摘要:

A recent report in the literature suggested a link between occupational exposure to lead and brain cancer. To explore the hypothesis, we applied a job-exposure matrix for lead to the occupation and industry codes given on the death certificate of 27,060 brain cancer cases and 108,240 controls who died of non-malignant diseases in 24 US states in 1984-1992. Brain cancer risk increased by probability of exposure to lead among Caucasian men and women with high-level exposure, with a significant twofold excess among Caucasian men with high probability and high level of exposure to lead (odds ratio = 2.1; 95% confidence interval, 1.1-4.0). Risks were also elevated in the low- and medium-probability cells for African-American men with high-level exposure to lead. Trend by intensity level was statistically significant among African-American men (all probabilities combined). Although exposure assessment was based solely on the occupation and industry reported on the death certificate, these results add to other epidemiologic and experimental findings in lending some support to the hypothesis of an association between occupational exposure to lead and brain cancer risk. Analytic studies are warranted to further test this hypothesis.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

It is estimated that over 120 million Americans suffer from moderate to severe attacks of migraine characterized by headache and other debilitating symptoms, resulting in impaired functional capacity and diminished quality of life. And, it appears, its prevalence is increasing. Since the prevalence peaks during the ages of 25-55, the prime working years, migraine places a tremendous burden on employers, primarily in the form of lost productivity as well as increased health benefits costs. The fact that migraine is underdiagnosed and undertreated suggests the existence of opportunities for interventions that will reduce that toll. This article focuses on the contributions that employee health units may make to such interventions. In addition to first aid for migraine attacks occurring during working hours, these interventions may include educating occupational health staff, managers, and line supervisors about the management of migraine; identifying migraineurs in the workforce; educating them about their problem and ensuring that they are receiving optimal care; controlling exposures to factors in the workplace that may trigger migraine attacks; and managing disability to minimize loss of productivity. Perhaps most important is encouraging migraineurs to be more aggressive in confronting this problem and empowering them to seek out personal physicians who will guide them to effective treatment and preventive regimens.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This report describes the types of chromosome damage in peripheral blood found in patients exposed to domestic application of organophosphate pesticides. These changes serve as a biomarker of cumulative toxic exposure. Susceptible individuals show DNA damage as chromosome alterations. The importance of these findings is that the apparent genotoxic changes occurred from domestic application of two of the commonly used organophosphate pesticides in America and adds one more adverse potential effect from these hazardous chemicals. Peripheral blood from eight patients exposed to the domestic spraying of organophosphate pesticides was cultured and the chromosomes photographed. The types of chromosome alterations seen included chromatid and chromosome breaks, single and double minutes, dicentrics, rings, translocations, exchanges (including sister chromatid), and endoreduplications. Our findings support previous findings that organophosphate pesticides have genotoxic effects even at domestically sprayed levels.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Most episodes of low back pain are considered non-specific in nature, with the vast majority resolving within 2 weeks and almost all resolving within 6 weeks regardless of the medical intervention. Recently published clinical guidelines have clearly delineated a limited set of circumstances that would indicate the need for specialist referral. The purpose of this study was to describe the healthcare utilization and physician referral patterns for new-onset, uncomplicated, low back workers' compensation disability cases randomly selected from a large insurance carrier data source. The provision of care in urgent care centers and emergency departments for both initial and main sources of care occurred more frequently than was probably indicated. For this selected group of uncomplicated low back pain cases, specialist care was provided more commonly than would be expected or indicated (36% of the sample was seen by a surgeon, while only 2% received surgery). In addition, referral to specialists (other than occupational medicine specialists) was often made sooner than would be expected or indicated, with a median of 13 days for such referrals. Such overutilization of resources can reasonably be expected to increase overall medical costs.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Quebec and Denmark passed legislation in 1981 that aims to protect pregnant women and their unborn children from health hazards in the workplace. Finland passed similar legislation in 1991. While these measures have much in common, they are applied in very different ways. Approximately 1% of pregnant working women benefit from a "special maternity leave" in Denmark, compared with 0.1% in Finland, while in Quebec, nearly 40% of working women benefit from preventive reassignment measures during their pregnancies. In this article, we will analyze the reasons for these disparities between rates of utilization in Finland, Denmark, and Quebec in light of the Quebec experience over the last 16 years.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Expert judgment of peak flow-time graphs provides an important tool to detect occupational asthma. This technique has mainly been used in clinics to evaluate reversible airflow obstruction and to assess potential work-related patterns. The reproducibility of this technique in an open working population is unknown. Agreement between and within nine experts was studied using peak flow-time graphs of 49 potato-processing workers. All graphs were classified into four categories by the nine experts, while seven experts read ten graphs at two occasions. Thirty-four graphs (69%) were classified as "no airway obstruction" while four graphs (8%) showed "work-related airway obstruction." There was only slight agreement between the nine experts; mean Cohen's kappa (κ) was 0.19. Agreement within experts was moderate; mean κ was 0.47 for judging graphs twice. Our results suggest that in a "healthy" working population, judgment of peak flow graphs is not a favorable method for detection of airway obstruction. If this technique is applied in epidemiological studies, judgment of the graphs should be done by more than one expert.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

This study assessed the impact of participation in a health promotion program and engagement in healthy behaviors on job satisfaction. A survey response rate of 70% (n = 1,283) was obtained at a northern state university with an established worksite health promotion program. Significant differences in job satisfaction were obtained by education level, job classification, marital status, dependents, and regular exercise behaviors. No differences in job satisfaction were obtained by health promotion program involvement or any other health behavior other than regular exercise. Results suggest that health promotion programs do not significantly impact job satisfaction. Rather, job design and the psychosocial aspects of the work environment may be more influential in improving job satisfaction. Based on the results of this study, organizations attempting to improve employee health should provide health promotion programs and address the job itself. To improve job satisfaction, attention to the job itself is required.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The airline industry may be an occupational setting with specific health risks. Two environmental agents to which flight crews are known to be exposed are cosmic radiation and magnetic fields generated by the aircraft's electrical system. Other factors to be considered are circadian disruption and conditions specific to air travel, such as noise, vibration, mild hypoxia, reduced atmospheric pressure, low humidity, and air quality. This study investigated mortality among US commercial pilots and navigators, using proportional mortality ratios for cancer and noncancer end points. Proportional cancer mortality ratios and mortality odds ratios were also calculated for comparison to the proportional mortality ratios for cancer causes of death. Results indicated that US pilots and navigators have experienced significantly increased mortality due to cancer of the kidney and renal pelvis, motor neuron disease, and external causes. In addition, increased mortality due to prostate cancer, brain cancer, colon cancer, and cancer of the lip, buccal cavity, and pharynx was suggested. Mortality was significantly decreased for 11 causes. To determine if these health outcomes are related to occupational exposures, it will be necessary to quantify each exposure separately, to study the potential synergy of effects, and to couple this information with disease data on an individual basis.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The respiratory function and immunological status of workers employed in the paper recycling industry were studied. The mean age of the 101 studied workers was 41 years, and the mean duration of their exposure was 17 years. A group of 87 unexposed workers of similar age, duration of employment, and smoking history was studied for the prevalence of chronic respiratory symptoms. Lung function in the paper workers was measured by recording maximum expiratory flow volume (MEFV) curves and recording forced vital capacity (FVC), 1-second forced expiratory volume (FEV1), and maximum expiratory flow rates at 50% and the last 25% of the FVC (FEF50, FEF25). Immunological studies were performed in all 101 paper workers and in 37 control workers (volunteers). These included skin-prick tests with paper-dust extracts and other nonoccupational allergens, as well as the measurement of total serum immunoglobulin E. Significantly higher prevalences of all chronic respiratory symptoms were found in paper compared with control workers (P < 0.01). The highest prevalences were found for chronic cough (36.6%), chronic phlegm (34.7%), chronic bronchitis (33.7%), sinusitis (31.7%), and dyspnea (18.8%). Occupational asthma was diagnosed in four (4.0%) of the paper workers. A logistic regression analysis performed on chronic respiratory symptoms of paper workers indicated significant effects of smoking and exposure, with the smoking effect being the most important. Multivariate analysis of lung-function parameters indicate significant effects of exposure. For paper workers, the measured FEF50and FEF25were significantly decreased, compared with predicted values, suggesting obstructive changes located primarily in smaller airways. Among 101 tested paper workers, 16 (15.8%) had positive skin-prick tests to at least one of the paper extracts; none of the control workers reacted to these extracts. Increased serum IgE levels were found in 21% of the paper workers and in 5% of control workers (P < 0.05). Paper workers with positive skin-prick tests to any of the paper and/or other tested extracts had higher prevalences of chronic respiratory symptoms and lower measured lung-function tests compared with predicted than did those with negative skin-prick tests, but the differences were not statistically significant. The measured concentrations of total and respirable dust in this industry were higher than those recommended by Croatian standards. Our study suggests that work in the paper-recycling industry is associated with respiratory impairment and that sensitive workers employed in this industry may be at particular risk of developing chronic respiratory abnormalities.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

There are few studies that examine the overall morbidity of women in industrial settings. Results from a surveillance program of 21,294 female employees of the US Department of Energy for a 12-month period are presented. Illness/absence data of 5 or more workdays were collected from an epidemiologic surveillance program at eight sites. Approximately 11% of the workforce reported an absence of 5 or more workdays in the 12-month period. The five most common disease categories accounted for 70% of all illness or injury absences among female workers. These were respiratory illnesses (22.1%), musculoskeletal disorders (13.2%), injury and poisonings (13.0%), genitourinary illnesses (9.8%), and digestive illnesses (8.8%). Sprains and strains were most frequently attributable to workplace conditions.

ISSN:1076-2752    

出版商:OVID    

年代:1998

数据来源: OVID