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L Rudolph

Publications and source records attributed to L Rudolph.

9 recordsLinked to original sources

Design and methods for a survey of lead usage and exposure monitoring in California industry.

A probability sample of California workplaces in 1986 estimated the numbers of workers using lead and their coverage by biological and environmental monitoring. Study steps included (1) identifying 505 stand ard industrial classifications (SICs) with possible lead use; (2) creating an employer lis; (3) identifying for oversampling seven single SICs and a group of 165 SICs with documented high ambient air lead; (4) further stratification by workforce size; (5) prediction from National Institute for Occupational Safety and Health surveys the number of lead-using workers for each employer; (6) drawing facilities into the sample with selection probability proportional to the number of workers predicted to use lead; (7) adjusting the sample selection if an employer listing covered multiple facilities; (8) sending a first-stage telephone/mail questionnaire to identify lead users, who were sent a second questionnaire; (10)follow-up which, aided by statutory authority, resulted in completion rates over 90%; (11) ranking lead-using processes by intensity of exposure; and (12) analysis. Sources of error include random sampling error, misleadingly large standard errors because sampling was with replacement, gaps in the employer list, and inaccurate responses. As a measure for the probability proportional to size sampling, total work force count would have been superior to the predicted number of lead users. Restriction to a single hazard makes a questionnaire-based study feasible, but names of workers, rather than counts, should be requested and a subsample should be visited.

California

Lead use in California industry: its prevalence and health implications.

An estimated 230,000 workers were reported to work in lead-using activities as a result of a 1986 statistical survey of employers in California. However, 68% of these workers worked in activities of relatively low hazard. This included 114,000 workers engaged in electronic soldering. Over 1800 workers were reported to work in battery manufacture, a relatively high-hazard activity, but with consistent monitoring and protection. In contrast, over 4300 workers were involved in radiator repair activities, a high-hazard activity with inconsistent monitoring and protection. Over 8% of construction workers were reported to work in lead-using processes. This sector is exempt from federal Occupational Safety and Health Administration (Fed/OSHA) and California Occupational Safety and Health (Cal/OSHA) lead standards, yet some of the most hazardous activities (welding, grinding, and cutting, etc.) occurred here. Comparison of projections from the National Occupational Hazard Survey of potential lead exposure in California with these survey results suggests consistent and reliable assessment of the major sources of potential occupational exposure to lead.

California

The identification of occupational lung disease from hospital discharge data.

The Bureau of Labor Statistics-State Health Department Select Committee on Occupational Illnesses and Injuries conducted a study of hospital discharge records to determine their usefulness for identifying cases of occupational disease. Four states searched the diagnosis fields on computerized hospital discharge records for selected occupational lung diseases; pneumoconiosis, extrinsic allergic alveolitis, and respiratory conditions due to chemical fumes and vapors. The hospital discharge data identified more cases of pneumoconiosis than did the BLS data systems. Numerous cases of extrinsic allergic alveolitis and respiratory conditions due to chemical fumes and vapors were also identified. Patterns evidenced in the data were generally consistent with current knowledge of the diseases. The inclusion of industry and occupation on the hospital discharge record, further study of the quality of diagnosis coding, and the use of these data by additional states will enhance the usefulness of these data for occupational disease surveillance.

Alveolitis, Extrinsic Allergic

Environmental and biological monitoring for lead exposure in California workplaces.

Patterns of environmental and biological monitoring for lead exposure were surveyed in lead-using industries in California. Employer self-reporting indicates a large proportion of potentially lead-exposed workers have never participated in a monitoring program. Only 2.6 percent of facilities have done environmental monitoring for lead, and only 1.4 percent have routine biological monitoring programs. Monitoring practices vary by size of facility, with higher proportions in industries in which larger facilities predominate. Almost 80 percent of battery manufacturing employees work in job classifications which have been monitored, versus only 1 percent of radiator-repair workers. These findings suggest that laboratory-based surveillance for occupational lead poisoning may seriously underestimate the true number of lead poisoned workers and raise serious questions regarding compliance with key elements of the OSHA Lead Standard.

California

Elevated blood lead in California adults, 1987: results of a statewide surveillance program based on laboratory reports.

California medical laboratories that test for blood lead are required to report results exceeding 1.21 mumols/L (25 micrograms/dl). Between April and December 1987, the California Department of Health Services received 3,077 blood lead reports from 34 laboratories for 1,293 civilian, non-institutionalized adults. Approximately 1 percent of all reports exceeded 3.87 mumols/L (80 micrograms/dl), 7 percent exceeded 2.42 mumols/L (50 micrograms/dl), and 21 percent exceeded 1.93 mumols/L (40 micrograms/dl). Individuals tested were overwhelmingly male (94 percent), disproportionately Hispanic surnamed (44 percent), and most often residents of Los Angeles County (81 percent). Workers in lead smelting, battery manufacturing, and brass foundries accounted for nearly 80 percent of reports. Construction, radiator repair, pottery and ceramics manufacturing, and gun firing ranges accounted for the remainder. All adults with reports of greater than or equal to 2.90 mumols/L who were contacted reported on occupational exposure. Approximately half were not in routine medical monitoring programs. Despite OSHA standards, elevated blood lead with the potential for serious acute and chronic lead poisoning in California adults remains a significant public health and major occupational health concern.

Adolescent

Intraarterial cis-platinum chemotherapy for patients with primary and metastatic brain tumors.

A total of 49 patients were treated using intraarterial cis-platinum infusions at a dose of 100 mg/m2. The patients were separated into three groups. There were 13 patients with metastatic tumors, 10 with recurrent malignant gliomas, and 22 patients with high-grade gliomas who received intraarterial cis-platinum as part of an adjuvant program. In addition, four nongliomatous primary brain tumors were treated in this fashion. Cis-platinum was filtered immediately prior to intraarterial infusion using a 0.22-micron filter. Response to treatment was evaluated by follow-up CAT scans and neurologic examinations. There were three complete and eight partial responses in metastatic tumors, and eight partial responses in recurrent gliomas. The median survival was 19 weeks for patients with metastatic disease, and 16 weeks for patients with recurrent gliomas. Those high-grade glioma patients who received intraarterial cis-platinum as adjuvant chemotherapy along with CCNU and radiation therapy had a projected median survival of 91+ weeks. Toxicity from intraarterial cis-platinum following drug filtration was markedly reduced when compared with previous reports. Only five patients experiencing visual or central nervous system toxicity utilizing filtered cis-platinum and no radiographic or histopathologic evidence of central nervous system toxicity was observed. Bilateral deafness was observed following vertebral artery infusion in both patients treated in this manner and thus vertebral artery infusions should be avoided. Systemic toxicity was mild. Intracarotid infusion is a safe, well-tolerated delivery system for filtered cis-platinum with a high response rate for patients with both metastatic and primary malignant brain tumors.

Brain

Reproductive hazards in the microelectronics industry.

There has been increased awareness of the potential for occupational and environmental exposures to hazardous substances to adversely affect reproductive outcome in men and women. The purpose of this article is to familiarize the clinician with some of the normal physiologic changes of pregnancy and how those may interact with working conditions in the electronics industry. It also reviews some of the data regarding potential reproductive hazards of substances and physical agents used in this industry.

Abortion, Spontaneous

The worker's perspective.

The author recommends involvement of workers in every phase of epidemiologic research or clinical surveillance programs, from hypothesis generation and study design through interpretation of results and discussion of recommendations for notification, counseling, and intervention. Clinicians must be aware of the potential work-relatedness of illness and routinely obtain an occupational history.

Female