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1.
J Occup Environ Med ; 66(5): e145-e152, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38349323

ABSTRACT

OBJECTIVE: This study explores occupational health burdens faced by domestic and sexual violence advocates, many of which intensified during the COVID-19 pandemic. It identifies key stressors and offers advocate-driven recommendations to improve their wellbeing, addressing the lack of system-level interventions in the occupational health literature. METHODS: Semistructured interviews were conducted with 22 advocacy professionals. Thematic content analysis guided transcript coding, and researchers shared initial results with participants in two member checking sessions to validate the preliminary findings. RESULTS: Advocates experienced logistical, emotional, and systemic stressors, including loss of peer support and unempathetic workplace cultures. Recommendations prioritize advocate wellbeing and call for systemic changes. CONCLUSIONS: Advocates' occupational stressors highlight the need for system-level solutions to enhance their occupational wellbeing, particularly during large-scale emergencies. Collaborative efforts among employers, funders, and staff are essential to address system deficiencies.


Subject(s)
COVID-19 , Gender-Based Violence , Occupational Health , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Female , Male , Gender-Based Violence/psychology , SARS-CoV-2 , Adult , Interviews as Topic , Middle Aged , Occupational Stress/epidemiology , Occupational Stress/psychology , Pandemics , Qualitative Research , Workplace/psychology
2.
Ann Work Expo Health ; 66(9): 1122-1135, 2022 11 15.
Article in English | MEDLINE | ID: mdl-36000755

ABSTRACT

BACKGROUND: While there is evidence that workers in nonstandard employment arrangements are disproportionately exposed to recognized occupational hazards, existing studies have not comprehensively examined associations between employment precarity and exposure to occupational hazards for these workers in the USA. The aim of this study was to examine relationships between employment precarity and occupational hazards in two contiguous high socio-economic hardship neighborhoods in Chicago. METHODS: Using a community-based participatory research approach, community researchers administered a community-developed survey to 489 residents of Greater Lawndale who reported current or recent employment in a job that met at least one characteristic of precarious employment (e.g. unpredictable schedule, insecure work, no living wage/benefits). Employment precarity was calculated using a modified version of the Employment Precarity Index (EPI) developed by the Poverty and Employment Precarity in Southern Ontario group. We modeled the association between employment precarity and occupational exposures using logistic regression models. RESULTS: We identified a high prevalence of precarious employment in this sample, as well as a high prevalence of self-reported exposure to recognized occupational hazards. Increases in relative employment precarity were significantly associated with self-reported exposure to chemical and biological hazards, physical hazards, and slip, trip, strike, fall, trap or crush hazards at work. CONCLUSIONS: Results highlight the importance of using community research approaches and robust measures of employment characteristics, such as the EPI, to evaluate associations between employment precarity and hazardous exposures. These results suggest that variability in employment situations and resultant relative employment precarity are important predictors of exposure to recognized occupational hazards. Findings also suggest that health inequities observed among precariously employed workers may be partly explained by increased risk for exposure to occupational hazards, which has implications for community health and should be investigated in future longitudinal research.


Subject(s)
Occupational Exposure , Humans , Occupational Exposure/adverse effects , Employment , Surveys and Questionnaires , Self Report
3.
Article in English | MEDLINE | ID: mdl-34769621

ABSTRACT

Work is a key social determinant of health. Community health and well-being may be impacted in neighborhoods with high proportions of people engaged in precarious work situations compounded by health inequities produced by other social determinants associated with their residential geography. However, little is known about how community residents experience work at the neighborhood level nor how work impacts health at the community-level, particularly in communities with a high proportion of residents engaged in precarious work. We sought to understand, through participatory research strategies, how work is experienced at the community level and to identify community interventions to establish a culture of healthy work. As part of a mixed-methods community health assessment, community researchers conducted focus groups with residents in two high social and economic hardship neighborhoods on Chicago's southwest side. Community and academic researchers engaged in participatory data analysis and developed and implemented member-checking modules to engage residents in the data interpretation process. Twelve focus group discussions (77 community resident participants) were completed. Three major themes emerged: systematic marginalization from the pathways to healthy work situations; contextual and structural hostility to sustain healthy work; and violations in the rights, agency, and autonomy of resident workers. Findings were triangulated with findings from the concept-mapping research component of the project to inform the development of a community health survey focused on work characteristics and experiences. Listening to residents in communities with a high proportion of residents engaging in precarious work allows for the identification of nuanced community-informed intervention points to begin to build a culture of healthy work.


