Agricultural dust exposure and respiratory symptoms among California farm operators

OBJECTIVE: To study whether dust exposure in California agriculture is a risk factor for respiratory symptoms. METHODS: A population-based survey of 1947 California farmers collected respiratory symptoms, occupational and personal exposures. Associations between dust and respiratory symptoms were assessed by logistic regression models. RESULTS: The prevalence of persistent wheeze was 8.6%, chronic bronchitis 3.8%, chronic cough 4.2%, and asthma 7.8%. Persistent wheeze was independently associated with dust in a dose-response fashion odds ratio, 1.2 (95% confidence interval[CI]=0.8-2.0) and 1.8 (95% CI=1.1-3.2) for low and high time in dust. A borderline significant association between chronic bronchitis and dust exposure was found. Asthma was associated with keeping livestock, but not with dust exposure. CONCLUSIONS: Occupational dust exposure among California farmers, only one third of whom tended animals, was independently associated with chronic respiratory symptoms.     

Occupational mouse allergen exposure among non-mouse handlers

This study assessed mouse allergen exposure across a range of jobs, including non-mouse handling jobs, at a mouse facility. Baseline data from 220 new employees enrolled in the Jackson Laboratory (JAXCohort) were analyzed. The baseline assessment included a questionnaire, allergy skin testing, and spirometry. Exposure assessments consisted of collection of two full-shift breathing zone air samples during a 1-week period. Air samples were analyzed for mouse allergen content, and the mean concentration of the two shifts represented mouse allergen exposure for that employee. The mean age of the 220 participants was 33 years. Ten percent reported current asthma and 56% were atopic. Thirty-eight percent were animal caretakers, 20% scientists, 20% administrative/support personnel, 10% materials/supplies handlers, and 9% laboratory technicians. Sixty percent of the population handled mice. Eighty-two percent of study participants had detectable breathing zone mouse allergen, and breathing zone mouse allergen concentrations were 1.02 ng/m3 (0.13-6.91) (median [interquartile range (IQR)]. Although mouse handlers had significantly higher concentrations of breathing zone mouse allergen than non-handlers (median [IQR]: 4.13 ng/m3 [0.69-12.12] and 0.21 ng/m3 [below detection (BD)-0.63], respectively; p < 0.001), 66% of non-handlers had detectable breathing zone mouse allergen. Mouse allergen concentrations among administrative/support personnel and materials/supplies handlers, jobs that generally do not entail handling mice, were median [IQR]: 0.23 ng/m3 [BD-0.59] and 0.63 ng/m3 [BD-18.91], respectively. Seventy-one percent of administrative/support personnel, and 68% of materials/supplies handlers had detectable breathing zone mouse allergen. As many as half of non-mouse handlers may have levels of exposure that are similar to levels observed among mouse handlers.     

Neuropsychological symptoms and occupational exposure to anaesthetics.

OBJECTIVE--To analyse the relation between symptoms regularly reported by hospital personnel and exposure to anaesthetics. SETTING--Personnel of 18 hospitals in Paris from 1987 to 1989. DESIGN--An exposed group that included all operating theatre members except for doctors, and which was divided into three subgroups depending on the degree of exposure--exposure was measured by the frequency of the use of the scavenging system--and a control group that included other hospital personnel matched by hospital, sex, occupation, age, and duration of service. SUBJECTS--557 exposed workers and 566 unexposed workers. MAIN OUTCOME MEASURES--The groups were compared according to the crude rates of regular symptoms. Adjusted odds ratios were calculated to estimate the risks associated with exposure to anaesthetic gas. Liver transaminase activities (alanine aminotransferase, aspartate aminotransferase (s-ASAT, and gamma-glutamyl transpeptidase) were measured and compared between groups of exposure. RESULTS--After controlling for working conditions and matching factors, neuropsychological symptoms and tiredness were reported more by workers in less often scavenged theatres than by controls. No difference was found between workers of the well scavenged theatres and controls. Among the exposed workers, the members of paediatric surgical staffs reported a higher rate of neurological complaints (tingling, numbness, cramps) and tiredness than the members of the other surgical staffs. They had a high value of s-ASAT more frequently than the other exposed workers. CONCLUSION--These results strengthen the hypothesis of a causal relation between exposure to anaesthetics and neuropsychological symptoms, and show a dose-response effect. They suggest that the use of ventilating systems in operating rooms is an effective means of prevention.     

