Invited commentary: assessing latex sensitization using data from NHANES III.
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Gloves, Surgical↗
Biomedical subjects
G Buckler
Publications and source records attributed to G Buckler.
Neuropsychological and stress evaluation of a residential mercury exposure.
Residents of a former factory building converted to apartments were exposed to mercury over a 2-year period. The neurobehavioral and emotional health effects of this exposure and subsequent evacuation are presented. Urine mercury levels were measured before (urine1) and 3-10 weeks after evacuation (urine2) of the building, when neurobehavioral and psychological measures were also completed. Performance on neurobehavioral and psychologic measures were compared between subjects above and below the median for urine1 (>=19 microg/g creatinine) and were correlated with urine1 mercury levels. The high urine mercury group made more errors on a test of fine motor function and 84% of the residents reported clinically significant elevations in somatic and psychologic symptoms. Although subclinical tremor from mercury exposure may have affected subtle hand-eye coordination, other tests of motor function were not affected. Therefore, the observation of reduced hand-eye coordination may be due to chance. Significant levels of psychosocial stress were more closely associated with the evacuation necessitated by mercury exposure rather than a direct effect of mercury exposure.
Adult↗
Taking an exposure history.
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Environmental Exposure↗
Accuracy and reproducibility of blood lead testing in commercial laboratories.
OBJECTIVE: To assess the proficiency of commercial laboratories in analyzing lead in clinical blood samples from subjects without overt lead exposure. DESIGN: We submitted masked duplicate blood lead specimens to 8 masked laboratories. Each laboratory received blood aliquots immediately following drawing (time 1) and 2 weeks later (time 2) from 7 human subjects and 3 bovine blood samples with known lead levels of 0.26, 0.57, and 0.79 micromol/L (5.4, 11.8, and 16.4 microg/dL). Of the 8 laboratories, 5 were commercial laboratories, 1 was a state laboratory, 1 was a research laboratory, and 1 was the Centers for Disease Control and Prevention reference laboratory. OUTCOME MEASURES: Correlation coefficients were calculated, and differences within and between laboratories were assessed by analysis of variance. RESULTS: Results were obtained for all specimens, with all the human subjects' overall mean lead levels being less than 0.48 micromol/L (<10 microg/dL). Each laboratory reported all human blood specimens appropriately, as having lead levels less than 0.48 micromol/L (<10 microg/dL) and within 0.14 micromol/L (3 microg/dL) of the overall mean for that subject. All internal reproducibilities were very high (range, 0.92-1.00) except for one (0.60), possibly lower because of 1 pair of specimens. Mean differences between blood samples analyzed at time 1 and time 2 ranged from -1.4 to 1.2, with only 2 laboratories having significant differences (P<.01). CONCLUSIONS: Overall, there was strong reproducibility within and among laboratories, with no overall time trend or interlaboratory or intralaboratory variance. The storage conditions did not seem to affect the aggregate results. The data suggest that through implementation of the Centers for Disease Control and Prevention/Wisconsin Blood Lead Proficiency Testing Program, the Centers for Disease Control and Prevention's Blood Lead Laboratory Reference System, and mandated federal and state proficiency programs, laboratories in this geographic region have improved their performance as compared with previous published studies and an unpublished study.
Humans↗
Accumulated exposure to ozone and measurement of health effects in children and counselors at two summer camps.
In the summer of 1988 a multiorganizational field health study was conducted at two summer day camps in suburban-central New Jersey. Thirty-four campers and counselors had daily pulmonary function tests performed each afternoon while attending camp during the month of July. The subjects ranged from 9 to 35 years of age. A mobile medical screening van was used to house the spirometric equipment and travel to each camp. Continuous ozone measurements were collected over the 19-test day study period. An intense ozone episode was recorded just prior to and during the first 2 weeks of the study. The campers had an increase in respiratory symptoms with increases in ozone concentrations above 120 ppb. Exposures below 120 ppb ozone were not significantly associated with symptoms. Peak expiratory flow rate in children was the only lung function measure associated with increasing ozone concentrations, with an average loss of 4.74 ml/sec/ppb (P-value = 0.05) for the 8-hr ozone exposure measure. Furthermore, it appears that the early intense exposure to ozone produced a persistent decrease in lung function and baseline shift for three days after the episode that obscured the daily dose-response relationship.
Adolescent↗
Quality assurance audits of medical surveillance programs for hazardous waste workers.
The Occupational Safety and Health Administration (OSHA) Hazardous Waste Operations and Emergency Response Regulation (29 CFR 1910.120) requires medical surveillance examinations for hazardous waste workers. We investigated the consistency and appropriateness of the services provided under OSHA 29 CFR 1910.120 as part of a quality control audit. Our study revealed that in most cases the required paperwork including fitness for duty and restrictions or limitations was completed. However, it is also apparent that many of the components of a complete occupational history were not performed. Spirometric examinations often were performed incorrectly. Documentation of baseline tests was not uniformly done, nor were patients always informed of the findings of their examinations. Our study indicated there may be a lack of education, training, and experience of occupational health providers. This suggests that further efforts should be made to educate physicians and nurses providing medical surveillance and other services to hazardous waste workers.
Adult↗
Heat stress in hazardous waste workers: evaluation and prevention.
The risk of heat stress for hazardous waste workers is high due to the unique aspects of their work, particularly the use of vapor-barrier clothing. Such garments interfere with one of the body's principal mechanisms for dissipating heat, that is, evaporative cooling. Under such conditions the body's heat load rapidly increases and heat-related illness may occur. The medical surveillance examination is an important tool for identifying those workers with risk factors for developing heat stress or underlying diseases that may be exacerbated by heat strain. Further testing to determine fitness for duty, e.g., exercise stress testing, needs to be individualized with respect to the patient's specific work situation and/or clinical status. Appropriate medically related recommendations regarding an individual's ability to perform hazardous waste work can then be determined by the examining physician. Finally, preventive strategies, such as training, physiological and environmental monitoring in the field, judicious scheduling of work and rest periods, appropriate hydration, and use of cooling equipment and canopies, are available and should be employed to reduce the occurrence of heat-related illness in hazardous waste workers.
Hazardous Waste↗