Evaluation of high blood pressure and obesity among US coal miners participating in the Enhanced Coal Workers' Health Surveillance Program.

Since 2005, the Enhanced Coal Workers' Health Surveillance Program (ECWHSP) has offered respiratory examinations to coal miners in a mobile examination unit. As little is known about the cardiovascular health of coal miners, we describe the prevalence of high blood pressure (BP) and obesity among ECWHSP participants. During 2015, 1402 ECWHSP health examinations were performed. The prevalence of BP consistent with hypertension (systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg), prehypertension (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg), and hypertensive crisis (systolic BP ≥ 180 mm Hg or diastolic BP ≥ 110 mm Hg) were calculated and compared with the US adult population using standardized morbidity ratios (SMRs). Most participants were male (N = 1317, 94%), White (N = 1303, 93%) and non-Hispanic (N = 1316, 94%). Thirty-one percent (N = 440) of participants had BP in the hypertensive range and 87% (N = 1215) were overweight/obese. Twenty-four participants (2%) had a BP reading consistent with a hypertensive crisis. Prevalence of obesity (52%, SMR = 1.52, 95% confidence interval = 1.41-1.64) and BP consistent with hypertension (31%, SMR = 1.60, 95% confidence interval = 1.45-1.76) was higher than the US adult population.The prevalence of obesity and BP consistent with hypertension in this population of coal miners is substantial, indicating a need for cardiovascular health interventions in coal mining communities.

Medical surveillance for workplace exposure to hazardous drugs.

NIOSH recommends that employers establish a medical surveillance program as part of a comprehensive program to minimize worker exposure to hazardous drugs.

Update of the NIOSH life table analysis system: a person-years analysis program for the windows computing environment.

BACKGROUND: Person-years analysis is a fundamental tool of occupational epidemiology. A life table analysis system (LTAS), previously developed by the National Institute for Occupational Safety and Health, was limited by its platform and analysis and reporting capabilities. We describe the updating of LTAS for the Windows operating system (LTAS.NET) with improved properties. SOFTWARE DEVELOPMENT PROCESS: A group of epidemiologists, programmers, and statisticians developed software, platform, and computing requirements. Statistical methods include the use of (indirectly) standardized mortality ratios, (directly) standardized rate ratios, confidence intervals, and P values based on the normal approximation and exact Poisson methods, and a trend estimator for linear exposure-response associations. SOFTWARE FEATURES: We show examples using LTAS.NET to stratify and analyze multiple fixed and time-dependent variables. Data import, stratification, and reporting options are highly flexible. Users may export stratified data for Poisson regression modeling. CONCLUSIONS: LTAS.NET incorporates improvements that will facilitate more complex person-years analysis of occupational cohort data.

Work-related fatalities associated with tree care operations--United States, 1992-2007.

Workers in various industries and occupations are involved in the care and maintenance of trees, such as tree trimming, pruning, and removal. This work is recognized as having many safety hazards. Although previous analyses have involved subgroups of workers who perform this type of work, no analysis has focused on identifying injured workers from all industries and occupations that perform tree care operations. This report summarizes the characteristics of fatal occupational injuries, using data from the Census of Fatal Occupational Injuries (CFOI) and a case series of fatality investigations conducted by CDC's National Institute for Occupational Safety and Health (NIOSH) Fatality Assessment and Control Evaluation (FACE) program. During 1992--2007, a total of 1,285 workers died while performing tree care and maintenance; 44% were trimming or pruning a tree when fatally injured. The most common causes of death were being struck by or against an object (42% of deaths), most commonly a tree or branch; falls to a lower level (34%); and electrocutions (14%). Most of the decedents (57%) worked for small establishments with 10 or fewer employees. Employers, trade and worker associations, and policymakers should take additional steps to improve the safety of workers involved in tree care, such as providing formal training to workers and ensuring that personal protective equipment (e.g., fall protection equipment) is used properly.

Adult blood lead epidemiology and surveillance--United States, 2005-2007.

Overexposure to inorganic lead continues to be an important health problem worldwide. Furthermore, recent research has caused increased concerns about the toxicity of lead at low doses. Lead can cause acute and chronic adverse effects in multiple organ systems, ranging from subclinical changes in function to symptomatic, life-threatening intoxication. Since 1992, CDC's state-based Adult Blood Lead Epidemiology and Surveillance (ABLES) program has tracked laboratory-reported elevated blood lead levels (BLLs) in U.S. adults. The vast majority (95%) of reported elevated BLLs have been work related. One of the Healthy People 2010 national public health objectives is to reduce to zero the prevalence of BLLs =25 microg/dL among adults (objective 20-7). ABLES surveillance results through 2004 have been published previously. This report summarizes results for the period 2005--2007. An overall decline in national rates of elevated BLLs among state residents plus nonresidents from 14.0 in 1994 to 7.8 in 2007 has been observed. The national rate of state resident adults with BLLs =25 microg/dL was 7.2 per 100,000 employed adults in 2005 and 7.4 in 2006 and 2007. Industry subsectors with the highest numbers of lead-exposed workers were manufacturing of storage batteries, mining of lead and zinc ores, and painting and paper hanging. The most common nonoccupational exposures were shooting firearms; remodeling, renovating, or painting; retained bullets (gunshot wounds); and eating food containing lead. These findings indicate a need for increased preventive interventions to promote healthier workplaces and help move toward the Healthy People 2010 objective.

Metal and non-metal miners' exposure to crystalline silica, 1998-2002.

BACKGROUND: Crystalline silica is well known to cause silicosis and other diseases. Exposure is common in the mining industry and consequently, the US Mine Safety and Health Administration (MSHA) evaluates miners exposure to silica to determine compliance with its exposure limit. METHODS: MSHA exposure measurements were obtained for the 5-year period from 1998 to 2002 and average exposure was calculated classified by occupation and by mine. Evaluation criteria were whether average values exceeded MSHA's permissible exposure limit or the limit recommended by the National Institute for Occupational Safety and Health (NIOSH), whether there was a risk of exposure to freshly fractured silica, and whether there was a risk of a high rate of exposure to silica. RESULTS: Miners in certain jobs are exposed to silica above permissible and recommended exposure limits. Some miners may also be exposed at a high rate or to freshly fractured silica. CONCLUSIONS: Known dust control methods should be implemented and regular medical surveillance should be provided.

Hearing protector use in noise-exposed workers: a retrospective look at 1983.

Although hearing protectors have been available for more than 60 years, little field surveillance has been done to assess their appropriate wear in noisy occupational environments. This study examined historical field survey data to determine whether workers use hearing protection when exposed to loud noise. Data from the 1981-83 NIOSH National Occupational Exposure Survey were analyzed to determine whether workers in noise greater than or equal to 85 dBA were using hearing protection. The study also looked at the effect of company personal protective equipment (PPE) policies on hearing protector compliance. This study found that, in 1981-83, an estimated 4.1 million industrial workers were exposed to noise greater than or equal to 85 dBA. Of these, 41% were wearing some form of hearing protection. This percentage varied from 79% of workers exposed in SIC 76 (Miscellaneous Repair Service) to less than 1% in Communications (SIC 48), Wholesale Trade Nondurable Goods (SIC 51), and Automotive Dealers & Service Stations (SIC 55). Whether an establishment had a written policy on wearing PPE seemed to make no difference, because there appeared to be no tie between the percentage of workers wearing of hearing protection and presence of a PPE policy.