Occupational, Environmental, and Climate Medicine Program

Electrocardiographic changes predate Parkinson’s disease onset

Oguz Akbilgic
Rishikesan Kamaleswaran
Akram Mohammed
G. Webster Ross
Kamal Masaki
Helen Petrovitch
Caroline M. Tanner
Robert L. Davis
Samuel M. Goldman
2020

Autonomic nervous system involvement precedes the motor features of Parkinson’s disease (PD). Our goal was to develop a proof-of-concept model for identifying subjects at high risk of developing PD by analysis of cardiac electrical activity. We used standard 10-s electrocardiogram (ECG) recordings of 60 subjects from the Honolulu Asia Aging Study including 10 with prevalent PD, 25 with prodromal PD, and 25 controls who never developed PD. Various methods were implemented to extract features from ECGs including simple heart rate variability (HRV) metrics, commonly used signal processing...

Inorganic Dust Exposure During Military Service as a Predictor of Rheumatoid Arthritis and Other Autoimmune Conditions

David Ying
Gabriela Schmajuk
Laura Trupin
Paul D Blanc
2021

Objective
Rheumatoid arthritis (RA) and other autoimmune (AI) conditions are associated with inorganic dust exposure. Many military activities are likely to entail inorganic dust exposures. We wished to identify associations between prior military dust exposure and RA and other AI conditions.

Methods
We studied persons from a roster of Army, Navy, Air Force, or Marine Corps personnel who had served in Operation Enduring Freedom and Operations Iraqi Freedom and New Dawn. We linked military occupational codes to a job exposure matrix assigning dust exposure likelihood. We used...

Fractional exhaled NO in a metalworking occupational cohort

Denis Vinnikov
Zhangir Tulekov
Paul D Blanc
2021

Purpose: Secondary metalworking carries exposure to relatively heavy levels of respirable particulate. We investigated the extent to which metalworking is associated with increased exhaled nitric oxide (FeNO), an established inflammatory biomarker.

Methods: We studied 80 metalworking factory employees in Kazakhstan. Informed by industrial hygiene data, we categorized them into three groups: (1) machine operators (41%); (2) welders or assemblers (33%); and (3) all others, including administrative and ancillary staff (26%). Participants completed...

Exposure to respirable dust among workers fabricating aluminium trihydroxide-containing synthetic countertops

Denis Vinnikov
Paul D Blanc
Aizhan Raushanova
Arailym Beisbekova
Jerrold L. Abraham
Yelena Zlobina
2021

The aim of this study is to characterize personal exposure of workers to respirable particulate matter (PM) generated in cutting and other fabrication activities when fabricating acryl polymer/aluminium trihydroxide synthetic countertops. We collected 29 personal full-day samples of respirable PM from three workers in a small private workshop. We tested differences between- and within-worker variances of mass concentrations using the Kruskall-Wallis test. We used segmented regression to test the means and medians 15-min interval concentrations changes over time and to identify a breakpoint...

Prevention of Occupational Heat-Related Illnesses

Aaron Tustin
Yusef Sayeed
Manijeh Berenji
Kathleen Fagan
Ronda B McCarthy
Judith Green-McKenzie
James McNicholas
Charles Babajide Onigbogi
William Brett Perkison
James W Butler
ACOEM Work Group on Occupational Heat-Related Illness
2021

High ambient temperatures and strenuous physical activity put workers at risk for a variety of heat-related illnesses and injuries. Through primary prevention, secondary prevention, and treatment, OEM health providers can protect workers from the adverse effects of heat. This statement by the American College of Occupational and Environmental Medicine provides guidance for OEM providers who serve workers and employers in industries where heat exposure occurs.

Cumulative occupational exposure to inorganic dust and fumes and invasive pneumococcal disease with pneumonia

Kjell Torén
Paul D Blanc
Rajen Naidoo
Nicola Murgia
Leo Stockfelt
Linus Schiöler
2022

Purpose
Occupational exposure to inorganic dust and fumes in the year preceding disease has been associated with increased pneumococcal pneumonia risk, but the impact of prior cumulative exposure has not been characterized.

