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Biomedical subjects

Linda A McCauley

Publications and source records attributed to Linda A McCauley.

13 recordsLinked to original sources
PubMed2006

Studying health outcomes in farmworker populations exposed to pesticides.

A major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Although a number of health conditions have been associated with pesticide exposure, clear linkages have yet to be made between exposure and health effects except in cases of acute pesticide exposure. In this article, we review the most common health end points that have been studied and describe the epidemiologic challenges encountered in studying these health effects of pesticides among farmworkers, including the difficulties in accessing the population and challenges associated with obtaining health end point data. The assessment of neurobehavioral health effects serves as one of the most common and best examples of an approach used to study health outcomes in farmworkers and other populations exposed to pesticides. We review the current limitations in neurobehavioral assessment and strategies to improve these analytical methods. Emerging techniques to improve our assessment of health effects associated with pesticide exposure are reviewed. These techniques, which in most cases have not been applied to farmworker populations, hold promise in our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population. Key words: biomarkers, cancer, epidemiology, health outcomes, immigrants, neurobehavioral, neuropathy, pesticides.

Agriculture↗
PubMed2006

Effectiveness of cleaning practices in removing pesticides from home environments.

The deposition of agricultural pesticides in the homes of agricultural workers and residents of agricultural communities is a major environmental health concern. The effectiveness of home cleaning activities in removing pesticides from home surfaces has not been tested. An intervention study was conducted to assess the effectiveness of cleaning windowsills, floors and carpets in a sample of 10 farmworker homes. Baseline measures of organophosphorus (OP) pesticide residues were obtained, a standardized cleaning intervention was applied and follow-up measures of pesticide residues were obtained within 24-48 hours after the cleaning and 12 months later. House dust was analyzed for six OP pesticides. All homes had detectable baseline levels of OP pesticides on floors and windowsills. Cleaning of linoleum floors was ineffective in removing total pesticide residues and cleaning effectiveness varied among the pesticides. The cleaning of total OP pesticides on the windowsills was effective (median decrease was 0.0029 microg/cm(2), 1-sided p-value = 0.01). Steam cleaning carpets essentially reduced the amounts to non-detectable levels. In 12 months the levels in carpets had accumulated to one-third of the baseline levels. These results provide evidence that cleaning practices can reduce the amount of pesticides in agricultural homes; however the type of surface being cleaned and the pesticides present in the home may influence results.

Environmental Exposure↗
PubMed2005

Immigrant workers in the United States: recent trends, vulnerable populations, and challenges for occupational health.

Immigrant workers are a rapidly growing segment of the U.S. work force, and these increasing numbers have resulted in a different ethnic mix in the work force than in previous decades. Immigrant workers are not a homogenous group, but are over-represented in low-paying occupations. Their diversity and vulnerability present distinct challenges for occupational health nurses. High-risk occupations in which a large proportion of immigrant workers are hired include agriculture, sweatshops, day laborers, and construction. Initiatives needed to improve the working conditions of this vulnerable population include improved surveillance and research, culturally competent care providers, improved health care access, advocacy, and changes in immigration and health policy.

Accidents, Occupational↗
PubMed2005

Nanotechnology: are occupational health nurses ready?

Nanotechnology is a rapidly advancing area of science, and development increasingly will be seen in an array of manufacturing sectors, including sporting goods, cosmetics, clothing, transistors, and biomedical products. Nanoparticles are so small that they interact with other substances at the atomic or subatomic level. They do not behave like solids, liquids, or gases, and have unique mechanical and electronic properties. A serious lack of information about the human health and environmental implications of nanomaterials exists, but scientific experts agree that the potential effects of nanomaterials on working populations and the environment is a serious consideration. Occupational health nurses should be aware of the potential use of nanotechnology in their workplaces and stay aware of emerging information on methods to protect worker health.

Forecasting↗
PubMed2005

Occupational and environmental health in the 21st century: the new frontier in genetics and disease prevention.

