Biomedical subjects

Matthew Keifer

Publications and source records attributed to Matthew Keifer.

15 recordsLinked to original sources

PubMed2006

A descriptive study of workers' compensation claims in Washington State orchards.

BACKGROUND: Previous studies have reported high rates of occupational injury and illness among workers in the tree fruit industry. However, many common and preventable risk factors and conditions in orchards have not been investigated. AIMS: To identify and rank risk conditions leading to workers' compensation claims among orchard workers with respect to frequency, severity and cost. METHODS: State Fund workers' compensation claims between 1996 and 2001 for orchard workers in the main tree fruit growing region of Washington were reviewed and categorized according to cause of injury. Descriptive analyses were performed to characterize claims by cause of injury. RESULTS: Of the 13,068 claims in the dataset, 4,020 (31%) were determined to be ladder-related injuries. Ladder-related claims accounted for nearly half (48%) of all 'compensable' claims (e.g. claims involving time loss, disability or 'loss of earning power' in addition to medical expenses). Claims related to ladders were not only the most frequent but also the most expensive collectively in terms of medical aid, time loss and other costs. On a per-claim basis, ladder-related injuries were among the most severe and costly reported injuries. Other common causes of injury among claims were branches and vegetation, structure and material and ground-related injuries. CONCLUSIONS: There is a strong and compelling need to develop interventions to reduce the number of ladder-related injuries in orchards.

Accidental Falls↗

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↗

PubMed2005

Spectrophotometric determination of plasma and red blood cell cholinesterase activity of 53 fruit farm workers pre- and post-exposed chlorpyrifos for one fruit crop.

We sought to investigate the early biological effects of chlorpyrifos among 53 Thai fruit farm workers by measuring the plasma cholinesterase (PChE) and red blood cell cholinesterase (AChE) activities, a biomarker of organophosphate (OPs) pesticide during one fruit crop. The ChE activity (V(m)/K(m)) was spectrophotometrically analyzed before and after exposing to chlorpyrifos. The V(m)/K(m) values of both non-spraying and spraying seasons are found as normal distribution pattern. The median PChE and AChE activities among farm workers in the non-spraying season were 2.3 x 10(-3) s(-1) and 7.26 x 10(-5) s(-1), respectively. The median PChE and AChE activities of the farm workers in the spraying season were 2.02 x 10(-3) s(-1) and 5.95 x 10(-5) s(-1), respectively. The mean V(m)/K(m) values of PChE shifted left (t-test, p=0.013), indicating a decrease in PChE activity in the farm workers exposed to chlorpyrifos. However, the V(m)/K(m) values of AChE in nonspraying season and in the spraying season were not different (t-test, p=0.246). We propose that PChE activity can be used as a biomarker for monitoring early toxicity induced by chlorpyrifos insecticide.

Adolescent↗

PubMed2004

Central nervous system effects of acute organophosphate poisoning in a two-year follow-up.

OBJECTIVES: Patients hospitalized for acute organophosphate poisoning in León, Nicaragua, were followed for effects on the central nervous system (CNS) over a 2-year period. METHODS: Immediate verbal memory (Rey verbal learning), visuomotor performance (digit symbol), and neuropsychiatric symptoms (Q-16) were assessed for 53 poisoned persons at the time of hospital discharge, 7 weeks postpoisoning, and 2 years postpoisoning, and, at the same time intervals, for 28 persons who had never been poisoned. The poisonings were classified as moderate occupational (31), severe occupational (15), and severe through the oral route (7), representing low, medium, and high exposure, respectively. Longitudinal confounder-adjusted between-category comparisons and longitudinal analyses of variance and covariance were used to assess the effects of the exposure. RESULTS: Immediate verbal learning showed deficits in the high-exposure group, in particular at the time of discharge, but the estimate of the difference when compared with the values of the unexposed was imprecise. Visuomotor performance showed a deficit at 7 weeks in the medium-exposure group, but it had improved after 2 years relative to that of the unexposed, for whom improvement had occurred at 7 weeks and persisted during the 2 years of follow-up, possibly a test-retest effect. Neuropsychiatric symptoms were in excess 2 years after the hospital discharge in the low- and medium-exposure groups and all the groups combined. All the results were imprecise for the small high-exposure group. CONCLUSIONS: Visuomotor performance and possibly short-term verbal memory seem to be affected early after severe acute organophosphate poisoning and recover, either truly or by some compensatory mechanism. Neuropsychiatric symptoms seem to increase after a longer latency period.

Adolescent↗

PubMed2003

ISAAC-based asthma and atopic symptoms among Ha Noi school children.

Childhood asthma and atopy prevalence patterns in the developing world are only beginning to be defined. No such information exists for Vietnam. Estimates would assist in anticipating health service needs as well as add to the growing database on global patterns of atopy. To estimate the prevalence of atopic symptoms in school children in Ha Noi, Vietnam, a cross-sectional survey was conducted of children aged 5- to 11-years-old in two schools using the parent self-administered International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The response rate was 66.4% (969 responses). The overall prevalence of selected symptoms were: 'ever wheezed' 24.9%, 'wheezed in past 12 months' 14.9%, 'ever had asthma' 12.1%, 'doctor-diagnosed asthma' 13.9%, 'ever experienced allergic rhinitis (AR) symptoms' 34.9%, 'AR-conjunctivitis symptoms in past 12 months' 10.7%, 'ever had hay fever' 7.8%, 'doctor-diagnosed hay fever' 11.2%, 'ever had eczema' 3.3% and 'doctor-diagnosed eczema' 3.2%. Kappa statistics demonstrated high within symptom category consistency for 'ever had asthma/doctor-diagnosed asthma' (0.728) and 'ever had eczema/doctor-diagnosed eczema' (0.906). Age and gender adjusted odds ratios (OR) were also consistently significant across wheeze and allergic rhinitis symptom categories [highest OR = 10.10 (95% CI 6.23-16.35) between allergic rhinoconjunctivitis and wheeze in past 12 months]. There is a high prevalence of ISAAC-based symptoms in school children in Ha Noi, Vietnam, often above global averages. The high level of association between atopic symptoms suggests some degree of reliability and validity. Childhood atopy symptom prevalence in Vietnam is more similar to that in developed countries rather than developing countries.

Asthma↗

PubMed2002

Pneumoconiosis among workers in a Vietnamese refractory brick facility.

BACKGROUND: Vietnam is a rapidly industrializing country with increasing needs for building materials, including refractory bricks. The manufacture of refractory bricks results in high levels of free silica, a recognized occupational hazard. METHODS: A cross-sectional survey was conducted among 158 employees using a respiratory symptom questionnaire and ILO classification of radiographs for pneumoconiosis. RESULTS: The prevalence of radiographic silicosis (ILO category 1/0 and greater) was 10% in all workers with evidence of a dose-response gradient. Pneumoconiosis prevalence increased from 0% in workers employed < 10 years at the plant to 18% for workers employed > 20 years (trend test P = 0.01 for each year increment after adjusting for gender and tobacco use). CONCLUSIONS: Workers in this plant demonstrate a consistent pattern of radiographic evidence of pneumoconiosis, which appears to be related to duration of work. Future studies should assess exposure control measures that are appropriate to countries undergoing rapid industrialization such as Vietnam.

Adult↗

PubMedDate not supplied

Occupational risk among orchard workers: a descriptive study.

Orchard workers are exposed to an array of occupational health and safety hazards that result in injury, illness, and, in some cases, death. The purpose of this qualitative study was to identify and explore factors that contribute to occupational risks related to orchard work. Twenty-five Hispanic orchard workers were interviewed. They reported that the most common type of accident was falls, usually from a ladder; and the most common injuries were strains and sprains. Three broad categories of factors that contributed to the occurrence of such injuries were Knowledge, Attitudes and Behaviors; Work-Related Factors; and Factors External to Work.

Accident Prevention↗

PubMedDate not supplied

Surveillance of pesticide-related illness in the developing world: putting the data to work.

With PLAGSALUD support, pesticide illness surveillance has extended to all seven Central American countries, producing 7,000 poisoning reports in 2000, but governments' use of the surveillance data has been limited by inadequacies of data management, interpretation, and reporting and an influential pesticide industry in weak economies. Overrepresented reports of suicides minimize occupational hazards. In six countries, 32,245 questionnaire responses indicated 98% underreporting of pesticide poisonings and a regional estimate of 400,000 poisonings per year (1.9% of the population), 76% work-related. A potentially far-reaching measure to come out of this surveillance is an agreement of the ministers of health of Central America and the Dominican Republic (RESSCAD 2000) for a harmonized list of banned and restricted pesticides, including the 12 most frequently reported. The RESSCAD agreement has met considerable resistance from industry. Its achievement versus failure will disclose the ability of Central American governments to prioritize protection of human health against commercial corporate interests. Surveillance data have potential for policy reform, but a more aggressive health sector is needed, linked with the environmental sector, grass-roots organizations, and universities.

Central America↗

PubMedDate not supplied

Tactile vibration thresholds after acute poisonings with organophosphate insecticides.

This study evaluated the association between acute poisoning with organophosphate pesticides (OPs) and quantitative tactile vibration thresholds. Thresholds of the dominant index fingers and big toes of 56 men hospitalized for acute poisoning with OPs were measured at hospital discharge (1-24 days after poisoning) and around seven weeks later (24-176 days after poisoning), and compared with those of controls. Thresholds of the big toes of men with severe intentional poisonings due to neuropathic OPs (metamidophos and chlorpyrifos) increased between the first and second examinations. Threshold impairment was not detected in the index finger regardless of poisoning agent or severity. The development of threshold impairment as a consequence of severe intentional poisonings with neuropathic OPs is consistent with other reports indicating that only severe OP poisonings produce sensory peripheral nerve effects.

Acute Disease↗

PubMedDate not supplied

Onset of grip- and pinch-strength impairment after acute poisonings with organophosphate insecticides.

The course of organophosphate-induced delayed polyneuropathy (OPIDP) in humans has not been quantitatively measured in epidemiologic studies. This study evaluated the association of acute OP poisonings with motor neurologic impairment. Hand grip and pinch strength were evaluated among 62 Nicaraguan men hospitalized for acute OP poisoning between 1992 and 1996; 39 cattle ranchers and fishermen who had never experienced pesticide poisoning were controls. Exposure categories were moderate and severe poisonings with neuropathic and non-neuropathic OPs. Strength was measured at hospital discharge and seven weeks after poisoning. Grip and pinch strength were impaired among all OP-poisoned subjects at both examinations, more noticeably among those poisoned with OPs with suspected neuropathic effects, methamidophos and chlorpyrifos. In those with severe poisonings with neuropathic OPs, impairments were more marked among intentional than among occupational poisonings. The performances of suicidal subjects worsened at the second examination, consistent with OPIDP. Early motor impairment at the time of hospital discharge is consistent with cholinergic depolarization blockade after acute poisoning. The persistence of deficits in motor strength in all severely poisoned patients regardless of pesticide type was unexpected, and may reflect persistent cholinergic blockade or intermediate syndrome, neuropathy, or a combination of these.

Adolescent↗

PubMedDate not supplied

Long-term neurobehavioral effects of mild poisonings with organophosphate and n-methyl carbamate pesticides among banana workers.

Organophosphate poisoning has been associated with chronic neurobehavioral dysfunction, but no epidemiologic data exist with regard to long-term consequences from carbamate poisoning. This cross-sectional study evaluated the neurobehavioral performances of 81 banana workers who, on average 27 months earlier, had received medical attention not requiring hospitalization for mild occupational poisoning by either an organophosphate or a carbamate pesticide. These performances were compared with those of 130 banana workers who had never sought medical attention for pesticide poisoning. Poisoned subjects did less well than controls on tests measuring psychomotor and visuomotor skills, language function, and affect, the differences being significant for coding skills on the Digit-Symbol test and two tests of neuropsychiatric symptoms. These deficits, in particular a marked increase of neuropsychiatric symptoms, occurred among the organophosphate-poisoned subjects, but small deficits in performance were also seen in the carbamate-poisoned subjects. The performances of the previously poisoned subjects who had had contact with cholinesterase inhibitors within three months before testing were particularly poor. These findings in workers with mild poisoning are consistent with previous findings of persistent damage to the central nervous system from organophosphate poisoning. The possibility of persistent neurobehavioral effects associated with poisonings by nmethyl carbamate insecticides cannot be excluded. Workers with histories of poisoning may be more susceptible to neurobehavioral effects with subsequent exposures.