Neuropsychological symptoms and occupational exposure to anaesthetics.

OBJECTIVE--To analyse the relation between symptoms regularly reported by hospital personnel and exposure to anaesthetics. SETTING--Personnel of 18 hospitals in Paris from 1987 to 1989. DESIGN--An exposed group that included all operating theatre members except for doctors, and which was divided into three subgroups depending on the degree of exposure--exposure was measured by the frequency of the use of the scavenging system--and a control group that included other hospital personnel matched by hospital, sex, occupation, age, and duration of service. SUBJECTS--557 exposed workers and 566 unexposed workers. MAIN OUTCOME MEASURES--The groups were compared according to the crude rates of regular symptoms. Adjusted odds ratios were calculated to estimate the risks associated with exposure to anaesthetic gas. Liver transaminase activities (alanine aminotransferase, aspartate aminotransferase (s-ASAT, and gamma-glutamyl transpeptidase) were measured and compared between groups of exposure. RESULTS--After controlling for working conditions and matching factors, neuropsychological symptoms and tiredness were reported more by workers in less often scavenged theatres than by controls. No difference was found between workers of the well scavenged theatres and controls. Among the exposed workers, the members of paediatric surgical staffs reported a higher rate of neurological complaints (tingling, numbness, cramps) and tiredness than the members of the other surgical staffs. They had a high value of s-ASAT more frequently than the other exposed workers. CONCLUSION--These results strengthen the hypothesis of a causal relation between exposure to anaesthetics and neuropsychological symptoms, and show a dose-response effect. They suggest that the use of ventilating systems in operating rooms is an effective means of prevention.     

长期低剂量职业照射对放射工作者健康影响

目的了解长期低剂量职业照射对放射工作人员健康影响。方法采用流行病学横断面调查方法, 调查分析2013年山东省临沂市6所三级医院的624名放射工作者健康状况。结果放射工作人员人均年剂量<5 mSv者占97.28%;淋巴细胞微核率为57.85%(361/624), 染色体畸变率为53.21%(332/624);血常规指标受暴露年限、年均剂量及累计剂量的影响, 差异均有统计学意义(均P<0.05);甲状腺激素水平、染色体畸变率、淋巴细胞微核率及眼晶状体浑浊率与暴露年限及累计剂量有关, 差异均有统计学意义(均P<0.05)。结论长期低剂量职业辐射可使机体产生一定的辐射损伤, 应加强放射工作人员防护。     

手术医生术中血源性职业暴露调查

目的了解某院手术医生术中发生血源性职业暴露情况,以制定有效的防护措施。方法对该院2011年6月—2013年6月发生血源性职业暴露手术医生的监测资料结合问卷调查,进行统计分析。结果共有49名手术医生发生血源性职业暴露(115例次),其中普通外科医生42例次(36.52%),骨科医生36例次(31.30%),妇产科医生31例次(26.96%),泌尿外科医生6例次(5.22%)。暴露种类主要是锐器伤,占61.74%(71例次),其次为血液及体液的喷溅,占38.26%(44例次);暴露部位前2位是手(49.57%)和面部(17.39%)。暴露发生后的紧急局部处理率为88.70%,上报率为55.65%。经追踪随访,发生职业暴露的手术医生均未因此感染。结论手术医生术中面临职业暴露的严重威胁。该院需加强职业防护培训,提高医务人员职业防护意识和能力,改进暴露发生后的处置措施。     

Atopic symptoms among California veterinarians

BACKGROUND: The prevalence of allergic symptoms among veterinarians has not been studied adequately. METHODS: A questionnaire was sent to 2,000 California veterinarians; the return rate was 73% (N=1416). RESULTS: A history of either asthma, allergic rhinitis (AR), or atopic dermatitis (AD) was reported by 66% of respondents. AR was reported by 62%, asthma by 16%, and AD by 11%. Forty percent of the veterinarians reported animal related respiratory and/or skin symptoms. The most commonly reported causes of symptoms were cats and dogs. In multivariate logistic analysis, the significant risk factors for having adult asthma were the history of AR with the history of AD (OR 13.9), AR alone (OR 6.3), and asthma in childhood (OR 6.4). CONCLUSIONS: The prevalence of asthma and other atopic symptoms was high in the studied population. Most veterinarians with respiratory or skin symptoms reported the symptoms as being related to specific animal contact.     

医务人员HIV职业暴露分析

目的了解某传染病医院医务人员人类免疫缺陷病毒(HIV)职业暴露情况。方法收集2011年1月—2014年12月该传染病医院发生HIV职业暴露的医务人员信息,分析医务人员HIV职业暴露环节、方式等情况。结果 4年共发生49例HIV职业暴露,其中护士37例,医生7例,医技人员4例,保洁员1例;职业暴露人员中工龄≤5年者占75.51%。暴露方式以手术中器械、注射器针头、输液器针头等造成的锐器伤为主(36例,占73.47%);暴露环节以注射穿刺及有创术中操作为主(28例,57.14%);职业暴露中手术室发生22例(44.90%)、病房17例(34.69%)、检验科4例、产房3例、急诊2例、消毒供应中心1例。发生职业暴露后无1例感染HIV病毒。结论护士为HIV职业暴露的高发群体,针刺伤为暴露的主要方式。     

Eye and airway symptoms in low occupational exposure to toluene diisocyanate

OBJECTIVES: Exposure to diisocyanates is a well known occupational hazard. The objective of this study was to determine the possibility of an association between low exposure to toluene diisocyanate (TDI) (airborne isocyanates and biomarkers of isocyanates in plasma and urine) and symptoms of the eyes and upper and lower airways. METHODS: Altogether 136 workers occupationally exposed to TDI and 118 unexposed employees were studied. A physician compiled thorough medical and occupational histories and registered symptoms, total and work-related, of the eyes, nose, and lower airways. The exposure was assessed with personal air measurements and with biomarkers of exposure in plasma and urine. The average exposure in the ambient air at the workplace of the exposed participants was below 1 ppb. RESULTS: Compared with the unexposed group, the exposed workers reported more total symptoms of the eyes and lower airways, as well as nose bleeding. A similar pattern, with even higher odds ratios, was observed for work-related symptoms. However, only eye symptoms proved to be significantly associated with the exposure, notably with all of the exposure measures. The risk was more pronounced for exposure to 2,4-TDI than for exposure to 2,6-TDI. CONCLUSIONS: Even very low exposure to TDI is related to negative health effects on exposed workers. Clear dose-response relationships were observed between three different measures of exposure and symptoms of the eyes.     

Respiratory symptoms and intensity of occupational dust exposure

Objectives: Occupational exposure to dusts may result in chronic respiratory symptoms. Methods: To investigate the utility of obtaining a history of occupational exposure to dust in US veterans, a respiratory health survey was conducted between 1988 and 1992 in a community-based cohort of US veterans in southeastern Massachusetts that were eligible for Veterans Affairs (VA) healthcare benefits but were not regular users. A mail questionnaire was used to obtain a history of cough, phlegm, and wheeze, work in a dusty job, and duration, type, and intensity of dust exposure. Information on cigarette use and other possible confounders was obtained. Results: In 2,617 white men, after the data had been adjusted for cigarette smoking, age, distance to the nearest major roadway, and chronic respiratory disease, the relative odds of chronic cough, chronic phlegm, and persistent wheeze attributable to occupational dust exposure was increased twofold. Risk also increased, based on exposure intensity. For heavy dust exposure the OR was 1.98 (95% CI 1.39–2.81) for chronic cough, 2.82 (95% CI 2.03–3.93) for chronic phlegm, and 2.70 (95% CI 1.95–3.75) for persistent wheeze. Conclusions: After active cigarette smoking and other possible confounders had been considered, it was found that dust exposure was related to respiratory symptoms in US veterans and that the greatest risk was attributable to heavy intensity exposure.Presented in abstract form at the 1994 annual meeting of the American Thoracic Society.     

