Standardized mortality odds ratios.
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Biomedical subjects
Publications and source records attributed to R M Park.
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Explore the source record for details and available documents.
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Surveillance for cumulative trauma disorders (CTDs) of the hand and wrist was carried out in five US automotive plants from 1985 to 1986, using Occupational Safety and Health Administration (OSHA) Form 200 injury and illness logs and medical insurance claims. Results using both record sources indicated that hand and wrist disorders may be more common in foundries than in other types of automotive plants. Similarly, in assembly plants, employees in certain departments appeared to be at higher risk for CTDs. Although our results are based on small numbers of cases, they suggest plants and departments that might be targeted for more detailed investigation.
Medical insurance claims, linked with work histories for a large automotive manufacturer over a 3-year period, identified large numbers of cases of potentially work-related diseases, including 30,600 episodes of probable cumulative trauma disorders (CTD). CTD incidence rates were calculated within five plants, and high-risk areas identified, however, unknown differences in medical insurance coverage by exposure group limited interpretation. Case-control analyses, with controls also identified by insurance claims, addressed coverage and produced age-adjusted and sex-adjusted estimates of risks. All five plants had departments with statistically significant, elevated risks for one or more of the diagnoses carpal tunnel syndrome, CTD of other upper extremities, rotator cuff syndrome, CTD of the neck and of the lower back. Medical insurance claim data linked with work history provide the basis for practical and comprehensive surveillance for CTD and potentially a variety of other occupational diseases.
Cross-sectional transmission electron microscopy (TEM) sample preparation of ZnSe/GaAs epitaxial films is investigated. Conventional argon ion milling is shown to produce a high density (approximately 5-8 x 10(11)/cm2) of small (diameter approximately 60-80 A) extended defects (stacking faults, microtwins, double positioning twins, etc.). In addition, transmission electron diffraction results indicate a thin ZnO layer can also occasionally form upon ion milling or electron-beam irradiation although the exact conditions for ZnO formation are not well understood. Conventional TEM (amplitude contrast) and high-resolution TEM (phase contrast) imaging in combination with transmission electron diffraction studies were performed to determine the optimum method of removing the ion milling related damage and ZnO layers during sample preparation. HF/HCl, NaOH/H2O, H2SO4/H2O2/H2O and Br2/CH3OH etching mixtures as well as low voltage argon or iodine ion milling were studied. A low energy (2 keV) iodine or argon ion milling step was shown to remove the ZnO layer and reduced the density of the extended defects associated with Ar+ ion milling, but was unsuccessful in removing all of the defects. Auger electron spectroscopy results indicate residual iodine was either left on the surface or implanted beneath the surface during iodine ion milling. Etching the XTEM samples in HF/HCl was shown to be effective in removing the ZnO layer but had little or no effect on the ion milling induced defects. Etching the samples in a 0.5% Br2/CH3OH solution resulted in complete elimination of the ion milling induced extended defects including the residual defects associated with iodine ion milling. In addition the Br2/CH3OH etch produced the best surface morphology. Thus a brief (1-2 seconds) Br2/CH3OH etch after conventional preparation (argon ion milling) of cross-sectional ZnSe/GaAs TEM samples appears to be an inexpensive and superior alternative to iodine ion milling.
Standardized mortality ratios (SMRs) for occupational diseases are confounded by health differences between industrial and general populations. In 109 industrial cohorts largely free of work-related mortality, these selection effects were sizable for both malignant and nonmalignant outcomes. All-cancer SMRs were considerably less than 1.0 for many cohorts, and lung cancer was subject to almost as much selection-derived confounding as nonmalignant disease. Standardized proportional mortality ratios (PMRs) (approximated by relative SMRs (RSMRs] were less confounded than SMRs in estimating occupational risk. PMRs appeared to overestimate cancer mortality on average by 6%, while SMRs underestimated by 13%. PMRs underestimated nonmalignant respiratory disease by 16 percent but SMRs underestimated by 39 percent. The sources of confounding, in addition to selection on health status at hire, most likely include social class. SMRs, in the absence of internal population comparisons, would fail to detect both malignant and nonmalignant work-related mortality in many industrial cohorts.
Standardized proportional mortality ratios and mortality odds ratios were calculated for 583 deaths between 1950 and 1986 among employees who had worked for at least 10 years at a facility manufacturing missile and aircraft guidance systems. There was a statistically significant excess of brain cancer proportional mortality (PMR = 16/3.8 = 4.2, p = .0001). Among hourly employees, 12 brain cancer deaths occurred for 2.7 expected (PMR = 4.4, p = .00005). The PMR for brain cancer increased from 1.8 (p = .45) among hourly workers with less than 20 years to 8.7 (p = .000003) in those with more than 20 years employment. Work in "clean rooms," where gyroscopes were assembled, was associated with the brain cancer excess but did not fully account for it. Among 105 deceased hourly women, all three brain cancer deaths occurred among gyro assemblers working in clean rooms, and the risk increased with duration in clean rooms. Although the proportion of brain cancer deaths among hourly men with clean-room experience was similar to that for women, only three of the seven male brain cancer deaths occurred in this group. The suspect agents include gyro fluids and chlorofluorocarbon solvents.
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Recent studies identify digestive cancer excesses among workers exposed to cutting fluids, abrasive dusts, and oil smoke. Standardized proportional mortality and mortality odds ratio studies were carried out for a ball bearing plant. Cause of death and work histories were obtained for 702 of 768 hourly employees with ten or more years' service who died between 1969 and 1982. Union and company records were used to define exposure measures. The major findings were significant excesses in proportional mortality ratios (PMR) from stomach cancer (PMR = 2.0) and rectal cancer (PMR = 3.1) among white men. After control for age at death, there was a significant association between stomach cancer and precision grinding exposures, consisting primarily of direct contact with water-based cutting fluids (usually emulsified oils) and their aerosols. Some straight oils and synthetic cutting fluids were used as well. The pattern of stomach cancer is consistent with previous findings and suggests an association with the soluble oil cutting fluids.
A new statistical analysis strategy for proportionate mortality data is proposed. It is assumed that the occupational exposure, if it has an effect on mortality, increases the rate of death for some subset of causes by a multiplicative factor while not affecting the rates for the remaining causes of death. The unconditional logistic regression model is shown to provide a structure for the data analysis, with one of the predictors being the logit of the probability in the reference population that death was due to the affected causes. Using this model, one can estimate the effect of exposure while simultaneously controlling for a number of potential confounding and selection variables. Also, this model avoids the problems of comparing standardized proportionate mortality ratios, which are indirectly standardized measures. The model is demonstrated on a set of proportionate mortality data for factory workers from the northeastern United States.
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A case-control study was conducted an at automotive carburetor plant to investigate exposures associated with a cluster of cases exhibiting neurological symptoms that resembled multiple sclerosis. Eighteen cases were identified with symptom onset between 1970 and 1985. Four controls per case were selected randomly from the plant population, and they were matched by year of birth, gender, and ethnicity. From work histories and telephone interviews, cumulative exposures for 10 chemical or process categories were computed, based on rank estimates of exposure levels. Mantel-Haenszel procedures and logistic regression modeling produced statistically significant relative risks associated with die-casting and organophosphate exposures, using unweighted and latency-weighted cumulative exposures. The study was hampered by the inability to pursue further clinical neurological evaluation of the cases, by the small number of cases, and by uncertainties of exposure assessment. A delayed neuropathy arising from organophosphate exposure in hydraulic and machining fluids is proposed.