Biomedical subjects

Susan M Kennedy

Publications and source records attributed to Susan M Kennedy.

At least 19 recordsLinked to original sources

PubMed2006

Protection against Western diet-induced obesity and hepatic steatosis in liver fatty acid-binding protein knockout mice.

Liver fatty acid-binding protein (L-Fabp) regulates murine hepatic fatty acid trafficking in response to fasting. In this study, we show that L-Fabp(-/-) mice fed a high-fat Western diet for up to 18 weeks are less obese and accumulate less hepatic triglyceride than C57BL/6J controls. Paradoxically, both control and L-Fabp(-/-) mice manifested comparable glucose intolerance and insulin resistance when fed a Western diet. Protection against obesity in Western diet-fed L-Fabp(-/-) mice was not due to discernable changes in food intake, fat malabsorption, or heat production, although intestinal lipid secretion kinetics were significantly slower in both chow-fed and Western diet-fed L-Fabp(-/-) mice. By contrast, there was a significant increase in the respiratory exchange ratio in L-Fabp(-/-) mice, suggesting a shift in energy substrate use from fat to carbohydrate, findings supported by an approximately threefold increase in serum lactate. Microarray analysis revealed increased expression of genes involved in lipid synthesis (fatty acid synthase, squalene epoxidase, hydroxy-methylglutaryl coenzyme A reductase), while genes involved in glycolysis (glucokinase and glycerol kinase) were decreased in L-Fabp(-/-) mice. Fatty acid synthase expression was also increased in the skeletal muscle of L-Fabp(-/-) mice. In conclusion, L-Fabp may function as a metabolic sensor in regulating lipid homeostasis. We suggest that L-Fabp(-/-) mice are protected against Western diet-induced obesity and hepatic steatosis through a series of adaptations in both hepatic and extrahepatic energy substrate use. (HEPATOLOGY 2006;44:1191-1205.).

Animals↗

PubMed2006

Gender differences in respiratory symptoms-does occupation matter?

Little attention has been given to gender differences in respiratory health, particularly in occupational settings. The purpose of this paper was to evaluate gender differences in respiratory morbidity based on surveys of hospitality workers, radiographers, and respiratory therapists. Data were available from mail surveys of 850 hospitality industry workers (participation rate 73.9%; 52.6% female), 586 radiographers (participation rate 63.6%; 85% female), and 275 respiratory therapists (participation rate 64.1%; 58.6% female). Cross-tabulations by gender were evaluated by chi(2) analysis and logistic regression with adjustment for personal and work characteristics. Women consistently had greater respiratory morbidity for symptoms associated with shortness of breath, whereas men usually had a higher prevalence of phlegm. There were few differences in work exposures apart from perception of exposure to ETS among hospitality workers. Gender differences in symptoms were often reduced after adjustment for personal and work characteristics but for respiratory therapists there were even greater gender disparities for asthma attack and breathing trouble. Population health findings of elevated symptoms among women were only partially supported by these occupational respiratory health surveys. The influence of differential exposures and personal factors should be considered when interpreting gender differences in health outcomes.

Adult↗

PubMed2006

Subjective assessment of listening environments in university classrooms: perceptions of students.

A questionnaire is developed to evaluate perception of the listening environment by university students. The objectives were to develop a questionnaire-based measurement tool, derive a measure of perceived classroom-listening quality, use the questionnaire to investigate factors that enhance, impair, or do not affect perceived listening quality, and consider the implications for classroom design. The questionnaire was administered to over 5700 students in 30 classrooms at one university. Physical and acoustical measurements were also performed in each classroom. The questionnaire included items that recorded aspects of student perception, as well as individual, course-, and instructor-specific factors. Responses to 19 perception items generated a perception of listening ease (PLE) score for each student and a classroom-average score. Decreased PLE was associated with women, English-second-larguage students, those with hearing impairment, students not interested in the course material, and those who found the material difficult. Increased PLE was associated with higher speech transmission index, acceptable lighting, temperature and seating, better instructor voice, increased visual-aid use, and easier course material. Results indicate that PLE is a useful measure of student perception of the classroom-listening environment, and that optimal classroom acoustical design must take into consideration "in-use" conditions, as well as classroom physical characteristics.

