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Biomedical subjects

D Shusterman

Publications and source records attributed to D Shusterman.

31 records · Page 2Linked to original sources
PubMed1990

Methylene chloride intoxication in a furniture refinisher. A comparison of exposure estimates utilizing workplace air sampling and blood carboxyhemoglobin measurements.

A 35-year-old furniture refinisher came to the occupational medicine clinic with complaints of upper respiratory irritation, fatigue, and lightheadedness occurring on a daily basis after using a methylene chloride-containing paint stripper. Determinations of blood carboxyhemoglobin (COHb) on three occasions showed an apparently linear elevation of COHb as a function of hours worked on the day of sampling. COHb levels predicted from spot industrial hygiene measurements were in close concordance with those observed in the patient, indicating the potential usefulness of COHb monitoring in estimating airborne exposure levels. Methylene chloride (or dichloromethane) is an organic solvent that has found wide use as a degreaser, paint remover, aerosol propellant, and a blowing agent for polyurethane foams, and as a solvent in food processing, photographic film production, and plastics manufacturing. Discovery of its unusual metabolic fate--conversion to carbon monoxide in vivo--has earned the compound a special place in the solvent toxicology literature. Demonstration of oncogenicity in experimental animals has occasioned a reconsideration of exposure limits, with emphasis upon stricter controls. In some workplaces, conditions prevail in which controls are inadequate to prevent even acute toxicity, much less long-term exposure risks.

Adult↗
PubMed1986

Prolonged fever associated with inhalation of multiple pyrolysis products.

A case of smoke inhalation with a self-limited but prolonged febrile course, including headaches and chills, is reported. A final diagnosis of polymer fume fever was made, although the duration of fever was longer than generally has been reported with this syndrome. Pyrolysis products involved included those of polyurethane, methylene chloride, and polytetrafluoroethylene ("Teflon"). The results of toxicological testing are reported and discussed.

Adult↗
PubMed1985

Problem-solving techniques in occupational medicine.

The diagnosis of occupational illnesses may be considerably more difficult than is the case with occupational injuries because of a variety of factors: an intervening latency period, uncertainty in identifying the most significant chemical or physical exposures, determination of exposure levels retrospectively, and coordination of the physician with regulatory and workers' compensation bureaucracies. Such problem-solving techniques as retrospective industrial hygiene and attention to in-situ chemistry can act as means of reducing the uncertainty in making the diagnosis of occupational illness. Advance familiarity with workers' compensation and state or federal regulatory agencies can further facilitate diagnosis and patient advocacy.

Adult↗
PubMed1979

Kinetics of bilirubin oxidation with peroxidase, as applied to studies of bilirubin-albumin binding.

In the determination of unbound bilirubin by rate of oxidation with peroxidase, errors may be caused by (1) phenol, propylparaben, and phenothiazines (free radical acceleration), (2) haemoglobin (peroxidase effect), and (3) ascorbate (inhibition). Such errors may be diminished by dilution 1:40, or with an anti-oxidant, tert-butyl-p-hydroxyanisole, and ascorbate oxidase.

Ascorbate Oxidase↗
PubMedDate not supplied

Critical review: the health significance of environmental odor pollution.

Environmental odor pollution problems generate a significant fraction of the publicly initiated complaints received by air pollution control districts. Such complaints can trigger a variety of enforcement activities under existing state and local statutes. However, because of the frequently transient timing of exposures, odor sources often elude successful abatement. Furthermore, because of the predominantly subjective nature of associated health complaints, air pollution control authorities may predicate their enforcement activities upon a judgment of the public health impact of the odor source. Noxious environmental odors may trigger symptoms by a variety of physiologic mechanisms, including exacerbation of underlying medical conditions, innate odor aversions, aversive conditioning phenomena, stress-induced illness, and possible pheromonal reactions. Whereas relatively consistent patterns of subjective symptoms have been reported among individuals who live near environmental odor sources, documentation of objective correlates to such symptoms would require as-yet unproven research tools. Therefore, given our current state of knowledge, any differential regulatory response to environmental odor pollution, which is based upon the distinction between community "annoyance reactions" and "health effects," is a matter of legal--not scientific--interpretation.

Air Pollution↗
PubMedDate not supplied

Measurement of nasal irritant sensitivity to pulsed carbon dioxide: a pilot study.

Nasal irritation and associated symptoms (e.g., nasal congestion, rhinorrhea, sinus headache) are important air-pollution-related health complaints, particularly in so-called problem buildings. Individual differences in nasal irritant sensitivity are therefore of both clinical and regulatory interest. To document such differences, one must first functionally define perceptual acuity to airborne irritants. In an adaptation of an established sensory testing method, the authors used the odorless irritant carbon dioxide in an electronically controlled dilution apparatus to deliver brief (approximately 3 s) pulses at controlled levels (10%-70%, vol/vol), synchronized with the inspiratory phase of the respiratory cycle. Investigators who use this apparatus can use a variant of the forced-choice paradigm for threshold determination to document nasal irritant sensitivity. The authors recruited 30 adult volunteers (17 males, 13 females; average age = 41 y, range = 19-79 y) from a university laboratory complex and from the general community. Within this group, there was a skewed distribution of carbon dioxide thresholds (arithmetic mean = 28%, geometric mean = 27% [vol/vol]). In univariate analyses, geometric mean carbon dioxide thresholds differed significantly with respect to smoking status (36% carbon dioxide in smokers versus 25% in nonsmokers; p < .005), but not with respect to age, gender, or self-reported history of allergic rhinitis. In a multivariate analysis, gender also approached significance; females tended to show better perceptual acuity than males (p = .06). Neither self-reported "vasomotor rhinitis" symptoms nor self-reported symptomatic reactivity to environmental tobacco smoke predicted carbon dioxide thresholds. Pulsed carbon dioxide is well tolerated by subjects who participate in a threshold detection task; the procedure yields a potential endpoint with which to compare individuals (and groups) with respect to nasal irritant perceptual acuity. The relationship between such acuity and nasal physiologic reactivity-as well as the generalizability of such measures to other, more environmentally realistic irritants-has yet to be defined.

Adult↗