摘要:

To determine clinical health effects in a small group of US Gulf War veterans (n = 50) who were victims of depleted uranium (DU) “friendly fire,” we performed periodic medical surveillance examinations. We obtained urine uranium determinations, clinical laboratory values, reproductive health measures, neurocognitive assessments, and genotoxicity measures. DU-exposed Gulf War veterans with retained metal shrapnel fragments were excreting elevated levels of urine uranium 8 years after their first exposure (range, 0.018 to 39.1 &mgr;g/g creatinine for DU-exposed Gulf War veterans with retained fragments vs 0.002 to 0.231 &mgr;g/g creatinine in DU exposed but without fragments). The persistence of the elevated urine uranium suggests ongoing mobilization from the DU fragments and results in chronic systemic exposure. Clinical laboratory outcomes, including renal functioning, were essentially normal. Neurocognitive measures showing subtle differences between high and low uranium exposure groups, seen previously, have since diminished. Sister chromatid exchange frequency, a measure of mutation in peripheral lymphocytes, was related to urine uranium level (6.35 sister chromatid exchanges/cell in the high uranium exposure group vs 5.52 sister chromatid exchanges/cell in the low uranium exposure group;P= 0.03). Observed health effects were related to subtle but biologically plausible perturbations in central nervous system function and a general measure of mutagen exposure. The findings related to uranium’s chemical rather than radiologic toxicity. Observations in this group of veterans prompt speculation about the health effects of DU in other exposure scenarios.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was to evaluate the effect of four common types of mandatory state-level workplace safety regulations on injury severity rates during the period 1992 to 1997 for the manufacturing sector. The full Poisson regression model showed safety committee regulations to have a highly significant reducing effect on injury rates, &khgr;2(1,n= 3286) = 10.1774,P= 0.0014. Safety program regulations were significant at the &agr; = 0.10 level, &khgr;2(1,n= 3286) = 3.5676,P= 0.0589. The effect of insurance carrier loss control regulations in the full model was nonsignificant. However, insurance carrier loss control regulations were highly significant (&agr; = 0.01) in the final reduced model. Targeting initiatives were nonsignificant in both the full and reduced models (&agr; = 0.05). The study results are important to state and federal agencies considering adopting workplace safety regulations that are similar to the four types evaluated in this study.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The objective of this study was to assess and compare the self-perceived work-related stress of emergency department (ED) and general ward (GW) nurses and to assess the relationship between self-perceived stress and salivary cortisol levels in these groups of nurses. Seventy-three female ED (n= 23) and GW (n= 50) nurses from a general hospital completed a self-administered questionnaire. A modified mental health professional stress scale (PSS) was used to measure self-perceived work-related stress. Salivary samples were collected at the start and end of morning shiftwork. An enzyme-linked immunosorbent assay method was used to determine the salivary cortisol concentration (nmol/L). ED nurses perceived that nursing was more stressful (mean, 1.58; 95% confidence interval [CI], 1.35 to 1.81) than did GW nurses (mean, 1.30; 95% CI, 1.18 to 1.40). On the PSS subscales, scores of organizational structure and process, lack of resources, and conflict with other professionals were higher in ED nurses (allP< 0.01). The morning cortisol was significantly lower in ED (geometric mean, 9.10; 95% CI, 6.62 to 12.42 nmol/L) than in GW (geometric mean, 15.45; 95% CI, 11.86 to 20.14 nmol/L) nurses. Log morning salivary cortisol was negatively correlated with PSS (r= −0.255), scores of organizational structure and process, and conflict with other professionals (allP< 0.05). The difference between morning and afternoon cortisol concentration in ED nurses (geometric mean, 6.35; 95% CI 4.14 to 9.93 nmol/L) was lower than in GW nurses (geometric mean, 12.42; 95% CI, 9.38 to 16.28 nmol/L). The log value of the difference correlated marginally with PSS (r= −0.21,P= 0.07) and significantly with scores of organizational structure and process, lack of resources, and conflict with other professionals (allP< 0.05). There was no difference between the two groups in afternoon salivary cortisol level. ED nurses perceived more stress compared with GW nurses. Morning salivary cortisol concentration is better correlated with PSS compared with the morning-afternoon salivary cortisol difference. The result raises the possibility of using a single morning salivary cortisol sample to reflect self-perceived stress.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Frequency of weekly aerobic activity was compared with annual illness-related absenteeism in 79,070 adult US adult workers. Weekly exercise, days per week of aerobic activity (≥20 minutes), and absenteeism consisting of days per year and grouped as 1 to 3, 4 to 6, and 7+ days were recorded. After controlling for confounding variables, chi-squared values and odds ratios were calculated. A significant (&khgr;2= 280.37) relationship was found between absenteeism and exercise. Differences (P< 0.05) in absenteeism were found between no exercise and all frequencies of weekly exercise. One day of exercise was associated with lower absenteeism when compared with no exercise, and 2 days of exercise was more favorable than one. No differences were found between any other combinations (2 to 3, 2 to 4+, 3 to 4+ days) of exercise frequency and absenteeism. These data suggest a significant relationship between exercise frequency and illness-related absenteeism.