Ramazzini; Blog on work and health

Medical News: Hairdressers at Risk for Occupational Asthma – in Pulmonology, Asthma from MedPage Today

Annet — Thu, 23 Jun 2011 17:35:59 +0000

Medical News: Hairdressers at Risk for Occupational Asthma – in Pulmonology, Asthma from MedPage Today.

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Suggestive relation between multiple myeloma and chlorinated solvent exposure

Annet — Wed, 18 May 2011 10:42:51 +0000

The relationship between multiple myeloma and occupational exposure to six chlorinated solvents
Laura S Gold et al. 2011

Evidence from a relatively large case-control study (181 cases (71% response) vs. 481 controls (52% response)) suggests that exposures to certain chlorinated solvents may be associated with increased incidence of multiple myeloma; however, the study is limited by relatively low participation (52%) among controls

What this paper adds:

The aetiology of multiple myeloma is poorly understood.
The purpose of this research was to examine relationships between occupational exposures to chlorinated solvents and multiple myeloma.
This research provides evidence that certain chlorinated solvents, most notably trichloroethylene, are associated with increased incidence of multiple myeloma.
While results were less clear, exposure to 1,1,1-trichloroethane, methylene chloride, perchloroethylene, carbon tetrachloride and chloroform also conferred increased risk of multiple myeloma in our population.

Abstract

Objectives Few studies have examined whether exposure to chlorinated solvents is associated with multiple myeloma. We evaluated associations between multiple myeloma and occupational exposure to six chlorinated solvents: 1,1,1-trichloroethane, trichloroethylene (TCE), methylene chloride (DCM), perchloroethylene, carbon tetrachloride and chloroform.

Methods In-person interviews obtained occupational histories and information on jobs with likely solvent exposure. We assigned exposure metrics of probability, frequency, intensity and confidence using job-exposure matrices modified by job-specific questionnaire information. We used logistic regression to estimate ORs and 95% CIs for associations between multiple myeloma and ever exposure to each, and any, chlorinated solvent and analysed whether associations varied by duration and cumulative exposure. We also considered all occupations that were given the lowest confidence scores as unexposed and repeated all analyses.

Results Risk of multiple myeloma was elevated for subjects ever exposed to 1,1,1-trichloroethane (OR (95% CI): 1.8 (1.1 to 2.9)). Ever exposure to TCE or DCM also entailed elevated, but not statistically significant, risks of multiple myeloma; these became statistically significant when occupations with low confidence scores were considered unexposed (TCE: 1.7 (1.0 to 2.7); DCM: 2.0 (1.2 to 3.2)). Increasing cumulative exposure to perchloroethylene was also associated with increasing multiple myeloma risk. We observed non-significantly increased multiple myeloma risks with exposure to chloroform; however, few subjects were exposed.

Conclusions Evidence from this relatively large case-control study suggests that exposures to certain chlorinated solvents may be associated with increased incidence of multiple myeloma; however, the study is limited by relatively low participation (52%) among controls.

Filed under: Chemical agents, Occupational cancer Tagged: chlorinated solvents, myeloma

Daily exposure measures prevent further hearing loss

Annet — Wed, 18 May 2011 09:02:20 +0000

Interesting study on a preventive intervention for occupational noise-induced hearing loss (NIHL). Workers who could daily monitor their noise exposure “at-ear” experienced no further worsening of high frequency hearing 4 years after the intervention. This might be a promising approach to enhance the situation of this frequent occupational disease.

Effect of daily noise exposure monitoring on annual rates of hearing loss in industrial workers
Peter M Rabinowitz, Deron Galusha, Sharon R Kirsche, Mark R Cullen, Martin D Slade, Christine Dixon-Ernst
Occup Environ Med 2011;68:414-418
Abstract

Objectives Occupational noise-induced hearing loss (NIHL) is prevalent, yet evidence on the effectiveness of preventive interventions is lacking. The effectiveness of a new technology allowing workers to monitor daily at-ear noise exposure was analysed.

