Biomedical subjects

M B Lax

Publications and source records attributed to M B Lax.

8 recordsLinked to original sources

PubMed2000

Medical examination for asbestos-related disease.

There are millions of workers whose exposure to asbestos dust prior to the implementation of asbestos regulation and improved control measures places them at risk of asbestos-related disease today. In addition, workers are still being exposed to significant amounts of asbestos, when asbestos materials in place are disturbed during renovation, repair, or demolition. Given the continued presence of asbestos-containing materials in industrial, commercial, and residential settings throughout the U.S., a sizeable population remains at risk of asbestos-related disease. This article reviews the health effects associated with exposure to asbestos and delineates the steps necessary for the comprehensive screening and clinical assessment for asbestos-related disease, in order to assist physicians in identifying and preventing illness associated with exposure to asbestos among their patients.

Asbestos↗

PubMed1998

Recognizing occupational disease--taking an effective occupational history.

Occupational exposures contribute to the morbidity and mortality of many diseases. However, occupational diseases continue to be underrecognized even though they are responsible for an estimated 860,000 illnesses and 60,300 deaths each year. Family physicians can play an important role in improving the recognition of occupational disease, preventing progressive illness and disability in their own patients, and contributing to the protection of other workers similarly exposed. This role can be maximized if physicians raise their level of suspicion for workplace disease, develop skills in taking occupational histories and establish routine access to occupational health resources.

Adult↗

PubMed1998

Lead exposure in a developmentally disabled workforce.

Over-exposure to lead was identified among developmentally disabled workers engage in furniture refinishing at two separate sites. The index case was identified at the first site by a public health nurse assigned to provide care to some of the workers. Referral to a regional occupational health clinic initiated an exposure assessment and medical consultation at both work sites. Blood lead levels (BLLs) among sanders and helpers at site A averaged 60 micrograms per deciliter of blood (mcg/dl). At site B, BLLs were lower, but 6 individuals had BLLs greater than mcg/dl. Hand sanding of chemically stripped wood previously coated with lead-based paint was determined to be the exposure source. These incidents document potential lead overexposure in an underecognized setting. They also emphasize the importance of incorporating a workplace health risk assessment in the process of placing and protecting the developmentally disabled on the job.

Persons with Disabilities↗

PubMed1998

Multiple chemical sensitivities: the social construction of an illness.

Multiple chemical sensitivities (MCS) has emerged as an important and highly controversial issue in occupational health. Debate centers on whether the illness is "physical" or "psychological." A strong corporate-backed campaign has framed the debate and has pushed MCS advocates into a strategy of "proving the physical" nature of MCS. Proponents of both positions, however, share key assumptions that impede long-term efforts to benefit MCS sufferers, including acceptance of the physical/psychological dichotomy as a paradigm for the illness, a desire to rid the debate of "politics" to allow "objective scientific" data to be amassed, and a view of MCS as unique without links to other occupational illnesses. While a grassroots movement has benefited MCS sufferers in a number of important ways, the shared assumptions have impeded development of a more complex model for the illness that is reflective of a complex reality, reproduced mainstream expert/non-expert relationships, and failed to connect with the broader occupational health and safety movement. The author outlines an alternative theory and practice to begin addressing these issues, beginning with a recognition of MCS as a problem of developing knowledge within a context of class power.

Humans↗

PubMed1996

Lead poisoning in telephone cable strippers: a new setting for an old problem.

Lead poisoning among workers processing lead sheathed telephone cable was identified at five worksites. High blood lead levels (BLLs) were identified during the medical evaluation of symptomatic workers following employer mandated air monitoring and through employer mandated blood lead levels. Once high BLLs were identified, governmental agencies became involved at every site, either as a result of worker complaints to OSHA or as a registry reporting mechanism. Workplace evaluation revealed significant overexposure to lead, particularly among workers mechanically stripping the lead sheaths. After intervention by a government agency, four of the workplaces chose to stop lead cable processing. Because the ongoing replacement of lead sheathed telephone cable with fiber optics may be continuing in many areas of the country, there is concern that the clusters we have identified represents a widespread and little recognized setting for lead overexposure. Recommendations for preventing overexposure to lead in this setting are given.

Conservation of Natural Resources↗

PubMed1996

Decrements in spirometry values associated with chlorine gassing events and pulp mill work.

In a previous study of older pulp and paper workers in Berlin, New Hampshire, decrements in spirometry results associated with accidental exposures to high levels of irritant gases depended on cumulative levels of pulp mill exposure and cigarette smoking. Many of those subjects were older and retired. A new study was initiated to assess whether gassing events were a problem among current workers. Three hundred white male pulp and paper workers from the mill in Berlin, New Hampshire, were surveyed in 1992. Testing included spirometry and questionnaires. The mean age was 40.4 yr, and the mean tenure with the company was 18.5 yr. A total of 105 of the 300 subjects (35%) reported ever having an episode of high exposure to chlorine gases (i.e., being gassed). The percentage gassed was 51% for pulp mill workers and only 13% for other employees. For subjects with no more than 26 pack-years of cigarette smoking, obstruction (i.e., abnormally low FEV1 and FEV1/FVC) was observed only among those with a history of gassing. Also, the combination of high cigarette smoking (i.e., > 26 pack-years) and gassing had a greater than additive effect on obstruction. These findings suggest that additional controls are needed to minimize the number of gassing events in this and other chemical pulp mills.

Adult↗

PubMedDate not supplied

Patients with multiple chemical sensitivities in an occupational health clinic: presentation and follow-up.

Thirty-five people with work-related Multiple Chemical Sensitivities were studied to learn about the onset and progression of illness. The subjects were selected from patients at an occupational health clinic. Individuals were identified as subjects if they fulfilled a seven-point case definition for Multiple Chemical Sensitivities and if onset of symptoms was related to workplace exposures. Three occupational exposures to solvents, poor indoor-air quality, and remodeling were associated with onset of Multiple Chemical Sensitivities in 63% of the subjects. Symptoms indicative of a nervous-system disorder topped the list of the most frequently reported symptoms. Commonalities in exposures and symptoms suggest that Multiple Chemical Sensitivities represents a distinct diagnostic category. Even with an incomplete understanding of etiology, it may be possible to limit the onset of work-related Multiple Chemical Sensitivities.

Adult↗

PubMedDate not supplied

Lung cancer mortality in a cohort of older pulp and paper workers.

The occurrence of deaths due to lung cancer was studied among 883 white male workers from a pulp and paper company in northern New Hampshire. All subjects had participated in a longitudinal study of respiratory morbidity, and data from interviews were used to construct lifetime cigarette smoking and occupational histories. Most of the subjects had entered follow-up in the 1960s and, at that time, their mean age was 51 years and they had worked for the pulp and paper company a mean of 25 years. By the end of follow-up in 1992, the 512 deceased subjects included 35 whose underlying cause of death had been lung cancer. With an internal comparison using the Cox proportional-hazards model, the hazard ratio for sulfite pulp mill work was 2.5 (95% CI 1.3-4.9), while controlling for the effects of age, cigarette smoking, and work in other parts of the pulping operation. In addition, the hazard ratio for the combination of >35 pack-years of smoking and >10 years sulfite mill work was greater than the product of the hazard ratios for each factor alone. While these findings are consistent with past asbestos exposure in the sulfite pulp mill environment, the absence of mesothelioma cases is inconsistent with this type of exposure.

Cause of Death↗