- Email: [email protected]
Occupational Asthmagens among Domestic and Industrial Cleaners: A Qualitative Study
AEP Vol. 17, No. 9 September 2007 : 723–751
ABSTRACTS (ACE)
workers in 1980. Six investigations have been conducted for the cohort through 2002. At each iteration, standardized mortality ratios (SMR) taking into account age and period characteristics have been reported. The objective of this study is to apply the proportionate mortality ratio (PMR) and the proportionate cancer mortality ratio (PCMR) to compare serial estimates of respiratory and all malignant cancer mortality risks in a closed cohort. METHODS: The cohort includes 2,548 male employees from two fiber production facilities operating from 1947 through 1991. Sequential mortality risks have been assessed through the years 1976, 1981, 1991, 1997, and 2002. We calculated the PMR and PCMR from estimates of the SMR for respiratory cancer, malignant cancer, and overall mortality based on two referent populations, the U.S. general population and a regional population of workers from the same company. RESULTS: Compared to the company reference rates, respiratory cancer, malignant cancer, and overall SMR were increased in early analyses (SMR O 1.1 for each mortality category) but decreased over time (SMR ! 1.0 for each). PMR and PCMR estimates for cancer mortality were consistent (PMR Z 0.98 to 1.05) indicating a non-varying mortality pattern over time. Bias in the overall SMR due to the healthy worker effect resulted in notable upward bias for PMR calculated from SMR based on the U.S. population. CONCLUSION: We find the PMR to be a useful indicator of temporal variation in mortality patterns for ongoing occupational cohort studies. As the number of deaths increases for an aging cohort, the magnitude and direction of the PMR may be used to compare serial estimates of cause-specific relative mortality risks. SMR estimates can vary within a closed cohort over time and may not be a suitable longitudinal risk indicator. The PMR can be applied to evaluate internal consistency of results as well as the strength of association for sequential investigations of closed cohorts. doi: 10.1016/j.annepidem.2007.07.033
P30 ROUTINE DIAGNOSTIC X-RAY EXAMINATIONS AND INCREASED FREQUENCY OF CHROMOSOME TRANSLOCATIONS AMONG UNITED STATES RADIOLOGIC TECHNOLOGISTS P Bhatti, AJ Sigurdson, DL Preston, MM Doody, D Kampa, BH Alexander, LC Yong, AA Edwards, JD Tucker, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD PURPOSE: Low radiation doses and potentially inaccurate recall of the number of past x-ray examinations have hampered designing informative studies of cancer risk associated with medical radiation exposure. We investigated whether cumulative exposure from personal diagnostic x-rays was associated with increased frequencies of chromosome translocations among radiologic technologists because they may recall past radiographic procedures better than the general public. METHODS: 150 U. S. radiologic technologists who began working before 1950 were selected for blood collection and telephone interview, including past x-ray examinations. The number of and the examination types were converted to a radiation dose score with units that were an approximation of cGy. For each study subject, the frequencies of translocations were identified by whole chromosome painting. A linear Poisson regression model was used to assess the relationship between radiation dose score and translocation frequency.
733
RESULTS: After adjustment for age, translocation frequencies increased with increasing diagnostic RBM dose score with an estimate of 0.04 translocations per 100 CEs per unit RBM score (95% CI, 0.02 to 0.07; PZ0.003). Adjustment for gender, cigarette smoking, occupational radiation dose, allowing practice x-rays while training, work with radioisotopes, and radiotherapy for benign conditions did not materially affect the slope estimate. CONCLUSIONS: Cumulative radiation exposure from routine x-ray examinations was associated with increased numbers of chromosome translocations. While the enormous benefit of radiation in disease diagnosis and patient treatment remains unquestioned, potential long-term chromosome damage and other associated health risks argue against excess use or unnecessary repeats of diagnostic x-ray examinations. doi: 10.1016/j.annepidem.2007.07.034
P31 OCCUPATIONAL ASTHMAGENS AMONG DOMESTIC AND INDUSTRIAL CLEANERS: A QUALITATIVE STUDY AA Arif1, PC Hughes2, GL Delclos3, 1Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, 2Department of Communication Studies, Texas Tech University, Lubbock, TX, 3Department of Environmental and Occupational Health, University of Texas at Houston, School of Public Health, Houston, TX PURPOSE: Despite being a large part of the workforce, cleaners remained a relatively understudied occupational group in the U.S. The potential adverse respiratory health effects of work-related exposure to cleaning agents have not been widely recognized. The objective of this focus group study was to identify and characterize occupational exposures and job tasks among domestic and industrial cleaners. METHODS: Twelve separate focus group sessions, six in Lubbock, Texas and six in Houston, Texas were conducted. Each focus group session was made up of six to ten participants. A bilingual study member of the research team, experienced in conducting focus group interviews, served as facilitator for all 12 sessions. Participants were asked about their job tasks, type of products they use to clean, job training, and work environment. The focus group data were analyzed using content analysis and open coding. RESULTS: A total of 99 subjects participated in twelve focus group sessions: 43 attended in Lubbock and 56 in Houston for the overall participation rate of 66%. Their mean age was 43.2 years (SDZ11.9). The majority were Hispanic (61%), female (88%), non-smokers (62%) and had worked as cleaners for a mean of 9.6 years (SDZ8.5). Participants reported using a total of 66 different cleaning products to clean residential, industrial, and commercial zones. From these 66 cleaning products, a total of 48 different respiratory irritants and sensitizers were identified. The majority of domestic cleaners reported adverse respiratory symptoms including congestion, coughing, nausea, and trouble breathing, as compared to the industrial cleaners. Reports of eye irritation were also common among domestic cleaners. Three general themes emerged regarding cleaning professionals’ work experiences: a) job training; b) chemical exposure and use; and c) competence. Domestic cleaners demonstrated significant skills deficit among across each of these three themes as compared to industrial cleaners.
