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Biomedical subjects

D F Goldsmith

Publications and source records attributed to D F Goldsmith.

At least 19 recordsLinked to original sources
PubMed1999

Nested case-control study of esophageal cancer in relation to occupational exposure to silica and other dusts.

BACKGROUND: Standardized proportionate mortality ratio (SPMR) was found to be 2.2 (95% CI = 1.3-3.5) for esophageal cancer (EC) among workers exposed to refractory brick dust in a large iron-steel complex in China. METHODS: A nested case-control design within a cohort of industrial workers. One hundred and twenty-five EC cases and 250 controls were identified from the death registry file. Interviews were conducted of the next of kin for past exposure information on job, domestic, and lifestyle factors. History of occupational exposure to various dusts was reconstructed from personnel files and by interviewing colleagues utilizing a job-exposure matrix. RESULTS: After adjusting for confounders, occupational exposure to silica dust was the most important risk factor among all variables investigated, with a 2.8-fold risk and a clear dose-response by length of exposure. Alcohol drinking (OR = 1.8) and coal cooking (OR = 2.0) were risk factors and high consumption of fruit diet (OR = 0.5) and meat diet (OR = 0.6) were protective factors. CONCLUSIONS: The relationship between occupational exposure to silica dust and the risk of EC found in an earlier SPMR study was confirmed. Ingestion of silica particles after lung clearance may increase the risk of EC among workers exposed to silica.

Aged↗
PubMed1999

End stage renal disease among ceramic workers exposed to silica.

OBJECTIVES: To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease. METHODS: On the basis of a health surveillance programme, a cohort of 2980 male ceramic workers has been enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data, and x ray film readings were available. The vital status was ascertained for all cohort members. All 2820 people still alive and resident in the Lazio region as in June 1994 were searched for a match in the regional end stage renal diseases registry, which records (since June, 1994) all patients undergoing dialysis treatment in public and private facilities of the region. Expected numbers of prevalent cases from the cohort were computed by applying the rate of patients on dialysis treatment by the age distribution of the cohort. RESULTS: A total of six cases was detected when 1.87 were expected (observed/expected (O/E) = 3.21; 95% confidence interval (95% CI) 1.17 to 6.98). The excess risk was present among non-smokers (O = 2; O/E = 4.34) and smokers (O = 4; O/E = 2.83), as well as among workers without silicosis (O = 4; O/E = 2.78) and workers with silicosis (O = 2; O/E = 4.54). The risk was higher among subjects with < 20 years since first employment (O = 4; O/E = 4.65) than among those employed > 20 years. CONCLUSION: These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.

Adult↗
PubMed1997

Mothers' and toddlers' coordinated joint focus of attention: variations with maternal dysphoric symptoms.

This investigation compared the attention patterns of 40 toddlers and their mothers with or without dysphoric symptoms in a situation that allowed both common and independent foci of attention. Mother-toddler dyads with a dysphoric mother spent a smaller proportion of the session engaged in attention to an activity in common than did dyads with nondysphoric mothers. In addition, even when primarily attending elsewhere, nondysphoric mothers more extensively time-shared their attention between their child and a competing activity than did dysphoric mothers. Thus, dysphoric mothers appear to attend to an event in common with their children less frequently than do nondysphoric mothers in terms of both their primary focus of attention and their attentiveness to the child when primarily attending to a competing event.

Adult↗
PubMed1996

Cancer prevention strategies among California farmworkers: preliminary findings.

This study was conducted to identify barriers to cancer prevention and evaluate the effectiveness of a cancer prevention project to increase screening for cervical and breast cancer among Spanish-speaking farmworkers in California's Central Valley. Bilingual health educators met with farmworker communities near Merced and Modesto, CA, to determine barriers that prevented women from seeking screening for breast and cervical cancer. Using information from focus groups and health fairs, a targeted outreach protocol was developed that will eventually enroll 2,500 farmworkers in a cancer education and screening program. Participants received a presentation in Spanish on breast and cervical cancer that included a pretest and post-test to assess increases in knowledge. Clients were encouraged to attend Golden Valley Health Centers Inc. (GVHC) to receive free breast and cervical cancer screenings. Vouchers, redeemable for modest personal hygiene gifts by clients, were tracked to assess prevention behavior when appointments were kept at GVHC. Sixty farmworkers attended focus groups and 363 attended health fairs to provide input to The cancer prevention program. As of December 1, 1995, 1,732 female farmworkers were enrolled in an outreach program designed to increase knowledge and promote cancer screening. Data from pretests and post-tests indicated a statistically significant increase in knowledge about cancer and its prevention among participants. Furthermore, 317 participants redeemed vouchers for cancer screenings at GVHC. Active community collaboration and culturally appropriate intervention strategies, employed in conjunction with clinical services, can be successful in increasing cancer prevention awareness and screenings among female farmworkers.

