Mortality and workers' compensation patterns were studied among 1,064 Ontario asbestos insulation workers. A proportional mortality analysis of 153 asbestos worker deaths found increased mortality from malignant diseases (65 deaths observed; 35.1 expected), cancers of the lungs and pleura (32 deaths observed; 11.5 expected), peritoneal mesothelioma (4 deaths), and respiratory diseases (14 deaths observed; 7.9 expected). Despite the publicity given to asbestos-associated diseases, dependents of many men potentially eligible for workers compensation awards have not received pensions because claims were not filed. These findings suggest that much occupationally related disease is not being recognized in Ontario.
Asbestos has been widely used in the refinery and petrochemical sector. Mesothelioma has occurred among maintenance employees, and it was hypothesized that mesothelioma is a marker for exposures which might increase lung cancer risk. A death certificate-based case-control study of mesothelioma and lung cancer from 1980 to 1992 was conducted in an Ontario county with a substantial presence of these industries. Each of the 17 men who died of mesothelioma and 424 with lung cancer were matched with controls who died of other causes. The Job and Industry fields on the death certificates were abstracted. Employment as a maintenance worker in the refinery and petrochemical sector was associated with an increased risk of mesothelioma (odds ratio: 24.5; 90% confidence interval 3.1-102). The risk of lung cancer among petrochemical workers, in comparison with all other workers in the county, was 0.88. In an internal comparison of maintenance employees with other blue-collar workers in the refinery and petrochemical sector, the odds ratio for lung cancer was 1.73 (90% confidence interval 0.83-3.6). This finding is consistent with no difference in risk between maintenance and other employees, but it is also compatible with study power being too low to achieve statistical significance. The hypothesis of increased lung cancer risk could be examined more fully with nested case-control studies in existing cohorts. Meanwhile, it would be prudent to reinforce adherence to asbestos control measures in the refinery and petrochemical sector.
We studied the development of compensable (certified) asbestosis among the 201 workers at an asbestos-cement factory who were first exposed to asbestos dust prior to 1980 and who had been employed at least 15 yr. By July 1980, 39% of the production workers and 20% of the maintenance workers had developed a compensable chest disability; the "latent interval" generally exceeded 20 yr. Workers with asbestosis were found to have markedly elevated mortality rates with deaths caused by malignancies and respiratory disease being primarily responsible. We combined the limited air sampling data available with individual work histories to calculate 18-yr cumulative fiber exposures. The cumulative probability of certification was related to the cumulative exposures and the exposure-response relationship was found to be sigmoidal in form.
To test the hypothesis that reports of back pain in a working population are associated with parenthood.
A questionnaire survey of back pain in municipal fire fighters and police officers in a municipality in Ontario, Canada. The questionnaire was distributed to current employees of fire and police departments. The survey was completed by 129 fire fighters (68% of the active force) and 346 police officers (74% of the force).
36% of the respondents complained of a back problem. The prevalence increased from 13% among men aged 19 to 28 to 47% among men aged 49 to 59. The complaint was more common among firefighters (42%) than among police officers (33%). In a logistic regression analysis, back problems were significantly associated with the duration of employment, cigarette smoking, and the number of children.
Back pain is a multifactorial problem with significant impact on the working population. This survey has found that parenthood, a risk factor not previously described among men, is associated with self reported back pain. The mechanism presumably involves lifting of children or recreational factors. Fatherhood seems to be a confounder that should be controlled for in studies of occupational causes of back pain.
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Comment In: Occup Environ Med. 1995 Oct;52(10):699-7007489063
The prevalence of overweight and obesity is increasing and contributes to the burden of ill health in the community. The impact of obesity on health-related quality of life has been less well studied than how it affects physical morbidity and mortality.
A survey of health-related quality of life using the 12-item Short Form (SF-12) of the Medical Outcomes Study Short Form-36 was mailed to patients attending a family medicine clinic. Multiple regression analyses were used to investigate the relationships between scores on the mental and physical components of the SF-12 and body mass index (BMI) while controlling for age, sex, and family income.
Responses were received from 565 subjects (53%). The relationships among BMI and quality of life in the mental and physical domains were nonlinear. Quality of life scores were optimal when BMI was in the range of 20 to 25 kg per m2.
The National Heart, Lung, and Blood Institute has published evidence-based clinical guidelines for the identification, evaluation, and treatment of overweight and obesity in adults. Subjects with BMI in the range 18.5 to 24.9 kg per m2 are classified as having normal weight. These observations suggest that achieving a weight in this range will maximize the patient's subjective sense of well-being.
The National Institute for Occupational Safety and Health (NIOSH) published a report in 1995 suggesting the possibility of increased incidence of testicular cancer, leukemia, and cancers of the brain, eye, and skin among police officers working with traffic radar. NIOSH recommended epidemiologic study of the issue. This report presents the results of a retrospective cohort cancer incidence study among 22,197 officers employed by 83 Ontario police departments. The standardized incidence ration (SIR) for all tumors sites was 0.9% (95% confidence interval [CI] = 0.83-0.98). There was an increased incidence of testicular cancer (SIR = 1.3, 90% CI = 0.9-1.8) and melanoma skin cancer (SIR = 1.45, 90% CI = 1.1-1.9). These anatomical sites might absorb energy from radar units, but at this time the author has no information about individual exposures to radar emissions, and it is not possible to draw etiologic conclusions. Nested case-control studies are planned to assess individual radar exposures.