Alysha R Meyers | Centers for Disease Control and Prevention (original) (raw)
Papers by Alysha R Meyers
Journal of Safety Research
MMWR. Morbidity and Mortality Weekly Report
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Work-related musculoskeletal disorders (WMSDs) are a common health problem in many industries. Na... more Work-related musculoskeletal disorders (WMSDs) are a common health problem in many industries. National Occupational Research Agenda (NORA) is a research framework for the nation and for the National Institute for Occupational Safety and Health (NIOSH). The process for developing the 2016-2026 NORA for the Prevention of WMSDs is presented along with the identified five critical areas of research: (1) defining the incidence and impact of MSDs; (2) understanding the risk factors for WMSDs; (3) describing the underlying mechanism of MSDs; (4) developing and evaluating interventions to prevent MSDs and limit disability due to MSDs; and (5) disseminating and implementing interventions to prevent WMSDs and limit disability. The research agenda is being promoted by the NORA Musculoskeletal Health Council which is comprised of 32 volunteer members from universities, businesses, professional societies, worker organizations and government agencies. Stakeholders for the prevention of WMSDs are...
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Historically, work-related upper-extremity musculoskeletal disorders (MSD) have comprised a signi... more Historically, work-related upper-extremity musculoskeletal disorders (MSD) have comprised a significant portion of the number and cost of injuries in the workplace. The problem of work-related upper-extremity MSD has been, and continues to be, widespread and costly. This panel will present recent research from the Upper Extremity Musculoskeletal Consortium studies. Presentations will be made on new health outcomes such as wrist tendinosis, epicondylitis and rotator cuff syndrome, as well as provide updates on applying new risk assessment methods to prior analyses. The application of the Revised Strain Index will be presented as will a comparison of results from the 2001 ACGIH TLV for Hand Activity to the 2018 ACGIH TLV for Hand Activity. Additionally, the impact of healthy worker survivor effect on the pooled analyses of incident CTS and CTS related disability will be discussed.
Occupational and Environmental Medicine
BackgroundAs the proportion of older workers in the U.S. increases, understanding the health and ... more BackgroundAs the proportion of older workers in the U.S. increases, understanding the health and safety needs of an aging workforce is critical, especially in the hazardous and physically demanding construction industry. According to the Bureau of Labor Statistics (BLS), in 2016 the rate of work-related musculoskeletal disorders (WMSDs) in construction was 32.7 per 10 000 full-time equivalent workers, which was 11% higher than the rate for all industries combined. The objective of this study was to examine the rate and cost of WMSDs due to overexertion, the leading cause of WMSDs, among construction workers by age group in Ohio using workers’ compensation claims.MethodsOverexertion related WMSDs allowed claims, submitted to Ohio Bureau of Worker’s Compensation (OBWC) by workers in the construction industry for injuries occurring from 2007–2013 were analyzed to compute rates of allowed claims and claim costs by age group. The American Community Survey of the U.S. Census Bureau was us...
American Journal of Industrial Medicine
Journal of Occupational and Environmental Hygiene
Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACG... more Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACGIH V R) Threshold Limit Value (TLV V R) for Hand Activity was not sufficiently protective for workers at risk of carpal tunnel syndrome (CTS). These studies led to a revision of the TLV and Action Limit. This study compares the effect of applying the 2018 TLV vs. the 2001 TLV to predict incident CTS within a large occupational pooled cohort study (n ¼ 4,321 workers). Time from study enrollment to first occurrence of CTS was modeled using Cox proportional hazard regression. Adjusted and unadjusted hazard ratios for incident CTS were calculated using three exposure categories: below the Action Limit, between the Action Limit and TLV, and above the TLV. Workers exposed above the 2001 Action Limit demonstrated significant excess risk of carpal tunnel syndrome, while the 2018 TLV demonstrated significant excess risk only above the TLV. Of 186 total cases of CTS, 52 cases occurred among workers exposed above the 2001 TLV vs. 100 among those exposed above the 2018 value. Eliminating exposures above the 2001 TLV might have prevented 11.2% of all cases of CTS seen in our pooled cohort, vs. 25.1% of cases potentially prevented by keeping exposures below the 2018 value. The 2018 revision of the TLV better protects workers from CTS, a recognized occupational health indicator important to public health. A significant number of workers are currently exposed to forceful repetitive hand activity above these guidelines. Public health professionals should promulgate these new guidelines and encourage employers to reduce hand intensive exposures to prevent CTS and other musculoskeletal disorders.
