Mary M. Prince

Polychlorinated Biphenyls and Neurodegenerative Disease Mortality in an Occupational Cohort

Background: Production of polychlorinated biphenyls (PCBs) ended in the United States in the 1970s, but PCBs persist in the environment and are detectable in the blood of approximately 80% of Americans over age 50. PCBs decrease dopamine levels in rats and monkeys. Loss of dopamine is the hallmark of Parkinson disease, a neurodegenerative disease. There are no epidemiologic studies of PCBs and neurodegenerative disease. Methods: We conducted a retrospective mortality study of 17,321 PCB-exposed workers to determine whether mortality from Parkinson disease, dementia, and amyotrophic lateral sclerosis was elevated compared with the U.S. population. All workers had a least 90 days employment in 1 of 3 electrical capacitor plants using PCBs from the 1940s to the 1970s. PCB serum levels from a sample of these workers in the 1970s were approximately 10 times the level of community controls. Results: We found no overall excess of Parkinson disease, amyotrophic lateral sclerosis, or dementia in the PCB-exposed cohort (standardized mortality ratios [SMRs]-1.40, 1.11, and 1.26, respectively, and number of deaths-14, 10, and 28 respectively). However, sex-specific analyses revealed that women had an excess of amyotrophic lateral sclerosis (SMR-2.26; 95% confidence interval [CI] = 1.08–4.15; 10 deaths). Furthermore, among highly exposed women (defined by a job-exposure matrix), we found an excess of Parkinson disease (SMR-2.95; 95% CI = 1.08–6.42; 6 deaths) and dementia (SMR-2.04; 95% CI = 1.12–3.43; 14 deaths). Conclusions: Our data are limited due to small numbers and reliance on mortality rather than incidence data, but are suggestive of an effect of PCBs on neurodegenerative disease for women. The literature does not offer an explanation for why women would be more affected than men by PCB exposure for these outcomes.

Mortality and Exposure Response among 14,458 Electrical Capacitor Manufacturing Workers Exposed to Polychlorinated Biphenyls (PCBs)

Background We expanded an existing cohort of workers (n = 2,588) considered highly exposed to polychlorinated biphenyls (PCBs) at two capacitor manufacturing plants to include all workers with at least 90 days of potential PCB exposure during 1939–1977 (n = 14,458). Causes of death of a priori interest included liver and rectal cancers, previously reported for the original cohort, and non-Hodgkin lymphoma (NHL), melanoma, and breast, brain, intestine, stomach, and prostate cancers, based on other studies. Methods We ascertained vital status of the workers through 1998, and cumulative PCB exposure was estimated using a new job exposure matrix. Analyses employed standardized mortality ratios (SMRs; U.S., state, and county referents) and Poisson regression modeling. Results Mortality from NHL, melanoma, and rectal, breast, and brain cancers were neither in excess nor associated with cumulative exposure. Mortality was not elevated for liver cancer [21 deaths; SMR 0.89; 95% confidence interval (CI), 0.55–1.36], but increased with cumulative exposure (trend p-value = 0.071). Among men, stomach cancer mortality was elevated (24 deaths; SMR 1.53; 95% CI, 0.98–2.28) and increased with cumulative exposure (trend p-value = 0.039). Among women, intestinal cancer mortality was elevated (67 deaths; SMR 1.31; 95% CI, 1.02–1.66), especially in higher cumulative exposure categories, but without a clear trend. Prostate cancer mortality, which was not elevated (34 deaths; SMR 1.04; 95% CI, 0.72–1.45), increased with cumulative exposure (trend p-value = 0.0001). Conclusions This study corroborates previous studies showing increased liver cancer mortality, but we cannot clearly associate rectal, stomach, and intestinal cancers with PCB exposure. This is the first PCB cohort showing a strong exposure–response relationship for prostate cancer mortality.

