Last data update: Jul 01, 2024. (Total: 47134 publications since 2009)
Records 1-10 (of 10 Records) |
Query Trace: Kullman G [original query] |
---|
Prevalence of chronic obstructive pulmonary disease among US working adults aged 40 to 70 Years: National Health Interview Survey data 2004 to 2011
Doney B , Hnizdo E , Syamlal G , Kullman G , Burchfiel C , Martin CJ , Mujuru P . J Occup Environ Med 2014 56 (10) 1088-93 OBJECTIVE: To estimate the prevalence and prevalence odds ratios of chronic obstructive pulmonary disease (COPD) among US workers by major occupational groups. METHODS: The 2004 to 2011 National Health Interview Survey data for working adults 40 to 70 years old was analyzed to estimate the prevalence of COPD by major occupational groups. Logistic regression models were used to evaluate the associations between COPD (chronic bronchitis or emphysema) and occupations. RESULTS: The estimated overall COPD prevalence was 4.2% (95% CI, 4.0 to 4.3). The odds of COPD were highest among workers in health care support occupations (prevalence odds ratio, 1.64; 95% CI, 1.25 to 2.14) followed by food preparation and serving-related occupations (prevalence odds ratio, 1.57; 95% CI, 1.20 to 2.06). CONCLUSIONS: Prevalence varied by occupations, suggesting workplace exposures may contribute to COPD. Preventive measures such as interventions to reduce smoking may reduce the prevalence of COPD. |
Occupational risk factors for COPD phenotypes in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study
Doney B , Hnizdo E , Graziani M , Kullman G , Burchfiel C , Baron S , Fujishiro K , Enright P , Hankinson JL , Stukovsky KH , Martin CJ , Donohue KM , Barr RG . COPD 2014 11 (4) 368-80 INTRODUCTION: The contribution of occupational exposure to the risk of chronic obstructive pulmonary disease COPD in population-based studies is of interest. We compared the performance of self-reported exposure to a newly developed JEM in exposure-response evaluation. METHODS: We used cross-sectional data from Multi-Ethnic Study of Atherosclerosis (MESA), a population-based sample of 45-84 year olds free of clinical cardiovascular disease at baseline. MESA ascertained the most recent job and employment, and the MESA Lung Study measured spirometry, and occupational exposures for 3686 participants. Associations between health outcomes (spirometry defined airflow limitation and Medical Research Council-defined chronic bronchitis) and occupational exposure [self-reported occupational exposure to vapor-gas, dust, or fumes (VGDF), severity of exposure, and a job-exposure matrix (JEM)-derived score] were evaluated using logistic regression models adjusted for non-occupational risk factors. RESULTS: The prevalence of airflow limitation was associated with self-reported exposure to vapor-gas (OR 2.6, 95%CI 1.1-2.3), severity of VGDF exposure (P-trend < 0.01), and JEM dust exposure (OR 2.4, 95%CI 1.1-5.0), and with organic dust exposure in females; these associations were generally of greater magnitude among never smokers. The prevalence of chronic bronchitis and wheeze was associated with exposure to VGDF. The association between airflow limitation and the combined effect of smoking and VGDF exposure showed an increasing trend. Self-reported vapor-gas, dust, fumes, years and severity of exposure were associated with increased prevalence of chronic bronchitis and wheeze (P < 0.001). CONCLUSIONS: Airflow limitation was associated with self-reported VGDF exposure, its severity, and JEM-ascertained dust exposure in smokers and never-smokers in this multiethnic study. |
Pesticide use and fatal injury among farmers in the Agricultural Health Study
Waggoner JK , Henneberger PK , Kullman GJ , Umbach DM , Kamel F , Beane Freeman LE , Alavanja MC , Sandler DP , Hoppin JA . Int Arch Occup Environ Health 2012 86 (2) 177-87 PURPOSE: To assess whether pesticide use practices were associated with injury mortality among 51,035 male farmers from NC and IA enrolled in the Agricultural Health Study. METHODS: We used Cox proportional hazards models adjusted for age and state to estimate fatal injury risk associated with self-reported use of 49 specific pesticides, personal protective equipment, specific types of farm machinery, and other farm factors collected 1-15 years preceding death. Cause-specific mortality was obtained through linkage to mortality registries. RESULTS: We observed 338 injury fatalities over 727,543 person-years of follow-up (1993-2008). Fatal injuries increased with days/year of pesticide application, with the highest risk among those with 60+ days of pesticide application annually [hazard ratio (HR) = 1.87; 95% confidence interval (CI) = 1.10, 3.18]. Chemical-resistant glove use was associated with decreased risk (HR = 0.73; 95% CI = 0.58, 0.93), but adjusting for glove use did not substantially change estimates for individual pesticides or pesticide use overall. Herbicides were associated with fatal injury, even after adjusting for operating farm equipment, which was independently associated with fatal injury. Ever use of five of 18 herbicides (2,4,5-T, paraquat, alachlor, metribuzin, and butylate) were associated with elevated risk. In addition, 2,4-D and cyanazine were associated with fatal injury in exposure-response analyses. There was no evidence of confounding of these results by other herbicides. CONCLUSION: The association between application of pesticides, particularly certain herbicides, and fatal injuries among farmers should be interpreted cautiously but deserves further evaluation, with particular focus on understanding timing of pesticide use and fatal injury. |
