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Biomedical subjects

J M Harrington

Publications and source records attributed to J M Harrington.

At least 19 recordsLinked to original sources
PubMed1997

Non-specific symptoms in response to hazard exposure in the workplace.

Recent concerns in occupational health have shown a shift in emphasis from the study of diseases with well-established pathology toward the investigation of conditions characterized by a range of nonspecific symptoms. Exposure to potential hazards differing widely in terms of their physical nature or chemical composition, for example, electromagnetic fields, organophosphate-based pesticides, and organic solvents, frequently results in the reporting of a relatively consistent group of symptoms. Furthermore, these symptoms may arise among groups of workers where no specific physical or chemical cause can be implicated; for example, in many cases of sick building syndrome. The role of psychosocial factors in the expression of ill-health has been well-documented in the psychological literature. Important modifying factors include the attitudes and belief systems of the individuals concerned, certain personality and behavior patterns, and the presence of current stress or pre-existing psychological distress. In addition, social processes may be involved in the generation and reinforcement of health concerns at the group level. These include the workers' perceptions of the competence and credibility of managers and professionals, and the influence and involvement of the media, pressure groups, and the legal system. A proper understanding of the association between putative hazards and the reporting of nonspecific symptoms therefore requires consideration not only of the direct physical pathway between hazard and harm, but also an assessment of factors which may modify the relationship between exposure and symptom reporting. The results of such investigations have important implications for determining the focus of any management and control strategies which may subsequently be implemented in the workplace.

Attitude to Health↗
PubMed1997

Occupational exposure to magnetic fields in relation to mortality from brain cancer among electricity generation and transmission workers.

OBJECTIVE: To investigate whether the risks of mortality from brain cancer are related to occupational exposure to magnetic fields. METHODS: A total of 112 cases of primary brain cancer (1972-91) were identified from a cohort of 84,018 male and female employees of the (then) Central Electricity Generating Board and its privatised successor companies. Individual cumulative occupational exposures to magnetic fields were estimated by linking available computerised job history data with magnetic field measurements collected over 675 person-workshifts. Estimated exposure histories of the case workers were compared with those of 654 control workers drawn from the cohort (nested case-control study), by means of conditional logistic regression. RESULTS: For exposure assessments based on arithmetic means, the risk of mortality from brain cancer for subjects with an estimated cumulative exposure to magnetic fields of 5.4-13.4 microT.y v subjects with lower exposures (0.0-5.3 microT.y) was 1.04 (95% confidence interval (95% CI) 0.60 to 1.80). The corresponding relative risk in subjects with higher exposures (> or = 13.5 microT.y) was 0.95 (95% CI 0.54 to 1.69). There was no indication of a positive trend for cumulative exposure and risk of mortality from brain cancer either when the analysis used exposure assessments based on geometric means or when the analysis was restricted to exposures received within five years of the case diagnosis (or corresponding period for controls). CONCLUSIONS: Although the exposure categorisation was based solely on recent observations, the study findings do not support the hypothesis that the risk of brain cancer is associated with occupational exposure to magnetic fields.

Brain Neoplasms↗
PubMed1997

Efficiency of different grouping schemes for dust exposure in the European carbon black respiratory morbidity study.

OBJECTIVES: The aim of this study was to assess the theoretical efficiencies of different grouping strategies and its effect on the exposure-response relation in a study of respiratory morbidity associated with exposure to total inhalable and respirable carbon black dust. METHODS: A large epidemiological study is being undertaken to investigate the respiratory health of employees in the European carbon black manufacturing industry in relation to exposure to carbon black dust. In phase 2 of the study, repeated measurements of total inhalable and respirable dust were taken which enabled estimation of various components of variability in the exposure data (within and between worker variance and within and between group variance). These variance components were used to calculate the contrast in exposure between the groups in various classification schemes and to calculate the theoretical attenuation of the exposure-response relation and the standard error (SE) of the slope. RESULTS: High contrast in exposure was found when workers were classified according to the combination of their factory and job category as well as when these combinations were amalgamated into five exposure groups. Attenuation was minimal with most grouping schemes; only with the individual based strategy was the attenuation large. The SE of the theoretically attenuated exposure-response slope was smallest for the strategy based on individual people followed by the classification scheme based on factory and job category. CONCLUSIONS: It was concluded that, although some assumptions for the calculations of the attenuation of the exposure-response slope were not met, the most appropriate classification scheme of the worker seems to be by the combination of factory and job category.

Carbon↗
PubMed1997

Health and safety problems associated with long working hours: a review of the current position.

