PubMed Health⌕ Search

Biomedical subjects

W E Halperin

Publications and source records attributed to W E Halperin.

At least 19 recordsLinked to original sources
PubMed1997

Cancer mortality among laundry and dry cleaning workers.

A cancer mortality study of 8,163 deaths occurring among persons formerly employed as laundering and dry cleaning workers in 28 states is described. Age-adjusted sex-race cause-specific proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed for 1979 through 1990, using the corresponding 28-state mortality as the comparison. For those aged 15-64 years, there were excesses in black men for total cancer mortality (PMR = 130, 95% confidence interval (CI) = 105-159) and cancer of the esophagus 1 (PMR = 215, 95% CI = 111-376), and in white men for cancer of the larynx (PMR = 318, 95% CI = 117-693). For those aged 65 years and over, there were statistically nonsignificant excesses for cancer of the trachea, bronchus, and lung in black women (PMR = 128, CI = 94-170) and for cancer of other and unspecified female genital organs in white women (PMR = 225, CI = 97-443). The results of this and other studies point to the need for the effective implementation of available control measures to protect laundry and dry cleaning workers.

Adolescent↗
PubMed1996

Mortality study of workers employed in 1,3-butadiene production units identified from a large chemical workers cohort.

The IARC has given the designations of "sufficient evidence" of carcinogenicity of 1,3-butadiene in experimental animals and "limited evidence" of carcinogenicity in humans. To investigate the carcinogenic effect in humans, a cohort mortality study was conducted among 364 men who were assigned to any of three 1,3-butadiene production units located within several chemical plants in the Kanawha Valley of West Virginia, including 277 men employed in a U.S. Rubber Reserve Plant which operated during World War II. The butadiene production units included in this study were selected from an index developed by the Union Carbide Corporation which listed for each chemical production unit within their South Charleston and Institute plants all products, by-products and reactants. Departments included in the study were those where butadiene was a primary product and neither benzene nor ethylene oxide was present. A total of 185 deaths were observed; the standardized mortality ratio (SMR) for all causes of death was 91, reflecting lower mortality among the study population than the U.S. population. The study found a significantly elevated standardized mortality ratio (SMR) for lymphosarcoma and reticulosarcoma based on four observed cases (SMR = 577; 95% confidence interval (CI) = 157-1480), which persisted in an analysis using county referent rates. An excess of lymphosarcoma and reticulosarcoma among all workers and among workers with routine exposure to 1,3-butadiene was also observed in the only other cohort of 1,3-butadiene production workers previously studied. A statistically non-significant excess of stomach cancer was observed in the overall cohort (five cases; SMR = 243; CI = 79-568) that was most pronounced among workers employed in the Rubber Reserve plant for 2 or more years (five cases; SMR = 657; CI = 213-1530). We conclude that the results of this study add to the weight of evidence suggesting that butadiene is carcinogenic in humans.

Aged↗
PubMed1996

Closing the surveillance gap.

Since 1986 there has been substantial progress in developing surveillance systems for occupational disease and injury that meet the goals of surveillance: identification or new diseases and causes of injury; estimation of the magnitude and trend of injuries and illnesses; identification of epidemic clusters; and identification of sentinel cases representing failures of prevention. A quiltwork of surveillance systems for occupational diseases and injury has been implemented by several federal agencies; surveillance systems for many more disease and injuries are being developed by the states. The conceptual basis for "closing the surveillance gap" has been developed; national implementation is the next challenge.

Carpal Tunnel Syndrome↗
PubMed1996

The role of surveillance in the hierarchy of prevention.

Surveillance is the collection, analysis, and dissemination of results for the purpose of prevention. Surveillance tells us what our problems are, how big they are, where the solutions should be directed, how well (or poorly) our solutions have worked, and if, over time, there is improvement or deterioration. Surveillance is essential to successful sustained public health intervention for the purposes of prevention. Surveillance systems must be tailored to the specific disease or injury that is to be prevented. Surveillance should not be limited to the occurrence of death, disease, or disability. Public health is a multilevel cascade of activities involving recognition, evaluation, and intervention. Public health should include elements of experimentation as well as field implementation with evaluation. Surveillance is the mechanism to modify any element in the cascade based upon that element's contribution to prevention or lack thereof. Any element in the causal or intervention pathway is appropriate for surveillance as long as the monitoring of the element is useful in improving the prevention system. These elements include the occurrence of hazard and intervention as well as disease, death, or disability. Examples will be provided that demonstrate the roles of surveillance in the recognition of new diseases, the evaluation of the persistence of recognized problems, the estimation of the magnitude and trends of public health problems, and the provision of information to motivate intervention.

Persons with Disabilities↗
PubMed1996

Mortality of Carpenters' Union members employed in the U.S. construction or wood products industries, 1987-1990.

This study evaluated the mortality of 27,362 members of the U.S. Carpenters' Union who died in 1987-1990. Age-adjusted proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed using the U.S. age-, gender-, and race-specific proportional mortality for the years of the study. For white male carpenters who were last employed while in construction industry locals, raised mortality was observed for lung cancer (PCMR = 107, CI = 103, 111), bone cancer (PMR = 181, CI = 107, 286), asbestosis (PMR = 283, CI = 158, 457), emphysema (PMR = 115, CI = 102, 130), transportation injuries (PMR = 121, CI = 109, 135), and falls (PMR = 122, CI = 104, 142). For white male carpenters who were last employed while in industrial wood products locals, significantly raised mortality occurred for stomach cancer (PMR = 187, CI = 136, 250), male breast cancer (PCMR = 469, CI = 128, 720), and transportation injuries (PMR = 136, CI = 110, 173). Excess breast cancer was associated with last employment inn wood machining trades. Nasal cancer mortality was not elevated. A total of 121 mesotheliomas were observed. Contributing cause of death analyses revealed raised mortality for these and additional causes; 4,594 (18%) death certificates mentioned occupational and other lung disease as a contributing factor, resulting in significantly elevated mortality. These data show that construction carpenters have moderately elevated mortality for the diseases caused by asbestos (lung cancer and malignant mesothelioma) and from traumatic injuries. The finding of elevated mortality for stomach, bone, and breast cancer was unexpected and requires further evaluation of possible occupational factors. This study confirms that construction carpentry is an extremely hazardous trade. The data suggest that additional preventive action guarding against asbestos exposure and occupational injury is urgently needed in this occupation.

Accidental Falls↗
PubMed1995

Prevalence and work-relatedness of self-reported carpal tunnel syndrome among U.S. workers: analysis of the Occupational Health Supplement data of 1988 National Health Interview Survey.

To estimate the prevalence and work-relatedness of self-reported carpal tunnel syndrome (CTS) among U.S. workers, data from the Occupational Health Supplement of 1988 National Health Interview Survey (NHIS) were analyzed. Among 127 million "recent" workers" who worked during the 12 months prior to the survey, 1.47% (95% CI: 1.30; 1.65), or 1.87 million self-reported CTS, and 0.53% (95% CI: 0.42; 0.65), or 675,000, stated that their prolonged hand discomfort was called CTS by a medical person. Occupations with the highest prevalence of self-reported CTS were mail service, health care, construction, and assembly and fabrication. Industries with the highest prevalence were food products, repair services, transportation, and construction. The risk factor most strongly associated with medically called CTS was exposure to repetitive bending/twisting of the hands/wrists at work (OR = 5.2), followed by race (OR = 4.2; whites higher than nonwhites), gender (OR = 2.2; females higher than males), use of vibrating hand tools (OR = 1.8), and age (OR = 1.03; risk increasing per year). This result is consistent with previous reports in that repeated bending/twisting of the hands and wrists during manual work is etiologically related to occupational carpal tunnel syndrome.

Adolescent↗
PubMed1995

Medical screening and biological monitoring. A guide to the literature for physicians.

The use of medical screening and biological monitoring has seen substantial changes in the past two decades specifically in the provision of occupational medical services. For example, national surveys of workplaces conducted by the National Institute for Occupational Safety and Health (NIOSH) showed that the provision of off-site medical care to workers increased from 19.6% in 1972-1974 to 57.8% in 1981-1983, although the percent of workers receiving on-site services remained stable during the same period. After a recent survey in 1990-1991, the Occupational Safety and Health Administration (OSHA) estimated that 6.3% of US industries have a medical surveillance program at their individual establishment. We reviewed NIOSH documents, OSHA's Code of Federal Regulations, and texts on biological monitoring and medical screening for recommendations on medical surveillance of workers. This report summarizes the medical tests (including biologic monitoring) recommended or used by independent investigators and by the government for OSHA-regulated substances to provide guidance to physicians and occupational health professionals in accessing the pertinent literature; the utility of the recommendations is not evaluated.

Environmental Monitoring↗
PubMed1995

Molecular, cytogenetic, and hematologic effects of ethylene oxide on female hospital workers.

Women comprise the majority of workers exposed to ethylene oxide during sterilization of medical instruments and supplies. This article evaluates molecular, cytogenetic, and hematologic effects of ethylene oxide on 68 women workers employed in nine hospitals in the United States and one hospital in Mexico. Workers were classified by three exposure categories: none (0), low (> 0-32 ppm-hrs), and high (> 32 ppm-hrs). Hematologic effects were evaluated using complete blood count with differential, which has been questioned as a test for screening ethylene oxide-exposed workers. A statistically significant decrease in hematocrit (n = 0.02) and hemoglobin (P = 0.03) levels, an increase in lymphocyte percentages (P = 0.04), and a relative decrease in neutrophil percentages (P = 0.03) with exposure were observed in US workers. The absolute number of lymphocytes, however, showed no relationship with exposure. No statistically significant results were seen for Mexican workers, although hematocrit decreased with exposure. An exposure-response relationship for the percentage for lymphocytes (positive) and neutrophils (negative) in US subjects and for neutrophils (positive) in Mexican subjects was seen. No overall relation with exposure was observed for total number of white cells. Molecular and cytogenetic results are also reported for the 68 women, who constitute a subgroup from a previous report. US women workers showed a statistically significant exposure-response relationship for ethylene oxide and hemoglobin adducts (P = 0.0002) and sister chromatid exchanges (P = 0.001). For micronuclei, the difference (P = 0.02) between low and high exposure was statistically significant. In Mexican workers, an exposure-response relationship was observed (P = 0.002) for hemoglobin adducts but not for sister chromatid exchanges or micronuclei.

Adult↗
PubMed1995

Mortality study of workers in 1,3-butadiene production units identified from a chemical workers cohort.

The International Agency for Research on Cancer has given the designations of "sufficient evidence" of carcinogenicity of 1,3-butadiene in experimental animals and "limited evidence" of carcinogenicity in humans. To investigate the carcinogenic effect in humans, we conducted a cohort mortality study among 364 men who were assigned to any of three 1,3-butadiene production units located within several chemical plants in the Kanawha Valley of West Virginia, including 277 men employed in a U.S. Rubber Reserve Plant which operated during World War II. The butadiene production units included in this study were selected from an index developed by the Union Carbide Corporation, which listed for each chemical production unit within their South Charleston, West Virginia and Institute, West Virginia, plants all products, by-products, and reactants. Departments included in the study were those where butadiene was a primary product and neither benzene nor ethylene oxide was present. A total of 185 deaths were observed; the standardized mortality ratio (SMR) for all causes of death was 91, reflecting lower mortality among the study population than the U.S. population. The study found a significantly elevated standardized mortality ratio (SMR) for lymphosarcoma and reticulosarcoma based on four observed cases (SMR = 577; 95% CI = 157-1480), which persisted in an analysis using county referent rates. An excess of lymphosarcoma and reticulosarcoma among all workers and among workers with routine exposure to 1,3-butadiene was also observed in the only other cohort of 1,3-butadiene production workers previously studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Total serum testosterone and gonadotropins in workers exposed to dioxin.

Human reproductive endocrine data may be an important source of epidemiologic information in regard to the toxic potential of 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin). The association of serum dioxin with total serum testosterone, luteinizing hormone, and follicle-stimulating hormone was examined in 248 chemical production workers from New Jersey and Missouri plants and 231 nonexposed neighborhood referents who participated in a medical evaluation in 1987. In linear regression analyses, current serum dioxin was positively and significantly related to luteinizing hormone and follicle-stimulating hormone and inversely related to total testosterone after adjustment for potential confounders (p < 0.05). These trends were also apparent in logistic regression analyses, in which the authors examined the odds ratios of high luteinizing hormone (> 28 IU/liter), high follicle-stimulating hormone (> 31 IU/liter), and low testosterone (< 10.4 nmol/liter) by serum dioxin quartiles. There was a greater prevalence of high luteinizing hormone among workers in the second (odds ratio (OR) = 1.9, 95% confidence interval (CI) 0.7-5.5), third (OR = 2.5, 95% CI 0.9-7.3), and fourth (OR = 1.9, 95% CI 0.7-5.0) quartiles of serum dioxin compared with referents. For follicle-stimulating hormone, the authors observed a greater prevalence of high follicle-stimulating hormone among workers in the fourth quartile (OR = 2.0, 95% CI 0.7-5.6) compared with referents. Similarly, the prevalence of low testosterone was two to four times greater among workers in the second (OR = 3.9, 95% CI 1.3-11.3), third (OR = 2.7, 95% CI 0.9-8.2), and fourth quartiles (OR = 2.1, 95% CI 0.8-5.8) than among referents. The trends observed in these data offer human evidence of alterations in male reproductive hormone levels associated with dioxin exposure. The results support the animal literature in which dioxin-related effects have been observed on the hypothalamic-pituitary-Leydig-cell axis and on testosterone synthesis.

Adult↗
PubMed1994

Evaluation of porphyria cutanea tarda in U.S. workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

A cross-sectional medical study was performed to evaluate whether occupational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-contaminated substances is associated with porphyria cutanea tarda or porphyrinuria. The exposed participants were employed more than 15 years earlier in the manufacture of sodium trichlorophenol and its derivatives. The referent group consisted of individuals with no occupational exposure to phenoxy herbicides. A total of 281 workers and 260 referents participated. The pattern of urinary porphyrin excretion for each participant was assessed to determine if symptomatic or subclinical porphyria cutanea tarda was present. None of the participants were found to have symptomatic porphyria cutanea tarda. No difference was found between workers and referents in the prevalence of subclinical porphyria cutanea tarda (odds ratio [OR] = 0.93, 95% confidence interval [CI] 0.19, 4.54). There were also no differences in the risk between workers and referents for an out-of-range urinary uroporphyrin or coproporphyrin concentration. In conclusion, this study did not find an elevated risk for porphyria cutanea tarda or porphyrinuria among workers with high serum TCDD levels. Our review of the literature indicates that there is insufficient evidence available to convincingly support or refute an association in humans between TCDD exposure and porphyria cutanea tarda or porphyrinuria.

Adult↗
PubMed1994

Occupation and lung cancer mortality among women: using occupation to target smoking cessation programs for women.

Lung cancer mortality rates are increasing for women, despite the fact that 90% of these deaths could be prevented by smoking cessation. Targeted workplace smoking cessation programs may increase the effectiveness of lung cancer prevention for women. This study uses proportionate mortality ratio analysis of occupationally coded death certificates, from 28 states between 1979 and 1990, to identify occupations in which women are at high risk of lung cancer mortality. The study found gender and racial variation in the results for broad occupational groups. Blue-collar occupations associated with potentially carcinogenic workplace exposures also had elevated proportionate mortality ratios, probably reflecting both occupational and tobacco exposure. For women, specific occupations such as managers and financial officers revealed significant elevations in lung cancer mortality. Cessation programs targeting women in these occupational groups may increase the effectiveness of lung cancer prevention.

Adult↗
PubMed1993

Occupation as a risk identifier for breast cancer.

OBJECTIVES: Breast cancer mortality may be reduced if the disease is detected early through targeted screening programs. Current screening guidelines are based solely on a woman's age. Because working populations are accessible for intervention, occupational identification may be a way of helping to define and locate risk groups and target prevention. METHODS: We used a database consisting of 2.9 million occupationally coded death certificates collected from 23 states between 1979 and 1987 to calculate age-adjusted, race-specific proportionate mortality ratios for breast cancer according to occupation. We performed case-control analyses on occupational groups and on stratifications within the teaching profession. RESULTS: We found a number of significant associations between occupation and frequency of breast cancer. For example, white female professional, managerial, and clerical workers all had high proportions of breast cancer death. High rates of breast cancer in teachers were found in both proportionate mortality ratio and case-control analyses. CONCLUSIONS: These findings may serve as in an aid in the effective targeting of work-site health promotion programs. They suggest that occupationally coded mortality data can be a useful adjunct in the difficult task of identifying groups at risk of preventable disease.

Adult↗
PubMed1993

Mortality of workers employed in shoe manufacturing.

A retrospective cohort mortality study was conducted among 7814 white shoe manufacturing workers followed from 1940 through 1982. The workers were potentially exposed to solvents (including toluene) and solvent-based adhesives. Benzene may have been present as an impurity of toluene. Mortality due to leukemia and aleukemia was not statistically significantly elevated. Statistically significant excess mortality due to cancer of the trachea, bronchus and lung was observed in the total cohort [standardized mortality ratio (SMR) 147, 95% confidence interval (95% CI) 120-180] and showed a statistically significant trend in standardized relative risk with increasing potential latency, but not with increasing duration of employment. Chronic nonmalignant respiratory disease was significantly elevated among the men (SMR 158, 95% CI 114-217) but was less than expected among the women (SMR 79), a finding suggesting a possible contribution of smoking to the mortality from respiratory cancer. However, adjustment for the potential effects of smoking did not completely eliminate the increased risk for lung cancer.

Adult↗
PubMed1992

Colon and stomach cancer mortality among automotive wood model makers.

Automotive wood model makers have been reported to be at excess risk for colon and other cancers in recent epidemiologic studies. To further explore these risks, we conducted a retrospective cohort mortality study, with follow-up from 1940 through 1984, of 2294 white male wood model makers employed at any time until 1980 by three US auto makers. Using US mortality rates for comparison, we found elevated standardized mortality ratios of 1.2 (95% CI, 0.8-1.9) for colon cancer and 1.6 (95% CI, 0.9-2.6) for stomach cancer. We also conducted nested case-control studies for 20 colon and 17 stomach cancer cases and 543 age-matched controls. We found no trend of increased risk for colon or stomach cancer mortality with increased exposure to wood dust or to duration employed in wood model making.

Automobiles↗