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Presents a study which discussed the investigation of an outbreak of an influenza-like syndrome which occurred in a Massachusetts textile mill producing imitation crushed velvet that is a consequence of a fluorocarbon polymer. Background on the investigation of the outbreak; Materials that were considered as possibly responsible for the outbreak; Views on causative factors which contribute to the outbreak; Role of cigarette smoking in the outbreak.

Field studies of occupational exposure to airborne irritants have predominantly relied on symptom surveys of study participants. As part of a new approach to the study of acute irritant symptoms, subjects exposed to sodium borate dusts recorded their symptom responses at hourly interviews as well as instantaneously on an electronic device called an event marker. Overall, the unprompted marks indicated fewer irritant events than the interviews. Marks were more frequent in the presence of more than one type of symptom and also appeared to reflect more severe symptoms. A proportion of the marked events occurred in time intervals when no symptoms were recalled during the interview. The exposure-response relations were similar regardless of whether they were based on the interview reports or the electronically marked symptoms. The event marker provided a means to examine the time of onset of the acute symptom event. It also made it possible to examine directly the timing profiles of symptom response in relation to changes in exposure levels in a field setting. Despite some inconsistencies, the finding suggests that the event marker may provide an alternative to frequent interviews of exposed workers to obtain irritant symptom responses for exposure-response modeling.

Neurogenic bladder dysfunction, characterized by hesitancy, need to strain, decreased stream, and increased duration of urination, developed in 104 (63%) of 166 employees working in the manufacture of polyurethane foam. Highest rates of illness (69%) occurred in production workers, and no illness occurred in office or warehouse workers. Onset of the epidemic coincided with introduction of a catalyst, dimethylaminopropionitrile (DMAPN), and monthly case incidence rates increased as DMAPN use increased. Outbreak ceased abruptly when DMAPN use was stopped. Of eight patients who underwent neurourologic testing during recovery, seven lacked either detrusor reflex or normal sensation of bladder filling; seven had a subclinical sensory abnormality; three had prolonged sacral-evoked responses; and two of these three had limb motor neuropathies. Dimethylaminopropionitrile is unique among known neurotoxins in producing urinary symptoms more frequently than limb nerve symptoms.

This study examines cancer mortality patterns by occupation for white males in Massachusetts using 1971-1973 death records. Its purpose is to identify occupation-cancer associations that, when interpreted in conjunction with results from other studies and hypotheses about potential occupational carcinogens, can serve as leads for more definitive etiological investigations. Sixty-two malignancy categories (including grouped categories) were investigated for each of 397 occupational categories (including grouped categories) using an age-standardized mortality odds ratio approach. An important finding was the association between lung cancer and a large number of occupations for which there is support from other epidemiologic studies and/or for which there are reasonable hypotheses as to possible carcinogenic exposures. These occupations include truck drivers, painters, machinists, automobile mechanics, plumbers, cooks, fishermen, heated metal workers, sheet metal workers, and brickmasons/stonemasons/tile setters.

Analysis of the causes of death among workers employed in the manufacture of synthetic abrasive products was performed using data from death certificates and employment records. The subjects were 1,030 white male workers who had been employed by a single manufacturer and who were identified through a review of death certificates issued during a 20-year period. Proportional mortality analysis revealed excess digestive cancer and respiratory disease deaths. Personnel records permitted refinement of the study population to 968 with classification of each individual into one of seven employment categories. Case-control analysis of workers ever employed in the individual categories revealed elevated odds ratios for respiratory disease deaths among those most exposed to the synthetic abrasive dust. The excesses were greatest in those exposed 20 or more years. Excesses of esophageal and rectal cancers were noted in two manufacturing areas although the numbers were small. Review of the literature further supports the findings that synthetic abrasive exposures may be associated with elevated respiratory morbidity and mortality.

A proportional mortality analysis of jewelry workers as identified on death certificates is presented. The study group consisted of 931 males who died in Attleboro, Mass., between 1956 and 1975. An excess proportion of pancreas cancer was found in the entire group (16/9; p < 0.05) and was not explained by ethnic or other non-occupational factors. Job titles were specific enough to identify a subset of polishers and findings for this job category were compared to those for all other categories. Excesses of stomach cancer (odds ratio 4.4; p < 0.01) and stomach ulcer (odds ratio 5.0, p < 0.01) were found, but for each the observed number of deaths is small. Possible important exposures in the jewelry industry are reviewed.

A proportional mortality analysis of death certificates of 2,798 shoe and leather workers demonstrated a statistically significant excess of bladder cancer among female shoe workers (PMR = 2.51, 95% confidence interval 1.23 to 5.12). A case-referent analysis of 289 leather workers, on whom detailed occupational information was available, demonstrated an association of lung cancer with work in leather-tanning jobs (odds ratio = 4.2, 95% confidence interval 1.09 to 16.2).

An effort has been made to explore a case-finding surveillance system for occupationally-related disease using death records. A sentinel health event, here lung cancer in young males, was selected to seek unusual associations with occupations as listed on the death records. Fishermen appeared to be over-represented and population studies cited suggest lung cancer in this occupation deserves further exploration. Further efforts of this type could test the usefulness of an occupational health surveillance system based on the death certificate.