ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A broad range of health effects in a cohort of 601 health care personnel, immunized with anthrax vaccine adsorbed (AVA) as a military occupational health requirement, were assessed to evaluate adverse events both qualitatively and quantitatively. Active surveillance showed that localized reactions were common and occurred more often in women than men. Five patients were reported to the Vaccine Adverse Event Reporting System, but only one event could be definitively attributed to immunization, a large localized reaction. Two separate cohort studies, one using nested data from a standardized health risk appraisal instrument and the other comparing rates of outpatient visits and hospitalizations, did not reveal significant differences between AVA-immunized and unimmunized individuals. Our findings suggest that AVA is relatively reactogenic but do not indicate serious adverse health effects due to immunization.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Learning ObjectivesDescribe how employee health care delivery under the Washington state Managed Care Pilot (MCP) demonstration program differed from the preceding system of care.Recall the ways in which employers operating under the MCP and a comparison group utilizing the existing health care system differed in their perceptions of their employees’ health care, and of their own relationship with health care providers.Identify the critical factors in how employers viewed the MCP compared to the pre-existing system of workers’ health care.Developing more effective approaches to disability prevention has been a longstanding challenge for the workers’ compensation system. A major obstacle to this goal has been the lack of communication and interaction between employers and physicians who care for injured workers. From 1995 through 1997, the Washington State Department of Labor and Industries sponsored a major demonstration program, known as the managed care pilot (MCP), to assess the effects of managed care on medical and disability costs, patient satisfaction and employer satisfaction. We developed a telephone survey and administered it to 243 employers as part of the MCP evaluation. Topics covered in this survey include satisfaction with treatment rendered, duration of lost work time, work modifications, and satisfaction with communication received during the employee’s recovery period. Employers in the intervention (managed care) condition were more satisfied with the managed care/occupational medicine system than the employers in the comparison group were with the fee-for-service system. MCP employers were satisfied particularly with the frequency and quality of communication received from the health care provider regarding return to work and work modification issues. Improved employer-provider communication may foster early return to work and thereby have a beneficial effect on health and employment outcomes for injured workers.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Learning ObjectivesReview the epidemiology and clinical consequences of arsenic exposure.Explain the relationships found in this case-control study among cumulative arsenic exposure, primary and secondary arsenic methylation, gender, and skin cancer.Understand how widely—if at all—the study findings may be generalized to populations other than the Taiwanese.Arsenic is a known carcinogen, but data are especially lacking on the health effects of low-level exposure, and on the health significance of methylation ability. We conducted a case-control study (76 cases and 224 controls from 1996 to 1999) in southwestern Taiwan to explore the association among primary and secondary arsenic methylation index (PMI and SMI, respectively), cumulative arsenic exposure (CAE), and the risk of skin cancer. As compared with the controls, the skin cancer group reported more sun exposure (P = 0.02) and had a lower BMI (P = 0.03), as well as lower education level (P = 0.01). Skin cancer patients and controls were similar with regard to age, gender, smoking and alcohol consumption. Given a low SMI (≤5), CAE > 15 mg/L-year was associated with an increased risk of skin cancer (OR, 7.48; 95% CI, 1.65–33.99) compared to a CAE ≤2 mg/L-year. Given the same level of PMI, SMI, and CAE, men had a higher risk of skin cancer (OR, 4.04; 95% CI, 1.46–11.22) when compared to women. Subjects with low SMI and high CAE have a substantially increased risk of skin cancer. Males in all strata of arsenic exposure and methylation ability had a higher risk of skin cancer than women.