Methods Workers in the hearing conservation program of an aluminium smelter were recruited because of accelerated rates of hearing loss. The intervention consisted of daily monitoring of at-ear noise exposure and regular feedback on exposures from supervisors. The annual rate of change in high frequency hearing average at 2, 3 and 4 KHz before intervention (2000–2004) and 4 years after intervention (2006–2009) was determined. Annual rates of loss were compared between 78 intervention subjects and 234 controls in other company smelters matched for age, gender and high frequency hearing threshold level in 2005.

Results Individuals monitoring daily noise exposure experienced on average no further worsening of high frequency hearing (average rate of hearing change at 2, 3 and 4 KHz=–0.5 dB/year). Matched controls also showed decelerating hearing loss, the difference in rates between the two groups being significant (p<0.0001). Analysis of a subset of intervention subjects matched to controls for initial rate of hearing loss showed a similar trend but the difference was not statistically significant (p=0.06).

Conclusion Monitoring daily occupational noise exposure inside hearing protection with ongoing administrative feedback apparently reduces the risk of occupational NIHL in industrial workers. Longer follow-up of these workers will help determine the significance of the intervention effect. Intervention studies for the prevention of NIHL need to include appropriate control groups.

Filed under: Hearing loss, Noise, Physical agents Tagged: Noise, Noise-induced occupational hearing loss

More respiratory symptoms in municipal solid waste workers in Greece

Annet — Sun, 02 Jan 2011 10:30:29 +0000

To evaluate the respiratory health of municipal solid waste workers (MSWWs), Greek researchers studied 184 municipal employees of Keratsini (104 MSWWs and 80 controls) with questionnaire and spirometry. Spirometry revealed a reduced mean forced vital capacity (FVC) and forced expiratory volume in 1 s (as a percentage of predicted values) in MSWWs compared with controls. After adjustment for smoking status, only the decline in FVC was statistically significant (P < 0.05).
Prevalence of all respiratory symptoms was higher in MSWWs than in controls. After adjustment for confounding factors, the difference reached statistical significance (P < 0.05) for morning cough, cough on exertion and sore throat. Although this study had some limitations like small sample size, the results indicate a higher prevalence of respiratory symptoms and a greater decrease in lung function in MSWWs.

M. Athanasiou, G. Makrynos and G. Dounias, Respiratory health of municipal solid waste workers,
Occup Med (Lond) (2010) 60 (8): 618-623

Abstract

Background: There is an increasing evidence that the incidence of work-related pulmonary problems is greater in waste collectors than in the general workforce.

Aims: To evaluate the respiratory health of municipal solid waste workers (MSWWs).

Methods: One hundred and eighty-four municipal employees of Keratsini (104 MSWWs and 80 controls) participated in a cross-sectional study. All participants were asked to fill in a slightly modified version of the Medical Research Council questionnaire. Lung function was evaluated by spirometry.

Results: Spirometry revealed reduced mean forced vital capacity (FVC) and forced expiratory volume in 1 s (as a percentage of predicted values) in MSWWs compared with controls. After adjustment for smoking status, only the decline in FVC was statistically significant (P < 0.05). Prevalence of all respiratory symptoms was higher in MSWWs than in controls. After adjustment for confounding factors, the difference reached statistical significance (P < 0.05) for morning cough, cough on exertion and sore throat.

Conclusions: The results of this cross-sectional study indicate a higher prevalence of respiratory symptoms and a greater decrease in lung function in MSWWs. A number of limitations such as the relatively small size of population and the ‘healthy worker’ effect should be taken into account.