Agriculture↗
PubMed1996

Respiratory health of California rice farmers.

Rice farmers are occupationally exposed to agents that may affect respiratory health, including inorganic dusts and smoke from burning of agricultural waste. To assess respiratory health of this occupational group, we conducted a cross-sectional study, including a self-administered health and work questionnaire, spirometry, and chest radiography among 464 male California rice farmers. Mean age +/- SD was 48.3 +/- 15.2 yr; mean duration of rice farming was 25.7 +/- 14.3 yr. Prevalences for respiratory symptoms were: chronic bronchitis (6.3%), physician-diagnosed asthma (7.1%), and persistent wheeze (8.8%). Chronic cough was reported by 7.1% of respondents and was associated with reported hours per year burning rice stubble. Mean FEV1 and FVC were at expected values. FEV1 was inversely associated with years working in rice storage and use of heated rice dryers. Mean FEF25-75 was 93% of expected and was inversely associated with rice storage activities involving unheated rice driers. ILO profusion scores > or = 1/0 for small irregular opacities were seen in 18 (10.1%) of 178 chest radiographs. Study findings suggest increased asthma prevalence among California rice farmers. Radiologic findings consistent with dust or fiber exposure were increased compared with those of the general population, although no associations with specific farming activities were identified.

Agriculture↗
PubMed1995

Respiratory cancer and other chronic disease mortality among silicotics in California.

Silicotics have increased mortality from tuberculosis (TB) and from nonmalignant respiratory diseases (NMRD), including silicosis and silicotuberculosis. Since the publication of the International Agency for Research on Cancer monograph in 1987 indicating that silica was a probable human carcinogen, there has been an extensive debate about the cancer risks among silicotics. The authors identified 590 claims for silicosis among a registry of lung diseases compiled from California Workers' Compensation cases from 1945 to 1975. Using state vital records, we determined the mortality risks from 1946 to 1991. Our findings confirmed that these claimants had a significantly elevated risk for all causes of death with a standardized mortality ratio (SMR) of 1.30 (95% confidence interval [CI] = 1.18, 1.43); TB had a SMR of 56.35 (95% CI = 41.10, 75.40) and NMRD a SMR of 3.80 (95% CI = 3.11, 4.60). Cancers of the trachea, bronchus, and lung had a SMR of 1.90 (95% CI = 1.35, 2.60). For malignancies of the large intestine, there was a previously unreported SMR of 2.08 (95% CI = 1.14, 3.50). Mortality from all diseases of the heart was significantly less than expected with a SMR of 0.68 (95% CI = 0.55, 0.83); cancers of the prostate and lymphatic system were also significantly low with SMRs of 0.26 (95% CI = 0.03, 0.94) and 0.17 (95% CI = 0.04, 0.97), respectively. Workers with silicosis should be warned about these chronic disease risks, and prevention efforts to control occupational silica dust exposure should become a higher priority.

Aged↗
PubMed1995

Silica exposure and autoimmune diseases.

There have long been case reports linking silica exposure to a variety of autoimmune diseases (systemic sclerosis, rheumatoid arthritis, lupus, chronic renal disease). Evidence of this association in larger epidemiologic studies has been increasing in the last decade. We summarize this evidence here, and present some plausible mechanisms which have been discussed in the literature. The link between silica exposure and autoimmune disease may have been missed in cohort mortality studies because autoimmune diseases are rarely underlying causes of death. Similarly, case-control studies of autoimmune diseases have often failed to consider occupational exposure to silica. Further research is needed in occupationally exposed populations to verify this association. The link between respirable silica exposure and autoimmune disease may have some bearing on the possible association between silicone breast implants and autoimmune disease, although the nature of the silica involved is quite different in the two situations.

