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Biomedical subjects

E A Grossman

Publications and source records attributed to E A Grossman.

7 recordsLinked to original sources
PubMed1997

Follow-up of biologic monitoring results in cadmium workers removed from exposure.

Biological monitoring and exposure monitoring data for employees at a nickel-cadmium battery production facility were made available to OSHA for review. Sixteen employees were medically removed from occupational exposures to cadmium due to elevated levels of biological parameters (CdB, Cdu, B2U). While the biological monitoring parameters for most workers significantly declined during the 18 months of medical removal, the biological parameters for only one employee's values returned to the normal range. Only one worker had frank renal dysfunction, based on beta-2-microglobulin levels at the time of removal; this dysfunction remained throughout the 17 months of observation after medical removal. Significant policy implications of medical removal protection beyond the current 18-month period provided by the cadmium standards exist and require physician discretion. Mitigating issues which may make it ethically appropriate to return an employee to work despite elevated biologic monitoring parameters are also discussed.

Cadmium↗
PubMed1996

Biological monitoring results for cadmium exposed workers.

As part of a settlement agreement with the Occupational Safety and Health Administration (OSHA) involving exposure to cadmium (Cd), a battery production facility provided medical surveillance data to OSHA for review. Measurements of cadmium in blood, cadmium in urine, and beta 2-microglobulin in urine were obtained for more than 100 workers over an 18-month period. Some airborne Cd exposure data were also made available. Two subpopulations of this cohort were of primary interest in evaluating compliance with the medical surveillance provisions of the Cadmium Standard. These were a group of 16 workers medically removed from cadmium exposure due to elevations in some biological parameter, and a group of platemakers. Platemaking had presented a particularly high exposure opportunity and had recently undergone engineering interventions to minimize exposure. The effect on three biological monitoring parameters of medical removal protection in the first group and engineering controls in platemakers is reported. Results reveal that both medical removal from cadmium exposures and exposure abatement through the use of engineering and work practice controls generally result in declines in biological monitoring parameters of exposed workers. Implications for the success of interventions are discussed.

Air Pollutants, Occupational↗
PubMed1995

Silica exposures in workplaces in the United States between 1980 and 1992.

Between 1980 and 1992, compliance officers of the Occupational Safety and Health Administration in the United States measured respirable quartz in 1655 inspections in 255 industries. In 52% of the 255 industries where respirable quartz was measured, the average severity value was less than one, indicating average exposures below the permissible exposure limit, and in 48% the permissible exposure limit for silica was exceeded. Among industries where more than 10 facilities were inspected, the most severe respirable quartz exposures were found in fabricated structural metal; painting and paper hanging; nonresidential construction; shipbuilding and repair; masonry and other stone work; bridge, tunnel and elevated highway construction; metal coating, engraving and allied services; and special trades contractors.

Humans↗
PubMed1990

OSHA's approach to risk assessment for setting a revised occupational exposure standard for 1,3-butadiene.

In its 1980 benzene decision [Industrial Union Department, ALF-CIO v. American Petroleum Institute, 448 U.S. 607 (1980)], the Supreme Court ruled that "before he can promulgate any permanent health or safety standard, the Secretary [of Labor] is required to make a threshold finding that a place of employment is unsafe--in the sense that significant risks are present and can be lessened by a change in practices" (448 U.S. at 642). The Occupational Safety and Health Administration (OSHA) has interpreted this to mean that whenever possible, it must quantify the risk associated with occupational exposure to a toxic substance at the current permissible exposure limit (PEL). If OSHA determines that there is significant risk to workers' health at its current standard, then it must quantify the risk associated with a variety of alternative standards to determine at what level, if any, occupational exposure to a substance no longer poses a significant risk. For rulemaking on occupational exposure to 1,3-butadiene, there are two studies that are suitable for quantitative risk assessment. One is a mouse inhalation bioassay conducted by the National Toxicology Program (NTP), and the other is a rat inhalation bioassay conducted by Hazelton Laboratories Europe. Of the four risk assessments that have been submitted to OSHA, all four have used the mouse and/or rat data with a variety of models to quantify the risk associated with occupational exposure to 1,3-butadiene. In addition, OSHA has performed its own risk assessment using the female mouse and female rat data and the one-hit and multistage models.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants, Occupational↗
PubMed1986

Linear rank tests for interval-censored data with application to PCB levels in adipose tissue of transformer repair workers.

Linear rank statistics are described for testing for differences between groups when the data are interval-censored. The statistics are closely related to those described by Prentice (1978, Biometrika 65, 167-179) for right-censored data. Problems in calculating the statistics are discussed and several approaches to computation including estimation of the efficient rank scores are described. Results from a small simulation study are presented. The methods are applied to data from a study relating tissue levels of PCBs to occupational exposure.

Adipose Tissue↗
PubMed1984

The circumcision controversy: an update.

One constructive feature has come out of all of the circumcision controversy. It has made us aware that neonatal circumcision is not a simple procedure and that it should not be regarded as "routine." It is a surgical procedure and it should be taught as one. The authors of this article wrote a review article on circumcision in 1981 and Dr. Grossman has recently published a book designed to teach proper circumcision technique, and to familiarize the operator with the common congenital anomalies as well as the prevention and treatment of the complications of circumcision. The advocacy of neonatal circumcision cannot be considered as a cut and dried issue. For some, it has an absolute religious indication, which transcends current medical logic. For others the available facts still allow for a decision based on one's perception of those facts. If one has the perception that there is value in improving local hygiene, or that the loss of the prepuce will allow for an earlier discovery of a penile lesion, or that circumcision actually does cause a decrease in the incidence of penile or cervical cancer, or group conformity is important, then one might well advocate neonatal circumcision. If, however, one sees the potential values as insignificant in light of the lack of hard data relating circumcision to penile or cervical cancer, and that if one is concerned with the "rape of the phallus," then one is against routine neonatal circumcision. But, this individual must be aware that a small percentage of males will need a circumcision at a later time in life, when technical and psychological problems may lead to an increased morbidity. The decision of the physician, and the advice given to the new parents, at present, appears to be more subjective than the advice concerning RhoGAM, or DPT immunization, although it occasionally is given with as much certainty. We are dealing with the art of medicine rather than science. On this basis, rather than deride each other for positions taken, and religious considerations aside, we would do much better to develop better scientific studies to answer the scientific questions. Today's tendency to make decisions on evaluation of the risk:benefit ratio is clearly difficult if both are not adequately quantitated. Until these are available the decision of whether or not to circumcise must result from an objective discussion between the doctor and the parents of newborn males.(ABSTRACT TRUNCATED AT 400 WORDS)

Bible↗