734
ABSTRACTS (ACE)
AEP Vol. 17, No. 9 September 2007 : 723–751
CONCLUSION: This qualitative study suggests that domestic cleaners may be at increased risk of exposures that may have potential adverse respiratory health effects. doi: 10.1016/j.annepidem.2007.07.035
P32 REFERENT CONCENTRATIONS OF PCDD/FS AND DIOXIN-LIKE PCBS IN SERA OF PERSONS IN THE U.S. BASED ON THE NEW WHO 2006 TEFS AND 2001–2002 NHANES DATA DJ Pastenbach, LLF Scott, LM Nguyen, KM Unice, P Scott, LC Haws, M Harris, ChemRisk, Houston TX PURPOSE: Reference values for PCDD/Fs and dioxin-like PCBs in serum were recently published based on the WHO1998 TEFs and NHANES data. In 2006, the World Health Organization (WHO) revised toxic equivalency factors (TEFs) for a number of congeners. In accordance with these changes, we calculated new reference statistics using the WHO2006 TEFs. Additionally, the contribution of individual congeners to the total TCDD TEQ and the effect that the revised TEFs had on total TEQ serum concentrations for the general U.S. population were also determined. METHODS: All 2,3,7,8-substituted PCDD/F and nine dioxinlike PCB serum concentration data examined in this study are from the 2001–2002 NHANES survey. Total TCDD TEQ for each individual volunteer was calculated by summing the product of each congener’s concentration and the associated 2006 WHO TEF. Calculation of reference values and all statistical analyses were conducted using SAS and SUDAAN software. RESULTS: 2,3,7,8-TCDD, 1,2,3,7,8-PeCDD, 1,2,3,6,7,8HxCDD, 2,3,4,7,8-PeCDF, and PCB 126 still contributed the greatest percentage to the total TEQ. However, both PCBs 156 and 157 were no longer significant contributors, instead being displaced by 1,2,3,4,7,8-HxCDF and PCB 169. Using the new TEF scheme, TEQ17–9 was approximately equal to TEQ17–3. Average total TEQ estimates were 5–12 ppt lower than average estimates calculated using the WHO1998 TEFs, and 95th percentile estimates were reduced by 5 to 25 ppt with the largest reductions in total TEQ for older individuals. CONCLUSION: The updated TEFs had little impact on the percent contribution of the dioxin, furan, and co-planar PCB congeners to the total TEQ. However, the decrease in TEFs for the mono-ortho substituted PCBs decreased their contribution to total TEQ appreciably as well as reduced estimates of total TEQ body burden. doi: 10.1016/j.annepidem.2007.07.036
P33 ADIPOSITY AND DEPRESSIVE SYMPTOMS IN POLICE OFFICERS J Violanti1, D Fekedulegn2, M Andrew2, L Charles2, T Hartley2, C Burchfiel2, 1Social & Preventive Medicine, SUNY at Buffalo, NY, 2Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Morgantown, WV PURPOSE: To determine the association between measures of adiposity and depression in a sample of police officers.