Subject(s)
Poverty , Residence Characteristics , Community-Based Participatory Research , Focus Groups , Humans , Perception , Public Health
4.
PLoS One ; 16(8): e0254762, 2021.
Article in English | MEDLINE | ID: mdl-34347815

ABSTRACT

Environmental noise may affect hearing and a variety of non-auditory disease processes. There is some evidence that, like other environmental hazards, noise may be differentially distributed across communities based on socioeconomic status. We aimed to a) predict daytime noise pollution levels and b) assess disparities in daytime noise exposure in Chicago, Illinois. We measured 5-minute daytime noise levels (Leq, 5-min) at 75 randomly selected sites in Chicago in March, 2019. Geographically-based variables thought to be associated with noise were obtained, and used to fit a noise land-use regression model to estimate the daytime environmental noise level at the centroid of the census blocks. Demographic and socioeconomic data were obtained from the City of Chicago for the 77 community areas, and associations with daytime noise levels were assessed using spatial autoregressive models. Mean sampled noise level (Leq, 5-min) was 60.6 dBA. The adjusted R2 and root mean square error of the noise land use regression model and the validation model were 0.60 and 4.67 dBA and 0.51 and 5.90 dBA, respectively. Nearly 75% of city blocks and 85% of city communities have predicted daytime noise level higher than 55 dBA. Of the socioeconomic variables explored, only community per capita income was associated with mean community predicted noise levels, and was highest for communities with incomes in the 2nd quartile. Both the noise measurements and land-use regression modeling demonstrate that Chicago has levels of environmental noise likely contributing to the total burden of environmental stressors. Noise is not uniformly distributed across Chicago; it is associated with proximity to roads and public transportation, and is higher among communities with mid-to-low incomes per capita, which highlights how socially and economically disadvantaged communities may be disproportionately impacted by this environmental exposure.


Subject(s)
Noise , Residence Characteristics , Social Class , Chicago , Geography , Humans , Regression Analysis
5.
Health Promot Int ; 36(4): 1095-1104, 2021 Aug 30.
Article in English | MEDLINE | ID: mdl-33351056

ABSTRACT

Precarious work has recognized adverse impacts on the health of workers; however, there are few policy, systems and environmental (PSE) change public health interventions that target the causes and consequences of precarious work. To build the capacity of health organizations to develop and implement such interventions, researchers engaged representatives from health organizations in a six-session learning process, entitled the healthy work collaborative. Representatives of labor organizations were engaged as technical assistance (TA) providers, which involved sharing content and skill knowledge with health participants. Semi-structured interviews were conducted with providers and participants to examine perceptions of the role of TA; providers' motivations for providing TA; and providers' and participants' perceptions of the impact of TA on learning and preparing for subsequent intervention. Results suggest that the provider-participant engagement evolved from one-way knowledge translation to a robust, two-way knowledge exchange with potential for collaborative intervention development and implementation. These results highlight the ways in which this provider-participant model facilitated engagement between representatives from sectors that had not previously worked together and suggests that such a model may be effective in catalyzing multi-level, multi-sectoral PSE change to address precarious work.


