Biomedical subjects

Marc B Schenker

Publications and source records attributed to Marc B Schenker.

14 recordsLinked to original sources

PubMed2006

Chronic obstructive pulmonary disease mortality in diesel-exposed railroad workers.

Diesel exhaust is a mixture of combustion gases and ultrafine particles coated with organic compounds. There is concern whether exposure can result in or worsen obstructive airway diseases, but there is only limited information to assess this risk. U.S. railroad workers have been exposed to diesel exhaust since diesel locomotives were introduced after World War II, and by 1959, 95% of the locomotives were diesel. We conducted a case-control study of railroad worker deaths between 1981 and 1982 using U.S. Railroad Retirement Board job records and next-of-kin smoking, residential, and vitamin use histories. There were 536 cases with chronic obstructive pulmonary disease (COPD) and 1,525 controls with causes of death not related to diesel exhaust or fine particle exposure. After adjustment for age, race, smoking, U.S. Census region of death, vitamin use, and total years off work, engineers and conductors with diesel-exhaust exposure from operating trains had an increased risk of COPD mortality. The odds of COPD mortality increased with years of work in these jobs, and those who had worked >/= 16 years as an engineer or conductor after 1959 had an odds ratio of 1.61 (95% confidence interval, 1.12-2.30) . These results suggest that diesel-exhaust exposure contributed to COPD mortality in these workers. Further study is needed to assess whether this risk is observed after exposure to exhaust from later-generation diesel engines with modern emission controls.

Aged↗

PubMed2006

California surveillance for pesticide-related illness and injury: coverage, bias, and limitations.

The California Pesticide Illness Surveillance Program (PISP) is a major resource for pesticide illness epidemiology. This work attempts to improve characterization of pesticide illness in California, evaluate case ascertainment of the PISP and identify PISP's limitations and biases for studying the incidence and epidemiology of pesticide-related illness. Abstractors collected standardized information from 1994-1996 PISP files, poison control logs, hospital records, and death certificates. Linkage produced a merged file of all records that documented consideration of pesticide exposure as a cause of ill health. We identified 23 deaths and estimated 1,310 hospitalizations attributable to pesticide exposure, corresponding to 0.024 fatalities and 1.38 hospitalizations (95% confidence interval [CI] = 1.01-1.74) per 100,000 California population person-years. Most intoxications followed domestic exposures and were not reported to the surveillance program, which identified primarily occupational exposures. Excluding groups of five or more, we estimated 16% ascertainment (CI = 0.05-0.27) for non-agricultural occupational cases. Agricultural connections increased the probability of ascertainment to about 50%, cultural and economic barriers notwithstanding. Surveillance records existed for all identified episodes in which five or more people were exposed. California pesticide surveillance data appear complete for mass exposures, and adequate to characterize agricultural and occupational exposures. Work is needed to explore domestic exposures and occurrences beyond the reach of the health care system.

Adolescent↗

PubMed2005

Residential proximity to naturally occurring asbestos and mesothelioma risk in California.

RATIONALE: Little is known about environmental exposure to low levels of naturally occurring asbestos (NOA) and malignant mesothelioma (MM) risk. OBJECTIVES: To conduct a cancer registry-based case control study of residential proximity to NOA with MM in California. METHODS: Incident MM cases (n = 2,908) aged 35 yr or more, diagnosed between 1988 and 1997, were selected from the California Cancer Registry and frequency matched to control subjects with pancreatic cancer (n = 2,908) by 5-yr age group and sex. Control subjects were selected by stratified random sampling from 28,123 incident pancreatic cancers in the same time period. We located 93.7% of subjects at the house or street level at initial diagnosis. Individual occupational exposure to asbestos was derived from the longest held occupation, available for 74% of MM cases and 63% of pancreatic cancers. Occupational exposure to asbestos was determined by a priori classification and confirmed by association with mesothelioma. MAIN RESULTS: The adjusted odds ratios and 95% confidence interval for low, medium, and high probabilities of occupational exposures to asbestos were 1.71 (1.32-2.21), 2.51 (1.91-3.30), and 14.94 (8.37-26.67), respectively. Logistic regression analysis from a subset of 1,133 mesothelioma cases and 890 control subjects with pancreatic cancer showed that the odds of mesothelioma decreased approximately 6.3% for every 10 km farther from the nearest asbestos source, an odds ratio of 0.937 (95% confidence interval = 0.895-0.982), adjusted for age, sex, and occupational exposure to asbestos. CONCLUSIONS: These data support the hypothesis that residential proximity to NOA is significantly associated with increased risk of MM in California.

