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Biomedical subjects

M B Schenker

Publications and source records attributed to M B Schenker.

85 records · Page 5Linked to original sources
PubMed1984

Risk factors for childhood respiratory disease. Analysis of pulmonary function.

Four thousand elementary-school-age children from a rural area of western Pennsylvania participated in a cross-sectional survey that consisted of a standardized respiratory questionnaire completed by their parents and spirometric testing at school. Spirographic tracings were digitized to obtain the FVC, FEV0.75, FEF25-75, Vmax75, and Vmax90, which were standardized for height, age, and sex for the subsequent analyses. Independent associations of potential risk factors with the standardized pulmonary function measures were evaluated with multiple regression techniques. Asthma, persistent wheeze, and parental smoking habits, especially those of the mothers, were associated with lower flow rates. The effect of parental smoking was primarily due to smoking by the mother and was stronger in girls. In female children of currently smoking mothers, FEF25-75 was 96% of predicted, Vmax75 was 95% of predicted, and Vmax90 was 92% of predicted; each flow measure was 98% of predicted in male children of smoking mothers. Prolonged hospitalization at birth was independently associated with lower FEV0.75 and flow rates. Low socioeconomic status was associated with lower FVC and FEV0.75. Neither current gas stove use nor a history of severe chest illness before 2 yr of age were independently associated with lower levels of pulmonary function.

Adolescent↗
PubMed1983

Spirometry in children. Methodology for obtaining optimal results for clinical and epidemiologic studies.

Spirometric methodology for clinical and epidemiologic use in children was evaluated in 123 third and fourth grade school children 8 and 9 yr of age. They performed spirometric testing in the middle of October and again in the middle of November 1979. The results demonstrated that spirometric standards developed from adult studies can be applied to children. In addition, a minimum of 5 and a maximum of 8 maneuvers should be attempted to provide at least 3 acceptable tracings. In children, the allowable difference between the 2 best acceptable tracings of 5% or 100 ml, whichever is greater, was demonstrated to be a reasonable guideline. The results are equally reproducible when the maximal values, the mean of the 2 or 3 best values, or the values from the "best sum" tracing (the tracing with the highest value for the sum of the FVC and FEV1) are used.

Child↗
PubMed1983

Risk factors for childhood respiratory disease. The effect of host factors and home environmental exposures.

Standardized respiratory disease questionnaires (ATS-DLD-78-C) were completed by the parents of 4,071 children 5 to 14 yr of age, and risk factors for respiratory symptoms were evaluated by logistic analysis. Younger age, male sex, and lower socioeconomic status (SES) were independent risk factors for most respiratory symptoms and illnesses. All respiratory outcomes were significantly more prevalent in children with a physician's diagnosis of asthma. Asthma was more prevalent in male (4.5%) than in female (2.6%) children, and the greater prevalence of most respiratory symptoms in males did not persist in children with the same asthma status. Children whose questionnaires were completed by their fathers were reported to have significantly fewer respiratory symptoms than children with mother-completed questionnaires. We postulate that fathers underreport symptoms for their children. A positive parental history of allergy or respiratory illness was an independent predictor of respiratory symptoms and illnesses in the children. Chest illness before 2 yr of age and chest illness in the past year showed a significant positive linear trend with the number of parental smokers, and these effects of passive smoking were confirmed in the logistic analysis. The use of gas cooking stoves, inversely associated with SES, was not an independent risk factor for any respiratory symptoms or illnesses.

Adolescent↗
PubMed1982

Effect of cigarette tar content and smoking habits on respiratory symptoms in women.

