Browsing by Subject "Occupational medicine"

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    Effects of long-term organophosphate exposures on neurological symptoms, vibration sense and tremor amongst South African farm workers
    (1998) London, Leslie; Nell, V; Thompson, M L; Myers, J E
    OBJECTIVES: This study assessed the relationship between long-term exposure to organophosphate insecticides and neurological symptoms, vibration sense, and motor tremor after control for the effect of past poisoning and acute exposure. METHODS: This cross-sectional study included 164 pesticide applicators and 83 nonspraying reference workers on deciduous fruit farms. The workers were tested on the Vibratron II, on tests of dynamic and static tremor, and for a set of neurological and "dummy" symptoms. Exposure was derived with the use of a job-exposure matrix for pesticides in agriculture. RESULTS: Compared with nonapplicators, current applicators reported significantly more dizziness, sleepiness, and headache and had a higher overall neurological symptom score. This association remained statistically significant after multiple logistic regression analyses controlling for a range of confounders and effect modifiers [odds ratio (OR) 2.25, for current applicators having high neurological score, 95% confidence interval (95% CI) 1.15-4.39]. The average lifetime intensity of organophosphate exposure was nonsignificantly associated with both neurological (OR 1.98, 95% CI 0.49-7.94) and "dummy" symptoms (OR 2.37, 95% CI 0.54-10.35). Previous pesticide poisoning was significantly associated with the neurological scores (OR 4.08, 95% CI 1.48-11.22) but not with the "dummy" symptoms. Vibration sense outcomes were associated with age and height, but not with the organophosphate exposure measures. In the multiple linear regression modeling for tremor intensity in the dominant hand, recent organophosphate exposure in the past 10 days was a significant predictor (partial correlation coefficient = 0.04), but none of the long-term organophosphate exposure measures were significant. CONCLUSIONS: Strong evidence was found for an association between symptom outcomes and past organophosphate poisoning and between symptom outcomes and current spray activity. In contrast to symptoms, there was no association between either past poisoning or current spray activity and vibration sense or tremor outcome. Long-term organophosphate exposure did not appear to predict symptoms, vibration sense, or tremor outcome.
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    Silicosis among Cape gemstone workers : tigers' eye pneumoconiosis
    (1991) White, Neil W; Bateman, Eric D
    Silicosis continues to be an important occupational disease in South Africa, particularly in small, poorly regulated industries. A case series is described of six workers who developed silicosis whilst involved in the processing of semi-precious gem stones. They had been employed as stone sculptors in lapidaries where they processed tigers' eye, rose quartz, amethyst, quartz crystal and a variety of other locally occurring semi-precious stones. In five of the cases exposure was in small and poorly regulated lapidaries without specific dust control measures. The sixth was detected during the course of a health and hygiene survey (including dust sampling) that I conducted in one of two lapidaries still operating in the Western Cape. These workers developed serious disease. Progressive massive fibrosis (PMF) was noted in 4 of the 6 cases, three of whom had progression of their disease after cessation of exposure. With the development of PMF the initial restrictive pulmonary function abnormalities were followed by steadily worsening airflow obstruction. Lung biopsies confirmed silicosis in one case and were suggestive in a further two. Tuberculosis was confirmed in two cases and suspected and treated in a third. Workmen's' Compensation was awarded in five cases. The survey confirmed that in semiprecious gem stone processing, the risk of silicosis appears to be confined to stone sculptors. Tried and proven techniques of general and local exhaust ventilation combined with water or oil to control dust at source were capable of effectively reducing dust emission to acceptable levels.