NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Institute of Medicine (US) Committee on Curriculum Development in Environmental Medicine; Pope AM, Rall DP, editors. Environmental Medicine: Integrating a Missing Element into Medical Education. Washington (DC): National Academies Press (US); 1995.
Environmental Medicine: Integrating a Missing Element into Medical Education.
Show detailsINTRODUCTION
For those readers who are interested in learning more about environmental medicine, or have other resource needs related to environmental medicine, this appendix presents names, addresses, and phone numbers of relevant government agencies and professional associations and organizations, as well as information about computerized information services, and a listing of general references. Several lists of medical schools with federally funded environmental health activities are also provided. Finally, three tables are presented that describe (1) selected environmental agents and their associated sources and potential exposures, (2) selected work-related diseases, disorders, and conditions associated with various agents, and (3) selected job categories, exposures, and associated work-related diseases and conditions.
The information presented in this appendix is not intended to be comprehensive or exhaustive, but rather supplemental and complementary.
GOVERNMENT AGENCIES
Throughout our history, numerous federal and state agencies have been created to address the issues related to safety and health in the workplace, as well as the surrounding environment. Federal and state agencies have become increasingly involved in examining and monitoring the impact of the environment on the health of the public. The following list highlights several of the federal and state agencies currently involved in monitoring, evaluating, and protecting the environment and its relation to public health. Each agency is an invaluable source of information and can readily provide additional resources upon one's request. The agencies are listed in alphabetical order with federal organizations first, followed by state agencies.
Federal Agencies
Agency for Toxic Substances and Disease Registry
The Agency for Toxic Substances and Disease Registry (ATSDR) was created by Superfund legislation in 1980 as a part of the U.S. Department of Health and Human Services. ATSDR's mission is to prevent or mitigate adverse human health effects and diminished quality of life resulting from exposure to hazardous substances in the environment. In order to carry out its mission and to serve the needs of the American people, ATSDR conducts activities in public health assessments, health investigations, exposure and disease registry, emergency response, toxicological profiles, health education, and applied research.
ATSDR's Division of Health Education is mandated to assemble, develop, and distribute to the states, medical colleges, physicians, and other health professionals, educational materials on medical surveillance, screening, and methods of diagnosis and treatment of injury or disease related to exposure to hazardous substances. The Division also provides training and education for primary care physicians to diagnose and treat illness caused by hazardous substances and supports curriculum development and applied research in the area of environmental health.
The Division has developed a self-study series called Case Studies in Environmental Medicine which uses case studies to guide physicians through the diagnosis and treatment of illnesses related to hazardous substances exposure.
Several projects have also been developed and implemented to advance these goals. Some of the programs are described below:
- State Cooperative Agreements offer funding and assistance to state health departments for developing educational materials and activities in environmental medicine for health care professionals;
- National Association of County Health Officials Environmental Health Project is a cooperative agreement with ATSDR to conduct instructional sessions and develop supporting materials for local health officials and the medical community concerning the communication of health risks from exposure to hazardous substances;
- Project EPOCH-Envi is co-sponsored by ATSDR and the National Institute for Occupational Safety and Health (NIOSH). Through the cooperative agreement, a consortium of medical schools works towards introducing curricula in occupational and environmental medicine in primary care residency programs;
- The National Medical Association (NMA) is the largest organization of African-American physicians in the United States. ATSDR co-sponsors sessions and lectures on environmental health through the NMA's Regional Environmental Workshops. NMA has recognized the seriousness of environmental contamination in minority communities and is now working with ATSDR to provide training in environmental health for its members.
Agency for Toxic Substances and Disease Registry
1600 Clifton Road, N.E.
Mail Stop E-28
Atlanta, GA 30333
(404) 639–0501
Emergencies (404) 639–0615
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is charged with protecting the public health of the nation by providing leadership and direction in the prevention and control of diseases and other preventable conditions and responding to public health emergencies.
Centers for Disease Control and Prevention
1600 Clifton Road, N.E.
Atlanta, GA 30333
(404) 639–3286
Consumer Product Safety Commission
The Consumer Products Safety Commission provides information on health and safety effects related to consumer products. It has direct jurisdiction over chronic and chemical hazards in consumer products; assists consumers in evaluating the comparative safety of consumer products; develops uniform safety standards for consumer products and minimizes conflicting state and local regulations; and promotes research and investigation into the causes and prevention of product-related deaths, illnesses, and injuries.
Consumer Product Safety Commission
East West Towers
4340 East West Highway
Bethesda, MD 20814
(301) 504–0580
(800) 638–2772
Department of Energy
The Department of Energy (DOE) provides the framework for a comprehensive and balanced national energy plan through the coordination and administration of the energy functions of the federal government. The Department is responsible for long-term, high-risk research and development of energy technology; the marketing of federal power; energy conservation; the nuclear weapons program; energy regulatory programs; and a central energy data collection and analysis program.
The Environment, Safety and Health Office of the DOE provides independent oversight of departmental execution of environmental, occupational safety and health, and nuclear/nonnuclear safety and security laws, regulations, and policies; ensures that departmental programs are in compliance with environmental, health, and nuclear/nonuclear safety protection plans, regulations, and procedures; provides an independent overview and assessment of Department-controlled activities to ensure that safety-impacted programs receive management review; and carries out legal functions of the nuclear safety civil penalty and criminal referral activities mandated by the Price-Anderson Amendments Act.
Department of Energy
1000 Independence Avenue, S.W.
Washington, DC 20585
(202) 586–5000
Department of Health and Human Services
The Department of Health and Human Services (HHS) is the Cabinet-level department of the federal executive branch most concerned with people and most involved with then nation's human concerns. In one way or another—whether it is mailing out social security checks or making health services more widely available—HHS touches the lives of more Americans than any other federal agency. It is literally a department of people saving people, from newborn infants to our most elderly citizens.
Department of Health and Human Services
200 Independence Ave., S.W.
Washington, DC 20201
(202) 679–0257
Environmental Protection Agency
The Environmental Protection Agency (EPA) was established in 1970 in order to permit coordinated and effective governmental action on behalf of the environment. It endeavors to abate and control pollution systematically, by proper integration of a variety of research, monitoring, standard setting, and enforcement activities. As a complement to its other activities, the Agency coordinates and supports research and antipollution activities by state and local governments, private and public groups, individuals, and educational institutions. It also reinforces efforts among other federal agencies with respect to the impact of their operations on the environment, and it is specifically charged with publishing its determinations when those hold that a proposal is unsatisfactory from the standpoint of public health or welfare or environmental quality. In all, the EPA is designed to serve as the public's advocate for a livable environment.
Environmental Protection Agency
401 M Street, S.W.
Washington, DC 20460
(202) 260–2090
Food and Drug Administration
The Food and Drug Administration (FDA) inspects manufacturing plants and warehouses, collects and analyzes samples of foods, drugs, cosmetics, and therapeutic devices for adulteration and misbranding. Responsibilities also extend to sanitary preparation and handling of foods, waste disposal on interstate carriers, and enforcement of the Radiation Control Act as related to consumer products. Epidemiological and other investigations are conducted to determine causative factors or possible health hazards involved in adverse reactions or hazardous materials accidents. Investigators are located in resident posts in major cities throughout the country.
Food and Drug Administration
National Headquarters
200 C Street, S.W.
Washington, DC 20204
(301) 443–2410
Health Resources and Services Administration
Health Resources and Services Administration (HRSA) is responsible for general health services and resource issues relating to issues of access, equity, quality, and cost of care. In order to accomplish this goal, the Administration supports states and communities in their efforts to deliver health care to underserved segments of the population; participates in the federal campaign against AIDS; provides leadership in improving the education, distribution, quality, and use of the health professionals needed to staff the nation's health care system; tracks the supply of and requirements for health professionals and addresses their competence through the development of a health practitioner data bank; and strengthens the public health system by working with state and local public health agencies.
Health Resources and Services Administration
5600 Fishers Lane
Rockville, MD 20857
(301) 443–2086
National Cancer Institute
The National Cancer Institute (NCI) conducts and funds research on the causes, diagnosis, treatment, prevention, control, and biology of cancer and the rehabilitation of people with cancer. NCI also funds projects for innovative and effective approaches to preventing and controlling cancer, establishes multidisciplinary cancer care and clinical research activities in community hospitals, and supports cancer research training, clinical training, continuing education, and career development.
National Cancer Institute
National Institutes of Health
9000 Rockville Pike
Bethesda, MD 20892
(301) 496–5615
(800) 422–6237/(800) 4CANCER
National Center for Environmental Health
The mission of the National Center for Environmental Health (NCEH) is to promote health and quality of life by preventing or controlling disease, injury, and disability related to the interactions between people and their environment outside the workplace. To achieve these goals, NCEH directs programs both to prevent the adverse health effects of exposure to toxic substances and to combat the societal and environmental factors that increase the likelihood of exposure and disease. NCEH also works to prevent injuries and diseases resulting from natural or technologic disasters and to prevent birth defects and development disabilities resulting from nutritional deficiencies or exposure to environmental toxins in utero or during early childhood.
National Center for Environmental Health
Mailstop F29
4770 Buford Highway, N.E.
Atlanta, GA 30341–3724
(404) 488–7003
National Institute for Occupational Safety and Health
The National Institute for Occupational Safety and Health (NIOSH) was established by the Occupational Safety and Health Act of 1970 to conduct research on occupational diseases and injuries, respond to requests for assistance by investigating problems of health and safety in the workplace, recommend standards to the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA), and train professionals in occupational safety and health.
National Institute for Occupational Safety and Health
200 Independence Avenue, S.W.
Washington, DC 20201
(800) 356–4674
NIOSH Technical Information Branch provides a toll-free technical information service (1– 800–35-NIOSH) that provides convenient public access to NIOSH and its information resources. Callers may request information about NIOSH activities or about any aspect of occupational safety and health.
NIOSH Technical Information Branch
Robert A. Taft Laboratory
Mail Stop C-19
4676 Columbia Parkway
Cincinnati, OH 45226–1998
(800) 35-NIOSH
Project EPOCH-Envi. In conjunction with ATSDR, NIOSH established Project EPOCH-Envi to provide support and training to medical schools from around the country who wish to implement curricula in occupational and environmental medicine in primary care residency programs. Through this cooperative agreement, Project EPOCH-Envi conducts workshops and training programs for interested medical school faculty. The sessions focus on instructing faculty members how to develop curricula in occupational and environmental medicine.
