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Biomedical subjects

H Dimich-Ward

Publications and source records attributed to H Dimich-Ward.

At least 37 records · Page 2Linked to original sources
PubMed1997

Mortality and cancer incidence among sawmill workers exposed to chlorophenate wood preservatives.

OBJECTIVES: This study examined the association between exposure to chlorophenates and the risk of soft tissue sarcoma; non-Hodgkin's lymphoma; Hodgkin's disease; and cancers of the lung, nose, and nasopharynx. METHODS: A retrospective cohort study was conducted of 26487 workers employed for at least 1 year between 1950 and 1985 in 11 chlorophenate-using and 3 non-using sawmills in British Columbia, Canada. Exposures by job were ascertained with interviews of senior employees. RESULTS: Probabilistic record linkage to the Canadian Mortality Data Base and the British Columbia Cancer Registry found 4710 deaths between 1950 and 1990, and 1547 incident cases of cancer between 1969 and 1989. None of the cancers of interest had elevated mortality related to chlorophenate exposure. Non-Hodgkin's lymphoma incidence (n = 65) increased with increasing chlorophenate exposure hours, yielding the following standardized incidence ratios: less than 120 hours 0.68; 120 to 1999 hours, 0.59; 2000 to 3999 hours, 1.04; 4000 to 9999 hours, 1.02; and 10000 or more hours, 1.30. CONCLUSIONS: These results are consistent with the borderline positive associations seen in other recently reported studies of chlorophenate-exposed workforces.

British Columbia↗
PubMed1997

Laboratory and clinical evaluation of a portable computerized peak flow meter.

A mini-Wright based peak flow meter (VMX Mini-Log), which stores the readings together with the time and date of each measurement, has recently been marketed but has not yet been evaluated. The accuracy, reproducibility, and interdevice variability of this instrument were investigated using a pneumotachograph connected in series as a standard. Flows from 100 to 700 L/min were generated by an explosive decompression chamber. The performance of this instrument was also tested in 20 normal subjects and in 20 patients with airflow obstruction. The accuracy of the instrument was expressed as the percentage of error, and reproducibility and interdevice variability were assessed using the coefficient of variation. In the laboratory evaluation, all devices recorded flow rates that were within +/-10% of the pneumotachograph readings at flows between 200 and 600 L/min. At the extreme flow rates of 100 and 700 L/min, the mean error was higher than 10%. The reproducibility of the VMX was within +/-5% at all the flows tested. The interdevice variability was less than 5% at flow rates between 200 and 700 L/min. When tested on normal subjects with PEF between 400 and 700 L/min, the VMX performed well. In patients with airflow obstruction, four devices had greater than 10% error. The largest error was observed in those patients with PEF below 200 L/min. The VMX Mini-Log peak flow meter is accurate and precise in the flow range between 200 and 600 L/min. Its performance, however, may be affected in subjects with airflow obstruction and PEF below 200 L/min.

Adolescent↗
PubMed1996

Reliability of retrospective chlorophenol exposure estimates over five decades.

For a cohort study of chlorophenate-exposed sawmill workers, historical exposures from the 1940s to the 1980s were estimated by teams of 9-20 employees (each interviewed individually). The mill histories were divided into eras when jobs and exposures were relatively stable. Raters with at least 5 years of work experience in an era were asked to estimate the frequency and duration of exposure for each job in the mill. Reliability measures for these estimates were calculated for each of the 39 mill and time period combinations, using the individual intraclass correlation coefficient (ICCind) to assess agreement between raters and the group intraclass correlation coefficient (ICCgroup) to assess the stability of the mean estimates of exposure. ICCind were low, with means that increased from 0.24 to 0.35 over the five decades. ICCgroup were considerably higher (means increasing from 0.78 to 0.88 over time), indicating that the number of raters used in this study was sufficient to produce stable average estimates of exposure throughout the study period. These data confirm the intuitive expectation that reliability of exposure estimates decreases when reconstruction of conditions in the distant past is required, and therefore that the random component of exposure misclassification is a greater threat to validity in these earlier time periods.

Analysis of Variance↗
PubMed1996

Longitudinal decline in lung function in patients with occupational asthma due to western red cedar.