Adult↗

PubMed2005

Acculturation and smoking patterns among Hispanics: a review.

OBJECTIVE: To conduct a systematic review of published studies investigating the association of acculturation and smoking patterns among Hispanic men and women in the United States. METHODS: Online bibliographic databases were searched from 1985 to 2003 using three key search terms. The methodology and findings of all retrieved articles were critically evaluated. Data were extracted from each article regarding study population, study methods, exposure assessment, outcomes measured, acculturation measures used, and results. RESULTS: The literature search identified 78 articles from MEDLINE, PubMed, and PsychINFO databases; of these, 11 studies met the inclusion criteria. Seven regional studies based in the western United States and four nationwide studies were included in the review. Seven studies used formal acculturation scales, three used language spoken, and one used language spoken and country of birth to indicate acculturation status. Nine studies showed a positive association between acculturation and smoking among women, and one study involving men showed a negative association. CONCLUSIONS: The findings suggest that the association of acculturation and smoking is gender-specific. In this instance, increased smoking prevalence with increased acculturation is consistently observed among Hispanic women but not among men. As Hispanic women acculturate, their cigarette smoking may increase because their behavior becomes more strongly influenced by the norms and practices of the dominant group than among men. Immigrant- and gender-specific public health interventions need to be designed to combat the increase in smoking rates among Hispanics in the United States.

Acculturation↗

PubMed2005

Agricultural dust exposure and respiratory symptoms among California farm operators.

OBJECTIVE: To study whether dust exposure in California agriculture is a risk factor for respiratory symptoms. METHODS: A population-based survey of 1947 California farmers collected respiratory symptoms, occupational and personal exposures. Associations between dust and respiratory symptoms were assessed by logistic regression models. RESULTS: The prevalence of persistent wheeze was 8.6%, chronic bronchitis 3.8%, chronic cough 4.2%, and asthma 7.8%. Persistent wheeze was independently associated with dust in a dose-response fashion odds ratio, 1.2 (95% confidence interval[CI]=0.8-2.0) and 1.8 (95% CI=1.1-3.2) for low and high time in dust. A borderline significant association between chronic bronchitis and dust exposure was found. Asthma was associated with keeping livestock, but not with dust exposure. CONCLUSIONS: Occupational dust exposure among California farmers, only one third of whom tended animals, was independently associated with chronic respiratory symptoms.

Agricultural Workers' Diseases↗

PubMed2005

Acculturation and its association with health-risk behaviors in a rural Latina population.

PURPOSE: To evaluate the performance of proxy measures of acculturation and to examine the association between acculturation and selected health-risk behaviors. METHODS: Participants were 1062 Latina pregnant women who received prenatal care at clinics in San Joaquin County, California between 1999 and 2001. We used the receiver-operating characteristic (ROC) curve to characterize the sensitivity and specificity of proxy measures and regression analysis to examine health-risk behaviors. RESULTS: Using the ARSMA-II short version scale as a reference, age at immigration had the highest percentage of correctly classified individuals. Acculturation was significantly associated with a lifetime history of substance use, risky sexual behavior, low fruit consumption, and high fast-food meal consumption. CONCLUSIONS: Acculturation is an important predictor of health-risk behavior among women. Further research is needed to better understand the phenomenon and to avert associated adverse health consequences.

Acculturation↗

PubMed2004

Pulmonary function and exercise-associated changes with chronic low-level paraquat exposure.

The present study was undertaken to test the hypothesis that chronic, low-level paraquat exposure causes restrictive lung function with gas transfer impairment. Three hundred thirty-eight Costa Rican farm workers from banana, coffee, and palm oil farms completed a questionnaire, spirometry, and a test of single-breath carbon monoxide diffusing capacity. Subjects 40 years of age or older, without other medical risk factors, completed maximal cardiopulmonary exercise tests. Most (66.6%) were paraquat handlers; 24.8% of handlers and 27.3% of nonhandlers reported current cigarette smoking. In linear regression models, cumulative paraquat exposure was not an independent predictor of VA, carbon monoxide diffusing capacity, peak oxygen uptake, FVC, or oxygen pulse peak. However, the ventilatory equivalent for CO(2), although within normal range, was significantly higher with increased cumulative paraquat exposure. Oxygen desaturation greater than 5% from rest to peak exercise had an odds ratio of 1.7 (95% confidence interval = 0.9-3.0) with the cumulative paraquat exposure index in models adjusted for age, weight, and smoking status. The association of paraquat exposure with ventilatory equivalent and oxygen desaturation suggests that paraquat may be associated with subclinical gas exchange abnormalities, but overall these findings are consistent with no clinically significant increases in interstitial thickening or restrictive lung disease among this population.