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Learning ObjectivesCompare epidemiological aspects of prostate cancer in Hispanics and members of other racial groups.Outline the associations, if any, between prostate cancer risk in this largely Hispanic population and exposure to specific pesticides/herbicides.Present the investigators’ conclusions on how best to prevent adverse effects of chemical exposure in California farm workers.Previous studies have evaluated prostate cancer in farm-working populations and most, although not all, have found an elevated risk of this cancer in farmers and farm workers. Specific occupational risk factors have not been identified. A nested case-control study of prostate cancer was conducted within a large cohort of a predominantly Hispanic labor union in California, the United Farm Workers of America. By conducting an electronic record linkage between a roster of the union members and the California Cancer Registry for the years 1988 through 1999, newly diagnosed cases of prostate cancer were identified within the union. Age-matched controls were randomly selected from the remainder of the cancer-free cohort. Risk for prostate cancer was examined by examining the type of crops and commodities cultivated by the farm workers as well as by the date of first union activity and duration of union affiliation. In addition, the risk of prostate cancer was evaluated in association with use of several pesticides recorded by the California Department of Pesticide Regulation. Between 1988 and 1999, 222 newly diagnosed prostate cancer cases were identified for analysis and 1110 age-matched controls were selected. The risk of prostate cancer was not associated with patterns of employment in any crop/commodity. Increasing duration of union affiliation was associated with decreasing prostate cancer risk. Although risk was not associated with total pounds of pesticides applied in the years and counties where farm workers were employed, risk was increased with specific chemicals, including simazine, lindane, and heptachlor, and suggestive increases were observed with dichlorvos and methyl bromide. We concluded that Hispanic farm workers with relatively high levels of exposure to organochlorine pesticides (lindane and heptachlor), organophosphate pesticides (dichlorvos), fumigants (methyl bromide), or triazine herbicides (simazine) experienced elevated risk of prostate cancer compared to workers with lower levels of exposure.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Perfluorooctanesulfonyl fluoride (POSF, C8F17SO2F) is used to create applications for surfactants and paper, packaging, and surface (eg, carpets, textiles) protectants. Such POSF-based products or their residuals may degrade or metabolize to PFOS (C8F17SO3−). PFOS concentrates in liver and serum and results in hypolipidemia as an early effect of cumulative dosages. Male and female employees of two perfluorooctanyl-manufacturing locations (Antwerp, Belgium and Decatur, Alabama) participated in a periodic medical surveillance program that included hematology, clinical chemistry, thyroid hormone, and urinalysis testing. Serum concentrations of PFOS and perfluorooctanoate (PFOA, C7F15CO2−, used as a fluoropolymer emulsifier) were measured via mass spectrometry methods. The mean serum PFOS and PFOA concentrations for 263 Decatur employees were 1.32 parts per million (ppm; geometric mean 0.91, range 0.06–10.06 ppm) and 1.78 ppm (geometric mean 1.13, range 0.04–12.70 ppm), respectively. Mean concentrations were approximately 50% lower among 255 Antwerp workers. Adjusting for potential confounding factors, there were no substantial changes in hematological, lipid, hepatic, thyroid, or urinary parameters consistent with the known toxicological effects of PFOS or PFOA in cross-sectional or longitudinal analyses of the workers’ measured serum fluorochemical concentrations.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This analysis represents a 5-year update of our mortality study of 7075 PCB exposed capacitor workers that now includes 1654 deaths and 235,984 person-years of observation with follow-up through 1998. In hourly males and females the observed number of deaths from all-cancers and all-causes were similar to the expected numbers. In salaried males all-cause and all-cancer mortality were significantly below the expected. In salaried females, all-cause mortality was significantly below the expected and all-cancer mortality was below the expected, but not significantly. We again failed to find any significant excess mortality in the a priori cancers of concern or in any other cancers in the total cohort or in the highly exposed portion of the cohort. These results expand on our previous observations and as before the data fail to demonstrate any causal association between occupational PCB exposure and excess cancer mortality or any other causes of death.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Early and efficient prevention of occupational blood exposure at hospital requires knowledge of exposures and risks according to staff characteristics. Calculation of annual exposure rates and relative rates from personal and occupational data. The overall annual incidence was 3.5 per 100 workers per year; maximum for nurses and midwives (6.5); minimum for cleaners and paramedics (0.6). Exposures affected mainly nurses (57.81% of accidents, 12.12% of cohort) and occurred mostly in the surgical and the medical departments (26.34 and 25.20% of accidents). Men/women and students/physicians rate differences were not significant. Emergency and intensive care staffs had the highest relative rates (4.27 and 3.05) compared with maintenance staff. Nurses and laboratory staff were more exposed than physicians (3.76 and 2.30 times) were. Our results prompt prevention and training to be precisely focused and efficiently devised.

ISSN:1076-2752    

出版商:OVID    

年代:2003

数据来源: OVID