Journal of Occupational and Environmental Medicine
American Journal of Industrial Medicine
Journal of Occupational and Environmental Medicine
This study leveraged a state workers' compensation claims database and ma... more This study leveraged a state workers' compensation claims database and machine learning techniques to target prevention efforts by injury causation and industry. Injury causation auto-coding methods were developed to code more than 1.2 million Ohio Bureau of Workers' Compensation claims for this study. Industry groups were ranked for soft-tissue musculoskeletal claims that may have been preventable with biomechanical ergonomic (ERGO) or slip/trip/fall (STF) interventions. On the basis of the average of claim count and rate ranks for more than 200 industry groups, Skilled Nursing Facilities (ERGO) and General Freight Trucking (STF) were the highest risk for lost-time claims (>7 days). This study created a third, major causation-specific U.S. occupational injury surveillance system. These findings are being used to focus prevention resources on specific occupational injury types in specific industry groups, especially in Ohio. Other state bureaus or insurers may use similar methods.
Public health agencies, the workers' compensation industry, trade associations and the state-leve... more Public health agencies, the workers' compensation industry, trade associations and the state-level programs share interests in utilizing these data to protect workers from occupational injuries and illnesses. To help facilitate these goals, NIOSH has created a Center for Workers' Compensation Studies. Further information on the center may be obtained at
American Journal of Industrial Medicine, 2016
Workers' compensation (WC) claims data may be use... more Workers' compensation (WC) claims data may be useful for identifying high-risk industries and developing prevention strategies. WC claims data from private-industry employers insured by the Ohio state-based workers' compensation carrier from 2001 to 2011 were linked with the state's unemployment insurance (UI) data on the employer's industry and number of employees. National Labor Productivity and Costs survey data were used to adjust UI data and estimate full-time equivalents (FTE). Rates of WC claims per 100 FTE were computed and Poisson regression was used to evaluate differences in rates. Most industries showed substantial claim count and rate reductions from 2001 to 2008, followed by a leveling or slight increase in claim count and rate from 2009 to 2011. Despite reductions, there were industry groups that had consistently higher rates. WC claims data linked to employment data could be used to prioritize industries for injury research and prevention activities among State-insured private employers. Am. J. Ind. Med. 59:1087-1104, 2016. © 2016 Wiley Periodicals, Inc.
Human Factors the Journal of the Human Factors and Ergonomics Society, Feb 1, 2014
To better characterize associations between physical risk factors and upper-extremity musculoskel... more To better characterize associations between physical risk factors and upper-extremity musculoskeletal symptoms and disorders, a prospective epidemiologic study of 386 manufacturing workers was performed. Background: Methodological limitations of previous studies have resulted in inconsistent associations. Method: An individual, task-based exposure assessment strategy was used to assess upper-extremity exertion intensity, repetition, and time-in-posture categories. Participants recorded time spent performing daily work tasks on a preprinted log, which was then used to calculate time-weightedaverage exposures across each week of follow-up. In addition, a weekly Strain Index (SI) risk category was assigned to each participant. Incident musculoskeletal symptoms and disorders were assessed weekly. Proportional hazards analyses were used to examine associations between exposure measures and incident hand/arm and neck/shoulder symptoms and disorders. Results: Incident symptoms and disorders were common (incident hand/arm symptoms = 58/100 person-years (PY), incident hand/arm disorders = 19/100 PY, incident neck/shoulder symptoms = 54/100 PY, incident neck/shoulder disorders = 14/100 PY). Few associations between separate estimates of physical exposure and hand/arm and neck/shoulder outcomes were observed. However, associations were observed between dichotomized SI risk category and incident hand/arm symptoms (hazard ratio [HR] = 1.73, 95% confidence interval [CI] = [0.99, 3.04]) and disorders (HR = 1.93, 95% CI = [0.85, 4.40]). Conclusion: Evidence of associations between physical risk factors and musculoskeletal outcome was strongest when exposure was estimated with the SI, in comparison to other metrics of exposure. Application: The results of this study provide evidence that physical exposures in the workplace contribute to musculoskeletal disorder incidence. Musculoskeletal disorder prevention efforts should include mitigation of these occupational risk factors.