Subject(s)
Organizations , Public Health , Humans
6.
J Chiropr Educ ; 35(1): 116-123, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33271599

ABSTRACT

OBJECTIVE: This study uses a pre- and post-training program evaluation of chiropractic interns to (1) describe changes in their frequency of occupational history taking before and after a 1-hour training and (2) to document the attitudes and beliefs regarding occupational health and history taking. METHODS: All chiropractic interns at 1 clinic location completed questionnaires assessing their attitudes and perceptions regarding documenting the occupational history of their patients each trimester they were enrolled in the study. Each intern enrolled in the study for 2 or more trimesters participated in a 1-hour-long training session on taking an occupational history. The supervising clinician independently evaluated charting behaviors of interns for the duration of the study. RESULTS: The supervising clinician assessed 20 interns' level of documenting occupational history for 202 new patient or reexamination visits. A majority of interns (85% at baseline) were interested in occupational health, and 80% believed that occupational history taking was "very important." Intern charting behaviors increased after training related to documentation of past occupation (62.9% from 32.4%) and relating the chief complaint to work (59.7% from 30.0%). Detailed occupational history taking remained low throughout the study but demonstrated a doubling in documentation after training (16.1% from 8.6%). CONCLUSION: Chiropractic interns and clinicians should be adequately trained in occupational health history documentation practices as they are likely to care for work-related injuries. Short training modules appear to be effective in demonstrating small changes in documentation related to occupational history taking.

7.
J Occup Environ Med ; 62(2): 163-170, 2020 02.
Article in English | MEDLINE | ID: mdl-31834137

ABSTRACT

OBJECTIVE: Individuals in transitional housing programs often have a goal of reaching stable employment, but the unique needs and barriers for achieving this warrants further study. METHODS: A structured interview guide was administered orally and descriptive data analysis was done for this exploratory mixed-methods study. RESULTS: Commonly reported reemployment challenges included legal barriers and unmet transportation, housing, and financial needs. More than two-thirds of residents reported no place to live after the program regardless of if they had previous precarious housing. Emerging themes included challenges regarding sufficient time for the transition to being employed, fear of relapse, and lack of long-term goals and planning. CONCLUSIONS: Findings suggest that residential rehabilitation programs are an important resource. While these programs tend to focus on reemployment, their services could be enhanced by assessing individual needs and allowing for variation in reemployment preparation.


Subject(s)
Employment , Housing , Female , Humans , Male , Motivation , Needs Assessment
8.
Am J Ind Med ; 63(1): 23-35, 2020 01.
Article in English | MEDLINE | ID: mdl-31613400

ABSTRACT

OBJECTIVE: As part of community-based participatory research (CBPR) examining precarious employment and community health, academic, and community researchers used concept mapping to explore how residents in two high hardship neighborhoods perceive the impact of work on health. METHODS: Between January and May 2017, 292 individuals who lived or worked in two contiguous Chicago neighborhoods were engaged in brainstorming, sorting, and rating activities. Multidimensional scaling and hierarchical cluster analysis were applied, and findings were interpreted by a community-academic partnership. RESULTS: Brainstorming resulted in 55 unique ways that work impacts health, each of which was rated on its perceived impact on health and prevalence in the neighborhood. Four major themes emerged: Healthy Aspects of Work, Systemic/Structural Injustices, Lack of Control/Exploitation, and Psychological/Physical Stress, which was a multidimensional, cross-cutting theme. CONCLUSION: These findings provide critical insight into community perceptions of the mechanisms by which work influences health, providing a basis for community-driven, sustainable, work-focused interventions that promote community health.


Subject(s)
Employment/statistics & numerical data , Public Health , Adolescent , Adult , Chicago , Cluster Analysis , Community-Based Participatory Research , Female , Humans , Male , Middle Aged , Uncertainty
9.
Article in English | MEDLINE | ID: mdl-31618824

ABSTRACT

Universities may be well poised to support knowledge, skill, and capacity-building efforts to foster the development of multi-level interventions to address complex problems. Researchers at the University of Illinois at Chicago (UIC) engaged organizations interested in developing policy- and systems-level initiatives to address the drivers of precarious work in a six-meeting Action Learning (AL) process, in which the researchers served as technical assistance (TA) providers focused on facilitating learning and promoting critical thinking among participants. This exploratory qualitative study examined the role, facilitators, challenges, and impacts of university facilitation in this context. A total of 22 individuals participated in this study, including UIC TA providers, content expert TA providers from labor-focused organizations, and TA recipients from health-focused organizations. Results from interviews and a focus group highlight the utility of a university connecting organizations from different disciplines that do not traditionally work together, and suggest that the TA provided by UIC helped participants think concretely about precarious work and ways in which their organizations might work collaboratively to bring about sustainable change. Findings from this study suggest that university facilitation using an AL approach may be effective in increasing knowledge to action.


