Pulmonary function changes among fire fighters were evaluated by re-examining 632 Baltimore city fire fighters six to ten years after a baseline examination. Spirometry was used to determine forced expiratory volume in 1 second (FEV1). Information about exposures was obtained by questionnaire and by combining data from fire department records regarding the number of fires fought by fire fighting units with individual work histories. Men who never wore a mask while extinguishing fires experienced a 1.7 times greater rate of FEV1 decline than mask wearers. Men with ammonia exposure experienced a rate of decline 1.7 times greater than non-exposed men. Neither length of time spent in exposed jobs nor number of responses were associated with the rate of decline. Active fire fighters experienced a rate of decline 2.5 times greater than those who had retired or resigned. Some effects differed between men who were able to perform repeatable pulmonary function tests and those who were not.
Background
Nosocomial transmission of Mycobacterium tuberculosis among workers at a 1000‐bed inner‐city hospital led to an extensive evaluation of this risk among workers with potential exposure to TB patients or laboratory specimens.
Methods
Retrospective cohort study to determine the incidence and risk of tuberculin skin test (TST) conversions among workers employed 1/1/90 to 9/30/92.
Results
Personal, community, and occupational risk factors were evaluated in 2,362 workers with potential M. tuberculosis exposure and 886 workers with no known exposure. The 33‐month cumulative rate of TST conversion was 5.8% for potentially exposed workers and 2.0% for controls (RR 3.6; 95% CI; 2.2–5.8). Among workers with potential M. tuberculosis exposure, statistically significantly elevated risks were found for nurses, laboratory technicians, pharmacy workers, phlebotomists, housekeepers, clerks, emergency room workers, and emergency responders.
Conclusions
Workers with patient contact and those employed in certain occupational groups were at increased risk for occupational M. tuberculosis infection. Am. J. Ind. Med. 42:228–235, 2002. Published 2002 Wiley‐Liss, Inc.
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