摘要:

AbstractChest radiographs and spirometry were evaluated in 2,907 active and retired asbestos insulators; most (86.8%) had ≥ 30 years from onset of asbestos exposure. Testing was performed in 19 cities in the United States during 1981–1983. Complete demographic, smoking, clinical, and radiologic data were obtained for 2,790 workers. This is the largest single group of insulators that has been studied. Five hundred forty‐eight (19.7%) had never smoked cigarettes, 942 (33.9%) were current cigarette smokers, and 1,300 (46.6%) were ex‐smokers. Only 439 (15.7%) workers had no radiographic evidence of asbestos‐related disease (normal chest X‐ray); 668 (23.9%) had pleural fibrosis only, 325 (11.6%) had parenchymal fibrosis alone, and 1,358 (48.7%) had both parenchymal and pleural fibrosis. The prevalence of radiographic parenchymal changes increased significantly (p<.001) from 38.6% (DURONSET<30 years) to 70% (≥40 years). For pleural changes the comparative prevalences were 55% and 82%. Those with no history of cigarette smoking were more likely to have normal filMS than those with a history of smoking (19.2% versus 14.4% for current smokers and 15.2% among ex‐smokers), and were less likely to have parenchymal fibrosis (44.5% versus 69.7% for current smokers and 60.2% of ex‐smokers). Dyspnea, MRC grade 3 and higher, was more prevalent when pleural fibrosis was associated with interstitial pulmonary fibrosis (at all profusion levels of small opacities) than when pleural fibrosis was absent. Logistic regression analysis of factors contributing to such dyspnea showed that the presence of combined parenchymal and pleural abnormalities was a significant explanatory variable, in addition to age, smoking, and body mass (Quetelet index); the presence of parenchymal changes only or of pleural changes only, as factors contributing to dyspnea, did not reach the level of statistical significance in the regression analysis. The results of these examinations show that pleural fibrosis is a frequent finding in asbestos‐exposed groups with long‐term follow‐up and that its functional significance is not negligible. The contribution of cigarette smoking to prevalence and severity of interstitial fibrosis is an additional reason for smoking cessation among asbes

ISSN:0271-3586    

DOI:10.1002/ajim.4700200102

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

年代:1991

数据来源: WILEY

摘要:

AbstractWe reviewed the literature in order to summarize the present knowledge on the association between parental occupational exposures to chemicals and the risk of childhood malignancy. The 32 studies pertaining to this topic were evaluated by considering various study qualities such as sample size, specificity of outcome, confounding, exposure specificity, and control selection. When evaluating the findings from any epidemiologic study, the potential sources of bias have to be considered. The selection of subjects, misclassification of exposure or outcome, and confounding from extraneous factors can contribute to a biased estimate of effect. Studies done to minimize these potential biases will be more valid, and these studies should be given the most weight when parental occupational exposures are evaluated as risk factors for childhood malignancy. We conclude that the preponderance of evidence supports the hypothesis that occupational exposure of parents to chemicals increases the risk of childhood malignancy. The parental occupational exposures implicated in childhood malignancy risk are exposure to chemicals including paints, petroleum products, solvents (especially chlorinated hydrocarbons) and pesticides, and exposure to metals. The available data do not allow the identification of specific etiologic agents within these categories of compounds. Future epidemiologic and toxicologic studies should be designed to pursue these leads.

ISSN:0271-3586    

DOI:10.1002/ajim.4700200103

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

年代:1991

数据来源: WILEY

摘要:

AbstractInterstitial lung disease and airflow limitation have been reported in silicon carbide workers but it is uncertain whether these recent observations reflect past working conditions alone (30 years ago) or both past and present conditions even if the latter have improved. To investigate this, we analyzed pairs of chest radiographs obtained in 1977 and 1984 in 128 silicon carbide plant workers. Three indices, related to density of small opacities, profusion of opacities, and presence of pleural plaques, were obtained.Student t‐tests on results obtained in each time period showed the mean density (1.02 in 1977 and 0.56 in 1984) and profusion (4.27 in 1977 and 2.13 in 1984) indices to be significantly different. However, the pleural plaque index was not different in 1984 (0.34) as compared with 1977 (0.32). There was no deterioration of the radiographic image even in groups with density ratios equal or greater than 1/1. We concluded that the actual environmental working conditions did not influence the integrity of the lung radiographic image in these workers within a time span of 6 or 7 year

ISSN:0271-3586    

DOI:10.1002/ajim.4700200104

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

年代:1991

数据来源: WILEY

摘要:

AbstractNonspecific pleuritis, i.e., inflammation of the visceral pleura, is recognized by the presence of pleural strands on the routine posteroanterior chest radiograph. The computed tomograph counterparts of these strands are seen as interlobular septal intrusions and lenticular or wedge‐shaped subpleurai opacities. The pleural reaction is nonspecific and may be found with asbestos exposure, traumatic hemorrhagic effusions, pulmonary embolism, viral pleurisy, malignant pleural effusions, and lupus or rheumatoid effusions. The asbestos‐related pleural changes may be found alone or in association with parietal pleural plaque formation or with asbestotic lung fibro

ISSN:0271-3586    

DOI:10.1002/ajim.4700200105

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

年代:1991

数据来源: WILEY

摘要:

AbstractSince 1940, 760 cases of silicosis have been diagnosed as part of the State of North Carolina's (NC) pneumoconiosis surveillance program for dusty trades workers. Vital status was ascertained through 1983 for 714 cases that had been diagnosed since 1940 and death certificates were obtained for 546 of the 550 deceased.Mortality from tuberculosis, cancer of the intestine and lung, pneumonia, bronchitis, eMPHysema, asthma, pneumoconiosis, and kidney disease was significantly increased in whites. Mortality from tuberculosis, ischemic heart disease, and pneumoconiosis was significantly increased in non‐whites. The standardized mortality ratio (95% CI) for lung cancer based on U.S. rates was 2.6 (1.8–3.6) in whites, 2.3 (1.5–3.4) in those who had no exposure to other known occupational carcinogens, and 2.4 (1.5–3.6) in those who had no other exposure and who had been diagnosed for silicosis while employed in the NC dusty trades.Age‐adjusted lung cancer rates in silicotics who had no exposure to other known occupational carcinogens were 1.5 (.8–2.9) times higher than that in a referent group of coal miners with coalworkers' pneumoconiosis (CWP) and 2.4 (1.5–3.9) times higher than that in a referent group of non‐silicotic metal miners. Age‐ and smoking‐adjusted rates in silicotics were 3.9 (2.4–6.4) times higher than that in metal miners. This analysis effectively controls for confounding by age, cigarette smoking, and exposure to other known occupational carcinogens, and it is unlikely that other correlates of silica exposure could explain the excess lung cancer mortal

ISSN:0271-3586    

DOI:10.1002/ajim.4700200106

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

年代:1991

数据来源: WILEY

摘要:

AbstractWorkers 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 0, 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<.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 FEV1/FVC ratio and MMF (p<.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 accide

ISSN:0271-3586    

DOI:10.1002/ajim.4700200107

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

年代:1991

数据来源: WILEY

摘要:

AbstractPathologists eligible for inclusion in the study were identified from the membership lists of the Royal College of Pathologists from 1974 to 1987, establishing a population of 4,512 members. Overall mortality was lower among the study group compared with the general population of England and Wales, although there were significantly more deaths due to suicide (observed 13, expected 4.9, SMR 265, 95% CI 141–454). Excess deaths due to cancer of the lyMPHatic and hemopoietic system were noted but they were not significantly increased. An excess of brain cancer death was marginally significant for male pathologists (observed 6, expected 2.5, SMR 240, 95% CI 88–522). Six of the 9 (66.7%) cases of all types of brain tumors reported in total were among hematologists, although this sub‐specialty comprises approximately 16% of all patholo

ISSN:0271-3586    

DOI:10.1002/ajim.4700200108

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

年代:1991

数据来源: WILEY

摘要:

AbstractHydrogen sulfide (H2S) poisoning involves a risk of hypoxic brain damage. Six patients who lost consciousness due to H2S poisoning are described. The symptoMS varied from anosmia in the patient with the shortest but highest exposure to delayed neurological deterioration in the patient with the longest exposure. The two patients with the most serious symptoMS developed pulmonary edema, which may have prolonged the hypoxia. The patients were reexaminated 5 years or more after the poisoning. The five patients who had been unconscious in H2S atmosphere for from 5 to 15–20 min showed persisting impairment at neurological and neuropsychological re‐examination. Memory and motor function were most affected. One patient was seriously demented. Recent reports of large groups of H2S‐poisoned workers probably underestimate the risk of sequelae, due to the inclusion of cases with exposure of short duration and lack of foll

ISSN:0271-3586    

DOI:10.1002/ajim.4700200109

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe concentration of halothane (fluothane) in the ambient atmosphere was determined in five operating theaters of two hospitals in Italy. The concentrations of halothane in the ambient air exceeded the NIOSH recommended time‐weighted average exposure levels (median value: 10.38 mg/m3). Halothane was detected in the urine of 58 exposed subjects (anesthetists, surgeons, and nurses). A significant correlation was found between the halothane concentration in urine produced during the shift (Cu, μg/L) and halothane environmental concentration (CI, mg/m3) (Cu = 0.242 × CI + 3.51) (N = 58; r = 0.92; p<0.0001). The results show that the urinary halothane concentration can be used as an appropriate biological exposure index. The biological values proposed are: 92 μg/L, corresponding to a 50 ppm of environmental exposure; 6.5 μg/L, corresponding to 2 ppm of environmental exposure and 3.9 μg/L, corresponding to a 0.5 ppm of environmental ex

ISSN:0271-3586    

DOI:10.1002/ajim.4700200110

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

年代:1991

数据来源: WILEY

摘要:

AbstractIn a cross‐sectional study undertaken in 1981 using a postal questionnaire, the prevalence of irritative symptoMS was investigated among 2,654 Danish construction workers working with mineral wool. An evaluation was undertaken in a multivariate logit analysis of the relationship between exposure level (measured by hours of exposure to mineral wool per month) and prevalence of symptoMS. The analysis controlled for the confounders of age, smoking habits, and exposure to organic solvents. With greater exposure to mineral wool, there was a statistically significant increase in the frequency of irritative symptoMS from the eyes, the skin, and the upper respiratory tract. Among construction workers working with mineral wool 160–180 hours per month, two‐thirds had these symptoMS once a week or oftener. The occurrence was 2–3 times higher compared with the construction workers not working with mineral wool. The relationship between exposure to mineral wool and skin and mucous membrane symptoMS may be explained by the irritative action of the fibers that are given off during insulati

ISSN:0271-3586    

DOI:10.1002/ajim.4700200111

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

年代:1991

数据来源: WILEY