Subject(s)
Capacity Building , Universities/organization & administration , Chicago
10.
Eur Neuropsychopharmacol ; 28(2): 307-316, 2018 02.
Article in English | MEDLINE | ID: mdl-29426666

ABSTRACT

Accumulating evidence suggests that certain gut microbiota have antidepressant-like behavioural effects and that the microbiota can regulate neurogenesis and the expression of brain-derived neurotrophic factor (BDNF) in the hippocampus. The precise mechanisms underlying these effects are not yet clear. However, the vagus nerve is one of the primary bidirectional routes of communication between the gut and the brain and thus may represent a candidate mechanism. Yet, relatively little is known about the direct influence of vagus nerve activity on hippocampal function and plasticity. Thus, the aim of the present study was to determine whether constitutive vagus nerve activity contributes to the regulation of neurogenesis and BDNF mRNA expression in the hippocampus. To this end, we examined the impact of subdiaphragmatic vagotomy in adult mice on these parameters. We found that vagotomy decreased BDNF mRNA in all areas of the hippocampus. Vagotomy also reduced the proliferation and survival of newly born cells and decreased the number of immature neurons, particularly those with a more complex dendritic morphology. Taken together, these findings suggest that vagal nerve activity influences neurogenesis and BDNF mRNA expression in the adult hippocampus.


Subject(s)
Brain-Derived Neurotrophic Factor/metabolism , Hippocampus/physiology , Neurogenesis/physiology , Vagus Nerve/physiology , Animals , Cell Survival/physiology , Doublecortin Domain Proteins , Eating/physiology , Gene Expression Regulation/physiology , Hippocampus/cytology , Male , Mice, Inbred BALB C , Microtubule-Associated Proteins/metabolism , Neurons/cytology , Neurons/physiology , Neuropeptides/metabolism , RNA, Messenger/metabolism , Sincalide/administration & dosage , Sincalide/metabolism
11.
Ann Occup Hyg ; 59(4): 514-24, 2015 May.
Article in English | MEDLINE | ID: mdl-25587187

ABSTRACT

Prior investigation on medical laser interaction with tissue has suggested device operational parameter settings influence laser generated air contaminant emission, but this has not been systematically explored. A laboratory-based simulated medical laser procedure was designed and pilot tested to determine the effect of laser operational parameters on the size-specific mass emission rate of laser generated particulate matter. Porcine tissue was lased in an emission chamber using two medical laser systems (CO2, λ = 10,600 nm; Ho:YAG, λ = 2100 nm) in a fractional factorial study design by varying three operational parameters (beam diameter, pulse repetition frequency, and power) between two levels (high and low) and the resultant plume was measured using two real-time size-selective particle counters. Particle count concentrations were converted to mass emission rates before an analysis of variance was used to determine the influence of operational parameter settings on size-specific mass emission rate. Particle shape and diameter were described for a limited number of samples by collecting particles on polycarbonate filters, and photographed using a scanning electron microscope (SEM) to examine method of particle formation. An increase in power and decrease in beam diameter led to an increase in mass emission for the Ho:YAG laser at all size ranges. For the CO2 laser, emission rates were dependent on particle size and were not statistically significant for particle ranges between 5 and 10 µm. When any parameter level was increased, emission rate of the smallest particle size range also increased. Beam diameter was the most influential variable for both lasers, and the operational parameters tested explained the most variability at the smallest particle size range. Particle shape was variable and some particles observed by SEM were likely created from mechanical methods. This study provides a foundation for future investigations to better estimate size-specific mass emission rates and particle characteristics for additional laser operational parameters in order to estimate occupational exposure, and to inform control strategies.


