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Biomedical subjects

E Johanning

Publications and source records attributed to E Johanning.

12 recordsLinked to original sources
PubMed2000

Evaluation and management of occupational low back disorders.

This clinical practice review of occupational low back disorders describes work-related risk factors, occupational history, physical evaluation, clinical tests, diagnosis, care, and prevention. It is part of a quality assurance (QA) and quality improvement (QI) effort to establish exemplary occupational practice standards. It emphasizes the involvement of occupational medicine physicians in exposure assessment, care of injured workers, and disease prevention. Important occupational risk factors such as lifting, awkward body posture and vibration, in addition to psychosocial, socio-economic and other factors are summarized. The focus is on mechanical back disorders. Return-to-work, rehabilitation and prevention strategies are discussed as part of integrated disability management involving the injured worker, the primary care provider, employers and other relevant parties.

Delivery of Health Care, Integrated↗
PubMed1999

Clinical experience and results of a Sentinel Health Investigation related to indoor fungal exposure.

This is a review of exposure conditions, clinical presentation, and morbidity of children and adults with indoor fungal exposure such as toxic Stachybotrys chartarum. Indoor exposure was characterized using different methods including microscopic, culture, cytotoxicity screening tests, and chemical analyses. Clinical case histories and physical and laboratory findings are presented of children (age < 18 years, n = 22; mean age 9 years; 60% females) and adults (age >18 years, n = 125; mean age 39 years, 67% females) who consulted an environmental health specialty clinic. In the pediatric patients' exposure history, widespread fungal contamination of water-damaged building materials with known toxic or allergic fungi was identified. Primarily disorders of the respiratory system, skin, mucous membranes, and central nervous system were reported. Some enumeration and functional laboratory abnormalities, mainly of the lymphatic blood cells, were observed, although no statistically significant differences were found. IgE or IgG fungi-specific antibodies, used as exposure markers, were positive in less than 25% of all tested cases. In an evaluation of a symptomatic girl 11 years of age (sentinel case investigation) living in an apartment with verified toxigenic fungi (i.e., S. chartarum), several health indicators showed improvement after exposure cessation.

Adolescent↗
PubMed1996

Health and immunology study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water-damaged office environment.

There is growing concern about adverse health effects of fungal bio-aerosols on occupants of water-damaged buildings. Accidental, occupational exposure in a nonagricultural setting has not been investigated using modern immunological laboratory tests. The objective of this study was to evaluate the health status of office workers after exposure to fungal bio-aerosols, especially Stachybotrys chartarum (atra) (S. chartarum) and its toxigenic metabolites (satratoxins), and to study laboratory parameters or biomarkers related to allergic or toxic human health effects. Exposure characterization and quantification were performed using microscopic, culture, and chemical techniques. The study population (n = 53) consisted of 39 female and 14 male employees (mean age 34.8 years) who had worked for a mean of 3.1 years at a problem office site; a control group comprised 21 persons (mean age 37.5 years) without contact with the problem office site. Health complaints were surveyed with a 187-item standardized questionnaire. A comprehensive test battery was used to study the red and white blood cell system, serum chemistry, immunology/antibodies, lymphocyte enumeration and function. Widespread fungal contamination of water-damaged, primarily cellulose material with S. chartarum was found. S. chartarum produced a macrocyclic trichothecene, satratoxin H, and spirocyclic lactones. Strong associations with exposure indicators and significant differences between employees (n = 53) and controls (n = 21) were found for lower respiratory system symptoms, dermatological symptoms, eye symptoms, constitutional symptoms, chronic fatigue symptoms and several enumeration and function laboratory tests, mainly of the white blood cell system. The proportion of mature T-lymphocyte cells (CD3%) was lower in employees than in controls, and regression analyses showed significantly lower CD3% among those reporting a history of upper respiratory infections. Specific S. chartarum antibody tests (IgE and IgG) showed small differences (NS). It is concluded that prolonged and intense exposure to toxigenic S. chartarum and other atypical fungi was associated with reported disorders of the respiratory and central nervous systems, reported disorders of the mucous membranes and a few parameters pertaining to the cellular and humoral immune system, suggesting a possible immune competency dysfunction.