METHODS: This study was a cross sectional observational study of 115 police officers stratified by gender and selected at random from an urban police department. Measures of adiposity (Body Mass Index (BMI), abdominal height, and waist circumference) and depressive symptoms (Center for Epidemiological Studies Depression (CES-D) scale) were obtained during a clinic visit. One hundred and three officers (61 men and 42 women) had complete data and linear regression analysis was conducted separately for men and women. Covariate adjustments were made for age, alcohol use, years of police service, smoking, physical activity, fasting serum glucose, and marital status. RESULTS: We found statistically significant positive associations between the CES-D score and both BMI (p Z 0.005) and abdominal height (p Z 0.006) for men. No significant associations were found between CES-D score and adiposity in women (p Z0.591 for BMI, p Z 0.81 for abdominal height, p Z 0.52 for waist circumference). Adjustment for covariates did not result in any meaningful change in the reported associations. CONCLUSION: Results indicate a significant positive association between adiposity and depression among male police officers. The temporal sequence and additional physiological and psychological factors that might influence this association should be examined prospectively. doi: 10.1016/j.annepidem.2007.07.037
P34 FACTORS CONTRIBUTING TO BLOOD LEAD LEVELS OF U.S. CHILDREN LM Nguyen, LLF Scott, M Harris, LC Haws, ChemRisk Houston, TX PURPOSE: While elemental lead has been removed from a variety of products over the past 30 years, it is still a widely distributed metal in the environment and can be found in old electronics, children’s toys, and ceramics resulting in the exposure of young children. To determine what factors contribute to blood lead levels in children, and therefore, help determine possible exposure routes, we assessed the effect of housing and general demographic factors and determined which characteristics had the greatest influence on lead levels for children. METHODS: Blood lead levels (BLLs), demographic data, and housing data from the third National Health and Nutrition Examination Survey (NHANES) (1988–1994) and the three continuous NHANES cycles (1999–2000, 2001–2002, 2003–2004) were used in these analyses. Using SAS software, potential correlations between BLLs and various characteristics were determined using simple linear regression while multivariate regression was utilized to assess the significance of several factors while controlling for known predictors of blood lead levels in children 1–5 years of age. RESULTS: Age of housing, being non-Hispanic black, and age of child had the greatest effect on lead levels in children. NonHispanic black children had significantly higher BLLs than nonminority children even after adjusting for age of child and age of housing; however, significant differences in BLLs among the different races were not observed for children living in housing built prior to 1950. More notably, mean ln[BLL] was significantly associated with lead dust levels, which is consistent with the result that children who attend daycare/preschool have significantly lower BLLs than children who do not.
ABSTRACTS (ACE)
workers in 1980. Six investigations have been conducted for the cohort through 2002. At each iteration, standardized mortality ratios (SMR) taking into account age and period characteristics have been reported. The objective of this study is to apply the proportionate mortality ratio (PMR) and the proportionate cancer mortality ratio (PCMR) to compare serial estimates of respiratory and all malignant cancer mortality risks in a closed cohort. METHODS: The cohort includes 2,548 male employees from two fiber production facilities operating from 1947 through 1991. Sequential mortality risks have been assessed through the years 1976, 1981, 1991, 1997, and 2002. We calculated the PMR and PCMR from estimates of the SMR for respiratory cancer, malignant cancer, and overall mortality based on two referent populations, the U.S. general population and a regional population of workers from the same company. RESULTS: Compared to the company reference rates, respiratory cancer, malignant cancer, and overall SMR were increased in early analyses (SMR O 1.1 for each mortality category) but decreased over time (SMR ! 1.0 for each). PMR and PCMR estimates for cancer mortality were consistent (PMR Z 0.98 to 1.05) indicating a non-varying mortality pattern over time. Bias in the overall SMR due to the healthy worker effect resulted in notable upward bias for PMR calculated from SMR based on the U.S. population. CONCLUSION: We find the PMR to be a useful indicator of temporal variation in mortality patterns for ongoing occupational cohort studies. As the number of deaths increases for an aging cohort, the magnitude and direction of the PMR may be used to compare serial estimates of cause-specific relative mortality risks. SMR estimates can vary within a closed cohort over time and may not be a suitable longitudinal risk indicator. The PMR can be applied to evaluate internal consistency of results as well as the strength of association for sequential investigations of closed cohorts. doi: 10.1016/j.annepidem.2007.07.033
P30 ROUTINE DIAGNOSTIC X-RAY EXAMINATIONS AND INCREASED FREQUENCY OF CHROMOSOME TRANSLOCATIONS AMONG UNITED STATES RADIOLOGIC TECHNOLOGISTS P Bhatti, AJ Sigurdson, DL Preston, MM Doody, D Kampa, BH Alexander, LC Yong, AA Edwards, JD Tucker, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD PURPOSE: Low radiation doses and potentially inaccurate recall of the number of past x-ray examinations have hampered designing informative studies of cancer risk associated with medical radiation exposure. We investigated whether cumulative exposure from personal diagnostic x-rays was associated with increased frequencies of chromosome translocations among radiologic technologists because they may recall past radiographic procedures better than the general public. METHODS: 150 U. S. radiologic technologists who began working before 1950 were selected for blood collection and telephone interview, including past x-ray examinations. The number of and the examination types were converted to a radiation dose score with units that were an approximation of cGy. For each study subject, the frequencies of translocations were identified by whole chromosome painting. A linear Poisson regression model was used to assess the relationship between radiation dose score and translocation frequency.