Subject(s)
Air Pollutants, Occupational/analysis , Laser Therapy/instrumentation , Particle Size , Particulate Matter/analysis , Animals , Environmental Monitoring/methods , Gases/chemistry , Laser Therapy/methods , Microscopy, Electron, Scanning , Occupational Exposure/analysis , Pilot Projects , Smoke , Swine
12.
J Occup Environ Hyg ; 12(3): 189-98, 2015.
Article in English | MEDLINE | ID: mdl-25288024

ABSTRACT

Airborne biological hazards in hospitals require the use of respiratory protection. A well-implemented respiratory protection program can protect health care workers from these exposures. This study examines the relationship between written respiratory programs and reported practices in health care settings. Twenty-eight hospitals in Illinois and Minnesota were recruited to a study of respiratory protection programs and practices in acute care settings. Interviews were conducted with hospital managers, unit managers, and health care workers from departments where respirators are commonly required. Each hospital's written respiratory protection program was scored for the 11 elements required by the Occupational Safety and Health Administration (OSHA), using a standardized tool, for a maximum possible score of 22 (2 pts. per element). Twenty interview questions associated with program practices were also scored by percent correct responses. Written program scores ranged from 2-17 with an average of 9.2. Hospital and unit managers scored on average 82% and 81%, respectively, when compared to the OSHA standard; health care workers scored significantly lower, 71% (p < 0.001). Minnesota written program scores were not significantly higher than Illinois hospitals (p = 0.16), while all Illinois survey respondents scored higher than those in Minnesota (p < 0.001). There was no trend between written programs and interview responses. Written respiratory protection programs in the study sites did not provide the level of detail required OSHA. Interview responses representing hospital practices surrounding respiratory protection indicated that hospitals were aware of and following regulatory guidelines.


Subject(s)
Cross Infection/prevention & control , Occupational Exposure/prevention & control , Respiratory Protective Devices/statistics & numerical data , Adult , Health Personnel , Hospital Administration/standards , Hospitals , Humans , Illinois , Minnesota , Self Report , United States , United States Occupational Safety and Health Administration/standards
13.
J Public Health Manag Pract ; 21(4): 345-54, 2015.
Article in English | MEDLINE | ID: mdl-24378632

ABSTRACT

BACKGROUND: Green building systems have proliferated but health outcomes and associated costs and benefits remain poorly understood. OBJECTIVE: To compare health before and after families moved into new green healthy housing with a control group in traditionally repaired housing. DESIGN AND SETTING: Mixed methods study in 3 Chicago housing developments. PARTICIPANTS: Public housing and low-income subsidized households (n = 325 apartments with 803 individuals). MAIN OUTCOME MEASURES: Self-reported health status, visual assessment of housing condition, indoor air sampling, and Medicaid expenditure and diagnostic data. Medicaid expenditures and International Classification of Diseases, Ninth Revision codes were modeled using a generalized linear model with γ distribution and log-link. RESULTS: Housing conditions and self-reported physical and mental health improved significantly in the green healthy housing study group compared with both the control group and the dilapidated public housing from which the residents moved, as did hay fever, headaches, sinusitis, angina, and respiratory allergy. Asthma severity measured by self-reported lost school/work days, disturbed sleep, and symptoms improved significantly, as did sadness, nervousness, restlessness, and child behavior. Medicaid data in this exploratory study were inconclusive and inconsistent with self-reported health outcomes and visual assessment data on housing quality but hold promise for future investigation. Possible sources of bias in the Medicaid data include older age in the study group, changes in Medicaid eligibility over time, controlling for Medicaid costs in an urban area, and the increased stress associated with moving, even if the move is into better housing. CONCLUSION: The mixed method approach employed here describes the complex relationships among self-reported health, housing conditions, environmental measures, and clinical data. Housing conditions and self-reported physical and mental health improved in green healthy housing. Health care cost savings in Medicaid due to improved housing could not be quantified here but hold promise for future investigations with larger cohorts over a longer follow-up period.