Adult↗
PubMed1996

Cardiovascular Risk and Back-disorder Intervention Study of Mass Transit Operators.

A prospective intervention study was conducted to evaluate an employer/union-sponsored physical and psychological health program, which was offered to 125 transit operators aged >45 years with >15 years of job seniority. The one-year, biweekly program included physical exercise, relaxation, back school, and work-related stress management and diet counseling. A control group (n = 26) was available for comparison. Twenty-seven operators dropped out of the study. WHO cardiovascular risk survey methods, ergometry, Minnesota ECG coding, standardized low-back tests, blood lipids, lead, and carboxyhemoglobin were measured. Before the intervention, the ten-year cardiovascular-disease risk of all study subjects (15.1%) was greater than that of the general reference population (14.0%). After the intervention it fell to 12.9%, but not significantly compared with that of a non-exercising control group, which also showed a reduction. The prevalence and the self-rated intensity of back problems were reduced after the intervention: 55.4% of low-back-pain sufferers reported substantial improvement, and only 12.3% reported substantial worsening. The multidisciplinary intervention program appeared to be effective for musculoskeletal conditions, but not for overall cardiovascular risk, compared with the controls.

Journal Article↗
PubMed1994

Asbestos hazard evaluation in South Korean textile production.

The manufacture and use of asbestos-containing products has become the object of restrictive environmental and occupational health regulation in the United States and many European countries. World production, however, has not declined, but rather shifted to developing countries. Our knowledge of the working conditions in these countries is limited. This article describes an investigation conducted in 1991 into the conditions and work practices in asbestos textile manufacturing in South Korea. The findings are based on site visits to several asbestos textile manufacturing facilities, meetings with industrial safety experts, and labor and industry representatives. The authors describe the current status of exposure control technology and industrial hygiene practices, and the results of personal asbestos dust monitoring at five representative textile production workstations. In general, manufacturers and regulatory agencies have not taken the precautions necessary to adequately protect employee health and meet international standards. Worker exposure to asbestos dust well above U.S. and German standards is commonplace in South Korea. International cooperation of health and safety experts with experience in asbestos-related problems should be promoted to improve the level of industrial safety in developing countries.

Air Pollutants, Occupational↗
PubMed1991

Back disorders and health problems among subway train operators exposed to whole-body vibration.

Back disease associated with whole-body vibration has not been evaluated for subway train operators. A recent study demonstrated that this group is exposed to whole-body vibration at levels above the international standard. To investigate this risk further, a self-administered questionnaire survey was conducted among subway train operators (N = 492) and a similar reference group (N = 92). The operators had a higher prevalence than the referents in all aspects of back problems, particularly for cervical and lower back pain. In a multiple logistic regression model, the odds ratio for sciatic pain among subway train operators was 3.9 (95% CI 1.7-8.6); the operators also had a higher risk of hearing-related problems (odds ratio 3.2, 95% CI 0.6-17.4) and of gastrointestinal problems (odds ratio 1.6, 95% CI 1.1-2.5). Although a cumulative dose-response relationship could not be statistically demonstrated, the findings appear to be related to exposure to whole-body vibration and inadequate ergonomic conditions.

Adult↗
PubMed1991

Whole-body vibration exposure in subway cars and review of adverse health effects.

New York City Transit Authority subway operators have a high prevalence of back problems. To evaluate a possible dose-response relationship for whole-body vibration, we studied subway car vibrations measured and analyzed according to the International Standard Organization 2631 and Verein Deutscher Ingenieure 2057 standards. Vibration transducers in triaxial orientation were mounted in a disc pad directly on the subway operator's seat. The relatively high lateral and vertical accelerations, primarily the combined effects, may all contribute to the high rate of musculoskeletal complaints, especially of the lower back. Other factors aggravating whole-body vibrations include primitive ergonomic cab and seat design, forced body posture, high noise levels, and organizational work stress.

Back Pain↗
PubMedDate not supplied

Noise, vibration, and heat and cold.

Using information from the U.S. government and the scientific literature, the authors identify preventive strategies for specific types of injuries and categorize features of employers and workers that are associated with low injury rates. They conclude that safe working conditions are possible and are related to the attitudes of workers and management.

Adult↗