Society is currently on the threshold of a new revolution in understanding the interaction of genes and the environment. This research has profound implications for understanding occupational disease and will present ethical challenges to occupational health practice. The public must be educated about the potential promise, as well as the threats, posed by emerging genetic technologies.

Confidentiality↗
PubMed2004

Hispanic adolescent farmworkers' perceptions associated with pesticide exposure.

The migrant farmworker population in the United States is a vulnerable and understudied population whose characteristics are constantly shifting. The number of youth involved in agriculture work is increasing, and they, in particular, may be at increased risk for occupational hazards, such as pesticide exposure. The present study utilized an ecological framework for focus group discussions with 33 adolescent migrant farmworkers in Oregon. Adolescents' risk perception and health beliefs associated with pesticide exposure are examined on four levels of environmental influence: microenvironment, organizational environment, social/community environment, and macroenvironment. Adolescents provided insight on such topics as perceived vulnerability of illness due to pesticide exposure, attitudes toward farmwork, influence of their boss, knowledge of occupational hazards, safety training, and barriers to occupational choice. Cultural influences on occupational safety and health are discussed and increased attention to safety training is recommended.

Adolescent↗
PubMed2004

SARS update: Winter, 2003 to 2004.

Transmission of severe acute respiratory syndrome (SARS) related coronavirus (CoV) appears to be heterogeneous. Most transmission occurs through large droplets, but there is some evidence of spread through aerosol transmission. Proper use of personal protective equipment (PPE) and scrupulous attention to hand hygiene are critical to reducing transmission of SARS, especially in health care facilities. Surgical masks have been shown to be highly effective in reducing transmission when N-95 respirators are unavailable. Health care workers bore a large burden of illness during the 2002 to 2003 SARS epidemic. Occupational health nurses working in health care agencies will play a key role in preparing for a re-emergence of the disease. Occupational health nurses should "bookmark" the Centers for Disease Control and Prevention website for Public Health Guidance for Community-Level Preparedness and Response to SARS: www.cdc.gov/ncidod/sars/clinicalguidance.htm for easy retrieval and reference.

Global Health↗
PubMed2003

Pesticide exposure and self reported home hygiene: practices in agricultural families.

Little is known about environmental exposure to pesticides and the extent to which exposure is affected by drift from agricultural applications and take home exposure from agricultural workers. The study focused on 24 agricultural families in the northwestern United States and measured levels of organophosphate pesticides (OP) in house dust. Pesticide residues were significantly associated with the number of individuals in the home whose work included high exposure pesticide activities. Mean levels of pesticides were higher in the homes of workers who reported waiting more than 2 hours before changing out of their work clothes compared with homes where workers change within 2 hours after returning from work (p < .01). The results of this study provide evidence that workers can inadvertently carry agricultural chemicals from their work into their homes, thereby increasing the risk of pesticide exposure to other family members inside the home.

Agriculture↗
PubMed2002

Illness experience of Gulf War veterans possibly exposed to chemical warfare agents.

BACKGROUND: During the 1991 Gulf War, some Allied troops were potentially exposed to chemical warfare agents as the result of the detonation of Iraqi munitions at Khamisiyah. METHODS: In 1999, we conducted a computer-assisted telephone survey of 2918 Gulf War veterans from Oregon, Washington, California, North Carolina, and Georgia to evaluate the prevalence of self-reported medical diagnoses and hospitalizations among this potentially exposed population and among comparison groups of veterans deployed and nondeployed to the Southwest Asia theater of operations. RESULTS: Troops reported to be within 50 kilometers of the Khamisiyah site did not differ from other deployed troops on reports of any medical conditions or hospitalizations in the 9 years following the Gulf War. Hospitalization rates among deployed and nondeployed troops did not differ. Deployed troops were significantly more likely to report diagnoses of high blood pressure (odds ratio [OR]=1.7); heart disease (OR=2.5); slipped disk or pinched nerve (OR=1.5); post-traumatic stress disorder (OR=14.9); hospitalization for depression (OR=5.1); and periodontal disease (OR=1.8) when compared to nondeployed troops. There was a trend for deployed veterans to report more diagnoses of any cancer (OR=3.0). CONCLUSIONS: These findings do not provide evidence of any long-term health effect associated with exposure to the detonation of chemical warfare agents, but support findings from other investigations of increased morbidity among deployed troops. The prevalence of cancer among this population of deployed troops merits ongoing attention.

