Occupational Exposure to Air Pollutants in Older Adults

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
Work in America Relevant Trends

• 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

3
(No Transcript)
4
The Population and Proportion of Older Workers in
the Labor Force is Increasing2000-2010
5
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/

6
Current Employment SituationHealth and
Retirement Study - 1998

• Percent of total popn
• 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

7
HRS 1998Job 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

8
HRS1998 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

9
HRS 1998Job 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

10
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

11
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

12
A Closer Look at General ExposuresFinance,
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

13
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

14
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

15
One High Risk OccupationMechanics and Repair

• 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

16
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

17
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

18
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
• lt 25 30.0 32.2

19
(No Transcript)
20
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!