Marc Oliver - Academia.edu (original) (raw)

Papers by Marc Oliver

Research paper thumbnail of Health Surveillance of Gulf War I Veterans Exposed to Depleted Uranium: Updating the Cohort

Research paper thumbnail of Surveillance of Depleted Uranium Exposed Gulf War Veterans: Health Effects Observed in an Enlarged ???Friendly Fire??? Cohort

Journal of Occupational and Environmental Medicine, 2001

To determine clinical health effects in a small group of US Gulf War veterans (n = 50) who were v... more To determine clinical health effects in a small group of US Gulf War veterans (n = 50) who were victims of depleted uranium (DU) "friendly fire," we performed periodic medical surveillance examinations. We obtained urine uranium determinations, clinical laboratory values, reproductive health measures, neurocognitive assessments, and genotoxicity measures. DU-exposed Gulf War veterans with retained metal shrapnel fragments were excreting elevated levels of urine uranium 8 years after their first exposure (range, 0.018 to 39.1 micrograms/g creatinine for DU-exposed Gulf War veterans with retained fragments vs 0.002 to 0.231 microgram/g creatinine in DU exposed but without fragments). The persistence of the elevated urine uranium suggests ongoing mobilization from the DU fragments and results in chronic systemic exposure. Clinical laboratory outcomes, including renal functioning, were essentially normal. Neurocognitive measures showing subtle differences between high and low uranium exposure groups, seen previously, have since diminished. Sister chromatid exchange frequency, a measure of mutation in peripheral lymphocytes, was related to urine uranium level (6.35 sister chromatid exchanges/cell in the high uranium exposure group vs 5.52 sister chromatid exchanges/cell in the low uranium exposure group; P = 0.03). Observed health effects were related to subtle but biologically plausible perturbations in central nervous system function and a general measure of mutagen exposure. The findings related to uranium's chemical rather than radiologic toxicity. Observations in this group of veterans prompt speculation about the health effects of DU in other exposure scenarios.

Research paper thumbnail of Storage and Availability of Elastomeric Respirators in Health Care

Health Security, 2019

Use of reusable respirators, such as elastomeric half-face respirators (EHFRs), may serve as one ... more Use of reusable respirators, such as elastomeric half-face respirators (EHFRs), may serve as one solution to combating the problem of N95 respirator shortages experienced during infectious disease emergencies. To clarify whether logistical issues like respirator storage and availability are barriers to implementation of healthcare respiratory protection strategies that include EHFRs, this study aimed to evaluate the availability, storage, and respirator and filter replacement practices of EHFRs used in healthcare settings under routine use. Healthcare workers using EHFRs were surveyed about their use practices. To explore whether issues related to storage and availability of EHFRs affected compliance with assigned respirator use, responses were compared between concordant users and EHFR users who were assigned to use EHFRs but currently use different respirators ("discordant users"). Most concordant EHFR users reported that their respirator was always available when needed (63.8%). Almost two-thirds of concordant but only half of discordant users reported storing their EHFRs conveniently in the patient care area (p = <0.001). Among mobile workers, discordant users had higher odds (aOR = 3.2, 95% CI [1.4,7.5]) of reporting that their respirator was not stored in the patient care area, suggesting that storage location has a significant impact on compliance with expected practice, particularly in this group. Storage and access are barriers to optimal elastomeric respirator use in healthcare. Strategies to assure ready availability and storage of respirators will permit EHFR inclusion in pandemic and routine respiratory protection programs.

Research paper thumbnail of User acceptance of reusable respirators in health care

American Journal of Infection Control, 2019

Research paper thumbnail of Surveillance results and bone effects in the Gulf War depleted uranium-exposed cohort

Journal of Toxicology and Environmental Health, Part A, 2018

Research paper thumbnail of The U.S. Department of Veterans' Affairs depleted uranium exposed cohort at 25 Years: Longitudinal surveillance results

Environmental Research, 2017

Research paper thumbnail of Biologic monitoring and surveillance results for the department of veterans affairs' depleted uranium cohort: Lessons learned from sustained exposure over two decades

American Journal of Industrial Medicine, 2015

Research paper thumbnail of Pulmonary Function In Gulf War I Veterans 20 Years After Exposure To Depleted Uranium Inhalation And Shrapnel Injury

A26. WORK-RELATED LUNG DISEASE: CLINICAL AND EPIDEMIOLOGICAL APPROACHES, 2012

Research paper thumbnail of Long-term exposure to depleted uranium in Gulf-War veterans does not induce chromosome aberrations in peripheral blood lymphocytes

Mutation Research/Genetic Toxicology and Environmental Mutagenesis, 2013

Research paper thumbnail of Work Productivity Impairment From Musculoskeletal Disorder Pain in Long-Term Caregivers

Journal of Occupational and Environmental Medicine, 2009

Research paper thumbnail of Terrorism-Preparedness Training for Non-Clinical Hospital Workers: Tailoring Content and Presentation to Meet Workers’ Needs

Journal of Occupational and Environmental Medicine, 2004

Research paper thumbnail of Workplace Threats to Health and Job Turnover Among Women Workers

Journal of Occupational and Environmental Medicine, 2003

Research paper thumbnail of Pulmonary Health Effects in Gulf War I Service Members Exposed to Depleted Uranium

Journal of Occupational and Environmental Medicine, 2013

Research paper thumbnail of The Gulf War Depleted Uranium Cohort at 20 years

Research paper thumbnail of Urinary Uranium Concentrations in an Enlarged Gulf War Veteran Cohort

Research paper thumbnail of Male and Female Rate Differences in Carpal Tunnel Syndrome Injuries: Personal Attributes or Job Tasks?

Environmental Research, 2000

Research paper thumbnail of Health Effects of Depleted Uranium on Exposed Gulf War Veterans

Environmental Research, 2000

Research paper thumbnail of Cleaning and Disinfection Perceptions and Use Practices Among Elastomeric Respirator Users in Health care

Workplace Health & Safety, 2020

Background: Reusable elastomeric respirator use in health care may represent one solution to addr... more Background: Reusable elastomeric respirator use in health care may represent one solution to address N95 respirator shortages experienced during infectious disease outbreaks, but cleaning and disinfection requirements may limit their utility. Evidence of respirator cleaning and disinfection behaviors and practices by health care workers may inform guidance on reusable respirator use. Methods: Medical system elastomeric respirator users were surveyed about respirator cleaning and disinfection practices and perceptions via an electronic survey. Respondents were subsequently classified based on reported compliance with their assigned respirator use. To explore whether respirator cleaning and disinfection issues affected compliance with assigned device use, responses were compared between user groups and adjusted for covariates. Results: A total of 432 of 2,024 (21%) eligible elastomeric respirator users completed the survey. Most (>90%) reported that their respirator was clean, but ...

Research paper thumbnail of A Pilot Assessment of Hospital Preparedness for Bioterrorism Events

Prehospital and Disaster Medicine, 2006

Objective:Lessons on question content and refinement of a 2003 Agency for Healthcare Research and... more Objective:Lessons on question content and refinement of a 2003 Agency for Healthcare Research and Quality-Health Resources Services Administration (Agency for Healthcare Research and Quality-Health Resources Services) pilot hospital preparedness assessment tool designed to capture activities in more detail than previous studies are reported in this study.Methods:Responses from fixed-choice questions, including organizational and geographical differences, were analyzed using the chi-square test. Openended questions were evaluated qualitatively.Results:Of the respondents, 91% had developed plans and 97% designated a bio-event coordinator, but only 47% had allocated funds. Urban hospitals were more likely to participate in regional infectious disease monitoring. Hospitals that participated in a network were more likely to fund preparedness, share bio-event coordinators and medical directors, and provide advanced training.Conclusions:Several issues deserve further study: (1) hospital ne...

Research paper thumbnail of Biological monitoring and surveillance results of Gulf War I veterans exposed to depleted uranium

International archives of …, 2006

Biological monitoring and surveillance results of Gulf War I veterans ... Received: 2 November 20... more Biological monitoring and surveillance results of Gulf War I veterans ... Received: 2 November 2004 / Accepted: 6 April 2005 / Published online: 2 August 2005 © Springer-Verlag 2005 ... Abstract Objective: To relate medical surveillance out-comes to uranium biomonitoring results in a ...

Research paper thumbnail of Health Surveillance of Gulf War I Veterans Exposed to Depleted Uranium: Updating the Cohort

Research paper thumbnail of Surveillance of Depleted Uranium Exposed Gulf War Veterans: Health Effects Observed in an Enlarged ???Friendly Fire??? Cohort

Journal of Occupational and Environmental Medicine, 2001

To determine clinical health effects in a small group of US Gulf War veterans (n = 50) who were v... more To determine clinical health effects in a small group of US Gulf War veterans (n = 50) who were victims of depleted uranium (DU) &amp;amp;quot;friendly fire,&amp;amp;quot; we performed periodic medical surveillance examinations. We obtained urine uranium determinations, clinical laboratory values, reproductive health measures, neurocognitive assessments, and genotoxicity measures. DU-exposed Gulf War veterans with retained metal shrapnel fragments were excreting elevated levels of urine uranium 8 years after their first exposure (range, 0.018 to 39.1 micrograms/g creatinine for DU-exposed Gulf War veterans with retained fragments vs 0.002 to 0.231 microgram/g creatinine in DU exposed but without fragments). The persistence of the elevated urine uranium suggests ongoing mobilization from the DU fragments and results in chronic systemic exposure. Clinical laboratory outcomes, including renal functioning, were essentially normal. Neurocognitive measures showing subtle differences between high and low uranium exposure groups, seen previously, have since diminished. Sister chromatid exchange frequency, a measure of mutation in peripheral lymphocytes, was related to urine uranium level (6.35 sister chromatid exchanges/cell in the high uranium exposure group vs 5.52 sister chromatid exchanges/cell in the low uranium exposure group; P = 0.03). Observed health effects were related to subtle but biologically plausible perturbations in central nervous system function and a general measure of mutagen exposure. The findings related to uranium&amp;amp;#39;s chemical rather than radiologic toxicity. Observations in this group of veterans prompt speculation about the health effects of DU in other exposure scenarios.

Research paper thumbnail of Storage and Availability of Elastomeric Respirators in Health Care

Health Security, 2019

Use of reusable respirators, such as elastomeric half-face respirators (EHFRs), may serve as one ... more Use of reusable respirators, such as elastomeric half-face respirators (EHFRs), may serve as one solution to combating the problem of N95 respirator shortages experienced during infectious disease emergencies. To clarify whether logistical issues like respirator storage and availability are barriers to implementation of healthcare respiratory protection strategies that include EHFRs, this study aimed to evaluate the availability, storage, and respirator and filter replacement practices of EHFRs used in healthcare settings under routine use. Healthcare workers using EHFRs were surveyed about their use practices. To explore whether issues related to storage and availability of EHFRs affected compliance with assigned respirator use, responses were compared between concordant users and EHFR users who were assigned to use EHFRs but currently use different respirators ("discordant users"). Most concordant EHFR users reported that their respirator was always available when needed (63.8%). Almost two-thirds of concordant but only half of discordant users reported storing their EHFRs conveniently in the patient care area (p = <0.001). Among mobile workers, discordant users had higher odds (aOR = 3.2, 95% CI [1.4,7.5]) of reporting that their respirator was not stored in the patient care area, suggesting that storage location has a significant impact on compliance with expected practice, particularly in this group. Storage and access are barriers to optimal elastomeric respirator use in healthcare. Strategies to assure ready availability and storage of respirators will permit EHFR inclusion in pandemic and routine respiratory protection programs.

Research paper thumbnail of User acceptance of reusable respirators in health care

American Journal of Infection Control, 2019

Research paper thumbnail of Surveillance results and bone effects in the Gulf War depleted uranium-exposed cohort

Journal of Toxicology and Environmental Health, Part A, 2018

Research paper thumbnail of The U.S. Department of Veterans' Affairs depleted uranium exposed cohort at 25 Years: Longitudinal surveillance results

Environmental Research, 2017

Research paper thumbnail of Biologic monitoring and surveillance results for the department of veterans affairs' depleted uranium cohort: Lessons learned from sustained exposure over two decades

American Journal of Industrial Medicine, 2015

Research paper thumbnail of Pulmonary Function In Gulf War I Veterans 20 Years After Exposure To Depleted Uranium Inhalation And Shrapnel Injury

A26. WORK-RELATED LUNG DISEASE: CLINICAL AND EPIDEMIOLOGICAL APPROACHES, 2012

Research paper thumbnail of Long-term exposure to depleted uranium in Gulf-War veterans does not induce chromosome aberrations in peripheral blood lymphocytes

Mutation Research/Genetic Toxicology and Environmental Mutagenesis, 2013

Research paper thumbnail of Work Productivity Impairment From Musculoskeletal Disorder Pain in Long-Term Caregivers

Journal of Occupational and Environmental Medicine, 2009

Research paper thumbnail of Terrorism-Preparedness Training for Non-Clinical Hospital Workers: Tailoring Content and Presentation to Meet Workers’ Needs

Journal of Occupational and Environmental Medicine, 2004

Research paper thumbnail of Workplace Threats to Health and Job Turnover Among Women Workers

Journal of Occupational and Environmental Medicine, 2003

Research paper thumbnail of Pulmonary Health Effects in Gulf War I Service Members Exposed to Depleted Uranium

Journal of Occupational and Environmental Medicine, 2013

Research paper thumbnail of The Gulf War Depleted Uranium Cohort at 20 years

Research paper thumbnail of Urinary Uranium Concentrations in an Enlarged Gulf War Veteran Cohort

Research paper thumbnail of Male and Female Rate Differences in Carpal Tunnel Syndrome Injuries: Personal Attributes or Job Tasks?

Environmental Research, 2000

Research paper thumbnail of Health Effects of Depleted Uranium on Exposed Gulf War Veterans

Environmental Research, 2000

Research paper thumbnail of Cleaning and Disinfection Perceptions and Use Practices Among Elastomeric Respirator Users in Health care

Workplace Health & Safety, 2020

Background: Reusable elastomeric respirator use in health care may represent one solution to addr... more Background: Reusable elastomeric respirator use in health care may represent one solution to address N95 respirator shortages experienced during infectious disease outbreaks, but cleaning and disinfection requirements may limit their utility. Evidence of respirator cleaning and disinfection behaviors and practices by health care workers may inform guidance on reusable respirator use. Methods: Medical system elastomeric respirator users were surveyed about respirator cleaning and disinfection practices and perceptions via an electronic survey. Respondents were subsequently classified based on reported compliance with their assigned respirator use. To explore whether respirator cleaning and disinfection issues affected compliance with assigned device use, responses were compared between user groups and adjusted for covariates. Results: A total of 432 of 2,024 (21%) eligible elastomeric respirator users completed the survey. Most (>90%) reported that their respirator was clean, but ...

Research paper thumbnail of A Pilot Assessment of Hospital Preparedness for Bioterrorism Events

Prehospital and Disaster Medicine, 2006

Objective:Lessons on question content and refinement of a 2003 Agency for Healthcare Research and... more Objective:Lessons on question content and refinement of a 2003 Agency for Healthcare Research and Quality-Health Resources Services Administration (Agency for Healthcare Research and Quality-Health Resources Services) pilot hospital preparedness assessment tool designed to capture activities in more detail than previous studies are reported in this study.Methods:Responses from fixed-choice questions, including organizational and geographical differences, were analyzed using the chi-square test. Openended questions were evaluated qualitatively.Results:Of the respondents, 91% had developed plans and 97% designated a bio-event coordinator, but only 47% had allocated funds. Urban hospitals were more likely to participate in regional infectious disease monitoring. Hospitals that participated in a network were more likely to fund preparedness, share bio-event coordinators and medical directors, and provide advanced training.Conclusions:Several issues deserve further study: (1) hospital ne...

Research paper thumbnail of Biological monitoring and surveillance results of Gulf War I veterans exposed to depleted uranium

International archives of …, 2006

Biological monitoring and surveillance results of Gulf War I veterans ... Received: 2 November 20... more Biological monitoring and surveillance results of Gulf War I veterans ... Received: 2 November 2004 / Accepted: 6 April 2005 / Published online: 2 August 2005 © Springer-Verlag 2005 ... Abstract Objective: To relate medical surveillance out-comes to uranium biomonitoring results in a ...