Adolescent↗

PubMed2004

Self-reported dermatitis and skin cancer in California farm operators.

BACKGROUND: High rates of skin diseases and higher non-melanoma skin cancer rates have been reported in farmers. METHODS: Self-report of dermatitis and skin cancer was among the information collected from 1947 California farm operators, mostly men, in a telephone survey. The majority of the farmers cultivated fruits, nuts, or other field crops. RESULTS: Dermatitis was reported by 8.9% of men and 15.8% of women during the previous 12 months. In a logistic regression model, female gender (OR 2.0, 95% confidence interval 1.3-3.0) and respiratory atopy (OR 1.4, 1.01-1.90) were the only significant independent risk factors for reported dermatosis. There was significantly less reporting of skin cancer among field farmers when compared to others. Regular sunscreen use was reported significantly more often by women (42%) as compared to men (11%). CONCLUSIONS: More in-depth studies are needed to get information on the role of agrochemicals as risk factors for dermatitis and skin cancer.

Adult↗

PubMed2004

Personal exposures to inorganic and organic dust in manual harvest of California citrus and table grapes.

The aim of this study was to determine characteristics of personal exposure to inorganic and organic dust during manual harvest operations of California citrus and table grapes. Personal exposures to inhalable dust and respirable dust were measured five times over a 4-month period of harvesting season. We analyzed components of the dust samples for mineralogy, respirable quartz, endotoxin, and total and culturable microorganisms. Workers manually harvesting were exposed to a complex mixture of inorganic and organic dust. Exposures for citrus harvest had geometric means of 39.7 mg/m(3) for inhalable dust and 1.14 mg/m(3) for respirable dust. These exposures were significantly higher than those for table grape operations and exceeded the threshold limit value for inhalable dust and respirable quartz. Exposures for table grape operations were lower than the threshold limit value, except inhalable dust exposure during leaf pulling. Considered independently, exposures to inhalable dust and respirable quartz in citrus harvest may be high enough to cause respiratory health effects. The degree of vigorous contact with foliage appeared to be a significant determining factor of exposures in manual harvesting.

Adult↗

PubMed2003

Atopic symptoms among California veterinarians.

BACKGROUND: The prevalence of allergic symptoms among veterinarians has not been studied adequately. METHODS: A questionnaire was sent to 2,000 California veterinarians; the return rate was 73% (N=1416). RESULTS: A history of either asthma, allergic rhinitis (AR), or atopic dermatitis (AD) was reported by 66% of respondents. AR was reported by 62%, asthma by 16%, and AD by 11%. Forty percent of the veterinarians reported animal related respiratory and/or skin symptoms. The most commonly reported causes of symptoms were cats and dogs. In multivariate logistic analysis, the significant risk factors for having adult asthma were the history of AR with the history of AD (OR 13.9), AR alone (OR 6.3), and asthma in childhood (OR 6.4). CONCLUSIONS: The prevalence of asthma and other atopic symptoms was high in the studied population. Most veterinarians with respiratory or skin symptoms reported the symptoms as being related to specific animal contact.

California↗

PubMed2002

Use of protective equipment among California farmers.

BACKGROUND: Agriculture is a hazardous industry associated with many occupational injuries and illnesses. We describe California farmers' self-reported exposure to five agricultural hazards and their use of protective equipment. METHODS: A telephone survey of 1,947 California farmers recorded information on occupational exposure, health outcomes and use of protective equipment to lessen risk from exposure to dust, sun, noise, pesticides and tractors. RESULTS: Over 93% of respondents reported using personal protection around pesticides; however, fewer than 1/3 used consistent protection against other hazards. Younger age and male sex were associated with better use of protection from dust, noise, pesticide and tractors, but negatively associated with sun protection. There was no consistent relationship of protective behaviors with cigarette smoking, living on the farm, marital status, or time in non-administrative farmwork. Risk perception was strongly associated with behavior; farmers concerned about specific health problems were much more likely to use protective equipment. CONCLUSIONS: Some farmer characteristics are associated with more safe behaviors, but efforts to encourage protective behaviors on farms should be broadly based in view of a lack of a single risk-taking profile among California farmers.