Occupational lung disease risk and exposure to butter-flavoring chemicals after implementation of controls at a microwave popcorn plant
Kanwal R , Kullman G , Fedan KB , Kreiss K . Public Health Rep 2011 126 (4) 480-494 OBJECTIVES: After an outbreak of severe lung disease among workers exposed to butter-flavoring chemicals at a microwave popcorn plant, we determined whether or not lung disease risk declined after implementation of exposure controls. METHODS: National Institute for Occupational Safety and Health staff performed eight serial cross-sectional medical and industrial hygiene surveys at the plant from November 2000 through August 2003. Medical surveys included standardized questionnaires and spirometry testing. Industrial hygiene surveys measured levels of production-related air contaminants, including butter-flavoring chemicals such as diacetyl. All diacetyl concentrations above detectable limits were corrected for the effects of absolute humidity and days to sample extraction. RESULTS: Ventilation and isolation of the production process resulted in one to three orders of magnitude reductions in diacetyl air concentrations in different areas of the plant. Workers with past high exposures had stable chest symptoms over time; nasal, eye, and skin irritation symptoms declined. New workers had lower symptom prevalences and higher lung function than workers with past high exposures, and they did not worsen over time. In workers who had at least three spirometry tests, those with past high exposures were more likely to experience rapid declines in lung function than new workers. CONCLUSIONS: Implemented controls lowered exposures to butter-flavoring chemicals and decreased lung disease risk for much of the plant workforce. Some workers with continuing potential for intermittent, short-term peak and measurable time-weighted exposures remain at risk and should use respiratory protection and have regularly scheduled spirometry to detect rapid lung function declines that may be work-related. Close follow-up of such workers is likely to yield additional information on risks due to peak and time-weighted exposure levels. |
Occupational sensitization to soy allergens in workers at a processing facility
Green BJ , Cummings KJ , Rittenour WR , Hettick JM , Bledsoe TA , Blachere FM , Siegel PD , Gaughan DM , Kullman GJ , Kreiss K , Cox-Ganser J , Beezhold DH . Clin Exp Allergy 2011 41 (7) 1022-30 BACKGROUND: Exposure to soy antigens has been associated with asthma in community outbreaks and in some workplaces. Recently, 135 soy flake processing workers (SPWs) in a Tennessee facility were evaluated for immune reactivity to soy. Allergic sensitization to soy was common and was five times more prevalent than in health care worker controls (HCWs) with no known soy exposure. OBJECTIVE: To characterize sensitization to soy allergens in SPWs. Methods Sera that were positive to soy ImmunoCAP (n=27) were tested in IgE immunoblots. Wild-type (WT) and transgenic (TG) antigens were sequenced using nanoscale Ultra-Performance Liquid Chromatography Tandem Mass Spectrometry (nanoUPLC MS/MS). IgE reactivity towards 5-enolpyruvylshikimate-3-phosphate synthase (CP4-EPSP), a protein found in TG soy, was additionally investigated. De-identified sera from 50 HCWs were used as a control. Results Immunoblotting of WT and TG soy flake extracts revealed IgE against multiple soy antigens with reactivity towards 48, 54, and 62 kDa bands being the most common. The prominent proteins that bound SPW IgE were identified by nanoUPLC MS/MS analysis to be the high molecular weight soybean storage proteins, beta-conglycinin (Gly m 5), and Glycinin (Gly m 6). No specific IgE reactivity could be detected to lower molecular weight soy allergens, Gly m 1 and Gly m 2, in soybean hull (SH) extracts. IgE reactivity was comparable between WT and TG extracts; however, IgE antibodies to CP4-EPSP could not be detected. CONCLUSIONS AND CLINICAL RELEVANCE: SPWs with specific IgE to soy reacted most commonly with higher molecular weight soybean storage proteins compared with the lower molecular weight SH allergens identified in community asthma studies. IgE reactivity was comparable between WT and TG soy extracts, while no IgE reactivity to CP4-EPSP was observed. High molecular weight soybean storage allergens, Gly m 5 and Gly m 6, may be respiratory sensitizers in occupational exposed SPWs. |
Mortality in the Agricultural Health Study, 1993-2007