Subject(s)
Conservation of Natural Resources/methods , Environment Design/standards , Health Status , Outcome Assessment, Health Care , Public Housing/standards , Chicago , Conservation of Natural Resources/statistics & numerical data , Environment Design/statistics & numerical data , Family Characteristics , Female , Health Impact Assessment , Humans , Male , Poverty/statistics & numerical data , Public Housing/statistics & numerical data , Self Report , Urban Health/standards , Urban Health/statistics & numerical data
14.
J Occup Environ Hyg ; 12(1): 1-15, 2015.
Article in English | MEDLINE | ID: mdl-24918755

ABSTRACT

The objective of this study was to assess respiratory protection programs for aerosol-transmissible diseases in acute care hospitals for conformance with regulatory requirements and public health guidelines. Twenty-eight representative hospitals were selected by size, location, and ownership in Minnesota and Illinois. Interviews were conducted with 363 health care workers and 171 managers from high-risk departments. Written programs from each hospital were reviewed for required elements. Seventy-seven health care workers were observed donning and doffing a FFR. The most serious deficiency in many written programs was failure to identify a program administrator. Most written programs lacked adequate details about medical evaluation, fit-testing, and training and did not include a comprehensive risk assessment for aerosol transmissible diseases; tuberculosis was often the only pathogen addressed. Employees with the highest probability of tuberculosis exposure were most likely to pick a respirator for close contact, but higher levels of respiratory protection were rarely selected for aerosol-generating procedures. Surgical masks were most commonly selected for close contact with droplet disease- or influenza-infected patients; better protection (e.g., respirator) was rarely selected for higher-risk exposures. Most of the observed health care workers had access to a NIOSH-certified N95 FFR, properly positioned the facepiece, and formed the nose clip. The most frequent deficiencies were failure to correctly place straps, perform a user seal check, and remove the respirator using straps.


Subject(s)
Masks/statistics & numerical data , Occupational Exposure/prevention & control , Respiratory Protective Devices/statistics & numerical data , Adult , Health Personnel/education , Hospitals , Humans , Illinois , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Influenza, Human/prevention & control , Minnesota , National Institute for Occupational Safety and Health, U.S. , Tuberculosis/prevention & control , United States
15.
Int J Occup Environ Health ; 20(4): 271-80, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25072637

ABSTRACT

BACKGROUND: Stress is a common hazard in the work environment and is associated with multiple adverse health effects. The association between work-related stress (WRS) and cardiovascular disease has been established in a number of epidemiological studies. METHODS: A systematic review was conducted according to the PRISMA statement of the English literature involving WRS and carotid artery intima media thickness (CIMT). RESULTS: Four cohorts and six cross-sectional studies of occupational stress and CIMT were identified. All cohorts and five of the cross-sectional studies reported a significant positive association, while one reported an inverse association of WRS and CIMT. DISCUSSION: The weight of the evidence that we were able to identify suggests that occupational stress results in an increased risk of atherosclerosis, assessed via CIMT. Studies that include longitudinal measures of stress and intermediate cardiac endpoints, with adequate accounting for confounders, are needed. Interventional studies should also be conducted to determine whether CIMT progression can be prevented with workplace stress reduction.


Subject(s)
Atherosclerosis/etiology , Occupational Diseases/complications , Stress, Psychological/complications , Atherosclerosis/psychology , Carotid Intima-Media Thickness/psychology , Humans , Occupational Diseases/psychology , Stress, Psychological/etiology
17.
J Occup Environ Hyg ; 11(6): D69-76, 2014.
Article in English | MEDLINE | ID: mdl-24498966

ABSTRACT

The U.S. Occupational Safety and Health Administration (OSHA) estimates that half a million health-care workers are exposed to laser surgical smoke each year. The purpose of this study was to establish a methodology to (1) estimate emission rates of laser-generated air contaminants (LGACs) using an emission chamber, and to (2) perform a screening study to differentiate the effects of three laser operational parameters. An emission chamber was designed, fabricated, and assessed for performance to estimate the emission rates of gases and particles associated with LGACs during a simulated surgical procedure. Two medical lasers (Holmium Yttrium Aluminum Garnet [Ho:YAG] and carbon dioxide [CO2]) were set to a range of plausible medical laser operational parameters in a simulated surgery to pyrolyze porcine skin generating plume in the emission chamber. Power, pulse repetition frequency (PRF), and beam diameter were evaluated to determine the effect of each operational parameter on emission rate using a fractional factorial design. The plume was sampled for particulate matter and seven gas phase combustion byproduct contaminants (benzene, ethylbenzene, toluene, formaldehyde, hydrogen cyanide, carbon dioxide, and carbon monoxide): the gas phase emission results are presented here. Most of the measured concentrations of gas phase contaminants were below their limit of detection (LOD), but detectable measurements enabled us to determine laser operation parameter influence on CO2 emissions. Confined to the experimental conditions of this screening study, results indicated that beam diameter was statistically significantly influential and power was marginally statistically significant to emission rates of CO2 when using the Ho:YAG laser but not with the carbon dioxide laser; PRF was not influential vis-a-vis emission rates of these gas phase contaminants.


Subject(s)
Air Pollutants, Occupational/analysis , Carbon Dioxide/analysis , Environmental Monitoring , Laser Therapy , Particulate Matter/analysis , Smoke/analysis , Animals , Benzene/analysis , Formaldehyde/analysis , Gases/chemistry , Hydrogen Cyanide/analysis , Limit of Detection , Occupational Exposure/analysis , Pilot Projects , Toluene/analysis
18.
Occup Environ Med ; 71(1): 30-9, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24186945

ABSTRACT

OBJECTIVES: To evaluate respiratory related mortality among underground coal miners after 37 years of follow-up. METHODS: Underlying cause of death for 9033 underground coal miners from 31 US mines enrolled between 1969 and 1971 was evaluated with life table analysis. Cox proportional hazards models were fitted to evaluate the exposure-response relationships between cumulative exposure to coal mine dust and respirable silica and mortality from pneumoconiosis, chronic obstructive pulmonary disease (COPD) and lung cancer. RESULTS: Excess mortality was observed for pneumoconiosis (SMR=79.70, 95% CI 72.1 to 87.67), COPD (SMR=1.11, 95% CI 0.99 to 1.24) and lung cancer (SMR=1.08; 95% CI 1.00 to 1.18). Coal mine dust exposure increased risk for mortality from pneumoconiosis and COPD. Mortality from COPD was significantly elevated among never [corrected] smokers and former smokers (HR=1.84, 95% CI 1.05 to 3.22; HRK=1.52, 95% CI 0.98 to 2.34, respectively) but not current smokers (HR=0.99, 95% CI 0.76 to 1.28). Respirable silica was positively associated with mortality from pneumoconiosis (HR=1.33, 95% CI 0.94 to 1.33) and COPD (HR=1.04, 95% CI 0.96 to 1.52) in models controlling for coal mine dust. We saw a significant relationship between coal mine dust exposure and lung cancer mortality (HR=1.70; 95% CI 1.02 to 2.83) but not with respirable silica (HR=1.05; 95% CI 0.90 to 1.23). In the most recent follow-up period (2000-2007) both exposures were positively associated with lung cancer mortality, coal mine dust significantly so. CONCLUSIONS: Our findings support previous studies showing that exposure to coal mine dust and respirable silica leads to increased mortality from malignant and non-malignant respiratory diseases even in the absence of smoking.


Subject(s)
Coal Mining , Coal/adverse effects , Dust , Lung Diseases/mortality , Occupational Diseases/mortality , Occupational Exposure/adverse effects , Silicon Dioxide/adverse effects , Adolescent , Adult , Aged , Follow-Up Studies , Humans , Inhalation Exposure/adverse effects , Lung Neoplasms/mortality , Middle Aged , Occupations , Pneumoconiosis/mortality , Proportional Hazards Models , Pulmonary Disease, Chronic Obstructive/mortality , Smoking , United States/epidemiology , Young Adult
19.
Ann Allergy Asthma Immunol ; 110(5): 340-6, 2013 May.
Article in English | MEDLINE | ID: mdl-23622004

ABSTRACT

BACKGROUND: Community-based studies of obesity, asthma, biomarkers of oxidative stress, and adipokines among low-income, urban, minority populations are lacking. Oxidative stress, perhaps modulated by adipokines, may increase airway inflammation in obese individuals. OBJECTIVES: To characterize associations between obesity and asthma in a low-income, urban, minority community and evaluate adipokines, biomarkers of inflammation, and oxidant-antioxidant balance in association with asthma and obesity. METHODS: A door-to-door evaluation of asthma and obesity prevalence was performed in a low-income housing development. Nonsmoking adults and children underwent additional evaluation, including allergy skin testing, and measures of serum adipokines, and indicators of oxidative stress in blood and exhaled breath. RESULTS: The prevalences of current asthma and a body mass index in the 85th percentile or higher were 15.8% and 35.3%, respectively, among 350 nonsmokers older than 4 years. Asthma and obesity were not associated with one another (odds ratio, 1.0; 95% confidence interval, 0.55-1.84). Among 116 nonsmoking participants who underwent biomarker evaluation, obesity was not associated with exhaled nitric oxide. In multivariate logistic models that adjusted for age category, sex, and a body mass index in 85th percentile or higher, leptin concentrations in the highest quartile were associated with asthma (odds ratio, 8.34; 95% confidence interval, 1.29-50.2) but not with atopy. Adiponectin was associated with total antioxidant capacity in exhaled breath. CONCLUSION: Asthma and obesity, although both common in a low-income, minority community, were not associated with one another. Nevertheless, adipokines were associated with asthma status and with markers of oxidative stress in the lungs, providing some support for an adipokine-inflammatory mechanistic link between the two conditions.


Subject(s)
Asthma/epidemiology , Obesity/epidemiology , Adiponectin/blood , Adult , Asthma/blood , Biomarkers/analysis , Child, Preschool , Data Collection , Female , Humans , Leptin/blood , Male , Minority Groups , Obesity/blood , Oxidative Stress , Poverty , Urban Population
20.
Ind Health ; 49(1): 63-72, 2011.
Article in English | MEDLINE | ID: mdl-20823632

ABSTRACT

The objective of this study was to characterize personal exposures to welding-related metals and gases for production welders and non-welders in a large manufacturing facility. Welding fume metals and irritant gases nitrogen dioxide (NO(2)) and ozone (O(3)) were sampled for thirty-eight workers. Personal exposure air samples for welding fume metals were collected on 37 mm open face cassettes and nitrogen dioxide and ozone exposure samples were collected with diffusive passive samplers. Samples were analyzed for metals using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and welding fume metal exposure concentrations were defined as the sum of welding-related metals mass per volume of air sampled. Welding fume metal exposures were highly variable among similar types of welding while NO(2) and O(3) exposure were less variable. Welding fume metal exposures were significantly higher 474 µg/m(3) for welders than non-welders 60 µg/m(3) (p=0.001). Welders were exposed to higher concentrations of NO(2) and O(3) than non-welders but the differences were not statistically significant. Welding fume metal exposure concentrations for welders performing gas metal arc welding (GMAW) and shielded metal arc welding (SMAW) were higher than welders performing gas tungsten arc welding (GTAW). Non-welders experienced exposures similar to GTAW welders despite a curtain wall barrier separating welding and non-welding work areas.


Subject(s)
Air Pollutants, Occupational/adverse effects , Nitrogen Dioxide/adverse effects , Occupational Exposure/adverse effects , Ozone/adverse effects , Welding , Air Pollutants, Occupational/analysis , Case-Control Studies , Humans , Metals/adverse effects , Nitrogen Dioxide/analysis , Ozone/analysis
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