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BACKGROUND: The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes. OBJECTIVES: In this study we explored these associations in the all-male Health Professionals Follow-Up Study prospective cohort. METHODS: The same spatiotemporal exposure estimation models, similar outcomes, and biennially updated covariates were used as those previously applied in the female Nurses' Health Study cohort. RESULTS: Among 17,545 men residing in the northeastern and midwestern United States, there were 2,813 deaths, including 746 cases of fatal coronary heart disease (CHD). An interquartile range change (4 µg/m3) in average exposure to PM ≤ 2.5 µm in diameter in the 12 previous months was not associated with all-cause mortality [hazard ratio (HR) = 0.94; 95% confidence interval (CI), 0.87-1.00] or fatal CHD (HR = 0.99; 95% CI, 0.87-1.13) in fully adjusted models. Findings were similar for separate models of exposure to PM ≤10 µm in diameter and PM between 2.5 and 10 µm in diameter and for copollutant models. CONCLUSIONS: Among this cohort of men with high socioeconomic status living in the midwestern and northeastern United States, the results did not support an association of chronic PM exposures with all-cause mortality and cardiovascular outcomes in models with time-varying covariates. Whether these findings suggest sex differences in susceptibility or the protective impact of healthier lifestyles and higher socioeconomic status requires additional investigation. [ABSTRACT FROM AUTHOR]

An estimated 8.2 million occupational injuries occur annually to women in the United States. This case-crossover study of 1166 subjects compares transient risk factors for occupational traumatic hand injury to women and men. Study subjects were recruited over a 3-year period (1997 to 2000) from 23 occupational health clinics in five New England states. The case-crossover design was used to estimate the short-term risk of an acute hand injury while controlling between-person potential confounders. Subjects reported on the occurrence of seven transient exposures within a 90-min period and provided control exposure information during the month before an acute hand injury. A total of 275 women and 891 men were interviewed a median of 1.3 days after injury. Lacerations were the most common injury type in both women (58%) and men (64%). Relative risks for women were higher for being distracted, doing unusual tasks, and working with malfunctioning equipment or materials, and were lower than men for being rushed. Gloves provided significant protection for males and females. Results suggest the importance of considering both the prevalence of various exposures and gender in modifying risk factors to reduce the incidence of acute hand injury in the workplace. Thus, greater emphasis should be placed on the planning of safer working environments for all workers.

Temporal factors and the prevalence of exposure to transient risk factors for occupational traumatic hand injury were analyzed among 1166 subjects participating in a case-crossover study. Temporal factors included time of injury and elapsed time to injury since the start of the work shift. Transient exposures included work equipment, work practice, and worker-related factors. The highest frequency of injury was observed from 08:00 am to 12:00 pm (54.6%), with a peak from 10:00 to 11:00 am (14.9%). The median time into the work shift for injury was 3.5 hours. Subjects injured 2 to 3 hours into their work shift most often reported using a machine, tool, or work material that performed differently than usual (23.9%). These results suggest that acute hand injuries occur earlier in the workday and safety programs should place increased vigilance on these times.

The National Electronic Injury Surveillance System reports that the fingers and hand are the most frequent body parts injured at work and treated in hospital emergency departments. In this study, we describe the type, location, and severity of occupational hand injuries among 1166 patients recruited from 23 occupational health clinics in five New England states. Subjects ranged in age from 18 to 77 years, with a mean of 37.2 years (SD, 11.4), and approximately 75% were men. In decreasing order of frequency, subjects were employed in machine trades, service work, structural work, and less frequently, in benchwork, professional, technical managerial and clerical, and sales work. The majority of subjects (83.4%) had a single type of injury: 62.6% were lacerations, 13.1% were crush injuries, 8.0% were avulsions, and 6.1% were punctures. Metal items, such as nails, metal stock, and burrs accounted for 38.4% of the injuries, followed by hand tools with blades and powered machinery (24.4% and 12.3%, respectively). Hand tools with blades were least likely to result in multiple types of injuries, whereas powered machines or nonpowered hand tools were more likely to result in multiple types of injuries than other injury sources. The generalizability of these results should be limited to clinic-based patients employed in similar occupations. The results of this study may suggest possible prevention strategies for acute traumatic hand injuries.