Biomedical subjects

Joel D Kaufman

Publications and source records attributed to Joel D Kaufman.

8 recordsLinked to original sources

PubMed2006

Effect of particulate air pollution on lung function in adult and pediatric subjects in a Seattle panel study.

STUDY OBJECTIVE: To determine whether increased exposure to particulate matter air pollution (PM), measured with personal, residential, or central site monitoring, was associated with pulmonary function decrements in either adults with COPD or children with asthma. PARTICIPANTS: We studied 57 adults with or without COPD and 17 children aged 6 to 13 years with physician-diagnosed asthma in Seattle during a 3-year panel study. STUDY DESIGN AND MEASUREMENTS: Indoor and outdoor PM measurements were made at subjects' homes. The subjects wore personal exposure monitors for 10 consecutive 24-h periods, and PM was also measured at a central outdoor location. We assessed the within-subject effect of particulate exposure on FEV(1) and peak expiratory flow (PEF) in adults, and maximal midexpiratory flow (MMEF), PEF, FEV(1), and symptoms in children. RESULTS: FEV(1) decrements were associated with 1-day lagged central site PM </= 2.5 microm in diameter (PM(2.5)) in adult subjects with COPD. In children not receiving antiinflammatory medication, same day indoor, outdoor, and central site exposures to PM(2.5) were associated with decrements in MMEF, PEF, and FEV(1). Associations with PM(2.5) and lung function decrements were also observed for 1-day lagged indoor (MMEF, PEF, FEV(1)) and personal (PEF only) exposures. Antiinflammatory medication use in children significantly attenuated the PM effect on airflow rates and volumes. CONCLUSIONS: This study found consistent decrements in MMEF in children with asthma who were not receiving medications. It is notable that effects were observed even though PM exposures were low for an urban area. These findings suggest the need for future larger studies of PM effects in this susceptible population that repeatedly measure spirometry to include MMEF and potentially more sensitive markers of airway inflammation such as exhaled breath condensate and exhaled nitric oxide.

Age Factors↗

PubMed2006

Silica, silicosis, and lung cancer.

Evidence that crystalline silica is associated with an increased rate of lung cancer led the International Agency for Research on Cancer to conclude in 1997 that crystalline silica is a known human carcinogen. In Israel too, crystalline silica is considered as such. The decision raised a debate in the scientific arena, and a few scientists have questioned the basis upon which causality was determined. We review the literature regarding the level of evidence of crystalline silica carcinogenicity.

Humans↗

PubMed2005

Squamous cell carcinoma of the skin and coal tar creosote exposure in a railroad worker.

A 50-year-old male railroad worker presented to his primary care physician with an erythematous, tender skin lesion on the right knee; a biopsy of this lesion revealed squamous cell carcinoma in situ. The site of the lesion was sun-protected but had been associated with 30 years of creosote-soaked clothing. In this article, we review dermal and other malignancies associated with creosote, along with creosote occupational exposures and exposure limits. This is a unique case, given the lack of other, potentially confounding, polyaromatic hydrocarbons and the sun-protected location of the lesion.

Carcinoma, Squamous Cell↗

PubMed2004

Prediction of chronic disability in work-related musculoskeletal disorders: a prospective, population-based study.

BACKGROUND: Disability associated with work-related musculoskeletal disorders is an increasingly serious societal problem. Although most injured workers return quickly to work, a substantial number do not. The costs of chronic disability to the injured worker, his or her family, employers, and society are enormous. A means of accurate early identification of injured workers at risk for chronic disability could enable these individuals to be targeted for early intervention to promote return to work and normal functioning. The purpose of this study is to develop statistical models that accurately predict chronic work disability from data obtained from administrative databases and worker interviews soon after a work injury. Based on these models, we will develop a brief instrument that could be administered in medical or workers' compensation settings to screen injured workers for chronic disability risk. METHODS: This is a population-based, prospective study. The study population consists of workers who file claims for work-related back injuries or carpal tunnel syndrome (CTS) in Washington State. The Washington State Department of Labor and Industries claims database is reviewed weekly to identify workers with new claims for work-related back injuries and CTS, and these workers are telephoned and invited to participate. Workers who enroll complete a computer-assisted telephone interview at baseline and one year later. The baseline interview assesses sociodemographic, employment-related, biomedical/health care, legal, and psychosocial risk factors. The follow-up interview assesses pain, disability, and work status. The primary outcome is duration of work disability over the year after claim submission, as assessed by administrative data. Secondary outcomes include work disability status at one year, as assessed by both self-report and work disability compensation status (administrative records). A sample size of 1,800 workers with back injuries and 1,200 with CTS will provide adequate statistical power (0.96 for low back and 0.85 for CTS) to predict disability with an alpha of.05 (two-sided) and a hazard ratio of 1.2. Proportional hazards regression models will be constructed to determine the best combination of predictors of work disability duration at one year. Regression models will also be developed for the secondary outcomes.

