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Persistent asthma after repeated exposure to high concentrations of gases in pulpmills
The mortality experience of convicted drinking drivers (second offenders) (N = 347) randomly assigned to rehabilitation and control groups in two Ontario cities was examined. Over a follow-up period ranging between 8 and 13 years, 14 (11.0%) of the controls and 17 (7.7%) of the rehabilitation group died. Direct comparisons of the randomly assigned control and treatment groups revealed a tendency for lower total mortality and significantly lower mortality from accidental and violent death in those assigned to rehabilitation. Additional comparisons involving a combined rehabilitation group (N = 487) (rehabilitation participants randomly and not randomly assigned) confirmed these observations. Aging and Fatal Accidents in Male and Female Drivers. Journal of Gerontology, (in press). The effect of aging on fatal accident characteristics of male and female drivers was investigated using Finnish fatal-accident case study material from the period 1984-1990. Age-bound changes in accident characteristics (e.g. increase of at-fault accidents and of collisions in intersections) appeared in both sexes but seemed to affect female drivers at an earlier age and to a higher degree. When the sexes differed in accident characteristics, those of female drivers were more like the ones typically found in older drivers. The female drivers were also both quantitatively and qualitatively less experienced as drivers than their male counterparts. The lower resistance of women to the effects of aging on driving may be thus explained by their lower skill level. In future cohorts of old drivers, decrease of sex differences in experience will presumably attenuate the sex differences in accident characteristics. Responsibility Analysis: A Methodology to Study the Effects of Drugs in Driving. M. D. Robertson and 0. H. Drummer. Accident Analysis and Prevention, 26(2), 243-247. In order to study the role of drugs in driving, a responsibility analysis was developed to allow an assessment to be made of the driver’s 236
culpability or responsibility in an accident. Factors possibly mitigating drivers’ responsibility in each accident were identified and scored. Factors considered were: condition of road, condition of vehicle, driving conditions, accident type, witness observations, road law obedience, difficulty of task, and level of fatigue. If a sufficient number of mitigating factors were identified a driver would be found to be either partly or totally exonerated from blameworthiness and scored either as a contributory or nonculpable driver. If drugs present in a driver contributed to accident causation, it would be expected that they would be overrepresented in culpable drivers, i.e., those drivers not exonerated from blame. A total of 341 driver fatalities occurring in Victoria were analyzed for blood alcohol content (BAC). Twenty-nine percent had a BAC over .05% (the legal limit in Victoria). Alcohol-positive drivers were statistically overrepresented in the culpable group (p < .OOl), in single-vehicle accidents (p < .OS) and those accidents in which vehicles left the road for no apparent reason (p c .OOl). Odds-ratio estimation of relative risk of culpable and nonculpable drivers showed that the relative risk rose disproportionately to BAC. Industrial Safetv Persistent Asthma After Repeated Exposure to High Concentrations of Gases in Pulpmills. M. C. Yeung, S. Lam, S. M. Kennedy, and A. J. Frem. Am. J. Respix Crit. Care Med., 149(6), 1676-1680. This is a clinicopathologic study of three subjects with irritant-induced asthma. They were pulpmill workers who had a history of multiple “gassing” episodes that occurred over. a period of years. Persistent symptoms of asthma and nonspecific bronchial hyperresponsiveness and/or variable airflow obstruction occurred after at least one episode of “gassing,” resulting in symptoms severe enough to require emergency room treatment. One of the three subjects had normal spirometry values before he entered the pulpmill. Bronchial biopsy done on these subjects showed changes compatible with asthma, including thickened basement membrane in Journal of Safety Research