BACKGROUND: There are few reports about longitudinal changes in lung function in asthmatic patients. Patients with asthma had a greater loss of lung function than normal healthy adults. To date, there have been no studies about the longitudinal changes in lung function in patients with occupational asthma. METHODS: 280 male patients with red cedar asthma (RCA) who were followed up for at least one year were the study group. The exposed controls consisted of 399 male sawmill workers. Forced expiratory volume in one second (FEV1) was measured with a Collins water spirometer. Changes in FEV1 over time (FEV1 slope) were calculated by a two point method for each subject. Atopy was considered to be present if the subjects showed at least one positive response to three allergens by skin prick test. RESULTS: Multiple regression analysis was carried out to examine factors that might affect longitudinal decline in FEV1. Patients with RCA who were still exposed had a greater decline in FEV1 slope (-26 ml/y) than sawmill workers. Smokers also showed a greater rate of decline in FEV1 (-43 ml/y) than non-smokers. CONCLUSIONS: Patients with RCA who continued to be exposed had a greater rate of decline in FEV1 than sawmill workers. Early diagnosis of occupational asthma and removal of these patients from a specific sensitiser is important in the prevention of further deterioration of lung function and respiratory symptoms.

Adult↗
PubMed1996

Western red cedar dust exposure and lung function: a dose-response relationship.

The relationship between levels of cumulative red cedar dust exposure and decline in lung function was explored in an 11-yr follow-up study of 243 sawmill workers who participated in at least two occasions. We also studied 140 office workers in a similar manner as control subjects. Workers with asthma were excluded from the analysis. During the period of the study, 916 personal and 216 area samples of dust were collected from the sawmill. Cumulative wood dust exposure was calculated for each sawmill worker according to the duration and exposure in each job, based on the geometric mean of all dust measurements for that job. Average daily dust exposure was calculated by dividing the total cumulative exposure by the number of days of work. Workers were divided into low-, medium-, and high-exposure groups with mean daily level of exposure of < 0.2, 0.2 to 0.4, and > 0.4 mg/m3, respectively. Sawmill workers had significantly greater declines in FEV1 and FVC compared with office workers adjusted for age, smoking, and initial lung function. A dose-response relationship was observed between the level of exposure and the annual decline in FVC. We conclude that exposure to Western red cedar dust is associated with a greater decline in lung function which may lead to development of chronic airflow limitation.

Adult↗
PubMed1996

Reproductive effects of paternal exposure to chlorophenate wood preservatives in the sawmill industry.

OBJECTIVES: The purpose of the study was to determine whether paternal occupational exposure to dioxincontaminated chlorophenols is associated with an increased risk of congenital anomalies or other adverse reproductive outcomes in offspring. METHODS: As a result of a multistep linkage, 19675 births between 1952 and 1988 were identified as children of a cohort of 9512 fathers who had worked at least one year in British Columbia sawmills where chlorophenate wood preservatives had been used. A nested case-referent analysis was applied, using conditional logistic regression, with five referents matched per case according to year of birth and gender. Chlorophenate exposure was based on expert raters' estimations of hours of exposure applied to specific time windows prior to birth. RESULTS: The offspring of male sawmill workers were at increased risk for developing congenital anomalies of the eye, particularly congenital cataracts; elevated risks for developing anencephaly or spina bifida and congenital anomalies of genital organs were shown according to specific windows of exposure. No associations were found for low birthweight, prematurity, stillbirths, or neonatal deaths. CONCLUSIONS: The study adds further support to the hypothesis of male-mediated developmental toxicity. Paternal exposure to chlorophenates was associated with the development of certain congenital anomalies in offspring.

Abnormalities, Drug-Induced↗
PubMed1995

House dust mite allergen levels in two cities in Canada: effects of season, humidity, city and home characteristics.