Occupational and Environmental Medicine, 2015
We updated mortality through 2011 for 5203 boat-building workers potentially exposed to styrene, ... more We updated mortality through 2011 for 5203 boat-building workers potentially exposed to styrene, and analysed mortality among 1678 employed a year or more between 1959 and 1978. The a priori hypotheses: excess leukaemia and lymphoma would be found. Standardised mortality ratios (SMRs) and 95% CIs and standardised rate ratios (SRRs) used Washington State rates and a person-years analysis programme, LTAS.NET. The SRR analysis compared outcomes among tertiles of estimated cumulative potential styrene exposure. Overall, 598 deaths (SMR=0.96, CI 0.89 to 1.04) included excess lung (SMR=1.23, CI 0.95 to 1.56) and ovarian cancer (SMR 3.08, CI 1.00 to 7.19), and chronic obstructive pulmonary disease (COPD) (SMR=1.15, CI 0.81 to 1.58). Among 580 workers with potential high-styrene exposure, COPD mortality increased 2-fold (SMR=2.02, CI 1.08 to 3.46). COPD was more pronounced among those with potential high-styrene exposure. However, no outcome was related to estimated cumulative styrene exposure, and there was no change when latency was taken into account. We found no excess leukaemia or lymphoma mortality. As in most occupational cohort studies, lack of information on lifestyle factors or other employment was a substantial limitation although we excluded from the analyses those (n=3525) who worked <1 year. Unanticipated excess ovarian cancer mortality could be a chance finding. Comparing subcohorts with potential high-styrene and low-styrene exposure, COPD mortality SRR was elevated while lung cancer SRR was not, suggesting that smoking was not the only cause for excess COPD mortality.
Printout. Thesis (M.S.)--University of Iowa, 2005. Includes bibliographical references (leaves 84... more Printout. Thesis (M.S.)--University of Iowa, 2005. Includes bibliographical references (leaves 84-91).
American Journal of Industrial Medicine, 2014
Stationary sawing machinery is often a basic tool in the wood product manufacturing industry and ... more Stationary sawing machinery is often a basic tool in the wood product manufacturing industry and was the source for over 2,500 injury/illness events that resulted in days away from work in 2010. We examined 9 years of workers' compensation claims for the state of Ohio in wood product manufacturing with specific attention to saw-related claims. For the study period, 8,547 claims were evaluated; from this group, 716 saw-related cases were examined. The sawmills and wood preservation sub-sector experienced a 71% reduction in average incidence rate and an 87% reduction in average lost-time incidence rate from 2001 to 2009. The top three injury category descriptions for lost-time incidents within saw-related claims were fracture (35.8%), open wounds (29.6%), and amputation (14.8%). For saw-related injuries, preventing blade contact remains important but securing the work piece to prevent kickback is also important.
number of flights per day (adjusted OR 2.0, 95% CI 1.2-3.3 for 3+ versus 1 flights/day, p trend =... more number of flights per day (adjusted OR 2.0, 95% CI 1.2-3.3 for 3+ versus 1 flights/day, p trend = 0.007) and fewer time zones crossed per flight (adjusted OR 2.0, 95% CI 1.0-3.7 for 0 vs. 2 + time zones/flight, p trend = 0.04) were associated with a higher rate of endometriosis. Conclusions The rate of endometriosis increased with number of flights and decreased with time zones crossed, which might be surrogates for exposures specific to flying a series of short flights during the workday.