Accidents, Occupational↗

PubMed2002

Cervical cancer among Hispanic women: assessing the impact on farmworkers.

The purpose of this paper was to review the literature on Hispanic populations to outline: 1) demographics; 2) general health status; 3) cervical cancer incidence and mortality; 4) Pap smear screening rates; and 5) barriers to preventive care services. The methods: MEDLINE, Med66, Med75, and Med85 files, from 1966 to 1999, were searched for key words Hispanic health, cervical cancer and Hispanics, cervical cancer and Mexico, migrants and health, agricultural occupational health, farmworkers and cancer, and farmworker health. AGRICOLA (1982-98) was searched for key words farmworker health, agricultural workers and health, and agriculture and cancer. The results show that Hispanic immigrant women may have cervical cancer incidence rates ranging between the California rates for 1991-93 (19.8/100,000) and for Mexico in 1990 (115-220 per 100,000). Mortality rates for the same periods were 3.9/100,000 and 16.11/100,000 respectively. While survey results report Hispanic Pap smear rates above 70%, these surveys count urban women who do not share the barriers to care experienced by poor rural Hispanics. Since validated self-reports of survey responses are 20-50% lower than reported lower rates and Pap smear screening persist in Hispanic Pap evaluations and are reflected in higher morbidity and mortality from cervical cancer. That targeted community interventions have been successful in raising Pap smear rates among poor Spanish-speaking women. Such interventions should be a priority for preventive health care policy and practice.

Journal Article↗

PubMed2002

Costs of occupational COPD and asthma.

OBJECTIVE: To estimate the number of annual deaths, as well as the direct and indirect costs of occupational COPD and asthma, in the United States in 1996. DESIGN: Aggregation and analysis of national data sets collected by the National Center for Health Statistics, the Health Care Financing Administration, and other government bureaus and private firms. To assess mortality, we reviewed data from national surveys and applied a population attributable risk (PAR) of 15% for both asthma and COPD. We use a lower age limit of 35 years for occupational COPD and 20 years for occupational asthma. To calculate costs, we use the human capital method that decomposes costs into direct categories, such as medical expenses, as well as indirect categories, such as lost earnings and lost home production. We calculated proportionately adjusted costs for other plausible PARs. RESULTS: The 15% PARs result in costs of $5.0 billion for COPD and $1.6 billion for asthma. For COPD, 56% of costs were direct and 44% were indirect; for asthma, 74% were direct and 26% indirect. These estimates are conservative since we ignored costs associated with pain and suffering as well as the value of care rendered by family members. The proportionately adjusted costs for 10 to 20% PARs are $3.3 to $6.6 billion for COPD and $1.1 to $2.1 billion for asthma. CONCLUSIONS: The estimated $6.6 billion cost of occupational COPD and asthma in 1996 is likely to rise with the increasing prevalence of these diseases and warrants preventive intervention.

Absenteeism↗

PubMedDate not supplied

Identification of agricultural tasks important to cumulative exposures to inhalable and respirable dust in California.

Little data exists on the determinants of agricultural dust exposure, particularly in dry climates. Annual exposure indices to inhalable and respirable dust were constructed by exposure estimates for specific tasks, task duration, and task frequency. The estimates of exposure levels were based on actual field measurements and subjective dust exposure ranking. The task duration and frequency data were obtained by questionnaire from 546 farm operators in California. Annual exposure indices were analyzed to determine which tasks were major contributors to chronic dust exposure. The important tasks were identified by comparisons of the cumulative distribution of exposures for all tasks and the cumulative distribution of exposures with one task deleted. Thirteen and 11 tasks were identified to be important to both inhalable and respirable dust exposures, respectively. Tasks identified to be important to agricultural exposure may be ascribed to exposure duration more than to exposure intensity. Information on task-specific exposure is important for developing control strategies in the agricultural workplace.

Adult↗