The homes of 120 patients with asthma, 57 in Vancouver and 63 in Winnipeg, were studied. The characteristics of the homes were assessed by a questionnaire. Dust samples were collected and the indoor relative humidity was measured four times during the year covering all four seasons in both cities. Mite allergen levels were determined using monoclonal antibodies against Der p I and Der f I by the ELISA method. The mean levels of both mite allergens in mattress and floor samples in the homes in Vancouver and in Winnipeg were relatively low for all seasons. Mite allergen levels were found to be associated with city, season and individual home differences. They were significantly higher in Vancouver than in Winnipeg. Der p I and Der f I in mattress samples in both cities and Der f I in floor samples in Vancouver, varied by season. The indoor relative humidity level in the homes in Vancouver were also significantly higher than those in Winnipeg. There was, however, no significant association between the levels of indoor relative humidity and the levels of mite allergens after adjusting for variations in city, season and individual home. Although individual home differences were highly associated with mite allergen levels, only a few home characteristics were found to be related to mite allergen levels such as the type and the age of the home, the type of heating, the use of feather pillows and the number of occupants in the homes. Whether low levels of mite allergens are partially responsible for the relatively low prevalence of childhood asthma in Canada remains to be investigated.

Allergens↗
PubMed1995

Mite and cat allergen levels in homes and severity of asthma.

The relationships between mite and cat allergen levels in the home, skin test reactivity, and severity of asthma were explored in 120 asthmatic subjects, 57 in Vancouver and 63 in Winnipeg. Patients in the two cities were similar in age, gender distribution, and severity of asthma. Skin tests were performed using 13 common allergens, including D. pteronyssinus, D. farinae, and cat dander, as well as control subjects. Patients recorded their asthma symptoms, medication requirement, and twice daily peak expiratory flow rate for 1 yr. Dust samples were collected every 3 mo during each season of 1992 through 1993 in both cities. Mite and cat allergen levels were determined with an ELISA using monoclonal antibodies against Der p I, Der f I, and Fel d I. There was no relationship between skin test reactivity and levels of mite and cat allergens. In children with positive skin tests to either mite allergen, total mite (sum of Der p I and Der f I) allergen level was positively related to the mean daily symptom score and negatively related to the daily mean PEF (% of predicted). There was no such relationship among adult asthmatic patients with positive skin tests to either mite allergen. No relationship was found between cat allergen level and the severity of asthma.

Adult↗
PubMed1995

Major cat allergen (Fel d I) levels in the homes of patients with asthma and their relationship to sensitization to cat dander.

BACKGROUND: Exposure and sensitization to the major cat allergen, Felis domesticus allergen I (Fel d I), significant causes of allergic respiratory disease. Many patients who are allergic to cats, however, do not own a cat and there is not an obvious source of allergen in their home environment. OBJECTIVE: We investigated the levels of Fel d I in dust from homes of 120 subjects with asthma in two climatologically diverse Canadian cities (Vancouver and Winnipeg). Fel d I levels were related to exposure to cats as well as to skin reactivity to cat dander. METHODS: Dust samples from bedroom floors and mattresses were collected in four different seasons and Fel d I content was determined by 2-site monoclonal antibody based-ELISA. RESULTS: Although only 18 patients (15%) were cat owners, detectable levels of Fel d I were found on at least one occasion in all homes. The geometric mean concentration of Fel d I on floors was 1.15 micrograms/g of dust (range 0.07 to 26.3 micrograms/g) and on mattresses 0.89 micrograms/g (range 0.01 to 17.4 micrograms/g). Seasonal variation of Fel d I levels was only observed in Winnipeg, where Fel d I concentrations were highest in the winter and spring compared with either summer (P < .05) or autumn (P < .005). The highest Fel d I levels were found in homes with a cat (P < .05), however, rather high levels were also found in homes of patients who did not have a cat but visited others with cats. Cat dander was the most frequent sensitizer (60%) in these patients but no correlation was found between the size of the wheal induced by cat dander extract and Fel d I levels in dust samples. CONCLUSION: Cat allergen was universally found in homes of asthmatic patients and this may explain the high frequency of cat sensitization among patients with asthma in these two cities. A seasonal variation in cat allergen was observed in Winnipeg with no variation in Vancouver.

Adolescent↗
PubMed1994

Reanalysis of a longitudinal study of pulmonary function in coal miners in Lorraine, France.