Acoustic Stimulation↗

PubMed2006

Work organization and musculoskeletal injuries among a cohort of health care workers.

OBJECTIVES: This study investigated the relationship between work-organization factors (job control, job demands, and workload measures) and the risk of lower-body musculoskeletal injury among health care workers. METHODS: A four-year, retrospective cohort study of 3769 health care workers was carried out in one acute care hospital in the Canadian province of British Columbia. A job-exposure matrix was constructed for the work-organization factors from survey and administrative data and assigned to workers on the basis of their occupation and department of employment. Musculoskeletal injuries resulting in workers' compensation claims were ascertained from the injury database of the hospital's Occupational Health and Safety Department. RESULTS: In the final Poisson models adjusted for demographic and biomechanical factors, an increased risk for compensated musculoskeletal injuries of the lower back and lower limb was related to low job control [relative risk (RR) 1.64, 95% confidence interval (95% CI) 1.08-2.49] and workload defined by working during periods of high absenteeism within a department (RR 2.10, 95% CI 1.61-2.98). The risk also increased with more biomechanical demands in an occupation and with a recent previous injury. CONCLUSIONS: The results indicate that work-organization characteristics (job control and workload) were associated with an increased risk of musculoskeletal injuries resulting in a compensation claim. These associations remained after the effect of demographic and biomechanical factors was taken into consideration. The association with workload measured by departmental levels of absenteeism should be explored further in future studies as reverse causality (musculoskeletal symptoms resulting in absenteeism) could not be fully ruled out in the current study.

Absenteeism↗

PubMed2005

Asthma severity and exposure to occupational asthmogens.

RATIONALE: Severe asthma is a public health problem with limited information regarding preventable causes. Although occupational exposures have been implicated as important risk factors for asthma and asthma exacerbations, associations between occupational exposures and asthma severity have not been reported. OBJECTIVE: To examine associations between occupational exposures and asthma severity. METHODS: The Epidemiological Study on the Genetics and Environment of Asthma combines a case-control study with a family study of relatives of patients with asthma. Adult patients (n = 148) were recruited in chest clinics and control subjects without asthma (n = 228) were population-based. Occupational exposures to nonasthmogenic irritants and asthmogens (classified as "any asthmogen" including three broad groups: high-molecular-weight agents, low-molecular-weight agents, and mixed environments) were assessed by an asthma-specific job exposure matrix. Asthma severity was defined from an 8-grade clinical score (frequency of attacks, persistent symptoms, and hospitalization). Patients with severe (score >or= 2) and mild asthma were compared with control subjects using nominal logistic regression. MAIN RESULTS: Significant associations were observed between severe adult-onset asthma and exposure to any occupational asthmogen (odds ratio [OR], 4.0; 95% confidence interval [CI], 2.0-8.1), high-molecular-weight agents (OR, 3.7; CI, 1.3-11.1), low-molecular-weight agents (OR, 4.4; CI, 1.9-10.1), including industrial cleaning agents (OR, 7.2; CI, 1.3-39.9), and mixed environments (OR, 7.5; CI, 2.4-23.5). No significant associations were found between nonasthmogenic irritants and asthma severity, nor between asthmogens and childhood-onset asthma or mild adult-onset asthma. CONCLUSIONS: Our results suggested a strong deleterious role of occupational asthmogens in severe asthma. Clinicians should consider occupational exposures in patients with moderate to severe asthma.

Adult↗

PubMed2005

Effects of theatrical smokes and fogs on respiratory health in the entertainment industry.

BACKGROUND: Theatrical fogs (glycol or mineral oil aerosols) are widely used in the entertainment industry to create special effects and make lighting visible. METHODS: We studied 101 employees at 19 sites using fogs and measured personal fog exposures, across work shift lung function, and acute and chronic symptoms. Results were also compared to an external control population, studied previously. RESULTS: Chronic work-related wheezing and chest tightness were significantly associated with increased cumulative exposure to fogs (mineral oil and glycols) over the previous 2 years. Acute cough and dry throat were associated with acute exposure to glycol-based fogs; increased acute upper airway symptoms were associated with increased fog aerosol overall. Lung function was significantly lower among those working closest to the fog source. CONCLUSIONS: Mineral oil- and glycol-based fogs are associated with acute and chronic adverse effects on respiratory health among employees. Reducing exposure, through controls, substitution, and elimination where possible, is likely to reduce these effects.

