Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 76
Filtrar
2.
J Occup Environ Med ; 64(3): 263-270, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34723913

RESUMO

OBJECTIVE: Despite the large number of workers in surface sand and gravel mines, there are no previous studies on a cohort of these workers. METHODS: A cross-sectional study of Michigan surface mine workers included a questionnaire and for those who worked ≥15 years spirometry and chest x-ray. RESULTS: Questionnaires were completed by 1207 miners, 111 had an X-ray and 70 had spirometry. There were no silicosis cases. There were 117 with asthma, 22 COPD, 129 saw a doctor for shortness of breath (SOB), 125 with possible work-related asthma, and 26 abnormal spirometry results. CONCLUSIONS: Although, no cases of silicosis were identified, there was more current asthma; and an association of current asthma, COPD and seeing a doctor for SOB with time since first worked, and obstructive changes in some nonsmokers that suggested the potential for adverse respiratory effects.


Assuntos
Asma , Mineradores , Exposição Ocupacional , Doença Pulmonar Obstrutiva Crônica , Silicose , Asma/epidemiologia , Estudos Transversais , Dispneia/etiologia , Humanos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Areia , Silicose/diagnóstico por imagem , Silicose/epidemiologia
4.
Occup Environ Med ; 79(2): 120-126, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34535537

RESUMO

OBJECTIVES: Human leukocyte antigen-DP beta 1 (HLA-DPB1) with a glutamic acid at the 69th position of the ß chain (E69) genotype and inhalational beryllium exposure individually contribute to risk of chronic beryllium disease (CBD) and beryllium sensitisation (BeS) in exposed individuals. This retrospective nested case-control study assessed the contribution of genetics and exposure in the development of BeS and CBD. METHODS: Workers with BeS (n=444), CBD (n=449) and beryllium-exposed controls (n=890) were enrolled from studies conducted at nuclear weapons and primary beryllium manufacturing facilities. Lifetime-average beryllium exposure estimates were based on workers' job questionnaires and historical and industrial hygienist exposure estimates, blinded to genotype and case status. Genotyping was performed using sequence-specific primer-PCR. Logistic regression models were developed allowing for over-dispersion, adjusting for workforce, race, sex and ethnicity. RESULTS: Having no E69 alleles was associated with lower odds of both CBD and BeS; every additional E69 allele increased odds for CBD and BeS. Increasing exposure was associated with lower odds of BeS. CBD was not associated with exposure as compared to controls, yet the per cent of individuals with CBD versus BeS increased with increasing exposure. No evidence of a gene-by-exposure interaction was found for CBD or BeS. CONCLUSIONS: Risk of CBD increases with E69 allele frequency and increasing exposure, although no gene by environment interaction was found. A decreased risk of BeS with increasing exposure and lack of exposure response in CBD cases may be due to the limitations of reconstructed exposure estimates. Although reducing exposure may not prevent BeS, it may reduce CBD and the associated health effects, especially in those carrying E69 alleles.


Assuntos
Beriliose/genética , Berílio/toxicidade , Cadeias beta de HLA-DP/genética , Exposição Ocupacional/efeitos adversos , Beriliose/epidemiologia , Estudos de Casos e Controles , Doença Crônica , Feminino , Genótipo , Humanos , Masculino , Polimorfismo Genético , Estudos Retrospectivos
5.
Public Health Rep ; : 333549211061327, 2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34918567

RESUMO

OBJECTIVE: Take-home lead exposure involves lead dust inadvertently carried from the worksite by employees that becomes deposited in their homes and vehicles. We piloted a program in 2 counties in Michigan to investigate the countywide potential for take-home lead exposures across industries. METHODS: During 2018-2020, we identified establishments through internet searches and industry-specific registries. We visited establishments with a physical storefront in-person; we attempted to contact the remaining establishments via telephone. We administered questionnaires at the establishment level to assess the presence of lead and the current use of practices meant to mitigate the potential for take-home lead exposures. We recruited workers for wipe sampling of lead dust from their vehicle floors to test for lead levels. RESULTS: We identified 320 establishments with potential lead use or exposures. Questionnaire responses revealed widespread worker exposures to lead and a lack of education and implementation of best practices to prevent lead from leaving the worksite. Dust samples (n = 60) collected from employee vehicles showed a ubiquitous tracking of lead out of the workplace, with a range of 5.7 to 84 000 µg/ft2 and a geometric mean of 234 µg/ft2. Of the sample results, 95.0% were above the lead dust clearance levels for homes established by the US Environmental Protection Agency. CONCLUSIONS: This work suggests that take-home lead exposures are widespread and may be important sources of lead exposure among children. It also demonstrates the feasibility of a program for the identification of establishments whose employees may be susceptible to taking lead dust home with them and whose children may subsequently be targeted for blood lead monitoring.

7.
Occup Environ Med ; 78(9): 625-631, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33972377

RESUMO

OBJECTIVE: To determine whether there is an ongoing risk of developing bladder cancer in a previously studied cohort of workers exposed to both benzidine and dichlorobenzidine or dichlorobenzidine only in the last benzidine manufacturing plant in the USA. METHODS: Workers (n=488) were identified from the quarterly 941 forms the employer was required to submit to the Social Security Administration from 1960 to 1977. Exposures were assigned based on dates worked and known benzidine/dichlorobenzidine production schedules. Incidence, vital status and cause of death were determined through 2014. Analyses were restricted to white men. RESULTS: Bladder cancer incidence and mortality were significantly increased (25 incident cases, standardised incidence ratio (SIR) 2.19, 95% CI 1.42 to 3.23, and 5 deaths, standardised mortality ratio (SMR) 3.79, 95% CI 1.23 to 8.84). There were significant increases in incidence and mortality in those exposed to both benzidine and dichlorobenzidine (SIR 3.11, 95% CI 1.97 to 4.67, SMR 4.10, 95% CI 1.12 to 10.50), but not among workers exposed to dichlorobenzidine only (two incident cases, SIR 0.89, 95% CI 0.11 to 3.23 and one death, SMR 2.90, 95% CI 0.07 to 16.15). Bladder cancer incidence and mortality were increased in individuals with >20 years since last exposure with >5 years worked (six observed, SIR 5.94, 95% CI 2.18 to 12.92 and two deaths, SMR 7.93, 95% CI 0.96 to 28.65). CONCLUSIONS: Incidence and mortality due to bladder cancer increased among workers exposed to benzidine but not among workers exposed only to dichlorobenzidine. The risk of incidence and death from bladder cancer remain elevated more than 20 years after last exposure to benzidine in those who worked >5 years.


Assuntos
Benzidinas/toxicidade , Indústria Química , Doenças Profissionais/induzido quimicamente , Neoplasias da Bexiga Urinária/induzido quimicamente , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/epidemiologia , Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Fatores de Risco , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/mortalidade
8.
Public Health Rep ; 136(1): 27-31, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33059533

RESUMO

An increased use of disinfectants during the coronavirus disease 2019 (COVID-19) pandemic may increase the number of adverse health effects among people who apply them or among those who are in the area being disinfected. For the 3-month period from January 1 to March 30, 2020, the number of calls about exposure to cleaners and disinfectants made to US poison centers in all states increased 20.4%, and the number of calls about exposure to disinfectants increased 16.4%. We examined calls about cleaners and disinfectants to the Michigan Poison Center (MiPC) since the onset of the COVID-19 pandemic. We compared all calls related to exposure to cleaners or disinfectants, calls with symptoms, and calls in which a health care provider was seen during the first quarters of 2019 and 2020 and in relationship to key COVID-19 dates. From 2019 to 2020, the number of all disinfectant calls increased by 42.8%, the number of calls with symptoms increased by 57.3%, the average number of calls per day doubled after the first Michigan COVID-19 case, from 4.8 to 9.0, and the proportion of calls about disinfectants among all exposure calls to the MiPC increased from 3.5% to 5.0% (P < .001). Calls for exposure to cleaners did not increase significantly. Exposure occurred at home for 94.8%97.1% of calls, and ingestion was the exposure route for 59.7% of calls. Information about the adverse health effects of disinfectants and ways to minimize exposure should be included in COVID-19 pandemic educational materials.