Objectives To evaluate the mortality experience among all workers (n = 3199) employed at a phosph... more Objectives To evaluate the mortality experience among all workers (n = 3199) employed at a phosphate fertiliser plant in central Florida beginning 1953 and followed through 2005. Method All-cause, all-cancers, and cause-specific standardised mortality ratios (SMRs) were calculated with the U. S. population as referent. Lung cancer and leukaemia risks were further evaluated using conditional logistic regression. Employment duration was used as an exposure surrogate for dose-response analyses. Results The mortality due to all causes combined (SMR=1.07, 95% confidence interval (CI)=1.01-1.13, observed deaths n = 1124), lung cancer (SMR=1.25, 95% CI=1.04-1.49, n = 122), leukaemia (SMR=1.76, 95% CI=1.02-2.81, n = 17), and chronic obstructive pulmonary disease (SMR=1.45, 95% CI=1.09-1.89, n = 54) were significantly elevated. All-cancer mortality was elevated (SMR=1.09, 95% CI=0.97-1.22, n = 303) but not statistically significant for the cohort. Doseresponse modelling with adjustments for gender and race did not show statistically significant associations between employment duration (in years) and lung cancer (Odds Ratio (OR) =0.99, 95% CI=0.97-1.02) or leukaemia (OR=1.01, 95% CI=0.96-1.06) mortality. Conclusions Findings are suggestive of increased lung cancer and leukaemia mortality from exposures encountered in the phosphate fertiliser industry. Increased employment duration, however, did not have significant associations with increased lung cancer or leukaemia mortality.
Journal of Safety Research
MMWR. Morbidity and Mortality Weekly Report
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Work-related musculoskeletal disorders (WMSDs) are a common health problem in many industries. Na... more Work-related musculoskeletal disorders (WMSDs) are a common health problem in many industries. National Occupational Research Agenda (NORA) is a research framework for the nation and for the National Institute for Occupational Safety and Health (NIOSH). The process for developing the 2016-2026 NORA for the Prevention of WMSDs is presented along with the identified five critical areas of research: (1) defining the incidence and impact of MSDs; (2) understanding the risk factors for WMSDs; (3) describing the underlying mechanism of MSDs; (4) developing and evaluating interventions to prevent MSDs and limit disability due to MSDs; and (5) disseminating and implementing interventions to prevent WMSDs and limit disability. The research agenda is being promoted by the NORA Musculoskeletal Health Council which is comprised of 32 volunteer members from universities, businesses, professional societies, worker organizations and government agencies. Stakeholders for the prevention of WMSDs are...
Proceedings of the Human Factors and Ergonomics Society Annual Meeting
Historically, work-related upper-extremity musculoskeletal disorders (MSD) have comprised a signi... more Historically, work-related upper-extremity musculoskeletal disorders (MSD) have comprised a significant portion of the number and cost of injuries in the workplace. The problem of work-related upper-extremity MSD has been, and continues to be, widespread and costly. This panel will present recent research from the Upper Extremity Musculoskeletal Consortium studies. Presentations will be made on new health outcomes such as wrist tendinosis, epicondylitis and rotator cuff syndrome, as well as provide updates on applying new risk assessment methods to prior analyses. The application of the Revised Strain Index will be presented as will a comparison of results from the 2001 ACGIH TLV for Hand Activity to the 2018 ACGIH TLV for Hand Activity. Additionally, the impact of healthy worker survivor effect on the pooled analyses of incident CTS and CTS related disability will be discussed.