Health symptoms related to pesticide exposure and agricultural tasks among rice farmers from northern Thailand

Purpose

The objective of this cross-sectional study was to investigate health symptoms related to occupational pesticide exposure and agricultural tasks in rice farmers.

Methods

Data on demographic variables and health symptoms associated with pesticide exposure were collected from 182 rice farmers (exposed subjects) and 122 non-farmers (controlled group) using interviews and measuring whole blood acetylcholinesterase (AChE) activity during August and October 2012.

Results

Rice farmers had a significantly lower median AChE activity than the controls (9,594 vs. 10,530 U/L, respectively) and a significantly higher prevalence of difficulty in breathing and chest pain [odds ratio (OR) 2.8, P < 0.01 and OR 2.5, P < 0.05, respectively]. The prevalence of dry throat and cramp was associated with those farmers who sprayed and mixed pesticides (OR 2.5 and 2.6 for dry throat, OR 2.5 and 2.9 for cramp, respectively; P < 0.01). The prevalence of numbness and diarrhea was associated with those farmers who scattered seed (OR 2.2, P < 0.01 and OR 3.6, P < 0.05, respectively). The prevalence of numbness and increasing anxiety was also associated with those farmers who harvested crops (OR 3.6, P < 0.01 and OR 3.0, P < 0.05, respectively).

Conclusions

Our findings suggest that occupational pesticide exposure and agricultural tasks in the paddy field may be associated with the increasing prevalence of respiratory tract and muscle symptoms. This possibility warrants further investigation in more detail.     

Health symptoms and exposure to organophosphate pesticides in farmworkers

BACKGROUND: Few studies have examined the relationship between reported health symptoms and exposure to organophosphate (OP) pesticides. METHODS: Fisher's exact test was used to assess the relationship between self-reported health symptoms and indicators of exposure to OP pesticides in 211 farmworkers in Eastern Washington. RESULTS: The health symptoms most commonly reported included headaches (50%), burning eyes (39%), pain in muscles, joints, or bones (35%), a rash or itchy skin (25%), and blurred vision (23%). Exposure to pesticides was prevalent. The proportion of detectable samples of various pesticide residues in house and vehicle dust was weakly associated with reporting certain health symptoms, particularly burning eyes and shortness of breath. No significant associations were found between reporting health symptoms and the proportion of detectable urinary pesticide metabolites. CONCLUSIONS: Certain self-reported health symptoms in farmworkers may be associated with indicators of exposure to pesticides. Longitudinal studies with more precise health symptom data are needed to explore this relationship further.     

Reproductive effects of occupational DDT exposure among male malaria control workers

To assess potential effects of human DDT [1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane] exposure, we evaluated the reproductive history of 2,033 workers in the antimalaria campaign of Mexico. Data on occupational exposure to DDT and reproductive outcomes were gathered through a questionnaire, and workers provided information about 9,187 pregnancies. We estimated paternal exposure to DDT before each pregnancy using three approaches: a) a dichotomous indicator for pregnancies before and after exposure began, b) a qualitative index of four exposure categories, and c) an estimation of the DDT metabolite DDE [1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] accumulated in fat. To assess associations, we used logistic regression models that accounted for correlated observations and adjusted for parents' age at each child's birth, exposure to other pesticides, exposure to chemical substances in other employment, smoking, and alcohol consumption. The odds ratio for birth defects comparing pregnancies after and before the first exposure was 3.77 [95% confidence interval (95% CI), 1.19-9.52]. Compared with the lowest quartile of estimated DDE in fat, the ORs were 2.48 (95% CI, 0.75-8.11), 4.15 (95% CI, 1.38-12.46), and 3.76 (95% CI, 1.23-11.44) for quartiles 2, 3, and 4, equivalent to p,p -DDE in fat of 50, 82, and 298 microg/g fat, respectively. No significant association was found for spontaneous abortion or sex ratio. We found an increased risk of birth defects associated with high occupational exposure to DDT in this group of workers. The significance of this association at lower exposure levels found in the general population remains uncertain.     