Assuntos
COVID-19/epidemiologia , Desinfetantes/toxicidade , Centros de Controle de Intoxicações/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Michigan/epidemiologia , Pandemias , SARS-CoV-2
10.
Am J Ind Med ; 63(6): 527-534, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32144950

RESUMO

BACKGROUND: Death certificates contain a box labeled "Injury at Work" which is to be marked "Yes" for all fatal occupational injuries. The accuracy of this box in Michigan is not fully characterized. METHODS: The accuracy of the Injury at Work box on the Michigan death certificate was compared to deaths identified from 2001 through 2016 by the Michigan Fatality Assessment and Control Evaluation multi-source surveillance system. The sensitivity was calculated across this time period, while specificity and positive and negative predictive values were derived for 2011-2016. Univariate and multivariate regression were used to examine differences in the sensitivity over time and across demographic variables, industry, and the type of death. RESULTS: We found a sensitivity for the Injury at Work box of 73.1% among 2156 deaths. The sensitivity showed a significant declining trend over the 17 years, from 79.8% to 63.1%. Sensitivity varied significantly across incident type (aircraft, animal-related, drug overdose, motor vehicle, and suicides having particularly lower sensitivities, and electrocutions, falls, and machine-related incidents having higher sensitivities), and industry sector (construction, manufacturing, public safety, transportation, and trade sectors having higher sensitivities, and agriculture and services sectors showing lower sensitivities). Across nearly all categories the sensitivity was significantly below 1. CONCLUSIONS: The Injury at Work box on the Michigan death certificate was often incorrectly completed and has become less accurate with time, though the degree of this inaccuracy varies by the industry of the victim and the type of incident.


Assuntos
Confiabilidade dos Dados , Atestado de Óbito , Indústrias/estatística & dados numéricos , Traumatismos Ocupacionais/mortalidade , Vigilância da População , Acidentes de Trabalho/mortalidade , Adulto , Causas de Morte , Feminino , Humanos , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Análise de Regressão , Sensibilidade e Especificidade , Adulto Jovem
11.
J Agromedicine ; 25(1): 86-95, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31044658

RESUMO

Objectives: Development of a state-wide comprehensive surveillance system for non-fatal work-related farm injuries, since non-fatal injuries that occur to the self-employed (i.e., many farm owners/operators), family workers, federal government workers and small farms with fewer than 11 employees are not included in the Bureau of Labor Statistics employer-based survey used to produce the U.S. National statistics of work-related injuries.Methods: In 2015 and 2016, inpatient discharge summaries, emergency department, and hospital-based outpatient clinic records from all 134 of Michigan's hospitals with ICD-9 codes 989.0-.1, E827.0-.9, E849.1, E906.8, E919.0 or ICD-10 codesT65.0-.1, V80, Y92.7, W55.1-.4, W30 were reviewed to identify non-fatal work-related farm injuries.Results: We identified 1,559 non-fatal work-related farm injury incidents that occurred in 1,525 individuals, with 74% being among men. The most common parts of the body injured were an upper limb (38.2%) and a lower limb (23.7%). The most common types of injury were contusions (26.4%) and fractures (19.9%). Owners/operators accounted for 44.1% and hired hands for 42.9% of individuals injured. Injuries caused by cows were the predominant cause: 472 (31.5%) of all the injuries. Dairy farms accounted for 39.6% of all cases for which the farm type was recorded.Conclusion: A comprehensive system to identify non-fatal work-related farm injuries among all individuals who work on a farm, including owner/operators, family members and migrant and seasonal farm laborers, was implemented using hospital, emergency department and hospital-based outpatient clinic medical records. Such a system is important to be able to identify hazards and target prevention.


Assuntos
Agricultura , Fazendeiros/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Ferimentos e Lesões/classificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Bovinos , Criança , Pré-Escolar , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Ferimentos e Lesões/epidemiologia
12.
Ann Am Thorac Soc ; 17(3): 284-292, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31682471

RESUMO

Rationale: Exposure to a variety of substances in the workplace can cause new-onset asthma or aggravate preexisting asthma, both of which are considered work-related asthma (WRA). Understanding trends in the nature and causes of WRA can assist in the diagnosis and management of adult patients with asthma.Objective: To describe trends over 31 years of WRA surveillance in Michigan.Methods: Michigan law requires reporting of all known or suspected cases of occupational disease. WRA was confirmed by review of a standardized telephone interview and patient medical records. Enforcement inspections at the workplaces of the WRA cases included air monitoring and evaluation for asthma and asthma symptoms among coworkers.Results: The Michigan surveillance program identified 3,634 WRA cases from 1988 to 2018, including nine deaths. The cumulative incidence rate of WRA decreased from 3.5 to 2.0 cases per 100,000 workers. Cases most frequently worked in manufacturing (56%), health care (12%), and education (4%). The cumulative incidence rate of WRA decreased in each of those three industries, while increasing in retail trade and accommodations and food services. The most common exposures to known asthma inducers were to cleaning agents and isocyanates; the percentage exposed to cleaning agents increased from 5% to 20%, and the percentage exposed to isocyanates decreased from 20% to 7%. Fifty-one percent had not applied for workers' compensation benefits. Only 5% of the 571 workplaces where air sampling was performed were above the allowable exposure limit. Fifteen percent (1,622 of 10,493) of coworkers of the index cases reported onset of asthma since beginning to work at the facility or being bothered at work by daily or weekly chest tightness, shortness of breath, or wheezing.Conclusions: The industries and exposures where Michigan adults develop WRA have changed during the past 31 years. The identification of WRA cases, including WRA deaths, underscores the need for continued vigilance to monitor changes in where and how workers are exposed to asthma-causing agents, physician consideration of workplace exposures in new-onset or worsening adult asthma, and adoption of workplace standards that reduce exposure and require workplace medical monitoring to prevent and reduce the morbidity and mortality of WRA.