Adult↗

PubMedDate not supplied

Distribution of silica-exposed workers by province and industry in Vietnam.

To determine the number and distribution of exposures among workers exposed to silica dust in Vietnam, a cross-sectional study was conducted of the provincial Preventive Medicine Centers (PMCs) of 61 provinces, and data were collected from medical centers (MCs) of the Ministries of Construction, Industry, and Transportation. The PMC survey identified 112,956 exposed workers in 31 provinces. Ministry data identified 240,744 exposed workers. Quang Ninh province, with 50,000-70,000, had the highest concentration. These estimates provide a range of 40,000-350,000 exposed workers, supporting the development of a validated registry of silica-exposed workers, essential to the development of a program for silicosis prevention in Vietnam.

Cross-Sectional Studies↗

PubMedDate not supplied

An icon-based interview for the assessment of occupational pesticide exposure in a case-control study of childhood leukemia.

An icon-calendar interview form (ICF) for a case-control study of childhood leukemias and parental exposures to pesticides is described. It includes calendar sheets, icons for life events, crops, jobs, regions, non-agricultural jobs, application techniques and personal protection, markers for durations of exposure patterns, and checklists of pesticides. The ICF collects monthly data from two years before birth until diagnosis of cancer (index children) or until either the interview date or age 15 (controls). Data ascertainment was easy in 62% of interviews, moderately easy in 32%, and difficult in 6%. Seventy-eight subjects delivered data on specific pesticides with pesticide checklists, which improved identification of pesticides. ICF performs satisfactorily for crops, tasks, and other determinants of exposure. Data on pesticides will be further improved by introducing external data use on different crops, time periods, and regions, and by exposure modeling for 27 pesticides.

Adolescent↗

PubMedDate not supplied

Glycophorin A is a potential biomarker for the mutagenic effects of pesticides.

For individuals with multiple exposures to bone marrow mutagens the glycophorin A (GPA) assay appears to detect the cumulative genotoxic effects of these nonspecific exposures. To determine whether workers exposed to organophosphates and/or carbamate pesticides have more GPA variants compared with controls, this cross-sectional cohort study examined 67 Latino farm workers, most of whom were exposed to organophosphate or carbamate pesticides, and 68 age-, gender-, ethnicity-, and education-matched reference subjects. Of the 27 participants who completed the questionnaire and had the M/N alleleotype required for the GPA assay, the N/N variant frequency was 9.1 x 10(-6) in the ten subjects with more than 1,500 cumulative hours of exposure vs 3.8 x 10(-6) in the six referent subjects with no known pesticide exposure (p = 0.097). A consistent trend with increasing cumulative exposure was found for N/N and O/N allele-loss frequencies when exposures were stratified into three groups. Despite the small sample size due to the alleleotype restriction, these findings support the hypothesis that some pesticides are mutagenic to hematopoietic stem cells.

Adult↗

PubMedDate not supplied

Mortality among a cohort of banana plantation workers in Costa Rica.

The nematocide 1,2-dibromo-3-chloropropane (DBCP), widely used in Costa Rica during the late 1960s and 1970s, causes sterility in men and is a possible carcinogen. Mortality among a cohort of Costa Rican banana plantation workers was investigated. The cohort included 40,959 individuals who worked on banana plantations between 1972 and 1979. Employment records were linked with the Costa Rican Mortality Registry to determine outcomes through 1999. Standardized mortality ratios (SMRs) were calculated for all causes of death. Poisson regression was also used to calculate mortality risk estimates by duration of employment, but provided no additional insight. All-causes SMRs were 0.77 for men (95% CI 0.75-0.80) and 0.90 for women (95% CI 0.80-1.02) relative to national mortality rates. Mortality from septicemia was significantly higher than expected. Nonsignificant increases in mortality were also observed for testicular cancer, penile cancer, Hodgkin's disease, and Parkinson's disease in men, and for cervical cancer and lung cancer in women.

Agricultural Workers' Diseases↗