Filed under: Asthma, Occupational exposure Tagged: Respiratory symptoms, Solid waste

Exposure to neurotoxic solvents may influence blue-yellow color vision in aircraft maintenance workers

Annet — Sun, 02 Jan 2011 10:13:40 +0000

Australian researchers studied the possible persisting effects to color vision of exposure to formulations containing neurotoxins during F-111 fuel tank maintenance. They studied 3 groups: 512 exposed personnel, 458 technical-trade comparisons, and 330 non-technical comparisons. Forty five percent of all participants had blue-yellow color deficient vision (CDV) in at least one eye. Deficiencies of this nature are caused by environmental exposures. There were statistically significant differences in CCI a blue-yellow confusion in the exposed group versus technical group (odds ratio 1.4: 95% CI 1.1–1.7). No differences were observed between the exposed group and the non-technical group. The researchers concluded that the results indicate reduced color discrimination among the exposed subjects compared to one of two control groups. The findings may be due to previous exposure to solvents among the air force personnel

Maya Guest et al. 2010, Impairment of color vision in aircraft maintenance workers
International Archives of Occupational and Environmental Health (13 November 2010), pp. 1-11

Abstract

Purpose: The purpose of the study was to examine possible persisting effects to color vision in a group from the Royal Australian Air Force who had exposure to formulations containing neurotoxins during F-111 fuel tank maintenance, relative to two contemporaneous comparison groups.

Methods: Color vision was tested in 512 exposed personnel, 458 technical-trade comparisons, and 330 non-technical comparisons using the Ishihara test plates and the Lanthony D-15 Desaturated Color disk arrangement test. Participants were excluded if they failed the Ishihara test as this indicates congenital color blindness. From the Lanthony results, the type of color deficient vision (CDV) was diagnosed, and additionally, the Bowman’s color confusion index (CCI) was calculated. Regression models were used to examine whether there was an association between color vision deficiencies and F-111 fuel tank maintenance, adjusting for possible confounders.

Results The CCI ranged from 1 to 2.8 (median 1.2, quartiles 1.1, 1.4) in the 2,600 eyes tested. Forty five percent of all participants had blue-yellow CDV in at least one eye. Deficiencies of this nature are caused by environmental exposures. Logistic regression demonstrated statistically significant differences in CCI category in the exposed group versus technical group (odds ratio 1.7: 95% CI 1.3–2.0) and a blue-yellow confusion in the exposed group versus technical group (odds ratio 1.4: 95% CI 1.1–1.7). No differences were observed between the exposed group and the non-technical group.

Conclusion The results indicate reduced color discrimination among the exposed subjects compared to one of two control groups. The findings may be due to previous exposure to solvents among the air force personnel.

Filed under: Chemical agents Tagged: Chemicals, Color vision, Occupational exposure

Mobile phone use may influence tinnitis

Annet — Sun, 02 Jan 2011 09:59:43 +0000

The mechanisms that produce tinnitus are not fully understood. From anecdotal evidence we know that there may be a link between mobile phone use and tinnitus. Austrian researchers did an individually matched case-control study to study this relation in 100 patients and 100 controls. They found that mobile phone use up to the index date (onset of tinnitus) on the same side as the tinnitus did not have significantly elevated ORs for regular use and intensity or for cumulative hours of use. But the risk estimate was significantly elevated for prolonged use (≥4 years) of a mobile phone (OR 1.95; CI 1.00 to 3.80). They concluded that mobile phone use should be included in future investigations as a potential risk factor for developing tinnitus.

Hans-Peter Hutter et al. 2010, Tinnitus and mobile phone use
Occup Environ Med 2010;67:804-808

Abstract

Objectives: The mechanisms that produce tinnitus are not fully understood. While tinnitus can be associated with diseases and disorders of the ear, retrocochlear diseases and vascular pathologies, there are few known risk factors for tinnitus apart from these conditions. There is anecdotal evidence of an link between mobile phone use and tinnitus, but so far there have been no systematic investigations into this possible association.

