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Biomedical subjects

E Kusters

Publications and source records attributed to E Kusters.

6 recordsLinked to original sources
PubMed1996

Investigation of a cluster of ten cases of Hodgkin's disease in an occupational setting.

The objective of this study was to identify occupational exposures that might be etiologically linked to an unusual cluster of ten cases of Hodgkin's disease. The cases were identified within the active workforce of a large chemical manufacturing firm over a 23-year period by the medical director of the facilities. Based on comparison with regional cancer incidence rates, the standardized incidence ratio for Hodgkin's disease was 497 (95% confidence interval: 238-915) for the period from the construction of the facilities in 1966 through early 1992. A nested case-control study was undertaken with 200 controls selected according to case-cohort sampling. Simultaneously, efforts were initiated to confirm and characterize each case more fully. Occupational exposures were identified and categorized using process, work history, medical record, and industrial hygiene data. Tissue slides were available for eight cases and a second review confirmed the diagnosis of Hodgkin's disease. For one case, a final diagnosis of large-cell anaplastic lymphoma was determined after histology review. Among 214 different chemical agents studied, eight were identified to which three or more of the cases had been exposed prior to the date of their initial diagnosis. Exposure odds ratios were statistically elevated for five of these agents; dose-response evaluations for two of the agents, ethylene oxide and benzene, failed to provide additional support for a causal relationship. In conclusion, although several statistical associations were identified, no substance emerged as a likely candidate for explaining the observed Hodgkin's disease cluster.

Benzene↗
PubMed1996

A five year follow-up of lung function among chemical workers using flow-volume and impedance measurements.

Impedance of the respiratory system, measured using the forced oscillation technique (FOT), has repeatedly been proposed as a tool for occupational health screening. The aim of this study was to compare the outcome of impedance measurements and flow-volume curves, and to study relationships between lung function decline and specific exposures and smoking. Both measurements were applied in 136 chemical workers from seven main production/personnel groups during a 5 year follow-up (1990-1995). The prevalence of airway obstruction (forced expiratory volume in one second (FEV1) < 80% of predicted) at both time-points was about 5% but did not necessarily include the same subjects. The average decline in FEV1 over 5 yrs was 200 mL (predicted decline 160 mL). Although most impedance parameters correlated to flow-volume parameters in both years, a rapid 5 year decline of FEV1 (> 330 mL) was only accompanied by a significant decrease in the reactance at 8 Hz (X8) and an increase in the resonance frequency (f0). Interestingly, decline in FEV1 was significantly dependent on age, years of employment, pack-years, FEV1, and all impedance parameters at the start in 1990 (r = 0.35; p = 0.01). Similarly, the increase in f0 was significantly dependent on age, years of employment, pack-years, f0, FEV1, forced vital capacity (FVC), peak expiratory flow (PEF) and maximal mid-expiratory flow (MMEF) at the start (r = 0.56; p < 0.01). Those with a rapid decline in FEV1, were relatively more represented among acid workers (relative risk (RR) = 2.14), maintenance workers (RR = 2.1) and bulk/transport workers (RR = 1.78), but none of these was significant. Lung function, however, was significantly lower in the bulk/transport workers (n = 14) compared to the rest, based both on flow-volume (FEV1, FVC) and impedance (X8, f0) measurements. Smoking had a significant effect on most flow-volume parameters but only for frequency dependence among the impedance outcomes. It is concluded that alterations in impedance parameters do reflect changes in flow-volume curves induced by age. smoking and occupational exposure. Therefore, these data are a valuable extension to current cross-sectional data.

Acids↗
PubMed1990

Biological monitoring of exposure to monochlorobenzene.

We assessed the exposure to monochlorobenzene (MBC) of 44 male subjects performing maintenance work in a diphenylmethane-4-4'diisocyanate producing plant. In total, 251 whole shift personal air sampling measurements (passive diffusion) were carried out and at the end of the shift, during which the time-weighted average exposure (TWA) to MCB was determined, a urine sample was collected for the analysis of 4-chlorophenol and 4-chlorocatechol, the two main urinary metabolites of MCB in human. The MCB-TWA values were log normally distributed with a median of 1.2 ppm and a range from less than 0.05 to 106 ppm. The Pearson's correlation coefficient between the log MCB-TWA (ppm) and the log concentration (mg/g creatinine) of the metabolites in post shift-urine samples amounted to 0.65 (P less than 0.001) for 4-chlorophenol (log 4-chlorophenol = 0.22 + 0.43 log MCB-TWA) and 0.72 (P less than 0.001) for 4-chlorocatechol (log 4-chlorocatechol = 0.53 + 0.58 log MCB-TWA), respectively. On the average the workers excreted three times more 4-chlorocatechol than 4-chlorophenol. The follow up of 21 workers over several days did not show any tendency for the metabolite concentration in urine to increase during the workweek.

Adult↗