Assuntos
Asma Ocupacional/epidemiologia , Efeitos Psicossociais da Doença , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Adolescente , Adulto , Idoso , Asma Ocupacional/diagnóstico , Feminino , Humanos , Incidência , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Vigilância da População , Administração em Saúde Pública , Governo Estadual , Local de Trabalho , Adulto Jovem
13.
Ann Am Thorac Soc ; 15(12): 1404-1410, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30188758

RESUMO

RATIONALE: Exposure to respirable crystalline silica causes silicosis, a preventable, progressive occupational lung disease. A more rigorous occupational health standard for silica could help protect silica-exposed workers. OBJECTIVES: To describe trends over 29 years of silicosis surveillance in Michigan. METHODS: Michigan law requires the reporting of silicosis. We confirmed the diagnosis of silicosis in reported cases using medical questionnaires, review of medical records, and chest radiographs. The Michigan Occupational Safety and Health Administration (OSHA) conducted enforcement inspections at the workplaces of the silicosis cases, including air monitoring for silica and evaluation of workplace medical surveillance programs. RESULTS: The Michigan surveillance program identified 1,048 silicosis cases from 1988 to 2016, which decreased from 620 during 1988-1997, to 292 during 1998-2007, to 136 during 2008-2016. The cumulative incidence rate of silicosis decreased from 3.7 to 1.4 to 0.7 cases per 100,000 men 40 years of age and older in Michigan over the same three periods. African Americans had a higher cumulative incidence rate of silicosis, with 6.0 cases per 100,000 African American men 40 years of age and older in Michigan compared with 1.2 cases per 100,000 white men 40 years of age and older in Michigan. The cases identified had severe disease; 59% had progressive massive fibrosis or category 2 or 3 small opacities per B-reading classification of the chest radiograph. Seventeen percent reported ever having active tuberculosis. On spirometry, 76% of ever smokers and 72% of never smokers demonstrated either a restrictive or an obstructive pattern. Most (65%) had not applied for workers' compensation benefits; the percentage who applied for benefits decreased from 42% to 28-16% over the three periods. Thirty-four of 55 (62%) workplace inspections found exposures above the new OSHA 50 µg/m3 respirable crystalline silica permissible exposure limit, and only 11% of inspected companies screened their workers for silicosis. CONCLUSIONS: Adults with confirmed cases of silicosis have advanced disease and morbidity. Most are not using workers' compensation to pay for their care. The new OSHA silica standard, which lowers the permissible exposure limit for silica and requires medical monitoring to identify workers with silicosis, will help reduce the burden of silica exposure. It is critical for pulmonologists to be vigilant to recognize and manage this preventable occupational lung disease.


Assuntos
Afro-Americanos/estatística & dados numéricos , Efeitos Psicossociais da Doença , Exposição Ocupacional/estatística & dados numéricos , Silicose/epidemiologia , /estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Incidência , Masculino , Michigan , Pessoa de Meia-Idade , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/prevenção & controle , Vigilância da População , Silicose/diagnóstico , Adulto Jovem
14.
Am J Ind Med ; 61(2): 148-156, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29205424

RESUMO

BACKGROUND: Work-related crushing injuries are serious but preventable. For 2013 through 2015, the U.S. Bureau of Labor Statistics' (BLS) Survey of Occupational Injuries and Illnesses (SOII) reported 1260 crushing injuries in Michigan. In 2013, Michigan initiated multi-data source surveillance of work-related crushing injuries. METHODS: Records from all 134 of Michigan's hospitals/emergency departments (EDs), the Workers Compensation Agency (WCA) and Michigan's Fatality Assessment Control and Evaluation (MIFACE) program were used to identify work-related crushing injuries. Companies, where individuals were hospitalized or had an ED visit for a crushing injury, potentially had an OSHA enforcement inspection conducted. RESULTS: From 2013 through 2015, there were 3137 work-related crushing injury incidents, including two fatalities. The Michigan OSHA program completed inspections at 77 worksites identified by the surveillance system. CONCLUSION: The Michigan multisource surveillance system identified two and a half times more crushing injuries than BLS and was useful for initiating case-based enforcement inspections.