Multiple methods of statistical analysis were applied on data collected on 384 coal miners from the Lorraine region of France. Despite the irregularity of timing of visits over the follow-up period, similar estimates of decline resulted irrespective of the statistical method used. Deceased smokers showed the highest rates of decline in forced expiratory volume during 1 second (FEV1) of 65 to 72 ml/yr, whereas the alive non-smokers had the lowest decline estimates of 42 to 48 ml/yr. Estimates of FVC decline were found to parallel those of FEV1. For about one-half of the cohort, data were available to compare FEV1 decline before and after retirement using a profile analysis. Based upon a "differencing" method of regression, retirement from the coal mine had the effect of decreasing the rate of decline for those who had never smoked; smokers, however, showed an increasing rate of decline.

Coal Mining↗
PubMed1994

Respiratory health among retired grain elevator workers.

Previous studies of grain elevator workers have shown exposure-related increased rates for respiratory symptoms and reduced levels of lung function compared with those of other employed populations. However, some reports have suggested that this effect may be reversible after cessation of exposure. To investigate this, we conducted a respiratory health survey among 75 retired grain elevator workers and 37 retired civic workers. Methods included a standard respiratory questionnaire, routine spirometry, chest radiography, a 6-min walk test, and a specialized questionnaire to assess the impact of breathing trouble on the activities of daily life. Grain retirees were slightly older than civic retirees (69 versus 67 yr, p < 0.05) and less likely to be atopic (7 versus 35%, p < 0.01). Grain elevator retirees reported more dyspnea (44 versus 11%, p < 0.01) and had significantly lower levels for both FEV1 (78.6 versus 88.2% pred) and FVC (90.0 versus 97.7% pred) (both p < 0.05). Compared with civic retirees, grain retirees reported the same average level of breathlessness after the 6-min walk test, but they walked a significantly shorter distance (p < 0.01); they also scored higher on the impairment of activities scale and had a greater proportion of persons reporting impairment of daily activities caused by breathing trouble (p < 0.05). Comparison of the changes in lung function from 1975 to the present study (i.e., from active employment to retirement) showed that grain workers had consistently lower levels of lung function than did civic workers while still employed, with no reversibility after retirement.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1993

Clinical and socioeconomic features of subjects with red cedar asthma. A follow-up study.

A follow-up study of 128 subjects with red cedar asthma was conducted to evaluate the clinical and socioeconomic impact of the disease in determining the working status of the subjects after the diagnosis was made. The results suggest that the severity of asthma is not the main determinant of working status. Comparing the data at diagnosis and at follow-up examination, we found that the persistence of exposure resulted in a deterioration in the asthma despite the use of more medications. Subjects who were working were younger and had a larger number of dependents than the subjects who were not working at the time of the follow-up examination. We conclude that the socioeconomic factors are important in determining the working status of subjects with red cedar asthma. To prevent severe impairment and disability, there should be more economic incentives for these subjects to choose other jobs.

Adult↗
PubMed1992

Five cross-sectional studies of grain elevator workers.

Five cross-sectional studies were conducted on grain workers in all the terminal elevators in British Columbia, Canada, at 3-year intervals from 1976 to 1988. Civic workers were studied in the same manner as a referent group. The studies consisted of questionnaires, spirometry using the same spirometers, allergy skin tests, and measurement of dust concentration by personal sampling. Although the dust concentration in the elevators was reduced progressively over the years, grain workers had more respiratory symptoms and lower lung function compared with the civic workers in each of the five cross-sectional studies. Exposure to grain dust was associated with significant reduction in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) but not in maximal midexpiratory flow rate or FEV1/FVC, suggesting reduction in volume which may be due to lesions in the lung parenchyma or in the small airways. Cigarette smoking was associated with significant reduction in FEV1, maximal midexpiratory flow rate, and FEV1/FVC due to airflow obstruction, but had no influence on FVC. Workers who took part in all five surveys tended to be a "healthier" selected group, but the grain workers still had lower lung function compared with the civic workers. This study confirmed previous findings that grain dust has adverse effects on the lungs. Cross-sectional study of the grain elevator workers proved to be a consistent and useful method to evaluate occupational health hazards.

Adult↗
PubMed1992

Recognizing acute health effects of substitute fungicides: are first-aid reports effective?