Waggoner JK , Kullman GJ , Henneberger PK , Umbach DM , Blair A , Alavanja MC , Kamel F , Lynch CF , Knott C , London SJ , Hines CJ , Thomas KW , Sandler DP , Lubin JH , Beane Freeman LE , Hoppin JA . Am J Epidemiol 2011 173 (1) 71-83 Comparing agricultural cohorts with the general population is challenging because the general healthiness of farmers may mask potential adverse health effects of farming. Using data from the Agricultural Health Study, a cohort of 89,656 pesticide applicators and their spouses (N = 89, 656) in North Carolina and Iowa, the authors computed standardized mortality ratios (SMRs) comparing deaths from time of the enrollment (1993-1997) through 2007 to state-specific rates. To compensate for the cohort's overall healthiness, relative SMRs were estimated by calculating the SMR for each cause relative to the SMR for all other causes. In 1,198,129 person-years of follow-up, 6,419 deaths were observed. The all-cause mortality rate was less than expected (SMR(applicators) = 0.54, 95% confidence interval (CI): 0.52, 0.55; SMR(spouses) = 0.52, 95% CI: 0.50, 0.55). SMRs for all cancers, heart disease, and diabetes were significantly below 1.0. In contrast, applicators experienced elevated numbers of machine-related deaths (SMR = 4.15, 95% CI: 3.18, 5.31), motor vehicle nontraffic accidents (SMR = 2.80, 95% CI: 1.81, 4.14), and collisions with objects (SMR = 2.12, 95% CI: 1.25, 3.34). In the relative SMR analysis for applicators, the relative mortality ratio was elevated for lymphohematopoietic cancers, melanoma, and digestive system, prostate, kidney, and brain cancers. Among spouses, relative SMRs exceeded 1.0 for lymphohematopoietic cancers and malignancies of the digestive system, brain, breast, and ovary. Unintentional fatal injuries remain an important risk for farmers; mortality ratios from several cancers were elevated relative to other causes. |
Identification and measurement of diacetyl substitutes in dry bakery mix production
Day G , Lebouf R , Grote A , Pendergrass S , Cummings K , Kreiss K , Kullman G . J Occup Environ Hyg 2011 8 (2) 93-103 In 2008, a company using multiple buttermilk flavorings in the production of dry bakery mixes replaced one liquid flavoring containing 15-20% diacetyl with a proprietary substitute meant to lower occupational risk for diacetyl-related bronchiolitis obliterans. Subsequently, the National Institute for Occupational Safety and Health (NIOSH) evaluated buttermilk flavoring-related exposures at this company's facility, with a focus on measuring ketones by several methods. Volatile organic compounds (VOCs) were evaluated in the headspaces of six bulk flavorings samples, including the substitute buttermilk flavoring. Ketones were evaluated in workplace air via area and personal samples collected during batch preparation of the substitute buttermilk flavoring and production of a bakery mix containing the same flavoring. Air samples were evaluated using five different methods: NIOSH 2549, Modified OSHA PV2118, OSHA 1013, NIOSH Draft Procedure SMP2, and evacuated canisters. Of five buttermilk flavorings from five different flavorings manufacturers, diacetyl was present in four, including the substitute flavoring; acetoin in two; 2,3-pentanedione in four; 2,3-hexanedione in one; and 2,3-heptanedione in three. Among material safety data sheets (MSDS) for four flavorings, only one listed a hazardous ingredient, which was acetoin. The predominant flavoring ingredient identified in the headspace of the substitute flavoring was 2,3-pentanedione; all other chemicals noted above were also present. Diacetyl and 2,3-pentanedione were measured in workplace air via evacuated canisters. In one area and one personal air sample, 2,3-pentanedione was measured by OSHA Method 1013 at concentrations of 78 and 91 ppb, respectively. Without their or the employer's knowledge, workers who used buttermilk flavorings were exposed to substitute ketones from many flavorings manufacturers. Because 2,3-pentanedione, 2,3-hexanedione, and 2,3-heptanedione all share the same functional alpha-diketone group as diacetyl, these compounds also may share diacetyl's mechanism of toxicity. Until more is known about 2,3-pentanedione and other alpha-diketone compounds, they should not be assumed to be safe. Companies using artificial buttermilk flavorings should use a precautionary approach that assumes these flavorings pose a health risk and limit exposures through engineering and administrative controls and use of personal protective equipment. |
Correcting diacetyl concentrations from air samples collected with NIOSH Method 2557
