Alice D. Stark

Hearing Conservation for Farmers: Source Apportionment of Occupational and Environmental Factors Contributing to Hearing Loss

Those who work on farms continue to have a strikingly high prevalence of hearing loss, despite efforts to promote hearing conservation in agriculture. To develop improved hearing conservation programs, we performed a source apportionment analysis for hearing loss in a large, multiphasic health survey, the New York Farm Family Health and Hazard Survey. We used information from audiometric, otoscopic, and tympanometric examinations; detailed general health and farm exposure interviews; and a second interview that focused on additional potential determinants of hearing loss. Hearing loss on audiometry was significantly associated with increased age, male gender, education through high school or less, lifetime years of hunting with guns, lifetime years of use of a grain dryer, and a history of spraying crops during the previous year. Hearing conservation programs for farmers should thus be directed toward reduction in noise exposure, both from occupational and non-occupational sources. Additional study is needed to evaluate the association seen between crop spraying and hearing loss.

Asthma hospitalization rates and socioeconomic status in New York State (1987-1993).

This study examined the geographic distribution of asthma hospitalizations in New York State (NYS) and its association with socioeconomic status. Statewide asthma hospitalization data (1987-1993) were merged with 1990 census data by residential zip code. The asthma hospitalization rate increased in NYS from 1987 (2.54 per 1000) through 1993 (2.87 per 1000) and the increase is largely attributable to increases for children 4 years old and younger. The risk factors for asthma admission varied in different areas. However, rates of hospitalization because of asthma were generally higher in the zip codes areas with higher proportions of poverty, unemployment, poorly educated residents, African-Americans, and Hispanics.

The relationship of environmental lead to blood-lead levels in children☆

An in-depth study of the distribution of lead sources in the residential environment of 377 children in New Haven, Connecticut, was carried out. Substantial amounts of lead were present in soil, paint, and house dust throughout New Haven, but not in air or water. Multiple regression modeling indicated that the most important contributors to variation in childrens blood-lead levels were soil lead and exterior house paint lead. Using the best five-variable model only 11.7% of the variation in the childrens blood-lead levels could be explained. This led to the conclusion that availability of lead in the residential environment did not account for most of the variation observed in the population.

Mesothelioma, asbestos, and reported history of cancer in first‐degree relatives

Although malignant mesothelioma is known to be strongly related to asbestos exposure, its relationship to familial factors is unclear.

Variation in Blood Lead and Hematocrit Levels during Pregnancy in a Socioeconomically Disadvantaged Population

Abstract Lead is a long-recognized human toxicant that crosses the placenta. Fetal sensitivity to environmental agents can vary with stage of development; therefore, how maternal blood lead levels change during pregnancy and how fetal exposure is influenced provide useful knowledge. In this study, the authors describe longitudinal changes in blood lead levels during the course of pregnancy in a sample of socioeconomically disadvantaged pregnant women. The women were recruited early in pregnancy when they sought care at one of two obstetrics clinics in Albany, New York. Maternal blood lead levels changed between the 1st and 2nd trimesters, from 1.99 μmlg/dl to 1.69 μmlg/dl (hematocrit corrected, 1.70–1.62); between the 2nd and 3rd trimester from 1.78 μmlg/dl to 1.86 μmlg/dl (hematocrit corrected, 1.65–1.72); and between 3rd trimester and delivery from 1.80 μmlg/dl to 2.17 μmlg/dl (hematocrit corrected, 1.70–1.86). These changes were statistically significant and were corrected for secular trends. The rate of change per day in lead levels averaged −36.6% from trimester 1 to trimester 2, 18.3% from trimester 2 to trimester 3, and −40.8% from trimester 3 to delivery. The patterns in our study were consistent with the patterns reported in a few other longitudinal studies of change in lead level during pregnancy. Findings reveal significant associations between maternal blood lead levels and both hematocrit and trimester of pregnancy. Clinicians who interpret test results should take into account the dynamics of these variables when determining appropriate care for both mother and neonate.

Safety awareness among New York farmers.

BACKGROUND This study was conducted to assess the health status and safety practices among year-round adult farm workers and residents and included a telephone interview survey of 1,727 persons from 552 farms. METHODS Logistic regression was used to analyze four safety questions. RESULTS Among 541 farm owner/operators significant predictors of making substitutions in the use of chemicals and major changes to equipment include younger age, more persons assisting on the farm, and higher gross sales. Having training is associated with having more than a high school education. Among all participants the perception that personal protective equipment are useful is associated with being younger, male, an owner/operator or worker, and having at least a high school education. CONCLUSIONS These findings suggest that older and less educated farmers should be targeted for health and safety programs.

