ISSN:0271-3586    

DOI:10.1002/ajim.4700160402

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

年代:1989

数据来源: WILEY

摘要:

AbstractFollow‐up of a cohort of 1,165 steelworkers exposed to acid mists has been extended from 1981 to early 1986 for most cohort members, and information on smoking has also been collected. We obtained an SMR for lung cancer (unadjusted for smoking) of 1.56 (95% CI 1.12–2.11,41 observed). For those with 20 years or more since first exposure, the SMR was 1.72 (1.21–2.39). However, no trend was found with duration of exposure. To adjust for smoking, we used an indirect adjustment as suggested by Axelson to account for the fact that the exposed cohort smoked slightly more than the U.S. referent population. The SMR for the whole cohort dropped to 1.36 (0.97–1.84), while for those with more than 20 years since first exposure, the SMR was 1.50 (1.05–2.07). These results indicate that an excess risk for lung cancer persists after control for confounding b

ISSN:0271-3586    

DOI:10.1002/ajim.4700160403

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

年代:1989

数据来源: WILEY

摘要:

AbstractThis report describes the Compressed Mortality File available from the National Center for Health Statistics that can be used to easily and efficiently generate annual mortality rates for geographic areas as small as counties for any period from 1968 to 1985. Several ways of presenting geographic variation in mortality rates due to potentially work‐related deaths and changes in these rates over time are discussed for the 15‐year period from 1969 through 1983. Causes of death that are potentially work‐related were identified using the sentinel health events (occupational) [SHE(O)] concept. Data are given for nine diagnostic groups of occupationally related disorders, and maps are presented for bladder cancer, acute myeloid leukemia, and pneumoconioses. Significant changes in age‐adjusted mortality rates were noted for pneumoconioses and acute myeloid leukemia that could not be due to changes in the disease coding of death certificates. Racial differences in mortality rates due to pneumoconioses may be due to differences in employment patterns. The use of SHE(O) codes to search the Compressed Mortality File may be helpful in identifying areas for public health concern, even if only as a monitoring signal for subsequent time periods. This file also provides an easy way to generate reference population mortality rates for epidemiologic

ISSN:0271-3586    

DOI:10.1002/ajim.4700160404

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

年代:1989

数据来源: WILEY

摘要:

AbstractThis retrospective analysis reviews the clinical experience of a major urban referral hospital with diffuse malignant pleural mesothelioma during the 14‐year period from 1973 through 1986. Seventy‐five cases of definite or equivocal mesothelioma were identified. There were four cases of primary malignant peritoneal mesothelioma, seven cases of benign fibrous mesothelioma, and 64 cases of diffuse malignant pleural mesothelioma. In 43 cases (67%) of diffuse malignant pleural mesothelioma, there was historic evidence of asbestos exposure. In 21 cases (33%), there was no known history of asbestos exposure. An increase in annual incidence of diffuse malignant pleural mesothelioma was observed over the study period, from three cases in 1973 to ten cases in 1986.Despite greater awareness of this disease, the diagnosis remains a difficult one to establish given the nonspecific symptoms, signs and radiographic appearance, variable histologic appearance, and poor diagnostic sensitivity and specificity of thoracentesis and closed pleural biopsy. Thoracotomy, thoracoscopy, and CT‐guided needle biopsies gave higher yields and are the diagnostic measures of choice when diffuse malignant pleural mesothelioma is susp

ISSN:0271-3586    

DOI:10.1002/ajim.4700160405

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

年代:1989

数据来源: WILEY

摘要:

AbstractBenzene was measured in blood and alveolar air of 168 men, aged 20–58 years, subdivided into four groups: blood donors, hospital staff, chemical workers occupationally exposed to benzene, and chemical workers not occupationally exposed to benzene. The group of exposed workers was employed in work places with a mean environmental exposure to benzene of 1.62 mg/M3(8 hr TWA). Non‐exposed workers were employed elsewhere in the same plant, with an environmental exposure to benzene lower than 0.1 mg/M3. Blood and alveolar air samples were collected in the morning, before the start of the work shift for the chemical workers. The group of exposed workers was found to be significantly different from the other three groups, both for blood and alveolar benzene concentrations. The mean blood benzene concentration was 789 ng/1 in the exposed workers, 307 ng/1 in the non‐exposed workers, 332 ng/1 in the hospital staff, and 196 ng/1 in the blood donors. Apart from the exposed workers, blood benzene concentration was significantly higher in smokers than in non‐smokers. The mean alveolar benzene concentration was 92 ng/1 in the exposed workers, 42 ng/1 in the non‐exposed workers, 22 ng/1 in the hospital staff, and 11 ng/1 in the blood donors. Alveolar benzene concentration was significantly higher in smokers than in non‐smokers in the groups of the hospital staff and non‐exposed workers, but not in the blood donors and exposed workers. In the three groups without occupational exposure considered altogether, the alveolar benzene concentration correlated significantly with the environmental benzene concentration measured at the moment of the individual examinations, both in the smokers (r= .636; p<.001) and non‐smokers (r= .628; p<.001). In the same three groups and in the exposed workers, alveolar benzene concentration showed a significant correlation with the blood benzen