two and cellular infiltration with activated eosinophils and mononucle~ cells in all three. The results of immunohistology of bronchia mucosal biopsy of these subjects were compared with those of patients with allergic asthma and patients with Western red cedar-induced asthma. Subjects with irritant-induced asthma had a greater density of activated eosinophils and fewer T-lymphocytes, suggesting that cellmediated immune mechanisms are not involved in the pathogenesis of this condition. Airway Obstruction, Coal Mining, and DisabiIity. N. L. LqpP u! K. C. Morgan, and G. Zaldival: Occupational and Environmental Medicine, 51(4), 234-238. It has recently been suggested that the inhalation of coal in the absence of complicated coal workers’ pneumoconiosis (CWP) or smoking can lead to disabling airways obstruction. The cause of such obstruction has been variously attributed to emphysema or bronchitis. The frequency of significant airways obstruction in a group of United States coal miners seeking compensation for occupationally induced pulmonary impai~ent was therefore determined. In a sample of 611 “Black Lung” claimants there was only one subject who was a nonsmoker and who in the absence of other nonoccupationally related diseases - for example, asthma and bronchiectasis - had sufficient airways obstruction to render it difficult for him to carry out hard labour. An alternative explanation for his reduced ventilatory capacity other than coal dust or smoking may be available. If the inhalation of coal dust in the absence of smoking and complicated CWP ever induces sufficient ventilatory impairment to preclude a miner from working, it is indeed rare. Workload and Cardiovascular Risk Factors in Executives and Non-executive of the Same Company. J. E. Berg and A. 7: ~~~trnark. Occupational Medicine, 44(2), 87-90. The lifestyle of executive purportedly differs from that of their employees who are not in an executive position, with respect to workload, amount of travelling, and eating habit. Winter 1994Nolume 25/Number 4
These aspects of lifestyle and cardiovascular (CV) risk factors in blood were compared in 22 executives and a matched sample of nonexecutives in an insurance company in Norway. The mean age was 42.8 years in both groups and the mean body mass index was 25.5 and 24.8 kg/m2 in executives and nonexecutives, respectively. Executives travelled more and worked more hours than nonexecutives, but smoking habits, levels of physical activity, diet habits and blood pressure were comparable in the two groups. The blood lipoprotein estimates of total cholesterol, high density lipoprotein cholesterol, apolipoproteins and two compound li~protein indices of CV risk, as well as liver enzymes, were also the same magnitude in both groups. The executive lifestyle as such, compared to that of nonexecutives, does not imply an elevated CV risk in this study, as judged from CV risk factors in blood. The efforts of the occupational health service to improve health, including the opportunity for executives to choose their workload, may have contributed to this ‘negative’ finding. This may indicate that preventive health programmes in the company could have been acting as intended for all groups of employees. However, somewhat high mean levels of total cholesterol (>6.0 mmol/l) and of a compound atherogenic index in both groups suggest that continued action by the occupational health service is required. Risk of Occupational Glass Injury in Bar Staff. J. P. Shepherd, M. R. Brickley, D. Gallaghal; and R. V Walker: Injury, 25(4), 21-22. One hundred and twenty-six bar staff (median length of service 2.7 years) working in 42 randomly selected public houses in South Glamorgan were interviewed and examined in the workplace to investigate the incidence, characteristics and treatment of lacerations from bar glassware. 41 percent reported previous injury, 13 percent on five or more separate occasions. All injuries but one were of the hand. After 13 percent of incidents, treatment had been sought in an A&E department, but 58 percent of incidents causing hand lacerations were not treated. Straight-sided (nonik) on pint (0.61) capacity glasses were 237
culpability or responsibility in an accident. Factors possibly mitigating drivers’ responsibility in each accident were identified and scored. Factors considered were: condition of road, condition of vehicle, driving conditions, accident type, witness observations, road law obedience, difficulty of task, and level of fatigue. If a sufficient number of mitigating factors were identified a driver would be found to be either partly or totally exonerated from blameworthiness and scored either as a contributory or nonculpable driver. If drugs present in a driver contributed to accident causation, it would be expected that they would be overrepresented in culpable drivers, i.e., those drivers not exonerated from blame. A total of 341 driver fatalities occurring in Victoria were analyzed for blood alcohol content (BAC). Twenty-nine percent had a BAC over .05% (the legal limit in Victoria). Alcohol-positive drivers were statistically overrepresented in the culpable group (p < .OOl), in single-vehicle accidents (p < .OS) and those accidents in which vehicles left the road for no apparent reason (p c .OOl). Odds-ratio estimation of relative risk of culpable and nonculpable drivers showed that the relative risk rose disproportionately to BAC. Industrial Safetv Persistent Asthma After Repeated Exposure to High Concentrations of Gases in Pulpmills. M. C. Yeung, S. Lam, S. M. Kennedy, and A. J. Frem. Am. J. Respix Crit. Care Med., 149(6), 1676-1680. This is a clinicopathologic study of three subjects with irritant-induced asthma. They were pulpmill workers who had a history of multiple “gassing” episodes that occurred over. a period of years. Persistent symptoms of asthma and nonspecific bronchial hyperresponsiveness and/or variable airflow obstruction occurred after at least one episode of “gassing,” resulting in symptoms severe enough to require emergency room treatment. One of the three subjects had normal spirometry values before he entered the pulpmill. Bronchial biopsy done on these subjects showed changes compatible with asthma, including thickened basement membrane in Journal of Safety Research
