Biomedical subjects

S A McCurdy

Publications and source records attributed to S A McCurdy.

13 recordsLinked to original sources

PubMed1992

Epidemiology of dermatitis among California farm workers.

To estimate the prevalence of dermatitis and risk factors for skin disease in California farm workers, a cross-sectional survey was conducted among grape, citrus, and tomato workers. The prevalence of contact dermatitis was 2% and lichenified hand dermatitis was 13%. Grape workers were more likely to report rashes in the last 12 months than were tomato workers or citrus workers. Grape workers were more likely to have contact dermatitis and lichenified hand dermatitis than were citrus or tomato workers. Increasing hours per week in agriculture, male sex, and not wearing gloves were associated with more lichenified hand dermatitis. We conclude that skin disease in agricultural workers may be causally associated with crop-specific exposures and lack of protective equipment.

Adult↗

PubMed1992

Reduced FVC among California grape workers.

Pulmonary disease due to organic and inorganic dust inhalation represents a significant health problem in the agricultural community. In response to concern over the potential adverse health effects of agricultural exposures, and to address the question of whether the specific crop worked was associated with decreased lung function, we conducted a cross-sectional survey of pulmonary function in a population of 238 grape workers, 355 tomato workers, and 166 citrus workers in California's Central Valley. In addition, 92 workers (66 males and 26 females) performed spirometry before and after an 8-h work shift. Multiple regression analysis of pulmonary function in all 759 workers revealed that age, height, and smoking-adjusted mean preshift FVC was lower in grape workers than in citrus workers in each of three sex and age groups studied: decreased 314 ml for males greater than or equal to 25 yr of age p less than 0.05, 82 ml for males less than 25 yr, and 83 ml for females greater than or equal to 20 yr. Mean adjusted preshift FVC was also lower in grape workers than tomato workers (decreased 249 ml in males greater than or equal to 25 yr [p less than 0.05], 51 ml for males less than 25 yr, and 46 ml for females greater than or equal to 20 yr). Adjusted mean FEV1 was not different by crop, but FEV1/FVC and forced-expiratory flow from 25 to 75% of the FVC (FEF25-75) were significantly elevated in grape workers of the three age and sex groups compared with citrus or tomato workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Smoking, respiratory symptoms, and pulmonary function among a population of Hispanic farmworkers.

We conducted a cross-sectional study in the agricultural Central Valley to evaluate the prevalence of respiratory symptoms, smoking status, and pulmonary function in Hispanic California farmworkers. Of 759 farmworkers completing questionnaires and spirometry, 747 were Hispanic. The prevalences of current, former, and never smokers (29, 17, and 54 percent, respectively) were comparable to rates in other studies of Hispanics, but daily cigarette consumption (median-five for men and three for women) was lower than in comparison populations. Prevalences of chronic cough, chronic phlegm, and persistent wheeze were low (1.6, 5.1, and 2.8 percent, respectively). Current smoking, increased age, female sex, and working greater than or equal to 8 months per year in agriculture were associated with increased prevalence of respiratory symptoms. Adjusted lung function was higher than for reference populations. Hispanic California farmworkers have a similar smoking prevalence to other Hispanic populations, but lower respiratory symptom prevalences and higher pulmonary function are consistent with lower daily cigarette consumption and the "healthy worker effect."

Adolescent↗

PubMed1992

Accuracy and precision of a portable anticoagulation monitor in a clinical setting.

BACKGROUND: Office-based anticoagulation monitors offer significant advantages in convenience, yet their performance has been inadequately characterized. METHODS: We characterized the performance of a portable anticoagulation monitoring system with respect to precision and agreement with a reference laboratory. Eighty-five patients from a university outpatient anticoagulation clinic provided 143 whole blood sample pairs for evaluating agreement between the monitor and the laboratory. Fifty-four patients each provided a second pair of samples for assessing the monitor's precision, and 23 pairs of measurements from the reference laboratory were used for assessing the laboratory's precision. Anticoagulation was measured using International Normalized Ratio (INR) values. Agreement between monitor and laboratory was evaluated as the difference between paired measurements. Precision was calculated as the within-patient standard deviation based on paired values. RESULTS: Within the range of 2.0 to 3.0 INR units, the monitor yielded values that were up to 0.3 units higher on average than the laboratory values. Within the range of greater than 3.0 to 4.5 INR units, the monitor yielded values that were up to 0.5 units lower on average than the laboratory values. Seventy-five percent of paired monitor and laboratory values were within 0.7 INR units; 90% were within 0.9 units. Within-patient standard deviation was 0.23 units for the monitor and 0.19 units for the laboratory. CONCLUSIONS: The monitor differed systematically from the laboratory and was moderately less precise. The magnitude of these effects was not great, however, and accuracy was best at around INR = 3.0, the border between low and high therapeutic ranges. The clinic-based monitor is useful for patients requiring frequent surveillance of anticoagulation status.