A retrospective cohort study of cancer incidence among New York State Farm Bureau members.

Cancer incidence from 1973 through 1983 in 18,811 New York Farm Bureau members was examined using a retrospective cohort study design. The observed number of cancers for all age groups was 72% of the expected, and the major deficits in incidence occurred for lung (52% of expected), gastrointestinal (67% of expected), and bladder (78% of expected). Similar deficits have been reported by other researchers. Unlike other studies, we did not find a significant excess of cancer of any site. Given the healthy worker effect and the small numbers of incident tumors at some sites, the Standardized Cancer Incidence Ratios that were over 100 in value (i.e., lip, melanoma of the skin, prostate, multiple myeloma) merit further investigation. This study differs from previous research in population, setting, and method. Nonetheless, the general pattern of results is consistent with the findings of other investigations.

Watercraft-Related Drownings Among New York State Residents, 1988-1994

Objective. To describe environmental and personal risk factors associated with watercraft-related drownings. This information may be useful in developing boating safety programs, regulations, and enforcement priorities. Methods. A companion article in this issue (Unintentional Drownings Among New York State Residents, page 448) summarizes an investigation of 883 non-bathtub drownings among New York State residents for the years 1988 to 1994 using medical examiner, coroner, police, and hospital records in addition to death certificate data. This report details the environmental and personal risk factors associated with 216 watercraft-related drownings. Results. Ninety-three percent of watercraft-related drowning victims were male, with the highest rate of drowning observed among males ages 15–44 years. Most commonly, the victim entered the water when the watercraft capsized (36%), the victim fell overboard (24%), or the victim intended to swim (11%). Personal flotation devices (PFDs) were known to be worn by only 9% of drowning victims, and in these cases other risks overwhelmed the effectiveness of the PFD. Of 73 individuals 15 years of age or older for whom adequate blood alcohol concentration analyses were provided, 44% were positive for blood alcohol. Conclusions. Based on this study, increased use of PFDs, avoidance of dangerous currents, and less alcohol use by operators and passengers of all types of watercraft would result in a reduction in watercraft-related drownings. In addition to continued education efforts, boating safety measures that deserve consideration include enforcement of current PFD and boating while intoxicated (BWI) regulations and expansion of BWI laws to apply to all boaters.

Cancer Incidence among Former Love Canal Residents

Background The Love Canal was a rectangular 16-acre, 10-ft-deep chemical waste landfill situated in a residential neighborhood in Niagara Falls, New York. This seriously contaminated site came to public attention in 1978. Only one prior study examined cancer incidence in former residents of the Love Canal neighborhood (LC). Objective In this study we aimed to describe cancer incidence in former LC residents from 1979 to 1996 and to investigate whether it differs from that of New York State (NYS) and Niagara County (NC). Methods From 1978 to 1982, we interviewed 6,181 former residents, and 5,052 were eligible to be included in this study. In 1996, we identified 304 cancer diagnoses in this cohort using the NYS Cancer Registry. We compared LC cancer incidence with that of NYS and NC using standardized incidence ratios (SIRs), and we compared risks within the LC group by potential exposure to the landfill using survival analysis. Results SIRs were elevated for cancers of the bladder [SIRNYS = 1.44; 95% confidence interval (CI), 0.91–2.16] and kidney (SIRNYS = 1.48; 95% CI, 0.76–2.58). Although CIs included 1.00, other studies have linked these cancers to chemicals similar to those found at Love Canal. We also found higher rates of bladder cancer among residents exposed as children, based on two cases. Conclusions In explaining these excess risks, the role of exposure to the landfill is unclear given such limitations as a relatively small and incomplete study cohort, imprecise exposure measurements, and the exclusion of cancers diagnosed before 1979. Given the relatively young age of the cohort, further surveillance is warranted.

Blood Lead Level, by Year and Season, among Poor Pregnant Women

The authors conducted a longitudinal study of poor pregnant women and their infants to examine the determinants of maternal and infant lead levels. To accurately depict these determinants, one must account for secular and seasonal variations in these levels. The womens lead levels declined over the 5-y period of study by approximately 20%/y, depending on when in the course of pregnancy measurements were made. After correction for secular trend, we found a periodic effect that differed from that typically seen in children (i.e., peak occurs in summer). In this study, lead levels in these women peaked during December-March. If the effects of lead are greatest in the youngest conceptus, early pregnancies that occur in the December-March period pose the largest prenatal risk.