two and cellular infiltration with activated eosinophils and mononucle~ cells in all three. The results of immunohistology of bronchia mucosal biopsy of these subjects were compared with those of patients with allergic asthma and patients with Western red cedar-induced asthma. Subjects with irritant-induced asthma had a greater density of activated eosinophils and fewer T-lymphocytes, suggesting that cellmediated immune mechanisms are not involved in the pathogenesis of this condition. Airway Obstruction, Coal Mining, and DisabiIity. N. L. LqpP u! K. C. Morgan, and G. Zaldival: Occupational and Environmental Medicine, 51(4), 234-238. It has recently been suggested that the inhalation of coal in the absence of complicated coal workers’ pneumoconiosis (CWP) or smoking can lead to disabling airways obstruction. The cause of such obstruction has been variously attributed to emphysema or bronchitis. The frequency of significant airways obstruction in a group of United States coal miners seeking compensation for occupationally induced pulmonary impai~ent was therefore determined. In a sample of 611 “Black Lung” claimants there was only one subject who was a nonsmoker and who in the absence of other nonoccupationally related diseases - for example, asthma and bronchiectasis - had sufficient airways obstruction to render it difficult for him to carry out hard labour. An alternative explanation for his reduced ventilatory capacity other than coal dust or smoking may be available. If the inhalation of coal dust in the absence of smoking and complicated CWP ever induces sufficient ventilatory impairment to preclude a miner from working, it is indeed rare. Workload and Cardiovascular Risk Factors in Executives and Non-executive of the Same Company. J. E. Berg and A. 7: ~~~trnark. Occupational Medicine, 44(2), 87-90. The lifestyle of executive purportedly differs from that of their employees who are not in an executive position, with respect to workload, amount of travelling, and eating habit. Winter 1994Nolume 25/Number 4
These aspects of lifestyle and cardiovascular (CV) risk factors in blood were compared in 22 executives and a matched sample of nonexecutives in an insurance company in Norway. The mean age was 42.8 years in both groups and the mean body mass index was 25.5 and 24.8 kg/m2 in executives and nonexecutives, respectively. Executives travelled more and worked more hours than nonexecutives, but smoking habits, levels of physical activity, diet habits and blood pressure were comparable in the two groups. The blood lipoprotein estimates of total cholesterol, high density lipoprotein cholesterol, apolipoproteins and two compound li~protein indices of CV risk, as well as liver enzymes, were also the same magnitude in both groups. The executive lifestyle as such, compared to that of nonexecutives, does not imply an elevated CV risk in this study, as judged from CV risk factors in blood. The efforts of the occupational health service to improve health, including the opportunity for executives to choose their workload, may have contributed to this ‘negative’ finding. This may indicate that preventive health programmes in the company could have been acting as intended for all groups of employees. However, somewhat high mean levels of total cholesterol (>6.0 mmol/l) and of a compound atherogenic index in both groups suggest that continued action by the occupational health service is required. Risk of Occupational Glass Injury in Bar Staff. J. P. Shepherd, M. R. Brickley, D. Gallaghal; and R. V Walker: Injury, 25(4), 21-22. One hundred and twenty-six bar staff (median length of service 2.7 years) working in 42 randomly selected public houses in South Glamorgan were interviewed and examined in the workplace to investigate the incidence, characteristics and treatment of lacerations from bar glassware. 41 percent reported previous injury, 13 percent on five or more separate occasions. All injuries but one were of the hand. After 13 percent of incidents, treatment had been sought in an A&E department, but 58 percent of incidents causing hand lacerations were not treated. Straight-sided (nonik) on pint (0.61) capacity glasses were 237