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Occupational Exposure to Air Pollutants in Older Adults

Occupational Exposure to Air Pollutants in Older Adults. Robert B. Wallace, MD, MSc Dominic Cirillo, BS Gwenith Fisher, PhD University of Iowa College of Public Health. Globalization Less individual, local control of job policies Loss of manufacturing Work less injurious to older workers

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Occupational Exposure to Air Pollutants in Older Adults

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  1. Occupational Exposure to Air Pollutants in Older Adults Robert B. Wallace, MD, MSc Dominic Cirillo, BS Gwenith Fisher, PhD University of Iowa College of Public Health

  2. Globalization Less individual, local control of job policies Loss of manufacturing Work less injurious to older workers Less harm to the local environment Less union protection for workers Political era of less regulation/safety of work environment/ work policy Smaller, more adaptive companies Less occupational medicine/ Less job security Loss of pension wealth for future worker generations (e.g., defined benefit, Social Security) Less employer-provided health insurance Work in America: Relevant Trends

  3. The Population and Proportion of Older Workers in the Labor Force is Increasing2000-2010

  4. The Health and Retirement Study • Representative sample of older Americans • Biennial surveys since 1992 • New cohorts added periodically • Minority over-sample • Emphasizes: • Health and functional status • Economic status of individuals and families • Work and social status • Data available within six months of survey completion: http://hrsonline.isr.umich.edu/

  5. Current Employment SituationHealth and Retirement Study - 1998 Percent of total pop’n Category 51-64 65-74 75+ Working 65 20 7 Retired 15 67 76 Unemployed 1.8 0.3 0.2 Temp. off 1.3 0.2 0.2 Disabled 10 6 4 Other

  6. HRS 1998—Job Characteristics (%) Age Group (Yrs.) Charact. 51-64 65-74 75+ Self-employed 19 35 47 Part-time 19 59 77 Can reduce hours 31 51 60 Missed work/health 41 27 23 Make decisions: pay/promotions 18 9 9

  7. HRS—1998: Job Characteristics (%) Charact. Age group 51-64 65-74 75+ Job has a lot of stress 63 39 27 Employer promotes younger persons 17 12 8 Co-workers pressure to retire 13 8 7 Employer would allow less demanding job 35 35 31 Really enjoy work 88 93 97

  8. HRS 1998—Job Characteristics (%) Age Group Charact. 51-64 65-74 75+ Req. physical effort 62 56 44 Req. heavy lifting 40 30 20 Req. people skills 96 93 84 Req. good eyesight 96 95 93 Req. intense concent. 97 92 84 Req. stoop/crouch… 59 49 33

  9. General Environmental Exposures • American workers 51-61 years at baseline of the HRS • Exposures assessed as new cohorts enrolled • All are self-report • Includes all physio-chemical and biological exposures

  10. General Environmental Exposures by Job Category (last two jobs):Health and Retirement Study Job category--Industry % Exposed Agricult. forestry, fishing 50.4 Mining, construction 45.7 Manufacturing (non-durable) 43.6 Transportation 35.0 Wholesale 30.0 Retail 25.9 Finance, insurance, real estate 16.7 Professional and related services 21.6

  11. A Closer Look at General Exposures:Finance, Insurance and Real Estate Any Exposure 16.7% Solvents and cleaners 2.6 Fuels 0.9 Mineral dust 2.7 Wood, biologic 0.4 Chemical 0.9 Ag. Chemicals/ drugs 2.1 Multiple 5.7

  12. Occupations With the Most Respiratory Exposures Service: protection Personal services Farming, forestry, fishing Mechanics and repair Construction trade and extractors Precision production Operators: machine Operators: transport Operators: handlers

  13. Working Lifetime Respiratory ExposuresHealth and Retirement Study: Age 51-61 (N = 9794) Exposure Percent Solvents (15 named) 6.9 Mineral dust (incl. asbestos) 4.8 Dusts and ash 4.4 Agricultural pesticides 4.2 Cleaning solvents 3.6 Aerosol paints 2.9 Chemical acids 2.2 Miscellaneous fumes/vapors 1.7 Petroleum products 1.4

  14. Organic solvents 15.3% Asbestos 12.7 Dust/ash 6.6 Pesticides 3.8 Cleaning 4.0 Paint 5.7 Acids 5.4 Fuels 4.9 Fumes 0.9 Exhausts 4.5 Plastics 2.4 Mineral/coal dust 2.6 Fertilizers 1.7 One High Risk Occupation:Mechanics and Repair

  15. Working Lifetime Respiratory ExposuresHealth and Retirement Study: 1992 (N = 9794) Other less common exposures noted: Carbon dioxide Leather tanning chemicals Glass powder and dust Chalk dust Sulfur dioxide Chlorofluorocarbons (refrigerants) Nitrogen, nitrates

  16. Cautions in Interpreting Reports of Occupational Lung Exposures • Multiple exposures likely • Exposures by other routes possible (e.g., skin) • Chemical identifications not made • Biological exposures particularly hard to characterize • Dosimetry not performed • Non-occupational exposures not assessed (e.g., hobbies) • Use of protective devices not assessed

  17. Health Behaviors Associated with Respiratory Occupational Exposures – Current Workers:Health and Retirement Study Workplace Exposure Behavior Any Exp. No Exp. Current smoker % 32.4 29.1** 21+ Cigs./day % 37.9 25.6** CAGE items-% 2+ 20.8 15.5** Body Mass Index % <= 25 30.0 32.2

  18. Conclusions • Almost nothing known about new respiratory exposures in workers over 50 years – with or without prior exposure/disease -Few opportunities in the past -Jobs taken by younger persons • Powerful selective forces against older persons with clinical conditions taking jobs with exposures • Careers are waiting!

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