Biomedical subjects
K Luoma
Publications and source records attributed to K Luoma.
Turnover and health selection among foundry workers.
The quantity, reasons, and health selection involved in labor turnover were studied with the use of questionnaires and employers' records. The basic material was the personnel of 20 representative foundries. The turnover in 1950--1972 was estimated from a sample of 588 workers. The causes and health selection were studied with questionnaires put to the 1,789 current employees (91% response), the 493 foundrymen who had left after at least 5 years of exposure (the 5-year-plus men, 71% response) and 424 of those who had left after less than 1 year of exposure (the 1-year-minus men, 55% response). The men were asked to describe their present and earlier work at the foundry, the nature and duration of their exposure, diagnosed lung and heart diseases, and chronic bronchitis and angina pectoris and to assess their present and former state of health and work capacity. The disability analysis was based on a sample of 2,834 men whose data were taken from the Social Insurance Register. The disability findings were compared to expected values based on the Finnish male population. Turnover proved to be rapid; short periods of employment predominated. The major reasons for leaving were poor work conditions, physically demanding work, low pay, and poor health. The turnover was fastest in dusty occupations. Relatively more exfoundrymen, both 5-year-plus and 1-year-minus, than current employees felt their health and/or work capacity to be poor. More of the older men in the 5-year-plus group than men of the same age in the current group had chronic bronchitis and diagnosed lung disorders. Both the 5-year-plus and the 1-year-minus exfoundrymen had relatively more diagnosed heart disorders than did the current employees. The disability prevalences of the foundrymen in any category of diseases did not exceed the expected values based on the male population. The overall findings indicate early health selection prior to pensionable disability and/or death.
Prevalence of pneumoconiosis and chronic bronchitis in foundry workers.
The prevalence of pneumoconiosis, chronic bronchitis, and impaired lung function was studied among those 1,000 foundry workers (response rate 93.1%) with the longest exposure time (minimum 4.2, mean 17, SD 9 years) from a representative sample of 20 foundries. Pneumoconiosis was diagnosed from 100 x 100 mm radiographs, and the false positives and false negatives were evaluated from normal-size radiographs from all those with a positive finding and a sample of those with a negative finding. Chronic bronchitis was studied by means of a translation of the MRC Short Questionnarie on Respiratory Symptoms. Forced vital capacity and forced expiratory volume in 1 s were measured with a Vitalograph Single Breath Wedge Spirometer, and the FEV % was calculated from these variables. The subjects were grouped according to smoking habits and dust exposure, which could be fairly well evaluated from measurements performed in connection with the health survey. All comparisons were made between different subcategories. The overall prevalence of pneumoconiosis was 3.8%, when allowance had been made for false positive and false negative findings. Most cases were mild. Chronic bronchitis occurred more frequently among those occupied in jobs classified as dusty. Smoking also strongly increased its prevalence; a combination of both exposures produced the strongest effect. The effect of smoking was also evident as an impairment of lung function; however, no such effect of dust exposure could be shown in this material. Since this was a prevalence study, the selective removal of workers from dusty jobs probably led to underestimates of all the health effects studied. In spite of the effect of selection excess bronchitis could be demonstrated in workers from dusty environments. Therefore effective dust control must be initiated not only with regard to silica dust but also with respect to total dust.
Angina pectoris, ECG findings and blood pressure of foundry workers in relation to carbon monoxide exposure.
A prevalence study on angina pectoris, ECG changes, and blood pressure was carried out with those 1,000 workers (response rate 93.1%) with the longest exposure time (minimum 4.2 years) from a statistical sample of 20 foundries. The history of angina was obtained from a questionnaire recommended by the World Health Organization, and the ECGs were coded according to the Minnesota code. On the basis of measurements of the concentration of carbon monoxide (CO) in the air, the workers were divided into three occupational exposure groups, one with definite CO exposure, one with slight or occasional CO exposure, and one without CO exposure. Allowance was also made for present and past smoking habits. All comparisons were made on an intrastudy basis between the different subcategories. The prevalence of angina showed a clear dose-response relationship with regard to CO exposure from either occupation, smoking, or both, but no such trend was found for ECG findings suggestive of CHD. These results may suggest a greater sensitivity in detecting CHD on the part of the angina questionnaire. The systolic and diastolic blood pressures of CO exposed workers were slightly higher than those of other workers when age and smoking habits were taken into consideration. However, exposure to heat was intermixed with exposure to CO. It could be shown that selection based on health had operated in the foundries. Hence, the prevalence found can be considered to be underestimates of the "true" occurrence of cardiac disorders. Nevertheless both angina and "coronary" ECG findings were more prevalent than in other methodologically comparable studies on the general population or industrial workers without toxic exposure.