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Biomedical subjects

Carol Rice

Publications and source records attributed to Carol Rice.

10 recordsLinked to original sources
PubMed2006

Risk of lung cancer from exposure to dusts and fibers in Leningrad Province, Russia.

BACKGROUND: Exposures to several dusts and fibers (DFs) have been established or suggested as etiologic factors for lung cancer. METHODS: To investigate lung cancer risk in relation to exposure to DFs, we identified 540 pathologically-diagnosed lung cancer cases and 582 controls from the 1993-1998 autopsy records of the 88 hospitals of Leningrad Province, Russia. Lifetime job-specific exposure measurements were available for 15 organic, 15 man-made and 28 natural-inorganic agents. RESULTS: In male workers, increased risks were found for linen dust (OR = 3.68, 95% CI 1.00-13.6, adjusted for age, smoking and residence), and unspecified DFs (OR = 1.44, 95% CI 1.07-1.94). Small non-significant excess risks were observed for quartz dust (OR = 1.27; 95% CI 0.83-1.93) and man-made vitreous fibers (MMVFs) (OR = 1.82, 95% CI 0.88-3.75). In female subjects, risks were non-significantly associated with paper dust (OR = 1.77, 95% CI 0.74-4.20), and unspecified DFs (OR = 1.52, 95% CI 0.77-3.03). CONCLUSIONS: The study showed increased lung cancer risk for selected categories of DFs.

Adult↗
PubMed2005

Comparison of asbestos exposure assessments by next-of-kin respondents, by an occupational hygienist, and by a job-exposure matrix from the National Occupational Hazard Survey.

BACKGROUND: Assessments of occupational exposures in case-control studies of rapidly fatal illnesses often rely on data from next-of-kin respondents, which may be inaccurate. METHODS: Three methods for assessing exposure to asbestos from case-control data on mesothelioma, including next-of-kin assessment, expert assessment, and use of a generic job-exposure matrix (JEM). Interview data [Spirtas et al. (1994): Occup Environ Med 51:804-811] were reviewed to determine exposure status by an occupational hygienist (C.R.) who was unaware of disease status. Exposure odds ratios were calculated using standard methods, and measures of agreement included the kappa statistic and conditional and marginal odds ratios. RESULTS: Expert assessment detected higher proportions of exposed subjects than the next-of-kin respondents or JEM methods. The disease-exposure odds ratios were highest for respondents, perhaps because of recall bias, and lowest for the JEM method. The agreement was highest between the respondent and expert assessments. A combination of respondent's assessment and JEM assessment led to the best prediction of the expert's assessment. Results for spouse respondents were similar to those for other "next-of-kin" respondents. CONCLUSIONS: Expert assessments were the most plausible, but the data indicate that disease associations could also be detected with the other exposure assessment methods. Using some combination of the proxy respondent's assessment and the JEM assessment, one can predict the expert's assessment. A strategy that relied on the respondent's assessment when it was positive and otherwise obtained an expert assessment could reduce costs with little error, compared to expert assessment on all subjects.

Adult↗
PubMed2005

Chronic beryllium disease and sensitization at a beryllium processing facility.

We conducted a medical screening for beryllium disease of 577 former workers from a beryllium processing facility. The screening included a medical and work history questionnaire, a chest radiograph, and blood lymphocyte proliferation testing for beryllium. A task exposure and a job exposure matrix were constructed to examine the association between exposure to beryllium and the development of beryllium disease. More than 90% of the cohort completed the questionnaire, and 74% completed the blood and radiograph component of the screening. Forty-four (7.6%) individuals had definite or probable chronic beryllium disease (CBD), and another 40 (7.0%) were sensitized to beryllium. The prevalence of CBD and sensitization in our cohort was greater than the prevalence reported in studies of other beryllium-exposed cohorts. Various exposure measures evaluated included duration; first decade worked; last decade worked; cumulative, mean, and highest job; and highest task exposure to beryllium (to both soluble and nonsoluble forms). Soluble cumulative and mean exposure levels were lower in individuals with CBD. Sensitized individuals had shorter duration of exposure, began work later, last worked longer ago, and had lower cumulative and peak exposures and lower nonsoluble cumulative and mean exposures. A possible explanation for the exposure-response findings of our study may be an interaction between genetic predisposition and a decreased permanence of soluble beryllium in the body. Both CBD and sensitization occurred in former workers whose mean daily working lifetime average exposures were lower than the current allowable Occupational Safety and Health Administration workplace air level of 2 microg/m3 and the Department of Energy guideline of 0.2 microg/m3.