Occupational and Environmental Medicine
BackgroundAs the proportion of older workers in the U.S. increases, understanding the health and ... more BackgroundAs the proportion of older workers in the U.S. increases, understanding the health and safety needs of an aging workforce is critical, especially in the hazardous and physically demanding construction industry. According to the Bureau of Labor Statistics (BLS), in 2016 the rate of work-related musculoskeletal disorders (WMSDs) in construction was 32.7 per 10 000 full-time equivalent workers, which was 11% higher than the rate for all industries combined. The objective of this study was to examine the rate and cost of WMSDs due to overexertion, the leading cause of WMSDs, among construction workers by age group in Ohio using workers’ compensation claims.MethodsOverexertion related WMSDs allowed claims, submitted to Ohio Bureau of Worker’s Compensation (OBWC) by workers in the construction industry for injuries occurring from 2007–2013 were analyzed to compute rates of allowed claims and claim costs by age group. The American Community Survey of the U.S. Census Bureau was us...
American Journal of Industrial Medicine
Journal of Occupational and Environmental Hygiene
Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACG... more Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACGIH V R) Threshold Limit Value (TLV V R) for Hand Activity was not sufficiently protective for workers at risk of carpal tunnel syndrome (CTS). These studies led to a revision of the TLV and Action Limit. This study compares the effect of applying the 2018 TLV vs. the 2001 TLV to predict incident CTS within a large occupational pooled cohort study (n ¼ 4,321 workers). Time from study enrollment to first occurrence of CTS was modeled using Cox proportional hazard regression. Adjusted and unadjusted hazard ratios for incident CTS were calculated using three exposure categories: below the Action Limit, between the Action Limit and TLV, and above the TLV. Workers exposed above the 2001 Action Limit demonstrated significant excess risk of carpal tunnel syndrome, while the 2018 TLV demonstrated significant excess risk only above the TLV. Of 186 total cases of CTS, 52 cases occurred among workers exposed above the 2001 TLV vs. 100 among those exposed above the 2018 value. Eliminating exposures above the 2001 TLV might have prevented 11.2% of all cases of CTS seen in our pooled cohort, vs. 25.1% of cases potentially prevented by keeping exposures below the 2018 value. The 2018 revision of the TLV better protects workers from CTS, a recognized occupational health indicator important to public health. A significant number of workers are currently exposed to forceful repetitive hand activity above these guidelines. Public health professionals should promulgate these new guidelines and encourage employers to reduce hand intensive exposures to prevent CTS and other musculoskeletal disorders.
Journal of Occupational and Environmental Medicine
American Journal of Industrial Medicine
Journal of Occupational and Environmental Medicine
This study leveraged a state workers' compensation claims database and ma... more This study leveraged a state workers' compensation claims database and machine learning techniques to target prevention efforts by injury causation and industry. Injury causation auto-coding methods were developed to code more than 1.2 million Ohio Bureau of Workers' Compensation claims for this study. Industry groups were ranked for soft-tissue musculoskeletal claims that may have been preventable with biomechanical ergonomic (ERGO) or slip/trip/fall (STF) interventions. On the basis of the average of claim count and rate ranks for more than 200 industry groups, Skilled Nursing Facilities (ERGO) and General Freight Trucking (STF) were the highest risk for lost-time claims (>7 days). This study created a third, major causation-specific U.S. occupational injury surveillance system. These findings are being used to focus prevention resources on specific occupational injury types in specific industry groups, especially in Ohio. Other state bureaus or insurers may use similar methods.
