Biomedical subjects

Melissa J Perry

Publications and source records attributed to Melissa J Perry.

16 recordsLinked to original sources

PubMed2006

Prevalence and physical determinants of low back pain in a rural Chinese population.

STUDY DESIGN: This was a community-based cross-sectional study that is part of an ongoing study of genetics and osteoporosis. OBJECTIVES: To estimate the 1-year self-reported prevalence of low back pain (LBP); and to assess the association between physical exposures (occupation, physical stress, and vibration) and LBP in a rural Chinese population. This study also explored how these associations change when individuals with LBP report additional pains in other parts of the body. SUMMARY OF BACKGROUND DATA: Little is known about the prevalence and determinants of LBP in rural developing populations, even though approximately half of the world's population, mostly from the developing world, is engaged in agriculture, a known strenuous activity. METHODS: Families with at least three participating siblings residing in the surrounding rural region of Anqing city, Anhui Province, China, were invited to participate in the study through public announcements and direct invitations by village physicians. A questionnaire including demographics, physical exposures, and musculoskeletal pain was administered to 13,965 men and women (age, 25-64 years). Generalized estimating equations were used to estimate LBP prevalence and examine associations between LBP and physical exposures. RESULTS: The 1-year prevalence of LBP was 64%. Twenty-five percent reported no pain at any body site. Women had higher prevalence of LBP than men across all age groups. Being a farmer, reporting moderate or heavy physical stress, and having had former or current exposures to vibration were positively associated with LBP (P < 0.05). Physical exposures were also associated with cases of LBP combined with other musculoskeletal pains, and generally, the more pains individuals reported, the more likely it was that they were farmers and were exposed to vibration. CONCLUSION: A high prevalence of LBP and LBP with additional musculoskeletal pain existed in this rural Chinese sample. We found evidence of a link between physical exposures and LBP, and LBP with additional musculoskeletal pain. Further understanding of the characteristics and risk factors of LBP in rural developing areas is needed.

Adult↗

PubMed2006

A prospective study of serum DDT and progesterone and estrogen levels across the menstrual cycle in nulliparous women of reproductive age.

The authors explored whether exposure to 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) and its isomers and metabolites affects female reproductive hormones characterized by urinary pregnanediol-3-glucuronide (PdG) and estrone conjugate (E(1)C) levels. During 1996-1998, 287 newly married Chinese women nonsmokers intending to conceive were prospectively studied. Serum for DDT measurement was collected at enrollment, and daily menstrual diaries and urine specimens were collected for 1 year or until a clinical pregnancy was achieved. More than 500 menstrual cycles were studied totaling over 8,000 days. Day of ovulation was determined for each cycle, and the association of serum DDT levels with daily PdG and E(1)C levels in a +/-10-day window around ovulation was analyzed. After adjustment for covariates including age, body mass index, and occupational exposures, consistent inverse associations of most DDT forms occurred with urine E(1)C during the periovulation phase and with urine PdG during the luteal phase of the menstrual cycle. For example, a 10-ng/g increase in serum p,p'-DDE was associated with a 0.05-log(E(1)C) decrease (p = 0.03) in the periovulation phase and a 0.06-log(PdG) decrease (p = 0.03) in the luteal phase. These results support the potential for DDT to be associated with decrements in estrogen and progesterone levels at times during the menstrual cycle that are critical for ovulation and early pregnancy maintenance.

Adult↗

PubMed2006

Environmental pyrethroid and organophosphorus insecticide exposures and sperm concentration.

BACKGROUND: There is growing concern that poisoning and other adverse health effects are increasing because organophosphorous (OP) insecticides are now being used in combination with pyrethroid (PYR) insecticides to enhance the toxic effects of PYR insecticides on target insects, especially those that have developed PYR resistance. OBJECTIVES: We conducted a pilot biomonitoring study to determine whether men in our reproductive cohort study were being exposed to pesticides environmentally by virtue of frequenting an agricultural setting. METHODS: We screened 18 randomly selected urine samples collected from male participants of reproductive age for 24 parent compounds and metabolites of pesticides and examined the results in relation to sperm concentration. RESULTS: Results showed high prevalence of exposure to OP and PYR pesticides and our preliminary analyses provided some suggestion that the higher exposure group had lower sperm concentration. CONCLUSIONS: The potential of OP/PYR mixtures to have enhanced human toxicity needs more research attention.

