Among 701 Copenhagen plumbers we examined the lung function of 23 never smokers, who had removed asbestos insulation and intermittently been exposed to high levels of asbestos for about 25 years without being exposed to welding fume. The plumbers had significantly lower TLC, MEF25, MEF50, closing volume and closing capacity in comparison to 23 never smoking electricians without asbestos exposure. There was no reduction in TLCO. Pulmonary clearance of aerosolized 99mTc-DTPA was normal indicating that the asbestos had not induced increases in pulmonary epithelial permeability. However, in 11 of the 23 plumbers the 99mTc-DTPA ventilation scintigrams had a slightly irregular and spotty appearance, which together with the results of the lung function tests are suggestive of small airways' dysfunction. None of the subjects had symptoms or clinical signs of lung disease.
A cross sectional study was undertaken to assess lung health among plumbers and pipefitters. Respiratory symptoms, lung function, and radiographic changes among 99 actively employed plumbers and pipefitters with > or = 20 years of union membership were compared with 100 telephone workers.
A respiratory symptom questionnaire was administered, including smoking and occupational histories. Spirometry was conducted according to standard criteria. Posteroanterior chest radiographs were evaluated by two experienced chest physicians, with a third arbitrating disagreed films. Members of the union were categorised as pipefitters (n = 57), plumbers (n = 16), or welders (n = 26), based on longest service, and compared with the telephone workers and internally (between groups). Lung health was also compared with employment in several work sectors common to Alberta for time, and for time weighted by exposure to dust and fumes.
Compared with the telephone workers, plumbers and pipefitters had more cough and phlegm, lower forced vital capacity, and more radiographic changes (20% with any change), including circumscribed (10%) and diffuse pleural thickening (9%). None of the plumbers and pipefitters had small radiographic opacities. Among the three subgroups of workers, plumbers had the highest prevalence of radiographic changes. Both plumbers and pipefitters showed higher odds ratios for cough and phlegm than the welders. No differences between groups were found for lung function. Indicators of lung health were not related to work in any sector.
Plumbers and pipefitters had increased prevalence of symptoms suggestive of an irritant effect with no evidence of bronchial responsiveness. The chest radiographs showed evidence of asbestos exposure, especially in the plumbers, but at lower levels than previously reported. Health screening programmes for these workers should be considered, although the logistical problems associated with screening in this group would be considerable.
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Once central figures in American public health, waterworks engineers are no longer involved in many decisions made about the public water supplies. This paper argues that the profession's response to the early fluoridation movement of the 1940s and 1950s marked a change in the relationship between waterworks engineers and the other constitutive groups in public health and contributed to the disenfranchisement of the waterworks profession. Sensing a potentially divisive issue, two leaders of the profession, Abel Wolman and Linn Enslow, took steps they hoped would prevent a rift within the profession and allow waterworks engineering to continue its association with the wider public health community. Although the leaders saw the fluoridation issue differently, neither encouraged the profession to consider it openly or to take up the broader question of what limits, if any, should be placed on treating water supplies to meet human needs. Instead, they opted to locate authority for fluoridation outside the waterworks profession with dentists, doctors, and public health administrators. As a result, waterworks engineers conceded a great deal of the status and prestige associated with decision-making roles in community health issues and have largely faded from view.
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Problems associated with sewage treatment and human wastes at high latitudes are briefly reviewed. In view of the fact that E. coli and other faecal bacteria can survive in the snow and the coastal waters of polar regions, several methods of how to deal with sewage outfalls in the Arctic and Antarctic are compared and discussed. Some consequences of raw sewage on the health of captive populations of a variety of Antarctic invertebrates and fish are described. Locomotion and respiration appear to be most affected. However, gaps, both in understanding the biological impact of human sewage on polar ecosystems and in finding optimal solutions for the disposal and treatment of the wastes generated by people who live in polar settlements, unfortunately still remain.
Water distribution systems have been demonstrated to be a major source of nosocomial legionellosis. We describe an outbreak in our institution in which a novel source of Legionella pneumophila was identified in the plumbing system.
After an outbreak of 10 cases of legionellosis in our hospital, recommended measures including superheating of the hot water to 80 degrees C, hyperchlorination to 2 ppm, and flushing resulted in no new cases in the following 5 years. Recently, despite these control measures, three new cases occurred. Surveillance cultures of shower heads and water tanks were negative; cultures of tap water samples remained positive. This prompted a search for another reservoir. Shock absorbers installed within water pipes to decrease noise were suspected.
One hundred twenty-five shock absorbers were removed and cultured. A total of 13 (10%) yielded heavy growth of L. pneumophila (serogroup 1). Since their removal, no new cases have been found and the percentage of positive results of random tap water culture has dropped from 20% to 5%.
This is the first report that identifies shock absorbers as a possible reservoir for L. pneumophila. We recommend that institutions with endemic legionellosis assess the water system for possible removal of shock absorbers.
The microbiological quality of tap water and that of water from 50 water coolers located in residences and workplaces were comparatively studied. In addition, difference factors that might influence the bacteriological contamination of water dispensers were examined. Aeorbic and facultative anaerobic heterotrophic bacteria, total coliforms, and two indicators for fecal contamination (fecal coliforms and fecal streptococci) as well as three types of pathogenic bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, and Aeromonas spp.) were enumerated. It was found that 36 and 28% of the water dispenser samples from the residences and the workplaces, respectively, were contaminated by a least one coliform or indicator bacterium and/or at least one pathogenic bacterium. The respective proportions of tap water samples contaminated in a similar fashion were 18 and 22%, much less than those observed for water coolers (Chi2(1) = 3.71, P = 0.05). We were unable to discern the dominant factors responsible for the contamination of water coolers, but cleaning the water dispenser every 2 months seemed to limit the extent of contamination.
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