ABSTRACT
Work in confined spaces continues to present hazards to workers. The magnitude of this problem was recently addressed by the Occupational Safety and Health Administration in its Final Rule for "Permit-Required Control Spaces for General Industry" (29 CFR Parts 1910). Although illness and injury are typically due to asphyxiation, explosion, and drowning, toxic exposures also are an important risk. We describe herein four workers engaged in erosion-proofing enclosed chemical tanks with minimal ventilation and no respiratory protection. They were exposed to styrene-based solvents, styrene-based resins, silica, and fiberglass dust. Each experienced acute neurological effects and bronchitis. One worker developed a life-threatening pneumonia that resulted in numerous complications. The severity of the illness, which would likely not have otherwise occurred, resulted from impaired lung defense mechanisms due to the combined exposures. Several studies support the association of styrene exposure and respiratory illness that may be compounded by co-exposure to fiberglass in unique circumstances. To prevent the hazards of confined space, recommended procedures should be followed, including those established by the National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration.
Subject(s)
Air Pollutants, Occupational/adverse effects , Environment Design , Glass , Hazardous Substances/adverse effects , Occupational Diseases/etiology , Silicon Dioxide/adverse effects , Styrenes/adverse effects , Ventilation , Adult , Aged , Bronchitis/etiology , Humans , Lung Diseases, Obstructive/etiology , Male , Middle Aged , Nervous System Diseases/etiology , Respiratory Distress Syndrome/etiology , Risk Factors , Silicosis/etiology , Styrene , United States , United States Occupational Safety and Health AdministrationSubject(s)
Medicine , Occupational Medicine , Specialization , Terminology as Topic , Environmental Health , United StatesABSTRACT
An essential part of a carefully designed drug testing program is the Medical Review Officer's review of chain-of-custody forms and laboratory results. A positive drug test result does not necessarily identify a substance abuser. Federal drug testing regulations require that positive test results be reviewed and interpreted by the Medical Review Officer. Technical and administrative procedures can assure confidentiality and virtually eliminate the chance of persons being wrongfully characterized as using illicit substances.
Subject(s)
Employment , Physician's Role , Substance Abuse Detection , Humans , Substance Abuse Detection/methodsABSTRACT
A potential for occupational exposure to PCBs exists within the electrical utility industry, especially where PCB-containing equipment has been serviced. PCBs can also be found at hazardous waste sites, in sewage sludge, and in soot from transformer fires. The health effects, biological monitoring, and medical surveillance of PCBs are all discussed in this review.
Subject(s)
Environmental Monitoring/methods , Hazardous Waste , Occupational Diseases/prevention & control , Polychlorinated Biphenyls , Humans , Mass Screening/methods , Occupational Diseases/chemically inducedABSTRACT
Reported injuries from vibrating tools include vibration syndrome, arthropathies, pneumomediastinum, and rupture of the sigmoid colon. The use of jackhammers in particular is associated with these injuries. The authors have identified a construction worker who suffered torsion of the omentum as a result of using a 42.75-kg (95 lb) jackhammer. His clinical presentation of right upper-quadrant pain and fever was confused with acute cholecystitis, and it was not until laparotomy that the correct diagnosis was made. This diagnosis should be suspected in workers who experience acute abdominal pain and are exposed to vibration or repetitive blunt abdominal trauma.
Subject(s)
Occupational Diseases/etiology , Peritoneal Diseases/etiology , Vibration/adverse effects , Humans , Male , Middle Aged , Torsion AbnormalityABSTRACT
A cross-sectional study of 120 male workers was conducted to determine the prevalence of increased polychlorinated biphenyl (PCB) absorption as well as the presence of potentially related clinical and metabolic abnormalities. Three exposure categories ("exposed", "nominally exposed", "nonexposed") were defined. Complete work histories, clinical histories, physical examinations and laboratory tests, including plasma PCB determinations were obtained. In addition, fat PCB levels were determined in randomly selected subjects in each exposed group. Evidence of dermatotoxicity was observed and elevated PCB levels were noted more frequently in the exposed group (p less than .0001), correlating well with age and duration of employment. These correlations were stronger for fat (p less than .001) than for plasma (p less than .01) PCB levels. In the exposed group, significant correlations were found between plasma PCB and serum triglyceride (p less than .0001) and serum glutamic oxaloacetic transaminase (SGOT) levels (p less than .01). These correlations remained significant after controlling for either age or length of employment. No significant correlations were found between PCB levels and levels of cholesterol, high-density lipoprotein cholesterol or levels studied on liver function tests other than SGOT. Further analyses relating frequency of reported direct contact with PCB levels suggested a dermal route of exposure. An analysis by union affiliation demonstrated that those in crafts involving greater direct exposure had correspondingly higher elevations of PCB levels.