Recently, many British Columbia sawmills stopped using traditional chlorophenate anti-sapstain fungicides and substituted 2-(thiocyanomethylthio) benzothiazole (TCMTB) and copper-8-quinolinolate (Copper 8). We conducted a cross-sectional study with two aims: to ascertain which acute health effects, if any, were associated with the use of the substitute fungicides; and to determine the effectiveness of first-aid records as a means of detecting acute health outcomes. Workers in five coastal sawmills were asked to complete a self-administered questionnaire about symptoms considered potentially related and unrelated to fungicide exposure, and about injuries commonly reported in sawmills. In addition, we collected first-aid records from the mills, and asked senior workers to estimate the duration of exposure to fungicides for each job. Symptoms found to be consistently elevated in TCMTB mills included dry skin around the eyes, blood-stained mucus from the nose, nose bleed, peeling skin, burning or itching skin, and skin redness or rash. No symptoms were consistently elevated in the Copper 8 mills. Symptoms related to TCMTB exposure were recorded only 12 times in first-aid logs during the study period (versus 335 questionnaire self-reports). This low symptom-recording frequency may be a function of established patterns of first-aid use in which illness symptoms are reported less frequently than injuries.

Acute Disease↗
PubMed1989

A comparison of exposure estimates by worker raters and industrial hygienists.

The validity and reliability of nine senior sawmill workers' estimates of frequency, duration, and routes of exposure were compared with individual workers' ratings of their own job titles and industrial hygienists' ratings of all job titles in the plant. The reliability of the senior workers' mean exposure estimates [group intraclass correlation coefficient (ICC) = 0.71] compared favorably with those of three pairs of hygienists (group ICC = 0.57, 0.67, and 0.81). The validity of their ratings was assessed in a comparison with urinary chlorophenate measurements representing 92% of the job titles in the sawmill. The senior workers' ratings [coefficient of determination (R2) = 0.22] resembled those of two pairs of industrial hygienists (R2 = 0.24, 0.22) and was significantly greater than that of the third pair (R2 = 0.08). The validity of the self-reports was also low (R2 = 0.15), but the difference was not statistically significant. Senior workers' exposure ratings appear to be as effective as the other methods tested.

Air Pollutants, Occupational↗
PubMed1988

Validity and reliability of a method for retrospective evaluation of chlorophenate exposure in the lumber industry.

This paper describes the validity and reliability of a method to retrospectively assess exposure to antisapstain agents used in sawmills (chlorophenates). The method is based on experienced workers' estimates of exposure for each job title at the sawmill where they work. At a pilot mill, 10 randomly selected workers estimated the frequency and duration of exposures to chlorophenates for all 59 job titles. The reliability of their mean exposure estimates was very high, with an intraclass correlation coefficient for all raters of 0.91 (based on a calculated index of exposure). To assess validity, urinary chlorophenate levels were measured for 86% of the workers at the mill during the summer and/or fall, and compared to experienced workers' estimates of exposure. The correlation between workers' exposure estimates and the urinary chlorophenate levels for each job title were consistently above 0.65 for all analyses and greater than 0.72 when summer and fall urine sample results were averaged. The evidence indicates that the validity and reliability of worker exposure estimates are high enough to justify investigation of the method's generalizability to other sawmills.

Chlorophenols↗
PubMed1983

Building illness in the white-collar workplace.

An increasing incidence of "building illness" is being noted among white-collar workers due to the high pollutant content of air in modern energy-efficient office buildings. These buildings are hermetically sealed, mechanically ventilated, and contain many materials that give off a variety of toxic fumes and aerosols. Severe outbreaks of illness have also been traced to ventilation problems in sealed hospital buildings. Similarly, tightly sealed and well insulated private homes present many sources of toxic pollutants to homemakers. Recent studies linking increases in the frequency and duration of respiratory illnesses with increasing pollution levels warn us that increases in indoor pollution levels should be avoided in the white-collar workplace, hospital, and private residence. Unfortunately, the cost of adequate ventilation of modern air-tight buildings is high. However, proper planning must be conducted to foresee and correct the impact of energy management policies on the livability and healthfulness of the indoor environment.

Air Pollutants↗