eggs and scales or waste of Chrysoperla carnea, Leptinotarsa decemlineata, Ostrinia nubilalis and Ephestia kuehniella. These attacks occurred after an average exposure period of 18 months. A RAST test, prepared by Lofarma, was carried out on subjects' serum against the above-mentioned allergens and was positive in all symptomatic subjects (7 of 13) and negative in the others. This demonstrates IgE direct sensitization mediated by complete antigens.

Medical screening for occupational disease risk is not a control measure

Medical screening for occupational disease risk is not a control measure

The case for worker notification.

There is currently a heated debate about whether the U.S. Congress should enact the High Risk Occupational Disease Notification and Prevention Act. This Act would set up an orderly system for identifying, notifying, and assisting workers at high risk of occupational disease. Significant underpinning for this legislation comes from three pilot projects conducted by the National Institute for Occupational Safety and Health and the Workers' Institute for Safety and Health. These projects demonstrate that notification and intervention for occupational high-risk groups can be implemented feasibly within the existing structures of community health and labor management relations. These projects also suggest that, contrary to the views of opponents of current legislation, it is the absence of systematic programs that leads to massive litigation and high costs. At present, these costs are borne by workers and society.

Projects demonstrate how to involve physicians in care of workers at risk of health impairment

FROM 1980 TO 1984, the Washington, DC—based Workers' Institute for Safety and Health (a private nonprofit educational and technical resource center for labor unions), with funds from the National Cancer Institute, initiated three demonstration projects to assess means to identify, notify, screen, and educate workers exposed to various toxic substances (<i>J Occup Med</i>1986;28:719-727). Each project, which continues to monitor workers and collect data, elicited the cooperation and participation of community-based physicians. At a New York Academy of Sciences meeting on Occupational Health in the 1990s, one project investigator, Knut Ringen, DPH, discussed the projects in light of new national efforts to notify workers at risk, including national notification legislation recently defeated in the Senate, and an ongoing National Institute for Occupational Safety and Health (NIOSH) program to notify members of its cohort studies of occupational disease risks. The Augusta, Ga, project identified 1385 workers at risk for bladder cancer

Distribution of lost-work-time claims for skin disease in California agriculture: 1978-1983.

In order to identify California agricultural workers at high risk for occupational skin disease, we evaluated the distribution of 2,722 claims for lost-work-time skin conditions reported between 1978 and 1983 by Standard Industrial Classification (SIC) and source of illness. In the overall work force, cases were most frequently attributed to plants (52.1%), chemical exposures (20.4%), and food products (12.5%), but considerable variation occurred in the distribution of cases among the subdivisions of agriculture. The forestry subdivisions (SICs 081, 082, 084, and 085) had the highest rate (given as cases/10,000 employed) of claims for skin disease attributed to plants (53.5), but no cases due to other exposures. For chemical exposures, the highest rate of claims occurred in the horticultural specialities (SIC 018) subdivision (5.1), but this group also had a significant claims rate for plant-related skin disease (15.9). The highest claims rate for cases attributed to food products occurred in the vegetables/melons subdivision (4.7), but this group had claims rates for exposure to plants (3.8) and chemicals (2.8) that were nearly as high. Efforts to evaluate and prevent skin disease in agricultural workers should recognize the complex range of exposures to which this work force is subject.

A strategy for merging and analyzing work history data in industry-wide occupational epidemiological studies.

Study populations examined in epidemiologic investigations of occupational disease risks often are assembled by the pooling of employee data from several workplaces that share common exposure factors. The primary objectives of this approach are to enhance the representativeness of the overall study population and to obtain sufficient employee sample sizes in exposure subgroups of interest. Among the many epidemiologic aspects that must be considered carefully in such industry-wide studies is the inter- and intra-company or plant comparability of employee work history data. Currently, the literature is void of articles that specifically address the fundamental data reduction and statistical analysis issues related to merging work history data from several distinct cohorts. This paper describes the basic methodologic problems associated with the pooling of work history data and proposes a joint job title/job exposure-based uniform coding scheme (UCS) that facilitates the aggregation of data from similar or diverse cohorts in a variety of epidemiologic study settings. The utility of the UCS as both an efficient data coding structure and a flexible basis for statistical analysis is described within the context of a popular computer software program for analyzing occupational cohort data. The fundamental features of the UCS are illustrated using data from a recent industry-wide study of copper and zinc smelter workers.

A Strategy for Merging and Analyzing Work History Data in Industry-Wide Occupational Epidemiological Studies

Study populations examined in epidemiologic investigations of occupational disease risks often are assembled by the pooling of employee data from several workplaces that share common exposure factors. The primary objectives of this approach are to enhance the representativeness of the overall study population and to obtain sufficient employee sample sizes in exposure subgroups of interest. Among the many epidemiologic aspects that must be considered carefully in such industry-wide studies is the inter- and intra-company or plant comparability of employee work history data. Currently, the literature is void of articles that specifically address the fundamental data reduction and statistical analysis issues related to merging work history data from several distinct cohorts. This paper describes the basic methodologic problems associated with the pooling of work history data and proposes a joint job title/job exposure-based uniform coding scheme (UCS) that facilitates the aggregation of data from similar or diverse cohorts in a variety of epidemiologic study settings. The utility of the UCS as both an efficient data coding structure and a flexible basis for statistical analysis is described within the context of a popular computer software program for analyzing occupational cohort data. The fundamental features of the UCS are illustrated using data from a recent industry-wide study of copper and zinc smelter workers.