Ki Moon Bang

Prevalence of obesity by occupation among US workers: the National Health Interview Survey 2004-2011.

Objective: To estimate the prevalence of obesity and the change of prevalence of obesity between 2004−2007 and 2008−20011 by occupation among US workers in the National Health Interview Survey. Methods: Self-reported weight and height were collected and used to assess obesity (body mass index ≥ 30 kg/m2). Gender-, race/ethnicity-, and occupation-specific prevalence of obesity were calculated. Results: Prevalence of obesity steadily increased from 2004 through 2008 across gender and race/ethnicity but leveled off from 2008 through 2011. Non-Hispanic black female workers in health care support (49.2%) and transportation/material moving (46.6%) had the highest prevalence of obesity. Prevalence of obesity in relatively low-obesity (white-collar) occupations significantly increased between 2004−2007 and 2008−2011, whereas it did not change significantly in high-obesity (blue-collar) occupations. Conclusions: Workers in all occupational categories are appropriate targets for health promotion and intervention programs to reduce obesity.

National trends in silicosis mortality in the United States, 1981–2004†‡

BACKGROUND This article describes trends in mortality with silicosis and identifies industries and occupations with elevated silicosis mortality. METHODS A total of 6,326 deaths with silicosis for 1981-2004 were analyzed for trends and association with occupation and industry. Annual mortality rates were age-adjusted to the U.S. Year 2000 population. A linear regression model was used for analyzing mortality trends. Proportionate mortality ratios (PMRs) were based on 1,440 deaths with information on usual industry and occupation. RESULTS Overall age-adjusted mortality rates per million declined from 2.4 in 1981 to 0.7 in 2004. Industries having significantly elevated PMRs for silicosis included mining and quarrying. Occupations with elevated PMRs included those associated with metal and mineral processing. CONCLUSIONS The results suggest that considerable progress has been made towards elimination of this preventable disease. However, about 30 silicosis deaths per year have been recorded since 1995 among those of working age, warranting continued efforts to effectively limit workplace exposures.

Respiratory Disease in Agricultural Workers: Mortality and Morbidity Statistics

ABSTRACT To quantify the respiratory disease burden among agricultural workers, we examined the 1988–1998 National Center for Health Statistics (NCHS) “Multiple Cause of Death Data” and the 1988–1994 Third National Health and Nutrition Examination Survey data (NHANES III). Proportionate mortality ratios (PMRs) were determined for 11 respiratory conditions among 6 agricultural groups: crop farm workers, livestock farm workers, farm managers, landscape and horticultural workers, forestry workers, and fishery workers. Prevalence ratios (PRs) were determined for 12 respiratory conditions among 3 agricultural groups: farm workers, farm managers, and other agricultural workers. Disease categories groups were based on the 9th International Classification of Diseases and the agricultural groups on the NCHS or NHANES III industry and occupation codes, respectively. Crop farm workers and livestock farm workers had significantly elevated mortality for several respiratory conditions, with mortality for hypersensitivity pneumonitis being 10 and 50 times higher than expected. Landscape and horticultural workers had significantly elevated mortality for abscess of the lung and mediastinum and chronic airways obstruction. Forestry workers had significantly elevated mortality for pulmonary tuberculosis, chronic airways obstruction, and pneumonia. Prevalence of wheeze was elevated for female farm workers, shortness of breath was elevated for farm workers who had ever smoked, and hay fever was elevated for black, non-Hispanic farm workers. Prevalence of asthma was elevated for other agricultural workers who had ever smoked. Farm workers had a PR of 173 for obstructive respiratory abnormality. Continued improvement in occupational health surveillance systems for agriculture is essential to help guide prevention efforts for respiratory disease.

Malignant Mesothelioma Mortality in the United States, 1999–2001

Abstract Malignant mesothelioma is strongly associated with asbestos exposure. This paper describes demographic, geographic, and occupational distributions of mesothelioma mortality in the United States, 1999–2001. The data (n = 7,524) were obtained from the National Center for Health Statistics multiple-cause-of-death records. Mortality rates (per million per year) were age adjusted to the 2000 U.S., standard population, and proportionate mortality ratios (PMRs) were calculated by occupation and industry, and adjusted for age-sex, and race. The overall age-adjusted mortality rate was 11.52, with males (22.34) showing a six fold higher rate than females (3.94). Gographic distribution of mesothelioma mortality is predominantly coastal. Occupations with significantly elevated PMRs included plumbers/pipefitters and mechanical engineers. Industries with significantly elevated PMRs included ship and boat building and repairing, and industrial and miscellaneous chemicals. These surveillance findings, can be useful in generating hypotheses and developin strategies to prevent mesothelioma.

Malignant Mesothelioma Surveillance: A Comparison of ICD 10 Mortality Data with SEER Incidence Data in Nine Areas of the United States

Abstract With the implementation in 1999 of ICD-10 death certificate coding in the United States, mortality data specific to malignant mesothelioma became readily available on a national basis. To evaluate the accuracy and completeness of diagnosis and coding for mesothelioma on the death certificate, mortality information was compared with incidence data. A mortality /incidence ratio was calculated for each of the nine areas covered by the SEER Program, using National Vital Statistics mortality data from 1999 and 2000, and the SEER incidence data for 1998 and 1999. The mortality /incidence ratio for the two years combined for all areas was 0.82. Only two areas (Connecticut and Atlanta) had ratios <80%. The overall correlation coefficient between mortality and incidence rates was 0.96. Thus, mortality data coded using ICD-10 can be a valid source for mesothelioma surveillance and can be instituted without major cost if a national mortality statistics program based on ICD-10 is in place, making it feasible even for developing countries.