Activities of Daily Living↗

PubMed2004

Effect of ambient air pollution on pulmonary exacerbations and lung function in cystic fibrosis.

Information concerning the impact of environmental factors on cystic fibrosis (CF) is limited. We conducted a cohort study to assess the impact of air pollutants in CF. The study included patients over the age of 6 years enrolled in the Cystic Fibrosis Foundation National Patient Registry in 1999 and 2000. Exposure was assessed by linking air pollution values from the Aerometric Information Retrieval System with the patients' home zip code. After adjusting for confounders, a 10 microg/m(3) rise in particulate matter (both with a median aerodynamic diameter of 10 microm (PM(10)) or less and with an aerodynamic diameter of 2.5 microm or less (PM(2.5)) was associated with an 8% (95% confidence interval [CI], 2-15%) and 21% (95% CI, 7-33%) increase in the odds of two or more exacerbations, respectively; a 10-ppb rise in ozone was associated with a 10% (95% CI, 3-17%) increase in odds of two or more exacerbations. For every increase in PM(2.5) of 10 microg/m(3), there was an associated fall in FEV(1) of 24 ml (7-40) (95% CI) after adjusting for confounders. PM(2.5)'s association with mortality did not achieve statistical significance (adjusted RR = 1.32 per 10 microg/m(3) 0.91-1.93; 95% CI). Annual average exposures to particulate air pollution was associated with an increased risk of pulmonary exacerbations and a decline in lung function, suggesting a role of environmental exposures on prognosis in CF.

Adolescent↗

PubMed2004

Comparison of ergonomist, supervisor, and worker assessments of work-related musculoskeletal risk factors.

In primary prevention efforts to reduce the incidence of work-related musculoskeletal disease (MSD), many employers will use supervisor or worker assessments for initial evaluation of MSD risk factors. This cross-sectional study examined the ability of supervisors and workers to accurately assess the presence of MSD risk factors at four work sites in four different industries, examining five jobs that represented six primary categories of risk factors: posture, force, repetition, impact, lifting, and vibration. Thirty-seven supervisors and 55 workers assessed the jobs they oversee or perform through the use of a 14-item questionnaire. Their assessments were compared with detailed ergonomist job analyses to determine their accuracy in identifying the presence or absence of MSD risk factors. In assessing the absence or presence of all risk factors, agreement with the ergonomist was found 81% of the time for supervisors and 77% of the time for workers. Overall, supervisors and workers overestimated the presence of risk in assessing the jobs. Supervisors and worker assessments appear promising in recognizing risk in initial ergonomic assessments.

Administrative Personnel↗

PubMed2003

Genetic factors and asthma in aluminum smelter workers.

An asthma-like condition has been reported among aluminum smelter potroom workers. The pathophysiologic mechanisms and the causative agent involved are unknown. Inasmuch as gene polymorphisms are associated with asthma in the general population, the authors of this case-control study examined whether polymorphisms were associated with the development of potroom asthma. Genotyping was performed for the beta2-adrenoreceptor, high-affinity Ig (immunoglobulin) E receptor, and Tumor Necrosis Factor on potroom workers who developed a new asthma-like condition and on individuals who did not develop respiratory problems. No associations were found between potroom asthma case status and genotype. The asthma-like condition associated with potroom work remains poorly understood. Future investigations of genetic susceptibility and occupational asthma may provide pathophysiologic insights into these work-related conditions, but larger numbers of subjects will be required.

Adult↗

PubMed2002

New developments in work-related asthma.

Although work-related asthma is the most commonly recognized occupational lung disease, the condition remains underrecognized and underreported. New-onset occupational asthma and work aggravated asthma can have deleterious medical and socioeconomic consequences for the individual. Although interpretation and comparison between studies are hampered by the use of variable definitions of WRA and criteria for the diagnosis, as many as 20% of cases of new or aggravated adult asthma has important work-related factors. Thus, all asthmatic patients should be asked about their work, if their respiratory symptoms are worse when they work, or if a new job/exposure preceded the onset of symptoms. A series of longitudinal inception and apprentice cohort studies were undertaken to address significant weakness in the previous medical literature. These studies are just beginning to produce results, and provide strong evidence for asthma caused by exposure to specific occupational environments. They have begun to produce new understanding of the risk factors for developing OA, the natural history of OA and immune sensitization, and the existence of the healthy worker effect. New, non-invasive measures of airway inflammation have been developed with the potential for broad applications in the field of WRA. Although the measurement of exhaled NO and induced sputum analysis are primarily used as research tools, their place in clinical practice is likely to become clearer. These methods also have the potential to elucidate the various pathophysiologic mechanisms involved in WRA and may broaden our concept of occupational exposures that can initiate the onset of asthma.

Asthma↗