Autoimmune Diseases↗
PubMed1995

Mortality in agricultural workers after compensation claims for respiratory disease, pesticide illness, and injury.

The long-term mortality experience of California agricultural workers who filed workers' compensation claims for respiratory diseases, pesticide illnesses, and injuries between 1946 and 1975 was observed until 1991 and compared to U.S. death rates. The respiratory disease claimants had an elevated relative risk of 3.27 (95% CI 2.09-4.86) for mortality from nonmalignant respiratory diseases (NMRD). Emphysema mortality was particularly high, with a relative risk of 5.94 (95% CI 2.56-11.70). NMRD mortality peaked 5 to 9 years after the claims were filed (relative risk 9.83, 95% CI 4.47-18.57) and was most strongly associated with exposure to wood, rice, coffee, and flour dusts. Among the pesticide illness claimants, mortality from heart disease was slightly elevated in the subcohort with systemic pesticide illness (SMR = 1.32, 95% CI 0.86-1.94). Among the injury claimants, risk was increased for motor vehicle deaths (relative risk 1.62, 95% CI 0.74-3.08). It was concluded that respiratory disease claimants in agriculture have a significantly elevated risk of mortality from respiratory diseases and that the risk is highest (10-fold) 5-9 years after claims are filed.

Accidents, Occupational↗
PubMed1995

Comparative cancer potency for silica from extrapolations of human and animal findings.

The International Agency for Research on Cancer has judged that the evidence for the carcinogenicity of silica in animals is sufficient, and for humans it is limited. With the use of the Global 86 computer model, animal and human cancer potency data were extrapolated and the findings compared. The animal findings were based on inhalation rat studies. The cancer slope factors ranged from 2.3 x 10(-5) to 6.0 x 10(-3) for (1 mu g center dot m(-3)-1 among three experimental studies. The epidemiologic findings were from gold workers exposed to quartz and diatomaceous earth workers exposed to cristobalite. The cancer slope factors ranged from 6.8 x 10(-7) to 1.85 x 10(-5) for lifetime exposure to 1 (mu g center dot m-3)-1 of silica dust. Because of the many uncertainties involved in extrapolating to humans from animal data, more rational risk assessments are achieved when data from silica-exposed workers are used than when laboratory findings are relied on.

Animals↗
PubMed1993

Fiberglass or silica exposure and increased nephritis or ESRD (end-stage renal disease).

The U.S. multiplant cohort mortality study of workers producing manufactured mineral fibers is finding increasing mortality from nephritis and/or nephrosis. We examine other data sets to see if similar effects can be identified. In a case-referent study among Michigan patients with end-stage renal disease (ESRD), men with exposures to silica have elevated odds ratio for ESRD. In a California occupational mortality study based on 1979-81 data, a number of the construction trades, farmers, and farm laborers show excess mortality for renal disease. The highest mortality ratio is found in the category including insulation workers. This ratio remains significantly elevated when adjusted for estimated exposures to smoking, alcohol, and for socio-economic status. California mortality data from 20 years earlier (1959-61) fail to show much excess renal disease in construction workers, but do for farmers. In Singapore, granite workers with a long-term exposure to silica have excess excretion of albumin and similar compounds compared to less exposed controls, leading to the presumption that silica exposure can lead to silica nephrotoxicity. Balkan nephropathy has been associated with consumption of well water high in silica. In the Negev of Israel, dust storms are a vehicle for increasing respiratory uptake of silica. The Beduin, thought to be a population with maximal exposures, have higher rates of ESRD than do Jews in the age groups over 60 years. Although high blood concentrations of silica are found in persons with renal failure, the close association with elevated creatinine has been interpreted as evidence that the buildup of silica is due to renal failure, rather than vice-versa.(ABSTRACT TRUNCATED AT 250 WORDS)

Cohort Studies↗
PubMed1988

A cohort study of workers employed in a refractory brick plant.