A Survey of Private Sector Respirator Use in the United States: An Overview of Findings

Limitations of previous surveys of respirator use led the National Institute for Occupational Safety and Health (NIOSH) and the Bureau of Labor Statistics to undertake a survey of respirator use and practices among U.S. private sector employers. The survey was mailed to 40,002 private sector establishments in August 2001; the responses were used to develop national estimates. Respirator use was required in 4.5% of establishments and for 3.1% of employees. Of the establishments requiring respirator use, 95% used air-purifying respirators and 17% used air-supplied respirators. Manufacturing; mining (including oil and gas extraction); construction; and agriculture, forestry, and fishing had the highest rates of establishment respirator use. Respirators were used most frequently to protect against dust/mist, paint vapors, and solvents. Large percentages of establishments requiring respirator use had indicators of potentially inadequate respirator programs. Of establishments requiring respirator use, 91% had at least one indicator of a potentially inadequate respiratory protection program, while 54% had at least five indicators. The survey findings suggest that large numbers of employers may not follow NIOSH recommendations and Occupational Safety and Health Administration (OSHA) and Mine Safety and Health Administration (MSHA) requirements for the selection and use of respirators, potentially putting workers at risk. The findings will aid efforts to increase the appropriate use of respirators in the workplace.

Prevalence of Chronic Obstructive Pulmonary Disease in the U.S. Working Population: An Analysis of Data from the 1997–2004 National Health Interview Survey

To estimate the prevalence and the population attributable fraction of chronic obstructive pulmonary disease (COPD) in the U.S. adult workers, we analyzed data obtained from the National Health Interview Surveys for the period 1997–2004. The overall COPD prevalence was 4.0% (95% confidence interval [CI] 3.9–4.1%). The prevalence was higher in females (5.4%, 95% CI 5.3–5.6%) than in males (2.8%, 95% CI 2.7–2.9%); in Whites (4.2%, 95% CI 4.1–4.3%) than in Blacks (3.4%, 95% CI 3.1–3.7%) and other races (2.4%, 95% CI 2.1–2.8%). Compared with insurance, real estate and other finance industry, the top three industries associated with significantly higher prevalence odds ratios (PORs) (adjusted for age, sex, race, and smoking) were other educational services (POR = 1.5, 95% CI 1.0–2.3); transportation equipment (POR = 1.4, 95% CI 1.1–1.8); and social services, religious and membership organizations (POR = 1.4, 95% CI 1.1–1.7). Compared with managers and administrators, except public administration occupation, the top three occupations with significantly higher PORs were health service (1.8, 95% CI 1.5–2.1), other protective service (POR = 1.6, 95% CI 1.2–2.2), and material moving equipment operators (POR = 1.6, 95% CI 1.1–2.3). The overall population attributable fraction for association of COPD with employment was 12.2% for industry and 17.4% for occupation. Further studies are needed to determine specific risk factors associated with COPD in industries and occupations with elevated prevalence and POR.

Silicosis Mortality Surveillance in the United States, 1968–1990

Abstract The temporal, demographic, geographic, and occupational patterns of silicosis mortality in the United States were examined based on the national multiple-cause-of-death data available since 1968 from the National Center for Health Statistics. Since silicosis is an occupational lung disease, decedents less than 15 years old were excluded. The total number of deaths with silicosis was 13,744 for the period 1968 to 1990, and silicosis was the underlying cause of death in approximately 46 percent of these deaths. Approximately 98 percent of deaths with silicosis occurred in males. The racial distribution of decedents with silicosis was 88.4 percent white, 11.3 percent black, and 0.3 percent other races. An annual maximum of 1157 silicosis deaths occurred in 1968 and a minimum of 301 occurred in 1988. The annual age-adjusted mortality rate per million population declined from a maximum of 5.64 in 1968 to a minimum of 0.96 in 1988 and 1989. In recent years the annual silicosis death counts and rates ha...

Prevalence of lifetime asthma and current asthma attacks in U.S. working adults: an analysis of the 1997-2004 National Health Interview Survey data.

Objective: To estimate national prevalences of lifetime asthma and asthma attacks among workers by age, sex, race, occupation and industry, and estimate population attributable fraction to employment for asthma attacks in the United States. Methods: The 1997–2004 National Health Interview Survey data for currently working adults aged ≥18 years were analyzed. Results: Lifetime asthma prevalence was 9.2%; the social services religious and membership organizations industry and the health service occupation had the highest asthma prevalence. Asthma attack prevalence among workers with asthma was 35.4%; the primary metal industry and the health assessment and treating occupation had the highest attack prevalence. Approximately, 5.9% of cases reporting an asthma attack were attributed to employment when considering industries and 3.8% when considering occupations. Conclusions: Future studies and intervention strategies should address the higher prevalence of asthma in certain industries and occupations.

Chronic Obstructive Pulmonary Disease Prevalence Among Nonsmokers by Occupation in the United States

Objective:To examine the prevalence of chronic obstructive pulmonary disease (COPD) among nonsmokers by occupation in the United States. Methods:The 1997 to 2004 National Health Interview Survey data for working adults aged 25 years or more were used to estimate the COPD prevalence and to examine change in COPD prevalence between 1997 to 2000 and 2001 to 2004 by occupational groups. Results:During 1997 to 2004, COPD prevalence was 2.8%. The COPD prevalence was highest in financial records processing (4.6%) occupations. There was a slight increase in COPD prevalence during the two survey periods from 2.8% during 1997 to 2000 compared with 2.9% during 2001 to 2004. Conclusions:No significant changes in the COPD prevalence between the two periods were found. Nevertheless, the elevated COPD prevalence in certain occupational groups suggests that other risk factors play a role in developing COPD.