摘要:

AbstractCohort and case‐control studies are two standard approaches for investigating the etiology of occupational diseases. This paper, which is the first of a four‐part series, contains a review of the design features of occupational cohort studies. Topics discussed include the basic features of prospective and historical cohort studies, options for defining the cohort, disease incidence ascertainment, and considerations involved in planning an occupational cohort study. Subsequent papers in this series will focus on data analysis of occupational cohort studies and the design and analysis of occupational case‐control st

ISSN:0271-3586    

DOI:10.1002/ajim.4700150402

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThis paper reviews strategies and statistical methods for analyzing data from occupational cohort studies. Emphasis is placed on the common methods for grouped data analysis involving external and internal comparison populations. Analysis procedures reviewed are standardized mortality ratio, standardized rate ratio, and Mantel‐Haenszel techniques for estimating relative risks. Methods for control of confounding, assessment of effect modification, and allowance for disease latency are discussed. These concepts and procedures are illustrated with data from an historical cohort mortality study of workers from an asbestos textile plan

ISSN:0271-3586    

DOI:10.1002/ajim.4700150403

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractCurrently available approaches for the design of occupational case‐control studies are reviewed. An accompanying paper reviews methods of analysis. We commence by drawing a distinction between cohort‐based and registry‐based studies. Methods for selecting cases and controls are then reviewed, including cumulative incidence and incidence density sampling, matching, sources of controls, and issues in control selection. Finally, the advantages and disadvantages of the case‐control approach are sum

ISSN:0271-3586    

DOI:10.1002/ajim.4700150404

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThis paper reviews the basic methods of analysis of data from case‐control studies. The standard analytic methods are outlined first for a single stratum. The discussion is then extended to stratified analysis, multiple exposure levels, and analyses allowing for disease induction and latency periods. Finally, logistic regression is discussed as an extension of the more basic forms of analysis. The methods are illustrated with data from a study of lung cancer among asbestos textile plant worker

ISSN:0271-3586    

DOI:10.1002/ajim.4700150405

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe relationship of respiratory airway and airspace geometry to radiographic evidence of pleural abnormality consistent with asbestos exposure was studied in 178 construction insulators. Lung geometry was assessed from tracings of radiographic shadows, and the measures taken were tracheal length and diameter, subcarinal angle, right and left lung lengths, and upper, middle, and lower lung widths. Important modifying variables—age, height, weight, exposure estimates, and smoking history—were included in a logistic regression model to test the significance of the lung geometry measurements as predictors of the presence or absence of pleural abnormality. No such relationships were found. Neither were there any differences in prevalence or severity of pleural disease between the right and left sides which might have been found if airway geometry were a significant determinant of asbestos pleural disease. These results do not support the hypothesis that lung geometry is a host risk factor for the development of asbestos‐related pleural di

ISSN:0271-3586    

DOI:10.1002/ajim.4700150406

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractSimple pneumoconiosis due to compact particles, notably in coal workers, sometimes departs from its customary focal formations and a more diffuse distribution of dust‐impregnated fibrosis is superimposed. To account for this change, which may be reflected in the acquisition of radiologically irregular opacities in addition to rounded ones, attention is directed first toward type II alveolar epithelium. These cells come early into contact with inhaled particles and the lipid secretion provoked prevents their characteristic aggregation, so they remain in a more dispersed state and the consequent fibrotic reaction then tends to become diffuse. Second, submicron particles appear to act not from within the alveolus like the more usual larger ones, but after direct passage through type I epithelium into the interstitium, where lacking focal accumulation they are able to produce diffuse changes. Complexities, however, remain, among which are coalescence of focal lesions as their severity increases and interplay of agents producing interstitial fibrosis in the general populatio

ISSN:0271-3586    

DOI:10.1002/ajim.4700150407

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractUsing data from the Swedish Cancer‐Environment Register, time trends in the standardized incidence ratio (SIR) for lung cancer 1961–1979 were studied in different occupations. After adjustments for differences in the SIR with respect to year of birth, only the decreasing trends for blacksmiths and members of the armed forces as well as increasing trends for foundry workers and construction machine operators were significant (p<0.05). For bakers and pastry cooks, there was a significant interaction between year of birth and observation period in relation to SIR. Data on smoking habits, obtained from a sample of the population, did not seem to explain the tre

ISSN:0271-3586    

DOI:10.1002/ajim.4700150408

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractTo evaluate the medical aspects of the Health Hazard Evaluation (HHE) program of the National Institute for Occupational Safety and Health (NIOSH), 170 lead‐related HHE reports published through 1984 were examined. The percentages of HHEs conducting basic medical examination procedures justified by elevated environmental exposure to lead at worksites were as follows: blood or urine lead level testing, 57%; medical history taking, 55%; physical examinations, 23%; CBCs, 18%; and urinalysis, 7%. The HHE program has primarily focused on whether or not environmental worksite hazards are present at the time of the evaluation and not on ascertaining whether there is evidence of adverse health effects attributable to past worksite exposures. The program has not focused on minimizing adverse health effects when they exist or on providing a series of building blocks for health effects research. More clearly defined HHE program goals and a logic for deciding when and how medical examinations should be performed during HHEs need to be develope

ISSN:0271-3586    

DOI:10.1002/ajim.4700150409

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractIn the wake of efforts to pass legislation mandating notification of workers at high risk of developing occupational disease, considerable controversy exists regarding the potential costs and benefits of such notification efforts. It has been suggested that individual notification would cause undue psychological distress, especially when primary prevention efforts are no longer possible. In this study, we assessed reactions of asbestos‐exposed workers to a letter notifying them of their risk for asbestos‐related illnesses and the availability of a medical screening program. Two hundred forty‐seven workers who attended the screening program and 53 who chose not to attend completed a questionnaire that tapped reactions to notification. Workers reported neither undue psychological distress nor avoidance behavior in response to notification, and many respondents reported engaging in active and appropriate coping behaviors. Workers who first learned of their risk through the notification letter (33.7%) were no more likely to report distress or denial than were workers who had learned previously through other sources. Individuals who chose not to attend the screening program were less likely than attenders to report experiencing distress upon learning of their risk status, more likely to engage in minimization of risk, and less likely to have taken direct action. Our results suggest that the psychological costs of notifying workers of increased risk for asbestosrelated illness appear to be outweighed by the benefits of notification and scre

ISSN:0271-3586    

DOI:10.1002/ajim.4700150410

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe mortality of workers from an Ontario factory manufacturing amosite asbestos insulation materials under poorly controlled environmental conditions is reported here. Seven (58%) of 12 deaths among exposed workers 10 or more years after first exposure were due to malignancies; four (25%) were from lung cancer, and there were two deaths from peritoneal mesothelioma. Those dying from mesothelioma were 47 and 49 years of age. Three (25%) of 12 deaths were from respiratory disease, two were attributed to asbestosis (in men 42 and 53 years of ages), and one to pneumonia in a 54‐year‐old m

ISSN:0271-3586    

DOI:10.1002/ajim.4700150411

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY