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Showing papers in "Journal of Occupational and Environmental Medicine in 1981"


Journal Article
TL;DR: A comparison of 30 patients with carpal Tunnel syndrome and 90 matched controls indicated that the use of vibratory hand tools and a history of gynecological surgery, specifically hysterectomy and oophorectomy, were strongly associated with the onset of carpal tunnel syndrome.
Abstract: This paper describes a case control study of the personal and environmental factors associated with the onset of carpal tunnel syndrome in workers at an aircraft engine manufacturing company. A comparison of 30 patients with carpal tunnel syndrome and 90 matched controls indicated that the use of vibratory hand tools and a history of gynecological surgery, specifically hysterectomy and oophorectomy, were strongly associated with the onset of carpal tunnel syndrome.

216 citations


Journal ArticleDOI
TL;DR: Firemen's reaction to alarm was investigated with a pulse rate and ECG analysis and the psychophysiological alarm reaction and its relation to psychosomatic diseases.
Abstract: Firemen's reaction to alarm was investigated with a pulse rate and ECG analysis. The frame of reference was the psychophysiological alarm reaction and its relation to psychosomatic diseases. ECG and pulse rate measurements were recorded continuously from 22 first-string firemen. According to an exercise stress test, the subjects were healthy, but not more fit than a sedentary population. High pulse rates occurred during the alarm due to vigorous movement to the trucks. No anticipatory pulse rate rise occurred as the firemen approached the fire. Non-pathological ECG deviations were found 13 subjects although no abnormalities were found in the same subjects during exercise test. Different firefighting practices, environment, selection, and training might explain the differences between the findings of the present investigation and those of other recent studies.

91 citations



Journal ArticleDOI
TL;DR: This retrospective cohort study examines mortality and cancer incidence among 3,686 men and 75 women who were employed as chemists in 1959 to 1977, finding that male chemists experienced lower overall mortality than other salaried employees of the chemical company.
Abstract: This retrospective cohort study examines mortality and cancer incidence among 3,686 men and 75 women who were employed as chemists in 1959. During the period 1964 to 1977, the male chemists experienced lower overall mortality than other salaried employees of the chemical company (198 deaths observed, 241.0 expected, SMR = 82). Large deficits are seen in lung cancer and arteriosclerotic heart disease death. The chemist appear to be at slightly higher risk for death from malignancies of the colon (12 observed, 6.7 expected, SMR = 178) and from cerebrovascular disease (15 observed, 10.8 expected, SMR = 138). The low overall mortality resulted in a larger than expected proportion of deaths due to cancer. Fewer than expected cases were diagnosed of cancer of all sited combined (61 observed, 86.5 expected, SIR = 71) and of the lung (8 observed, 20.0 expected, SIR = 40). The incidence rates of melanoma and of cancer of the prostate are slightly higher than expected, relative to the Third National Cancer Survey and the experience of nonchemists, respectively. Among female chemists, deaths due to all causes and suicide occurred more frequently than expected. Possible explanations for the lack of anticipated excess risks and for the observed deficits are presented.

72 citations



Journal Article
TL;DR: The suggestive finding was an increased number of lung cancer deaths in a group of chemical workers hired at greater than or equal to 45 years of age in a cohort of 18,869 white males employed at a uranium conversion and enrichment plant in Oak Ridge, Tenn.
Abstract: Mortality is described in a cohort of 18,869 white males who were employed between 1943 and 1947 at a uranium conversion and enrichment plant in Oak Ridge, Tenn. Workers in certain departments (especially chemical workers) were exposed to high average air levels of uranium dust. Based on deaths reported in 1974 by the Social Security Administration (SSA) and using mortality rates for U.S. white males, standardized mortality ratios (SMRs) for various causes in the entire cohort were generally less than 1.00. After correction for unascertained deaths and missing death certificates, the SMR for lung cancer was 1.22 (95% confidence limits, 1.10 and 1.36). SMRs for various causes, including lung cancer, did not tend to be higher in 8,345 workers employed in areas where uranium dust was present or in 4,008 of these 8,345 workers employed for one year or longer at the plant. Other causes of particular interest (i.e., bone cancer, leukemia, diseases of respiratory and genitourinary systems) did not exhibit high SMRs. The suggestive finding of the authors was an increased number of lung cancer deaths in a group of chemical workers hired at greater than or equal to 45 years of age. Continued follow-up of the cohort is necessary for further evaluation of the long-term health effects of exposure to uranium.

61 citations


Journal ArticleDOI
TL;DR: A case-control epidemiologic study showed over-representation of the Eastman Kodak Company (Rochester) on death certificates of brain tumor patients, and higher risk for older workers when compared to the general population, may have resulted from a "diagnostic sensitivity bias" arising from more complete medical evaluation of Kodak employees.
Abstract: Preliminary data showing over-representation of the Eastman Kodak Company (Rochester) on death certificates of brain tumor patients, and higher risk for older workers when compared to the general population, led to a case-control epidemiologic study. Chemical exposure histories of 56 workers with brain tumors were compared with those of other Kodak employees. No differences were found in exposure to a variety of chemicals. In addition, employees with brain tumors were compared to other upstate New York brain tumor patients; there was no difference in histology. However, the Kodak employees had diagnoses more frequently confirmed by histologic examination and more thorough diagnostic studies. Thus, the apparent initial excess of diagnosed tumors may have resulted from a "diagnostic sensitivity bias" arising from more complete medical evaluation of Kodak employees.

60 citations


Journal ArticleDOI
TL;DR: A mortality study of workers with potential exposure to ethylene oxide at the Texaco Chemical Company Plant in Port Neches, Tex., found no deaths from leukemia, nor were there any statistically significant excesses from any specific causes of death.
Abstract: Because of reports linking an increased risk of leukemia with exposure to ethylene oxide, a mortality study of workers with potential exposure the ethylene oxide at the Texaco Chemical Company Plant in Port Neches, Tex., was undertaken. A total of 767 males with potential exposure to ethylene oxide were identified. Forty-six deaths occurred in this cohort with 80 expected (standardized mortality ration; SMR = 58). No deaths from leukemia were seen, nor were there any statistically significant excesses from any specific causes of death.

54 citations


Journal ArticleDOI
TL;DR: The present findings suggest that occupational exposures etiologically relevant to these diseases may not have been reduced in recent years or that sufficient time has not elapsed for such reductions to result in decreased mortality.
Abstract: This report describes mortality occurring between 1940 and mid-1978 among 29,087 men and women employed in a rubber plant for at least two years. Mortality patterns for the period July 1, 1974, to July 1, 1978, were compared to previously published findings for January 1, 1940, through June 30, 1974. Expected numbers of deaths were based on U.S. general population mortality data. There were excess deaths from bladder cancer and leukemia among white male union members during both follow-up periods. During recent follow-up of white male union members employed for at least five years, there were excesses in deaths from three additional cancers: esophageal cancer (11 observed/4.8 expected), biliary and liver cancer (6 observed/3.3 expected) and lymphoma and multiple myeloma (14 observed/5.8 expected). Evidence from other studies of rubber workers suggests that observed excesses in deaths from bladder cancer and leukemia are related to work-place exposures. The present findings suggest that occupational exposures etiologically relevant to these diseases may not have been reduced in recent years or that sufficient time has not elapsed for such reductions to result in decreased mortality. Further investigation is required to clarify the contribution of occupational factors to observed excesses in deaths form cancers of the esophagus and the biliary passages and liver and from lymphoma and multiple myeloma.

53 citations



Journal ArticleDOI
TL;DR: Possible immunoreactivity to chemically well-characterized mono- and diisocyanate protein conjugates was reevaluated in 15 workers with TDI asthma and 17 normal (nonexposed) volunteers and suggest that isocyanates have the potential for eliciting heterogeneous immune responses in certain subpopulations of exposed workers.
Abstract: Possible immunoreactivity to chemically well-characterized mono- and diisocyanate protein conjugates was reevaluated in 15 workers with TDI asthma and 17 normal (nonexposed) volunteers. Lymphocytes of nine sensitive workers were incubated with TDI human serum albumin (HSA) conjugates. Leucocyte inhibitory factor (LIF) was produced. Leucocyte inhibitory factor was also induced by hexamethylene diisocyanate (HDI) protein conjugates in four of these workers who had no prior history of exposure to HDI. Disappearance of TDI- and HDI-induced LIF was noted in several sensitive workers who were removed from further TDI exposure. Three LIF-positive workers also demonstrated positive intracutaneous reactivity to TDI-HSA. One workers had a markedly positive RAST (25.5% binding) to a monofunctional (p-tolyl isocyanate) protein reagent. These studies suggest that isocyanates have the potential for eliciting heterogeneous immune responses in certain subpopulations of exposed workers. Continued contact with isocyanates may be necessary for maintenance of specific immunity. Possible cross reactivity between TDI and HDI may be determined by new antigenic sites created by isocyanate protein interactions.

Journal Article
TL;DR: Normal findings suggest an impairment in the receptiveness of the ganglion cells or demyelination of the optic nerve fibers, but impaired color discrimination occurred significantly more often in the exposed group than among the referents.
Abstract: A possible effect of chronic carbon disulfide exposure on the optic nerve was studied by giving the Farnsworth Munsell 100-Hue Test for color discrimination to 62 exposed and 40 nonexposed men. Carbon disulfide exposure did not relate to specific pattern defects in color discrimination, but impaired color discrimination occurred significantly more often in the exposed group than among the referents. The abnormal findings suggest an impairment in the receptiveness of the ganglion cells or demyelination of the optic nerve fibers.

Journal ArticleDOI
TL;DR: A survey of mortality among copper smelter workers in the western United States revealed that a respiratory cancer excess previously observed during the period 1938 through 1963 continued from 1964 through 1977, and was linked to work in plant areas where airborne arsenic concentrations were elevated.
Abstract: A survey of mortality among copper smelter workers in the western United States revealed that a respiratory cancer excess previously observed during the period 1938 through 1963 continued from 1964 through 1977. When analyzed in relation to smelter employment prior to 1964, the recent increase in respiratory cancer was linked to work in plant areas where airborne arsenic concentrations were elevated and to a cumulative arsenic exposure index, although some excess risk was also associated with long-term employment in jobs with limited exposures to arsenic. The arsenic-related excess remained after adjustment for work in areas of the plant with elevated concentrations of sulphur dioxide, which was not found to have an independent influence upon cancer risk. Increased rates for nonmalignant respiratory disease were also observed, but were not significantly associated with arsenic exposure.

Journal Article
TL;DR: Relationships to CHD risk factors of work environment variables, of the Type A behavior pattern, and of their interaction were studied in 384 male salaried workers and no significant independent relationships were found.
Abstract: Relationships to CHD risk factors of work environment variables, of the Type A behavior pattern, and of their interaction were studied in 384 male salaried workers. Except for an association between physical comfort in the work environment and systolic blood pressure, no significant independent relationships were found between any of the work environment variables or the Type A behavior pattern and coronary heart disease (CHD) risk factors. Type A workers who described their work environments as encouraging autonomy or being high in peer cohesion had lower blood pressures than those who did not. The reverse was found for Type Bs. Type Bs who described their environments as low in physical comfort had higher systolic blood pressure than those who did not. These significant interactions are discussed from the perspective of person-environment fit. Future directions for research and implications for CHD risk reduction are presented.

Journal ArticleDOI
TL;DR: It is argued that mass hysteria may be the result of interactions of low levels of toxicants and may not be a result of the "hysterical" behavior in women at all.
Abstract: Mass hysteria is an epidemic diagnostic term used to characterize unexplained outbreaks of syncope among women. A syncope outbreak among women in a meeting in a rural area of Michigan prompted an intense investigation for etiology. Low levels of ozone, carbon monoxide, and pentane were found associated with the outbreak. These levels were too low by themselves to explain the symptoms. A sociometric scale of intensity of illness was devised and found to be highly correlated (r = -0.94) with the weight of those who fainted. It is argued that mass hysteria may be the result of interactions of low levels of toxicants and may not be a result of the hysterical behavior in women at all.

Journal Article
TL;DR: The effects of an employee fitness program upon absenteeism and productivity were investigated in a controlled trial involving two large offices, with small and relatively similar gains of productivity, with reduction of absenteeism at both test and control companies.
Abstract: The effects of an employee fitness program upon absenteeism and productivity were investigated in a controlled trial involving two large offices. During the six-month experimental program, the test company developed substantial gains of fitness. However self-reports and supervisor evaluations showed small and relatively similar gains of productivity, with reduction of absenteeism at both test and control companies. Further studies on a large scale are warranted. The presently observed changes probably reflect (1) sample attenuation, (2) seasonal trends, and (3) a "Hawthorne" effect. If the last factor is substantiated, employee fitness programs may be of economic interest, despite the nonspecific nature of the resultant gains in productivity. Language: en



Journal Article
TL;DR: It should be noted that the employees subjected to mutagenicity studies had been in contact with a wide range of substances and products in the course of their occupation, which means that the increased aberrations rate found cannot be attributed unequivocally to exposure to a particular substance.
Abstract: Employees of plants where alkylene oxide is manufactured or processed were subjected to mutagenicity studies carried out on lymphocyte cultures in accordance with the methods of Moorhead at al, de Jong and Anders. The employees were divided into four groups, according to their periods of exposure: (1) Long-term exposure for more than 20 years; (2) exposure for less than 20 years; (3) long-term exposure and accident (ethylene oxide inhalation or skin contact); and (4) accident, i.e., brief high exposure to ethylene oxide. Measurement of the concentrations in various sections of the plant yielded values of up to 3 ppm under conditions of normal operation. However, this figure rose briefly to 1900 ppm under plant breakdown hat workers were subjected to higher exposure in the past. One hundred metaphases per person were analyzed for chromosome aberrations. The results are given in Tables 1 through 4. A significant increase in the aberration rate was found only in employees in Group 1. This was confirmed by a control examination carried out one year later. The employees of groups 2, 3 and 4 displayed no significant increases. However, in evaluating these findings, it should be noted that the employees had been in contact with a wide range of substances and products in the course of their occupation, which means that the increased aberrations rate found cannot be attributed unequivocally to exposure to a particular substance.


Journal Article
TL;DR: It can be expected that men in occupations associated with higher indices of smoking intensity will have higher rates of tobacco-related diseases than those in occupations with lower cigarette intensity exposures.
Abstract: A study was conducted to determine the associations between occupational status and detailed measures of smoking exposure: ever vs. never smoking, type of tobacco used, current vs. ex-cigarette smoking, amount smoked, age began, and tar yield of the usual brand smoked. Date were obtained between the years 1977 and 1979 as part of a large-scale epidemiological study of tobacco use. Subjects interviewed were 2,528 white males aged 41 to 70 while they were patients in hospitals located in five U.S. cities. Thirty-eight percent of the sample had cancer of a site not previously linked with use of tobacco and 62% had non-cancer conditions also unrelated to tobacco exposure. It was found that men in professional and technical occupations showed a markedly higher rate of never smoking than did men from all other occupations who showed only slight differences among themselves. The intensity of other cigarette smoking variables--current vs. ex-smoking, age began, and tar yield of cigarette smoked (but not number per day)--varied significantly by occupational level, with higher levels of smoking intensity observed among men in blue-collar than among those in white-collar occupations. These findings indicate that an appropriate evaluation of an occupationally related disease also affected by smoking must include detailed and comprehensive smoking data. Moreover, it can be expected that men in occupations associated with higher indices of smoking intensity will have higher rates of tobacco-related diseases than those in occupations with lower cigarette intensity exposures.

Journal ArticleDOI
TL;DR: It is concluded that work in this industry presents no major health hazard and workers experienced a level of mortality that compares favorably with that of the U.S. white male population.
Abstract: Information has been obtained on a cohort of 16,243 men employed for at least one year in the manufacture of paint or vanish after January 1, 1946, and for seven subgroups on the basis of exposure. These workers experienced a level of mortality that compares favorably with that of the U.S. white male population. The workers' pattern of mortality differed somewhat from the U.S. pattern, with considerably reduced mortality from psychiatric, metabolic, respiratory, and violent causes. There was an increased mortality due to bowel and rectal cancer. While the numbers are smaller, there are also increased rates for liver and skin cancer. Lung cancer rates, while not in excess of the national average, did not match the low mortality from nonmalignant, noninfectious respiratory disease. The authors have concluded that work in this industry presents no major health hazard.