Chemical Warfare Agents↗
PubMedDate not supplied

Chronic fatigue in a population-based study of Gulf War veterans.

Fatigue has been associated with illness in veterans of the Gulf War; however, few studies have confirmed self-reported fatigue by using clinical evaluation, and symptomatic veterans have not been evaluated with established criteria for Chronic Fatigue Syndrome (CFS). The authors describe the frequency and clinical characteristics of CFS in a sample of veterans residing in the northwestern United States. The sample was selected randomly from U.S. Department of Defense databases of troops deployed to southwest Asia during the Gulf War. The selected individuals were invited to participate in a clinical case-control study of unexplained illness. Of 799 survey respondents eligible for clinical evaluation, 178 had fatigue symptoms. Of the 130 veterans who were evaluated clinically, 103 had unexplained fatigue, and 44 veterans met the 1994 U.S. Centers for Disease Control criteria for CFS. In this population, the authors estimated a minimum prevalence of any unexplained fatigue to be 5.1%, and of CFS to be 2.2%. The estimated prevalence was greater among females than among males. Cases were similar to healthy controls, as determined by laboratory tests and physical findings. In comparison to several clinical studies of CFS patients, the authors of this study found a lower proportion of veterans who reported a sudden onset of symptoms (19%) vs. a gradual onset (50%). Although it has previously been suggested that veterans of the Gulf War suffer from higher rates of chronic fatigue than the general population, the study results described herein--on the basis of clinical examination of a population-based sample of veterans-actually indicate that an increased rate may indeed exist. Gulf War veterans with unexplained fatigue should be encouraged to seek treatment so that the impact of these symptoms on overall quality of life can be reduced.

Adult↗
PubMedDate not supplied

Determining severe respiratory distress in older out-of-hospital patients.

OBJECTIVES: This preliminary investigation represents the first step in developing a clinical decision rule (CDR) to assist out-of-hospital providers in caring for older patients in respiratory distress. The specific aims of the study were: 1) to identify up to ten candidate clinical indicators of severe respiratory distress in older out-of-hospital patients and 2) to determine the feasibility of obtaining data on these indicators from out-of-hospital treatment records, and of obtaining a measure of severe respiratory distress from the emergency department (ED) medical record. METHODS: This mixed-methods study included a qualitative component to list possible clinical indicators of severe respiratory distress, and a Delphi survey N = six experts) to reduce the comprehensive list that resulted (aim 1). The feasibility of gathering clinical indicators and a measure of severe distress was evaluated using a retrospective chart review (N = 640) of out-of-hospital and ED medical records (aim 2). RESULTS: Nine clinical indicators were identified: level of consciousness/mentation, inability to speak in full sentences, position of the patient on arrival, decreased oxygen saturation, accessory muscle use, dyspnea, increased respiratory effort, altered respiratory rate, and retractions. There were sufficient data available on all indicators except dyspnea and retractions; a measure of severe distress was readily obtained from the ED medical record. CONCLUSION: Medical record data were available on seven out-of-hospital clinical indicators and an ED measure of severe distress. Further work needs to be done to refine the operational definitions of the indicators and to standardize the way they are documented in the out-of-hospital medical record.

Consensus↗
PubMedDate not supplied

How to reduce DEHP in your NICU: a plan of simple steps to promote change.

The integration of research into practice can be a challenge; however, the DEHP-reduction steps provided in this column should make the process simpler and faster. DEHP's link to adverse effects makes it crucial for neonatal nurses to do their best to protect their patients using a preventative approach. As critically ill neonates and infants continue to be exposed to DEHP-leaching devices, neonatal nurses can be at the forefront in taking precautionary action to reduce DEHP exposure among their most vulnerable patients.

Diethylhexyl Phthalate↗