Assuntos
Lesões por Esmagamento/epidemiologia , Serviço Hospitalar de Emergência , Hospitalização , Traumatismos Ocupacionais/epidemiologia , Indenização aos Trabalhadores , Adolescente , Adulto , Idoso , Monitoramento Epidemiológico , Feminino , Humanos , Armazenamento e Recuperação da Informação , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Estados Unidos , United States Occupational Safety and Health Administration , Adulto Jovem
15.
J Occup Environ Med ; 59(10): 966-973, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28727667

RESUMO

OBJECTIVE: The aim of this study was to examine the practices of Michigan Occupational and Environmental Medicine Association (MOEMA) members regarding screening for sleep apnea during required driver medical examinations. METHODS: A 13-question survey on sleep apnea screening practices was emailed to the MOEMA member. Nonresponders received additional E-mails and calls. RESULTS: The survey response rate was 66%. Fifty-five percent of respondents performed driver examinations and 94% screened for sleep apnea. Variations in practice included differences in how many risk factors were used to determine the need for polysomnography, 13% never ordered polysomnography and 42% never denied medical certification because of sleep apnea. CONCLUSION: Although there was significant consensus that sleep apnea screening was important, there was a large variation in the indication for and frequency in which sleep studies were ordered and drivers were denied approval because of concern about sleep apnea.


Assuntos
Programas de Rastreamento/métodos , Síndromes da Apneia do Sono/diagnóstico , Transportes , Condução de Veículo/normas , Humanos , Michigan , Medicina do Trabalho/métodos , Política Organizacional , Seleção de Pessoal/métodos , Recursos Humanos
16.
MMWR Morb Mortal Wkly Rep ; 63(55): 73-78, 2016 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-27736836

RESUMO

CDC's National Institute for Occupational Safety and Health (NIOSH), state health departments, and other state entities maintain a state-based surveillance program of confirmed silicosis cases. Data on confirmed cases are collected and compiled by state entities and submitted to CDC. This report summarizes information for cases of silicosis that were reported to CDC for 2003-2011 by Michigan and New Jersey, the only states that continue to provide data voluntarily to NIOSH. The data for this report were final as of January 8, 2015. Data are presented in tabular form on the number and distribution of cases of silicosis by year (Table 1), duration of employment in occupations with potential exposure to dust containing respirable crystalline silica (Table 2), industry (Table 3), and occupation (Table 4). The number of cases by year is presented graphically (Figure). This report is a part of the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks - United States, which encompasses various surveillance years but is being published in 2016 (1). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (2).


Assuntos
Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Vigilância da População , Dióxido de Silício/toxicidade , Silicose/epidemiologia , Poeira , Emprego/estatística & dados numéricos , Humanos , Indústrias/estatística & dados numéricos , Michigan/epidemiologia , New Jersey/epidemiologia , Fatores de Tempo
18.
J Occup Environ Med ; 58(9): 892-5, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27414013

RESUMO

OBJECTIVE: The aim of this study was to assess the standard of care among occupational medicine practioners for determining medical fitness to wear a respirator. METHODS: A 15-item email/telephone survey was conducted of members of the Michigan Occupational and Environmental Medical Association. RESULTS: Sixty-seven percent of occupational medicine practioners who responded performed respirator evaluations; 75% did more than just the required Occupational Safety Health Administration questionnaire. Cardiovascular and respiratory symptoms and problems wearing a respirator (87% to 95%) were the most common reasons for additional testing and denying medical clearance (58% to 82%). Sixty percent of practioners required workers to have an annual evaluation. CONCLUSIONS: The frequency of medical evaluation, which specific tests were performed, and the criteria used to determine fitness to wear a respirator varied markedly between practioners. Further research is needed to determine whether the widespread variation is a sign of too little or too much testing by different practioners.


Assuntos
Medicina do Trabalho , Dispositivos de Proteção Respiratória/estatística & dados numéricos , Avaliação da Capacidade de Trabalho , Humanos , Michigan , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...