Cases reported "Occupational Diseases"

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1/22. radium-induced malignant tumors of the mastoid and paranasal sinuses.

    In the records of 5,058 persons with therapeutic or occupational exposure to radium, 21 patients with carcinoma of the mastoid and 11 with malignant tumors of the paranasal sinuses were identified. Tumor induction times were 21-50 years for mastoid tumors (median, 33) and 19-52 years for paranasal sinus tumors (median, 34). Dosimetric data are given for the patients whose body burdens of radium have been measured. We found a high proportion of mucoepidermoid carcinoma, comprising 38% of the mastoid and 36% of the paranasal sinus tumors. Three patients had antecedent bone sarcoma at 20, 11, and 5 years, respectively, and a bone sarcoma was discovered at autopsy in a fourth patient. Radiographic changes in the mastoid and paranasal sinuses were similar to those seen in nonradium malignant tumors. More than 800 known persons exposed to radium before 1930 and another group of unknown size who received radium water or injections of radium from physicians are still alive and at risk of developing malignant tumors of the mastoid and paranasal sinuses.
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2/22. asbestosis and small cell lung cancer in a clutch refabricator.

    OBJECTIVES: To present a case of asbestosis and small cell lung cancer caused by asbestos in a clutch refabricator. methods: Exposed surfaces of used clutches similar to those refabricated in the worker's workplace were rinsed, and the filtrate analysed by analytical transmission electron microscopy. Tissue samples were also analysed by this technique. RESULTS: Numerous chrysotile fibres of respirable dimensions and sufficient length to form ferruginous bodies (FBs) were detected from rinsed filtrates of the clutch. bronchoalveolar lavage fluid contained many FBs, characteristic of asbestos bodies. Necropsy lung tissue showed grade 4 asbestosis and a small cell carcinoma in the right pulmonary hilum. Tissue analysis by light and analytical electron microscopy showed tissue burdens of coated and uncoated asbestos fibres greatly exceeding reported environmental concentrations (3810 FBs/g dry weight and 2,080,000 structures > or = 0.5 micron/g dry weight respectively). 72% Of the cores were identified as chrysotile. CONCLUSIONS: Clutch refabrication may lead to exposure to asbestos of sufficient magnitude to cause asbestosis and lung cancer.
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3/22. The impact of commuter war on military personnel.

    BACKGROUND: The U.S. armed forces recently experienced a reduction in forces along with an increase in operational tempo. The air Force and other branches supporting its mission share this common military burden and also experience a unique stressor. The air Force has developed a military force that can fight by night and return home by day. The relatively new phenomenon of "commuter war" was especially evident during Operation Allied Force over kosovo. methods: military personnel (N = 540) participating in Operation Allied Force were administered a survey measuring morale, wellness behaviors, and work-family conflict. RESULTS: The deployment had adverse effects on wellness behaviors of permanent party and temporary duty assignment populations. Additionally, levels of morale and motivation varied between the two groups. Permanent party personnel also reported increased rates of work-family conflict. CONCLUSIONS: Commuter war affects wellness behaviors, morale, and work-family conflicts of military personnel.
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4/22. Experience of cumulative trauma disorders on life roles of worker and family member: a case study of a married couple.

    The prevalence of diagnosed cumulative trauma disorders (CTD) within the workforce comes at a high price for employers burdened with financial losses from missed work and worker's compensation costs. research has focused primarily on the impact of CTD on the worker role within the workplace, overlooking the impact on roles across multiple environments [24,35,54]. Furthermore, the influence of CTD on life roles of a spouse has not been examined. This single case study illustrated the experience of CTD within a marital relationship through the use of grounded theory. Results indicated that adaptations to CTD symptoms were least altering to the established routines and roles of the couple. With progression of symptoms, the spouse without symptoms was relied on more heavily for adaptations to manage pain. The results of this study indicate that occupational therapists must examine the client's valued roles and incorporate the family into intervention strategies.
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5/22. Malignant mesothelioma in the jewelry industry.

    We conducted a clinical, environmental, pathologic, and mineral lung burden investigation of a 61-year-old man with malignant mesothelioma. For 35 years, up until three weeks prior to pneumonectomy, the patient made asbestos soldering forms at a costume jewelry production facility. Only chrysotile asbestos was used at the plant during the last decade of the patient's employment, and recent environmental sampling of the work-place identified no other asbestos fiber type. Anticipating that the patient would add to the very small number of cases of mesothelioma attributable solely to chrysotile, we found instead that the patient's lung tissue contained large numbers of both coated and uncoated amosite asbestos fibers but, surprisingly, no chrysotile. We subsequently learned that a distributor of both chrysotile and amosite supplied the company during the first 25 years the patient was fabricating soldering forms. The findings underscore the futility of estimating environmental exposure to chrysotile on the basis of fiber counts in lung tissue. Although we previously described non-neoplastic asbestos-related disease among patients engaged in similar work, this case, to the best of our knowledge, represents the first report of mesothelioma in the commercial jewelry industry. As such, it prompted us to initiate a public health campaign to replace asbestos soldering forms in this industry with readily available, safer alternatives.
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6/22. Persistent brominated and chlorinated dioxin blood levels in a chemist. 35 years after dioxin exposure.

    This is the first report on occupational health hazards to dioxin chemists associated with laboratory exposure to 2,3,7,8-tetrabromodibenzodioxin (TBrDD), and further characterizes the human response to 2,3,7,8 tetrachlorodibenzodioxin (TCDD). In this case study the chemist was exposed on two separate occasions. In March 1956, after synthesizing 10 g of TBrDD, the chemist suffered from mild and transient chloracne of the neck and wrists; in September 1956, after synthesizing 16 g of TCDD, he suffered severe chloracne of the entire body, headaches, backache, and leg pain on exertion. His measured 2,3,7,8-TBrDD in 1991 was 625 parts per trillion (ppt) in whole blood lipid, 35 years after initial exposure and 18 ppt TCDD, an elevated level in comparison with the mean 2,3,7,8-TCDD level of 5 ppt in the US population. This is the first reported detection of a brominated dioxin in human tissue. The total halogenated dioxin body burden in September 1956 is estimated to have been between 13,005 ppt and 146,726 ppt. This amount can be considered to be, at least in this person, a strong chloracnegenic dose, and a dose causing human nervous system and muscular or circulatory system responses. This uptake demonstrates an occupational hazard to chemists and chemical workers, and the usefulness of human tissue dioxin measurements to document absorption.
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7/22. Work-related asthma among health care workers: surveillance data from california, massachusetts, michigan, and new jersey, 1993-1997.

    BACKGROUND: asthma morbidity has increased, posing a public health burden. Work-related asthma (WRA) accounts for a significant proportion of adult asthma that causes serious personal and economic consequences. methods: Cases were identified using physician reports and hospital discharge data, as part of four state-based surveillance systems. We used structured interviews to confirm cases and identify occupations and exposures associated with WRA. RESULTS: Health care workers (HCWs) accounted for 16% (n = 305) of the 1,879 confirmed WRA cases, but only 8% of the states' workforce. Cases primarily were employed in hospitals and were nurses. The most commonly reported exposures were cleaning products, latex, and poor air quality. CONCLUSIONS: Health care workers are at risk for work-related asthma. Health care providers need to recognize this risk of WRA, as early diagnosis will decrease the morbidity associated with WRA. Careful product purchasing and facility maintenance by health care institutions will decrease the risk.
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8/22. Neuropsychologic and postural sway improvement after Ca( )-EDTA chelation for mild lead intoxication.

    Neuropsychologic and postural sway test performance improved following Ca( )-EDTA chelation in a bridge worker with persistent central nervous system (CNS) symptoms 2 years after an episode of subacute lead intoxication. This case highlights the value of these tests in verifying symptoms and documenting response to therapy. Persistent disabling CNS symptoms with objective neuropsychologic deficits was unexpected, given the borderline total body lead burden.
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9/22. Desquamative interstitial pneumonia associated with chrysotile asbestos fibres.

    The drywall construction trade has in the past been associated with exposure to airborne asbestos fibres. This paper reports a drywall construction worker with 32 years of dust exposure who developed dyspnoea and diminished diffusing capacity, and showed diffuse irregular opacities on chest radiography. He did not respond to treatment with corticosteroids. Open lung biopsy examination showed desquamative interstitial pneumonia. Only a single ferruginous body was seen on frozen section, but tissue examination by electron microscopy showed an extraordinary pulmonary burden of mineral dust with especially high concentrations of chrysotile asbestos fibres. This report emphasises the need to consider asbestos fibre as an agent in the aetiology of desquamative interstitial pneumonia. The coexistent slight interstitial fibrosis present in this case is also considered to have resulted from exposure to mineral dust, particularly ultramicroscopic asbestos fibres.
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10/22. adult chronic lead intoxication. A clinical review.

    A stained-glass artisan with depression and a retired junkyard worker with congestive cardiomyopathy had increased mobilizable body burdens of lead by calcium ethylenediaminetetaacetic acid testing. Although both patients improved with several months of intramuscular chelation therapy, the efficacy of such therapy in chronic lead poisoning is controversial. Recognition of unusual manifestations of chronic lead poisoning may at least interrupt further exposure, even if specific therapy is not undertaken.
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