Adult↗

PubMed2005

Monoclonal antibody 5C3 raised against formalin fixed paraffin-embedded invasive breast tumour tissue: characterisation of its reactive antigen via immunoprecipitation and internal sequencing.

Monoclonal antibodies (MAbs) provide a powerful tool for the identification of novel tumour associated antigens. In an attempt to identify such an antigen, MAbs were generated by immunization with paraffin wax-embedded formalin-fixed invasive ductal breast tumour tissue from a patient who relapsed following an initial response to adjuvant chemotherapy. Extensive immunocytochemical and Western blot analysis of a range of cell lines and tissues including a series of pre- and post-chemotherapy treated invasive ductal breast carcinomas, with one of these MAbs, antibody 5C3, indicated that the 5C3 reactive antigen displayed a wide spectrum of reactivity amongst various human tumours. A reduced level of 5C3 expression was observed in non-cancerous archival breast tissues and breast cell lines and normal murine tissues compared to the expression observed in infiltrating breast tumour cells. Immunoprecipitation studies using the human ductal breast carcinoma cell line, ZR-75-1 resulted in the isolation of a 175 kDa reactive band which was excised from an SDS-PAGE gel and subjected to internal sequencing. Sequencing analysis and database searching revealed that this 175 kDa band represented a cytokeratin heteropolymer, composed of type I cytokeratin 9 and type II cytokeratin 6. Further studies confirmed that antibody 5C3 recognised this heteropolymer of cytokeratin 9 and 6 but not the individual cytokeratins. This novel method of MAb generation may facilitate the isolation of further potentially interesting cellular antigens. Characterisation of these novel antigens may identify specific disease targets with possible prognostic or predictive significance.

Antibodies, Monoclonal↗

PubMed2005

Exposures to atmospheric effects in the entertainment industry.

Theatrical fogs are commonly used in the entertainment industry to create special atmospheric effects during filming and live productions. We examined exposures to mineral oil-and glycol-based theatrical fogs to determine what fluids and effects were commonly used, to measure the size distributions of the aerosols, and to identify factors associated with personal exposure levels. In nonperformance jobs in a range of production types (television, film, live theater, and concerts),we measured airborne concentrations of inhalable aerosol,aldehydes, and polycyclic aromatic hydrocarbons, and collected observations about the sites and tasks performed. Both mineral oil and glycols were observed in use on about one-half the production days in the study. The most common effect produced was a generalized haze over the entire set. Mean personal inhalable aerosol concentrations were 0.70 mg/m3(range 0.02 to 4.1). The mean proportion of total aerosol mass less than 3.5 microns in aerodynamic diameter was 61%. Exposures were higher when mineral oils, rather than glycols, were used to generate fogs. Higher exposures were also associated with movie and television productions, with using more than one fog machine, with increased time spent in visible fog, and for those employed as "grips." Decreased exposures were associated with increasing room temperature, with increasing distance from fog machines, and for those employed as "sound technicians." Exposures to theatrical fogs are just beginning to be measured. It is important to consider these exposures in light of any health effects observed, since existing occupational exposure limits were developed in other industries where the aerosol composition differs from that of theatrical fogs.

Aerosols↗

PubMed2005

Occupational exposure to noise and mortality from acute myocardial infarction.

BACKGROUND: Exposure to noise is highly prevalent in the workplace, and an etiologic association with cardiovascular disease has been hypothesized. Although there is evidence of hypertension among noise-exposed workers, evidence of heart disease has been less conclusive. METHODS: We identified a cohort of 27,464 blue-collar workers from 14 lumber mills in British Columbia who worked at least 1 year between 1950 and 1995 and who were followed up over the same period. Cumulative noise exposure was quantitatively assessed. Vital status was ascertained from the Canadian Mortality Database. We estimated standardized mortality ratios using the general population as referents, and we estimated relative risks using an internal low-exposure group as controls. To examine acute effects of noise, we assessed relative risks during subjects' working years in lumber mills. Because of the possibility of exposure misclassification as a result of hearing-protector use, we investigated a subgroup that had been employed before widespread use of protectors. RESULTS: During the follow-up period, 2510 circulatory disease deaths occurred. Relative risks for acute myocardial infarction mortality were elevated in the full cohort, with a stronger association in the subgroup without hearing protection. There was an exposure-response trend, with a relative risk in the highest exposed group of 1.5 (95% confidence interval=1.1-2.2). The highest relative risks (2.0-4.0) were observed during subjects' working years. Smoking did not appear to confound these associations. CONCLUSIONS: Chronic exposure to noise levels typical of many workplaces was associated with excess risk for acute myocardial infarction death. Given the very high prevalence of excess noise exposure at work, this association deserves further attention.