Aged↗
PubMed2003

Surveillance of respiratory diseases among construction and trade workers at Department of Energy nuclear sites.

BACKGROUND: Medical screening programs were begun in 1996 and 1997 at three Department of Energy (DOE) nuclear weapons facilities (Hanford Nuclear Reservation, Oak Ridge, and the Savannah River Site) to evaluate whether current and former construction workers are at significant risk for occupational illnesses. The focus of this report is pneumoconiosis associated with exposures to asbestos and silica among workers enrolled in the screening programs through September 30, 2001. METHODS: Workers provided a detailed work and exposure history and underwent a respiratory examination, which included a respiratory history and symptom questionnaire, a posterior-anterior (P-A) chest radiograph, and spirometry. Both stratified and multivariate logistic regression analyses were used to explore the risk of disease by duration of DOE employment and frequency of exposure, while controlling for potential confounders such as age, race, sex, and other work in the construction and building trades. RESULTS: Of the 2602 workers, 25.2% showed one or more chest X-ray changes by ILO criteria and 42.7% demonstrated one or more pulmonary function defects. The overall prevalence of parenchymal changes by ILO criteria (profusion 1/0 or greater) was 5.4%. In the logistic regression models, the odds ratio for parenchymal disease was 2.6 (95% confidence interval (CI) = 1.0-6.6) for workers employed 6 to 20 years at Hanford or Savannah River and increased to 3.6 (95% CI = 1.1-11.6) for workers employed more than 35 years, with additional incremental risks for workers reporting routine exposures to asbestos or silica. CONCLUSIONS: Continued surveillance of workers is important given their increased risk of disease progression and their risk for asbestos related malignancies. Smoking cessation programs should also be high priority and continued abstinence for former smokers reinforced. Although the observed respiratory disease patterns are largely reflective of past exposures, these findings suggest that DOE needs to continue to review industrial hygiene control programs for work tasks involving maintenance, repair, renovation, and demolition.

Age Factors↗
PubMed2003

Application of a method to evaluate the quality of work histories and document the exposure assessment process.

BACKGROUND: Review of work history records by industrial hygienists is an important component of many occupational epidemiologic studies. A number of factors may influence the hygienist, such as the quality of the data and his or her previous experience. As part of a case-control study of mesothelioma, a system was developed to capture data on several factors that can be considered in a review of work history information. METHODS: The overall quality of the work history record was described by noting the completeness and the consistency of the information; for any potential exposures, the reviewer experience on which the decision was based and the relative quality of the information were categorized. Because of the potential for mesothelioma cases and their next-of-kin to have undergone rigorous questioning about previous asbestos exposure an evaluation of the knowledge of the respondent was included. The frequency and intensity of exposure were also evaluated. RESULTS: Evaluation of 3,444 work records is described. The importance of data completeness in the overall evaluation of quality is shown; follow-up questions regarding specific work tasks provide information not elicited in the standard interview process. The use of the literature was an important resource to the reviewer. Asbestos was reported by the respondent as an exposure on 149 work records; of these, 111 (74%) were judged to represent an unusual level of knowledge for a next-of-kin respondent. CONCLUSIONS: The approach presented allows capture of information about data quality and experience of the reviewer in an epidemiologic analysis. The ratings of frequency and intensity of exposure allow exploration of differences in exposure-response analyses using various exposure metrics.

