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Biomedical subjects

Peter M Rabinowitz

Publications and source records attributed to Peter M Rabinowitz.

11 recordsLinked to original sources
PubMed2006

Trends in the prevalence of hearing loss among young adults entering an industrial workforce 1985 to 2004.

OBJECTIVES: Studies have suggested that hearing loss due to recreational noise exposure may be on the rise among adolescents and young adults. This study examines whether the hearing status of young US adults entering an industrial workforce has worsened over the past 20 yr. DESIGN: The baseline audiograms of 2526 individuals ages 17 to 25 beginning employment at a multisite US corporation between 1985 and 2004 were analyzed to determine the yearly prevalence of hearing loss. RESULTS: Approximately 16% of the young adults in the sample had high frequency hearing loss (defined as hearing thresholds greater than 15 dB in either ear at 3,4, or 6 kHz). In a linear regression model, this prevalence decreased over the 20-yr period (odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.94, 0.99). Almost 20% of subjects had audiometric "notches" consistent with noise exposure; this rate remained constant over the 20 yr, as did the prevalence (5%) of low frequency hearing loss. CONCLUSIONS: These results indicate that despite concern about widespread recreational noise exposures, the prevalence of hearing loss among a group of young US adults has not significantly increased over the past two decades.

Adolescent↗
PubMed2006

Audiogram notches in noise-exposed workers.

OBJECTIVES: Diagnostic criteria for noise-induced hearing loss include the audiometric notch, yet no standardized definition exists. This study tested whether objective notch metrics could match the clinical judgments of an expert panel. DESIGN: A panel of occupational physicians, otolaryngologists, and audiologists reviewed audiograms of noise-exposed workers. In a two-sample process, the panel judged whether a notch was present and whether hearing loss had progressed in a notch pattern. Quantitative notch metrics were compared against expert decisions. RESULTS: At least five of six experts agreed about notch identification in 71 and 72% of the cases in the two samples, and agreement about notch progression was 61 and 67%. Notch depth and professional specialty appeared to affect notch judgments. Despite this variability, a notch metric showed excellent agreement with expert notch consensus in each sample (94.7 and 96.6%; kappa = 0.88 and 0.92). CONCLUSIONS: Audiogram notch metrics can agree with expert clinical consensus and assist in the surveillance of noise-exposed workers.

Adult↗
PubMed2006

Incidence of asthma among aluminum workers.

Exposures to respiratory irritants encountered in aluminum smelters in Europe, Australia, and New Zealand have been suggested as the cause of "potroom asthma." However, there remains disagreement in North America regarding the existence of this entity. This study was designed to assess whether asthma occurs excessively among potroom workers and if so, delineate dose-response relationships for possible causal risk factors. The asthma incidence ratio between potroom and nonpotroom workers after adjusting for smoking was 1.40. Although bivariate analyses showed a relationship between asthma incidence and exposure to total fluoride, gaseous fluoride, particulate fluoride, sulfur dioxide, and smoking, only the effects of gaseous fluoride (relative risk [RR] = 5.1) and smoking (RR = 7.7) remained significant in a multivariate model. Potroom asthma appears to occur at the studied U.S. aluminum smelters at doses within regulatory guidelines.

Adult↗
PubMed2005

Risk factors for tuberculin skin test positivity in an industrial workforce results of a contact investigation.

OBJECTIVE: The objective of this study was to determine the prevalence of and risk factors for tuberculin skin test (TST) positivity among an industrial workforce employing many foreign-born workers after one employee was hospitalized for active tuberculosis (TB). METHODS: A contact investigation was performed. We used crude odds ratios and a multivariate model to assess risk factors for TST positivity. RESULTS: The rate of TST positivity was 37.1% (N=97). Twenty-nine of 36 (80.6%) workers from higher TB prevalence countries versus seven of 61 (11.5%) workers born in low-prevalence countries were positive. Workplace risk factors included using the lunchroom, carpooling with the case, or working on the same or subsequent shift. A total of 66.7% of immigrant workers denied previous screening. CONCLUSION: TB contact investigations should probe into workplace transmission. Workplaces with workers from higher TB prevalence countries should consider pre-placement TB screening.

Adult↗
PubMed2005

Proximity to pollution sources and risk of amphibian limb malformation.

The cause of limb deformities in wild amphibian populations remains unclear, even though the apparent increase in prevalence of this condition may have implications for human health. Few studies have simultaneously assessed the effect of multiple exposures on the risk of limb deformities. In a cross-sectional survey of 5,264 hylid and ranid metamorphs in 42 Vermont wetlands, we assessed independent risk factors for nontraumatic limb malformation. The rate of nontraumatic limb malformation varied by location from 0 to 10.2%. Analysis of a subsample did not demonstrate any evidence of infection with the parasite Ribeiroia. We used geographic information system (GIS) land-use/land-cover data to validate field observations of land use in the proximity of study wetlands. In a multiple logistic regression model that included land use as well as developmental stage, genus, and water-quality measures, proximity to agricultural land use was associated with an increased risk of limb malformation (odds ratio = 2.26; 95% confidence interval, 1.42-3.58; p < 0.001). The overall discriminant power of the statistical model was high (C = 0.79). These findings from one of the largest systematic surveys to date provide support for the role of chemical toxicants in the development of amphibian limb malformation and demonstrate the value of an epidemiologic approach to this problem.

