bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of selection bias in a cross‐sectionai survey
Authors: Selikoff Irving J. , Seidman Herbert
Published: April 2007

Selection bias is inherent in all occupational cohorts. Selection bias at entry has long been known and is commonly referred to as a “healthy worker effect.” Less well appreciated is selection during the life of a cohort resulting from life‐style factors (e.g., cigarette smoking); aging with accompanying chronic diseases, economic and demographic circumstances; and diseases that might result from exposures suffered by the cohort being studied, that influence whether individuals remain in a trade. These factors weigh differently at different times. Thus, at any point in time, “surviving” members of a cohort reflect an amalgam of selection factors. When such groups are studied in cross‐sectional surveys there can be uncertainty whether clinical, radiological and phyeiological findings are necessarily representative for the trade or occupation as a whole. We analyzed the results of a large clinical field survey of long‐term asbestos insulation workers to investigate whether the non‐participants differed substantially from those who were examined. Five thousand three hundred and fifty‐five (5,355) men, of an initial cohort of 17,800 established January 1, 1967, had reached 30 or more years from onset of their work by July 1, 1981. All were invited to come for examination. Two thousand and seventy‐seven (2,077) came, and 3,278 did not. We questioned a sample of 1,393 non‐responders to see why they failed to appear. The answers did not give evidence of significant health‐related selection influence. Sickness only infrequently kept them away. We then followed both groups—those examined and those not examined—to the end of 1987 for their mortality experience. There was no great difference. The non‐responders had somewhat fewer deaths overall and proportionately fewer of asbestos‐associated cancers, such as mesothelioma and lung cancer. The results indicated that, in this cohort, there did not seem to be health‐related selection bias that determined whether or not cohort members responded to invitations for examinations.
Estimating human cancer risk from the results of animal experiments: Relationship between mechanism and dose‐rate and dose
Authors: Vainio Harri , Cardis Elisabeth
Published: April 2007

Experimental animals are often used as surrogate models in estimating human cancer risk from environmental agents when adequate epidemiological data are not available. Studies in experimental animals have usually evaluated the effects of exposure to single substances; however, humans receive combinations of exposures, to both initiators and promoters of carcinogenesis. Exposure to several agents may modify the carcinogenic process of one of them. For many agents, the relationship between dose and carcinogenic response depends on both dose‐rate and cumulative dose. For a given total dose, dose‐rate may affect carcinogenic potency both qualitatively (target organ) and quantitatively. The effects of dose‐rate are a function of total dose, species, and, most importantly, the mechanism by which the agent exerts its carcinogenic effect. Prediction of the effects of different dose‐rates of potentially carcinogenic agents can be based on knowledge of its mechanism of action.
The use of experimental studies to reveal suspected neurotoxic chemicals as occupational hazards: Acute and chronic exposures to organic solvents
Authors: Kyrklund Titus
Published: April 2007

The nervous system differs from many other body organs by its central control of vital functions and its low regeneration capacity. Organic solvents have, as a group, been suspected to have neurotoxic effects. Because of their similar physical properties and the fact that in industrial uses, they are often present in various mixtures, organic solvents have also been regarded, unfortunately, to induce common neurotoxic effects.

However, it is evident from experimental studies using specified exposure conditions that different organic solvents have very diverse neurotoxic effects and also that the toxic mechanism may differ between acute and chronic exposures. No specific method used to describe a neurotoxic effect or single toxic response can be used for the overall occupational risk assessment of all organic solvents. Each solvent has to be considered as having its own unique toxic effects.
Occupational exposure and dose over time: Limitations of cumulative exposure
Authors: Smith Thomas J.
Published: April 2007

Cumulative exposure (average intensity times duration) is one of the most common summary measures for exposure used in occupational epidemiology. Its utility for describing quantitative exposure‐effect relationships is based on several interlocking assumptions about the processes relating exposure to tissue dose, and tissue dose to adverse effects. The pharmacokinetic relationship between cumulative exposure and tissue dose was examined with models for two common exposures: inhalation of insoluble, respirable particles, and toxic metabolites of a nonpolar organic solvent. It was found that the assumption of a linear relationship between cumulative exposure and tissue dose was violated for typical exposure intensity for both substances. This caused strong nonlinear exposure‐tissue dose relationships and variability in the relationship. The findings provide a possible explanation for the common observation of a disproportionately high risk of pulmonary effects for workers with relatively short, intense dust exposures, and for the finding that workers exposed to metabolically activated organic agents have a risk that is related to years of exposure but not to intensity.
Use of chemical, biochemical, and genetic markers in cancer epidemiology and risk assessment
Authors: Hemminki Kari
Published: April 2007

New molecular methods have been developed to be used in assessing exposure to and effects of genotoxic and carcinogenic compounds. DNA and protein adducts are measures or surrogates of target dose. Molecular methods are available to probe mutations in oncogenes, antioncogenes, and other specific genes. Furthermore, concentrations of oncoproteins can be determined in biological fluids. If a close link is established between these markers and risk of cancer, they can be used as independent endpoints in the prevention of cancer.
Validation of exposure information in occupational epidemiology
Authors: Ulfvarson Ulf , Techn D.
Published: April 2007

Exposure data may be inadequate mainly for two reasons; they may not comply with a reasonable exposure‐effect model or they may be biased.

In the use of historical data it is essential to keep track of what the data were supposed to mean when collected in the first place. Most measurements of air contaminants in work places are probably carried out to establish compliance or non‐compliance with limit values. Sometimes measurements are also made to evaluate control measures. Unfortunately, measurement data acquired in this way may have very little to do with the true average exposure of employees.

The influence of trends and variations in production on the exposure level is substantial. This influence is similar and coincidental in widely different industries. In addition the variations attributed to production levels, there can be important variations due to season.
Occupational risk factors for sinonasal cancer: A case‐control study in France
Authors: Luce Danièle , Leclerc Annette , Morcet Jean‐François , Casal‐Lareo Amparo , Gérin Michel , Brugère Jacques , Haguenoer Jean‐Marie , Goldberg Marcel
Published: April 2007

A case‐control study was conducted in France to examine occupational risk factors for sinonasal cancer; 207 cases and 409 controls were included in the study. Detailed information was collected on occupational history and other potential risk factors for nasal cancer. Results are presented for three histologic types: adenocarcinoma, squamous cell carcinoma, and others. Among males, the risk of adenocarcinoma was significantly elevated for cabinetmakers (odds‐ratio = 35.4, 95% confidence interval = 18.1–69.3), carpenters and joiners (OR = 25.2, 95% CI = 14.6–43.6), and wood‐working machine operators (OR = 7.4, 95% CI = 3.4–15.8), whereas the odds‐ratios were less than 1 for loggers and wood preparation workers. Odds‐ratios associated with cabinetmakers (OR = 11.2, 95% CI = 2.7–45.9)) and carpenters and joiners (OR = 5.8, 95% CI = 1.8–18.6) were also significantly elevated for the other‐histologic‐types category. Significant excesses in risk of squamous cell cancer were noted for “bakers, pastry cooks, grain millers” (OR = 3.9, 1.2–12.8), construction workers (OR = 3.7, 95% CI = 1.7–8.0), and carpenters and joiners having worked for at least 15 years in the wood manufacturing industry (OR = 8.1, 95% CI = 1.3–50.3). Among females, a significant increase in risk of squamous cell carcinoma (OR = 9.5, 95% CI = 1.7–54.1) and a moderate increase in risk of adenocarcinoma (OR = 4.0, 95% CI = 0.7–23.5) was observed for textile workers. Elevated risks of squamous cell cancer were noted for farm workers of both sexes (males: OR = 2.2, 95% CI = 1.1–4.4; females: OR = 4.9, 95% CI = 1.0–24.9).
Occupational lead exposure in Los Angeles county: An occupational risk surveillance strategy
Authors: Papanek Paul J. , Ward Carolyn E. , Gilbert Kathleen M. , Frangos Stephen A.
Published: April 2007

To better understand occupational lead exposures in Los Angeles County, we undertook a questionnaire survey of lead‐using industrial facilities not previously identified by county health department staff. Previously our staff had identified 112 lead‐using companies with approximately 2,000 lead‐exposed workers countywide. For this survey, we developed a database of 1,353 possible lead‐using industrial facilities from several sources, including community “right‐to‐know” databases, air pollution or sewer permit records, or other environmental databases. A questionnaire interview was completed with 1,001 (81%) of these companies, yielding 178 previously unidentified facilities employing 7,734 workers with potentially significant occupational lead exposures. Compliance with the OSHA lead standard was often poor in these facilities, particularly for workplaces with 20 or fewer employees. Devoting more public health resources to targeted identification of such industrial facilities and to educational outreach would likely help control occupational lead exposure.
Workmens' compensation and byssinosis in South Africa: A review of 32 cases
Authors: White Neil W. , Cheadle Halton , Dyer R. B.
Published: April 2007

Byssinosis has been compensable in the Republic of South Africa (RSA) since 1973. The legal and administrative provisions for byssinosis compensation are reviewed. A series of 32 cases of presumed byssinosis was submitted to the compensation authorities by the authors. Identical reports were submitted to an independent medical panel. The findings and outcomes in these cases are presented and compared. Seventeen of the 32 claims initially received compensation and four were subsequently accepted following appeals. Analysis of the medical basis of decision making indicated that seven claims were refused and at least four had their awards reduced as a consequence of inconsistent decisions. Arguable decisions resulted in five claims being refused and one award being reduced. Our experience illustrates problems inherent in the compensation system in South Africa. Initiation of a claim is expensive relative to wages in the industry, and awards are low since they are linked to wages (mean $60.47 per week). Processing of a claim took a mean of 13.8 months, while appeals for refusal to compensate took a further 29.8 months. It is argued that consensus medical definitions of compensable occupational disease should be used routinely and that provision must be made to facilitate entry of claimants into the compensation system.
Recommendations for the investigation of abnormal hepatic function in asymptomatic workers
Authors: Herip Donald S.
Published: April 2007

Occupational medicine programs use medical surveillance tests to measure physiologic parameters that may be affected by workplace exposures. Surveillance tests can detect early detrimental changes before workers manifest recognizable symptoms. Hepatic function testing is one type of surveillance test used to monitor workers exposed to hepatotoxins. However, a significant proportion of these test reports return showing abnormal hepatic function without a readily apparent etiology. Follow‐up investigation of abnormal liver enzyme tests is a commonly encountered problem in occupational medicine clinics. The algorithm proposed in this paper will outline a systematic approach for investigating abnormal hepatic function tests from asymptomatic workers.
Hospital records as a data source for occupational disease surveillance: A feasibility study
Authors: Balmes John , Rempel David , Alexander Mark , Reiter Randy , Harrison Robert , Bernard Bruce , Benner Douglas , Cone James
Published: April 2007

To assess the feasibility of using hospital records for occupational disease surveillance and to evaluate the quality of the industry/occupation (I/O) information available in these records, the computer file of all discharge diagnoses from a large health maintenance organization during 1985 was reviewed. The frequencies of discharge diagnoses previously listed as Sentinel Health Events (Occupational), or SHE (O), were calculated and three possible SHE(O) diagnoses—lung cancer, bladder cancer, and toxic hepatitis—were selected for further review. Outpatient charts of patients discharged for each diagnosis were abstracted with regard to I/O information and the discharged patients were interviewed by telephone to obtain a lifetime occupational history. The accuracy of the I/O information obtained from the hospital chart was compared to that obtained by patient interview by number of digits matched on standard classification codes. The frequencies of matches for occupation and industry were greater for “usual” than for “last” categories with both cancer diagnoses, but were similar for “usual” and “last” categories with toxic hepatitis. To assess the proportion of each possible SHE(O) diagnosis that was related to workplace exposures, the I/O information obtained by interview was rated in a blinded fashion by an experienced occupational medicine physician. The highest probability ratings for work‐relatedness were noted for lung cancer, primarily due to asbestos exposure. The results of this study suggest that hospital records can be used to identify possible SHE(O); if adequate I/O information is available, then work‐relatedness can be assessed. However, the accuracy of I/O obtained from hospital charts is relatively low. The efficient and accurate collection of I/O information from hospital records will require the use of a simple, easily coded instrument to be routinely administered on admission.
Recognizing acute health effects of substitute fungicides: Are first‐aid reports effective?
Authors: Teschke Kay , Hertzman Clyde , Wiens Michele , Dimich‐Ward Helen , Hershler Ruth , Ostry Aleck , Kelly Shona J.
Published: April 2007

Recently, many British Columbia sawmills stopped using traditional chlorophenate anti‐sapstain fungicides and substituted 2‐(thiocyanomethylthio) benzothiazole (TCMTB) and copper‐8‐quinolinolate (Copper 8). We conducted a cross‐sectional study with two aims: to ascertain which acute health effects, if any, were associated with the use of the substitute fungicides; and to determine the effectiveness of first‐aid records as a means of detecting acute health outcomes. Workers in five coastal sawmills were asked to complete a self‐administered questionnaire about symptoms considered potentially related and unrelated to fungicide exposure, and about injuries commonly reported in sawmills. In addition, we collected first‐aid records from the mills, and asked senior workers to estimate the duration of exposure to fungicides for each job.

Symptoms found to be consistently elevated in TCMTB mills included dry skin around the eyes, blood‐stained mucus from the nose, nose bleed, peeling skin, burning or itching skin, and skin redness or rash. No symptoms were consistently elevated in the Copper 8 mills. Symptoms related to TCMTB exposure were recorded only 12 times in first‐aid logs during the study period (versus 335 questionnaire self‐reports). This low symptom‐recording frequency may be a function of established patterns of first‐aid use in which illness symptoms are reported less frequently than injuries.
Immunological status and respiratory findings in furriers
Authors: Zuskin Eugenija , Kanceljak Bozica , Stilinovic Luka , Schachter E. Neil , Kopjar Branko
Published: April 2007

We studied 42 women occupationally exposed in the fur manufacturing industry (mean age: 34 years, mean duration of exposure: 11 years). The highest prevalence of positive immediate skin reactions to antigen of animal hair was found for marten (10%), followed by fox and lamb (7%), mink (5%), and Chinese lamb, domestic fox, and Chinese calf (2%). Precipitating antibodies were demonstrated for lamb (17%), astrakhan (14%), mink, domestic fox and skunk (12%), Chinese lamb (10%), and Chinese calf (7%). Increased total IgE was found in 9.5% of subjects. Chronic symptoms were consistently more prevalent among workers with positive skin tests and positive precipitins than among workers with negative tests. A high prevalence of acute symptoms during the work shift was found among furriers. The prevalence of these symptoms was higher among workers with positive precipitating antibodies than among those with negative studies but not for workers with positive skin tests. Mean acute reductions in ventilatory capacity over the work shift were recorded for most ventilatory parameters. In general, greater drops in respiratory parameters occurred in individuals with positive precipitins (e.g., FEVp:—6.5% vs. —2.8%; positive vs. negative precipitins) but not in those with positive skin tests. Our study suggests that workers in the fur manufacturing industry develop acute and chronic respiratory problems often associated with specific indicators of atopy.
Adjustment for smoking, alcohol consumption, and socioeconomic status in the california occupational mortality study
Authors: Beaumont James J. , Singleton James A. , Doebbert Gwendolyn , Riedmiller Kathryn R. , Brackbill Robert M. , Kizer Kenneth W.
Published: April 2007

This paper presents methods for adjusting for smoking, alcohol, and socioeconomic status in death certificate‐based occupational mortality surveillance. The methods were applied in the California Occupational Mortality Study, a statewide study of rates based on 180,000 deaths and census estimates of occupations. For each occupation, levels of smoking, alcohol consumption, and socioeconomic status were estimated using National Health Interveiw Survey and U.S. Census data, and an empirical Bayes procedure was used to improve the stability of smoking and alcohol estimates for small occupations. Expected death rates for occupations were calculated by modeling rates as a function of age, smoking, alcohol, and socioeconomic status with Poisson regression. The effect of adjustment was usually moderate and in the expected direction, and the adjusted mortality ratios were generally closer to 1.0. Full data on agricultural occupations are presented for illustration.
Questionnaire survey of masters, mates, and pilots of a state ferries system on health, social, and performance indices relevant to shift work
Authors: Sparks Patricia J.
Published: April 2007

A questionnaire survey of health, social, and performance indices related to shiftwork among masters, mates, and pilots of a State Ferries System was performed in response to a joint request from labor and management. The questionnaire results for the group as a whole resembled those reported for other groups of shiftworkers. Significantly more sick days, dissatisfaction with work schedules, poor sleep patterns, physician consultations for insomnia, and reports of errors of judgement and near misses attributed to fatigue were reported on the ferry run with one of the most erratic schedules compared to all other runs, suggesting the need for further study.
Silicosis surveillance in New Jersey: Targeting workplaces using occupational disease and exposure surveillance data
Authors: Valiante David J. , Richards Thomas B. , Kinsley Kathleen B.
Published: April 2007

To identify workplaces in New Jersey with potential for silica exposure, the New Jersey Department of Health compared four‐digit Standard Industrial Classifications (SICs) identified by three different data sources: the National Occupational Exposure Survey (NOES), a new Jersey silicosis case registry, and regulatory agency compliance inspections in New Jersey. In total, the three data sources identified 204 SICs in New Jersey with potential for silica exposure. Forty‐five percent of these SICs were identified by NOES only, 16% by registry cases only, 6% by compliance inspections only, and 33% by two or more sources. Since different surveillance sources implicate different SICs, this type of analysis is a useful first step in planning programs for prevention of silicosis.
Auditory event‐related potential (P300) in relation to peripheral nerve conduction in workers exposed to lead, zinc, and copper: Effects of lead on cognitive function and central nervous system
Authors: Araki Shunichi , Murata Katsuyuki , Yokoyama Kazuhito , Uchida Eiichi
Published: April 2007

By measuring auditory event‐related potential (P300 and N100) and peripheral nerve conduction velocities, the subclinical effects of lead, zinc, and copper on the central and peripheral nervous system were examined in 22 male gun metal foundry workers exposed to these metals. Their blood lead (BPb) concentrations ranged from 12 to 59 μg/dl (median 30). Control subjects were 14 healthy workers, employed at the same factory, who had never been occupationally exposed to these metals. In the gun metal foundry workers, the latencies of P300 and N100 were significantly prolonged; the latency of P300 was significantly correlated with BPb concentrations and other indicators of lead absorption. Similarly, the maximal motor and sensory conduction velocities in the radial and median nerves were significantly slowed, and were significantly correlated with indicators of lead absorption. The data suggest that lead exposure at low levels affects cognitive and central auditory nervous system function together with peripheral nerve conduction.
Historical perspectives in occupational medicine. Allergic asthma to Bacillus subtilis enzyme: A model for the effects of inhalable proteins
Authors: Pepys Jack
Published: April 2007

The passage of 24 years since the diagnosis of allergic asthma in heavily exposed workers and in a few consumers due to dusty enzyme preparations of Bacillus subtilis compounded with laundry powder makes it possible to review objectively the many problems it raised. It emphasizes the lessons to be learned, relevant to inhalable enzyme products and to other inhalable proteins in general. Occupational allergic respiratory diseases were little studied at the time and the enzyme problems stimulated interest in what has now become a well‐established and important field of medicine involving not only protein allergens but low molecular weight chemicals as well.
Non‐fatal farm injuries on 117 eastern ontario beef and dairy farms: A one‐year study
Authors: Brison Robert James , Pickett Charles William Lawrence
Published: April 2007