The European Community Directive on Working Time, which should have been implemented in member states of the European Community by November 1996, contains several requirements related to working hours, including the right of employees to refuse to work more than 48 hours a week. The United Kingdom government attempted to oppose the Directive, arguing that there is no convincing evidence that hours of work should be limited on health and safety grounds. Much of the research in this area has focused on the problems of shiftworking and previous reviews have therefore tended to emphasise this aspect of working hours. However, there is much less information about the effects of overtime work, which is a central element of the terms of the Directive. This paper reviews the current evidence relating to the potential effects on health and performance of extensions to the normal working day. Several gaps in the literature are identified. Research to date has been restricted to a limited range of health outcomes--namely, mental health and cardiovascular disorders. Other potential effects which are normally associated with stress--for example, gastrointestinal disorders, musculoskeletal disorders, and problems associated with depression of the immune system, have received little attention. Also, there have been few systematic investigations of performance effects, and little consideration of the implications for occupational exposure limits of extensions to the working day. Existing data relate largely to situations where working hours exceed 50 a week and there is a lack of information on hours below this level, which is of direct relevance to the European Community proposal. Finally, it is clear from investigations relating to shiftwork that a range of modifying factors are likely to influence the level and nature of health and performance outcomes. These include the attitudes and motivation of the people concerned, the job requirements, and other aspects of the organisational and cultural climate. It is concluded that there is currently sufficient evidence to raise concerns about the risks to health and safety of long working hours. However, much more work is required to define the level and nature of those risks.

Adaptation, Psychological↗
PubMed1996

Occupational exposure to carbon black in its manufacture: data from 1987 to 1992.

Carbon black is a very pure form of very finely divided particulate carbon used mainly in the automotive tyre industry. Its carbonaceous nature and submicron size (unpelleted) have raised concerns with regard to its ability to affect respiratory morbidity. This paper describes the exposure to carbon black dust in the first and second phase of a large multi-national epidemiological study investigating the magnitude of these exposure-related effects. In Phase I, 1278 respirable dust samples were taken (SIMPEDS cyclone) which increased to 2941 in Phase II with a similar rise in the number of total inhalable dust samples (IOM head) from 1288 in Phase I to 3433 Phase II. Exposure dropped markedly between the two phases with total inhalable dust showing a bigger reduction (49.9%) than respirable dust (42%), although the mean exposure for certain factories and job categories dropped more than others. The data are presented by the 14 job titles/numbers (21-34). The highest mean exposure in both phases and for both dust fractions is experienced by the warehouse packers and they are also most likely to exceed the OES of 3.5 mg m-3 (35.1% of samples in Phase I and 12.0% in Phase II).

Air Pollutants, Occupational↗
PubMed1996

Modifiers of non-specific symptoms in occupational and environmental syndromes.

Many occupational and environmental health hazards present as an increased reporting of non-specific symptoms such as headache, backache, eye and respiratory irritation, tiredness, memory problems, and poor concentration. The pattern and number of such symptoms is surprisingly constant from hazard to hazard suggesting that common psychological and social factors, not directly related to the exposure may be involved. A recent workshop (see acknowledgements) was held to review the pattern of symptoms in varying hazardous situations and the psychological mechanisms behind the genesis and maintenance of symptoms. The involvement of both direct physicochemical and psychological mechanisms in symptom generation and reporting in any situation was discussed and is reported here. A model that identifies the issues that need to be considered in any epidemiological study based on the incidence or prevalence of non-specific symptoms is proposed.

Affective Symptoms↗
PubMed1996

Abnormalities on neurological examination among sheep farmers exposed to organophosphorous pesticides.

OBJECTIVES: Organophosphates are effective pesticides which are frequently used in several agricultural settings. Although their acute effects are well characterised, it remains unclear whether long term exposure can damage the human nervous system. This study sought to investigate their long term effects by comparing abnormalities on neurological examination between groups of workers exposed to organophosphates and an unexposed group. METHODS: 146 exposed sheep farmers and 143 unexposed quarry workers were recruited into a cross sectional study of symptoms and neuropsychological effects of long term exposure to organophosphates in sheep dip. From a symptom questionnaire given immediately after dipping the 10 most symptomatic and 10 least symptomatic farmers were selected. Several months later each of these, along with 10 of the unexposed quarry workers, underwent a standardised neurological examination similar to that which might be used in clinical practice, at at time as remote as possible from recent exposure to organophosphates so as to exclude any acute effects. RESULTS: All 30 selected subjects agreed to participate. The components of the examination which showed a significant difference were two point discrimination on the dorsum of the hand (symptomatic farmers 22 mm; asymptomatic farmers 13 mm; quarry workers 8 mm) and the dorsum of the foot (symptomatic farmers 34 mm; asymptomatic farmers 10 mm; quarry workers 11 mm), and mean calf circumference (symptomatic farmers 35.0 cm; asymptomatic farmers 36.3 cm; quarry workers 38.6 cm). Overall the prevalence of neurological abnormalities was low. CONCLUSIONS: The differences in neurological examination detected between groups were subtle and their clinical significance was unclear. However, they do suggest evidence of an adverse neurological effect from exposure to organophosphates. Further, larger scale studies will be required before it is possible to confirm or refute the differences detected.