Adult↗

PubMed2006

Urinary estrogen and progesterone metabolite concentrations in menstrual cycles of fertile women with non-conception, early pregnancy loss or clinical pregnancy.

BACKGROUND: Knowledge is limited of how estrogen and progesterone variability in fertile women are associated with achieving pregnancy. METHODS: From 1996 to 1998, we enrolled 347 textile workers without hormone treatment in Anhui, China, who provided daily urine and data upon stopping contraception for up to 1 year until clinical pregnancy. Urinary hCG was assayed to detect conception and early pregnancy losses. We compared urinary concentrations of estrone conjugates (E(1)C) and pregnanediol-3-glucuronide (PdG) in 266 clinical pregnancies, 63 early pregnancy losses and 272 non-conception cycles from 347 women and also in 94 clinical pregnancy and 94 non-conception cycles from the same women. RESULTS: Using generalized estimating equations and relative to 266 clinical pregnancy cycles, log(E(1)C) was lower in 272 non-conception cycles [beta = -0.3 ng/mg creatinine (Cr); SE = 0.1; P < 0.0001]. On average, daily E(1)C was 18 ng/mg Cr lower in non-conception cycles than in clinical pregnancy cycles. Relative to 94 clinical pregnancy cycles, log(E(1)C) was lower in 94 non-conception cycles (beta = -0.4 ng/mg Cr; SE = 0.1; P < 0.0001) from the same women (average difference in daily E(1)C was 20 ng/mg Cr). The odds of E(1)C less than the 10th percentile (<30 ng/mg Cr) were higher in early pregnancy loss cycles [odds ratio (OR) = 4.8; P = 0.0027] than in clinical pregnancy cycles in the early luteal phase. Compared with clinical pregnancy cycles, log(PdG) concentrations were lower in non-conception cycles during the follicular phase, but this analysis lacked power for multiple testing. CONCLUSIONS: Estrogen concentrations varied from cycle to cycle, and higher estrogen was associated with achieving clinical pregnancy.

Abortion, Spontaneous↗

PubMed2006

Work-related ladder fall fractures: identification and diagnosis validation using narrative text.

OBJECTIVE: To identify ladder-related fracture injuries and determine how ladder fall fractures differ from other ladder-related injuries. METHODS: Ladder-related fracture cases were identified using narrative text and coded data from workers' compensation claims. Potential cases were identified by text searches and verified with claim records. Injury characteristics were compared using proportionate injury ratios. RESULTS: Of 9826 ladder-related injuries, 7% resulted in fracture cases. Falls caused 89% of fractures and resulted in more medical costs and disability days than other injuries. Frequent mechanisms were ladder instability (22%) and lost footing (22%). Narrative text searches identified 17% more fractures than injury codes alone. Males were more likely to sustain a fall fracture than other injuries; construction workers were most likely, and retail workers were the least likely to sustain fractures. CONCLUSIONS: Fractures are an important injury from ladder falls, resulting more serious consequences than other ladder-related injuries. Text analysis can improve the quality and utility of workers compensation data by identifying and understanding injury causes. Proportionate injury ratios are also useful for making cross-group comparisons of injury experience when denominator data are not available. Greater attention to risk factors for ladder falls is needed for targeting interventions.

Accidental Falls↗

PubMed2006

Nonpersistent pesticide exposure self-report versus biomonitoring in farm pesticide applicators.