ISSN:0271-3586    

DOI:10.1002/ajim.4700160406

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

年代:1989

数据来源: WILEY

摘要:

AbstractIn the Negev region of Israel, I tested a model approach to occupational health planning. This model included components assessing exposures, measuring adverse health outcomes, and evaluating health services.I analyzed employment survey data, compiled an exposure data base, and carried out site visits covering 10,707 employees (over 50% of the regional industrial work force). Site visits identified exposure hazards of inorganic and organic dusts, heavy metals, chemicals, pesticides, and noise. I identified elevated relative regional injury rates by Standard Morbidity Ratios (SMRs) in a variety of industries, including sixfold increases for mining and non‐metallic minerals manufacture (SMR 6.8, 99% CI6.1–7.7). Review of biological monitoring data suggested deficiencies in pesticide and heavy metals surveillance. A survey of primary care clinics estimated 13,707 cases of occupational injury and illness untreated by existing occupational medical services.Based on these findings, I formulated regional occupational health planning goals, including targeting high‐risk industries for increased preventive activities. This regional approach, combining multiple measures of occupational health status, can serve as a model for assessing local public health planning

ISSN:0271-3586    

DOI:10.1002/ajim.4700160407

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

年代:1989

数据来源: WILEY

摘要:

AbstractIn order to obtain information on the current magnitude of occupational disease in New York State, four data sources were reviewed: Workers' Compensation records, disease registries maintained by the state department of health, data from the Bureau of Labor Statistics (BLS), and data from the California's physician reporting system. A proportionate attributable risk approach is used to develop estimates of mortality due to occupational diseases. The distribution of occupational hazards was assessed using data from the Occupational Safety and Health Administration (OSHA), the National Institute for Occupational Safety and Health (NIOSH), and the New York State Department of Environmental Conservation (NYDEC). Finally, econometric estimates of the direct and indirect costs of occupational illness were developed.The best available data indicate that 5,000 to 7,000 deaths are caused each year in New York State by work‐related illnesses, and at least 35,000 new cases of occupational illness develop each year in the State. It is also estimated that between 150,000 and 750,000 workers in New York State are employed in the 50 most hazardous industries. OSHA standards regulating exposure to selected chemicals were found to have been violated frequently. The annual costs of occupational disease in New York State are approximately 600,000,000; only a small fraction is covered by workers' compensation insurance. Of the 52,000 physicians in New York State, only 73 are board‐certified in occupational medicine. Most of these are involved in administrative, teaching, and research aspects of occupational medicine. Of the 300 industrial hygenists in New York State, two‐thirds are employed by major corporations.Recommendations are described to improve the recognition of occupational disease in New York State and to reduce the burden of this disease. A statewide network of occupational health clinical services is proposed and has been funded by the New York State Legislature. Other recommendations are also

ISSN:0271-3586    

DOI:10.1002/ajim.4700160408

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

年代:1989

数据来源: WILEY

摘要:

AbstractOccupational diseases and deaths are costly events. They are responsible for: 1) direct medical costs; 2) indirect costs, resulting from lost production, foregone opportunities, and diminished investment; and 3) non‐economic costs, including pain and suffering, disrupted careers, and devastated families. To develop a partial estimate of the total costs of occupational disease in New York State, we have examined four categories of illness: occupational cancer, chronic respiratory disease and the pneumoconioses, cerebrovascular and cardiovascular disease, and end‐stage renal failure. We base our partial estimate on the human capital approach to the costs of these illnesses. Using the best measures available, including both incidence and prevalence statistics, mortality records, and a variety of financial data, we employ two cost accounting techniques of the human capital approach, the incidence method, and the prevalence method. Our analysis shows that these four occupational illnesses are costing New York over 600 million per year. This figure is a pragmatic but conservative, lower‐bound estimate of the relative magnitude of total economic costs of occupational disease in New York State. The largest proportion of these costs (80%) is due to occupational cancer. The failure of the health care system to recognize the costs of occupational disease precludes recognition of the economic benefits which would result from preventing these illnesses. This study, it is hoped, will stimulate advances in epidemiological and economic approaches to resolve this important measurement pr

ISSN:0271-3586    

DOI:10.1002/ajim.4700160409

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

年代:1989

数据来源: WILEY

ISSN:0271-3586    

DOI:10.1002/ajim.4700160410

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

年代:1989

数据来源: WILEY

摘要:

AbstractDespite continuing controversies related to public policy, information on the molecular biology of 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin (TCDD) has advanced significantly over the past decade. Current understanding of the biological mechanisms of TCDD action is based upon the interactions of TCDD with a genetically expressed cytosolic macromolecule that functions as a receptor in many cells across many species. The Ah receptor recognizes TCDD and structurally similar molecules and serves as the transducing step whereby TCDD alters gene expression through the association of the TCDD:receptor complex with specific TCDD‐responsive elements on the genome. Understanding these molecular events and their relevance to the organ‐level manifestations of TCDD toxicity may be critical to formulating scientifically based assessments of the risk of TCDD

ISSN:0271-3586    

DOI:10.1002/ajim.4700160411

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

年代:1989

数据来源: WILEY