We studied 50 lung cancer cases and 154 matched referents, all dock workers, for whom we obtained smoking information and employment histories. We assessed exposures from information on annual diesel fuel consumption from each of the 15 ports included. We used a smoker/nonsmoker term and three exposure variables (machine time, cumulative fuel, and exposed time with fuel consumption above a minimum cutpoint) in the analyses, with three categories for each exposure variable. Odds ratios (ORs) for medium and high exposure groups are consistently higher than reference (low), with an increasing exposure-response trend that is most marked for the exposed time variable (ORs: low = 1.0; medium = 1.6; high = 2.8). When smoking and that exposure variable are simultaneously included in the analyses, odds ratios for the medium (OR = 2.7) and high (OR = 6.8) levels of exposure increase, as does the odds ratio for smoking. Separating smokers and nonsmokers, with the low exposed nonsmokers as the common reference category, the odds ratios are 1.6 (medium) and 2.9 (high) for the nonsmokers, and 10.7 (medium) and 28.9 (high) for smokers. These results indicate an independent effect of diesel exhaust exposure and a strong interaction between smoking and diesel exhaust.
Results from a descriptive study on Swedish Telemedical Advice Services (TMAS) from 1997, 2002, 2007, and the first six months of 2009 on infectious conditions are presented. These findings concern symptoms, actions taken, number of evacuations, means of communication, and use of digital photos. They show that infectious conditions are a significant contributor to calls to the service and that they can be more frequently treated on board than can other conditions.
A sample of 187 medically treated injuries among fishermen was the basis for this study. Nearly half the injuries occurred while shooting or hauling fishing gear. The most common injuries were in the upper extremities (48.7%). Twenty-two percent of the injuries occurred while working with winches ropes and wires and about 30% were caused by falls or slips. Seventy-five percent of accidents occurred on trawlers, where the trawl doors (other boards) are a special hazard. Medical treatment ashore was delayed for more than 24 hours in 35% of the injuries, showing the need for providing optimal treatment facilities on board. Prevention measures should include technical improvements, safety training courses and efforts to enhance the motivation for safe work. The fishermen's proposals for prevention seem to be most useful and should be used to the full extent.
The objective of this study was to find a model to describe the relationship between the occurrence of pleural plaques and exposure to asbestos. A simple model based on the cumulative exposure was postulated and empirically tested on shipyard workers occupationally exposed to asbestos. Exposure time was used to approximate the cumulative dose. It was found that the incidence of pleural plaques could be described as K(t-w)a where 't' is time since onset of exposure; 'K' is a constant that would depend on the level of asbestos exposure; 'w' is a latency period and was around 13 years; 'a' is a constant that was 0.4. In subgroups of the workers, i.e. plumbers, fitters and platers, 'a' was 0.4, 0.6 and 0.2 respectively.
Few studies have investigated the incidence of injuries in kayakers. The aim was to study the prevalence of shoulder pain in competitive flatwater kayakers and to evaluate any differences in range of motion or scapula stability of the shoulder joint among kayakers with or without the history of shoulder pain. Thirty-one kayakers were participated in the study, and a questionnaire including background data was used. Shoulder range of motion was measured with a goniometer, and the participants were observed for scapula dyskinesis in flexion and abduction. Of the participating kayakers, 54.8% (n = 17) had experienced shoulder pain. Kayakers who had experienced shoulder pain showed a significantly lower degree of internal rotational range of motion versus kayakers with no reported shoulder pain, with a mean degree of internal rotation in the right shoulder 49.3 vs. 60.0 (P = 0.017) and the left shoulder 51.9 vs. 66.0 (P = 0.000). Kayakers who had experienced shoulder pain were also observed with a scapular dyskinesis (n = 15 of 17 kayakers) to a significantly higher degree (P = 0.001) than kayakers with no reported shoulder pain. Findings suggest that screening for scapular dyskinesis and testing for rotational range of motion in the shoulder joint is essential in order to treat and maybe prevent shoulder pain in kayakers.
A prospective cohort study of 3,893 shipyard workers, mainly exposed to chrysotile, indicated no increased risk of lung cancer 7-15 yrs after exposure to asbestos had ceased. The shipyard workers, however, had an increased risk of pleural mesotheliomas with 11 observed cases versus 1.5 expected. An explanation for these observations may be that asbestos may have different carcinogenic mechanisms in causing lung cancer and mesothelioma. A non-increased risk of lung cancer some years after exposure to asbestos has stopped is in accordance with asbestos acting as a promotor. The high risk of mesothelioma, on the other hand, may indicate that asbestos acts as a complete carcinogen in developing this disease.
Comment In: Eur Respir J. 1992 Oct;5(9):1161-21426229
In a prospective cohort study of 3893 shipyard workers, we estimated the value of medical monitoring, including chest radiograph, spirometry, and questions about smoking habits, asbestos exposure, and respiratory symptoms, as predictors of the risk of developing mesothelioma. There was no strong association between different exposure parameters and risk of mesothelioma. Impaired lung function and smoking were not predictors of risk of mesothelioma. Pleural plaque was not found to be associated with an increased risk of mesothelioma. Respiratory symptoms were of low value as predictors of risk of mesothelioma. Thus, traditional methods in health monitoring seem to be of low value in identifying persons with a high risk of mesothelioma in populations exposed to asbestos.