PURPOSE: Few studies using biologic markers to examine nonpersistent pesticide exposure among pesticide applicators were conducted in field settings. This study compares self-reported dermal, inhalation, and ingestion exposures with urinalysis results after one-time application of the commonly used herbicide atrazine to field crops. It was hypothesized that: i) applicator reports of exposure would be associated positively with detection of urinary atrazine metabolites, and ii) applicator reports of personal-protective-equipment (PPE) use would be associated negatively with detection of urinary atrazine metabolites. METHODS: Wisconsin dairy farmers were randomly selected to participate in 1997 to 1998 and were instructed to collect a urine sample 8 hours after the first pesticide application of the season. Farmers then were interviewed within 1 week of their first application to report on application practices. Eighty-six urine samples were analyzed for deethylatrazine, a major atrazine metabolite. RESULTS: Comparing urinalysis results with self-reported dermal, inhalation, and ingestion exposure showed poor agreement between self-reported exposure and urinary deethylatrazine detections (all kappa < 0.40). Multivariate linear regression modeling with deethylatrazine level as the outcome showed that self-reported practices did not significantly predict atrazine metabolite levels. CONCLUSIONS: Possible explanations for the discrepancies between urinalysis results and self-reported data include: i) inaccuracies in self-reported data and ii) substantial interpersonal variation in atrazine metabolism, resulting in major differences in body burden for similar exposures. Either explanation poses challenges for epidemiologic studies of the health effects of pesticides, which rely solely on self-reported measures of exposure. Additional evaluation of determinants of accuracy in self-assessed occupational and environmental exposures is needed.

Agricultural Workers' Diseases↗

PubMed2005

Laceration injuries among workers at meat packing plants.

BACKGROUND: Employees in meat packing experience one of the highest occupational laceration injury rates in the US. METHOD: A retrospective study was conducted using OSHA 200 injury and illness logs and First Reports of Injury from two large US meat packing plants from 1998 to 2000. The total workers observed during the study period ranged between 2,449 and 2,682 per year. RESULTS: Laceration injury incidence rates in Plant 1 were 14.0 injuries per 200,000 person hours (per 100 workers per year) in 1998, 11.5 in 1999, and 8.3 in 2000, whereas in Plant 2 the overall incidence rate was 3.7 in 1998, 4.8 in 1999, and 3.0 in 2000. Laceration injury rates in Plant 2 were close to the expected OSHA recordable laceration injury rate in 1999 (3.0 per 100 workers per year), but Plant 1 was considerably higher. Plant 1 had a kill support department, and removed animal hides whereas Plant 2 did not. Handheld non-powered tools were the most common contact objects whereas the slaughter department had the highest number of injuries. Finger injuries from a handheld non-powered tool were the most frequent. CONCLUSIONS: Findings confirm the high rate of injury from laceration in this industry and indicate hazard varies across time into shift, task being performed, and type of tool being used.

Accidents, Occupational↗

PubMed2005

Emergency department surveillance of occupational injuries in Shanghai's Putuo District, People's Republic of China.

PURPOSE: Although the People's Republic of China has an enormous worker population, occupational injury data availability has been hindered by the lack of a national surveillance system. This study compared work with non-work-related injuries by diagnosis, cause, and demographic characteristics of cases treated in a moderate-sized emergency department (ED) in Shanghai. METHODS: Data on all injury cases presenting to the ED were collected prospectively from November 1, 1998 through November 31, 1999 at the Putuo District Hospital. RESULTS: A total of 5200 injuries were recorded; 3175 (61.1%) injuries occurred in individuals aged 18 to 60 years and of these, 38% occurred at work, 15.8% occurred going to or coming from work, and 46.2% were non-work-related. Top three causes of at-work-only injuries were cutting/piercing instruments, assault, and struck by/caught in objects. Injuries caused by machinery (prevalence ratio [PR]=2.4; 95% confidence interval [CI], 2.2-2.6) and being struck by a falling object (PR=1.8; CI, 1.6-2.1) were among those more likely to have occurred at work. CONCLUSIONS: These findings are an important first step in implementing injury surveillance in Shanghai hospitals to track injury patterns and to ultimately inform injury prevention efforts in this major international urban center.

Accidents, Occupational↗

PubMed2005

Body mass index and serum 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane in nulliparous Chinese women.