Occupational Exposure to Polychlorinated Biphenyls and Risk of Breast Cancer

Background Despite the endocrine system activity exhibited by polychlorinated biphenyls (PCBs), recent studies have shown little association between PCB exposure and breast cancer mortality. Objectives To further evaluate the relation between PCB exposure and breast cancer risk, we studied incidence, a more sensitive end point than mortality, in an occupational cohort. Methods We followed 5,752 women employed for at least 1 year in one of three capacitor manufacturing facilities, identifying cases from questionnaires, cancer registries, and death certificates through 1998. We collected lifestyle and reproductive information via questionnaire from participants or next of kin and used semiquantitative job-exposure matrices for inhalation and dermal exposures combined. We generated standardized incidence ratios (SIRs) and standardized rate ratios and used Cox proportional hazards regression models to evaluate potential confounders and effect modifiers. Results Overall, the breast cancer SIR was 0.81 (95% confidence interval, 0.72–0.92; n = 257), and regression modeling showed little effect of employment duration or cumulative exposure. However, for the 362 women of questionnaire-identified races other than white, we observed positive, statistically significant associations with employment duration and cumulative exposure; only smoking, birth cohort, and self- or proxy questionnaire completion had statistically significant explanatory power when added to models with exposure metrics. Conclusions We found no overall elevation in breast cancer risk after occupational exposure to PCBs. However, the exposure-related risk elevations seen among nonwhite workers, although of limited interpretability given the small number of cases, warrant further investigation, because the usual reproductive risk factors accounted for little of the increased risk.

Agreement between Task-Based Estimates of the Full-Shift Noise Exposure and the Full-Shift Noise Dosimetry

Noise assessments have been conducted using full-shift dosimetry and short-term task-based measurements. Advantages of the task-based method include the opportunity to directly identify high-noise exposure tasks and to target control measures, as well as obtain estimates of task-based full-shift exposures; however, there is little empirical evidence comparing the two methods. National Institute for Occupational Safety and Health assessed noise exposures at three industrial facilities using dosimetry and task-based methods with the objective of comparing the two strategies and assessing the degree of agreement and causes of disagreement. Eight indices of task-based full-shift exposures were created from task-based sampling using three methods to assess time-at-task (direct observation by industrial hygienist, end-of-shift worker estimates and supervisor estimates) and three methods to assign noise levels to tasks [direct measurement, arithmetic mean (AM) and geometric mean (GM)]. We assessed aspects of agreement (precision, bias and absolute agreement) using Bland-Altman plots and concordance correlation coefficient (CCC). Overall, the task-based methods worked fairly well, with mean biases less than +/-2.8 dBA and precision ranges of 3.3-4.4 dBA. By all measures, task-based full-shift estimates based on supervisor assessment of time-at-task agreed most poorly with the dosimetry data. The task-based full-shift estimates based on worker estimates of time-at-task generally agreed as well as those based on direct observation. For task noise level, task-based full-shift estimates based on directly measured task agreed the best with dosimetry data, while agreement for task-based indices based on task AM or GM was variable. Overall, the task-based full-shift estimates based on direct observation task and direct measured task noise level achieved the best agreement with the dosimetry data (CCC 0.84) with 95% of their differences being within 7.4 dBA and 56% of the differences <3 dBA. For this index, a high degree of accuracy was observed (accuracy coefficient = 0.96) with major cause of disagreement arising from a lack of precision (precision coefficient = 0.88). When the measurements were classified by job characteristics, significant improvements in the degree of agreement were observed in the low job mobility, low job complexity and low job variability categories. Our data suggest that a high degree of absolute agreement can be achieved between the task-based and dosimetry-based estimates of full-shift exposures. The task-based approach that uses worker reports combined with task AM or GM levels is similar to the more time-intensive direct observation method to estimate full-shift exposures.

Development of a Retrospective Job Exposure Matrix for PCB-exposed Workers in Capacitor Manufacturing

Development of a Retrospective Job Exposure Matrix for PCB‐exposed Workers in Capacitor Manufacturing: Nancy B. Hopf, et al. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluation and Field Studies, Industry‐wide Studies Branch, USA

Response to “Comments on ‘A re-examination of risk estimates from the NIOSH Occupational Noise and Hearing Survey’ ” [J. Acoust. Soc. Am. 103, 2734 (1998)]