Project EPOCH-Envi
National Institute for Occupational Safety and Health
Division of Training and Manpower Development
Curriculum Development Branch
Robert A. Taft Laboratories
4676 Columbia Parkway
Cincinnati, OH 45226–1998
(800) 356–4674
In 1992–1993, the following medical schools were involved in Project EPOCH-Envi or represented by faculty members:
University of Arkansas College of Medicine
University of California, San Francisco, School of Medicine
University of Connecticut School of Medicine
University of Florida College of Medicine
University of Miami School of Medicine
Emory University School of Medicine
Medical College of Georgia
Morehouse School of Medicine
University of Illinois College of Medicine at Peoria
University of Illinois College of Medicine at Urbana-Champaign
University of Illinois College of Medicine at Chicago
Loyola University Chicago, Stritch School of Medicine
Southern Illinois University School of Medicine
University of Massachusetts Medical School
University of Missouri, Columbia School of Medicine
Saint Louis University School of Medicine
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School
Cornell University Medical Center
University of Rochester School of Medicine
State University of New York at Brooklyn College of Medicine
State University of New York at Syracuse College of Medicine
Bowman Gray School of Medicine
Duke University School of Medicine
East Carolina University School of Medicine
University of North Carolina at Chapel Hill School of Medicine
Medical University of South Carolina College of Medicine
University of South Carolina School of Medicine
University of Texas Medical Center at San Antonio
University of Vermont College of Medicine
West Virginia University School of Medicine
NIOSH Educational Resource Centers
The National Institute for Occupational Safety and Health (NIOSH) funds Educational Resource Centers (ERCs) which conduct research and administer graduate training programs in occupational medicine, occupational health nursing, and industrial hygiene and safety. They also provide continuing education programs for safety and health professionals and outreach programs for the community.
ALABAMA
Deep South Center for Occupational Health and Safety
University of Alabama at Birmingham
Elizabeth Murray
Continuing Education
(205) 934–7178
CALIFORNIA
Northern California ERC
Center for Occupational and Environmental Health
University of California at Berkeley
Barbara Plog, Continuing Education
(510) 231–5647
Southern California ERC
University of Southern California
Ramona Cayuela, Continuing Education
(213) 740–3995
ILLINOIS
Illinois ERC
Occupational Health and Safety Center
University of Illinois, Chicago
Leslie Nickels, School of Public Health
(312) 996–7473
MARYLAND
Johns Hopkins ERC
Johns Hopkins University
Department of Environmental Health Sciences
Dr. Jacqueline Corn,
Continuing Education
(410) 955–2609
MASSACHUSETTS
Harvard ERC
Harvard Educational Resource Center
Daryl Bichel, Continuing Education
(617) 432–3314
MICHIGAN
Michigan ERC
University of Michigan
Center for Occupational Health and Safety
Randy Rabourn, Continuing Education
(313) 936–0148
MINNESOTA
Midwest Center for Occupational Health and Safety
University of Minnesota
Jeanne Ayers, Continuing Education
(612) 221–3992
NEW YORK/NEW JERSEY
UMDNJ-Robert Wood
Johnson Medical School
Barbara Young, Registrar
(908) 235–5062
NORTH CAROLINA
Occupational Safety and Health ERC
University of North Carolina
Larry Hyde, Continuing Education
(919) 962–2101
OHIO
University of Cincinnati ERC
University of Cincinnati
Department of Environmental Health
Judy Jarrell, Continuing Education
(513) 558–1730
TEXAS
Southwest Center for Occupational Health and Safety
Pam Parker, Continuing Education
(713) 792–4648
UTAH
Rocky Mountain Center for Occupational and Environmental Health
University of Utah
Connie Crandall, Continuing Education
(801 581–5710
WASHINGTON
Northwest Center for Occupational Health and Safety
University of Washington
Jan Schwert, Continuing Education
(206) 543–1069
National Institute of Environmental Health Sciences
The National Institute of Environmental Health Sciences (NIEHS) is the principal federal agency for biomedical research on the effects of chemical, physical, and biological environmental agents on human health and well-being. The Institute supports research and training focused on the identification, assessment, and mechanism of action of potentially harmful agents in the environment. Research results form the basis for preventive programs for environmentally-related diseases and for action by regulatory agencies.
The NIEHS currently sponsors several programs available to the medical school community, individual researchers, and other organizations or centers interested in studying the effects of the environment on health and how to better educate medical school students, employees, and the general public about environmental health risks and hazards. Some of the awards are described below:
- The Environmental/Occupational Medicine Academic Award Program was established by the NIEHS to address the need for increased awareness by physicians of the impact of environmental and occupational conditions on illness, injury, and death. The award serves to assist in improving the quality of environmental/occupational medicine curricula and of fostering research careers in occupational medicine.
Environmental/Occupational Medicine Academic Awards
Chief, Environmental Health Resources Branch
Division of Extramural Research and Training
National Institute of Environmental Health Services
P.O. Box 12233
Research Triangle Park, NC 27709
(919) 541–7825
Environmental/Occupational Medicine Academic Awards Recipients of NIEHS' Environmental/Occupational Medicine Academic Awards for 1994 include:
University of California, Davis, School of Medicine
University of California, Irvine, College of Medicine
University of California, San Francisco, School of Medicine
University of Colorado School of Medicine
Yale University School of Medicine
George Washington University School of Medicine
Emory University School of Medicine
Morehouse School of Medicine
University of Iowa College of Medicine
University of Maryland School of Medicine
Harvard Medical School
University of Massachusetts Medical School
Wayne State University School of Medicine
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School
Mount Sinai School of Medicine
University of Rochester School of Medicine and Dentistry
University of Washington School of Medicine
- Environmental Health Sciences Center Awards provide core support to universities for multidisplinary research in environmental health. Each center serves as national resources for environmental health research and manpower development. Areas of particular interest include: air, water, and food pollution; toxic mechanisms and body defense mechanisms; and the environmental aspects of cancer, birth defects, behavioral anomalies, respiratory and cardiovascular disease and diseases of other organs.
- Superfund Hazardous Substances—Basic Research and Education Program supports research to expand the base of scientific knowledge needed for adequate assessment of exposure and health risks from the release of hazardous substances, reduction in the amount and toxicity of hazardous substances, and ultimately, to prevent adverse human health effects.
- Hazardous Waste Worker Health and Safety Training provides grant support for the development and administration of health and safety training programs for workers and supervisors engaged in activities related to hazardous waste removal, containment, and transportation, or emergency response. In 1991, this program was expanded to include workers involved in generating and transporting hazardous materials and wastes, oil spill cleanup workers and workers involved in the cleanup of nuclear workshops facilities.
- Clinical Investigator Award provides for the development of clinical investigators in the field of environmental health/human toxicology. The award of up to $35,000 per year supports the research development of physicians to work with research teams on problems arising from the exposures of human populations to environmental chemicals.
National Institute of Environmental Health Sciences
P.O. Box 12233
104 T.W. Alexander Drive
Research Triangle, NC 27709
(919) 541–3212
National Institutes of Health
The National Institutes of Health (NIH) is the principal biomedical research agency of the federal government. Its mission is to pursue knowledge to improve human health. To accomplish this goal, the Institute seeks to expand fundamental knowledge about the nature and behavior of living systems, to apply that knowledge to extend the health of human lives, and to reduce the burdens resulting from disease and disability. In the quest of this mission, NIH supports biomedical and behavioral research around the world, trains promising young researchers, and promotes the acquisition and distribution of medical knowledge. Research activities conducted by NIH will determine much of the quality of health care for the future and reinforce the quality of health care currently available.
National Institutes of Health
9000 Rockville Pike
Bethesda, MD 20892
Nuclear Regulatory Commission
The Nuclear Regulatory Commission (NRC) licenses and regulates civilian use of nuclear energy to protect health and safety and the environment. This is achieved by licensing persons and companies to build and operate nuclear reactors and other facilities and to own and use nuclear materials. The Commission makes rules and sets standards for these types of licenses. It also carefully inspects the activities of the persons and companies licensed to ensure that they do not violate the safety rules of the Commission.
Nuclear Regulatory Commission
Washington, DC 20555
(301) 492–7000
Occupational Safety and Health Administration
The Occupational Safety and Health Administration (OSHA) was created within the Department of Labor under the Occupational Safety and Health Act of 1970 to enforce national occupational health and safety standards. OSHA encourages employers and employees to reduce workplace hazards, implements new or improved safety and health programs, provides research in occupational safety and health, requires a reporting and recording system to monitor job-related illnesses and injuries, training, develops mandatory job safety and health standards and enforces them effectively, and provides for the development, analysis, evaluation, and approval of state occupational safety and health programs.
Occupational Safety and Health Administration
Office of Administrative Services
200 Constitution Ave., N.W.
Room N-310
Washington, DC 20210
(202) 219–4667
State Agencies
State Health Departments and Radon Contacts
Alabama Department of Public Health
434 Monroe Street
Montgomery, AL 36130
(205) 242–5052
Radon: Montgomery
(800) 582–1866
(205) 242–5315
Alaska Division of Public Health
Department of Health and Social Services
P.O. Box H
Juneau, AK 99811
(907) 465–3090
Radon: Juneau
(800) 478–4845
(907) 465–3019
Arizona Department of Health Services
1740 W. Adams Street
Phoenix, AZ 85007
(602) 542–1024
Radon: Phoenix
(602) 255–4845
Arkansas Department of Health
4815 W. Markham Street
Little Rock, AR 72205
(501) 661–2111
Radon: Little Rock
(501) 661–2301
California Department of Health Services
714 P Street
Sacramento, CA 95814
(916) 657–1425
Radon: Sacramento
(916) 324–2208
Colorado Department of Health
4210 E. 11th Avenue
Denver, CO 80220
(303) 331–4600
Radon: Denver
(800) 846–3986
(303) 692–3057
Connecticut Department of Health Services
150 Washington Street
Hartford, CT 06106
(203) 566–2038
Radon: Hartford
(203) 566–3122
Delaware Division of Public Health
Department of Health and Social Services
P.O. Box 637
Dover, DE 19903
(302) 739–4701
Radon: Dover
(302) 739–3787
(800) 554–4636 (In-state)
District of Columbia Department of Human Services
Commission of Public Health
1660 L Street, N.W., 12th Floor
Washington, D.C. 20036
(202) 673–7700
Radon: Washington, D.C.
