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

A nested case-control study was undertaken to identify the determinants of lung cancer mortality in a cohort of 8147 foundry men among whom an excess of lung cancer deaths was previously observed. The present study consisted of all lung cancer deaths (N = 220) that occurred within this cohort between 1950 and 1989. both living and dead controls, matched on race and attained age, were selected in the ratio of 10:1 (N = 2200) by means of the incidence density sampling procedure. All cases and two controls per case, randomly selected from each case's 10 controls, were included in a smoking history survey. Basic smoking history information was obtained for about 71% of these study subjects. For the purpose of this study, formaldehyde exposure levels were categorized as high, medium, low, and none. Airborne silica exposure was categorized only as high, medium, and low levels, because all foundry workers were known to be exposed to silica. Conditional logistic regression analyses indicated that cigarette smoking was a strong predictor of lung cancer mortality in this cohort. Neither exposure to formaldehyde nor silica exposure level, nor employment in any of the six major work areas within the foundry, showed an association with lung cancer.

Industrial workers on rotating shifts were evaluated for the effects of rotating shift work. Twenty-five (86%) of 29 workers in the study area who work 12-hour shifts in a scheduled 16-day rotation participated. The mean number of hours of sleep at home after working day shifts (5.6 hours) was less than after the first three night shifts (6.0, 6.4, and 6.6 hours, respectively). At work, the mean number of hours at reported peak alertness was greater during the night shift (6.1 hours) than the day shift (4.9 hours), but the perceived alertness levels were relatively lower on the night shift. Increased perceived difficulty working and decreased perceived productivity and safety were reported on the first night of the night shift. We demonstrate that workers on rotating shift work exhibit low alertness-related outcomes on both shifts. These workers have early shift work starting times that appear to disrupt sleep patterns on both day and night shifts. At this work site, a number of interventions to lessen the effects of rotating shift work are being evaluated.

We conducted a cross-sectional environmental and medical survey of 355 male sugarcane workers in Hawaii to determine whether exposure to biogenic silica fibers (BSF) affected their respiratory health. Exposures to BSF ranged from nondetectable to more than 0.700 BSF/mL and varied by job and department. Respiratory symptoms, chest radiograph findings, and pulmonary function were not associated with BSF exposures. Cigarette smoking was associated with respiratory symptoms and pulmonary obstruction. Fifteen workers had pleural thickening or pleural plaques and 3 of these workers were exposed to BSF for more than 10 years. BSF exposure does not appear to influence the respiratory health of sugarcane workers; however, further study is warranted.

Studies linking medical costs to behavioral risk and risk-lowering often use means for comparisons, although claims data are highly skewed. The result overestimates and obscures the case for work-site health promotion. In this study, high-cost analysis is illustrated in a sample of university employees. Five risk factors were examined: cholesterol, blood pressure, cardiovascular fitness, body fat, and smoking status. Screened employees who released their claims (n = 367) were examined against a random sample of employees (n = 587). Linear regression was used to determine the risk of having high claims costs within four gender-specific age groups. A formula was then applied to determine that more than 43% of the cost of medical claims was associated with elevated risk. High-cost analysis accounts for the skewness in claims data and presents a clear case for work-site health promotion.

The incidence of adenocarcinoma of the gastric cardia and esophagus is increasing steadily in the United States. Little is known about the etiology of these cancers. We used occupation and industry information on the death certificates from 24 states (1984 to 1989) to conduct a case-control analysis of gastric cardia and gastric cardia/lower esophagus cancer. Risks were also calculated for other gastric cancers combined. Controls were deaths from other causes except cancer and gastrointestinal disorders. Increased risks of gastric cardia and cardia/lower esophagus among white women were found for administrative jobs (cardia odds ratio (OR) = 3.9; 95% confidence interval (CI), 1.5-9.8) and health professionals (cardia OR = 1.8; 95% CI, 0.6-5.3). Occupations associated with a lower socioeconomic status showed no significant excess risks. A similar pattern in risks was seen for men.

The Agricultural Health Study is a collaborative effort involving the National Cancer Institute, the US Environmental Protection Agency, and the National Institute of Environmental Health Sciences. A goal of this investigation is to establish a large cohort of men and women that can be followed prospectively for 10 years or more to evaluate the role of agricultural exposures in the development of cancer, neurologic disease, reproductive difficulties, childhood developmental problems, and other chronic diseases. The study also will provide an opportunity to assess the role that diet, cooking methods, and other lifestyle factors have on the cause of cancer and other diseases. The cohort will be composed of approximately 112,000 adult study subjects, including 42,000 women, making this one of the largest cohorts of women ever assembled for an epidemiologic investigation of environmental and occupational exposures. Children of farm families also will be enrolled. The study will be conducted in Iowa and North Carolina. Enrollment will begin in December 1993 and continue for 3 years.

