Heat strain, volume depletion and kidney function in California agricultural workers

Background

Agricultural work can expose workers to increased risk of heat strain and volume depletion due to repeated exposures to high ambient temperatures, arduous physical exertion and limited rehydration. These risk factors may result in acute kidney injury (AKI).

Methods

We estimated AKI cumulative incidence in a convenience sample of 283 agricultural workers based on elevations of serum creatinine between preshift and postshift blood samples. Heat strain was assessed based on changes in core body temperature and heart rate. Volume depletion was assessed using changes in body mass over the work shift. Logistic regression models were used to estimate the associations of AKI with traditional risk factors (age, diabetes, hypertension and history of kidney disease) as well as with occupational risk factors (years in farm work, method of payment and farm task).

Results

35 participants were characterised with incident AKI over the course of a work shift (12.3%). Workers who experienced heat strain had increased adjusted odds of AKI (1.34, 95% CI 1.04 to 1.74). Piece rate work was associated with 4.24 odds of AKI (95% CI 1.56 to 11.52). Females paid by the piece had 102.81 adjusted odds of AKI (95% CI 7.32 to 1443.20).

Discussion

Heat strain and piece rate work are associated with incident AKI after a single shift of agricultural work, though gender differences exist. Modifications to payment structures may help prevent AKI.

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Work and health in Latin America: results from the working conditions surveys of Colombia, Argentina, Chile, Central America and Uruguay

Objective

To describe working and employment conditions, and health status between non-agricultural employees with a written contract from Colombia, Argentina, Chile, Central America and Uruguay.

Methods

We compared data from the first working condition surveys (WCS) of Colombia, Argentina, Chile, Central America and Uruguay. For comparative purposes, we selected a subsample of 15 241 non-agricultural employees aged 18–64 years and working with a written contract. We calculated prevalences and 95% CIs for the selected variables on working and employment conditions, and health status, separated by sex.

Results

Across all countries, at least 40% of women and 58% of men worked >40 hours a week. The most prevalent exposures were repetitive movements, followed by noise and manual handling, especially among men. Psychosocial exposures were very common among both sexes. Workers in Chile (33.4% of women and 16.6% of men) and Central America (24.3% of women and 19.1% of men) were more likely to report poor self-perceived health and were least likely to do so in Colombia (5.5% of women and 4.2% of men). The percentage of workers reporting occupational injuries was <10% across all countries.

Conclusions

This study provides, for the first time, a broad picture of work and health in different Latin American countries, based on the national WCSs available. This allows for a better understanding of occupational health and could serve as a baseline for future research and surveillance of work and health in the Region. However, greater efforts are needed to improve WCSs comparability.

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IJERPH, Vol. 14, Pages 84: Lipoprotein Lipase (LPL) Polymorphism and the Risk of Coronary Artery Disease: A Meta-Analysis

Background: In recent years, the lipoprotein lipase (LPL) polymorphism has been extensively investigated as a potential risk factor for coronary artery disease (CAD). However, the results of these studies have been inconsistent. Therefore, we performed this meta-analysis to explore the association between LPL polymorphism and CAD risk. Methods: The literature was searched from electronic databases such as Embase, China Biological Medicine Database, PubMed, Knowledge Infrastructure, and China National Web of Science by the key words “coronary artery disease”, “lipoprotein lipase” and “polymorphism”. All of the studies included in this manuscript met the inclusion and exclusion criteria. An odds ratio (OR) analysis using a 95% confidence interval (CI) was employed to assess the association of the LPL polymorphism with CAD susceptibility. Results: We performed a meta-analysis of 14 case-control studies including HindIII, Ser447X and PvuII polymorphism. A statistically significant increase in the risk of CAD was associated with LPL HindIII polymorphism. This included HindIII H+H+ genotype (OR = 1.28, 95% CI = 1.09–1.49, p = 0.002, I2 = 43%) and H+ allele genotype (OR = 1.27, 95% CI = 1.03–1.58, p = 0.03, I2 = 67%). Ser447X XX genotype (OR = 2.37, 95% CI = 1.33–4.24, p = 0.004, I2 = 53%) was also associated with CAD risk. However, PvuII polymorphism was found to have no significant association with CAD risk. Conclusions: LPL HindIII polymorphism was significantly associated with the risk of CAD. For Ser447X polymorphism, it was found that only XX genotype was significantly associated with CAD risk. Furthermore, PvuII polymorphism had no significant association with CAD risk. It was considered that LPL HindIII polymorphism might serve as a potential biomarker for CAD risk.

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Evaluating predictors of lead exposure for activities disturbing materials painted with or containing lead using historic published data from U.S. workplaces

Objectives

We evaluated predictors of differences in published occupational lead concentrations for activities disturbing material painted with or containing lead in U.S. workplaces to aid historical exposure reconstruction.

Methods

For the aforementioned tasks, 221 air and 113 blood lead summary results (1960–2010) were extracted from a previously developed database. Differences in the natural log-transformed geometric mean (GM) for year, industry, job, and other ancillary variables were evaluated in meta-regression models that weighted each summary result by its inverse variance and sample size.

Results

Air and blood lead GMs declined 5%/year and 6%/year, respectively, in most industries. Exposure contrast in the GMs across the nine jobs and five industries was higher based on air versus blood concentrations. For welding activities, blood lead GMs were 1.7 times higher in worst-case versus non-worst case scenarios.

Conclusions

Job, industry, and time-specific exposure differences were identified; other determinants were too sparse or collinear to characterize. Am. J. Ind. Med. 60:189–197, 2017. © 2017 Wiley Periodicals, Inc.

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Corporate corruption of science—Another asbestos example

Background

Kelsh et al. [2007]: Occup Med (Lond) 57:581–589 published a paper reanalyzing one of the few data sources publicly available on mesothelioma amongst brake workers, the Australian Mesothelioma Surveillance Registry (AMSR). This reanalysis was commissioned by lawyers representing the automobile manufacturing companies and did not align with an independent analysis published by Leigh and Driscoll [2003]: Occup Environ Health 9:206–217.

Methods

We sought to reevaluate the AMSR data ourselves to understand how the company-sponsored research categorized the data.

Results

In our re-analysis of the 78 brake-related folios in the AMSR, we determined that 57 were employed brake mechanics, 35 were employed brake mechanics with no other asbestos exposure besides brake work or repair, and 41 of these cases had no other asbestos exposure besides brake work or repair. Our classifications differed significantly from Kelsh et al.

Conclusions

We discuss how Kelsh et al. methodically reduced the relevant cases by following overly stringent criteria for inclusion. Am. J. Ind. Med. 60:152–162, 2017. © 2017 Wiley Periodicals, Inc.

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Cryptosporidiosis outbreak at an academic animal research laboratory―Colorado, 2014

Background

After cryptosporidiosis was reported in three workers caring for preweaned calves at an academic research laboratory, we sought to identify cases, determine risk factors, and implement control measures.

Methods

A cryptosporidiosis case was defined as diarrhea duration ≥72 hr, abdominal cramps, or vomiting in an animal research laboratory worker during July 14–July 31. A confirmed case had laboratory evidence of Cryptosporidium infection. Staff were interviewed regarding illness, potential exposures, training, and personal protective equipment (PPE) standard operating procedures (SOPs).

Results

The cryptosporidiosis attack rate (AR) was 74% (20/27); five were laboratory-confirmed. Median job training was 2 hr including respiratory-fit testing. No SOPs existed for doffing PPE. AR for workers who removed their gloves first was 84% (16/19) compared with 20% (1/5) for workers who removed gloves last (risk ratio = 4.2; P < 0.02).

Conclusions

This outbreak highlights the importance of adequate training, enforced proper PPE procedures, and promoting a culture of safety. Am. J. Ind. Med. 60:208–214, 2017. © 2017 Wiley Periodicals, Inc.

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Response to Goodman et al

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