A one‐year prospective survey was conducted to study the incidence of and potential risk factors for farm‐related injuries in Eastern Ontario. One hundred and seventeen dairy and beef farms were surveyed using a personal interview. Information was collected on demographic characteristics of the farm owners, workers, and families; characteristics of the farm operations; and information on behaviors potentially affecting injury risk. Monthly telephone contact was then maintained with the farms for one year in order to document all farm‐related injuries. Overall and specific injury rates were calculated. Treatment patterns for these injuries were described. The statistical significance of several potential risk factors for injury was evaluated; assessment of relative risk estimates (RR) and adjustment for confounding factors was done using logistic regression analysis. The overall farm injury rate was 7.0 persons injured per 100 person‐years (95% C.I.: 4.9,9.1, n = 547). Common patterns of injury by ICD‐9 E‐Code included accidents caused by farm machinery (E919.0), accidental falls (E880‐8), and injuries caused by animals (E906). Variables found in multivariate logistic models to be predictive of injury occurrence were living on a beef farm (RR = 2.5; p = 0.01); increased farm work experience (trend: p<0.01); full‐time exposure to farm work (RR = 2.5; p = 0.04); and, in farm owners, the use of prescription medications (RR = 2.7; p = 0.07). Forty‐six percent of the farm‐related injuries were treated in a hospital‐based emergency department (ER). Efforts to monitor the incidence of farm injuries using an ER‐based information system have the potential to significantly under‐estimate the scope of the regional farm injury problem in Eastern Ontario. © 1992 Wiley‐Liss, Inc.
A cohort study on cancer incidence among danish gardeners
Authors: Hansen Eva Støttrup , Hasle Henrik , Lander Flemming
Published: April 2007

This study was performed to examine the cancer risk of Danish gardeners having been highly exposed to pesticides. We have followed a cohort of 4,015 employed gardeners (859 females and 3,156 males) from May 1975 until the end of 1984 with regard to cancer incidence. The observed incidence was compared with expected numbers calculated from national incidence rates. For all cancer sites combined, the standardized morbidity ratio (SMbR) was 104. Among male gardeners a significantly increased incidence was seen for soft tissue sarcoma (SMbR = 526, 95% confidence interval (CI): 109‐1,538), and chronic lymphatic leukemia (SMbR = 275, 95% CI: 101‐599). The incidence of non‐Hodgkin's lymphoma was twice that which was expected (SMbR = 200, 95% CI: 86‐393). We suggest that some of the pesticides to which the gardeners have been exposed are capable of initiating or promoting the development of malignant neoplasms in tissues of mesenchymal origin. © 1992 Wiley‐Liss, Inc.
Gamma‐glutamyltransferase isoenzyme pattern in workers exposed to tetrachloroethylene
Authors: Gennari Piero , Naldi Massimo , Motta Roberto , Nucci Maria C. , Giacomini Carmen , Violante Francesco S. , Raffi Giovanni B.
Published: April 2007

In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (PCE) in Italy, isoenzyme fractioning of serum gamma‐glutamyltransferase (GGT) was performed on 141 workers of both sexes and on 130 control subjects.

None of the workers showed any clinical symptoms of liver disease and their enzymatic profiles, including AST, ALT, 5′‐NU, ALP, and GGT, were within the normal reference limits. A statistically significant increase in total GGT serum level was found in the exposed subjects, which was associated with an increase in one of the two fractions normally present in healthy individuals (GGT‐2), as well as with the appearance and progressive increase of the level of a fraction (GGT‐4) considered to be an expression of hepato‐biliary impairment.

Further research is ongoing among these workers, which will clarify whether or not electrophoretic GGT tests may be useful in detecting liver function changes due to occupational exposure to PCE. © 1992 Wiley‐Liss, Inc.
Exposure‐response relationships for coal mine dust and obstructive lung disease following enactment of the federal coal mine health and safety act of 1969
Authors: Seixas Noah S. , Robins Thomas G. , Attfield Michael D. , Moulton Lawrence H.
Published: April 2007

Underground U.S. coal miners were studied cross‐sectionally for the association of respirable coal mine dust exposure with pulmonary function and symptoms of airways obstruction. The study group included 1,185 miners participating in Round 4 of the National Study of Coal Workers' Pneumoconiosis who had started mining in or after 1970 when comprehensive exposure regulations first came into effect. Quantitative estimates of cumulative exposure, derived using respirable dust measurements taken by the Mine Safety and Health Administration over the entire study period, were used in linear and logistic regression models on indicators of pulmonary function and chest symptoms while controlling for smoking status, pack‐years, and other potential confounders. Statistically significant associations between log cumulative exposure and decrements in FVC, FEV1, and FEV1/FVC were observed. In logistic models, statistically significant associations of cumulative exposure with increasing prevalence of FEV1 and FEV1/FVC less than 80% predicted and symptoms including chronic phlegm, chronic bronchitis, breathlessness, wheeze, and wheeze with shortness of breath were found. It is concluded that exposures to respirable coal mine dust present in U.S. mines since 1970 continue to affect respiratory health in underground miners. © 1992 Wiley‐Liss, Inc.
Perspectives on risk assessment impact of recent reports on benzene
Authors: Johnson Eric S. , Lucier George
Published: April 2007

Very sensitive methods that can detect the benzene metabolite muconic acid (MA) in the urine of virtually all members of the general population have recently become available and have been used in a few occupational studies as a marker of benzene exposure. Preliminary findings from these studies suggest that urinary MA may be a reliable marker of occupational exposure to > 5 ppm benzene. It was also consistently observed that a certain proportion of the general population have urinary MA levels compatible with those seen in persons occupationally exposed to > 1 ppm benzene. It is unlikely that these elevated levels can be explained solely as being artifactual. The frequency with which they occur for a given individual, and the duration with which they are maintained, are not known. Information on these two factors is needed in order to adequately assess whether or not these levels present a significant risk for a segment of the general population. © 1992 Wiley‐Liss, Inc.
Accelerated loss of lung function and alveolitis in a longitudinal study of non‐smoking individuals with occupational exposure to asbestos
Authors: Rom William N.
Published: April 2007

Long‐term asbestos workers who insulate pipes and boilers may develop interstitial lung disease associated with loss of lung function. To quantitate annual loss of lung function, 77 individuals with chest X‐rays ≥1/0 ILO category who were life‐long non‐smokers or ex‐smokers for >5 years were evaluated. Study parameters included pulmonary function tests and bronchoalveolar lavage for a mean of 3 visits over 30±2 months. The study participants were 56±1 years old and had 31 ± 1 years' occupational exposure to asbestos. At the first visit, multiple regression analysis revealed significant associations between rales or radiographic opacities and VC, FEV1, and total lung capacity; significant associations were also found between neutrophils/ml lavage fluid with FEV1 and diffusing capacity (all p<0.05). Annual declines for the asbestos‐exposed were VC −92±28 ml/yr and FEV1 −66±21 ml/yr. Declines in VC and FEV1 were less in those with reduced lung function at the initial visit. There were no significant associations between any of the annual declines and cells recovered by bronchoalveolar lavage. Compared to other asbestos‐exposed cohorts followed longitudinally, asbestos insulators with radiographs ≥1/0 and exposure ≥20 years have larger rates of FVC and FEV1 decline for both non‐smokers and ex‐smokers. © 1992 Wiley‐Liss, Inc.
A mortality cohort study of seamen in Italy
Authors: Rapiti Elisabetta , Turi Edoardo , Forastiere Francesco , Borgia Piero , Comba Pietro , Perucci Carlo A. , Axelson Olav
Published: April 2007

A total of 2,208 male subjects, enrolled as merchant marine seamen at the Civitavecchia (Italy) harbor from 1936 to 1975 were followed up through 1989 in order to evaluate their mortality experience. Available information about the number of sailings made it possible to divide subjects into two subgroups: 948 workers with at least one sailing (cohort A) and 1,260 with no reported sailing (cohort B). Fewer than expected overall deaths were observed in both cohorts (cohort A: SMR = 0.83; cohort B: SMR = 0.81), mainly due to a lower mortality from circulatory, respiratory, and digestive diseases. Lung cancer deaths were significantly increased in cohort A (O = 30, SMR = 1.71, 95% CI = 1.15–2.44), whereas no excess was observed in cohort B (O = 6, SMR = 0.57, 95% CI = 0.21–1.26). Among subjects employed aboard ship, a trend in SMRs for lung cancer increasing with duration of employment was observed. Furthermore, three neoplasms of other parts of the respiratory system (including one mesothelioma) were detected in cohort A (SMR = 5.87), and one in cohort B. The study substantiates an increased risk of respiratory cancer among subjects with an occupational history of sailing; past exposure to asbestos and to other environmental carcinogens aboard could be implicated. © 1992 Wiley‐Liss, Inc.
Renal cell cancer among architects and allied professionals in Sweden
Authors: McLaughlin Joseph K. , Malker Hans S. R. , Blot William J. , Weiner Jan A. , Stone B. J. , Ericsson Jan L. E. , Fraumeni Joseph F.
Published: April 2007

The Swedish Cancer‐Environment Registry was used to evaluate a recent report of a large excess risk of renal cell cancer among architects in Los Angeles. We identified 131 renal cell cancers among male Swedish architects and allied professionals during a 19‐year follow‐up period (1961–1979). Compared with the Swedish population, there was no significant excess of renal cell cancer among architects and allied professionals (standardized incidence ratio (SIR) = 1.15; 131 cases). Although it was not possible to estimate the risk for architects alone, the SIR was only 1.06 (16 cases) in a subset of professionals employed in architectural and engineering firms. However, a significant increase in risk (SIR = 1.38) was observed in a related group of workers employed as engineers and construction supervisors in the home construction industry. © 1992 Wiley‐Liss, Inc.
Bladder cancer and occupation in Shanghai, 1980–1984
Authors: Zheng Wei , McLaughlin Joseph K. , Gao Yu‐Tang , Silverman Debra T. , Gao Ru‐Nie , Blot William J.
Published: April 2007

To investigate occupational determinants of bladder cancer in the urban area of Shanghai, occupation and industry information for 1,219 incident bladder cancer cases diagnosed during the period 1980 to 1984 were compared with 1982 census data on employment. Standardized incidence ratios (SIR) for bladder cancer were estimated for occupation and industry classifications. Significant excess risks were observed for plastic products workers (male: SIR = 432; female: SIR = 368); textile bleachers, dyers, and finishers (male: SIR = 169); metal refining and processing workers (male: SIR = 139; female: SIR = 197); petroleum refining workers (male: SIR = 2152); railway engine drivers and firemen (male: SIR = 683); and workers employed in industries of apparel and other textile products manufacturing (female: SIR = 204); paper processing (male: SIR = 146; female: SIR = 226); organic chemical manufacturing (male: SIR = 186); plastic product manufacturing (male: SIR = 218; female: SIR = 272); and metallurgy (male: SIR = 107; female: SIR = 561). This study indicates that many of the industries and occupations that are responsible for increased risk throughout the world are also associated with occupational bladder cancer in Shanghai. © 1992 Wiley‐Liss, Inc.
Electron microscopy analysis of mineral fibers in human lung tissue
Authors: Friedrichs Karl Heinz , Brockmann Michael , Fischer Margit , Wick Gabriele
Published: April 2007

In the present study, lung samples from 126 autopsied cases were examined to determine the content of mineral fibers using analytical transmission electron microscopy (ATEM). The cases were divided into four groups (22 lungs of persons exposed to ambient environmental pollution, 32 cases of mesothelioma, 38 cases of primary lung cancer, and 34 asbestosis cases, 13 of these with additional pleural plaques). Fibers were counted, measured, and mineralogically identified using a combination of X‐ray microanalysis and electron diffraction of the non‐oriented fiber. Concentration of fibrous particles (defined as particles above 1 μm in length with roughly parallel long sides and an aspect ratio of 5:1 and greater) was calculated as fibers 106/g dry lung weight. The concentration of chrysotile was found to be similar throughout the groups except for two cases in the asbestosis group with comparably high numbers of chrysotile. However, a remarkable difference for amphiboles could be observed between the groups. Asbestos bodies were mostly found in the asbestosis group. There was a rather good correlation between numbers of amphibole fibers and asbestos bodies, with an average ratio of 10:1. For compariso purposes between occupationally exposed/non‐exposed individuals, a transition was found in the concentration range of 3–107 asbestos fibers/g dried lung weight. © 1992 Wiley‐Liss, Inc.
Organic solvent encephalopathy: An old hazard revisited
Authors: Houck Peter , Nebel Diane , Milham Samuel
Published: April 2007

This report describes neurologic and respiratory symptoms among 26 engineers and contract laborers who used organic solvents and detergents to remove polychlorinated biphenyl contamination from a poorly ventilated factory basement. Neurologic symptoms included persistent central nervous system deficits; these developed in one worker after only 3 days. Respiratory symptoms included cough that persited for more than 2 years. Laborers were more likely to report symptoms than were engineers. Appropriate ventilation or respirator use might have prevented the workers' morbidity. This incident serves as a reminder that organic solvent‐related occupational illness continues to occur despite worker‐health regulations and knowledge of preventive measures. © 1992 Wiley‐Liss, Inc.
Medical management of three workers following a radiation exposure incident
Authors: House Ronald A. , Sax Solly E. , Rumack Eric R. , Holness D. Linn
Published: April 2007

The medical management of three individuals involved in an exposure incident to whole‐body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole‐body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole‐body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post‐traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress‐related symptoms. © 1992 Wiley‐Liss, Inc.
Use of death certificates in epidemiological studies, including occupational hazards: Variations in discordance of different asbestos‐associated diseases on best evidence ascertainment
Authors: Selikoff Irving J. , Seidman Herbert
Published: April 2007

There is extensive information on discordance in general between accuracy of medical diagnoses on death certificate categorization of cause of death and available clinical and histopathological data. This is as true for occupational disease as for other conditions. But occupational illnesses bear a special problem. Discordance is not equal across the board—it may vary with each occupationally related disease, and no single formula can be applied. It may be high for angiosarcoma and low for acute hydrogen sulfide poisoning, low for bladder cancer, high for unsuspected methyl mercury poisoning.

We have found that for one agent—asbestos—there were different rates of discordance for different asbestos‐related diseases (e.g., lung cancer, mesothelioma, asbestosis, kidney cancer) among 4,951 deaths studied prospectively from 1967 to 1986. Caution is therefore required before accepting generalizations concerning (unstudied) discordance in occupational mortality studies, and in their use in risk assessment models.
Death certificates in epidemiological studies, including occupational hazards: Inaccuracies in occupational categories
Authors: Selikoff Irving J.
Published: April 2007

We compared death certificates for asbestos‐associated diseases (mesothelioma, lung cancer, asbestosis) in two asbestos workers' cohorts. One (insulation workers) had current or recent employment and a strong, continuing union support system which gave them much information about the effects of asbestos exposure. The second cohort, asbestos factory workers, had no such advantage. The factory had closed almost 30 years before, and its workers had dispersed into many areas of the state and nation.

Accuracy of medical diagnosis was comparable in the two groups, but occupational listings were not. Three‐quarters of the insulators' death certificates told of asbestos work, while virtually none of the factory workers' certificates provided such information, even for deaths of mesothelioma and asbestosis.

The data indicate that disease categories, based on medical and pathological diagnoses, at least for asbestos‐associated disease, tend to be accurate. Attempts to identify groups at risk by sorting occpational categories can give variable results, good for those with current exposures, much less satisfactory for those with long‐past occupational exposures.
An environmental survey in chrysotile asbestos milling processes in India
Authors: Mukherjee A. K. , Rajmohan H. R. , Dave S. K. , Rajan B. K. , Kakde Y. , Raghavendra Rao S.
Published: April 2007

Environmental monitoring to determine airborne asbestos fiber levels has been carried out in four different mills processing chrysotile asbestos in the Cuddapah District (Andhra Pradesh) of India. The “membrane filter method” comprising standard asbestos sampling techniques, acetone‐triacetin method for sample preparation, fiber counting, and sizing using the phase contrast optical microscope were adopted in the study. Fiber concentrations both with respect to personal exposures and processing areas were found in most of the cases to be much higher than the prescribed Threshold Limit Value (TLVs) of the developed and developing countries for chrysotile asbestos. By optical microscopy, fiber length distribution showed 70% of fibers in the milling processes were in size range >5–10 μm, whereas in >10–20 and >20 μm, 20% and 8%, respectively. Fiber identification for major elemental content, also done by using scanning electron microscope equipped with an energy dispersive X‐ray analyzer, indicated the presence of tremolite along with chrysotile.

The study stresses the urgent need to adopt suitable engineering controls at the dust generating sources to reduce the fiber level in the mill environment below the threshold limit.
Acute high dose exposure to benzene in shipyard workers
Authors: Midzenski Malinda A. , McDiarmid Melissa A. , Rothman Nathaniel , Kolodner Ken
Published: April 2007

Fifteen degassers were acutely exposed over several days to high concentrations (>60 ppm) of benzene during removal of residual fuel (degassing) from shipboard fuel tanks. Medical surveillance evaluation mandated by the Occupational Safety and Health Administration's (OSHA) Benzene Standard initially revealed 11 workers (73%) reporting neurotoxic symptoms while degassing. Workers with more than 2 days (16 hours) of acute exposure were significantly more likely to report dizziness and nausea than those with 2 or fewer days of acute exposure. Repeated laboratory analyses performed over a 4‐month period after the acute exposure revealed at least one hematologic abnormality consistent with benzene exposure in 9 (60%) of these degassers. One year later, 6 workers (40%) had persistent abnormalities; an additional worker with normal hematologic parameters at the time of our initial evaluation subsequently developed an abnormality consistent with benzene exposure. Numerous large granular lymphocytes were observed on 6 (40%) of the peripheral blood smears. Despite these laboratory findings, there were no significant associations between the presence of hematologic abnormalities and either the number of hours of acute benzene exposure or the duration of employment as a degasser. Volatilization of benzene from the residual fuel was the suspected source of benzene in the headspace of tanks. Confined space exposure to petroleum products may be exposing workers to benzene at levels above the OSHA Short‐Term Exposure Limit (STEL). This situation warrants further study.
Epidemiologic evidence of cancer in aluminum reduction plant workers
Authors: Rönneberg Alf , Langmark Fröydis
Published: April 2007

This paper reviews the epidemiologic evidence of cancer risks among workers in aluminum reduction plants with emphasis on associations with specific work areas and exposures. Studies of workers manufacturing carbon products outside the aluminum industry were also reviewed since the work environment is similar to that encountered in the carbon area of aluminum plants. We obtained 22 reports from references cited in earlier reviews, through compact disc literature search 1980–1990, and from the Nordic Aluminum Industry's Secretariat for Health, Environment and Safety. Six reports were excluded because the material was included in later studies or because a critical evaluation was impossible. This left 16 publications from 11 separate studies.

Work in potrooms with Söderberg electrolytic cells was associated with increased risk of bladder cancer, and the increase was correlated to duration of tar exposure. There was a suggestion of increased risk of leukemias and pancreatic cancers in potroom workers, and of kidney and brain cancers without any clear association with specific exposures or work areas. Singular results showed associations between lung cancer risk and tar exposure in Söderberg plants, and between lung cancer and work in prebake or carbon plants, but interpretation was limited by inadequate data on smoking and asbestos exposure, and by problems connected with the choice of reference populations in these studies.
Use of participatory training techniques in a right‐to‐know train‐the‐trainer course for New Jersey public employees
Authors: Miles Karen K.
Published: April 2007

The New Jersey Department of Health, in conjunction with the Department of Personnel's Human Resources Development Institute, has developed a Right‐to‐Know Train‐the‐Trainer course. In this course, various participatory activities have been utilized since the course's inception in December 1989 to train future trainers who train public employees about recognizing, evaluating, and controlling hazardous substances in their facilities. These participatory training techniques have offered a means by which the trainers can encourage workers to become proactive in making their working conditions safer. With the use of various methods of evaluation, course participants learn the content and develop their skills in the use of participatory training techniques. Though evaluations indicate that participants have a favorable impression of the course, the extent to which these participants take the information back to their worksites has not been formally evaluated.