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Few epidemiological studies have been conducted that have incorporated clinical evaluations of Gulf War veterans with unexplained health symptoms and healthy controls. We conducted a mail survey of 2022 Gulf War veterans residing in the northwest United States and clinical examinations on a subset of 443 responders who seemed to have unexplained health symptoms or were healthy. Few clinical differences were found between cases and controls. The most frequent unexplained symptoms were cognitive/psychological, but significant overlap existed with musculoskeletal and fatigue symptoms. Over half of the veterans with unexplained musculoskeletal pain met the criteria for fibromyalgia, and a significant portion of the veterans with unexplained fatigue met the criteria for chronic fatigue syndrome. Similarities were found in the clinical interpretation of unexplained illness in this population and statistical factor analysis performed by this study group and others.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Many factors have been considered as possible causes of the unexplained illness reported by veterans of the Gulf War (GW). In this study, we report an analysis of risk factors and unexplained illness in a population-based sample of GW veterans who underwent clinical evaluation. Multiple risk factors were compared in 241 veterans who met criteria for unexplained illness and 113 healthy controls. Results suggest that GW unexplained illness is most highly associated with combat conditions, heat stress, and having sought medical attention during the GW. When controlling for multiple simultaneous exposures during the GW, interactions around pyridostigmine bromide, insecticides and repellents, and stress were not significant. These results indicate that most unexplained illness in GW veterans cannot be explained by neurotoxic effects of exposures to chemicals that inhibit cholinesterase activity.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This article presents a mathematical procedure to adjust for one component of the healthy worker effect (HWE), namely, the healthy hired effect, on diabetes in the case of firefighting and heart disease. Three examples from real studies are given to illustrate, step-by-step, the application of the mathematical procedure. The mathematical procedure can be applied to adjust for other components of the HWE (eg, the low-risk hired effect on obese individuals and smokers). In such cases, additional information will be needed to use the mathematical procedure. Results of applying the mathematical procedure in the case of firefighting and heart disease revealed the rather unexpected results that adjusting for diabetes selection on hiring leads to only a 3% to 9% increase in the magnitude of ratio statistics such as the standardized mortality ratio. It might be argued that the HWE from one component such as the healthy hired effect on diabetes might be small, but together with other components, the HWE might be large. Further investigation will be needed to support this argument.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Firefighters in Queensland are exposed to hot, humid weather conditions that contribute to the overall workload encountered during emergency operations. Responding to certain hazardous material incidents requires firefighters to wear fully encapsulated chemical protective suits for a maximum period of 20 minutes. The nature of these suits, combined with workload and environmental conditions, poses a potential heat stress problem for firefighters. This study evaluates the heat-induced physiological responses of firefighters while wearing fully encapsulated chemical protective suits in a series of controlled thermal environments. Heart rate, body (aural) temperature, blood pressure, fluid loss, and a rating of perceived exertion were measured to evaluate the effect of increasing ambient air temperature during the performance of standard tasks. The results of the study indicated that the significant increase in heart rate, body temperature, and blood pressure was directly related to the increase in air temperature. The research indicates that the recommended suit wearing time of 20 minutes provided adequate physiological protection under the research conditions.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Anger, stress, and depression in the workplace are growing concerns among management. Traditionally, health outcomes have functioned under the realm of workplace health professionals. This study assessed whether a traditional worksite health promotion program had an impact on mental health factors. The results suggested that worksite health promotion programs play a limited role in ameliorating work-related mental health outcomes. Rather, management must play a greater role in addressing workplace stress, anger, and depression.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This study provides rate ratios for sickness absence in relation to workload, which was accessed by means of a job exposure matrix. Emphasis is given to diseases that are seldom studied by sickness absence data either because the incidence is low or because medical treatment is not supplemented by rest from work. A total of 42,508 employees from the metal processing and retail trade were followed for 3 years. Sick leave related to hypertension, ischemic heart diseases, ulcer, neurotic disorders, or work accidents was most frequent in employees exposed to physical demands and low control. In contrast, an inverse relation was observed for psychological demands, for which rate ratios decreased with increasing exposure. This finding might be an expression of work commitment or pressure to attend rather than of coping behavior, because both hard and soft diagnoses were considered.

ISSN:1076-2752    

出版商:OVID    

年代:2001

数据来源: OVID