Cockroach allergen abatement with extermination and sodium hypochlorite cleaning in inner-city homes.

BACKGROUND: Although the importance of cockroach allergen in chronic asthma has now been well defined, little progress has been made in the control of cockroach allergen in infested homes. OBJECTIVE: The objective of this study was to examine the ability of a combination of professional pest extermination and household cleaning using a solution of sodium hypochlorite to reduce cockroach infestation and allergen levels in cockroach infested homes. METHODS: Seventeen cockroach-infested homes were studied with three homes serving as controls. In the intervention homes, a professional exterminator applied 0.05% abamectin twice at 2-week intervals at study entry and a professional cleaner cleaned the homes before and after the extermination. All washable surfaces were cleaned throughout the study with a solution of 0.5% hypochlorite. Monthly home visits were conducted to inspect the home, interview the homeowner, place passive cockroach traps, and to collect settled dust samples from the kitchen, bedroom, and TV/living room. RESULTS: The number of cockroaches in the passive traps decreased rapidly after the initial intervention in most homes. Median Blatella germanica allergen 1 levels in the settled dust samples fell by 91% in the kitchen, 78% in the bedroom, and 77% in the living room over the course of the study in the intervention homes but gradually rose in the control homes. The overall reductions were very similar to those seen in a previous study with a similar protocol except for the use of the sodium hypochlorite. CONCLUSIONS: Successful extermination is possible in most inner-city homes and cockroach allergen levels can be reduced by 80% to 90%. However, 0.5% sodium hypochlorite did not seem to improve allergen reduction, and in many homes, allergen levels remained above the proposed threshold of 8 U/g of dust throughout the study.

US Army Chemical Corps Vietnam veterans health study: preliminary results.

The long-term health consequences of exposure to phenoxyherbicides used in Vietnam has been a great concern to the veterans. In addition to the Air Force Ranch Hand personnel, Army Chemical Corps personnel who served in Vietnam are thought to have had some of the highest herbicide exposures. The Department of Veterans Affairs commenced a study of veterans who served in Vietnam as members of the Army Chemical Corps and a comparison cohort of Army Chemical Corps personnel who served elsewhere. A total of 2872 Vietnam veterans and 2737 non-Vietnam veterans who served in the Army Chemical Corps were identified for inclusion in a telephone health interview survey with a random 20% sample of veterans receiving serum dioxin and other congeners assessments. In a feasibility study which included 284 Vietnam veterans and 281 non-Vietnam veterans, 100 serum assessments were conducted of which 95 were included in the analysis. Vietnam veterans with a history of spraying herbicides were found to have a statistically significant elevation in their current serum 2,3,7,8-TCDD concentrations compared to non-Vietnam veterans without a spray history (P = 0.05). Other 2,3,7,8-substituted dioxins levels were comparable to the levels found in the non-Vietnam veterans. This feasibility study demonstrated that serum dioxin concentrations from a sample of the study participants can be used to identify exposure variables in the health survey that can serve as a surrogate measure of phenoxyherbicide exposure.

Comparison of personal exposure meter placement for the determination of office worker ELF magnetic field exposures.

This article compares extremely low frequency (ELF) magnetic field exposures measured by placing EMDEX Lite personal exposure meters (PEMs) at the head, chest, and waist level for a group of office workers. Twenty-three volunteers were solicited to wear three PEMs simultaneously; one was attached to a baseball cap worn on the head, one was attached to a band and worn around the neck (positioned on the chest), and one was worn in a belted pouch around the waist (positioned on the right side of the hip). The effect of PEM placement was evaluated by comparing full-shift average exposures and daily maximum or peak exposure. The results of this investigation indicate that time-weighted average magnetic field exposures determined at the hip provide the highest mean exposure estimates. Averages of the full-shift mean magnetic field measurements taken at hip and head levels were statistically greater than measurements taken at the chest level by 33 and 22%, respectively. Comparisons of the maximum or peak magnetic field exposures by body position indicate that the hip position produced an average exposure estimate that was 136% greater than the average head-level measurement. Results suggest that for office workers PEM meter placement on the body does not produce large differences in full-shift average ELF magnetic flux density exposures. However, the hip position produced the largest daily maximum or peak exposures. It is recommended that PEMs be placed on the hip for exposure assessments in office environments, because this placement is the most commonly used, the most convenient, and resulted in the highest magnetic field exposures.