This cancer surveillance investigation uses death certificates from 24 states for the period 1984-1989 to identify multiple myeloma and occupation associations and to stimulate hypotheses. A case-control study of multiple myeloma was created from 3,159,417 certificates in which 12,148 male and female cases were frequency matched by age, race, and gender with five controls per case. We screened 231 industries and 509 occupations. Women demonstrated significant excess risk among managers and administrators, post-secondary teachers, elementary teachers, social workers, other sales workers, waitresses, and hospital maids. Men showed significant risks among computer system scientists, veterinarians, elementary teachers, authors, engineering technicians, general office supervisors, insurance adjusters, barbers, electronic repairers, supervisors of extracting industries, production supervisors, photoengravers, and grader/dozer operators. Men and women elementary school teachers demonstrated the most consistent, statistically significant increased risk of multiple myeloma.

We conducted a mortality odds ratio (MOR) analysis among women employed in the telephone industry, using death certificates from 24 reporting states for 1984 through 1989. Usual occupation and industry from the death certificates were coded using the 1980 Bureau of the Census occupational and industrial classification system. There were 2444 cancer deaths among women in the telephone industry (code 441). Among younger (age < 49) white women, significant excess risks were observed from cancers of the rectum (MOR = 3.3; 95% confidence interval [CI] = 1.2 to 8.7), connective tissue (MOR = 4.4; 95% CI = 2.2 to 8.8), breast (MOR = 1.6; 95% CI = 1.3 to 2.1), corpus uteri (MOR = 3.3; 95% CI = 1.5 to 7.5), ovary (MOR = 2.1; 95% CI = 1.3 to 3.5), and brain (MOR = 2.1; 95% CI = 1.2 to 3.7). Cancer of the connective tissue showed an almost sixfold risk (MOR = 5.5; 95% CI = 2.0 to 14.8) for the age group of 30 to 39 years. Excess risks of cancer of the connective tissue were observed among engineers and technicians, office workers, telephone operators, and mechanics and repairers (MOR = 8.5, 4.9, 1.7, and 4.4, respectively), suggesting a possible relationship with modern technological exposures in the telephone industry. Risks for cancers of the breast, corpus uteri, ovary, and brain were also elevated among these jobs. We did not have information on other risk factors for these cancer sites; therefore, socioeconomic status or lifestyle may explain these observed associations, particularly for the cancers of the reproductive system.(ABSTRACT TRUNCATED AT 250 WORDS)

With its long tradition of population registration, Denmark has outstanding possibilities for occupational health research. The municipality registers date back to 1924, the national death and cancer registers to 1943, and unique personal identification numbers were introduced in 1968. For studies on occupational cancer, the cancer register has been linked with census data, pension data, and personnel files from various companies. Suspected associations between occupational exposures and cancer have been studied. For example, women in dry cleaning exposed to tetrachloroethylene had an excess risk of liver cancer (observed = 14; expected = 5.2; standardized incidence ratio (SIR) = 2.7; 95% CI = 1.5-4.5), and oncology nurses handling antineoplastic drugs had an excess risk of leukemia (SIR = 10.7), based on two cases. The linked registers have also been used to systematically search for associations between occupations and cancer risks (eg, female hairdressers). Cancer patterns differ greatly across countries and across main occupational groups within countries. Future efforts should focus not only on traditional approaches to occupational cancer research but also incorporate indirect influences of the work environment (eg, smoking, parity, age at first birth) and labor market participation on cancer risk.

In 1990, the US construction industry employed 7.6 million workers, of whom 8% were women. Only one epidemiologic study for women employed in the construction industry was previously published. We analyzed usual occupation and industry codes on death certificates from 28 states between 1979 and 1990 to evaluate mortality patterns among both black and white female construction industry workers. Proportionate mortality for cancer and several other chronic diseases was significantly elevated among 2,273 white female and 197 black female construction workers. White women younger than age 65 at death had significantly elevated proportionate mortality ratios (PMRs) for all cancer, lung cancer, and traumatic fatalities. Black women younger than age 65 at death had a significantly elevated PMR for traumatic fatalities. Elevated mortality for specific cancer sites and other diseases was observed for white and black women employed in construction trades. These results suggest that more detailed investigations that include women and other minorities should be undertaken.