733
RESULTS: After adjustment for age, translocation frequencies increased with increasing diagnostic RBM dose score with an estimate of 0.04 translocations per 100 CEs per unit RBM score (95% CI, 0.02 to 0.07; PZ0.003). Adjustment for gender, cigarette smoking, occupational radiation dose, allowing practice x-rays while training, work with radioisotopes, and radiotherapy for benign conditions did not materially affect the slope estimate. CONCLUSIONS: Cumulative radiation exposure from routine x-ray examinations was associated with increased numbers of chromosome translocations. While the enormous benefit of radiation in disease diagnosis and patient treatment remains unquestioned, potential long-term chromosome damage and other associated health risks argue against excess use or unnecessary repeats of diagnostic x-ray examinations. doi: 10.1016/j.annepidem.2007.07.034
P31 OCCUPATIONAL ASTHMAGENS AMONG DOMESTIC AND INDUSTRIAL CLEANERS: A QUALITATIVE STUDY AA Arif1, PC Hughes2, GL Delclos3, 1Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, 2Department of Communication Studies, Texas Tech University, Lubbock, TX, 3Department of Environmental and Occupational Health, University of Texas at Houston, School of Public Health, Houston, TX PURPOSE: Despite being a large part of the workforce, cleaners remained a relatively understudied occupational group in the U.S. The potential adverse respiratory health effects of work-related exposure to cleaning agents have not been widely recognized. The objective of this focus group study was to identify and characterize occupational exposures and job tasks among domestic and industrial cleaners. METHODS: Twelve separate focus group sessions, six in Lubbock, Texas and six in Houston, Texas were conducted. Each focus group session was made up of six to ten participants. A bilingual study member of the research team, experienced in conducting focus group interviews, served as facilitator for all 12 sessions. Participants were asked about their job tasks, type of products they use to clean, job training, and work environment. The focus group data were analyzed using content analysis and open coding. RESULTS: A total of 99 subjects participated in twelve focus group sessions: 43 attended in Lubbock and 56 in Houston for the overall participation rate of 66%. Their mean age was 43.2 years (SDZ11.9). The majority were Hispanic (61%), female (88%), non-smokers (62%) and had worked as cleaners for a mean of 9.6 years (SDZ8.5). Participants reported using a total of 66 different cleaning products to clean residential, industrial, and commercial zones. From these 66 cleaning products, a total of 48 different respiratory irritants and sensitizers were identified. The majority of domestic cleaners reported adverse respiratory symptoms including congestion, coughing, nausea, and trouble breathing, as compared to the industrial cleaners. Reports of eye irritation were also common among domestic cleaners. Three general themes emerged regarding cleaning professionals’ work experiences: a) job training; b) chemical exposure and use; and c) competence. Domestic cleaners demonstrated significant skills deficit among across each of these three themes as compared to industrial cleaners.
734
ABSTRACTS (ACE)
AEP Vol. 17, No. 9 September 2007 : 723–751
CONCLUSION: This qualitative study suggests that domestic cleaners may be at increased risk of exposures that may have potential adverse respiratory health effects. doi: 10.1016/j.annepidem.2007.07.035
P32 REFERENT CONCENTRATIONS OF PCDD/FS AND DIOXIN-LIKE PCBS IN SERA OF PERSONS IN THE U.S. BASED ON THE NEW WHO 2006 TEFS AND 2001–2002 NHANES DATA DJ Pastenbach, LLF Scott, LM Nguyen, KM Unice, P Scott, LC Haws, M Harris, ChemRisk, Houston TX PURPOSE: Reference values for PCDD/Fs and dioxin-like PCBs in serum were recently published based on the WHO1998 TEFs and NHANES data. In 2006, the World Health Organization (WHO) revised toxic equivalency factors (TEFs) for a number of congeners. In accordance with these changes, we calculated new reference statistics using the WHO2006 TEFs. Additionally, the contribution of individual congeners to the total TCDD TEQ and the effect that the revised TEFs had on total TEQ serum concentrations for the general U.S. population were also determined. METHODS: All 2,3,7,8-substituted PCDD/F and nine dioxinlike PCB serum concentration data examined in this study are from the 2001–2002 NHANES survey. Total TCDD TEQ for each individual volunteer was calculated by summing the product of each congener’s concentration and the associated 2006 WHO TEF. Calculation of reference values and all statistical analyses were conducted using SAS and SUDAAN software. RESULTS: 2,3,7,8-TCDD, 1,2,3,7,8-PeCDD, 1,2,3,6,7,8HxCDD, 2,3,4,7,8-PeCDF, and PCB 126 still contributed the greatest percentage to the total TEQ. However, both PCBs 156 and 157 were no longer significant contributors, instead being displaced by 1,2,3,4,7,8-HxCDF and PCB 169. Using the new TEF scheme, TEQ17–9 was approximately equal to TEQ17–3. Average total TEQ estimates were 5–12 ppt lower than average estimates calculated using the WHO1998 TEFs, and 95th percentile estimates were reduced by 5 to 25 ppt with the largest reductions in total TEQ for older individuals. CONCLUSION: The updated TEFs had little impact on the percent contribution of the dioxin, furan, and co-planar PCB congeners to the total TEQ. However, the decrease in TEFs for the mono-ortho substituted PCBs decreased their contribution to total TEQ appreciably as well as reduced estimates of total TEQ body burden. doi: 10.1016/j.annepidem.2007.07.036
P33 ADIPOSITY AND DEPRESSIVE SYMPTOMS IN POLICE OFFICERS J Violanti1, D Fekedulegn2, M Andrew2, L Charles2, T Hartley2, C Burchfiel2, 1Social & Preventive Medicine, SUNY at Buffalo, NY, 2Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Morgantown, WV PURPOSE: To determine the association between measures of adiposity and depression in a sample of police officers.
METHODS: This study was a cross sectional observational study of 115 police officers stratified by gender and selected at random from an urban police department. Measures of adiposity (Body Mass Index (BMI), abdominal height, and waist circumference) and depressive symptoms (Center for Epidemiological Studies Depression (CES-D) scale) were obtained during a clinic visit. One hundred and three officers (61 men and 42 women) had complete data and linear regression analysis was conducted separately for men and women. Covariate adjustments were made for age, alcohol use, years of police service, smoking, physical activity, fasting serum glucose, and marital status. RESULTS: We found statistically significant positive associations between the CES-D score and both BMI (p Z 0.005) and abdominal height (p Z 0.006) for men. No significant associations were found between CES-D score and adiposity in women (p Z0.591 for BMI, p Z 0.81 for abdominal height, p Z 0.52 for waist circumference). Adjustment for covariates did not result in any meaningful change in the reported associations. CONCLUSION: Results indicate a significant positive association between adiposity and depression among male police officers. The temporal sequence and additional physiological and psychological factors that might influence this association should be examined prospectively. doi: 10.1016/j.annepidem.2007.07.037
P34 FACTORS CONTRIBUTING TO BLOOD LEAD LEVELS OF U.S. CHILDREN LM Nguyen, LLF Scott, M Harris, LC Haws, ChemRisk Houston, TX PURPOSE: While elemental lead has been removed from a variety of products over the past 30 years, it is still a widely distributed metal in the environment and can be found in old electronics, children’s toys, and ceramics resulting in the exposure of young children. To determine what factors contribute to blood lead levels in children, and therefore, help determine possible exposure routes, we assessed the effect of housing and general demographic factors and determined which characteristics had the greatest influence on lead levels for children. METHODS: Blood lead levels (BLLs), demographic data, and housing data from the third National Health and Nutrition Examination Survey (NHANES) (1988–1994) and the three continuous NHANES cycles (1999–2000, 2001–2002, 2003–2004) were used in these analyses. Using SAS software, potential correlations between BLLs and various characteristics were determined using simple linear regression while multivariate regression was utilized to assess the significance of several factors while controlling for known predictors of blood lead levels in children 1–5 years of age. RESULTS: Age of housing, being non-Hispanic black, and age of child had the greatest effect on lead levels in children. NonHispanic black children had significantly higher BLLs than nonminority children even after adjusting for age of child and age of housing; however, significant differences in BLLs among the different races were not observed for children living in housing built prior to 1950. More notably, mean ln[BLL] was significantly associated with lead dust levels, which is consistent with the result that children who attend daycare/preschool have significantly lower BLLs than children who do not.