Case-Control Studies↗
PubMed2003

An asbestos job exposure matrix to characterize fiber type, length, and relative exposure intensity.

The relationship between asbestos exposure and disease has been well documented, although questions persist as to variation in risk by the type and length of fiber. For a series of jobs with potential asbestos exposure, the primary fiber type (e.g., amosite, anthophylite, chrysotile, crocidolite, or tremolite) and fiber length were identified and the relative exposure intensity was estimated. The resulting job exposure matrix may be useful in epidemiological studies where asbestos is an exposure of interest.

Asbestos↗
PubMed2003

Exposure assessment for endocrine disruptors: some considerations in the design of studies.

In studies designed to evaluate exposure-response relationships in children's development from conception through puberty, multiple factors that affect the generation of meaningful exposure metrics must be considered. These factors include multiple routes of exposure; the timing, frequency, and duration of exposure; need for qualitative and quantitative data; sample collection and storage protocols; and the selection and documentation of analytic methods. The methods for exposure data collection and analysis must be sufficiently robust to accommodate the a priori hypotheses to be tested, as well as hypotheses generated from the data. A number of issues that must be considered in study design are summarized here.

Adolescent↗
PubMed2002

A qualitative evaluation of questions and responses from five occupational questionnaires developed to assess exposures.

Questionnaires are increasingly being used in the workplace to assess exposures to chemicals and other agents. Although the literature contains much information on questionnaire design in general, little information is available on the challenges related to questionnaires applied to the occupational setting. Questionnaires on dry cleaning workers, nurses, farmers, car mechanics, and truck drivers were administered to a total of 25 people currently performing one of these jobs. After asking each question, the interviewer probed to identify the difficulties the respondents had in answering the questions. Overall, the respondents were able to answer the questions. Problems were found, however, with particular questions that reduced the effectiveness of the questionnaire. These included the use of unclear terms, questions open to multiple interpretations, difficult computational requirements (e.g., asking for averages for highly variable tasks), ineffective transitions between topics, and overlapping response categories. This type of testing is a crucial part of questionnaire development and can be used to effectively identify potential problems with questions and, therefore, improve them to enhance collection of higher-quality data for assessments of occupational exposures.

Humans↗
PubMed2002

A longitudinal study of chest radiographic changes of workers in the refractory ceramic fiber industry.

STUDY OBJECTIVE: This industry-wide longitudinal study examines chest radiographic changes of workers manufacturing refractory ceramic fibers (RCF). DESIGN: Chest radiographs were obtained every 3 years and were interpreted using the 1980 International Labour Organization classification for pneumoconiosis. Three exposure metrics were calculated: duration and latency in a production job, and cumulative exposure (fiber-months per cubic centimeter). PARTICIPANTS: The radiographic survey included 625 current workers at five manufacturing sites and 383 former workers at two of the five sites. MEASUREMENTS AND RESULTS: Pleural changes were seen in 27 workers (2.7%). Of workers with > 20 years of latency from initial production job or 20 years of duration in a production job, 16 workers (8.0%) and 5 workers (8.1%) demonstrated pleural changes, respectively. Results from the cumulative exposure analysis (> 135 fiber-months per cubic centimeter) demonstrated a significant elevated odds ratio (OR) of 6.0 (95% confidence interval [CI], 1.4 to 31.0). The incidence of irregular opacities at profusion categories > or = 1/0 was similar to other nonspecified dust-exposed worker populations at 1.0%, and showed a nonsignificant elevated OR in regard to cumulative fiber exposure of 4.7 (95% CI, 0.97 to 23.5). CONCLUSIONS: RCF are significantly associated with pleural changes that were predominantly pleural plaques, but have not resulted in a statistically significant increase in interstitial changes.

Adult↗