Methods: 100 consecutive patients presenting with tinnitus were enrolled in an individually matched case–control study. For each case a control subject was randomly selected from visiting outpatients matched for sex and age. The patient’s history was obtained and clinical examinations were conducted to exclude patients with known underlying causes of tinnitus. Mobile phone use was assessed based on the Interphone Study protocol. ORs were computed by conditional logistic regression with years of education and living in an urban area as covariates.

Results: Mobile phone use up to the index date (onset of tinnitus) on the same side as the tinnitus did not have significantly elevated ORs for regular use and intensity or for cumulative hours of use. The risk estimate was significantly elevated for prolonged use (≥4 years) of a mobile phone (OR 1.95; CI 1.00 to 3.80).

Conclusions: Mobile phone use should be included in future investigations as a potential risk factor for developing tinnitus.

Filed under: Physical agents Tagged: Noise-induced occupational hearing loss, Tinnitus

2010 in review

Annet — Sun, 02 Jan 2011 09:41:06 +0000

The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

The Blog-Health-o-Meter™ reads Fresher than ever.

Crunchy numbers

The average container ship can carry about 4,500 containers. This blog was viewed about 24,000 times in 2010. If each view were a shipping container, your blog would have filled about 5 fully loaded ships.

In 2010, there were 24 new posts, growing the total archive of this blog to 208 posts. There were 9 pictures uploaded, taking up a total of 237kb. That’s about a picture per month.

The busiest day of the year was March 22nd with 163 views. The most popular post that day was Smoking ban good for your health.

Where did they come from?

The top referring sites in 2010 were wellsphere.com, stanford.wellsphere.com, safetyatworkblog.wordpress.com, search.aol.com, and en.wordpress.com.

Some visitors came searching, mostly for no smoking, skin cancer, smoking, cyclist, and women cyclists.

Attractions in 2010

These are the posts and pages that got the most views in 2010.

Smoking ban good for your health September 2008

Genital problems in competitive women cyclists October 2009

How to influence health behaviour to prevent skin cancer? January 2010

Vibration induced white fingers September 2008

Top 10 of most hazardous jobs, at least in the USA May 2008

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Elevated suicide risk among veterinary surgeons

Annet — Thu, 07 Oct 2010 17:58:08 +0000

An accumulating body of research demonstrates that risk of suicide varies between occupational groups. There is preliminary evidence to suggest that veterinary surgeons are a group at risk. A systematic review of studies of rates and methods of suicide in the veterinary profession shows that there appears to be an elevated risk of suicide for veterinary surgeons in several countries.

Systematic review of the prevalence of suicide in veterinary surgeons
B. Platt, K. Hawton, S. Simkin and R. J. Mellanby

Abstract
Background: An accumulating body of research demonstrates that risk of suicide varies between occupational groups. Identification of the occupations at risk, and the factors that contribute to the increased risk of suicide in these groups is essential for the development of effective suicide prevention strategies. There is preliminary evidence to suggest that veterinary surgeons are a group at risk.

Aims: To conduct a systematic review of studies of rates and methods of suicide in the veterinary profession.

Methods: A systematic search of the international research literature was performed in May 2008. The data from the 19 studies of the prevalence of suicide in the veterinary profession were extracted by two independent reviewers and analysed.

Results: Between 0 and 43% of veterinary surgeon deaths were due to suicide. In all but one of the 15 studies presenting risk of suicide in veterinary surgeons with a comparison population, an elevated risk was found.

The better quality studies with the lowest risk of bias indicated that in the UK, the rate of suicide in the veterinary profession was at least three times the general population rate. Studies of the methods of suicide veterinary surgeons use suggest that self-poisoning and firearms are particularly common.

Conclusions: There appears to be an elevated risk of suicide for veterinary surgeons in several countries. Access to means of suicide influences the methods used and may contribute to increased risk.