Anticoagulants↗

PubMed1991

Prevalence of hepatitis C virus antibodies among patients infected with human immunodeficiency virus.

A study was undertaken to determine the prevalence and risk factors for serological evidence of hepatitis C virus (HCV) infection in patients infected with the human immunodeficiency virus (HIV). Tests for anti-HCV antibody were carried out by enzyme-linked immunoassay (EIA) on 101 HIV-infected patients from two university-based outpatient clinics. Anti-HCV antibody reactive samples were tested by using a recombinant immunoblot assay (RIBA) for HCV antibodies. Fourteen of 101 (13.9%) HIV-infected patients were anti-HCV reactive by EIA. Of these 14, only seven were reactive by RIBA: four were intravenous drug users as a sole risk factor for HIV infection; and the remaining three acquired HIV by blood transfusion, contaminated instrument exposure or IV drug use and sexual contact. Acquisition of HIV by sexual activity alone was not associated with HCV infection. It is concluded that HCV infection is found in approximately 7% of a university HIV clinic population. False-positive anti-HCV antibody serology may lead to overestimation of the prevalence of HCV infection. Female sex and intravenous drug use are significantly associated with HCV infection among HIV-infected individuals.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Measuring personal exposure to airborne mutagens and nicotine in environmental tobacco smoke.

The exposure of individuals to environmental tobacco smoke (ETS) is of increasing public health concern because epidemiological studies have associated passive smoking with increased risk of a variety of adverse health effects among non-smokers including lung cancer. As a way to measure individual exposure to the mutagenic compounds in the complex mixture of ETS, we used a sensitive Salmonella/microsome micro pre-incubation (microsuspension) assay to detect mutagenicity of particulate matter collected on filters from low volume (1.7 1/min flow rate) personal sampling pumps. Airborne nicotine was collected concurrently as a marker for ETS exposure. In pilot-field studies, individual exposure to ETS was measured in two separate indoor environments in which smokers were present: a gambling casino and a bingo parlor. Total suspended particulate matter (TSP) was collected on filters worn near the breathing zone of non-smoking individuals. Sampling times ranged from 40 min to 6 h. All extracts of filters had detectable levels of mutagenic activity (TA98, +S9) resulting in airborne mutagenic activity concentrations of 500-5000 rev/m3. The mutagenic activity of the filters from the casino and bingo parlors was significantly correlated with total particulate matter per filters (n = 12; Rho = 0.85, p less than 0.01) and with airborne nicotine per filter (n = 12; Rho = 0.95, p less than 0.01). The microsuspension assay was sufficiently sensitive to detect the mutagens associated with extracts of particulate matter from low volume samples (0.2-0.6 m3) in these indoor environments over a relatively short sampling time, and could be useful in studies of personal exposure to the mutagens in environmental tobacco smoke. Further, airborne nicotine concentrations were highly correlated with airborne mutagenicity and the mutagenic activity associated with ETS could therefore be estimated by the concentrations of nicotine.

Air Pollution↗

PubMed1991

Reporting of occupational injury and illness in the semiconductor manufacturing industry.

In the United States, occupational illness and injury cases meeting specific reporting criteria are recorded on company Occupational Safety and Health Administration (OSHA) 200 logs; case description data are submitted to participating state agencies for coding and entry in the national Supplementary Data System (SDS). We evaluated completeness of reporting (the percentage of reportable cases that were recorded in the company OSHA 200 log) in the semiconductor manufacturing industry by reviewing company health clinic records for 1984 of 10 manufacturing sites of member companies of a national semiconductor manufacturing industry trade association. Of 416 randomly selected work-related cases, 101 met OSHA reporting criteria. Reporting completeness was 60 percent and was lowest for occupational illnesses (44 percent). Case-description data from 150 reported cases were submitted twice to state coding personnel to evaluate coding reliability. Reliability was high (kappa 0.82-0.93) for "nature," "affected body part," "source," and "type" variables. Coding for the SDS appears reliable; reporting completeness may be improved by use of a stepwise approach by company personnel responsible for reporting decisions.

Accidents, Occupational↗

PubMed1990

Occupational health among migrant and seasonal farmworkers: the specific case of dermatitis.

Occupational health studies of agricultural workers have generally excluded migrant and seasonal farmworkers, and this population experiences a high degree of health risk from agricultural exposures. A survey of dermatologic disorders among migrant and seasonal farmworkers will be used to illustrate this point. Data from a recent field study are presented to illustrate epidemiologic approaches to studying dermatologic disorders in farmworkers and risk factors for dermatitis. This study suggests there is generally a high health risk to agricultural workers and this study also suggests methods to investigate other acute and chronic diseases among agricultural workers.