Journal Article
TL;DR: The cancer morbidity pattern among 788 men with at least five years' exposure to oil mist was investigated and the mortality from all causes showed the so-called "healthy worker effect," that is, 126 deaths compared to 154.3 expected.
Abstract: The cancer morbidity pattern among 788 men with at least five years' exposure to oil mist was investigated. Based on measurements, interviews of workers and a survey of changes over the years, the average exposure level was estimated to have been 5 mg/m/sup 3/ or more prior to 1965. Exclusive of cancer of the scrotum, there were 39 observed cases of cancer compared to 52.9 expected. There were four cases of cancer of the scrotum among the turners but none among the grinders. Three cases of lung cancer were found, compared to 5.4 expected. Among the grinders there was a doubled, but not statistically significant, increase in cancer of the stomach. The mortality from all causes showed a so-called healthy worker effect, that is, 126 deaths compared to 154.3 expected.

Journal ArticleDOI
TL;DR: The cheletable part of lead body burden was measured in 32 workers and seven office workers after an infusion test with CaNa2EDTA and there was good correlation between blood lead and chelatable urinary lead excretion and the urinary ALA-excretion.
Abstract: The chelatable part of lead body burden was measured in 32 workers and seven office workers after an infusion test with CaNa/sub 2/EDTA. The workers had been exposed to lead at a lead and zinc processing unit for one to three years (mean one year). There was good correlation (r = 0.87) between blood lead and chelatable urinary lead excretion described by the equation y = 0 07.10/sup 0.46 x/. From this equation it can be predicted that the generally accepted limit value for chelatable urinary lead excretion, 0.42 ..mu..mol/mmol CaNa/sub 2/EDTA administered per 24 hours (3.1 ..mu..mol/24 hours or 650 ..mu..g/24 hours), corresponds to a blood lead concentration (PbB) of 1.7 ..mu..mol/l (or 35 ..mu..g/100 ml), which is lower than the commonly accepted limit value of 2.9 ..mu..mol/1 (or 60..mu..g/100 ml) for occupationally lead-exposed persons. There was a better correlation between the chelatable lead excretion and the urinary ALA-excretion (r = 0.45; p 0.05).

Journal ArticleDOI
TL;DR: There was no significant difference among the groups in the prevalence of various dermatoses, skin tumors, alterations in visual acuity or clinical ocular abnormalities on slit lamp biomicroscopy and fundoscopy apart from variations in the amount of dust in the lids.
Abstract: The prevalence of skin and eye abnormalities was determined in 77 journeymen welders, 75 members of other trades exposed to welding operations and 58 non-exposed comparison workers. Characteristics including possible risk factors for skin cancer were compared among the groups. Localized cutaneous erythema was frequent in welders and occasional in other exposed workers. Small cutaneous scars were frequent in welders. There was no significant difference in the prevalence of actinic elastosis by occupational group; however, the degree of elastosis was significantly associated with type of complexion, original hair color, eye color, childhood freckling poor ability to tan and ease of sunburning. There were no significant difference among the groups in the prevalence of various dermatoses, skin tumors, alterations in visual acuity or clinical ocular abnormalities on slit lamp biomicroscopy and fundoscopy apart from variations in the amount of dust in the lids. The observed prevalences of skin and eye diseases may provide useful comparative data.

Journal Article
TL;DR: A method has been developed for monitoring industrial workers and others exposed to environmental agents which may impair fertility and it is demonstrated that the surveillance technique would have been capable of detecting occupationally induced infertility among workers in advance of the actual discovery date.
Abstract: A method has been developed for monitoring industrial workers and others exposed to environmental agents which may impair fertility. National birth probabilities specific for maternal birth cohort, age, parity, and race are used to derive expected fertility. Observed fertility is obtained by questionnaire. Standardized fertility ratios are computed for exposure and non-exposure periods and compared. The analytic techniques have been validated by applying the method to a group of 36 male factory employees working in an agricultural chemical division (ACD) where pesticides including the nematocide dibromochloropropane were formulated. Twelve of these employees in mid-1977 had been discovered to have severely depressed sperm counts related to occupational exposure. The standardized fertility ratio (SFR) computed from data available in mid-1977 for the period at risk from employment in the ACD (SFR = 0.75) was significantly lower than those derived for the entire not-at-risk period (SFR = 1.88) and the portion related to employment in other areas of the factory (SFR = 2.16). Similar differences also were evident from data available several years earlier, demonstrating that the surveillance technique would have been capable of detecting occupationally induced infertility among these workers in advance of the actual discovery date.

ReportDOI
TL;DR: Results of this longitudinal study showed that men assigned to Hospital Corpsman and Mess Management Specialist (culinary work) categories had the highest health risks for stress-related illness during nearly all phases or decades of a Navy career.
Abstract: : This study examined hospitalization rates for 10 stress-related illnesses among Navy occupational groups during four phases of a 30-year career and identified possible reasons for differences in health risks among occupations and career phases. Results of this longitudinal study, which covered 11 years and included an initial population of 184,122 male Navy enlisted Caucasians, showed that men assigned to Hospital Corpsman and Mess Management Specialist (culinary work) categories had the highest health risks for stress- related illness during nearly all phases or decades of a Navy career. Other groups with elevated hospitalization rates included Construction/Manufacturing, Deck, Ordnance, and Engineering/Hull whereas the lowest rates were observed for Miscellaneous/Technical, Electronics, and Administrative/Clerical. The highest hospitalization rates for stress-related diseases were evidenced during the third decade. Job stress scores were computed from ratings of environmental characteristics, occupational stressors, and career considerations; high scores on these dimensions tended to be associated with increased illness. Implications of these results for prevention programs were discussed.

Journal ArticleDOI
TL;DR: It is concluded that the association between lung cancer and VCM exposure, if present, is indeed rather small and the exposed workers are known to have had a cigarette smoking experience similar to that of those who were not exposed.
Abstract: The present study was undertaken to find out whether there was an excess of cancer mortality from causes other than angiosarcoma of the liver among a group of workers heavily exposed to vinyl chloride monomer (VCM). The mortality of 451 workers exposed to VCM for more than five years was compared with that of 870 workers from the same company who had not been exposed to VCM. The relative risk for digestive cancer was significantly higher than 1 (6.25, confidence interval 2.69 to 14.52) in the exposed group. The standardized mortality ratio (SMR) for digestive cancer was also higher (SMR 259.26 p less than 0.01) than that of the general population. No other cancer was in excess. Since the exposed workers are known to have had a cigarette smoking experience similar to that of those who were not exposed, it is concluded that the association between lung cancer and VCM exposure, if present, is indeed rather small.

Journal ArticleDOI
TL;DR: The results of the present study suggest that the association of lymphatic leukemia with a work history of possible solvent exposure is weaker than previously described, however, recently acquired detailed environmental information reported elsewhere tends to support the initial finding at this company.
Abstract: A matched case-control study was conducted for 72 cases of leukemia occurring among employees of four rubber and tire manufacturing companies during the period from 1964 to 1973, to determine if certain environmental exposures were related to the risk of developing leukemia. Earlier studies conducted in one company had shown an association of lymphatic leukemia with a work history of possible solvent exposure, and the results of the present study suggest that the association is weaker than previously described. However, recently acquired detailed environmental information reported elsewhere tends to support the initial finding at this company. Further studies are required to fully resolve this issue. A finding was the lack of association in the order three companies. In addition, lymphatic leukemia was found to be associated with work experience in general service jobs for the two larger companies from which a majority (89%) of the cases derive. Intervals from exposure death peaked at 27 to 38 years. No elevated risk for myeloid leukemia was found.

Journal ArticleDOI
TL;DR: Adverse reproductive outcomes that may be related to occupational exposure are discussed and some of the possible mechanisms of action are explored.
Abstract: Concern regarding adverse effects of occupational exposures on the reproductive health of workers is increasing. Several sociopolitical and legal issues influence both the regulation of worker exposure and the ability to study exposure and possible reproductive effects. Adverse reproductive outcomes that may be related to occupational exposure are discussed and some of the possible mechanisms of action are explored. Epidemiologic approaches to the study of reproductive hazards of the workplace are considered and illustrated in this paper.