Methods
We studied 3184 cases of invasive pneumococcal disease with pneumonia. The case index date was the day the infection was diagnosed. We selected six controls for each case from the Swedish population registry; each control was assigned the index date of their corresponding case. We linked job histories to a job-exposure matrix to calculate a...

Identifying impacts of air pollution on subacute asthma symptoms using digital medication sensors

Jason G Su
Meredith A Barrett
Veronica Combs
Kelly Henderson
David Van Sickle
Chris Hogg
Grace Simrall
Sarah S Moyer
Paul Tarini
Oktawia Wojcik
James Sublett
Ted Smith
Andrew M Renda
John Balmes, MD
Rahul Gondalia
Leanne Kaye
Michael Jerrett
2022

Background: Objective tracking of asthma medication use and exposure in real-time and space has not been feasible previously. Exposure assessments have typically been tied to residential locations, which ignore exposure within patterns of daily activities.

Methods: We investigated the associations of exposure to multiple air pollutants, derived from nearest air quality monitors, with space-time asthma rescue inhaler use captured by digital sensors, in Jefferson County, Kentucky. A generalized linear mixed model, capable of accounting for repeated...

Dusty trades and associated rheumatoid arthritis in a population-based study in the coal mining counties of Appalachia

Gabriela Schmajuk
Laura Trupin
Edward H Yelin
Paul D Blanc
2022

Objectives: We previously showed increased coal mining-associated risk of rheumatoid arthritis (RA). Using additional survey data, we sought to delineate this risk further.

Methods: We used data from two cross-sectional, random-digit-dial, population-based surveys (males;≥50 years) in selected counties in the Appalachian region of the inland, mid-Atlantic USA with elevated pneumoconiosis mortality. Surveys ascertained age, smoking, coal mining and non-coal silica exposure jobs. In a subset, we surveyed ergonomic exposures, scored by intensity. We...

Remote smartphone monitoring of Parkinson's disease and individual response to therapy

Larsson Omberg
Elias Chaibub Neto
Thanneer M Perumal
Abhishek Pratap
Aryton Tediarjo
Jamie Adams
Bastiaan R Bloem
Brian M Bot
Molly Elson
Samuel M Goldman
Michael R Kellen
Karl Kieburtz
Arno Klein
Max A Little
Ruth Schneider
Christine Suver
Christopher Tarolli
Caroline M Tanner
Andrew D Trister
John Wilbanks
E Ray Dorsey
Lara M Mangravite
2021

Remote health assessments that gather real-world data (RWD) outside clinic settings require a clear understanding of appropriate methods for data collection, quality assessment, analysis and interpretation. Here we examine the performance and limitations of smartphones in collecting RWD in the remote mPower observational study of Parkinson's disease (PD). Within the first 6 months of study commencement, 960 participants had enrolled and performed at least five self-administered active PD symptom assessments (speeded tapping, gait/balance, phonation or memory). Task performance, especially...

Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults

Martin W Njoroge
Patrick Mjojo
Catherine Chirwa
Sarah Rylance
Rebecca Nightingale
Stephen B Gordon
Kevin Mortimer
Peter Burney
John Balmes
Jamie Rylance
Angela Obasi
Louis W Niessen
Graham Devereux
IMPALA consortium
2021

Background: In Sub-Saharan Africa cross-sectional studies report a high prevalence of abnormal lung function indicative of chronic respiratory disease. The natural history and health impact of this abnormal lung function in low-and middle-income countries is largely unknown.

Methods: A cohort of 1481 adults representative of rural Chikwawa in Malawi were recruited in 2014 and followed-up in 2019. Respiratory symptoms and health-related quality of life (HRQoL) were quantified. Lung function was measured by spirometry.

Findings:...