Agriculture↗
PubMed2005

Hearing loss in migrant agricultural workers.

BACKGROUND: Farmers have high rates of hearing loss, yet little is known about the hearing status of migrant agricultural workers. We performed a cross-sectional survey to assess the prevalence and impact of hearing loss in this population. METHODS: One hundred fifty migrant and seasonal agricultural workers were surveyed at a series of health fairs held at migrant camps. A bilingual questionnaire included items related to hearing loss risk factors and subjective hearing difficulties. Pure tone audiometry and tympanometry were performed in a mobile testing van. RESULTS: More than half the subjects had some degree of hearing loss at audiometric frequencies between 500 and 6,000 Hz, especially in the higher frequencies. Hispanic males in the sample had significantly greater prevalence of high-frequency hearing loss compared to adults in the national Hispanic Health and Nutrition Examination Survey (HHANES). More than 35% of respondents complained of subjective difficulty hearing or understanding speech, yet no workers reported use of hearing aids. Even after adjusting for measured hearing loss, Hispanic farm workers were more likely than their English- speaking counterparts to complain of difficulty hearing or understanding speech, suggesting that language barriers could worsen the impact of hearing loss. Risk factors for hearing loss included age and abnormal tympanometry. Occupational exposures to noise from tractors and other machinery as well as pesticides were frequently reported, while use of hearing protection was rare. CONCLUSION: Hearing loss is a significant and under-recognized problem in the migrant worker population. Further preventive and treatment efforts are warranted.

Acoustic Impedance Tests↗
PubMed2003

Host-environment medicine: a primary care model for the age of genomics.

Rapid developments in genomic and proteomic testing promise to impact the way in which clinicians assess disease risk and drug selection in their patients. Because most diseases result from host-environment interactions, however, primary care providers will need to avoid the trap of biological determinism by examining the important role of environmental factors in their clinical assessments and interventions. This article discusses the application of host-environment concepts to recent developments in the areas of genomics and proteomics.

Antidepressive Agents, Tricyclic↗
PubMed2003

Impact of OSHA final rule--recording hearing loss: an analysis of an industrial audiometric dataset.

The 2003 Occupational Safety and Health Administration (OSHA) Occupational Injury and Illness Recording and Reporting Final Rule changed the definition of recordable work-related hearing loss. We performed a study of the Alcoa Inc. audiometric database to evaluate the impact of this new rule. The 2003 rule increased the rate of potentially recordable hearing loss events from 0.2% to 1.6% per year. A total of 68.6% of potentially recordable cases had American Academy of Audiology/American Medical Association (AAO/AMA) hearing impairment at the time of recordability. On average, recordable loss occurred after onset of impairment, whereas the non-age-corrected 10-dB standard threshold shift (STS) usually preceded impairment. The OSHA Final Rule will significantly increase recordable cases of occupational hearing loss. The new case definition is usually accompanied by AAO/AMA hearing impairment. Other, more sensitive metrics should therefore be used for early detection and prevention of hearing loss.

Adult↗
PubMed2002

Acute inhalation injury.

Recent events have underscored the importance of proper diagnosis and management of patients with inhalation injury. Clinicians who care for individuals who have sustained inhalation damage to their respiratory tract need to take a careful exposure history and be alert to possibilities of delayed effects and clinical deterioration. Although supportive care and prevention remain the cornerstone of current approaches to this condition, better understanding of the mechanisms of cellular injury and repair may lead to improved treatments in the future.

Acute Disease↗
PubMed2002

Antioxidant status and hearing function in noise-exposed workers.

The cellular antioxidant system appears to protect cochlear hair cells from oxidative stress due to noise and aging. The role of individual metabolic variables remains poorly understood, however. We examined the role of a number of metabolic factors on human cochlear function in noise-exposed individuals. In 58 factory workers we measured audiometry and distortion product otoacoustic emissions prior to a workshift. Simultaneously we measured levels of vitamin E, vitamin C, and polymorphism status for two metabolic genes related to glutathione S-transferase function (GSTM1 and GSTT1). Age and total noise exposure were predictive of hearing status. Vitamin E levels were negatively correlated with hearing function, and this effect was partly explained by an increase in vitamin E levels with age. No effect was found for vitamin C. Individuals possessing the GSTM1 gene had significantly better high frequency otoacoustic emissions compared to GSTM1 null individuals. The protective effect of GSTM1 was present even after adjusting for age, race, sex, and years of noise exposure. GSTT1 did not exhibit a similarly protective effect. While the cross-sectional nature of the study precludes drawing conclusions about causation, these data suggest that GSTM1, an antioxidant enzyme which is found in the mammalian cochlea, may play a protective role in humans against hair cell damage due to noise or aging.

Adult↗