Standardized respiratory disease questionnaires (ATS-DLD-78) were administered to 5,686 adult women. Risk factors were evaluated by logistic analysis that adjusted for multiple potential confounding factors. Among current smokers, the number of cigarettes smoked per day was consistently the strongest risk factor for chronic cough, chronic phlegm, wheeze, and dyspnea. The odds ratios for these symptoms in a smoker of 25 or more cigarettes per day relative to a smoker of 1--14 cigarettes per day were 4.74, 4.21, 2.05, and 3.71, respectively. Ex-smokers showed risks between those of current and never smokers. Cigarette tar content was a significant independent risk factor for chronic cough (p = 0.005) and of borderline significance for chronic phlegm (p = 0.077). High tar cigarette smokers in this population (average, 22 mg) had an odds ratio of 2.01 for chronic cough and 1.59 for chronic phlegm relative to low tar cigarette smokers (average, 7 mg). The effect of cigarette tar was linear and independent of cigarettes smoked per day. Smoke inhalation was a significant risk factor for chronic cough (p = 0.029) and for chronic phlegm (p = 0.038). Tar content and smoke inhalation were not significant risk factors for wheeze or dyspnea. Cigarette particulate content (tar) appears to be causally linked to cough and phlegm production., but the association of cigarette smoking and symptoms of wheeze and dyspnea may be more strongly related to the vapor phase of cigarette smoke.

Adolescent↗
PubMed1980

Diesel exhaust - an occupational carcinogen?

The existence of polycyclic aromatic hydrocarbons (PAH) in the particulate phase of diesel engine exhaust has raised concern about a carcinogenic effect in workers exposed to exhaust from diesel engines. Some of the PAH are carcinogenic following inhalation by experimental animals and are associated with excess cancer mortality in some occupational exposures. Studies of occupational exposure to diesel exhaust show concentrations of PAH are above ambient levels but below the very high levels in occupations with demonstrated excess cancer mortality. A critical review of the epidemiologic evidence on the carcinogenicity of workplace exposure to diesel engine exhaust is suggestive of a carcinogenic effect but the existing data are sparse and contradictory. Further epidemiologic studies of this question are needed.

Benzopyrenes↗
PubMedDate not supplied

Health effects of air pollution due to coal combustion in the Chestnut Ridge Region of Pennsylvania: results of cross-sectional analysis in adults.

Respiratory questionnaires (ATS-DLD-78) were administered to 5557 adult women in a rural area of Western Pennsylvania to evaluate the health effects of air pollution resulting from coal combustion. Air pollution data were derived from 17 air quality monitor sites and stratified to define low, medium, and high pollution areas. The means of 4 yr (1975-1978) annual averages for sulfur dioxide in each strata were 62, 66, and 99 micrograms/m3, respectively. Total suspended particulates were not tested as a risk factor because they reflected air pollution from sources other than coal combustion (e.g., agricultural, road dusts). Risks of respiratory symptoms were evaluated in a multiple logistic model that adjusted for several potential confounding factors. The risk of "wheeze most days or nights" in nonsmokers residing in the high and medium pollution areas was 1.58 and 1.26 (P = .02), respectively, relative to residents in the low pollution area. In the subset of residents who had lived in the same location for at least 5 yr, relative risks increased to 1.95 and 1.40 (P less than .01), respectively. An increased risk of grade 3 dyspnea in nonsmokers was associated with sulfur dioxide but did not achieve statistical significance (P = .11), and there was no association of cough or phlegm and air pollution in nonsmokers. Cigarette smoking characteristics were the major determinant of respiratory symptoms in smokers, and no independent association of air pollution was found. This study suggests that wheezing may be associated with ambient exposure to sulfur dioxide in nonsmokers, but no effect of sulfur dioxide on cigarette smokers was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Health effects of air pollution due to coal combustion in the Chestnut Ridge region of Pennsylvania: cross-section survey of children.

A cross-sectional study of 4,071 children aged 6-11 yr of age from a rural region of Western Pennsylvania was conducted in spring of 1979. Standardized children's questionnaires were distributed to the parents and returned by the children to school, where spirometry was performed. The region was divided into low-, moderate-, and high-pollution areas on the basis of the 1974-1978, 3-hr, 24-hr, and annual averages for sulfur dioxide (SO2). Seventeen monitoring stations in the region and a triangulation procedure were used to estimate centroid levels in each geographic residence area. After adjusting the respiratory symptom response outcomes and the pulmonary function levels for known predictors, no significant association was noted for level of SO2. However, the highest exposure categories were only slightly above the present annual and 24-hr National Air Quality Standards for SO2. We conclude that at levels of exposure to which these children were exposed, only by study of potentially sensitive subsets or measures of acute response would it be possible to detect respiratory outcomes associated with ambient air pollution.