Public health agencies, the workers' compensation industry, trade associations and the state-leve... more Public health agencies, the workers' compensation industry, trade associations and the state-level programs share interests in utilizing these data to protect workers from occupational injuries and illnesses. To help facilitate these goals, NIOSH has created a Center for Workers' Compensation Studies. Further information on the center may be obtained at
American Journal of Industrial Medicine, 2016
Workers' compensation (WC) claims data may be use... more Workers' compensation (WC) claims data may be useful for identifying high-risk industries and developing prevention strategies. WC claims data from private-industry employers insured by the Ohio state-based workers' compensation carrier from 2001 to 2011 were linked with the state's unemployment insurance (UI) data on the employer's industry and number of employees. National Labor Productivity and Costs survey data were used to adjust UI data and estimate full-time equivalents (FTE). Rates of WC claims per 100 FTE were computed and Poisson regression was used to evaluate differences in rates. Most industries showed substantial claim count and rate reductions from 2001 to 2008, followed by a leveling or slight increase in claim count and rate from 2009 to 2011. Despite reductions, there were industry groups that had consistently higher rates. WC claims data linked to employment data could be used to prioritize industries for injury research and prevention activities among State-insured private employers. Am. J. Ind. Med. 59:1087-1104, 2016. © 2016 Wiley Periodicals, Inc.
Human Factors the Journal of the Human Factors and Ergonomics Society, Feb 1, 2014
To better characterize associations between physical risk factors and upper-extremity musculoskel... more To better characterize associations between physical risk factors and upper-extremity musculoskeletal symptoms and disorders, a prospective epidemiologic study of 386 manufacturing workers was performed. Background: Methodological limitations of previous studies have resulted in inconsistent associations. Method: An individual, task-based exposure assessment strategy was used to assess upper-extremity exertion intensity, repetition, and time-in-posture categories. Participants recorded time spent performing daily work tasks on a preprinted log, which was then used to calculate time-weightedaverage exposures across each week of follow-up. In addition, a weekly Strain Index (SI) risk category was assigned to each participant. Incident musculoskeletal symptoms and disorders were assessed weekly. Proportional hazards analyses were used to examine associations between exposure measures and incident hand/arm and neck/shoulder symptoms and disorders. Results: Incident symptoms and disorders were common (incident hand/arm symptoms = 58/100 person-years (PY), incident hand/arm disorders = 19/100 PY, incident neck/shoulder symptoms = 54/100 PY, incident neck/shoulder disorders = 14/100 PY). Few associations between separate estimates of physical exposure and hand/arm and neck/shoulder outcomes were observed. However, associations were observed between dichotomized SI risk category and incident hand/arm symptoms (hazard ratio [HR] = 1.73, 95% confidence interval [CI] = [0.99, 3.04]) and disorders (HR = 1.93, 95% CI = [0.85, 4.40]). Conclusion: Evidence of associations between physical risk factors and musculoskeletal outcome was strongest when exposure was estimated with the SI, in comparison to other metrics of exposure. Application: The results of this study provide evidence that physical exposures in the workplace contribute to musculoskeletal disorder incidence. Musculoskeletal disorder prevention efforts should include mitigation of these occupational risk factors.
Occupational and Environmental Medicine, 2015
We updated mortality through 2011 for 5203 boat-building workers potentially exposed to styrene, ... more We updated mortality through 2011 for 5203 boat-building workers potentially exposed to styrene, and analysed mortality among 1678 employed a year or more between 1959 and 1978. The a priori hypotheses: excess leukaemia and lymphoma would be found. Standardised mortality ratios (SMRs) and 95% CIs and standardised rate ratios (SRRs) used Washington State rates and a person-years analysis programme, LTAS.NET. The SRR analysis compared outcomes among tertiles of estimated cumulative potential styrene exposure. Overall, 598 deaths (SMR=0.96, CI 0.89 to 1.04) included excess lung (SMR=1.23, CI 0.95 to 1.56) and ovarian cancer (SMR 3.08, CI 1.00 to 7.19), and chronic obstructive pulmonary disease (COPD) (SMR=1.15, CI 0.81 to 1.58). Among 580 workers with potential high-styrene exposure, COPD mortality increased 2-fold (SMR=2.02, CI 1.08 to 3.46). COPD was more pronounced among those with potential high-styrene exposure. However, no outcome was related to estimated cumulative styrene exposure, and there was no change when latency was taken into account. We found no excess leukaemia or lymphoma mortality. As in most occupational cohort studies, lack of information on lifestyle factors or other employment was a substantial limitation although we excluded from the analyses those (n=3525) who worked <1 year. Unanticipated excess ovarian cancer mortality could be a chance finding. Comparing subcohorts with potential high-styrene and low-styrene exposure, COPD mortality SRR was elevated while lung cancer SRR was not, suggesting that smoking was not the only cause for excess COPD mortality.
