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4.  An assessment of exposure to glutaraldehyde in hospitals: typical exposure levels and recommended control measures. 
An assessment of exposure to glutaraldehyde in cold sterilisation and x ray development processes was undertaken in 14 locations at six hospitals in south east England. The results obtained indicate that routine exposures of hospital workers to airborne concentrations of the compound are within the current United Kingdom occupational exposure limit of 0.7 mg m-3. There was the potential for skin contact in many of the activities observed and alternative sterilisation and disinfection procedures would have been more appropriate in some situations. Recommendations are made on reducing exposures as the current occupational exposure limit for this compound may not be appropriate.
PMCID: PMC1061246  PMID: 8435342
6.  Factors relating to the development of respiratory symptoms in coffee process workers. 
After several cases of occupational asthma had been reported in a coffee processing factory in England, 197 coffee workers representing 80% of the production workforce were studied to determine the factors affecting the development of work related respiratory symptoms of wheeze, cough, and dyspnoea. Two computer administered questionnaires concerning the presence of respiratory symptoms and the occurrence of work related respiratory symptoms were used. Workers underwent skin prick testing to green coffee bean extract (GCB) and 11 common inhalant allergen extracts and bronchial provocation testing with methacholine. The presence of specific immunoglobulin E (IgE) antibodies to GCB and castor bean extract (CAB) were determined by a radioallergosorbent test (RAST). The prevalence of work related respiratory symptoms was 12.7%, bronchial hyperresponsiveness 30%, atopy 54%, positive GCB skin prick test 14.7%, positive GCB RAST 14%, and positive CAB RAST 14.7%. None of the workers was sensitised to fungi present in the factory and the numbers of certain species of fungi, despite being greater than may be found out of doors or in an uncontaminated indoor environment, were fewer than are generally associated with the presence of work related respiratory symptoms among agricultural workers. Storage mites were not isolated. Green coffee bean extract and CAB RAST were significantly correlated using the McNemar test but there was limited allergenic cross reactivity in RAST inhibition studies of the two extracts. The only factors that were significantly and independently associated with work related symptoms were CAB RAST and duration of employment. Bronchial hyperresponsiveness was not independently associated with work related respiratory symptoms. The significant independent associations of bronchial hyperresponsiveness included GCB RAST, duration of employment, and resting forced expiratory volume in one second. Exposure to CAB, a highly potent antigen, may be overriding the effects of other factors such a GCB, atopy, bronchial hyperresponsiveness, and smoking. This study suggests that CAB contamination remains a potential problem in the coffee processing industry and all efforts to eliminate it from the working environment should continue.
PMCID: PMC1012039  PMID: 2039743
7.  Medical planning for toxic releases into the community: the example of chlorine gas. 
Emergency planning for a major accidental release of chlorine gas from industrial installations into the community is outlined for emergency services and hospitals. Realistic planning has been made possible with the advent of computer models for gas dispersion which may be used to estimate the numbers of deaths and casualties, according to their severity. For most purposes sufficient accuracy may be obtained by using a small number of computer analyses for the most serious reasonably foreseeable events under typical day and night weather conditions, and allowing for the emergency response to be scaled up or down according to the size of an actual release. In highly populated areas triage should be preplanned to deal with a large number of victims; field stations will be needed for the treatment and observation of minor casualties. The management and treatment of casualties is summarised. The best protection against a gas cloud is afforded by buildings whose windows, doors, and ventilation systems have been closed. Hospitals in the vicinity of an installation should draw up plans to protect patients and staff. Coordination in a disaster will require toxicological and epidemiological expertise and hospital plans should allow for this.
PMCID: PMC1009767  PMID: 2713283
8.  Laboratory animal allergy in a pharmaceutical company. 
A cross sectional survey was carried out on 138 workers exposed to laboratory animals. Sixty (44%) had symptoms in a self completed questionnaire that were consistent with laboratory animal allergy (LAA) of whom 15 (11%) had chest symptoms. There was a positive skin prick test to one or more animal urine extracts (rat, mouse, guinea pig, rabbit) in 13% and 38% had a positive radioallergosorbent test to urine extract. LAA chest symptoms were almost five times more common in atopic than non-atopic subjects (who were distinguished by skin test response to common, non-animal aeroallergens). A positive skin test to animal urine was associated with LAA chest symptoms and with atopy. Nose, eye, or skin symptoms without chest symptoms were not associated with atopy. There was an inverse relation between duration of employment at the firm and LAA chest symptoms, suggesting selection of affected people out of employment with animals.