Air Pollutants↗
PubMedDate not supplied

Risk factors for occupational illnesses associated with the use of paraquat (1,1'-dimethyl-4,4'-bipyridylium dichloride) in California.

This study was conducted to identify risk factors for paraquat-related occupational illnesses. Pesticide-related illness is a reportable disease in California. A total of 231 skin (26.0%), eye (32.0%), local respiratory (3.5%), and systemic (38.5%) paraquat-related cases were reported to the Worker Health and Safety Branch, California Department of Food and Agriculture, during 1971 through 1985. Following paraquat exposure, we found no cases of pulmonary fibrosis. Annual numbers of cases ranged between 1 and 33 (median = 14 cases/y). Information on illnesses reported during 1981 through 1985 (n = 62) was merged with detailed information on paraquat use in agricultural settings (111,716 applications) for the same years. We found that crop treated, method of application, and season of application all contributed independently to the risk of reported illness. Hand application was associated with a higher risk of illness, compared with air application (RR = 99.1, 95% CI = 22.16-443.47); summer application was associated with a higher risk of illness than was winter application (RR = 4.1, 95% CI = 1.91-8.61); and fruit trees were associated with higher risk of illness than were other crops (mainly cotton) (RR = 3.6, 95% CI = 1.18-11.21).

Adolescent↗
PubMedDate not supplied

Costs of occupational injuries in agriculture.

OBJECTIVE: This study was conducted to estimate the costs of job-related injuries in agriculture in the United States for 1992. METHODS: The authors reviewed data from national surveys to assess the incidence of fatal and non-fatal farm injuries. Numerical adjustments were made for weaknesses in the most reliable data sets. For example, the Bureau of Labor Statistics (BLS) Annual Survey estimate of non-fatal injuries is adjusted upward by a factor of 4.7 to reflect the BLS undercount of farm injuries. To assess costs, the authors used the human capital method that allocates costs to direct categories such as medical expenses, as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Cost data were drawn from the Health Care Financing Administration and the National Council on Compensation Insurance. RESULTS: Eight hundred forty-one (841) deaths and 512,539 non-fatal injuries are estimated for 1992. The non-fatal injuries include 281,896 that led to at least one full day of work loss. Agricultural occupational injuries cost an estimated $4.57 billion (range $3.14 billion to $13.99 billion) in 1992. On a per person basis, farming contributes roughly 30% more than the national average to occupational injury costs. Direct costs are estimated to be $1.66 billion and indirect costs, $2.93 billion. CONCLUSIONS: The costs of farm injuries are on a par with the costs of hepatitis C. This high cost is in sharp contrast to the limited public attention and economic resources devoted to prevention and amelioration of farm injuries. Agricultural occupational injuries are an underappreciated contributor to the overall national burden of health and medical costs.

Accidents, Occupational↗
PubMedDate not supplied

Introduction: rationale for an update. Reproductive hazards.

More than 104,000 chemical and physical agents have been identified in the workplace, but the effects on reproduction of at least 95% of them have not been assessed. Here, the editors of this volume describe changing demographics in the workplace, which underscore the need for evaluating potential hazards to reproduction. They also review findings regarding occupational reproductive hazards to men and women that have been reported over the past decade.

Adult↗
PubMedDate not supplied

Workplace policy on hazards to reproductive health.

At present, workplace policies regarding reproductive hazards are not regulated directly, and inappropriate policies are occasionally corrected by legal actions or union pressures on the employers. Further, information on reproductive hazards is incomplete; however, employees have a legal right to know available information about hazards, including reproductive hazards, that they face in the workplace. Occupational health personnel play a major role in communicating information about reproductive hazards in the workplace and in implementing company policy and complying with legislation. Regulatory and case law likely will continue to evolve as many issues related to safety from reproductive hazards in the workplace have not yet been resolved.

Ethics, Medical↗