Printout. Thesis (M.S.)--University of Iowa, 2005. Includes bibliographical references (leaves 84... more Printout. Thesis (M.S.)--University of Iowa, 2005. Includes bibliographical references (leaves 84-91).
American Journal of Industrial Medicine, 2014
Stationary sawing machinery is often a basic tool in the wood product manufacturing industry and ... more Stationary sawing machinery is often a basic tool in the wood product manufacturing industry and was the source for over 2,500 injury/illness events that resulted in days away from work in 2010. We examined 9 years of workers' compensation claims for the state of Ohio in wood product manufacturing with specific attention to saw-related claims. For the study period, 8,547 claims were evaluated; from this group, 716 saw-related cases were examined. The sawmills and wood preservation sub-sector experienced a 71% reduction in average incidence rate and an 87% reduction in average lost-time incidence rate from 2001 to 2009. The top three injury category descriptions for lost-time incidents within saw-related claims were fracture (35.8%), open wounds (29.6%), and amputation (14.8%). For saw-related injuries, preventing blade contact remains important but securing the work piece to prevent kickback is also important.
number of flights per day (adjusted OR 2.0, 95% CI 1.2-3.3 for 3+ versus 1 flights/day, p trend =... more number of flights per day (adjusted OR 2.0, 95% CI 1.2-3.3 for 3+ versus 1 flights/day, p trend = 0.007) and fewer time zones crossed per flight (adjusted OR 2.0, 95% CI 1.0-3.7 for 0 vs. 2 + time zones/flight, p trend = 0.04) were associated with a higher rate of endometriosis. Conclusions The rate of endometriosis increased with number of flights and decreased with time zones crossed, which might be surrogates for exposures specific to flying a series of short flights during the workday.
Objectives To evaluate the mortality experience among all workers (n = 3199) employed at a phosph... more Objectives To evaluate the mortality experience among all workers (n = 3199) employed at a phosphate fertiliser plant in central Florida beginning 1953 and followed through 2005. Method All-cause, all-cancers, and cause-specific standardised mortality ratios (SMRs) were calculated with the U. S. population as referent. Lung cancer and leukaemia risks were further evaluated using conditional logistic regression. Employment duration was used as an exposure surrogate for dose-response analyses. Results The mortality due to all causes combined (SMR=1.07, 95% confidence interval (CI)=1.01-1.13, observed deaths n = 1124), lung cancer (SMR=1.25, 95% CI=1.04-1.49, n = 122), leukaemia (SMR=1.76, 95% CI=1.02-2.81, n = 17), and chronic obstructive pulmonary disease (SMR=1.45, 95% CI=1.09-1.89, n = 54) were significantly elevated. All-cancer mortality was elevated (SMR=1.09, 95% CI=0.97-1.22, n = 303) but not statistically significant for the cohort. Doseresponse modelling with adjustments for gender and race did not show statistically significant associations between employment duration (in years) and lung cancer (Odds Ratio (OR) =0.99, 95% CI=0.97-1.02) or leukaemia (OR=1.01, 95% CI=0.96-1.06) mortality. Conclusions Findings are suggestive of increased lung cancer and leukaemia mortality from exposures encountered in the phosphate fertiliser industry. Increased employment duration, however, did not have significant associations with increased lung cancer or leukaemia mortality.