Health effects from unintentional occupational exposure to opioids among law enforcement officers: Two case investigations

Recent increases in the rate of drug overdose-related deaths, the emergence of potent opioids such as carfentanil, and media reports of incidents have raised concerns about the potential for work-related exposure to a variety of illicit drugs among law enforcement officers (LEOs), other emergency responders, and other workers in the United States. To characterize the risk associated with unintentional occupational exposure to drugs, we retrospectively investigated two incidents that occurred in 2017 and 2018 where LEOs were exposed to opioid and stimulant drugs and experienced health effects. We interviewed five affected LEOs and others. We reviewed records, including emergency department documentation, incident reports, forensic laboratory results, and when available, body camera footage. Multiple drug types, including opioids and nonopioids, were present at each incident. Potential routes of exposure varied among LEOs and were difficult to characterize with certainty. Health effects were not consistent with severe, life-threatening opioid toxicity, but temporarily precluded affected LEOs from performing their essential job duties. While health risks from occupational exposure to drugs during law enforcement activities cannot currently be fully characterized with certainty, steps to prevent such exposures should be implemented now. The creation and implementation of appropriate controls plus education and training are both important to protecting first responders from these hazardous agents. To more fully characterize potential exposures, timely prospective toxicological evaluation of affected responders is recommended.     

Past occupational exposure to asbestos among men in France

OBJECTIVES: This study aimed at reconstructing changes in the frequency and levels of occupational asbestos exposure in France over the past century. METHODS: Work histories were collected during 11 population-based case-referent studies recently carried out in France, and an asbestos-specific job-exposure matrix including 10 625 jobs was used to estimate indices of past occupational asbestos exposure. The results were estimated from a sample of 4287 subjects, bootstrapped 200 times. RESULTS: The distribution of socioeconomic categories within the sample was compared with that of the general population in 1954, 1962, 1968, 1975, and 1982. The proportion of blue-collar workers was similar. The highest proportion of exposed subjects was found between 1950 and 1980. Around 10% of each 10-year age class was exposed to asbestos. For those born in 1930-1939, 15.2% was exposed between the ages of 20 and 29 years. For each age class born in 190-1939, the proportion exposed at least once by 60 years of age ranged from 18.2% to 24.5 % and, of those exposed, the cumulative duration of exposure ranged from 11.3 to 15.4 years by the age of 60 years. A population exposure index showed that the heaviest exposure occurred between 1960 and 1970 and that the age classes born between 1920 and 1929 were the most heavily exposed. Time trends showed that the mean value of this index for the men aged 20-59 years reached a peak in the 1960s and then decreased. CONCLUSIONS: This study presents data of reasonable validity about occupational asbestos exposure in France and its trends over the past century; the data are being used to forecast the development of male mortality from mesothelioma in France.     

Health effects of solvent exposure among dockyard painters: mortality and neuropsychological symptoms

OBJECTIVES: To study mortality and prevalence of neuropsychological symptoms among a cohort of painters known to have been heavily exposed to organic solvents. METHODS: A mortality study of 1292 male painters who had worked in a dockyard in Scotland for > or = 1 year between 1950 and 1992 comprised a nested cross sectional study of 953 surviving painters from the cohort and 953 male non-painters randomly selected from the local population and a case-control study of those with high symptom scores. Mortality, symptoms, and risks associated with painting, adjusting for age, education, smoking, alcohol, and personality were measured. RESULTS: The proportional mortality ratio for all cancers was not increased significantly (110 (95% confidence interval (95% CI) 84 to 143), except for a possible excess of deaths from ischaemic heart disease (132, 105 to 164). Standardised mortality ratios were not significantly increased. Among the 260 surviving painters and 539 community controls who responded to the questionnaire there was a significant excess of symptoms among painters; adjusted relative risk (RR) increased significantly with increasing symptom score. These RRs suggested an exposure-response relation; for a high score (12-22) for all symptoms RR was 2.27 (1.20 to 4.30) for 1-4 years of exposure, 2.42 (1.18 to 4.95) for 5-9 years, 2.89 (1.42 to 5.88) for 10-14 years, and 3.41 (1.82 to 6.36) for 15-41 years, compared with controls. In multivariate analyses, painting exposure, and aging were associated with high symptom scores and there was again an increased risk relative to time worked as a painter. CONCLUSION: This study supports the hypothesis that heavy and prolonged exposure to paint solvents leads to neuropsychological ill health.