Susan Buchanan

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.

Environmental exposures: how to counsel preconception and prenatal patients in the clinical setting

A growing body of scientific evidence suggests that preconception and prenatal exposures can impact fetal development adversely and lead to potential long-lasting health effects. Reproductive health professionals have little training on these exposures and how to counsel patients effectively. We present short summaries of some of the most common environmental exposures and give providers practical tools with which to counsel patients in the clinical setting. These tools may enable practitioners to help prevent harmful environmental exposures and to reduce the risk of future adverse health impacts for the prenatal and preconception patient population.

Pilot study investigating the effect of the static magnetic field from a 9.4-T MRI on the vestibular system

Objective: To objectively evaluate workers’ sensory symptoms and vestibular function after exposure to a strong, new generation 9.4-T Magnetic Resonance Imaging (MRI) scanner. Method: Six MRI employees underwent standardized electronystagmographic evaluation, postural testing, and caloric function at baseline evaluation, 30 minutes postexposure to 9.4 T static field and at a 3-month follow-up. Results: All participants noted sensory symptoms after exposure. No overall deterioration in vestibular function was noted following 30-minute exposure or at a 3-month follow-up. A higher occurrence of tonic vestibular asymmetry, hyperreactive caloric responses, and spontaneous nystagmus was noted compared with that of the normal population. Conclusion: Workers exposed to the new, stronger MRIs experience sensory symptoms but it is unclear as yet whether long-term vestibular damage occurs. The higher rates of vestibular changes noted could argue for improved worker surveillance and exposure control.

A combined ecological and epidemiologic investigation of metal exposures amongst Indigenous peoples near the Marlin Mine in Western Guatemala

In August 2009 a combined epidemiological and ecological pilot study was conducted to investigate allegations of human rights abuses in the form of exposures to toxic metals experienced by mine workers and Indigenous Mam Mayan near the Marlin Mine in Guatemala. In the human study there were no differences in blood and urine metals when comparing five mine workers with eighteen non-mine workers, and there were no discernible relationships between metal exposures and self-reported health measures in any study group. On the other hand, individuals residing closest to the mine had significantly higher levels of certain metals (urinary mercury, copper, arsenic, and zinc) when compared to those living further away. The levels of blood aluminum, manganese, and cobalt were elevated in comparison to established normal ranges in many individuals; however, there was no apparent relationship to proximity to the mine or occupation, and thus are of unclear significance. In the ecological study, several metals (aluminum, manganese, and cobalt) were found significantly elevated in the river water and sediment sites directly below the mine when compared to sites elsewhere. When the human and ecological results are combined, they suggest that exposures to certain metals may be elevated in sites near the mine but it is not clear if the current magnitude of these elevations poses a significant threat to health. The authors conclude that more robust studies are needed while parallel efforts to minimize the ecological and human impacts of mining proceed. This is critical particularly as the impact of the exposures found could be greatly magnified by expected increases in mining activity over time, synergistic toxicity between metals, and susceptibility for the young and those with pre-existing disease.

Methyl mercury exposure in populations at risk: Analysis of NHANES 2011-2012.

BACKGROUND Ingestion of fish contaminated with methyl mercury can lead to adverse health outcomes, particularly when exposure occurs in utero. NHANES 2011-2012 includes total blood mercury (TBHg) and methyl mercury (MeHg) measurements as well as a unique race/ethnicity category for Asians, allowing for improved analysis of determinants of risk. OBJECTIVE Our objective was to characterize the current burden of MeHg exposure in the US among subgroups who are at risk of health effects due to their physiologic vulnerability to MeHgs effects and/or due to frequent fish consumption, specifically women of childbearing age (WCBA) and adults ≥50 years of age. METHODS We calculated 90th and 95th percentile estimates as well as geometric means of MeHg for predictive variables. We used multivariable linear regression analyses to estimate the proportional change in mean MeHg associated with each category of all predictive variables. We calculated the validity of screening procedures using fish consumption questions and TBHg testing to predict elevated MeHg. RESULTS The geometric mean MeHg levels were highest among Asian WCBA (1.17 µg/L) and Asians ≥50 years old (2.49 µg/L). Over 23% of Asian WCBA had levels ≥3.5 µg/L and 25% of Asians ≥50 years old had levels ≥5.8 µg/L. Frequency of fish consumption explained 21-23% of the variation in MeHg. Twenty-five percent of women eating fish ≥ twice per week had MeHg ≥3.5 µg/L. TBHg showed high validity for MeHg ≥5.8 µg/L, and two-step screening using ≥2 fish meals/month followed by TBHg also showed high validity. CONCLUSION Asian WCBA continue to have increased MeHg exposure from fish consumption, putting their offspring at risk. Screening for MeHg among high-risk groups should be considered.

Alternatives to the mercury sphygmomanometer

The mercury sphygmomanometer was introduced over 100 years ago. Mercury, however, is a potent human neurotoxin. An international effort has developed to eliminate health-care sources of mercury – the thermometer and sphygmomanometer – and replace them with less toxic alternatives. There is concern regarding the accuracy of these alternative devices. We conducted a literature review of articles published between 1995 and 2009 evaluating the accuracy of mercury, aneroid, and oscillometric blood pressure devices. Mercury sphygmomanometers fared the best although they do not always perform as expected, failing calibration tests between 1 and 28 per cent of the time. Up to 61 per cent of aneroid sphygmomanometers failed. Recently calibrated aneroid devices performed well. Oscillometric devices were less studied and their performance was variable. All three devices showed variable performance. They should be validated before purchase and calibrated on a regular basis.

Piloting a personal protection equipment distribution program among Chicago day laborers

BACKGROUND Occupational injury rates among day laborers have been estimated to be as high as 31%, where lack of personal protective equipment (PPE) use is repeatedly noted as a contributor to occupational injuries. METHODS We distributed duffel bags containing nine pieces of PPE and provided training on their use to Chicago day laborers during six distribution sessions over two summers. Participants were contacted 4-8 weeks post-distribution and queried on PPE use. RESULTS Of 117 participants who received the equipment, 42 completed the follow-up survey. Workers performed construction, demolition, and painting type tasks and most often used gloves, safety glasses, and respirators. Hardhats, coveralls, and earplugs were the least used. CONCLUSIONS The PPE we provided was used during 94% of the jobs, and every one of the nine items was used. Hearing protection was underused. This project showed that providing PPE, along with training on its use, may increase PPE use among Chicago day laborers, likely preventing occupational injuries.

Association of methylmercury intake from seafood consumption and blood mercury level among the Asian and Non-Asian populations in the United States

Background MeHg is a well‐established neurotoxicant for fetal brain growth and development and has been shown to increase the risk of cardiovascular disease in aging populations. In the U.S., Asian populations are of particular concern because of their seafood consumption behaviors. Objectives Our objective was to calculate the average daily MeHg intake (ADMI) from seafood and to assess the relationship between ADMI with blood methylmercury (BMeHg) concentrations, specifically among women of reproductive age (WORA) and adults ≥ 50 years of age. Methods We estimated ADMI from seafood using the 30‐day fish consumption data from the NHANES 2011–2014 datasets. Using multivariable linear regression, we estimated the proportional change in mean BMeHg associated with a doubling of the ADMI. Further, correlations between ADMI and BMeHg were compared between Asians and other racial/ethnic groups. Results Our analysis found both Asian WORA and Asian adults age ≥ 50 years old had significantly higher BMeHg levels and ADMI than their Non‐Asian counterparts. Correlations between ADMI from seafood and blood Hg levels were stronger among Asian WORA than among Non‐Asian WORA. Key fish species that influenced the dietary MeHg intake for Asians were mackerel, tuna, and “other known/unknown fish species”. Conclusion We confirmed that Asian populations have higher MeHg intake than the Non‐Asian population in the U.S. and seafood intake is a key predictor of blood Hg concentration, especially among Asian women of reproductive age. Future studies should incorporate information on other known and unknown fish species that are frequently consumed by Asian populations and different parts and fish organs eaten to better understand determinants of MeHg exposure. HighlightsMeHg intake from seafood using the NHANES 2011–2014 datasets was calculated.Women of reproductive age and adults age ≥ 50 years among Asian and Non‐Asian populations were studied.Correlation between MeHg intake from dietary survey with blood Hg biomarker concentrations were assessed.Key fish species that influenced the dietary MeHg intake among different subgroups were identified.Results provide important information for risk communication of seafood in vulnerable population.

Fish consumption and hair mercury among Asians in Chicago

Objectives: The aim of the study was to characterize the risk for elevated mercury (Hg) from fish consumption among Asians in Chicago. Consumption of fish contaminated with methyl Hg (MeHg) can affect the neurodevelopment in children and cardiovascular disease risk in adults. Methods: We collected fish consumption information and hair samples for Hg at two health fairs. We purchased fish from Asian fish markets. Results: Geometric mean hair Hg from 71 participants was 0.58 &mgr;g/g, with 28% overall and 29% of women of childbearing age having hair Hg levels at least 1 &mgr;g/g; 20% ate fish 4 or more times/wk. Tuna consumption and non-Chinese Asian ethnicity were associated with elevated Hg. Hg levels in purchased fish were generally low. Conclusions: Our study confirms other findings that, compared with estimates of the general US population, Asians are at higher risk of elevated MeHg because of frequent fish consumption.

Beyond black lung: scientific evidence of health effects from coal use in electricity generation.

While access to electricity affects health positively, combustion of coal in power plants causes well-documented adverse health effects. We review respiratory, cardiovascular, reproductive, and neurologic health outcomes associated with exposure to coal-fired power plant emissions. We also discuss population-level health effects of coal combustion and its role in climate change. Our review of scientific studies suggests that those we present here can be used to inform energy policy.