Adult↗
PubMed1996

Research priorities in occupational medicine: a survey of United Kingdom personnel managers.

A Delphi survey was carried out in an attempt to identify areas of priority in occupational health that should be targeted by research. Previously 53 occupational physicians identified and ranked these areas. These were then assessed by personel managers. There was considerable agreement on priorities between the two groups with musculoskeletal disorders and stress securing the highest ranking.

Delphi Technique↗
PubMed1995

Neuropsychological effects of long-term exposure to organophosphates in sheep dip.

Organophosphate-based pesticides are widely used throughout the world. The acute effects of over-exposure to such compounds are well known. Concern has also been expressed that long-term exposure may result in damage to the nervous system. In a cross-sectional study, we compared neuropsychological performance in 146 sheep farmers who were exposed to organophosphates in the course of sheep dipping with 143 non-exposed quarry workers (controls). The farmers performed significantly worse than controls in tests to assess sustained attention and speed of information processing. These effects remained after adjustment for covariates. The farmers also showed greater vulnerability to psychiatric disorder than did the controls as measured by the General Health Questionnaire. There were no observed effects on short-term memory and learning. Repeated exposure to organophosphate-based pesticides appears to be associated with subtle changes in the nervous system. Measures should be taken to reduce exposure to organophosphates as far as possible during agricultural operations.

Adolescent↗
PubMed1995

Exposure to acid anhydrides in three resin and one cushioned flooring manufacturing plants.

Acid anhydrides are reactive organic chemicals of low molecular weight which cause occupational asthma. No previous research on the relationship between exposure to these chemicals and respiratory sensitization and development of occupational asthma has been reported. A retrospective cohort study was carried out in four factories (three alkyd resin factories and one cushioned flooring factory) to investigate the nature of exposure-response relationships for sensitization to phthalic anhydride (PA), trimellitic anhydride (TMA) and maleic anhydride (MA). This paper describes the results of full-shift and task-specific exposure measurements. Exposure to PA was low in relation to the Occupational Exposure Standard (OES). The highest full-shift PA exposures occurred among resin operators in the resin factory that used solid PA as compared to other resin factories where liquid PA was used. Arithmetic mean exposure levels to TMA and MA in the resin factories were well below their respective OESs. Short-term high exposures occurred during loading of acid anhydrides into the reactors and sampling and testing of the resin. Relatively high full-shift exposure to TMA occurred in the cushioned flooring factory, although no high peak exposures were detected.

Anhydrides↗
PubMed1995

Mortality of copper cadmium alloy workers with special reference to lung cancer and non-malignant diseases of the respiratory system, 1946-92.

OBJECTIVES: To identify and quantify any relations between occupational exposure to cadmium oxide fume and mortalities from lung cancer and from chronic non-malignant diseases of the respiratory system. METHODS: The mortality experience of 347 copper cadmium alloy workers, 624 workers employed in the vicinity of copper cadmium alloy work (vicinity workers), and 521 iron and brass foundry workers (all men) was investigated for the period 1946-92. All subjects were first employed in these types of work in the period 1922-78 and for a minimum period of one year at one of two participating factories. Two analytical approaches were used, indirect standardisation and Poisson regression. RESULTS: Compared with the general population of England and Wales, mortality from lung cancer among copper cadmium alloy workers was close to expectation (observed deaths 18, expected deaths 17.8, standardised mortality ratio (SMR) 101, 95% confidence interval (95% CI) 60 to 159). A significant excess was shown for lung cancer among vicinity workers but not among iron and brass foundry workers (vicinity workers: observed 55, expected 34.3, SMR 160, 95% CI 121 to 209, P < 0.01; iron and brass foundry workers: observed 19, expected 17.8, SMR 107, 95% CI 64 to 167). Increased SMRs for non-malignant diseases of the respiratory system were shown for each of the three groups (alloy workers: observed 54, expected 23.5, SMR 230, 95% CI 172 to 300, P < 0.001; vicinity workers: observed 71, expected 43.0, SMR 165, 95% CI 129 to 208, P < 0.001; iron and brass foundry workers: observed 34, expected 17.1, SMR 199, 95% CI 137 to 278, P < 0.01). Work histories of the copper cadmium alloy workers were combined with independent assessments of cadmium exposures over time to develop individual estimates of cumulative exposure to cadmium; this being a time dependent variable. Poisson regression was used to investigate risks of lung cancer and risks of chronic non-malignant diseases of the respiratory system in relation to three levels of cumulative cadmium exposure (< 1600, 1600-4799, > or = 4800 micrograms.m-3.y). After adjustment for age, year of starting alloy work, factory, and time from starting alloy work, there was a significant positive trend (P < 0.01) between cumulative exposure to cadmium and risks of mortality from chronic non-malignant diseases of the respiratory system. Relative to a risk of unity for the lowest exposure category, risks were 4.54 (95% CI 1.96 to 10.51) for the middle exposure category and 4.74 (95% CI 1.81 to 12.43) for the highest exposure category. There was a non-significant negative trend between cumulative cadmium exposure and risks of mortality from lung cancer. Relative to a risk of unity for the lowest exposure category, risks were 0.85 (95% CI 0.27 to 2.68) for the middle exposure category and 0.81 (95% CI 0.18 to 3.73) for the highest exposure category. Similar findings were obtained when adjustment was made for age only. CONCLUSIONS: The findings are consistent with the hypothesis that exposure to cadmium oxide fume increases risks of mortality from chronic non-malignant diseases of the respiratory system. The findings do not support the hypothesis that exposure to cadmium oxide fume increases risks of mortality for lung cancer.