Filed under: Job well being, Psychosocial disorders, Psychosocial exposure, Stress, Well-being Tagged: Review, Suicide, Veterinary surgeon

Bakery employees at risk for work-related allergies

Annet — Thu, 07 Oct 2010 17:39:08 +0000

NIOSH study confirms that despite all the knowledge on the risks of exposure to flour, employees of large commercial bakeries are still at risk of sensitization and respiratory symptoms from exposure to high levels of bakery associatied antiges (BAA). Higher exposure comes with more work-related symptoms.

Exposure to flour dust and sensitization among bakery employees

Elena H. Page et al. American Journal of Industrial Medicine, Article first published online: 22 SEP 2010

Abstract
Background: The National Institute for Occupational Safety and Health conducted a study to determine prevalences of sensitization to bakery-associated antigens (BAAs) and work-related respiratory symptoms at a large commercial bakery.

Methods: The following measurements were carried out: personal breathing zone (PBZ) and general area (GA) monitoring for inhalable flour dust, α-amylase and wheat, a questionnaire, and blood tests for IgE specific to flour dust, wheat, α-amylase, and common aeroallergens.

Results: Of 186 bakery employees present during our site visit, 161completed the questionnaire and 96 allowed their blood to be drawn. The geometric mean PBZ and GA inhalable flour dust concentrations for the lower-exposure group was 0.235 mg/m3, and for the higher-exposure group was 3.01 mg/m3.

Employees in the higher-exposure group had significantly higher prevalences of work-related wheezing, runny nose, stuffy nose, and frequent sneezing than the lower-exposure group.

The prevalence of IgE specific to wheat was significantly higher among employees who ever had a job in the higher-exposure group or in production at another bakery at both the ≥ 0.10 kU/L and the ≥ 0.35 kU/L cutoffs, and to flour dust and α-amylase at the ≥ 0.10 kU/L cutoff, compared to the lower-exposure group.

Conclusions: Despite knowledge of the risks of exposure to flour being available for centuries, U.S. employees are still at risk of sensitization and respiratory symptoms from exposure to high levels of BAA.

Filed under: Allergies, Asthma, Chemical agents Tagged: Baker, Flour dust, Occupational asthma

HAVS at your feet? Vibration-white foot

Annet — Thu, 07 Oct 2010 17:27:30 +0000

At the Netherlands Center of Occupational Diseases earlier this year a question was asked about complaints of back and legs in a construction worker exposed to vibration through his feet. At that time no relevant literature was found in an initial search, now there is this interesting case-report of a 54-year-old miner presented with a chief complaint of blanching and pain in his toes. He had a history of foot-transmitted vibration exposure over 18 years. The complaints at his feet were analogous to complaints of hand arm vibration syndrome (HAVS) occurring at the hands of workers handling vibrating tools.

Vibration-white foot: a case report
A. M. S. Thompson, R. House, K. Krajnak and T. Eger
Occupational Medicine Volume 60, Issue 7 Pp. 572-574

Background
Hand–arm vibration syndrome (HAVS) refers to the neurological, vascular and musculoskeletal problems that may arise due to exposure to segmental vibration to the hands. An analogous syndrome may occur in the lower extremities of workers exposed to foot-transmitted vibration.

Aims: This report describes the case of a worker with a history of foot-transmitted vibration exposure presenting with cold intolerance in the feet and blanching in the toes.

Case report:
A 54-year-old miner presented with a chief complaint of blanching and pain in his toes. The worker had a history of foot-transmitted vibration exposure over his 18 year career as a miner, primarily from the operation of vehicle-mounted bolting machines. Cold provocation digital plethysmography showed cold-induced vasospastic disease in the feet, but not in the hands.

Conclusions This case illustrates a condition descriptively termed ‘vibration-white foot’: a disease analogous to HAVS arising after segmental vibration exposure to the feet. Further research is required to increase awareness of, and direct preventive efforts for, this potentially debilitating condition.

Filed under: Occupational exposure, Physical agents, Vibration Tagged: Feet, Vibration