British Columbia↗

PubMed2004

Occupational exposures and asthma in 14,000 adults from the general population.

The association of asthma with occupational exposures was studied in 14,151 adults, aged 25-59 years, from the general population of the 1975 French Pollution Atmospherique et Affections Respiratoires Chroniques (PAARC) Survey. Associations of asthma with specific jobs, such as personal care workers, waiters, and stock clerks, were observed, with age-, sex-, and smoking-adjusted odds ratios between 1.5 and 1.7. Exposures to 18 asthmagenic agents (low and high molecular weight and mixed environment) were estimated by an asthma-specific job exposure matrix. Risks associated with asthma increased when subjects with imprecise estimates of exposure were excluded. Risks increased further with increasing specificity of the definition of asthma when considering jobs or specific agents, such as industrial cleaning agents, latex, flour, highly reactive chemicals, and textiles. For example, for industrial cleaning agents, odds ratios increased from 1.55 (95% confidence interval (CI): 1.08, 2.23) for "ever asthma," to 2.17 (95% CI: 1.41, 3.34) for asthma onset after age 14 years, to 2.35 (95% CI: 1.38, 4.00) for asthma onset after beginning current job, and to 2.51 (95% CI: 1.33, 4.75) for asthma with airflow limitation. Results underlined the importance of the specificity of exposure and asthma definitions and indicated a deleterious role of occupational exposure on asthma, especially for cleaning agents.

Adult↗

PubMed2004

Evaluation and a predictive model of airborne fungal concentrations in school classrooms.

Exposure to airborne fungal products may be associated with health effects ranging from non-specific irritation of the respiratory tract or mucus membranes to inflammation provoked by specific fungal antigens. While concentrations of airborne fungi are frequently measured in indoor air quality investigations, the significance of these measurements in the absence of visual mold colonization is unclear. This study was undertaken to evaluate concentrations of airborne fungal concentrations in school classrooms within a defined geographic location in British Columbia, Canada, and to build a model to clarify determinants of airborne fungal concentration. All elementary schools within one school district participated in the study. Classrooms examined varied by age, construction and presence or absence of mechanical ventilation. Airborne fungal propagules were collected inside classrooms and outdoors. Variables describing characteristics of the environment, buildings and occupants were measured and used to construct a predictive model of fungal concentration. The classrooms studied were not visibly contaminated by fungal growth. The data were evaluated using available guidelines. However, the published guidelines did not take into account significant aspects of the local environment. For example, there was a statistically significant effect of season on the fungal concentrations and on the proportional representation of fungal genera. Rooms ventilated by mechanical means had significantly lower geometric mean concentrations than naturally ventilated rooms. Environmental (temperature, outdoor fungal concentration), building (age) and ventilation variables accounted for 58% of the variation in the measured fungal concentrations. A methodology is proposed for the evaluation of airborne fungal concentration data which takes into account local environmental conditions as an aid in the evaluation of fungal bioaerosols in public buildings.

Air Microbiology↗

PubMed2004

Determinants of exposure to metalworking fluid aerosol in small machine shops.

The purpose of this study was to evaluate personal exposure to metalworking fluid (MWF) aerosols in very small machine shops (1-8 machinists per shop) and to investigate workplace factors associated with exposures. A total of 20 willing machine shops in Vancouver, Canada (from 46 eligible shops, 43%) and 88 machinists participated (participation rate for machinists 92%). Most machinists wore two personal sampling trains (an open-faced 37 mm cassette and a PM10 impactor) on each of two full work shifts. Observational data were collected regarding potential determinants of exposure at 15 min intervals throughout each shift. A total of 322 personal samples were taken over 54 days. Mean aerosol exposure was 0.32 mg/m3 (range 0.06-2.19) for the 37 mm cassette samples and 0.27 mg/m3 (range 0.026-3.67) for PM10. Exposures from the two sampler types were highly correlated (R = 0.86). The mean shop-specific ratio comparing exposure from the 37 mm cassette with that from the PM10 sampler was 1.43 and varied significantly across shops, ranging from 0.97 to 2.19. Machine, task and shop characteristics associated with significantly increased aerosol exposure included the proportion of time spent grinding, operating an enclosed computer controlled machine, the presence of welding in the shop for both sampler types and the number of machines using MWF for PM10 samples only. Factors associated with reduced aerosol exposure included machining aluminum, milling, the height (and shape) of the shop roof (for both sample types) and the presence of mechanical shop ventilation (for the 37 mm cassette samples).

Aerosols↗

PubMed2004

Reducing attenuation in exposure-response relationships by exposure modeling and grouping: the relationship between wood dust exposure and lung function.

BACKGROUND: In a study of wood dust exposure and lung function, we tested the effect on the exposure-response relationship of six different exposure metrics using the mean measured exposure of each subject versus the mean exposure based on various methods of grouping subjects, including job-based groups and groups based on an empirical model of the determinants of exposure. METHODS: Multiple linear regression was used to examine the association between wood dust concentration and forced expiratory volume in 1s (FEV(1)), adjusting for age, sex, height, race, pediatric asthma, and smoking. RESULTS: Stronger point estimates of the exposure-response relationships were observed when exposures were based on increasing levels of aggregation, allowing the relationships to be found statistically significant in four of the six metrics. The strongest point estimates were found when exposures were based on the determinants of exposure model. CONCLUSIONS: Determinants of exposure modeling offers the potential for improvement in risk estimation equivalent to or beyond that from job-based exposure grouping.

Adolescent↗

PubMed2004

Women and occupational lung disease: sex differences and gender influences on research and disease outcomes.

We have attempted to describe the current state of knowledge regarding occupational lung disease in women. A large section of this article was devoted to describing the methodologic challenges that face researchers when evaluating gender differences in occupational lung disease. The findings of the presented studies are likely limited by many of the methodologic problems that were identified earlier. To accurately identify the true risk of occupational lung disease in women workers, these findings must be replicated in future studies with special attention paid to the various aspects of occupational lung disease research that are susceptible to gender-related bias.

Female↗

PubMed2004

Evaluation of specific occupational asthma risks in a community-based study with special reference to single and multiple exposures.

OBJECTIVES: To compare two job exposure matrices (JEMs) for the evaluation of asthma risks related to specific occupational exposures in a community-based study. METHODS: A questionnaire on self-reported asthma, respiratory symptoms and current occupation was sent to the participants of the European Community Respiratory Health Survey in five areas in Spain. Both an asthma-specific JEM, including expert judgment steps and a general JEM, were applied to occupational codes. Risks of current asthma symptoms and wheeze in the last year associated with the obtained exposure estimates were evaluated. Correlations between specific exposures were investigated using explanatory factor analysis. RESULTS: Occupational exposures to the high-molecular-weight (MW) agents flour dust, enzymes, mites and animal-derived proteins as obtained by the asthma-specific JEM were positively associated with asthma outcomes. The effect of additional expert judgment steps was limited. High exposures to biological dust assessed by the general JEM without expert judgment was also associated with asthma. Many of the exposed individuals worked in environments with multiple exposures. CONCLUSIONS: Asthma risks associated with occupational exposures to specific high-MW agents could be identified from a population-based study using an asthma-specific JEM. Application of JEMs can be a useful tool to estimate asthma risks attributable to specific occupational exposures in the general population. However, these specific exposure risks should be interpreted in connection with the whole of concomitant exposures constituting the work environment.

Adult↗

PubMed2004

Evaluation and determinants of airborne bacterial concentrations in school classrooms.