Alloys↗
PubMed1995

Are the respiratory health effects found in manufacturers of ceramic fibres due to the dust rather than the exposure to fibres?

OBJECTIVES: To determine whether the respiratory symptoms and decrements in lung function found in manufacturers of ceramic fibres are related to exposure to the respirable fibre or inspirable mass constituents of the air in the working environment. METHODS: Cross sectional survey of all current European primary producers of ceramic fibre was carried out, with measurement of exposure to respiratory fibres by personal samplers that measured inspirable and total mass, together with a health survey with an expanded respiratory questionnaire and standardised measurement of lung function. Odds ratios were calculated for symptoms and current exposure by multiple logistic regression, and multiple linear regression coefficients for lung function related to cumulative exposures controlled for the effects of respirable fibre and inspirable mass separately and together. RESULTS: Significant effects of current exposure to both inspirable dust and respirable fibres were related to dry cough, stuffy nose, eye and skin irritation and breathlessness. The decrements found in smokers and to some extent in ex-smokers in forced expiratory volume in one second and forced expiratory flow from 25% to 75% of expiratory volume, seem to be related to the respirable fibres rather than the inspirable mass constituents of the environment. CONCLUSIONS: Current symptoms were related to both current exposure to inspirable dust and respirable fibre. The decrements in lung function were related to the fibre constituent of the exposure.

Air Pollutants, Occupational↗
PubMed1995

Study of the respiratory health of employees in seven European plants that manufacture ceramic fibres.

OBJECTIVES: To study the relation between occupational exposure to ceramic fibres during manufacture and respiratory health. METHODS: The respiratory health of 628 current employees in the manufacture of ceramic fibres in seven European plants in three countries was studied with a respiratory questionnaire, lung function tests, and chest radiography. Simultaneous plant hygiene surveys measured subjects' current exposure to airborne ceramic fibres from personal samples with optical microscopy fibre counts. The measured exposures were combined with occupational histories to derive estimates of each subject's cumulative exposure to respirable fibres. Symptoms were related to current and cumulative exposure to ceramic fibres and lung function and findings from chest radiographs were related to cumulative exposure. RESULTS: The mean duration of employment was 10.2 years and mean (range) cumulative exposure was 3.84 (0-22.94) (f.ml-1.y). Eye and skin symptoms were frequent in all plants and increased significantly, as did breathlessness and wheeze, with increasing current exposure. Dry cough and stuffy nose were less common in the least exposed group but did not increase with increasing exposure. After adjustment for the effects of age, sex, height, smoking, and past occupational exposures to respiratory hazards, there was a significant decrease in both forced expiratory volume in one second (FEV1) and forced midexpiratory flow related to cumulative exposure in current smokers (P < 0.05) and in FEV1 in ex-smokers (P < 0.05). Small opacities were found in 13% of the chest radiographs; their prevalence was not related to cumulative exposure to ceramic fibres. CONCLUSIONS: It is concluded that exposure to ceramic fibres is associated with irritant symptoms similar to those seen in other exposures to man made mineral fibres (MMMFs) and that cumulative exposure to respirable ceramic fibres may cause airways obstruction by promoting the effects of cigarette smoke.

Adult↗