Acute respiratory effects on workers exposed to metalworking fluid aerosols in an automotive transmission plant

Exposure to metalworking fluids has been linked to modest cross-shift reductions in FEV 1 and occupational asthma. To identify responsible agents, we measured personal exposures to thoracic particulate (TP), viable plus nonviable thoracic bacteria (BAC), and vapor phase nicotine (VPN) (as a surrogate for tobacco particulate) among 83 machinists exposed to soluble oils and 46 dry assemblers working in an automotive transmission machining plant using biocides infrequently. The participants completed interviews and performed pre- and postshift spirometry on Monday and Thursday of the same week in each of three rounds of data collection (June 1992, January 1993, June 1993). Generalized estimating equations were used to combine information across rounds in multiple regression models of cross-shift and cross-week changes in forced expiratory volume, I second (FEV 1 ) and forced vital capacity (FVC). Mean seniority was 19 years among machinists. Mean personal TP levels were 0.41 mg/m 3 in machinists and 0.13 mg/m 3 in assemblers. Six of the 83 machinists and none of the 46 assemblers experienced a greater than 19% cross-shift decrement in FEV 1 or FVC at least once (p = .07). In regression models using either TP or BAC, among subjects with lower baseline (Monday preshift) FEV 1 /FVC ratios, increasing exposure was significantly associated with increasing cross-shift decrements in FEV 1 and FVC in linear models, and with increased likelihood of a 10% or greater cross-shift decrement in FEV 1 or FVC in logistic models. Adjustment of TP for VPN did not affect models significantly. We conclude that clinically important cross-shift decrements in pulmonary function are associated with exposure to metalworking fluid aerosols within a high-seniority population. Am. J. Ind. Med. 31:510–524, 1997. © 1997 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34816/1/4_ftp.pd

Dust exposure and respiratory disease in U.S. coal miners.

This study examines the effectiveness of the dust standards set by the Coal Mine Health and Safety Act of 1969 in preventing obstructive lung disease by considering the exposure-response relationship in a group of miners whose exposure began in or after 1970 when the regulations took effect. Accurate and precise estimates of exposure for the cohort were developed using compliance data collected by the Mine Safety and Health Administration (MSHA). Adjustments in the data were made to account for several potential biases. Arithmetic mean concentrations were estimated within work categories defined by mine, occupation and year and decreasingly-specific categories, occupation/year, mine/year, and year. The mine/occupation/year estimates were combined with the occupation/year estimates so as to minimize the mean squared error of the resulting mean. Exposing-response relationships were examined among 1270 miners from the National Study of Coal Workers' Pneumoconiosis. Cross-sectional and longitudinal associations between cumulative exposure and pulmonary function test results (FVC, FEV\sb1, and FEV\sb1/FVC) and respiratory symptoms were modeled using linear and logistic regression while controlling for smoking. The results over a 15 year exposure period indicated statistically significant positive associations of cumulative exposure with decrements in FEV\sb1, FEV\sb1/FVC, the likelihood of these indices being less than 80% of predicted, and symptoms, including chronic bronchitis, breathlessness and wheeze with shortness of breath. The estimated effect of exposure of FEV\sb1 was 5.5 ml per mg/m\sp3-years which was substantially larger than previously reported estimates. However, examination of PFTs within five years of beginning work demonstrated a rapid initial exposure-related loss of both FVC and FEV\sb1 and no additional exposure-related loss over the following 10 years. The results of the study suggest that exposure to coal mine dust at concentrations present since the CMHSA regulations were put into effect have not been completely successful in preventing respiratory effects. Determination of the long-term significance of the initial exposure-response relationship observed requires additional follow-up of this cohort.Ph.D.Industrial HealthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/105283/1/9116296.pdfDescription of 9116296.pdf : Restricted to UM users only

Estimating the burden of United States workers exposed to infection or disease: A key factor in containing risk of COVID-19 infection

INTRODUCTION: With the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of contracting disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Quantifying the number of workers who are frequently exposed to infection and disease in the workplace, and understanding which occupational groups they represent, can help to prompt public health risk response and management for COVID-19 in the workplace, and subsequent infectious disease outbreaks. METHODS: To estimate the number of United States workers frequently exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with a BLS O*NET survey measure reporting how frequently workers in each occupation are exposed to infection or disease at work. This allowed us to estimate the number of United States workers, across all occupations, exposed to disease or infection at work more than once a month. RESULTS: Based on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair). CONCLUSIONS: The large number of persons employed in occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. Given the proportion of the United States workforce exposed to disease or infection at work, this analysis also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve

Estimation of Particulate Mass and Manganese Exposure Levels among Welders

Background: Welders are frequently exposed to Manganese (Mn), which may increase the risk of neurological impairment. Historical exposure estimates for welding-exposed workers are needed for epidemiological studies evaluating the relationship between welding and neurological or other health outcomes. The objective of this study was to develop and validate a multivariate model to estimate quantitative levels of welding fume exposures based on welding particulate mass and Mn concentrations reported in the published literature

Do Different Patterns of Employment Quality Contribute to Gender Health Inequities in the U.S.? A Cross-Sectional Mediation Analysis

Compared to recent generations, workers today generally experience poorer quality employment across both contractual (e.g., wages, hours) and relational (e.g., participation in decision-making, power dynamics) dimensions within the worker–employer relationship. Recent research shows that women are more likely to experience poor-quality employment and that these conditions are associated with adverse health effects, suggesting employment relations may contribute to gender inequities in health. We analyzed data from the General Social Survey (2002–2018) to explore whether the multidimensional construct of employment quality (EQ) mediates the relationship between gender and health among a representative, cross-sectional sample of U.S. wage earners. Using a counterfactually-based causal mediation framework, we found that EQ plays a meaningful role in a gender–health relationship, and that if the distribution of EQ among women was equal to that observed in men, the probability of reporting poor self-reported health and frequent mental distress among women would be lower by 1.5% (95% Confidence Interval: 0.5–2.8%) and 2.6% (95% CI: 0.6–4.6%), respectively. Our use of a multidimensional, typological measure of EQ allowed our analysis to better account for substantial heterogeneity in the configuration of contemporary employment arrangements. Additionally, this study is one of the first mediation analyses with a nominal mediator within the epidemiologic literature. Our results highlight EQ as a potential target for intervention to reduce gender inequities in health