BACKGROUND: Basic health indicators, such as body mass index (BMI), have been associated with serum 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane/1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDT/DDE) levels; however, both positive and inverse associations of BMI with serum DDT/DDE have been reported. Given the association of BMI with a number of outcomes, it may confound studies of DDT/DDE-associated health effects. We investigated the relationship of BMI with serum DDT/DDE accounting for other determinants of exposure among women with relatively recent environmental exposures to DDT. METHODS: Serum DDT/DDE was analyzed in 466 nonsmoking, nulliparous women recruited from Anhui province in China between 1996 and 1998 as part of a reproductive health study of textile workers. The women in the sample were born between 1963 and 1977, 8 to 21 years before China's 1984 DDT ban. We used multivariate linear regression to investigate associations of BMI, age, and birth year with serum DDT/DDE. RESULTS: Mean (SD) serum total DDT concentration was 32 ng/g (17.8 ng/g). Birth year showed an inverse relationship with serum DDT independent of age. Despite limited variability in BMI, there was a consistent inverse relationship between BMI and serum DDT. Specifically, each kg/m(2) increase in BMI was associated with a -1.34 ng/g (95% confidence interval, -2.12 to -0.56 ng/g) decrease in serum total DDT. CONCLUSIONS: There were high total DDT levels in this sample of nulliparous Chinese women relative to Western populations, birth year was more strongly associated with serum DDT than age, and BMI was inversely related to serum DDT in this study.

Adult↗

PubMed2005

Noise and chemical induced hearing loss: special considerations for farm youth.

Farm youth face multiple risks for injury and illness in agriculture. Reviewed here is evidence from current literature illustrating the noise and chemical exposure hearing risks that farm youth potentially face. Sources of noise (e.g., machinery) and potentially toxic chemical exposures (e.g. solvents and pesticides) common in the farm environment are reviewed, illustrating the need for heightened research attention to a problem that may affect up to 2 million children in the United States alone and that requires both public and occupational health solutions. As existing studies have not sufficiently explored potential ototoxic effects of these exposures on children and adolescents, recommendations are outlined for research characterizing both chemical and noise exposures to farm youth and their combined effects on hearing.

Adolescent↗

PubMed2004

Intimate partner abuse perpetrated by employees.

This exploratory study examined partner abuse perpetration in the context of employment. Qualitative and quantitative data from 29 men convicted of partner abuse were gathered through focus groups and a brief survey. Men attributed absences, reduced productivity, and errors to their perpetration of abuse and described harassing their victims using employers' phones, vehicles, e-mails and by enlisting coworkers. Findings also suggest that zero-tolerance policies may be ineffective and that employers may benefit from partner abuse training. For example, participants reported that their employers offered them alcohol-abuse services instead of batterer intervention, despite the fact that substance abuse was not a factor in all of the cases. These findings need to be tested through a larger scale, empirical investigation.

Absenteeism↗

PubMed2004

Tracking gender-based human rights violations in postwar Kosovo.

Four years have passed since the institution of the cease-fire in Yugoslavia, and questions remain as to how Kosovar women are faring in the country's postwar reconstruction. Reports, albeit fragmented, suggest that violence against women began to increase in 1998 and 1999. This trend continued through 2001, even while rates of other major crimes decreased. Despite considerable local efforts to address the conditions of women, there remains a lack of systematic data documenting the scope and frequency of violent acts committed against women. A centralized surveillance system focused on tracking human rights abuses needs to be established to address this critical need for empirically based reports and to ultimately guide reform efforts.

Female↗

PubMed2003

Farm pesticides: outcomes of a randomized controlled intervention to reduce risks.

BACKGROUND: In response to the multiple health risks that farm pesticide applicators experience and the need for controlled trials to evaluate prevention programs, this study tested the effects of a small-group educational intervention designed to increase personal protective equipment (PPE) use and to reduce direct pesticide exposure. DESIGN: A randomized controlled design was used with random selection of participants, random assignment to intervention and control groups, and baseline and postintervention assessments. SETTING/PARTICIPANTS: Four hundred Wisconsin dairy farmers certified to apply pesticides to field crops were recruited to participate over a 1-year evaluation period. INTERVENTION: Three-hour educational sessions were conducted with approximately 100 randomly assigned participants. Sessions targeted four educational messages: (1) existing evidence of excess cancers among farmers, (2) simulation of pesticide exposure presented through slide show and description, (3) feedback of self-reported data collected from the farmers reporting on frequency of exposure and gear use, and (4) cognitive behavioral strategies that can be adopted to reduce pesticide hazards. MAIN OUTCOME MEASURES: A change in use of required protective equipment use during application and self-reported dermal exposure were evaluated in the control and intervention groups postintervention. RESULTS: Six-month postintervention analyses showed that an educational intervention had significant effects on the use of gloves and gear during the most recent application and an actual reduction in the total number of pesticides used. However, the intervention did not have a significant impact on achieving full PPE compliance nor in reducing the amount of self-reported dermal pesticide exposure during the most recent application reported by applicators. CONCLUSIONS; This one-time educational intervention successfully increased protective equipment use. However, more-intensive programs are needed to achieve greater reductions in personal pesticide exposure.