Concern is raised by Dobie [J. Acoust. Soc. Am. 103, 2734 (1998)] regarding a recent analysis [, J. Acoust. Soc. Am. 101, 950–963 (1997)] of the NIOSH Occupational Noise and Hearing Survey data. Specifically, issues are raised concerning (1) definition of hearing handicap, (2) the use of frequency-specific articulation index (AI) weights applied to the binaural pure-tone average of 1, 2, 3, and 4 kHz, and (3) conclusions regarding significant excess risk based on this definition. We have reviewed the development of the definitions of hearing handicap and provide additional support for the use of a hearing handicap definition based on the binaural pure-tone average of 1, 2, 3, and 4 kHz and the weighting of specific frequencies. Furthermore, our definition of noise-induced hearing handicap is similar to one of several proposed by the International Standards Organization (Reference 1999Reference 1990) and the American National Standards Institute (Reference 3Reference 44Reference 1996). Additional analyses ...

Predicting noise‐induced hearing loss in human populations. The contribution of the ISO‐1999 and ANSI S3.44 standards

This paper reviews the ISO‐1999 and ANSI S3.44 standards and the literature related to prediction of noise‐induced hearing loss (NIHL) in humans. The dearth of contemporary population‐based studies of hearing loss among industrial, low noise‐exposed individuals have made the ISO‐1999 and ANSI S3.44 standards a key source of comparative data for assessing the risk of NIHL. This paper will highlight how these standards have been used in several published papers to examine the magnitude of NIHL risk, predictions of noise‐induced thresholds in hearing conservation data, and to generate hypotheses regarding the biologic plausibility of hearing loss due to chemicals or other ototoxic agents.

Analysis of impact/impulse noise for predicting noise induced hearing loss

Studies indicate that the statistical properties and temporal structure of the sound signal are important in determining the extent of hearing hazard. As part of a pilot study to examine hearing conservation program effectiveness, NIOSH collected noise samples of impact noise sources in an automobile stamping plant, focusing on jobs with peak sound levels (Lpk) of greater than 120 dB. Digital tape recordings of sounds were collected using a Type I Precision Sound Level Meter and microphone connected to a DAT tape recorder. The events were archived and processed as .wav files to extract single events of interest on CD‐R media and CD audio media. A preliminary analysis of sample wavelet files was conducted to characterize each event using metrics such as the number of impulses per unit time, the repetition rate or temporal pattern of these impulses, index of peakedness, crest factor, kurtosis, coefficient of kurtosis, rise time, fall time, and peak time. The spectrum, duration, and inverse of duration for e...

Noise sampling issues for impact/impulse noise surveys

Noise‐induced hearing loss (NIHL) has been recognized as a serious health concern for decades. ISO Standard 1999:1990 provides a means to predict noise‐induced hearing loss (NIHL) based on LAeq measurements in the working environments of workers. This standard seems to work well for predicting hearing loss in continuous noise fields. However, it is possible that ISO 1999 does not apply well to impact, impulsive, or other transient noise fields. NIOSH and University of Pittsburgh are currently developing noise‐sampling strategies to measure impact and impulse noise in a manufacturing environment with the aim of developing new impulsive noise metrics. As part of the study, broadband impact/impulse pressure measurements will be made. Issues such as instrumentation, data quality, repeatability, spatial sampling, equipment portability, and calibration are addressed. Also, the annotation, digitization, and editing of the waveforms will be discussed. As part of the project, an archival database of manufacturing ...

Use of structured, interactive interviews in retrospective noise exposure assessment in an occupational epidemiologic study

As part of a NIOSH study examining factors affecting hearing conservation program (HCP) effectiveness, a job‐noise exposure matrix was constructed using these data sources: (1) task‐based sound level survey data; (2) noise exposure data (dosimetry and sound level surveys) provided from plant historical reports; (3) information on process changes and engineering controls; (4) interviews with plant personnel (in engineering and safety departments); and (5) detailed work history data from personnel records for each employee in the plant HCP. For plants in which changes in exposures have occurred due to engineering control and process changes, exposure estimation becomes a challenge when there are data gaps in exposure and process changes. This paper discusses how data from structured employee interviews can be used in conjunction with available quantitative, records‐based data to reconstruct processes and machinery/layout history. The goal was to characterize how noise exposure determinants (manufacturing en...