Franklin E. Mirer

Occupational injury disparities in the US hotel industry

BACKGROUND Hotel employees have higher rates of occupational injury and sustain more severe injuries than most other service workers. METHOD OSHA log incidents from five unionized hotel companies for a three-year period were analyzed to estimate injury rates by job, company, and demographic characteristics. Room cleaning work, known to be physically hazardous, was of particular concern. RESULTS A total of 2,865 injuries were reported during 55,327 worker-years of observation. The overall injury rate was 5.2 injuries per 100 worker-years. The rate was highest for housekeepers (7.9), Hispanic housekeepers (10.6), and about double in three companies versus two others. Acute trauma rates were highest in kitchen workers (4.0/100) and housekeepers (3.9/100); housekeepers also had the highest rate of musculoskeletal disorders (3.2/100). Age, being female or Hispanic, job title, and company were all independently associated with injury risk. CONCLUSION Sex- and ethnicity-based disparities in injury rates were only partially due to the type of job held and the company in which the work was performed.

A survey of mortality at two automotive engine manufacturing plants

Mortality at two engine plants was analyzed using proportional mortality and logistic regression models of mortality odds ratios to expand previous observations of increased cancers of the stomach, pancreas, and bladder, and cirrhosis of the liver among workers exposed to machining fluids. Causes of death and work histories were available for 1,870 decendents. There was a significant excess of deaths coded as diabetes for white men in both plants (PMR = 25/16.7 = 1.5, 95% CI = 1.02, 2.20), and a deficit of respiratory diseases. Black men had fewer than expected diabetes deaths and more emphysema deaths. Elevated PMRs for cancers of the stomach, pancreas, prostate, bladder, and kidney were not statistically significant in plantwide populations. However, stomach cancer mortality increased with duration in camshaft and crankshaft production at Plant 1 (OR = 5.1, 95% CI = 1.6, 17; at mean duration of exposed cases), and among tool room workers (OR = 6.3, 95% CI = 1.3, 31), but these results were based on five cases. Nitrosamines were probably present in camshaft and crankshaft grinding at Plant 1. Pancreas cancer risk increased among workers at both plants ever employed in inspection (OR = 2.5, 16), in machining with straight oil (OR = 3.6, 95% CI = 1.04, 12), or in skilled trades (OR = 2.9, 95% CI = 1.1, 7.5). Lung cancer increased in cylinder head machining (OR = 3.9, 95% CI = 1.4, 11), millwright work (OR = 3.8, 95% CI = 1.6, 9.0), and in Plant 2 generally (OR = 1.45, 95% CI = 0.97, 2.2). Potential lung carcinogens included heat treatment emissions, chlorinated oils, and coal tar fumes (millwrights). Bladder cancer increased with duration among workers grinding in straight oil MF (OR = 3.0, 95% CI = 1.15, 7.8) and in machining/heat-treat operations (OR = 2.9, 95% CI = 1.14, 7.2).

Potential Health Impact of Switching From Car to Public Transportation When Commuting to Work

We assessed humidity-corrected particulate matter (PM(2.5)) exposure and physical activity (using global positioning system monitors and diaries) among 18 people who commuted by car to Queens College, New York, New York, for 5 days, and then switched to commuting for the next 5 days via public transportation. The PM(2.5) differed little between car and public transportation commutes (1.41 μg/M(3)·min; P = .226). Commuting by public transportation rather than by car increased energy expenditure (+124 kcal/day; P < .001) equivalent to the loss of 1 pound of body fat per 6 weeks.

Cumulative trauma disorders of the hand and wrist in the auto industry.

Surveillance for cumulative trauma disorders (CTDs) of the hand and wrist was carried out in five US automotive plants from 1985 to 1986, using Occupational Safety and Health Administration (OSHA) Form 200 injury and illness logs and medical insurance claims. Results using both record sources indicated that hand and wrist disorders may be more common in foundries than in other types of automotive plants. Similarly, in assembly plants, employees in certain departments appeared to be at higher risk for CTDs. Although our results are based on small numbers of cases, they suggest plants and departments that might be targeted for more detailed investigation.

Updated Epidemiology of Workers Exposed to Metalworking Fluids Provides Sufficient Evidence for Carcinogenicity

The 1998 National Institute for Occupational Safety and Health (NIOSH) criteria document for metalworking fluids (MWF) is the most recent authoritative review of mortality studies of workers with these exposures. NIOSH concluded that substantial evidence exists for increased risk of cancer at several sites (larynx, rectum, pancreas, skin, scrotum, and bladder) among workers exposed to MWF before the mid-1970s, and that evidence is equivocal for cancer at several other sites, including stomach, esophagus, lung, prostate, brain, colon, and hematopoietic system. The UAW believes that systematic analysis of that body of data makes a much stronger case for stomach cancer related to MWF exposure. Since the Criteria document, the mortality experience of three of the cohorts reviewed has been either updated or reanalyzed. These updates strengthen the evidence for increased mortality from stomach and liver cancer, and non-malignant respiratory disease associated with exposure to water-based metalworking fluids. Additional toxicological data providing clear evidence for carcinogenicity of diethanolamine, a widely used ingredient, also increases the biological plausibility of these findings. Despite changes in composition of MWFs with time, and reduced exposure levels, these data contradict the notion that cancer risks have been eliminated.

Mortality among workers exposed to coal tar pitch volatiles and welding emissions: an exercise in epidemiologic triage.

The United Automobile Workers International Union has established a system of epidemiologic triage to evaluate patterns of mortality among groups of union members. In response to worker concerns, the Union examined mortality at a metal stamping plant, using a method which linked pension records with the State of Michigan computerized death registry. The observed proportion of malignant neoplasms was nearly twice that expected (95% Confidence Limits 1.36, 2.62). Two- to five-fold excess proportional mortality from cancer of the digestive organs, lung cancer, and leukemia accounted for most of the overall excess. Strong associations were found between lung and digestive organ cancer and employment as maintenance welders or millwrights in the plant (odds ratios greater than 10). High levels of six polycyclic aromatic hydrocarbons with mutagenic and carcinogenic properties were found during hot coal tar application to wood block floors, work conducted by the high-risk groups. These levels were substantially reduced following the purchase of new tar pots. The example demonstrates that epidemiologic tools can play a valuable role in occupational health decision making, but care must be taken to avoid mechanical reliance on quantitative testing and to acknowledge the important role of social and political value judgments in the establishment of responsible public policy.

Characteristics of Worker Populations: Exposure Considerations in the Selection of Study Populations and Their Analysis

Abstract For many chemical exposures, the most appropriate study populations are among the diverse end-users of the materials rather than the large producers or processors. Important exposures often occur in complex process settings that are not easily characterized but which could be epidemiologically evaluated. Industrial hygiene approaches are needed for characterizing process emissions when the relevant constituents are unspecified. Aggregating study populations from plants where there is a mature labor-management dynamic allows access to the collective memory of the plant populations, a major resource in exposure reconstruction. In population-based studies that apply exposure matrices to interview data, the use of interviewers trained in industrial hygiene would help minimize misclassification. Restricting population-based studies to a subset of employers would also facilitate exposure classification. Analyses using internal exposure comparisons are essential to address noncomparability of study and ...

Occupational cancer in metalworking and transportation equipment industries.

Hazardous chemical exposures may be a more important public health problem in chemical-using industries, such as the metalworking and transportation equipment industries, than in chemical manufacturing plants. Recent studies have identified excess mortality from cancer among groups of workers in model and patternmaking, plating and die-cast, foundry, machining, electronics operations and vehicle assembly plants. The chemical agents or levels of exposure associated with these findings have not previously been thought to pose a cancer risk. Therefore, estimates of the fraction of cancers associated with workplace exposure may understate the importance of exposure in this setting.