(202) 727–7221
Florida Health Office
Department of Health and Rehabilitation Services
1323 Winewood Blvd.
Building 1
Tallahassee, FL 32301
(904) 487–2705
Radon: Orlando
(904) 488–1525
(800) 543–8279
Georgia Division of Public Health
878 Peachtree Street
Atlanta, GA 30309
(404) 894–7505
Radon: Atlanta
(404) 894–6644
Guam Public Health and Social Services
P.O. Box 2816
Agana, Guam 96910
(671) 734–2083
Hawaii Department of Health
1250 Punchbowl Street
P.O. Box 3378
Honolulu, HI 96801
(808) 586–4410
Radon: Honolulu
(808) 543–4383
Idaho Division of Health
Department of Health and Welfare
450 W. State Street
Boise, ID 83720
(208) 334–5945
Radon: Boise
(800) 445–8647
(208) 334–6584
Illinois Department of Public Health
535 W. Jefferson Street
Springfield, IL 62761
(217) 782–4977
Radon: Springfield
(800) 325–1245
(217) 786–6384
Indiana Board of Health
P.O. Box 1964
1330 W. Michigan Street
Indianapolis, IN 46206
(317) 633–8400
Radon: Indianapolis
(317) 633–0150
(800) 272–9723 (In-state)
Iowa Department of Public Health
Robert Lucas State Office Building
East 12th and Walnut Streets
Des Moines, IA 50319
(515) 281–5605
Radon: Des Moines
(515) 281–7781
(800) 383–5992 (In-state)
Kansas Department of Health and Environment
900 SW Jackson
Topeka, KS 66612
(913) 296–1522
Radon: Topeka
(913) 296–1560
Kentucky Department for Health Services
Cabinet for Human Resources
275 E. Main Street
Frankfort, KY 40621
(502) 564–3970
Radon: Frankfort
(502) 564–3700
Louisiana Department of Health and Hospitals
P.O. Box 629
Baton Rouge, LA 70821
(504) 342–9500
Radon: Baton Rouge
(800) 256–2494
(504) 925–7042
Maine Bureau of Health
Department of Human Services
State House Station 11
Augusta, ME 04333
(207) 289–2736
Radon: Augusta
(800) 232–0842
(207) 789–5689
Maryland Department of Health and Mental Hygiene
201 W. Preston Street
Baltimore, MD 21201
(301) 225–6500
Radon: Baltimore
(800) 872–3666
(301) 631–3300
Massachusetts Department of Public Health
150 Tremont Street
Boston, MA 02111
(617) 727–2700
Radon: North Hampton
(413) 586–7525
Michigan Department of Public Health
3423 N. Logan Street
Lansing, MI 48909
(517) 335–8024
Radon: Lansing
(517) 335–8190
Minnesota Department of Health
717 Delaware Street, S.E.
P.O. Box 9441
Minneapolis, MN 55440
(612) 623–5460
Radon: Minneapolis
(612) 627–5012
(800) 798–9050
Mississippi Department of Health
P.O. Box 1700
2423 N. State Street
Jackson, MS 39215
(601) 960–7634
Radon: Jackson
(800) 626–7739
(601) 354–6657
Missouri Department of Health
P.O. Box 570
Jefferson City, MO 65102
(314) 751–60001
Radon: Jefferson City
(314) 751–6083
(800) 669–7236 (In-state)
Montana Department of Health and Environmental Sciences
Cogswell Building
Helena, MT 59620
(406) 444–2544
Radon: Helena
(406) 444–3671
Nebraska Department of Health
301 Centennial Mall S.
P.O. Box 95007
Lincoln, NE 68509
(402) 471–4047
Radon: Lincoln
(402) 471–2168
(800) 334–9491 (In-state)
Nevada Health Division
505 E. King Street
Carson City, NV 89710
(702) 687–4740
Radon: Carson City
(702) 687–5394
New Hampshire Division of Public Health Services
Health and Welfare Building
Hazen Drive
Concord, NH 03301
(603) 271–4500
Radon: Concord
(603) 271–4674
New Jersey Department of Health
CN 360
Trenton, NJ 08625
(609) 292–7837
Radon: Trenton
(609) 987–6396
(800) 648–0394
New Mexico Health and Environmental Department
1190 South Francis Drive
Santa Fe, NM 87503
(505) 827–2613
Radon: Santa Fe
(505) 827–4300
New York Department of Health
Tower Building
Empire State Plaza
Albany, NY 12237
(518) 474–2011
Radon: Albany
(518) 458–6451
North Carolina Department of Environment
Health and Natural Resources
Division of Health Services
P.O. Box 27687
Raleigh, NC 27611
(919) 733–4984
Radon: Raleigh
(919) 571–4141
North Dakota Department of Health and Consolidated Labs
State Capitol Judicial Wing
600 E. Boulevard Avenue
Bismarck, ND 58505
(701) 224–2372
Radon: Bismarck
(701) 224–2348
Ohio Department of Health
246 N. High Street
Columbus, OH 43266
(614) 466–2253
Radon: Columbus
(614) 644–2727
(800) 523–4439 (In-state)
Oklahoma Department of Health
1000 NE 10th Street
P.O. Box 53551
Oklahoma City, OK 73152
(405) 271–4200
Radon: Oklahoma City
(405) 271–5221
Oregon State Health Division
1400 SW 5th Avenue
Portland, OR 97201
(503) 229–4032
Radon: Portland
(503) 731–4014
Pennsylvania Department of Health
P.O. Box 90
Harrisburg, PA 17108
(717) 787–6436
Radon: Harrisburg
(717) 787–2480
(800) 23-RADON (In-state)
Puerto Rico Department of Health
Building A, Call Box 70184
San Juan, PR 00936
(809) 766–1616
Radon: Rio Piedras
(809) 767–3563
Rhode Island Department of Health
Cannon Health Building
3 Capitol Hill
Providence, RI 02908
(401) 277–2231
Radon: Providence
(401) 277–2438
South Carolina Department of Health and Environmental Control
2600 Bull Street
Columbia, SC 29201
(803) 735–4880
Radon: Columbia
(800) 768–0362
(803) 734–4700
South Dakota Department of Health
445 E. Capitol
Pierre, SD 57501
(605) 773–3361
Radon: Pierre
(605) 773–3351
Tennessee Department of Health and Environment
344 Cordell Hull Building
Nashville, TN 37247–0101
(615) 741–3111
Radon: Nashville
(800) 232–1139
(615) 741–3651
Texas Department of Health
1100 W. 49th Street
Austin, TX 78756
(512) 458–7111
Radon: Austin
(512) 834–6688
Utah Department of Health
288 N. 1460 W.
P.O. Box 16700
Salt Lake City, UT 84116
(801) 538–6111
Radon: Salt Lake City
(801) 538–6734
Vermont Department of Health
P.O. Box 70
60 Main Street
Burlington, VT 05402
(802) 863–7280
Radon: Montpelier
(800) 640–0601
(802) 828–2886
Virgin Island Department of Health
L18 Sugar Estate
St. Thomas, VI 00802
(809) 774–4888
Virginia Department of Health
P.O. Box 2448
Richmond, VA 23218
(804) 786–3561
Radon: Richmond
(800) 468–0138
(804) 786–5932
Washington Department of Health
1112 S.E. Quince Street
Olympia, WA 98504–7890
(206) 753–5871
Radon: Olympia
(800) 323–9727
(206) 753–4518
West Virginia Department of Public Health
Building 3, State Capital Complex
Charleston, WV 25305
(304) 348–2971
Radon: South Charleston
(304) 558–3526
(800) 922–1255 (In-state)
Wisconsin Division of Health
Department of Health and Social Services
P.O. Box 309
Madison, WI 53707
(608) 266–1511
Radon: Madison
(608) 267–4795
Wyoming Health and Medical Services
Hathaway Building
Cheyenne, WY 82002
(307) 777–6464
Radon: Cheyenne
(800) 458–5847
(307) 777–6015
ASSOCIATIONS AND ORGANIZATIONS
American Association of Occupational Health Nurses
The American Association of Occupational Health Nurses (AAOHN) is an organization of registered professional nurses employed by business and industrial firms; nurse educators, nurse editors, nurse writers; and others interested in occupational health nursing.
American Association of Occupational Health Nurses
50 Lenox Pointe
Atlanta, GA 30324
(800) 241–8014
(404) 262–1162
American Association of Poison Control Centers
The American Association of Poison Control Centers (AAPCC) aids in the procurement of information on the ingredients and potential acute toxicity of substances that may cause accidental poisonings and on the proper management of such poisonings. The AAPCC has established standards for the poison information and control centers, offering immediate information through hotlines around the country. The AAPCC also conducts educational programs and prepares visual aids on prevention of accidental poisonings; maintains a national poisoning database; and operates a nationwide speakers' bureau.
American Association of Poison Control Centers
3800 Reservoir Road, N.W.
Washington, DC 20007
(202) 784–4666/362–7217
(202) 784–2530 FAX
ALABAMA
Birmingham
Regional Poison Control Center
The Children's Hospital of Alabama
Emergency (205) 939–9201
(800) 292–6678 (In-state)
(205) 933–4050
ARIZONA
Phoenix
Samaritan Regional Poison Center
(602) 253–3334
Tucson
Arizona Poison and Drug Information Center
Emergency (800) 362–0101 (In-state)
(602) 626–6016
CALIFORNIA
Fresno
Fresno Regional Poison Control Center
Valley Children's Hospital
Emergency (800) 346–5922 (In-state)
(202) 445–1222
Sacramento
University of California, Davis
Medical Center Regional Poison Control Center
Emergency (916) 734–3692
(800) 342–9293 (In-state)
San Diego
San Diego Regional Poison Control Center
University of California, San Diego Medical Center
Emergency (619) 543–6000
(800) 876–4766 (In-state)
San Francisco
San Francisco Bay Area Regional Poison Control Center
San Francisco General Hospital
Emergency (800) 523–2222
San Jose
Santa Clara Valley Medical Center Regional Poison Center
Emergency (408) 299–5112
(800) 342–9293 (In-state)
COLORADO
Denver
Rocky Mountain Poison and Drug Center
Emergency (303) 629–1123
DISTRICT OF COLUMBIA
Washington
National Capital Poison Control Center
Georgetown University Hospital
Emergency (202) 625–3333
(202) 784–4660 (TTY)
FLORIDA
Tampa
The Florida Poison Information Center and Toxicology Resource Center
Tampa General Hospital
Emergency (813) 253–444
(800) 282–3171 (In-state)
GEORGIA
Atlanta
Georgia Poison Center
Grady Memorial Hospital
Emergency (800) 282–5846 (In-state)
(404) 616–9000
INDIANA
Indianapolis
Indiana Poison Center
Methodist Hospital of Indiana
Emergency (800) 382–9097 (In-state)
(317) 929–2323
MARYLAND
Baltimore
Maryland Poison Center
Emergency (410) 528–7701
(800) 492–2414 (In-state)
MASSACHUSETTS
Boston
Massachusetts Poison Control System
Emergency (617) 232–2120
(800) 682–9211
MICHIGAN
Detroit
Poison Control Center
Emergency (313) 745–5711
MINNESOTA
Minneapolis
Hennepin Regional Poison Center
Hennepin County Medical Center
Emergency (612) 347–3141
(612) 337–7474 (TTY)
MISSOURI
St. Louis
Cardinal Glennon Children's Hospital Regional Poison Center
Emergency (314) 772–5200
(800) 366–8888 (In-state)
MONTANA
Denver (Colorado)
Rocky Mountain Poison and Drug Center
Emergency (303) 629–1123
NEBRASKA
Omaha
The Poison Center
Emergency (402) 390–5555
(800) 955–9119 (In-state)
NEW JERSEY
Newark
New Jersey Poison Information and Education System
Emergency (800) 962–1253 (In-state)
NEW MEXICO
Albuquerque
New Mexico Poison and Drug Information Center
Emergency (505) 843–2551
(800) 432–6866 (In-state)
NEW YORK
Mineola
Long Island Regional Poison Control Center
Winthrop University Hospital
Emergency (516) 542–2323
New York
New York City Poison Control Center
New York City Department of Health
Emergency (212) 340–4494
(212) P-O-I-S-O-N-S
(212) 689–9014 (TDD)
Nyack
Hudson Valley Poison Center
Nyack Hospital
Emergency (800) 336–6997
(914) 353–1000
OHIO
Columbus
Central Ohio Poison Center
Emergency (614) 228–1323
(800) 682–7625
(614) 228–2272 (TTY)
Cincinnati
Cincinnati Drug and Poison Information Center and Regional Poison Control System
Emergency (513) 558–5111
(800) 872–5111
OREGON
Portland
Oregon Poison Center
Oregon Health Sciences University
Emergency (503) 494–8968
(800) 452–7165 (In-state)
PENNSYLVANIA
Philadelphia
The Poison Control Center
One Children's Center
Emergency (215) 386–2100
Pittsburgh
Pittsburgh Poison Center
Emergency (412) 681–6669
Hershey
Central Pennsylvania Poison Center
Milton S. Hershey Medical Center
Emergency (800) 521–6110
RHODE ISLAND
Providence
Rhode Island Poison Center
Emergency (401) 277–5727
(401) 277–8062 (TDD)
TEXAS
Dallas
North Texas Poison Center
Emergency (214) 590–5000
(800) 441–0040 (In-state)
Galveston
Texas State Poison Center
The University of Texas Medical Branch
Emergency (409) 765–1420
(713) 654–1701 (Houston)
(512) 478–4490 (Austin)
UTAH
Salt Lake City
Utah Poison Control Center
Emergency (801) 581–2151
(800) 456–7707 (In-state)
VIRGINIA
Charlottesville
Blue Ridge Poison Center
Emergency (804) 924–5543
(800) 451–1428
Northern Virginia
National Capital Poison Center
Georgetown University Hospital
Emergency (202) 625–3333
(202) 784–4660 (TTY)
WEST VIRGINIA
Charleston
West Virginia Poison Center
Emergency (800) 642–3625 (In-state)
(304) 348–4211
WYOMING
Omaha (Nebraska)
The Poison Center
Emergency (402) 390–5555
(800) 955–9199 (NE and WY only)
American Board of Medical Toxicology
The American Board of Medical Toxicology (ABMT) evaluates and certifies physicians in medical toxicology and administers certifying examinations to qualified licensed physicians during sessions at annual meetings.
American Board of Medical Toxicology
777 East Park Drive
P.O. Box 820
Harrisburg, PA 17105–8820
(717) 558–7750
American College of Obstetricians and Gynecologists
The American College of Obstetricians and Gynecologists (ACOG) is dedicated to the advancement of women's health through education, advocacy, practice, and research. ACOG works to serve as a strong advocate for quality health care for women, maintain the highest standards of clinical practice and continuing education for its members, promote patient education and stimulate patient understanding of, and involvement in, medical care, and increase awareness among its members and the public of the changing issues facing women's health care.
American College of Obstetricians and Gynecologists
409 12th Street, S.W.
Washington, DC 20024
(202) 638–5577
American College of Occupational and Environmental Medicine
The American College of Occupational and Environmental Medicine (ACOEM) is an association of approximately 6,500 physicians attempting to educate members and other physicians, employers, other organizations, and the public-at-large about occupational and environmental health. The ACOEM has developed a continuing education course entitled Core Curriculum in Environmental Medicine in order to enhance physicians' critical thinking on environmental issues, improve their problem-solving skills, and make them more effective at decision-making about environmental concerns. Once the Curriculum has been fully developed, ACOEM will make the teaching materials available to other organizations, including medical schools. The ultimate goal of this project has been to enable health professionals to serve as environmental educators to all of the communities in which they are involved.
American College of Occupational and Environmental Medicine
55 West Seegers Road
Arlington Heights, IL 60005
(708) 228–6850
Occupational Physicians Scholarships Fund
The Occupational Physicians Scholarship Fund was established in 1988 to provide support to students entering the occupational health specialty field in their postdoctoral medical education over a ten year period (ending in 1998). The Fund intends to help address the acute shortage of occupational health specialists by supporting up to 100 outstanding postdoctoral students through their residency training. The awards for 1993 ranged from $25,000 to $31,000 for each participant.
Occupational Physicians Scholarship Fund
55 West Seegers Road
Arlington Heights, IL 60005
American College of Preventive Medicine
The American College of Preventive Medicine (ACPM) is a professional society of medical doctors specializing in preventive medicine, public health, aerospace medicine, and occupational medicine committed to educating physicians and students about the latest discoveries in disease prevention and health promotion. As a part of their charge to educate medical students, ACPM offers several core curriculum guidelines and inventories of knowledge and skills related to preventive medicine. In relation to occupational and environmental medicine, ACPM offers a core curriculum, competencies, and performance indicators for preventive medicine residency graduates.
American College of Preventive Medicine
1015 15th Street, N.W.
Suite 403
Washington, DC 20005
(202) 789–0003
American Lung Association
The American Lung Association (ALA) is a federation of state and local associations of physicians, nurses, and laymen interested in the prevention and control of lung disease. The Association works with other organizations in planning and conducting programs in community services, public, professional, and patient education, and research. The ALA also makes recommendations regarding medical care of respiratory disease, occupational health, hazards of smoking, and air conservation.
American Lung Association
1740 Broadway
New York, NY 10019–4374
(212) 315–8700
Association of Occupational and Environmental Clinics
The Association of Occupational and Environmental Clinics is dedicated to higher standards of patient-centered, multi-disciplinary care emphasizing prevention and total health through information sharing, quality service and collaborative research. As a national network of clinical facilities, the clinics vary greatly in orientation, physical facilities, and staff capabilities. However, every clinic does offer an on-site staff physician with either board-certification or demonstrated expertise in occupational medicine. Clinics must also have industrial hygienists and other professionals with expertise in occupational and/or environmental health such as nurses, social workers, and health educators either on staff or available through a pre-arranged referral network.
Association of Occupational and Environmental Clinics
1010 Vermont Avenue, #513
Washington, DC 20005
Contact: Edmund Kelly
Executive Director
(202) 347–4976
ALABAMA
Birmingham
Occupational and Environmental
Medicine Clinic
University of Alabama at Birmingham
Contact: Timothy J.Key, MD, MPH
Brian G.Forrester, MD, MPH
(205) 934–7303
CALIFORNIA
Davis
Occupational and Environmental Health
Clinic
University of California at Davis
Contact: Stephen McCurdy, MD, MPH
Marc Schenker, MD, MPH
(916) 752–3317
Irvine
Occupational and Environmental Clinic
University of California at Irvine
Contact: Dean Baker, MD, MPH
(714) 824–8641
San Francisco
Occupational and Environmental
Medicine Clinic
University of California at San Francisco
Contact: Patricia Quinlan, MPH
Diane Liu, MD, MPH
Jordan Rinker, MD, MPH
(415) 885–7770
COLORADO
Denver
Occupational and Environmental
Medicine Division
National Jewish Center for Immunology and Respiratory Medicine
Contact: Peggy Mroz, MSPH
Kathleen Kreiss, MD
Cecile Rose, MD, MPH
(303) 398–1520
CONNECTICUT
Farmington
University of Connecticut
Occupational and Environmental
Medicine Program
Contact: Eileen Storey, MD, MPH
(203) 679–2893
New Haven
Yale University Occupational/
Environmental Medicine Program
Yale School of Medicine
Contact: Mark Cullen, MD, MPH
(203) 785–5885
Waterbury
Waterbury Occupational Health
Contact: Gregory McCarthy, MD, MPH
(203) 573–8114
DISTRICT OF COLUMBIA
Washington DC
Division of Occupational and Environmental Medicine
George Washington University School of Medicine
Contact: Laura Welch, MD, MOH
Rosemary Sokas, MD
(202) 994–1734
GEORGIA
Atlanta
Environmental and Occupational
Program
The Emory Clinic at Perimeter
Contact: Howard Frumkin, MD, DrPH
Edward Galaid, MD, MPH
(404) 727–3697
(404) 248–5478
ILLINOIS
Chicago
Managed Care Occupational Health
Program
Mount Sinai Hospital Medical Center
Contact: Gene Miller, Director
Edward Mogabgab, MD
(312) 257–6480
Occupational Medicine Clinic
Cook County Hospital
Contact: Stephen Hessl, MD, MPH
(312) 633–5310
University of Illinois Occupational
Medicine Program
Contact: Linda Forst, MD, MS, MPH
Stephen Hessl, MD, MPH
(312) 996–1063
IOWA
Iowa City
University of Iowa Occupational
Medicine Clinic
Department of Internal Medicine College of Medicine
Contact: David Schwartz, MD, DrPH
Emma Rosenau, MPH
(319) 356–8269
KENTUCKY
Lexington
University of Kentucky Occupational
Medicine Program
Contact: Terence R.Collins, MD, MPH
Chaim Cohen, MD, MPH
(606) 257–5166
LOUISIANA
New Orleans
Ochsner Center for Occupational Health
Contact: Peter G.Casten, MD, MPH
Douglas A.Swift, MD, MSPH
(504) 838–3955
MAINE
Portland
Center for Health Promotion
Contact: Stephen Shannon, DO, MPH
Sue Upshaw, MD, MPH
(207) 774–7751
MARYLAND
Baltimore
Johns Hopkins University
Center for Occupational and Environmental Health
Contact: Edward J.Bernacki, MD, MPH
(410) 550–2322
Occupational Health Project
School of Medicine
Division of General Internal Medicine
University of Maryland
Contact: James Keogh, MD
Julie Gordon, ScM
(410) 706–7464
MASSACHUSETTS
Boston
Pulmonary Associates
(Occupational Medicine)
Contact: L.Christine Oliver, MD, MPH
Elisha Atkins, MD
Dean Hashimoto, MD, JD
David Christiani, MD, MPH
(617) 726–3741
Cambridge
Occupational and Environmental Health
Center
Cambridge Hospital
Contact: Rose Goldman, MD, MPH
Susan Rosenwasser, MEd
(617) 498–1580
South Braintree
Center for Occupational and Environmental Medicine
Massachusetts Respiratory Hospital
Contact: Diane Plantamura, MSW
(617) 848–2600
Worcester
Occupational Health Program
Department of Family and Community Medicine, University of Massachusetts
Contact: Glenn Pransky, MD, Occ.H.
Thomas Hicks, MD, MPH
(508) 856–3093
MICHIGAN
Ann Arbor
Occupational Health Program
School of Public Health
University of Michigan
Contact: David Garabrant, MD, MPH
Tom Robins, MD, MPH
Alfred Franzblau, MD, MPH
(313) 764–2594
Detroit
Division of Occupational Health
Wayne State University
Department of Family Medicine
Contact: Raymond Demers, MD, MPH
Mark Upfal, MD, MPH
James Blessman, MD, MPH
Maryjean Schenk, MD, MPH
Robert Morris, MD, MPH
Sushil Mankani, MD, MPH
(313) 577–1420
East Lansing
Michigan State University
Department of Medicine
Contact: Kenneth Rosenman, MD, MPH
(517) 353–1846
Lansing
Occupational Health Service
St. Lawrence Hospital and Health Institute
Contact: R.Michael Kelly, MD, MPH
(517) 377–0309
Southfield
Center for Occupational and Environmental Medicine
Contact: Margaret Green, MD, MPH
Michael Harbut, MD, MPH
(313) 559–6663
MINNESOTA
Minneapolis
Columbia Park Medical Group
Occupational Medicine Department
Contact: Donald Johnson, MD, MPH
Dorothy Quick, RN, COHN
(612) 572–5710
St. Paul
Ramsey Clinic
Occupational and Environmental Health and Occupational Medicine
Residency Training
Contact: Paula Geiger, Admin. Secretary
William H.Lohman, MD
(612) 221–3771
NEW JERSEY
Piscataway
Environmental and Occupational Health
Clinical Center
Environmental and Occupational Health
Sciences Institute
UMDNJ-Robert Wood Johnson
Medical School
Contact: Howard Kipen, MD, MPH
Gail Buckler, RN, MPH, COHN
(908) 445–0123
NEW YORK
Latham
Eastern NY Occupational Health
Program
Contact: Anne Tencza, RN, COHN
Eckhardt Johanning, MD, MSc
(518) 783–1518
New York
Bellevue Occupational and Environmental Health Clinic
Bellevue Hospital
Contact: George Friedman-Jimenez, MD
Rafael de la Hoz, MD, MPH
(212) 561–4572
Mount Sinai
J. Selikoff Occupational Health
Clinical Center
Contact: Stephen Mooser, MPH
Stephen Levin, MD
Robin Herbert, MD
(212) 241–6173
Rochester
Finger Lakes Occupational Health Services
Contact: Julie R.Cataldo, Administrator
(716) 275–1335
Stony Brook
Center for Occupational and Environmental Medicine
State University of NY School of Medicine
Contact: Wajdy Hailoo, MD, MPH
(516) 444–2167
Syracuse
Central New York Occupational Health
Clinical Center
Contact: Michael B.Lax, MD, MPH
(315) 432–8899
NORTH CAROLINA
Durham
Division of Occupational and Environmental Medicine
Duke University Medical Center
Contact: Dennis Darcey, MD, MPSH
Gary Greenberg, MD, MPH
(919) 286–3232
OHIO
Cincinnati
Center for Occupational Health
Holmes Hospital
Contact: James Donovan, MD, MS
Douglas Linz, MD, MS
Susan Pinney, PhD
(513) 558–1234
Greater Cincinnati Occupational Health Center
Jewish Hospital at Evendale
Contact: Harriet Applegate, Director
Margaret Atterbury, MD, MPH
(513) 769–0561
Cleveland
Occupational/Environmental Health
Clinic
Department of Family Medicine
MetroHealth Medical Center
Contact: Kathleen Pagan, MD, MPH
(216) 778–8087
OKLAHOMA
Oklahoma City
University Occupational Health Sciences
Division of Occupational and Environmental Medicine
Contact: David Paul, MD, MPH
Lynn Mitchell, MD, MPH
(405) 271–6177
Tulsa
WorkMed, Inc.
Contact: James W.Small, MD, MPH
Steve Snyder, MD
Tiari A.Harris, MD, MPH
Lloyd Anderson, MD
(918) 627–4646
PENNSYLVANIA
Philadelphia
Occupational Health Service
Department of Community and Preventive Medicine
Medical College of Pennsylvania
Contact: Eddy Bresnitz, MD, MS
Harriet Rubenstein, JD, MPH
(215) 842–6540
Pittsburgh
Occupational and Environmental
Medicine Program
University of Pittsburgh
Contact: David Tollerud, MD, MPH
(412) 624–3155
Willow Grove
Center for Occupational and Environmental Health
Abington Memorial Hospital
Contact: Jessica Herzstein, MD, MPH
(215) 881–5904
RHODE ISLAND
Pawtuckett
Memorial Hospital of Rhode Island
Occupational Health Service
Brown University
Contact: David G.Kern, MD, MPH
(401) 729–2859
TEXAS
Tyler
Texas Institute of Occupational Safety and Health
Contact: Jeffrey Levin, MD, MSPH
(903) 877–7262
UTAH
Salt Lake City
Rocky Mountain Center for Occupational and Environmental Health
Contact: Anthony Suruda, MD, MPH
Royce Moser, MD, MPH
(801) 581–5056
WASHINGTON
Seattle
Occupational Medicine Program
University of Washington
Harborview Medical Center
Contact: Scott Barnhart, MD, MPH
Drew Brodkin, MD, MPH
Matt Keifer, MD, MPH
(206) 223–3005
WEST VIRGINIA
Huntington
Division of Occupational and Environmental Health
Department of Family and Community
Medicine
Marshall University School of Medicine
Contact: Chris McGuffin, MS
James Becker, MD
(304) 696–7045
CANADA
Edmonton, Alberta
Occupational Medicine Consultation
Clinic
University of Alberta
Contact: Linda Cocchiarella, MD, MPH
Tee Guidotti, MD, MPH
(403) 492–7849
Manitoba, Winnipeg
MFL Occupational Health Centre, Inc.
Contact: Judy Cook, Executive Director
(204) 949–0811
Association of Teachers of Preventive Medicine
The Association of Teachers of Preventive Medicine (ATPM) is a national organization for medical educators, practitioners, and students committed to advancing the teaching of all aspects of preventive medicine. The scope of knowledge and competence distinctive to preventive medicine includes biostatistics, epidemiology, administration, environmental and occupational health, the application of social and behavioral factors in health and disease, and primary, secondary, and tertiary prevention measures within clinical medicine. ATPM was founded in 1942 with three basic objectives: (1) advancing medical education; (2) developing instruction, scientific skills and knowledge in preventive medicine; and (3) exchanging experience and ideas among its members.
Association of Teachers of Preventive Medicine
1015 15th Street, N.W.
Suite 405
Washington, DC 20005
(202) 682–1698
Center for Safety in the Arts
The Center for Safety in the Arts (CSA) seeks to gather and disseminate information about health hazards encountered by artists, craftsmen, teachers, children, and others working with art materials. The Center provides on-site assessments of the health and safety features of facilities used by artists, craftsmen, and students; responds to inquiries concerning art-related health hazards; and conducts consultation programs. CSA now offers extensive information through a gopher. To tap into gopher to tmn.com, choose the Arts Wire option, followed by the Center for Safety in the Arts options.
Center for Safety in the Arts
5 Beekman Street
New York, NY 10038
(212) 227–6220
Committees on Occupational Safety and Health
The Committees on Occupational Safety and Health are non-profit coalitions of local unions and individual workers, physicians, lawyers, and other health safety activists dedicated to the right of each worker to a safe and healthy job. Committees throughout the states provide health and safety training, technical assistance, consultations and on-site evaluations, and contract language assistance.
Committees on Occupational Safety and Health
275 Seventh Avenue
New York, NY 10001
(212) 627–3900
Consortium for Environmental Education in Medicine
The Consortium for Environmental Education in Medicine was established in 1994 as a non-profit organization committed to developing strategies to improve and enhance the education of physicians on the environment and health. The organization has developed pilot programs for curriculum and faculty development which would seek to make the relationship of environment to health an integral part of undergraduate and post-graduate education.
Consortium for Environmental Education in Medicine (CEEM)
P.O. Box 9132
Waltham, MA 02254–9132
(617) 893–4610
MotherRisk Program
The MotherRisk Program will counsel callers about the safety of an exposure to drugs, chemicals, or radiation during pregnancy or breast-feeding. The team of physicians and information specialists gives advice on whether medications, X-rays, or chemicals in the work environment will harm the developing fetus or breast-fed baby.
MotherRisk Program
Hospital for Sick Children
555 University Avenue
Toronto, Ontario, Canada M5G1X8
(416) 813–6780
National Association of Physicians for the Environment
The National Association of Physicians for the Environment (NAPE) was developed to work with the national medical specialties and subspecialties, with national, state, and local medical societies, and with individual physicians to deal with the impacts of environmental pollutants on the organs, systems, or diseases processes.
National Association of Physicians for the Environment
6410 Rockledge Drive
Suite 203
Bethesda, MD 20817–1809
(301) 571–9791
Pesticide Education Center
Founded in 1933 to educate the public about the hazards and health effects of pesticides, the Pesticide Education Center works with community groups, workers, individuals, and others harmed by or concerned about risks to their health from exposure to pesticides used in agriculture, the home and garden, and other environmental and industrial uses. Its goal is to provide critical information about pesticides so that the public can make more informed decisions and choices. The PEC provides information, curricular materials, and help with seminars and workshops on a nationwide basis.
Pesticide Education Center
P.O. Box 420870
San Francisco, CA 94142–0870
(415) 391–8511
Physicians for Social Responsibility
Physicians for Social Responsibility (PSR) is committed to achieving a sustainable environment. Its environmental program—which complements its work on eliminating weapons of mass destruction and handgun violence—consists of research, advocacy, professional and public education, and international projects designed to protect public health from the effects of toxic pollution and environmental degradation. PSR has also developed a Global Environmental Task Force to help organize informational conferences around the country.
Founded in 1961, PSR is a leading national organization of over 20,000 health professional and supporters working in 90 chapters throughout the U.S. It is the U.S. affiliate of IPPNW, recipient of the 1985 Nobel Peace Prize.
Physicians for Social Responsibility
1101 14th Street, N.W.
Suite 700
Washington, DC 20005
(202) 898–0150
Society for Occupational and Environmental Health
The Society for Occupational and Environmental Health (SOEH) includes scientists, academicians, and industry and labor representatives who seek to improve the quality of both working and living places by operating as a neutral forum for conferences involving all aspects of occupational and environmental health. SOEH's activities include studying specific categories of hazards, as well as developing methods for assessment of health effects and diseases associated with particular jobs.
Society for Occupational and Environmental Health
6728 Old McLean Village Drive
McLean, VA 22101
(703) 556–9222
Teratogen Exposure Registry and Surveillance
The Teratogen Exposure Registry and Surveillance (TERAS) is a network of geneticists and pathologists studying human embryos and fetuses exposed to teratogens. TERAS maintains information networks for consultation and evaluations.
Teratogen Exposure Registry and Surveillance
Frederick Bieber, PhD
Director
Department of Pathology
Brigham and Women's Hospital
75 Francis Street
Boston, MA
(617) 732–6507
WorldWatch Institute
The WorldWatch Institute is a research organization that aims to encourage a reflective and deliberate approach to global problem-solving. The Institute seeks to anticipate global problems and social trends and to focus attention on emerging global issues, including population growth, family planning, environmental degradation, and renewable energy options.
WorldWatch Institute
1776 Massachusetts Avenue, N.W.
Washington, DC 20036
(202) 452–1999
SELECTED TOPICAL RESOURCES
AIR POLLUTION
American Lung Association
(212) 315–8700
EPA Clean Air Act
(202) 382–7548
ART SUPPLIES
Center for Safety in the Arts
(212) 277–6220
ASBESTOS
EPA Asbestos Programs
(800) 368–5888
CANCER INFORMATION
National Cancer Institute
(800) 4-CANCER
EPA Carcinogen Assessment Group
(202) 382–5898
CHEMICAL EMERGENCIES
Chemical Spills Emergency Hotline
(800) 535–0202
EPA Hazardous Waste Hotline
(800) 535–0202
ATSDR Emergency Hotline
(404) 639–6300
CONSUMER PRODUCT SAFETY
Consumer Product Safety Commission
(800) 638–2772
HAZARDOUS WASTE
EPA Emergency Planning and Community
Right to Know Hotline
(800) 535–0202
Integrated Risk Information System (IRIS)
(202) 475–6743
IRIS User Support
(513) 569–7254
Superfund Records of Decision
(703) 920–9810
State Health Departments
LEAD
National Center for Environmental Health (CDC)
(404) 488–4880
National Lead Information Center
(800) LEAD-FYI
Child and Maternal Health Clearinghouse
(202) 625–8410
LUNG DISEASE
American Lung Association
(212) 315–8700
LUNGLINE/National Jewish Hospital
(800) 222–5864
OCCUPATIONAL HEALTH
National Institute for Occupational Safety and Health
(800) 356–4674
Occupational Safety and Health Administration
(202) 219–8151
PESTICIDES
EPA National Pesticides Hotline
(800) 535-PEST
National Pesticide Telecommunications Network
(800) 858–7378
POISONING
Poison Control Centers
PREGNANCY CONCERNS
MotherRisk Program
(416) 813–7378
RADON
EPA Office of Radon Programs
(202) 475–9605
National Radon Hotline
(800) SOS-RADON
State Health Departments
SMOKE
American Lung Association
(212) 315–8700
TOXIC SUBSTANCES
American Chemical Society's Chemical
Referral Center
(202) 887–1315
ATSDR Emergency Response Branch
(404) 639–6300
ATSDR Toxicological Profiles
(404) 639–6000
EPA Toxic Substances Control Act (TSCA)
Information Line
(202) 554–1404
EPA Toxic Chemical Release Inventory System
(800) 535–0202
WATER
EPA Safe Drinking Water Hotline
(800) 426–4791
COMPUTERIZED INFORMATION SERVICES
Computerized information services have become a valuable link in providing users with up-to-date information, resources, and opportunities for interaction with others interested in similar topics. The following list is by no means comprehensive, but merely provides points of access to relevant information and communication list-servers.
Internet
Department of Energy's Environment, Safety, and Health Technical Information Service
In 1993, DOE released its new computer-based information service, called the Environment, Safety, and Health Technical Information Service (TIS). TIS is designed to provide the DOE community with technical information that is reliable, current, and easy to use. Eventually, TIS will replace the current Safety Performance Measurement System (SPMS). For more information, please address any questions to the TIS Helpline at (208) 526–8955 or send e-mail to vog.leni.sit@troppus.
Electronic Green Journal
The ELECTRONIC GREEN JOURNAL is a professional refereed publication from the University of Idaho devoted to disseminating information concerning sources of international environmental topics including: assessment, conservation, development, disposal, education, hazards, pollution, resources, technology, and treatment. The journal serves communities as an educational environmental resource, and includes both practical and scholarly articles, bibliographies, reviews, editorial comments, and announcements. The journal is currently available via gopher, worldwide web, or ftp. Subscriptions are being planned for the future. To tap into the journal through gopher, type gopher.uidaho.edu and choose University of Idaho Electronic Publications; to tap in through World-Wide Web (WWW) type http://gopher.uidaho. edu/1/UI_gopher/library/egj/; or to tap in through ftp, type ftp.uidaho.edu.
EnviroLink Network
The Envirolink Network is a non-profit organization that is dedicated to facilitating communication on environmental issues. The network is composed of over 400,000 people in 93 countries. The Network has recently created a new network entitled EnviroFreenet. EnviroFreenet offers e-mail accounts, environmental billboards, chat conferences, the EnviroGopher, the EnviroWeb, and access to almost every other Internet Service available. The network can be accessed using either telnet or gopher. EnviroFreenet can be reached through telnet with the address envirolink.org. Directions then follow. If you have access to gopher, go to the main gopher list and choose international organizations and then choose “EnviroGopher,” followed by “Connect to EnviroFreenet” or gopher to: envirolink.org port 70.
HazDat
The HazDat system is a scientific and administrative database developed by ATSDR to provide rapid access to information on the release of hazardous substances from Superfund sites or from emergency events and on the effects of these substances on the health of human populations. The source documents used for the initial development of HazDat include environmental and health data contained in Agency products and in other non-Agency site characterization documents as appropriate. ATSDR's products include health assessments and supporting documentation for over 1,200 sites, toxicological profiles for over 150 substances, and more than 2,000 health consultations. ATSDR staff enter data into HazDat on a continuing basis. HazDat is available to the public over the Internet through a World-Wide Web (WWW) server. Access can be gained through: http://atsdr1.atsdr.cdc.gov:8080/atsdrhome.html.
Medical List—A Guide to On Line Medical Resources
The Medical List provides a complete listing of Internet resources connected with health, disease, therapy, and clinical medicine. This resource list is offered in text form as The Medical List and as Medical Matrix—a hypertest database accessible using World Wide Web browsers like Mosaic. The Medical List is the text of Healthmatrix—a Windows Help, icon drive, hypertext presentation of the database. For more information, call (209) 466–6878.
Gopher access to The Medical List is available at the URL: (Uniform Resource Locator) gopher://una.hh.lib.umich.edu:70/11/inetdirs/sciences/medclin:malet. Gopher allows key word searching and e-mail of this document to any Internet address. Access can also be gained through ftp—frp2.cc.ukans.edu pub/hmatrix/ and get file medlst94.txt or medlst94.zip.
Medical Matrix is a project of the Internet Working Group of the American Medical Informatics Association. Medical Matrix uses icons and keyword searches to locate on line medical resources. Access can be gained through: http://kuhttp.cc.ukans.edu/cwis/units/medcntr/Lee/HOMEPAHE.HTML.
WHO Global Environmental Epidemiology Network, GEENET
The Network was established in 1987 as a means for the World Health Organization to strengthen education, training and research in institutions involved in epidemiological teaching and research on the health effects of environmental hazards, and other epidemiological applications in environmental and occupational health.
The Network aims at improved communication and collaboration between institutions in this field in developed and developing countries. A series of documents with information of value for training and research development is prepared for the Network and lists of Network members are distributed on a regular basis. Training and research promotion workshops are organized in collaboration with national and international agencies.
For more information, write: WHO GEENET, Environmental Epidemiology, World Health Organization, 1211 Geneva, Switzerland.
List Servers
Air Pollution and Biology
The address is ku.ca.esabliam@esabliam; and you can join by sending the message join airpollution-biology Firstname Lastname and your address.
EHS-L Environmental Health Systems
The address is 2HDYNBLA@vrestsil; and you can join by sending the message subscribe EHS-L Firstname Lastname and your address.
ENVBEH-L Environment and Human Behavior
The address is MVYLOP@vrestsil; and you can join by sending the message subscribe ENVBEH-L Firstname Lastname and your address.
Enviroethics
The address is ku.ca.esabliam@esabliam; and you can join by sending the message join enviroethics Firstname Lastname and your address.
Occup-Env Med List (Occupational and Environmental Medicine Listing on Internet)
Occupational and environmental medicine represents a growing clinical and public health discipline, seeking to evaluate and prevent the diseases and health effects that may be related to exposures at work and from other environments. The Occup-Env Med Mail-list provides a moderated forum for announcements, dissemination of text files and academic discussion. The forum is designed to allow presentation of clinical vignettes, synopses of new regulatory issues and reports of interesting items from publication elsewhere (both the medical and the non-medical journals).
To subscribe, send a message of: subscribe occ-env-med-l “first name last name” to ude.ekud.cm@l-dem-vne-cco.
To post a message send the message to: ude.ekud@l-dem-vne-cco
PBLIST/PBL-LIST (Problem-Based Listing on Internet)
PBLIST is devoted to problem-based learning and related methods in health care education. PBL-LIST covers a broader discussion of problem-based learning in general throughout all disciplines. To subscribe to either of these lists, send a one line e-mail message of:
SUB PBL-LIST Your first name Your last name
to: ua.ude.hsanom.gne@VRESTSIL
One can also communicate with other list members by sending mail to ua.ude.hsanom.gne@TSIL-LBP
Other Gophers Relevant to Environmental Health, Medicine, and Safety
Center for Safety in the Arts
gopher://tmn.com to reach the CSA gopher and then choose the Arts Wire option, followed by the Center for Safety in the Arts
Division of Environmental Health and Safety
The Environmental Magazine
National Institute of Environmental Health Sciences (NIEHS)
U.S. Environmental Protection Agency
Computer-Based Databases*
The National Library of Medicine (NLM) is the world's largest research library in a single scientific or professional field. The library collects materials in all major areas of the health sciences, as well as in such areas as chemistry, physics, botany, and zoology.
The Library's computer-based Medical Literature Analysis and Retrieval System (MEDLARS) and toxicology (TOXLINE) databases provide on-line bibliographic access to the Library's store of bio-medical information. For information about access to MEDLARS and TOXLINE services, contact: MEDLARS Management Section, National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894, (301) 496–1131, (800) 638–8480 (outside Maryland).
Primary biomedical data bases included on the MEDLARS system are:
MEDLINE indexes articles from over 3200 biomedical journals published in the US and abroad. MEDLINE is indexed using NLM's controlled vocabulary, MESH (Medical Subject Headings), and contains all citations indexed in INDEX MEDICUS. Produced by the National Library of Medicine.
TOXLINE is designed to offer comprehensive bibliographic coverage of toxicological information. It covers the pharmacological, biochemical, physiological, environmental, and toxicological effects of chemicals and drugs. Produced by Specialized Information Services of the National Library of Medicine.
TOXNET (Toxicology Data Network) is a computerized system of toxicological data banks operated by the National Library of Medicine, and is part of the broader MEDLARS system.
The TOXNET software consists of modules to build, edit, and review the records of constituent data banks.
CCRIS (Chemical Carcinogenesis Research Information System) is a factual data bank sponsored by the National Cancer Institute. It contains data derived from both short- and long-term bioassays on approximately 1200 chemicals.
ETICBACK (Environmental Teratology Information Center Backfile) is a bibliographic data base covering teratology and development toxicology.
TRI (Toxic Chemical Release Inventory) contains information on the annual estimated releases of toxic chemicals to the environment in the United States. These data include the names and addresses of the facilities and the amounts of certain toxic chemicals they release to the air, water, or land or transfer to waste sites.
HSDB (Hazardous Substances Data Bank) is a comprehensive data base containing records for over 4100 toxic or potentially toxic chemicals. It contains information in such areas as toxicity, environmental fate, human exposure, chemical safety, waste disposal, emergency handling, and regulatory requirements.
IRIS (Integrated Risk Information System) is an on-line data base built by the Environmental Protection Agency (EPA). It contains EPA carcinogenic and noncarcinogenic health risk and regulatory information on about 400 chemicals. For more information, call (513) 569–7254.
RTECS (Registry of Toxic Effects of Chemical Substances) contains toxic effects data for approximately 100,000 chemicals. It is built and maintained by the National Institute for Occupational Safety and Health (NIOSH). Acute and chronic effects are covered in such areas as skin/eye irritation, carcinogenicity, mutagenicity, and reproductive consequences.
Contact: (800) 35-NIOSH
DIRLINE (NLM's Directory of Information Resources on-line) is an on-line database containing information on approximately 15,000 organizations that provide information and services directly to requesters. DIRLINE is available on-line through the MEDLARS system and can also be searched with GRATEFUL MED software.
Contact: (301) 496–1131
Various software packages are available for access to MEDLARS, including:
GRATEFUL MED, a microcomputer software interface that assists users in performing on-line searches of NLM's databases. GRATEFUL MED can be bought from the National Technical Information Service (NTIS)
CHEMLEARN (NTIS), an interactive, microcomputer-based training package for CHEMLINE. Produced by Specialized Information Services of the National Library of Medicine, it runs on IBM-PC/XT/AT/PS/2 compatibles. CHEMLEARN is available from NTIS, product number PB88–218144. For more information on the contents of the software, call (301) 496–1131.
TOXLEARN is an interactive, microcomputer-based training package for TOXLINE. Its menu-driven structure allows users to make choices in learning about basic aspects of TOXLINE. It contains approximately four hours of interactive instruction and is produced by the Specialized Information Services of the National Library of Medicine. TOXLEARN runs on IBM-PC compatibles and is available from NTIS, product number PB88–155766. For more information on the contents of the software, call: (301) 496–1131.
GENERAL REFERENCES
- Association of American Medical Colleges (AAMC). 1992. ACME-TRI Report—Educating Medical Students: Assessing Change in Medical Education, The Road to Implementation . Washington, DC: Association of American Medical Colleges. [PubMed: 8507321]
- AAMC. 1992. American Medical Education: Institutions, Programs, and Issues . Washington, DC: Association of American Medical Colleges.
- Burgess, WA. 1981. Recognition of Health Hazards in Industry: A Review of Materials and Processes . New York, NY: John Wiley and Sons.
- California Public Health Foundation. 1992. Kids and the Environment: Toxic Hazards . Berkeley: California Public Health Foundation.
- Chivian, E, editor; , McCally, M, editor; , Hu, H, editor; , and Haines, A, editor. , ed. 1993. Critical Condition: Human Health and the Environment . Cambridge: MIT Press.
- Institute of Medicine (IOM). 1983. Medical Education and Societal Needs: A Planning Report for the Health Professions . Washington, DC: National Academy Press. [PubMed: 25032443]
- IOM. 1988. Role of the Primary Care Physician in Occupational and Environmental Medicine . Washington, DC: National Academy Press. [PubMed: 25077202]
- IOM. 1990. Meeting Physicians' Needs for Medical Information on Occupations and Environ ments . Washington, DC: National Academy Press. [PubMed: 25077201]
- IOM. 1991. Addressing the Physician Shortage in Occupational and Environmental Medicine . Washington, DC: National Academy Press. [PubMed: 25077200]
- IOM. 1993. Environmental Medicine and the Medical School Curriculum . Washington, DC: National Academy Press.
- International Labour Office (ILO). 1983. Encyclopedia of Occupational Health and Safety , 3rd ed., 2 volumes. Geneva: ILO.
- LaDou, J. 1990. Occupational Medicine . Norwalk, CT: Appleton and Lange.
- Last, JM, editor; and Wallace, RB, editor. , ed. 1992. Public Health and Human Ecology . Norwalk: Appleton and Lange.
- Levy, B and Wegman, D. 1995. Occupational Health: Recognizing and Preventing Work- related Disease . 3rd ed. Boston, MA: Little, Brown.
- McCunney, RJ, editor. , ed. 1994. A Practical Approach to Occupational and Environmental Medicine . Boston: Little, Brown.
- Murdock, BS. 1991. Environmental Issues in Primary Care . Minneapolis: Freshwater Foundation's Health and the Environment Digest.
- National Library of Medicine. 1989. Improving Health Professionals' Access to Information: Challenges and Opportunities for the National Library of Medicine . Washington, DC: National Library of Medicine.
- National Research Council (NRC). 1989. Improving Risk Communication . Washington, DC: National Academy Press. [PubMed: 25032320]
- Paul, M, editor. , ed. 1993. Occupational and Environmental Reproductive Hazards: A Guide For Clinicians . Baltimore: Williams and Wilkins.
- Rom, W, editor. , ed. 1992. Environmental and Occupational Medicine , Second Edition . Boston: Little, Brown.
- Rosenstock, L and Cullen, M. 1986. Clinical Occupational Medicine . Philadelphia: W.B. Saunders Company.
- Rosenstock, L and Cullen, M. 1994. Textbook of Clinical Occupational and Environmental Medicine . Philadelphia: W.B.Saunders Company.
- Silbergeld, EK. 1993. Investing in Prevention: Opportunities to Reduce Disease and Health Care Costs Through Identifying and Reducing Environmental Contributions to Preventable Disease . Washington, DC: Environmental Defense Fund.
- Sullivan, JB and Krieger, GR. 1992. Hazardous Materials Toxicology: Clinical Principles in Environmental Health . Baltimore, MD: Williams and Wilkins.
- Tarcher, AB, editor. , ed. 1992. Principles and Practice of Environmental Medicine . New York: Plenum Medical Book Company.
- Upton, AC and Graber, E. 1993. Staying Healthy in a Risky Environment: The New York University Medical Center Family Guide . New York: Simon and Schuster.
- U.S. Environmental Protection Agency. 1988. Proposed Guidelines for Assessing Female Reproductive Risk . Federal Register 53:24834–24847.
- U.S. Environmental Protection Agency. 1988. Proposed Guidelines for Assessing Male Reproductive Risk . Federal Register 53:24850–24869.
- U.S. Environmental Protection Agency. 1992. Guidelines for Exposure Assessment . Federal Register 57:22888–22938.
- World Health Organization: Our Planet, Our Health. 1992. Report of the WHO Commission Health and Environment. World Health Organization, Geneva.
- The American College of Occupational and Environmental Medicine (ACOEM). 1993. Core Curriculum in Environmental Medicine: State-of-the-Art Conference, Dallas, Texas—Oct. 25–29 .
- Barrows, HS. 1985. How to Design a Problem-Based Curriculum for the Preclinical Years . New York: Springer Publishing Company.
- Kaufman, A, editor. , ed. 1985. Implementing Problem-Based Medical Education . New York: Springer Publishing Company.
- Marston, RQ, editor; and Jones, RM, editor. , eds. 1992. Medical Education in Transition . Princeton: The Robert Wood Johnson Foundation.
- Preventive Pulmonary Academic Award Program. 1993. Guidelines for Curriculum Devel opment for Undergraduate Medical Education in the Prevention of Pulmonary Diseases . Division of Lung Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, November.
- Preventive Pulmonary Academic Award Program. 1994. Knowledge Bases and Sample Curricula: A Companion Volume to the Guidelines for Curriculum Development for Undergraduate Medical Education in the Prevention of Pulmonary Diseases . Division of Lung Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, March.
- Stritter, FT. 1992. Faculty Evaluation and Development. Handbook of Health Professionals Education . 13:294–318.
Books and Reports
Curriculum Resources
TABLES OF TOXIC CHEMICALS, HEALTH EFFECTS, AND OCCUPATIONAL EXPOSURES
TABLE D-1Environmental Agents, Their Sources and Potential Exposures, and Adverse Health Effects: Metals and Metallic Compounds, Hydrocarbons, Irritant Gases, Chemical Asphyxiants, and Pesticides
| Agent | Exposure | Route of Entry | Systems(s) Affected | Primary Manifestations | Aids in Diagnosis | Remarks |
|---|---|---|---|---|---|---|
| Metals and Metallic Compounds | ||||||
| Arsenic | Alloyed with lead and copper for hardness; manufacturing of pigments, glass, pharmaceuticals; byproduct in copper smelting; insecticides; fungicides; rodenticides; tanning | Inhalation and ingestion of dust and fumes | Neuromuscular | Peripheral neuropathy, sensory-motor | Arsenic in urine | |
| Gastrointestinal | Nausea and vomiting, diarrhea, constipation | |||||
| Skin | Dermatitis, finger and toenail striations, skin cancer, nasal septum perforation | |||||
| Pulmonary | Lung cancer | |||||
| Arsine | Accidental byproduct of reaction of arsenic with acid; used in semiconductor industry | Inhalation of gas | Hematopoietic | Intravascular hemolysis: hemoglobinuria, jaundice, oliguria or anuria | Arsenic in urine | |
| Beryllium | Hardening agent in metal alloys; special use in nuclear energy production; metal refining or recovery | Inhalation of fumes or dust | Pulmonary (and other systems) | Granulomatosis and fibrosis | Beryllium in urine (acute); Beryllium in tissue (chronic); chest x ray; immunologic tests (such as lymphocyte transformation) may also be useful | Pulmonary changes virtually indistinguishable from sarcoid on chest x ray |
| Cadmium | Electroplating; solder for aluminum; metal alloys, process engraving; nickel-cadmium batteries | Inhalation or ingestion of fumes or dust | Pulmonary | Pulmonary edema (acute); Emphysema (chronic) | Also a respiratory tract carcinogen | |
| Renal | Nephrosis | Urinary protein | ||||
| Chromium | In stainless and heat-resistant steel and alloy steel; metal plating; chemical and pigment manufacturing; photography | Percutaneous absorption, inhalation, ingestion | Pulmonary | Lung cancer | Urinary chromate (questionable value) | |
| Skin | Dermatitis, skin ulcers, nasal septum perforation | |||||
| Lead | Storage batteries; manufacturing of paint, enamel, ink, glass, rubber ceramics, chemical industry | Ingestion of dust, inhalation of dust or fumes | Hematologic | Anemia | Blood lead Urinary ALA Zinc protoporphyrin (ZPP); free erythrocyte protophyrin (FEP) | Lead toxicity, unlike that of mercury, is believed to be reversible, with the exception of late renal and some CNS effects. |
| Renal | Nephropathy | |||||
| Gastrointestinal | Abdominal pain (“colic”) | |||||
| Neuromuscular | Palsy (“wrist drop”) | |||||
| CNS | Encephalopathy, behavioral abnormalities | |||||
| Reproductive | Spontaneous abortions (?) | |||||
| Mercury (Elemental) | Electronic equipment; paint; metal and textile production; catalyst in chemical manufacturing; pharmaceutical production | Inhalation of vapor; slight percutaneous absorption | Pulmonary CNS | Acute pneumonitis; Neuropsychiatric changes (erethism); tremor | Urinary mercury | Mercury illustrates several principles. The chemical form has a profound effect on its toxicology, as is the case for many metals. Effects of mercury are highly variable. Though inorganic mercury poisoning is primarily renal, elemental and organic poisoning are primarily neurological. |