Industry-wide study of mortality of pulp and paper mill workers.

A study of pulp and paper mill workers indicated low risks of death from all causes (standardized mortality ratio (SMR) = 0.74) and all cancers (SMR = 0.81) compared with U.S. rates. The leukemia death rate in workers was not higher than the U.S. rate but was higher than the rate in county populations surrounding mills. Workers whose last jobs were in the finishing areas of the mills had an elevated SMR for liver cancer. An internal comparison of occupational characteristics indicated that workers employed in mills using other chemical pulping operations had significantly elevated mortality from all causes, all cancers, heart disease, lymphomas, and brain cancers. Lung cancer mortality was elevated in mills using kraft pulping. The internal comparisons confirmed the association between work in finishing and the risk of liver cancer. This study was designed to investigate whether pulp and paper mill workers have any risks that would indicate the need for studies detailing exposures.

Characteristics of nonsmoking women in NHANES I and NHANES I epidemiologic follow-up study with exposure to spouses who smoke.

Few studies have examined the relation between passive smoking and dietary intake in a large population. This report examines the nutrition and behavioral characteristics of 3,896 nonsmoking women from the first National Health and Nutrition Examination Survey (NHANES I) population in relation to exposure to environmental tobacco smoke. The data indicate that nonsmoking women who were exposed to husbands who smoked were more likely to be older, have lower education, live in the city, and have other health behaviors that could increase their risk of lung cancer compared with nonsmoking women with husbands who did not smoke. The nonexposed women were more likely to take vitamin supplements, to not drink alcohol, and to consume higher levels of dietary vitamin A, vitamin C, and calcium. The exposed and nonexposed women showed no difference in the levels of fatty acid intake nor in the levels of several other foods from the food frequency list after correction for age. Many of the differences that the authors observed between the women who were exposed and nonexposed to passive smoking could affect the risk of cancer. Therefore, they recommend that future studies of nonsmokers examine the influence of both passive smoking and diet on the risk of disease rather than examine the influence of a single factor.

Reproducibility of the diagnosis of cervicitis in pregnancy.

Cervicitis has been associated with several infections of the female genital tract. Criteria have been established for making the diagnosis of cervicitis in gynecologic populations but there are no well-established criteria for diagnosing cervicitis in obstetrical populations. Because of the association of the cervicitis and sexually transmitted diseases, and because of the association of sexually transmitted diseases and adverse pregnancy outcome, the present study was undertaken in an attempt to establish criteria for the diagnosis of cervicitis in pregnancy. We also attempted to determine the reproducibility of that diagnosis with respect to intra- and interobserver variability. We concluded that intraobserver variability is improved after specific training has been completed and that interobserver variability may be reduced to an acceptable level. On a public health scale, this may allow for identification of a population at high risk for adverse pregnancy outcome when sophisticated microbiologic techniques are unavailable.

Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men.

In a cohort of 1835 homosexual men who were seropositive for human immunodeficiency virus (HIV) on entry into a prospective study, the acquired immunodeficiency syndrome (AIDS) developed in 59 during a median follow-up of 15 months. We matched 5 seropositive controls to each case according to study center and date of enrollment and performed a case-control analysis to determine factors predictive of AIDS. In a multivariate analysis, a decreased number of T helper lymphocytes, an increased number of T suppressor lymphocytes, a low level of antibody to HIV, a high titer of cytomegalovirus antibody, and a history of sex with someone in whom AIDS developed were independently associated with subsequent AIDS. Separate analyses of risk factors for Kaposi's sarcoma and opportunistic infections failed to support previously reported associations between the use of nitrites or an elevated cytomegalovirus-antibody titer and Kaposi's sarcoma. These variables may be markers rather than determinants of disease progression. A vigorous antibody response to HIV infection may confer at least temporary protection against the progression of immunodeficiency to AIDS, or a low level of antibody to HIV may reflect a later stage of infection. The increased risk associated with a history of sex with someone in whom AIDS developed may indicate earlier infection in cases or infection with a more virulent strain of HIV. These results may be useful in counseling HIV-seropositive persons and in designing studies of clinical interventions.