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Medical Screening Programs (medical + screening_program)
Selected AbstractsWTC medical monitoring and treatment program: Comprehensive health care response in aftermath of disasterMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 2 2008Jacqueline M. Moline MD Abstract The attack on the World Trade Center (WTC) on September 11th, 2001 exposed thousands of individuals to an unprecedented mix of chemicals, combustion products and micronized building materials. Clinicians at the Mount Sinai Irving Selikoff Center for Occupational and Environmental Medicine, in partnership with affected stakeholder organizations, developed a medical screening program to evaluate the health status of workers and volunteers who spent time at the WTC site and thus sustained exposure in the aftermath of September 11th. Standardized questionnaires were adapted for use in this unique population and all clinicians underwent training to ensure comparability. The WTC Worker and Volunteer Medical Screening Program (MSP) received federal funding in April 2002 and examinations began in July 2002. The MSP and the follow up medical monitoring program has successfully recruited nearly 22,000 responders, and serves as a model for the rapid development of a medical screening program to assess the health of populations exposed to environmental hazards as a result of natural and man-made disasters. The MSP constitutes a successful screening program for WTC responders. We discuss the challenges that confronted the program; the absence of a prior model for the rapid development of a program to evaluate results from mixed chemical exposures; little documentation of the size of the exposed population or of who might have been exposed; and uncertainty about both the nature and potential severity of immediate and long-term health effects. Mt Sinai J Med 75:67,75, 2008© 2008 Mount Sinai School of Medicine [source] Mortality among sheet metal workers participating in a medical screening programAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 8 2009John Dement PhD Abstract Background The Sheet Metal Occupational Health Institute Trust (SMOHIT) was formed in 1985 to examine the health hazards of the sheet metal industry in the U.S. and Canada through an asbestos disease screening program. A study of mortality patterns among screening program participants was undertaken. Methods A cohort of 17,345 individuals with 20 or more years in the trade and who participated in the asbestos disease screening program were followed for vital status and causes of death between 1986 and 2004. Data from the screening program included chest X-ray results by International Labour Office (ILO) criteria and smoking history. Standardized mortality ratios (SMRs) by cause were generated using U.S. death rates and Cox proportional hazards models were used to investigate lung cancer risk relative to chest X-ray changes while controlling for smoking. Results A significantly reduced SMR of 0.83 (95% CI,=,0.80,0.85) was observed for all causes combined. Statistically significant excess mortality was observed for pleural cancers, mesothelioma, and asbestosis in the SMR analyses. Both lung cancer and COPD SMRs increased consistently and strongly with increasing ILO profusion score. In Cox models, which controlled for smoking, increased lung cancer risk was observed among workers with ILO scores of 0/1 (RR,=,1.17, 95% CI,=,0.89,1.54), with a strong trend for increasing lung cancer risk with increasing ILO profusion score >0/0. Conclusions Sheet metal workers are at increased risk for asbestos-related diseases. This study contributes to the literature demonstrating asbestos-related diseases among workers with largely indirect exposures and supports an increased lung cancer risk among workers with low ILO profusion scores. Am. J. Ind. Med. 52:603,613, 2009. © 2009 Wiley-Liss, Inc. [source] Airways obstruction among older construction and trade workers at Department of Energy nuclear sitesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2010John M. Dement PhD Abstract Background A study of chronic obstructive pulmonary disease (COPD) among 7,579 current and former workers participating in medical screening programs at Department of Energy (DOE) nuclear weapons facilities through September 2008 was undertaken. Methods Participants provided a detailed work and exposure history and underwent a respiratory examination that included a respiratory history, respiratory symptoms, a posterior,anterior (P,A) chest radiograph classified by International Labour Office (ILO) criteria, and spirometry. Statistical models were developed to generate group-level exposure estimates that were used in multivariate logistic regression analyses to explore the risk of COPD in relation to exposures to asbestos, silica, cement dust, welding, paints, solvents, and dusts/fumes from paint removal. Risk for COPD in the study population was compared to risk for COPD in the general US population as determined in National Health and Nutrition Examination Survey (NHANES III). Results The age-standardized prevalence ratio of COPD among DOE workers compared to all NHANES III data was 1.3. Internal analyses found the odds ratio of COPD to range from 1.6 to 3.1 by trade after adjustment for age, race, sex, smoking, and duration of DOE employment. Statistically significant associations were observed for COPD and exposures to asbestos, silica, welding, cement dusts, and some tasks associated with exposures to paints, solvents, and removal of paints. Conclusions Our study of construction workers employed at DOE sites demonstrated increased COPD risk due to occupational exposures and was able to identify specific exposures increasing risk. This study provides additional support for prevention of both smoking and occupational exposures to reduce the burden of COPD among construction workers. Am. J. Ind. Med. 53:224,240, 2010. © 2009 Wiley-Liss, Inc. [source] Mortality of older construction and craft workers employed at department of energy (DOE) nuclear sitesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2009John M. Dement PhD Abstract Background The U.S. Department of Energy (DOE) established medical screening programs at the Hanford Nuclear Reservation, Oak Ridge Reservation, the Savannah River Site, and the Amchitka site starting in 1996. Workers participating in these programs have been followed to determine their vital status and mortality experience through December 31, 2004. Methods A cohort of 8,976 former construction workers from Hanford, Savannah River, Oak Ridge, and Amchitka was followed using the National Death Index through December 31, 2004, to ascertain vital status and causes of death. Cause-specific standardized mortality ratios (SMRs) were calculated based on US death rates. Results Six hundred and seventy-four deaths occurred in this cohort and overall mortality was slightly less than expected (SMR,=,0.93, 95% CI,=,0.86,1.01), indicating a "healthy worker effect." However, significantly excess mortality was observed for all cancers (SMR,=,1.28, 95% CI,=,1.13,1.45), lung cancer (SMR,=,1.54, 95% CI,=,1.24,1.87), mesothelioma (SMR,=,5.93, 95% CI,=,2.56,11.68), and asbestosis (SMR,=,33.89, 95% CI,=,18.03,57.95). Non-Hodgkin's lymphoma was in excess at Oak Ridge and multiple myeloma was in excess at Hanford. Chronic obstructive pulmonary disease (COPD) was significantly elevated among workers at the Savannah River Site (SMR,=,1.92, 95% CI,=,1.02,3.29). Conclusions DOE construction workers at these four sites were found to have significantly excess risk for combined cancer sites included in the Department of Labor' Energy Employees Occupational Illness Compensation Program (EEOCIPA). Asbestos-related cancers were significantly elevated. Am. J. Ind. Med. 52:671,682, 2009. © 2009 Wiley-Liss, Inc. [source] Asbestos-related disease among sheet metal workers 1986,2004: Radiographic changes over time,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2009FACOEM, Laura S. Welch MD Abstract Background In 1985, the Sheet Metal Workers International Association and the Sheet Metal and Air Conditioning National Association formed The Sheet Metal Occupational Health Institute Trust (SMOHIT) to examine the health hazards of the sheet metal industry. Between 1986 and 2004 18,211 individuals were examined. At the time of the first examination 9.6% of all participants (1,745) had findings consistent with parenchymal disease (ILO,>,1/0), and 21% (3,827) had pleural scarring. Methods 2181-Two thousand hundred eighty-one who had no radiographic evidence of pneumoconiosis on baseline examination underwent a second examination. Results By the second examination, 5.3% had developed parenchymal disease on chest radiograph; an additional 12.4% had developed pleural scarring without parenchymal disease. Factors that predicted new cases of pneumoconiosis on radiograph were the calendar year the worker entered the sheet metal trade, smoking, and shipyard work. Forty-seven percent of those smoking at the time of initial exam reported having quit smoking by the second examination. Conclusions Asbestosis is still occurring 50 years after first exposure. Exposed workers benefit from medical screening programs that incorporate smoking cessation. Am. J. Ind. Med. 52:519,525, 2009. © 2009 Wiley-Liss, Inc. [source] | ||||||||||