Journal of occupational medicine. : official publication of the Industrial Medical Association最新文献

Using the Cancer-Environment Registry of Sweden, which links census information (1960) with cancer incidence data (1961 to 1979), we conducted a systematic, population-based assessment of colon cancer incidence among cohorts defined by industry and occupation for all employed persons in Sweden. Small but statistically significant excesses of colon cancer were observed among white-collar occupations, including administrators, professionals, and clerical and sales workers, whereas a reduction in incidence was found among workers in agricultural and related jobs, such as farmers, fishermen, and hunters. Analysis by subsite within the colon revealed little difference in results. The observed risk patterns are consistent with previous reports on colon cancer risk and occupational physical activity levels, ie, elevated risk among sedentary white-collar workers and reduced risk among agricultural workers. Few craftsman and production processing jobs were linked to colon cancer, although statistically significant excesses were observed among shoe and leather workers, metal smiths, and foundry workers in the metal manufacturing industry. The findings indicate that occupation in general is likely to play a relatively small role in colon cancer etiology, with perhaps its major contribution an indirect one via physical activity.

In 1985, 864 patternmakers participated in a voluntary union-sponsored health screening program that included an evaluation of respiratory symtomatology and dysfunction. Pulmonary function test (PFT) measurements included a minimum of three readings of forced expiratory volume at 1 second (FEV1). A "reliable" test was one where the two best volumes were within 5%. Medical history and respiratory symptoms were assessed on a standardized questionnaire. Fifty-nine of the 864 tested were unable to reproduce their best FEV1 result. Although these 59 case subjects had significantly lower PFT results than the other 805 tested (P < .01), the mean values for FEV1 and forced vital capacity for the case subjects were greater than 90% of predicted values. The case subjects were more likely to experience wheezing and dyspnea and have a history of emphysema than the rest of the group screened (n = 805). They also had a higher mean age and more years in the trade. Twenty-one of the 59 case subjects were among the 602 who participated in a similar health screening program offered 3 years later. To minimize the effects of age and smoking status on PFT performance, these 21 case subjects were each matched on age and smoking with two comparison subjects who had reliable tests. At follow-up, the 21 case subjects and 41 comparison subjects both had a decline in ventilatory capacity that was significantly greater than would be expected by advancing age alone. A number of methodological issues that impact the interpretation of these data are discussed.

This study updates an earlier investigation that found a sixfold excess incidence of colorectal cancer among polypropylene workers for the period January 1960 to September 1985. The study cohort comprised 412 male workers with at least 6 months employment and 10 years latency. For the extended follow-up period (October 1985 to May 1992), the standardized incidence ratio (SIR) based on state comparison rates was slightly elevated and not statistically significant (SIR = 1.5, 95% confidence interval [CI] = 0.5 to 3.5). A 2.3-fold excess was observed among process workers (95% CI = 0.3 to 8.2), but this was based on only two cases. Risk among process/mechanical workers was greater for short-term workers (< 10 years, SIR = 3.2, 95% CI = 0.7 to 9.2) compared with longer-term workers (> or = 10 years, SIR = 0.7, 95% CI = 0.02 to 4.0). Overall, the update findings do not suggest an occupationally related risk. Possible influences of company-sponsored colorectal cancer screening, the polyolefin unit shutdown, and other factors are discussed.

The characteristics of companies that either accepted or declined participation in a 5-year randomized trial of a multirisk factor health promotion intervention were compared to investigate potential limitations on the generalizability of research findings. A representative sample of 151 manufacturing work sites in the northeast was recruited to participate. Sixty-four of the companies were determined to be eligible and 10 others, which refused to have an administrator interviewed, were presumed to be eligible. Of this group, 27 companies agreed to participate. Work force demographics, shift structure, and prior history of health promotion offerings were not significantly different in the two groups. However, participating companies employed fewer workers and had a more favorable financial outlook than did companies that declined to participate. Implications of these findings for research on work site health promotion are discussed.

In industrialized countries, the proportion of shift workers is currently estimated to be approximately 20% of the working population. The problem of sleep may be one of the major consequences of shift work. To study the relation between shift work and sleep quality in a female population, 469 nurses at 6 public hospitals in various French regions were interviewed about their working conditions and health in 1980. They were followed up and interviewed again in 1985 and 1990. First, the results showed that nurses had more sleep disorders on alternating schedule including night work at the beginning of the study in 1980, and there was no more association between shift work and sleep quality after 1980. Second, sleep disorders predicted transfer from shift work to day work between 1980 and 1985 and sleep disorders decreased strongly after such transfer. The absence of relation between time schedules and sleep in 1985 and 1990 can be explained by the fact that the follow-up sample was selected, ie, the nurses who continued to work on shift work were able to adapt to it.

Through a leak in the steam heating system, the anticorrosive agent 2-diethylaminoethanol was released into the air of a large office building. Irritative symptoms were experienced by most of the 2500 employees, and 14 workers developed asthma within 3 months of exposure. This study was undertaken to review clinical characteristics of these asthmatics. Environmental exposure monitoring data and medical records were reviewed. Seven of 14 cases were defined as "confirmed" and 7 of 14 as "suspect," using the National Institute for Occupational Safety and Health surveillance case definition of occupational asthma. Spirometry was positive in 4 of 14 of the cases and peak flow testing in 10 of 14. Three cases were diagnosed on the basis of work-related symptoms and physical examination alone. The study suggests that acute exposure to the irritating steam additive 2-diethylaminoethanol was a contributing factor in the development of clinical asthma in this population.

We present the case of a worker who was accidentally exposed (inhalational and dermal routes) to the chemicals dimethylacetamide and ethylenediamine for 90 minutes in a confined space. Clinical effects included delirium, hallucinations, skin burns, cellulitis, bilateral conjunctivitis, hepatitis, secondary coagulopathy, rhabdomyolysis, and a grade 2 esophagitis. Urinary monomethylacetamide levels 6 days after the exposure were 61 ppm.