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Journal Abstracts
| TITLE: |
A Follow-up Study of Job Strain and
Heart Disease Among Males in the NHANES1 Population
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| AUTHORS: |
Steenland K, Johnson J, Nowlin S
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| SOURCE: |
Am J Ind Med 1997 Feb;31(2):256-260
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| ABSTRACT: |
The relationship between job strain and
heart disease was evaluated via the National Health and Nutrition
Survey 1 (NHANES1) completed by a sample of US workers from 1971 to
1975. Because of the lack of job strain scores for women, the study
was restricted to 3,575 men with no history of heart disease. Analyses
were conducted using Cox regression by means of SAS PHREG. Two principal
scores were analyzed: job control (decision authority and latitude)
and job demand. Job control and job demand were strongly and positively
correlated, and both were positively correlated with education and
income, and negatively correlated with systolic blood pressure. Job
demand was negatively correlated with age, but job control showed
no correlation. Job demand remained highly correlated with job control
after adjusting for education, age, and race for white and blue collar
workers. Blue collar workers in high control and high demand jobs
had a significantly decreased risk of heart disease compared with
other blue collar workers. The same trend for white collar workers
did not appear. The authors conclude that there is no evidence from
this study of an increased risk of heart disease for those with high
strain jobs, however, those with the highest job control may have
a significantly decreased risk of heart disease. The authors suggest
that the variable of job demand should be measured in future studies.
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| TITLE: |
Cardiovascular Mortality among Munitions
Workers Exposed to Nitroglycerin and Dinitrotoluene
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| AUTHORS: |
Stayner LT, Dannenberg AL, Thun M,
Reeve G, Bloom TF, Boeniger M, Halperin W
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| SOURCE: |
Scand J Work, Environ & Health 1992
Feb;18(1):34-43
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| ABSTRACT: |
A study of cardiovascular mortality among
munitions workers exposed to nitroglycerin and dinitrotoluene (DNT)
was conducted. The cohort consisted of 15654 current or former white
male employees at a United States Army munitions factory in Radford,
Virginia. A total of 5529 were potentially exposed to nitroglycerin
and 4989 to DNT; 5136 were exposed to neither. The vital status of
the subjects was determined on December 31, 1982. Death certificates
were reviewed, and standardized mortality ratios (SMRs) and rate ratios
(SRRs) were computed using the general United States population as
the reference. Data were also analyzed by Poisson regression techniques.
Mortality from all causes was close to that expected for the nitroglycerin
and DNT exposed and unexposed subjects; SMRs were 1.03, 1.00, and
0.99, respectively. Mortality from cerebrovascular disease was less
than expected in nitroglycerin and DNT exposed subjects; SMRs were
0.90 and 0.95, respectively. Death due to ischemic heart disease (IHD)
was close to that expected in DNT exposed subjects, but slightly increased
in subjects exposed to nitroglycerin (SMRs 0.98 and 1.07). When expressed
as SRRs, IHD mortality was significantly increased in nitroglycerin
subjects under the age of 35 (SRR 5.46). Cerebrovascular mortality
was elevated in subjects 55 to 59 years old exposed to DNT (SRR 4.46).
Poisson regression analysis showed a significant interaction between
age and nitroglycerin exposure for IHD mortality. The strongest effect
was observed in workers actively exposed to nitroglycerin before the
age of 45 (SRR 3.30).
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| TITLE: |
Exposure of Motor Vehicle Examiners
to Carbon Monoxide: A Historical Prospective Mortality Study
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| AUTHORS: |
Stern FB, Lemen RA, Curtis RA
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| SOURCE: |
Arch Environ Health 1981;36(2):59-66
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| ABSTRACT: |
The effect of exhaust emissions, including
carbon-monoxide (CO), on motor vehicle examiners was investigated.
Mortality rates among 1,558 examiners employed for at least 6 months
between 1944 and 1973 were determined from local records. CO readings
were taken at 31 of 38 inspection stations and 27 examiners were administered
carboxyhemoglobin (COHb) tests. The mean CO concentrations for indoor
and outdoor inspection stations were 24.4 and 10.0 parts per million,
respectively. The mean pre and post shift COHb concentrations were
3.3 and 4.7 percent, respectively. There were 237 deaths from all
causes during the period of study, as opposed to an expected 260.4
deaths. Among the examiners, there were 124 deaths from cardiovascular
diseases compared to 118.4 expected, and 52 deaths from malignant
neoplasms compared to 47.8 expected. There were fewer deaths than
expected from diseases of the nervous system, nonmalignant diseases
of the respiratory and digestive systems, and accidents. The authors
suggest that the excess of deaths due to cardiovascular diseases is
due to CO exposure. The excess cancer death rate may be due to contaminants
other than CO.
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| TITLE: |
Heart Disease Mortality among Bridge
and Tunnel Officers Exposed to Carbon Monoxide
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| AUTHORS: |
Stern FB, Halperin WE, Hornung RW,
Ringenburg VL, McCammon CS
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| SOURCE: |
Am J Epidemiol 1988 Dec;128(6):1276-1288
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| ABSTRACT: |
Heart disease mortality among bridge and
tunnel officers occupationally exposed to carbon-monoxide was examined
in a retrospective study of 5,529 subjects employed between 1952 and
1981 at any one of nine New York City water crossings. Among former
tunnel officers, there were 61 deaths from arteriosclerotic heart
disease, a 35 percent excess risk compared with the New York City
population. Examination of the risk of mortality from arteriosclerotic
heart disease among tunnel officers in comparison to the less exposed
bridge officers using a proportional hazards model indicated no observable
association of arteriosclerotic heart disease with length of exposure;
there was, however, significant interaction of exposure with age.
The elevated risk of arteriosclerotic heart disease among tunnel officers
declined after cessation of exposure, with much of the increased risk
dissipating within as a little as 5 years. The authors conclude that
exposure to carbon-monoxide may be a major factor in arteriosclerotic
heart disease mortality; the parallel findings of this study and studies
showing the relation of cigarette smoking to cardiovascular mortality
suggest that carbon-monoxide may play an important role in the pathophysiology
of cardiovascular mortality associated with cigarette smoking.
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| TITLE: |
Occupational Heart Disease
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| AUTHOR: |
Fine LJ
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| SOURCE: |
Environmental and Occupational Medicine,
Second Edition 1992:593-600
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| ABSTRACT: |
Chemical and nonchemical causes of occupational
heart disease were reviewed. Several chemical agents were considered
to have a direct effect on the myocardium. Evidence for a direct causal
relationship between carbon-disulfide and coronary artery disease
(CAD) was strongest. Epidemiologic studies of cardiovascular disease
in exposed workers from Pennsylvania, Finland, and Belgium were quoted.
Researchers in Japan found no increased CAD in exposed workers, but
a striking increase in retinal microaneurysms. The association between
CAD and occupational exposure to nitroglycerin, ethylene-glycol-dinitrate
and other aliphatic nitrates, carbon-monoxide , nonhalogenated and
halogenated industrial solvents, arsenic, and cobalt, as well as blood
pressure problems caused by cadmium and lead were discussed. Passive
smoking was described as an important public health factor in deaths
from CAD. Nonchemical factors in occupational CAD were shift work,
noise, and stressors due to organization, work or psychosocial factors.
Cardiac disease secondary to occupational lung disease was a result
of pulmonary hypertension. The prevalence of CAD was reduced in occupations
with very high levels of energy expenditure.
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| TITLE: |
Shift Work, Long Hours, and Cardiovascular
Disease: A Review
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| AUTHOR: |
Steenland K
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| SOURCE: |
Occup Med 2000 Jan-Mar;15(1):7-17
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| ABSTRACT: |
Data from industrialized countries suggests
that irregular patterns of work, such as shift work and extensive
overtime work, have become increasingly common. In conjunction with
this trend, there are more epidemiologic studies of the health effects
of such irregular patterns of work, a number of which focus on heart
disease. The following is a review of the literature, with comments
on possible mechanisms linking irregular hours and heart disease as
well as on the methodologic difficulties of studying this topic. Shift
work and heart disease are the primary focus, because most of the
epidemiologic efforts have been directed at his area, but the epidemiology
of overtime work and heart disease also is reviewed.
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| TITLE: |
Shift Work, Shift Change, and Risk
of Death From Heart Disease at Work
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| AUTHORS: |
Steenland K, Fine L
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| SOURCE: |
Am J Ind Med 1996 Mar;29(3):278-281
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| ABSTRACT: |
The effect of current shift and recent
shift change, on risk of contracting ischemic heart disease, was studied
among workers at heavy equipment factories. A nested case/control
study was conducted in a cohort of 21,000 men at four heavy equipment
factories. The study compared 163 men who died of ischemic heart disease
at work or within a week of having worked to control workers. The
cases had no prior history of heart disease. Each case was matched
with five controls, based on age, factory and race. Shifts worked
by cases and controls were determined from personnel records. Data
were analyzed by conditional logistic regression with retained matching.
Mean time worked on the current shift, at the time of case death,
was 9 years, with 72% of study subjects working on the first shift,
22% on second shift and 6% on third shift. Differences in heart disease
associated with current shifts were not detected. Recent change from
second or third, to first shift lowered the risk of heart disease
initially, but the effect decreased with time. There was no corresponding
negative effect associated with changing from first to second or third
shifts. The authors conclude that there was little evidence for effects
on risk of death from heart disease, due to current shift. Their data
suggest a temporary lowering of risk after change from second or third
to first shift.
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