A mortality study was carried out on a cohort of workers who were exposed to silica dust in a refractory brick plant. The cohort was divided into two groups: workers with and without silicosis, and their mortality was contrasted with the death rate of Genova from 1960 to 1979. Results show an increased risk for laryngeal tumors (3 obs., 0.44 exp., SMR = 682), nonmalignant respiratory disease (16 obs., 3.2 exp., SMR = 500), and cardiovascular diseases (19 obs., 11 exp., SMR = 173) among silicotics. The mortality rate for lung cancer showed an increase for the cohort of workers as a whole (11 obs., 6 exp., SMR = 183). The almost double overall mortality observed in silicotic subjects raises some doubts about the validity of other proportional mortality studies that showed no excesses for workers in these industries.

Adult↗
PubMed1988

An epidemiologic study of respiratory health effects in a group of North Carolina furniture workers.

Woodworking is known to be associated with nasal cancer and with western red cedar asthma, but research is inconsistent with regard to respiratory health effects among furniture workers. The authors tested the hypotheses that employment in a North Carolina hardwood furniture plant was related to the prevalence of respiratory symptoms and to impairment of pulmonary function. Chronic symptom prevalence generally showed no significant differences between wood dust jobs and control exposures; however, frequent sneezing and eye irritation were significantly (P less than .05) correlated with wood dust exposed jobs; in both cases the prevalence odds ratio was 4.0. Peak flow was the only pulmonary function measure that correlated significantly (P = .0345) with wood dust employment. The difference in forced vital capacity suggested a weak association with current employment in finishing jobs, whereas the difference in peak flow showed a modest correlation with the fraction of particulate less than 10 microns. The relevance of the present associations to regulatory changes and research needs is discussed.

Adult↗
PubMed1988

Respiratory health effects from occupational exposure to wood dusts.

Occupational exposure to wood dusts has been well established as a cause of nasal cancer, dermatitis, and pneumonites from molds growing in wood chips. With the exception of studies on western red cedar asthma, there is a dearth of information on the respiratory toxicity of wood dust exposure. This paper reviews the clinical and epidemiologic literature and identifies the specific woods (with botanical names) and their respiratory disease correlates, including pulmonary function declines, chronic and acute symptoms, and impaired mucociliary transport.

Dust↗
PubMed1987

Calculating cancer latency using data from a nested case-control study of prostatic cancer.

Assessing latency for neoplastic diseases is crucial for determining the causal effects of a complex mix of carcinogenic exposures. An initial assessment of cancer risks in a U.S. tire and rubber plant revealed a significant SMR of 140 for prostatic cancer. Using an industry-based, case-control death certificate study of prostatic malignancies, we found matched odds ratios of about 3 (p less than 0.025) for Batch Preparation, the work area with the greatest exposure to carbon black, solvents, and heavy metal oxides. To assess latency, we used the matched case-control series to calculate annual estimates of the odds ratio by determining the proportion of cases and controls employed for greater than 1 month in Batch Preparation during each year under study. This approach produced a plot with great fluctuations. To reduce variability in the resulting curve, a method was developed that measured the "etiologic fraction", which is its highest point represents an estimate of the peak of the latency distribution. For Batch Preparation the modal point was 29 years before death with the greatest risk occurring from employment in the mid-1940's. The latency method allows risk assessment for time and year of greatest exposure difference, thus suggesting appropriate prevention strategies. Applications of this method for other types of studies and exposures are discussed.

Epidemiologic Methods↗
PubMed1986

Occupational cancer.

When cancer is possibly related to occupation, the family physician's task is to put the matter in perspective by educating the patient and carefully documenting the appearance of the tumor and the patient's work history. Occasionally, physicians are the first to recognize new associations between chemicals and cancer and can help to bring hazards under control.

Asbestos↗
PubMed1982

Does occupational exposure to silica cause lung cancer?

Silica is not generally considered to be a carcinogen, however, occupations characterized by high exposure to crystalline silica have excessive rates of lung cancer mortality. Respiratory cancer excesses have been reported from North America and from Europe for the following dusty trades in which exposure to silica is a common factor: iron and steel foundry workers, steel casting workers, sand blasters, metal molders, non-uranium miners, and ceramic workers. These findings have been reinforced by two reports from the Swedish Pneumoconiosis Register and the Ontario Ministry of Labor indicating that silicotics have statistically significant risks of lung cancer mortality. Animal studies suggest that silica can be an initiating carcinogen or can act as a cocarcinogen or promoter when combined with benzo(a)pyrene. We propose three candidate hypotheses and two pathways for silicocarcinogenesis.

Animals↗