ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Physicians who practice environmental medicine seek to identify and to prevent patient and population exposures that cause adverse human health outcomes. Epidemiologic, toxicologic, clinical, and public health skills essential to this enterprise are indistinguishable from those of the occupational physician. Several important controversies illustrate the essential role of occupational physicians in environmental health science and policy, including environmental asbestos, dioxin, electromagnetic fields, and carcinogenicity testing. Our continuing involvement in “environmental” issues is predicted by three conditions, each unlikely to change. The human remains the animal of greatest interest; the “natural” experiment will have been performed (however unwittingly); and the work site will continue to provide that first and clearest setting for measuring the outcome. Therefore, residency training must be expanded so that future occupational and environmental physicians will recognize their fundamental role in environmental health. The results of our industry cross factory walls with ease. So must our efforts.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This overview will discuss a number of the issues posed by the challenge of international environmental health. The reasons that environmental problems occurring elsewhere in the world are of importance to occupational and environmental physicians in North America include the interconnectedness of the biosphere of our planet so that environmental alterations in one part of the globe can have an adverse outcome on our health and well-being; the often high levels of pollution and environmental degradation elsewhere provide an opportunity to determine and predict adverse consequences of environmental agents pertinent to protecting our own health; and, most importantly, our own ability to provide assistance in helping economic development occur in a setting of low risk of environmental pollution.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We identified nine new cases of biopsy-confirmed chronic beryllium disease among 505 employees and ex-employees in a company that had manufactured beryllia ceramics from 1958 through 1975. Of tests commonly used in medical surveillance, only a confirmed blood beryllium lymphocyte transformation test had a high positive predictive value for beryllium disease (100%), However, two beryllium disease cases had either a normal or inconsistently abnormal blood test and were identified for diagnostic workup by abnormal chest radiograph. The only risk factor for beryllium disease was beryllium exposure; smoking or allergic history did not affect risk. Degree of beryllium exposure was associated with disease rates, which ranged from 2.9% to 15.8% for beryllia-exposed subgroups. One case of beryllium disease occurred in a “dust-disturber” who did not report past beryllium exposure and who began employment 8 years after commercial beryllia production had stopped. Our data support efforts to prevent beryllium disease by lowering beryllium exposures and to identify subclinical and early disease by broad-based medical surveillance using the blood beryllium lymphocyte test and chest radiograph in beryllium-using industries.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Research has indicated an association between mental health problems and physical illness, including higher physical health benefits utilization among persons with a mental health diagnosis. We hypothesized that mental health claimants will have higher covered health benefits and be more likely to make physical health claims than physical health claimants. The data for the study included all health benefits claims for 1989 and 1990. The results indicated that mental health claimants have higher total covered benefits and higher covered benefits in a number of diagnostic categories. In addition, the findings revealed a greater likelihood to make any health claim as well as a claim for several diagnostic categories among persons with a mental health diagnosis. The study indicates the need for coordination between mental health and physical health benefits cost management.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Various groups including the Occupational Safety and Health Administration, Environmental Protection Agency, and Consumer Product Safety Commission have expressed concern over methylene chloride and its possible effects on human health. A group of employees exposed to relatively high levels of methylene chloride (average = 475 ppm 8-hour time-weighted average) for greater than JO years were compared to a similar nonexposed group of employees for selected health parameters. All were participants in an employee health monitoring program. Selected questions evaluating cardiac and neurologic health effects revealed no differences between the two groups. Likewise, hematologic assessment also revealed no clinically significant differences between the two groups for SGOT(AST), SGPT(ALT), total bilirubin, and hematocrit. Therefore, it appears that chronic exposure to even high levels of methylene chloride produces no difference in symptoms or adverse health effects in this population as judged by selected liver, cardiac, and neurologic health parameters.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We evaluated 96 workers employed at facilities that manufacture or use TMXDIR(meta) aliphatic isocyanate and TMIR(meta) unsaturated aliphatic isocyanate. We used immunoglobulin (Ig) and IgG serum antibody enzyme-linked immunosorbent assay (ELISA) studies and a questionnaire designed to identify symptoms compatible with work-related syndromes such as asthma and hypersensitivity pneumonitis. There were no workers with immunologically induced disease due to TMIR isocyanate or TMXDIR isocyanate nor were there any workers whose questionnaires suggested new onset of asthma. Approximately 40% of workers experienced some irritant symptoms, mostly upper respiratory or ocular. One worker had low level IgE antibody against TMXDI-HSA but had no work-related respiratory symptoms. Very low-level IgG against TMI-HSA or TMXDI-HSA was present in 7% of workers, all of whom were in the high-exposure category.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

An analysis of the mortality experience of workers exposed to dinitrotoluene (DNT) was conducted to test the hypothesis that DNT exposure is associated with an increased risk of cancers of the liver and biliary tract. A total of 4,989 workers exposed to DNT and 7,436 unexposed workers who had worked for at least 5 months at the study facility between January 1, J 949 and January 21, 1980, were included in this investigation. Workers were considered exposed if they had worked at least 1 day on a job with probable exposure to DNT. The vital status as of December 31, 1982, was successfully ascertained for approximately 97% of these workers. Standardized mortality ratios (SMRs) were estimated based upon comparisons with the US population using a modified life-table program. In addition, standardized rate ratios (SRRs) were computed based upon direct comparisons between the DNT and the internal unexposed cohort. An excess of hepatobiliary cancer was observed among workers exposed to DNT in this study. The rate ratio for hepatobiliary cancer was 2.67 (six cases observed) based upon comparison with the US population (SMR = 2.67, 95% CI = 0.98, 5.83), and 3.88 based upon comparison using the internal unexposed referent group (SRR = 3.88, 95% CI = 1.04, 14.41). This study failed to demonstrate an exposure-response relationship between duration of DNT exposure and hepatobiliary cancer mortality. Our study was limited by the small number of workers with long duration of exposure to DNT, and by the lack of quantitative information on exposure to DNT and other chemicals. Nonetheless, the excess in hepatobiliary cancer mortality observed among DNT-exposed workers in this study is similar to the findings from experimental studies of DNT-exposed animals. On balance, we believe that our findings add some support for the hypothesis that occupational exposure to DNT may be carcinogenic.

ISSN:0096-1736    

出版商:OVID    

年代:1993

数据来源: OVID