A survey of 39 elementary schools was undertaken to determine indoor air concentrations of bioaerosols within a coastal, temperate climatic zone in British Columbia, Canada. This article reports the results for airborne bacteria. Determinants of exposure were grouped into environmental (outdoor temperature, relative humidity, season, weather), ventilation and comfort parameter (indoor relative humidity, temperature, indoor CO2 concentration, indoor fungal concentration), and occupancy (number of occupants, activity levels, occupancy patterns) variables. Regression modeling was used to evaluate the association between these factors and measured concentrations of indoor mesophilic bacteria. Naturally ventilated rooms (47% of the total rooms surveyed) had higher bacterial counts than mechanically ventilated rooms (geometric mean 325 vs. 166 CFU/m3, respectively, p < 0.001). In univariate analyses, bacterial counts were negatively correlated with supply and exhaust flow rates, air exchange rates, and the percentage of the day that occupants spent quietly sitting at their desks. Analysis of bacterial groups indicated various sources of the bacterial aerosol, with micrococci and staphylococci closely associated with occupancy variables, Bacillus with site and occupancy, and coryneform bacteria with site variables only. Approximately 60% of the variance in the outcome measurement of total bacteria was accountedfor by indoor CO2, lower air exchange rate, the age of the building, signs of current or old moisture stains, room volume, indoor relative humidity, and occupant activity level in a multiple linear regression model, with ventilation factors accounting for 40% of the variance.

Aerosols↗

PubMed2004

Participation in paid and unpaid work by adults with rheumatoid arthritis.

OBJECTIVE: To define determinants of participation in paid and unpaid work by adults with rheumatoid arthritis (RA). METHODS: A survey was designed in consultation with working age (< 65 yrs) adults with RA and sent to 269 patients recruited through 5 rheumatology practices. Hours worked "last week" was the measure of participation in employment and unpaid work (household, home maintenance, caregiving, studying, and volunteering). Potential determinants, conceptually organized as attributes of the person, environment, or occupation, were ascertained. RESULTS: Recruitment response rate was 40% of patients invited, and 89% of those recruited submitted complete surveys. The 239 respondents were mostly women (81%), with mean age 50 years and duration of RA 13 years. Respondents reported an average of 47 hours of work: 19 paid and 28 unpaid hours. Regression analyses indicated more hours of paid work were associated with psychologically demanding work, higher social function, less pain, being male, managerial job type, and lower ratings of occupational balance. More hours of unpaid work were associated with more children in the household, greater perceived physical and psychological demand of the work, social support from family, and having a post-secondary education. Work limitations, reported by 73 respondents, were associated with lower functional status, more pain, and less psychologically demanding work. CONCLUSION: Factors associated with greater participation in paid work differed from those associated with unpaid work. Work limitation affects both paid and unpaid workers. Work-related rehabilitation and education programs may be enhanced by addressing factors identified by this sample of paid and unpaid workers.

Adult↗

PubMed2003

Lack of prognostic significance of survivin, survivin-deltaEx3, survivin-2B, galectin-3, bag-1, bax-alpha and MRP-1 mRNAs in breast cancer.

The expression of transcripts for anti-apoptotic (survivin, survivin-deltaEx3, survivin-2B, galectin-3, bag-1 and bcl-2) and pro-apoptotic (bax-alpha) genes, and for multiple drug resistance related protein-1 (MRP-1) gene were investigated, using RT-PCR, in 106 breast tumour biopsies. Normal breast tissue was also analysed for comparative purposes. Overall, survivin, survivin-deltaEx3, survivin-2B, bcl-2, bag-1, galectin-3, bax-alpha and MRP-1 mRNAs were detected in 68, 54.7, 9.4, 78.4, 80.9, 98.9, 97.8 and 72.8%, respectively, of tumour specimens. Uniquely among the mRNAs analysed, the expression of bcl-2 correlated significantly with disease outcome, with bcl-2 expression indicative of favourable outcome in terms of both relapse-free survival and overall survival. This suggests that bcl-2 mRNA expression may be a key prognostic marker for breast cancer and that routine analysis of expression of this transcript should be considered. The results from this study suggest, however, that the expression of survivin, survivin-deltaEx3, survivin-2B, bag-1, galectin-3, bax-alpha and MRP-1 mRNAs cannot be considered as prognostic indicators of disease outcome for patients with breast cancer.

Adult↗