PubMed Health⌕ Search

Biomedical subjects

M Thun

Publications and source records attributed to M Thun.

31 records · Page 2Linked to original sources
PubMed1992

A quantitative assessment of lung cancer risk and occupational cadmium exposure.

We have performed a quantitative assessment of the risk of lung cancer from exposure to cadmium based on a retrospective cohort mortality study of cadmium-exposed workers. The findings were analysed using a life-table analysis to estimate standardized mortality ratios (SMRs), and various functional forms of Poisson and Cox proportionate hazards models to examine dose-response relationships. An excess mortality from lung cancer was observed for the entire cohort (SMR = 149,95% CI = 95-222). Lung cancer mortality was significantly elevated among non-hispanic workers, among those in the highest cadmium-exposure group, and among workers with 20 or more years since first exposure. A statistically significant dose-response relationship was evident in nearly all of the regression analyses. Based on our analyses, the lifetime excess lung cancer risk at the current OSHA standard for cadmium fumes of 100 micrograms/m3 is approximately 50-111 lung cancer deaths per 1000 workers exposed to cadmium for 45 years.

Adult↗
PubMed1990

Screening workers exposed to 4,4'-methylenebis(2-chloroaniline) for bladder cancer by cystoscopy.

A bladder cancer incidence study was conducted among 540 workers exposed to the potential bladder carcinogen 4,4'-methylenebis(2-chloroaniline) from 1969 to 1979. Among the 385 workers who participated in a urine screening examination, none had suspicious or positive cytology. Twenty-one workers had at least one reading of atypia and 60 had either a positive dipstick for heme or greater than five red blood cells per low power field. The study protocol initially involved referral to private physicians for follow-up of any suspicious laboratory results. However, the diagnosis by cystoscopy of a bladder tumor in a nonsmoking man less than 30 years old with low-level hematuria prompted us to offer cystoscopy to all members of the cohort. A total of three tumors were identified in 200 persons who received cystoscopy. All were low-grade, papillary tumors and two occurred in men with completely normal urine screening results. These findings suggest that cystoscopy of asymptomatic persons should be considered in designing bladder cancer screening programs in high-risk cohorts.

Adult↗
PubMed1989

Reducing knee morbidity among carpetlayers.

Carpetlayers have a high prevalence of occupational knee morbidity, partly attributable to their use of the knee kicker to stretch carpet for wall-to-wall installation. While a mechanical alternative "power stretcher" is available, knee kickers are still widely used. A questionnaire survey indicated that unavailability of the mechanical stretcher at installation sites was a major factor for continued use of the knee kicker. Strategies to reduce use of the knee kicker are discussed.

Floors and Floorcoverings↗
PubMed1988

Surveillance of occupational skin disease using the Supplementary Data System.

The utility of the Supplementary Data System (SDS) compiled by the Bureau of Labor Statistics (BLS) in conducting surveillance of occupational skin disease was evaluated by examining 14,703 workers' compensation cases reported to the SDS for the year 1981. Combined with state employment denominators obtained from the BLS Employment and Earnings Program, rates of illness (cases of dermatitis/10,000 employed) calculated for eight major industrial divisions varied significantly according to the criteria used for reporting cases. Despite quantitative variations in the rate of skin disease that depended on specific reporting criteria, the relative ranking of the major industrial divisions remained unchanged, with highest rates of skin disease consistently found in three major industry divisions: agriculture, manufacturing, and construction. This ranking of major industry divisions by rate of dermatitis corresponded extremely well with rankings generated from the 1981 Annual Survey (Spearman rank correlation = .98, p less than .01). At the two-digit level of the Standard Industrial Classification, the rankings based on the SDS had a 77% rank correlation with those from the Annual Survey. Two-digit SIC codes identified from the top 10 in both sets of rankings included crop and livestock production from the agricultural division and leather products, food products, rubber and plastic products from the manufacturing division.

Dermatitis, Occupational↗
PubMed1988

Bladder tumors in two young males occupationally exposed to MBOCA.

MBOCA (4,4' methylenebis (2-chloroaniline) is a structural analogue of benzidine and is carcinogenic in mice, rats, and dogs. MBOCA has not yet been demonstrated to be carcinogenic in humans and is not regulated as an occupational carcinogen in the United States. We report two noninvasive papillary tumors of the bladder identified in a screening study of 540 workers exposed to MBOCA during its production at a Michigan chemical plant from 1968 to 1979. Both tumors occurred in men under 30 years old who had never smoked. Although the prevalence of grade 1-2 tumors among asymptomatic males in this age group is unknown, the incidence of clinically apparent tumors on U.S. males aged 25-29 is only 1 per 100,000 per year. The detection of the two tumors in young, nonsmoking males is consistent with the hypothesis that MBOCA induces bladder neoplasms in humans.

Adult↗
PubMed1988

The estimated predictive value of screening for illicit drugs in the workplace.

This paper estimates the predictive values of screening tests for six illicit drugs of common concern in the workplace (amphetamines, barbiturates, cocaine, hallucinogens, marijuana, and opiates) using published information on test sensitivity and specificity and survey data on prevalence. Estimated predictive values (negative) were generally high, whereas the estimated predictive value of a positive test ranged from 1 per cent for amphetamines to 100 per cent for hallucinogens and was only 38 per cent for marijuana, the most prevalent drug.

Adult↗
PubMed1988

Use of workers' compensation claims data for surveillance of cumulative trauma disorders.