PMCID: PMC1009674  PMID: 3264181
9.  Volcanoes and occupational health. 
PMCID: PMC1007651  PMID: 3707865
10.  Occupation and cancer in London: an investigation into nasal and bladder cancer using the Cancer Atlas. 
The Atlas of Cancer Mortality for England and Wales showed pronounced excesses of male mortality from nasal and bladder cancer in certain London boroughs. These excesses were investigated by case-referent studies using death certificate data for male deaths, 1968-78. Nasal cancer was found to be significantly associated with occupations involving heavy exposure to wood dust. Bladder cancer was significantly associated with occupations in road transport driving and in the handling of leather, whereas consistently raised relative risk ratios were also found for wood-workers, engineering fitters, printers, machinists, plumbers, and motor mechanics. These findings highlight the potential role of occupational factors in cancer causation in London.
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PMCID: PMC1007599  PMID: 3947560
12.  Angiosarcoma of the liver: annual occurrence and aetiology in Great Britain. 
The annual occurrence of angiosarcoma of the liver (ASL) in Britain from 1963 to 1977 was studied, including clinical and occupational details for those cases agreed as ASL by a panel of histopathologists. Thirty-five cases (28 men, six women, and one infant girl) were agreed as ASL. The increase in the incidence of ASL observed in recent years was attributable to Thorotrast (thorium dioxide) usage (eight cases) and exposure to vinyl chloride (two cases) in the past. In its clinical presentation and prognosis ASL resembled primary liver carcinoma, except that extrahepatic metastases were found in only eight (23%) cases, and haemoperitoneum ws more common in those cases due to Thorotrast. The results suggested a possible increased risk of ASL in the electrical and plastics fabrication industries, but information on exposure was inadequate to implicate specific chemicals. The clinical features of one case were indicative of arsenical intoxication, but medications in the other patients did not appear to be of aetiological importance.
PMCID: PMC1008697  PMID: 7191719
13.  Ambulatory electrocardiography in car workers. 
A previous study in a car assembly plant showed that production-line workers had a lower incidence rate of heart attacks than executive staff. In the present study some major coronary risk factors and 24-hour ambulatory electrocardiograms were investigated in two age-matched samples of 30 middle-aged men drawn from these occupations. Men with a known history of heart disease were excluded. Compared with production-line workers, executive staff on average had a higher diastolic blood pressure (P less than 0.05) and fewer took heavy exercise during their leisure time (P less than 0.05). Ventricular premature beats (VPB was also similar for each of the periods of work, leisure and sleep. Apart from isolated ectopic beats, disturbances of rhythm were uncommon, and neither VPB nor other arrhythmias appeared to be induced by occupational factors.
PMCID: PMC1008361  PMID: 656344
14.  Myocardial infarction in car assembly workers. 
The incidence of myocardial infarction and the return to work for survivors were studied among the employees of an English car assembly plant by analysing 12 811 medical records of persons employed during the seven years between January 1966 and December 1972. The standardized morbidity ratio of myocardial infarction found in this study calculated on the basis of incidence rates reported by Kinlen )1973) for the Oxford community in which the factory was situated was 90. The standardized morbidity ratio from production line workers only was 66 and that for the monthly paid staff 272. Of the production line workers who survived the attack 22 (90%) returned to their previous jobs without undue difficulty and with two exceptions within four months of the onset of their illness; there was no relation between length of absence and age at the time of attack. These findings suggest that workers in mass production jobs such as car assembly are not special risk from myocardial infarction, and most of those who survive a heart attack are able to return to their former work. Taken with Kinlen's (1973) study and that of Armstrong et al. (1972) in Edinburgh, they also bear out mortality data by indicating that in Oxfordshire the incidence of coronary heart disease is lower than the British average.
PMCID: PMC1008094  PMID: 1268101

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