Cox-Ganser J , Ganser G , Saito R , Hobbs G , Boylstein R , Hendricks W , Simmons M , Eide M , Kullman G , Piacitelli C . J Occup Environ Hyg 2011 8 (2) 59-70 Diacetyl (2,3-butanedione), a diketone chemical used to impart a buttery taste in many flavoring mixtures, has been associated with bronchiolitis obliterans in several industrial settings. For workplace evaluations in 2000-2006, National Institute for Occupational Safety and Health (NIOSH) investigators used NIOSH Method 2557, a sampling and analytical method for airborne diacetyl utilizing carbon molecular sieve sorbent tubes. The method was subsequently suspected to progressively underestimate diacetyl concentrations with increasing sampling site humidity. Since underestimation of worker exposure may lead to overestimation of respiratory health risk in quantitative exposure-effect analyses, correction of the diacetyl concentrations previously reported with Method 2557 is essential. We studied the effects of humidity and sample storage duration on recovery of diacetyl from experimental air samples taken from a dynamically generated controlled test atmosphere that allowed control of diacetyl concentration, temperature, relative humidity, sampling duration, and sampling flow rate. Samples were analyzed with Method 2557, and results were compared with theoretical test atmosphere diacetyl concentration. After fitting nonlinear models to the experimental data, we found that absolute humidity, diacetyl concentration, and days of sample storage prior to extraction affected diacetyl recovery as did sampling flow rate to a much smaller extent. We derived a mathematical correction procedure to more accurately estimate historical workplace diacetyl concentration based on laboratory-reported concentrations of diacetyl using Method 2557, and sample site temperature and relative humidity (to calculate absolute humidity), as well as days of sample storage prior to extraction in the laboratory. With this correction procedure, quantitative risk assessment for diacetyl can proceed using corrected exposure levels for air samples previously collected and analyzed using NIOSH Method 2557 for airborne diacetyl. |
Adverse respiratory outcomes associated with occupational exposures at a soy processing plant
Cummings KJ , Gaughan DM , Kullman GJ , Beezhold DH , Green BJ , Blachere FM , Bledsoe T , Kreiss K , Cox-Ganser J . Eur Respir J 2010 36 (5) 1007-15 This study aimed to characterize the relationship between adverse health outcomes and occupational risk factors among workers at a soy processing plant.A questionnaire, spirometry, methacholine challenge, immune testing, and air sampling for dust and soy were offered. Prevalence ratios (PRs) of respiratory problems from comparisons with the US adult population were calculated. Soy-specific IgG and IgE among participants and healthcare worker controls were compared. Associations between health outcomes and potential explanatory variables were examined using logistic regression.One hundred forty-seven (52%) of 281 employees, including 66 (70%) of 94 production workers, participated. PRs were significantly elevated for wheeze, sinusitis, ever-asthma, and current asthma. Participants had significantly higher mean concentrations of soy-specific IgG (97.9 mg.L(-1) vs. 1.5 mg.L(-1)) and prevalence of soy-specific IgE (21% vs. 4%) than controls. Participants with soy-specific IgE had 3-fold greater odds of current asthma or asthma-like symptoms, and 6-fold greater odds of work-related asthma-like symptoms; the latter additionally was associated with production work and higher peak dust exposures. Airways obstruction was associated with higher peak dust. Work-related sinusitis, nasal allergies, and rash were associated with reported workplace mold exposure.Asthma and symptoms of asthma, but not other respiratory problems, were associated with immune reactivity to soy. |
Pesticide use and adult-onset asthma among male farmers in the Agricultural Health Study
Hoppin JA , Umbach DM , London SJ , Henneberger PK , Kullman GJ , Coble J , Alavanja MC , Beane Freeman LE , Sandler DP . Eur Respir J 2009 34 (6) 1296-303 Although specific pesticides have been associated with wheeze in farmers, little is known about pesticides and asthma. Data from 19,704 male farmers in the Agricultural Health Study were used to evaluate lifetime use of 48 pesticides and prevalent adult-onset asthma, defined as doctor-diagnosed asthma after the age of 20 yrs. Asthma cases were categorised as allergic (n = 127) and nonallergic (n = 314) based on their history of eczema or hay fever. Polytomous logistic regression, controlling for age, state, smoking and body mass, was used to assess pesticide associations. High pesticide exposure events were associated with a doubling of both allergic and nonallergic asthma. For ever-use, 12 individual pesticides were associated with allergic asthma and four with nonallergic asthma. For allergic asthma, coumaphos (OR 2.34; 95% CI 1.49-3.70), heptachlor (OR 2.01; 95% CI 1.30-3.11), parathion (OR 2.05; 95% CI 1.21-3.46), 80/20 mix (carbon tetrachloride/carbon disulfide) (OR 2.15; 95% CI 1.23-3.76) and ethylene dibromide (OR 2.07; 95% CI 1.02-4.20) all showed ORs of >2.0 and significant exposure-response trends. For nonallergic asthma, DDT (dichlorodiphenyltrichloroethane) showed the strongest association (OR 1.41; 95% CI 1.09-1.84), but with little evidence of increasing asthma with increasing use. Current animal handling and farm activities did not confound these results. There was little evidence that allergy alone was driving these associations. In conclusion, pesticides may be an overlooked contributor to asthma risk among farmers. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jul 01, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure