Cumulative sensitization and disease in a beryllium oxide ceramics worker cohort.

OBJECTIVE: We followed a cohort of 136 beryllium oxide ceramics workers from 1992 to 2003, including those who left employment, for beryllium sensitization and chronic beryllium disease (CBD). METHODS: We invited the cohort's participation in current worker surveys in 1992, 1998, 2000, and 2002-2003, and in former worker surveys in 2000-2001 and 2003. We calculated 11-year cumulative incidences (after 1992 initial survey) of sensitization and CBD, both crude and corrected for interval censoring; and period prevalences (including 1992 findings), crude and corrected. RESULTS: In 1992, point prevalences were 6% sensitized and 4% CBD. We obtained follow-up on 83% of 128 not sensitized in 1992. Crude cumulative incidences for sensitization and CBD were 13% and 9%, respectively; corrected were 15% and 11%. Crude period prevalences for sensitization and CBD were 16% and 11%, respectively; corrected were 20% and 14%. Corrected period prevalences for pre-1992 machining work were 30% and 20%. CONCLUSIONS: With repeated testing over 11 years, total sensitization and CBD in this cohort were triple initial 1992 survey results.

Enhanced preventive programme at a beryllium oxide ceramics facility reduces beryllium sensitisation among new workers.

BACKGROUND: A 1998 survey at a beryllium oxide ceramics manufacturing facility found that 10% of workers hired in the previous 6 years had beryllium sensitisation as determined by the beryllium lymphocyte proliferation test (BeLPT). In response, the facility implemented an enhanced preventive programme to reduce sensitisation, including increased respiratory and dermal protection and particle migration control. AIM: To assess the programme's effectiveness in preventing sensitisation. METHODS: In 2000, the facility began testing newly hired workers for beryllium sensitisation with the BeLPT at time of hire and during employment. The sensitisation rate and prevalence for workers hired from 2000 to 2004 were compared with that for workers hired from 1993 to 1998, who were tested in the 1998 survey. Facility environmental conditions for both time periods were evaluated. RESULTS: Newly hired workers in both cohorts worked for a mean of 16 months. Of the 97 workers hired from 2000 to 2004 with at least one employment BeLPT result, four had abnormal results at time of hire and one became sensitised during employment. Of the 69 workers hired from 1993 to 1998 and tested in 1998, six were found to be sensitised. The sensitisation rate for the 2000-4 workers was 0.7-2.7/1000 person-months of employment, and that for the 1993-8 workers was 5.6/1000 person-months, at least 2.1 (95% confidence interval (CI) 0.6 to 8.4) and up to 8.2 (95% CI 1.2 to 188.8) times higher than that for the 2000-4 workers. The sensitisation prevalence for the 2000-4 workers was 1% and that for the 1993-8 workers was 8.7%, 8.4 (95% CI 1.04 to 68.49) times higher than that for the 2000-4 workers. Airborne beryllium levels for production workers for the two time periods were similar. CONCLUSIONS: A comprehensive preventive programme reduced beryllium sensitisation in new workers during the first years of employment, despite airborne beryllium levels for production workers that were similar to pre-programme levels.

An occupational health services initiative at a women's hospital in Kabul, Afghanistan.

This article describes the process of developing targeted occupational health services for the health care workers in a women's hospital in Kabul, Afghanistan, as part of a larger project to establish an obstetrics and gynecology residency training program at the facility. The goal was to create a feasible and sustainable program to: (1) address basic health care needs impacting the ability of these Afghan health care workers to optimize learning opportunities; (2) decrease absenteeism due to illness; (3) decrease the likelihood of infectious disease transmission among staff, from staff to patients, and from patients to staff; (4) foster belief that a healthy and safe working environment is a basic right; (5) begin to collect preliminary health status indicators on health care workers in this employee population; and (6) serve as an adaptable program to expand to other Afghan health care workers.