Agricultural Workers' Diseases↗

PubMed1990

Subacute poisoning with phosalone, an organophosphate insecticide.

An illness characterized by weakness, dizziness, and gastrointestinal symtoms was identified among a crew of 30 migrant field-workers employed by a grape grower in Madera County, California, during August 1987. The onset of symptoms occurred between August 24 and August 30 and a median of 9 days from the date of first employment. The first crew member sought medical treatment on August 26, and 10 crew members were admitted to hospital between August 27 and August 30. For most workers, gastrointestinal and constitutional symptoms resolved shortly after admission, but 4 patients had episodes of severe sinus bradycardia persisting for several days. On the day of admission, transient atrioventricular dissociation developed in 2 persons. Interviews with 16 crew members not admitted to the hospital identified only 1 additional worker ill with gastrointestinal symptoms, but all 16 had moderate to severe inhibition of both plasma and red blood cell cholinesterase. Four other workers who were tested but not interviewed also had cholinesterase depression. The crew had had exposure since August 19 to the organophosphate insecticide phosalone, which was last applied to the vineyard on July 21, or 29 days earlier. Although this is the first report unequivocally linking phosalone to field-worker poisoning, the delayed onset and nonspecific nature of the symptoms associated with subacute poisoning may have hindered the recognition of previous similar episodes.

Adolescent↗

PubMed1989

Assessing dermatitis in epidemiologic studies: occupational skin disease among California grape and tomato harvesters.

We conducted a cross-sectional investigation to determine whether table grape harvesters, who have significant cutaneous contact with crop-associated materials that may cause skin disease, are more likely to develop dermatitis than are a control group of tomato workers performing mechanical harvesting with minimal cutaneous contact with crop-associated substances. A secondary aim was to develop methods for studying skin disease in farm workers, including a standard questionnaire and physical examination. California table grape workers (n = 183) and tomato workers (n = 43) completed an interviewer-administered questionnaire and waist-up physical examination at their work site during harvest operations. On physical examination, pustular eruptions such as acne and folliculitis were present in 30% of subjects, and eczematous rashes were noted in 10% of subjects. Irritant or allergic contact dermatitis was diagnosed in 2% of subjects. No significant differences in prevalence for these skin conditions were observed between the two groups of workers. In contrast to the physical examination results, grape workers were more likely than tomato workers to report a rash occurring in the previous 3 months (52% vs. 19%, p less than 0.001). Explanations for this discrepancy are discussed. The sensitivity of the questionnaire for current skin conditions was 31%, and the specificity was 94%. Improved sensitivity was seen for eczematous skin conditions (55%). We conclude that questionnaires provide an efficient means of assessing subject characteristics, but may have limited sensitivity for some dermatologic outcomes.

Agricultural Workers' Diseases↗

PubMed1989

Epistaxis due to glutaraldehyde exposure.

Glutaraldehyde is commonly used as a cold disinfecting agent in the hospital setting and may cause irritation of skin, mucous membranes, and the upper respiratory tract in exposed workers. We report an unusual case of recurrent epistaxis associated with other symptoms of upper respiratory tract irritation and skin rash in a hospital employee using glutaraldehyde for sterilization of endoscopy equipment. A visit to the workplace revealed inadequate personal protective measures and inadequate local ventilation. High-risk work practices contributing to the hazard included soaking of endoscopy equipment in uncovered basins, manual pouring of concentrated glutaraldehyde solutions without the use of proper protective measures, and the use of paper masks, which provide inadequate protection from solvent vapors. The patient's symptoms resolved with the implementation of personal protective measures and engineering controls.

Adult↗

PubMed1979

Circumcision.

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Circumcision, Male↗

PubMedDate not supplied

Early morbidity after total hip replacement: rheumatoid arthritis versus osteoarthritis.

The authors used the California Health Facilities Discharge data for 1984 and 1985 to compare retrospectively in-hospital morbidity and mortality of all 721 patients with rheumatoid arthritis versus all 8,859 patients with osteoarthritis who underwent a non-emergent, first-time, unilateral total hip arthroplasty. The lengths of hospitalization, in-hospital mortality rates, and incidences of postoperative complications were similar in the two groups except for higher rates of wound infection and wound dehiscence in the patients with rheumatoid arthritis and a higher rate of thromboembolic events in the osteoarthritis group. The short-term outcome of patients with rheumatoid arthritis appears comparable to that of patients with osteoarthritis.

Aged↗