Workers' compensation claims in Ohio were evaluated as a source of surveillance data for identifying workplaces at high risk of cumulative trauma disorders (CTDs) and analyzed for their demographic and industrial characteristics. During a 5-year period (1980 to 1984), 6,849 workers' compensation claims met the case criteria for CTDs. Tenosynovitis due to continuous motion was the most frequently reported condition (58%), and the wrist was the body part most frequently affected (48%). The highest case rate was observed for female workers in the 36 to 45 age group. Incidence rates for individual companies were determined and those with the highest rates for CTDs were identified. The employer-specific rates for CTDs based on workers' compensation claims data can be used as an effective surveillance tool in locating high-risk operations where ergonomic interventions can be implemented to reduce CTD hazards.

Adolescent↗
PubMed1987

Morbidity from repetitive knee trauma in carpet and floor layers.

Carpet layers comprise less than 0.06% of the United States workforce yet they submit 6.2% of compensation claims for traumatic knee inflammation. Their work involves multiple sources of acute and chronic knee trauma including kneeling, pressure from sharp objects, and use of a device called a "knee kicker" to stretch wall to wall carpet. To characterise the knee morbidity in carpet layers and to identify occupational risk factors, a questionnaire was completed by 112 carpet and floor layers, 42 tile and terrazo setters, and 243 millwrights and bricklayers (MWBL). The MWBL comparison workers seldom kneel and do not use a knee kicker. Physical and xray examinations were conducted on a subset of 108 respondents to validate the questionnaire responses. Compared with the MWBL, carpet layers reported more frequent bursitis (20% v 6%), needle aspiration of knee fluid (32% v 6%), and skin infections of the knee (7% v 2%). A score indicating frequency of using the knee kicker was the only statistically significant predictor of bursitis, whereas the score for kneeling was one of several predictors of knee aspiration and skin infections of the knee. These data suggest that carpet and floor layers experience substantially more knee morbidity than other occupational groups, and that kneeling and use of the knee kicker are risk factors providing opportunities for prevention.

Adult↗
PubMed1986

Interaction between tobacco smoking and occupational exposures in the causation of lung cancer.

The nature of the interaction between smoking and occupational exposure is controversial, in part because of lack of agreement on the definition of interaction and in part because of the scarcity of adequate epidemiologic data. Occupational investigators have assessed interaction primarily as a departure from an additive rather than from a multiplicative model of relative risks (or rate ratios). To determine whether smoking modifies the effect of occupational lung carcinogens, the literature was reviewed for the only four established occupational lung carcinogens for which there are data on smoking: radon daughters, asbestos, arsenic, and chloromethyl ethers. Where possible, departure was assessed from both an additive (synergism) and a multiplicative model (effect modification). Only nine studies were considered to have sufficient sample size and to provide sufficient information on tobacco use and occupational exposure to evaluate interaction. The existing data were contradictory for three of the agents studied: asbestos, radon daughters, and arsenic. Inconclusive or contradictory findings may result from small sample size or lack of comparability of the level of occupational or tobacco exposure. It is noteworthy that, for these four agents, whenever smoking did modify the effect of occupational exposure, the lung cancer rate ratio was greater for nonsmokers (compared to nonexposed nonsmokers) than smokers (compared to nonexposed smokers). However, with the exception of chloromethyl ethers, absolute lung cancer rates were higher for smokers than nonsmokers, regardless of occupational exposure.

Arsenic Poisoning↗
PubMed1981

Fatal chemical pneumonia from 1,1,2,3,3-pentafluoro-3-chloropropene in an unmarked gas tank.

Fatal chemical pneumonia occurred in a worker following exposure to an unidentified gas in a salvaged cylinder. Inspection of the tank revealed a scrawled chemical formula for 1,1,2,3,3-pentafluoro-3-chloropropene, a suspected pulmonary irritant. The report underscores the potential hazards which salvaged cylinders pose to individuals who use or refill them. The population at risk includes scuba divers, emergency rescue personnel, and workers in the compressed gas industry.

Adult↗
PubMedDate not supplied

Lung cancer mortality rates in birth cohorts in the United States from 1960 to 1994.

We sought to describe the changing death rates from lung cancer in the US white population in sequential birth cohorts, adjusting for cohort smoking prevalence and duration. We searched the US mortality database (1960-1994) for all deaths among whites in which lung cancer was listed as the underlying cause of death. To determine the population at risk for lung cancer, we used the 1970, 1978-1980, and 1992 National Health Interview Surveys to estimate the annual number of current and recent smokers (those who had quit within 5 years) in 11 5-year birth cohorts, starting in 1901. We then determined annual lung cancer mortality rates for each birth cohort, stratified by sex and adjusting for the prevalence and duration of smoking. The population-based rates of lung cancer mortality were much higher among men than among women across all ages and birth cohorts, reflecting higher smoking rates among men. These differences decreased after we controlled for current and recent smoking within the cohorts and were slightly increased in women after we controlled for duration of smoking. Differences in lung cancer death rates across birth cohorts of US men and women primarily reflect differences in the prevalence and duration of smoking in these birth cohorts. Changes in cigarette design that have greatly reduced tar yields have a relatively small effect compared with that of people's smoking status and duration of smoking.

Adult↗
PubMedDate not supplied

Cancer statistics, 2001.

Each year the American Cancer Society compiles estimates of the number of new cancer cases and deaths expected in the US in the current year and the most recent data on cancer incidence, mortality, and survival. An estimated 1,268,000 new cases of cancer will be diagnosed in the year 2001 and an estimated 553,400 Americans will die from cancer. Overall cancer incidence and death rates have continued to decrease in men and women since the early 1990s, and the decline in overall cancer mortality has been greater in recent years. Despite reductions in age-adjusted rates of cancer death, the total number of recorded cancer deaths in the US continues to increase, due to an aging and expanding population. Large disparities in cancer incidence and mortality across racial/ethnic groups continue. Black men and women experience higher incidence of cancer and poorer survival than white men and women. The disparity in survival reflects both diagnosis of cancer at later disease stages, and poorer survival within each stage of diagnosis.

Adolescent↗