Agricultural Workers' Diseases↗

PubMed2003

An exposure prevention rating method for intervention needs assessment and effectiveness evaluation.

This article describes a new method for (1) systematically prioritizing needs for intervention on hazardous substance exposures in manufacturing work sites, and (2) evaluating intervention effectiveness. We developed a checklist containing six unique sets of yes/no variables organized in a 2 x 3 matrix of exposure potential versus protection (two columns) at the levels of materials, processes, and human interface (three rows). The three levels correspond to a simplified hierarchy of controls. Each of the six sets of indicator variables was reduced to a high/moderate/low rating. Ratings from the matrix were then combined to generate a single overall exposure prevention rating for each area. Reflecting the hierarchy of controls, material factors were weighted highest, followed by process, and then human interface. The checklist was filled out by an industrial hygienist while conducting a walk-through inspection (N = 131 manufacturing processes/areas in 17 large work sites). One area or process per manufacturing department was assessed and rated. Based on the resulting Exposure Prevention ratings, we concluded that exposures were well controlled in the majority of areas assessed (64% with rating of 1 or 2 on a 6-point scale), that there is some room for improvement in 26 percent of areas (rating of 3 or 4), and that roughly 10 percent of the areas assessed are urgently in need of intervention (rated as 5 or 6). A second hygienist independently assessed a subset of areas to evaluate inter-rater reliability. The reliability of the overall exposure prevention ratings was excellent (weighted kappa = 0.84). The rating scheme has good discriminatory power and reliability and shows promise as a broadly applicable and inexpensive tool for intervention needs assessment and effectiveness evaluation. Validation studies are needed as a next step. This assessment method complements quantitative exposure assessment with an upstream prevention focus.

Adult↗

PubMed2003

Children's agricultural health: traumatic injuries and hazardous inorganic exposures.

CONTEXT: Farming is one of the most hazardous occupational industries in the USA, and farms pose numerous health risks for youth visiting, living in, or working in the farm environment. PURPOSE: This review discusses both potential traumatic injuries and hazardous inorganic exposures that are common in agricultural settings. FINDINGS: An estimated 2 million youth under the age of 20 currently live or work on US farms. Approximately 103 farm fatalities occur in this age group each year; over 32,000 nonfatal youth injuries occurred on farms in 1998. Children working in US agriculture make up only 8% of the population of working minors overall, yet they account for 40% of work-related fatalities among minors. Farm children and youth are also exposed to potentially harmful chemicals, such as pesticides and solvents, and many of these exposures go undetected. The long-term health effects of exposure to pesticides or solvents are not known, but the developmental vulnerabilities of children and youth are of particular concern. CONCLUSIONS: Clinical and epidemiologic research in pediatric populations is needed to expand the empirical data, particularly for inorganic and organic exposures, musculoskeletal trauma, skin disorders, occupation-induced hearing loss, and psychosocial stress. Rural health professionals can work to reduce these risks to farm youth by becoming more aware of the problem, by conducting clinical and epidemiologic research, and by engaging in advocacy at state and local levels.

Adolescent↗

PubMed2002

Compliance with required pesticide-specific protective equipment use.

BACKGROUND: This study measured compliance with pesticide-specific protective gear use requirements practiced by farmers applying pesticides to field crops. MATERIALS AND METHODS: Two hundred and twenty randomly selected dairy farmers were interviewed 1 week after pesticide application to determine use of personal protective equipment while applying at least 1 of 15 possible restricted use pesticides (response rate = 82.4%). RESULTS: Among the three most common pesticides used (dicamba, atrazine, and cyanazine), the proportions of farmers fully complying with gear use requirements were 8.8, 8.6, and 2.5%, respectively. For those same pesticides, the proportions (and 95% CI) using none of the required gear were 56.9% (47.3-66.5%), 38.6% (27.2-50.0%), and 47.5%(32.0-63.0%), respectively. CONCLUSIONS: Both full and partial compliance with required personal protective equipment was low for each of the 15 chemicals applied by the applicators in this sample.

Adult↗