Pneumoconiosis from agricultural dust exposure among young California farmworkers.

BACKGROUND: Agricultural workers are exposed to airborne pollutants, including organic and inorganic (mineral) dusts. OBJECTIVES: Lung autopsy specimens from consecutive coroner's cases of Hispanic males in Fresno County, California, (n = 112) were obtained to determine whether mineral dust exposure in agricultural work leads to pneumoconiosis. METHODS: The left lung was fixed by inflation. We evaluated airway and parenchymal pathology using standardized diagnostic criteria and semiquantitative grading schemata, including the grading of small airways for fibrosis and birefringent mineral dust particles. We analyzed lung dust burden on a subset of 37 lungs following bleach digestion, using scanning electron microscopy (SEM), X-ray spectrometry (XRS) and image analysis, and by X-ray diffraction for crystalline silica (CSi). Farmworkers comprised 51.5% and nonfarmworkers 48.5% of the samples. RESULTS: Proximal airways demonstrated little mineral dust accumulation, but membranous and respiratory bronchioles had wall thickening, remodeling, and inflammation associated with carbonaceous and mineral dust deposition. These changes were independently associated with agricultural work, cigarette smoking, and increased age. Mineral dust small airways disease, pneumoconiosis (macules and nodules), and pathologic changes consistent with chronic bronchitis, emphysema, and interstitial fibrosis predominated in farmworkers compared with nonfarmworkers. CSi, determined gravimetrically, and aluminum silicate particles, determined by SEM/XRS, were increased in the lungs of farmworkers compared with nonfarmworkers and were significantly (p < 0.05) associated with small airway disease and pneumoconiosis. CONCLUSION: Mineral dust exposure is associated with increased small airway disease and pneumoconiosis among California farmworkers; however, the clinical significance and natural history of these changes remains to be determined.

Acculturation and its association with health-risk behaviors in a rural Latina population.

PURPOSE: To evaluate the performance of proxy measures of acculturation and to examine the association between acculturation and selected health-risk behaviors. METHODS: Participants were 1062 Latina pregnant women who received prenatal care at clinics in San Joaquin County, California between 1999 and 2001. We used the receiver-operating characteristic (ROC) curve to characterize the sensitivity and specificity of proxy measures and regression analysis to examine health-risk behaviors. RESULTS: Using the ARSMA-II short version scale as a reference, age at immigration had the highest percentage of correctly classified individuals. Acculturation was significantly associated with a lifetime history of substance use, risky sexual behavior, low fruit consumption, and high fast-food meal consumption. CONCLUSIONS: Acculturation is an important predictor of health-risk behavior among women. Further research is needed to better understand the phenomenon and to avert associated adverse health consequences.

Genetic risk for alcoholism relates to level of response to alcohol in Asian-American men and women.

OBJECTIVE: Previous studies have shown that Asians who possess a variant aldehyde dehydrogenase allele (ALDH2*2) have lower rates of alcohol consumption and dependence. Research in Asian men has shown that those with ALDH2*2 have greater responses to alcohol than do those without this genetic variant. The present study was designed to determine whether similar levels of response to alcohol, using objective and subjective measurements, are seen in men and women with different ALDH2 genotypes. METHOD: Participants (N = 30) were 16 men and 14 women, of whom five each were heterozygous for ALDH2*2. They were evaluated in response to alcohol and placebo beverage challenges, dosed according to estimated body water. Objective and subjective responses were measured every 30 minutes from baseline to 150 minutes after ingestion. RESULTS: Men and women with ALDH2*1/*2 had greater pulse-rate increases, greater observed flushing responses and greater subjective feelings of being dizzy, drunk and high compared with ALDH2*1/*1 participants, despite having equivalent breath alcohol concentrations. ALDH2*1/*2 participants also reported being less likely to drive, following this level of intoxication, compared with ALDH2*1/*1 participants. Some gender differences were found in subjective, but not objective, responses to alcohol, with women reporting lower levels of being high, nauseated and uncomfortable and having a lower total subjective rating scale score. CONCLUSIONS: This study suggests that low risk for alcoholism based on possession of an ALDH2*2 allele relates to greater response to alcohol in both men and women.