| (Inorganic) | Agricultural and industrial poisons | Some inhalation and GI and percutaneous absorption | Pulmonary | Acute pneumonitis | Urinary mercury | The responses are difficult to quantify, so dose-response data are generally unavailable. Classic tetrad of gingivitis, sialorrhea, irritability, and tremor is associated with both elemental and inorganic mercury poisoning; the four signs are not generally seen together. Many effects of mercury toxicity, especially those in CNS, are irreversible. |
| Renal | Proteinuria | |||||
| CNS | Variable | |||||
| (Organic) | Efficient GI absorption, percutaneous absorption, and inhalation | Skin | Dermatitis | Blood and urine mercury, but sensitivity | ||
| CNS | Sensorimotor changes, visual field constriction, tremor | |||||
| Nickel | Corrosion-resistant alloys; electroplating; catalyst production; nickel-cadmium batteries | Inhalation of dust or fumes | Skin | Sensitization dermatitis (“nickel itch”) | ||
| Pulmonary | Lung and paranasal sinus cancer | |||||
| Zinc oxide | Welding byproduct; rubber manufacturing | Inhalation of dust or fumes that are freshly generated | “Metal fume fever” (fever, chills, and other symptoms) | Urinary zinc (useful as an indicator of exposure, not for acute diagnosis) | A self-limiting syndrome of 24–48 h with apparently no sequelae | |
| Hydrocarbons | ||||||
| Benzene | Manufacturing of organic chemicals, detergents, pesticides, solvents, paint removers; used as a solvent | Inhalation of vapor; slight percutaneous absorption | CNS | Acute CNS depression | Urinary phenol | Note that benzene, as with toluene and other solvents, can be monitored via its principal metabolite. |
| Hematopoietic | Skin | |||||
| Leukemia, aplastic anemia | Dermatitis | |||||
| Toluene | Organic chemical manufacturing; solvent; fuel component | Inhalation of vapor, percutaneous absorption of liquid | CNS | Acute CNS depression Chronic CNS problems such as memory loss | Urinary hippuric acid | |
| Skin | Irritation dermatitis | |||||
| Xylene | A wide variety of uses as a solvent; an ingredient of paints, lacquers, varnishes, inks, dyes, adhesives, cements; an intermediate in chemical manufacturing | Inhalation of vapor; slight percutaneous absorption of liquid | Pulmonary | Irritation, pneumonitis, acute pulmonary edema (at high doses) | Methylhippuric acid in urine, xylene in expired air, xylene in blood | |
| Eye, nose, throat | Irritation | |||||
| CNS | Acute CNS depression | |||||
| Ketones (Acetone) (Methylethyl ketone-MEK) (Methyl n-propyl ketone-MPK) (Methyl n-butyl ketone-MBK) (Methyl iso-butyl ketone-MIBK) | A wide variety of uses as solvents and intermediates in chemical manufacturing | Inhalation of vapor, percutaneous absorption of liquid | CNS | Acute CNS depression | Acetone in blood, urine, expired air (used as an index for exposure, not for diagnosis) | The ketone family demonstrates how a pattern of toxic responses (that is, CNS narcosis) may feature exceptions (that is, MBK peripheral neuropathy) |
| PNS | MBK has been linked with peripheral neuropathy | |||||
| Skin | Dermatitis | |||||
| Formaldehyde | Widely used as a germicide and a disinfectant in embalming and histopathology, for example, an in the manufacture of textiles, resins, and other products | Inhalation | Skin | Irritant and contact dermatitis | Patch testing may be helpful for dermatitis | Recent animal tests have shown it to be a respiratory carcinogen. Confirmatory epidemiologic studies are in progress |
| Eye | Pulmonary | |||||
| Eye irritation | Respiratory tract irritation, asthma | |||||
| Trichloro-ethylene (TCE) | Solvent in metal degreasing, dry cleaning, food extraction; ingredient of paints, adhesives, varnishes, inks | Inhalation, percutaneous absorption | Nervous | Acute CNS depression Peripheral and cranial neuropathy | Breath analysis for TCE | TCE is involved in an important pharmacological interaction. Within hours of ingesting alcoholic beverages, TCE workers experience flushing of the face, neck, shoulders, and back. Alcohol may also potentiate the CNS effects of TCE. The probable mechanism is competition for metabolic enzymes |
| Skin | Irritation, dermatitis | |||||
| Cardiovascular | Arrhythmias | |||||
| Carbon tetrachloride | Solvent for oils, fats, lacquers, resins, varnishes, other materials; used as a degreasing and cleaning agent | Inhalation of vapor | Hepatic | Toxic hepatitis | Expired air and blood levels | Carbon tetrachloride is the prototype for a wide variety of solvents that cause hepatic and renal damage. This solvent, like trichloroethylene, acts synergistically with ethanol. |
| Renal | Oliguria or anuria | |||||
| CNS | Acute CNS depression | |||||
| Skin | Dermatitis | |||||
| Carbon disulfide | Solvent for lipids, sulfur, halogens, rubber, phosphorus, oils, waxes, and resins; manufacturing of organic chemicals, paints, fuels, explosives, viscose rayon | Inhalation of vapor, percutaneous absorption of liquid or vapor | Nervous | Parkinsonism, psychosis, suicide Peripheral neuropathies | Iodine-azide reaction with urine (nonspecific since other bivalent sulfur compounds give a positive test); CS2 in expired air, blood, and urine | A solvent with unusual multisystem effects, especially noted for its cardiovascular, renal, and nervous system actions. |
| Renal | Chronic nephritic and nephrotic syndromes | |||||
| Cardiovascular | Acceleration or worsening of atherosclerosis; hypertension | |||||
| Skin | Irritation; dermatitis | |||||
| Reproductive | Menorrhagia and metrorrhagia | |||||
| Stoddard solvent | Degreasing, paint thinning | Inhalation of vapor, percutaneous absorption of liquid | Skin | Dryness and scaling from defatting; dermatitis | A mixture of primarily aliphatic hydrocarbons, with some benzene derivatives and naphthenes. | |
| CNS | Dizziness, coma, collapse (at high levels) | |||||
| Ethylene glycol ethers (Ethylene glycol monoethyl ether-Cellosolve) (Ethylene glycol monoethyl ether acetate-Cellosolve acetate) (Methyl- and butyl-substituted compounds such as ethylene glycol mono-methyl ether-Methyl Cellosolve) | The ethers are used as solvents for resins, paints, lacquers, varnishes, gum, perfume, dyes, and inks; the acetate derivatives are widely used as solvents and ingredients of lacquers, enamels, and adhesives. Exposure occurs in dry cleaning, plastic, ink, and lacquer manufacturing, and textile dying, among other processes. | Inhalation of vapor, percutaneous absorption of liquid | Reproductive, CNS, renal, liver | Ethylene glycol ethers, as a class of chemicals, have been shown in animals to have adverse reproductive effects, including reduced sperm count and spontaneous abortion, as well as CNS, renal, and liver effects. | ||
| Ethylene oxide | Used in the sterilization of medical equipment, in the fumigation of spices and other foodstuffs, and as a chemical intermediate | Inhalation | Skin | Dermatitis and frostbite | Recent animal tests have shown it to be carcinogenic and to cause reproductive abnormalities. Epidemiologic studies indicate that it may cause leukemia in exposed workers. | |
| Eye | Severe irritation; possibly cataracts with prolonged exposure | |||||
| Respiratory tract | Irritation | |||||
| Nervous system | Peripheral neuropathy | |||||
| Dioxane | Used as a solvent for a variety of materials, including cellulose acetate, dyes, fats, greases, resins, polyvinyl polymers, varnishes, and waxes | Inhalation of vapor, percutaneous absorption of liquid | CNS | Drowsiness, dizziness, anorexia, headaches, nausea, vomiting, coma Nephritis | Dioxane has caused a variety of neoplasms in animals. | |
| Renal Liver | Chemical hepatitis | |||||
| Polychlorinated biphenyls (PCBs) | Formerly used as a di-electric fluid in electrical equipment and as a fire retardant coating on tiles and other products. New uses were banned in 1976, but much of the electrical equipment currently used still contains PCBs | Inhalation, ingestion, skin absorption | Skin | Chloracne | Serum PCB levels for chronic exposure | Animal studies have demonstrated that PCBs are carcinogenic. Epidemiologic studies of exposed workers are inconclusive. |
| Eye | Irritation | |||||
| Liver | Toxic hepatitis | |||||
| Irritant Gases | ||||||
| Ammonia | Refrigeration; petroleum refining; manufacturing of nitrogen-containing chemicals, synthetic fibers, dyes, and optics | Inhalation of gas | Upper respiratory tract | Upper respiratory irritation | Also irritant of eyes and moist skin | |
| Hydrochloric acid | Chemical manufacturing; electroplating; tanning; metal pickling; petroleum extraction; rubber, photographic, and textile industries | Inhalation of gas or mist | Upper respiratory tract | Upper respiratory irritation | Strong irritant of eyes, mucous membranes, and skin | |
| Hydrofluoric acid | Chemical and plastic manufacturing; catalyst in petroleum refining; aqueous solution for frosting, etching, and polishing glass | Inhalation of gas or mist | Upper respiratory tract | Upper respiratory irritation | In solution, causes severe and painful burns of skin and can be fatal | |
| Sulfur dioxide | Manufacturing of sulfur-containing chemicals; food and textile bleach; tanning; metal casting | Inhalation of gas, direct contact of gas or liquid phase on skin or mucosa | Middle respiratory tract | Bronchospasm (pulmonary edema or chemical pneumonitis in high dose) | Chest x ray, pulmonary function tests | Strong irritant of eyes, mucous membranes, and skin |
| Chlorine | Paper and textile bleaching; water disinfection; chemical manufacturing; metal fluxing; detinning and dezincing iron | Inhalation of gas | Middle respiratory tract | Tracheobronchitis, pulmonary edema, pneumonitis | Chest x ray, pulmonary function tests | Chlorine combines with body moisture to form acids, which irritate tissues from nose to alveoli. |
| Ozone | Inert gas-shielded arc welding; food, water, and air purification; food and textile bleaching; emitted around high-voltage electrical equipment | Inhalation of gas | Lower respiratory tract | Delayed pulmonary edema (generally 6–8 h following exposure) | Chest x ray, pulmonary function tests | Ozone has a free radical structure and can produce experimental chromosome aberrations; it may thus have carcinogenic potential. |
| Nitrogen oxides | Manufacturing of acids, nitrogen containing chemicals, explosives, and more; byproduct of many industrial processes | Inhalation of gas | Lower respiratory tract | Pulmonary irritation, bronchiolitis fibrosa obliterans (“silo filler's disease”), mixed obstructive-restrictive changes | Chest x ray, pulmonary function tests | |
| Phosgene | Manufacturing and burning of isocyanates, and manufacturing of dyes and other organic chemicals; in metallurgy for ore separation; burning or heat source near trichloroethylene | Inhalation of gas | Lower respiratory tract | Delayed pulmonary edema (delay seldom longer than 12 h) | Chest x ray, pulmonary function tests | |
| Isocyanates TDI (toluene diisocyanate) MDI (methylene diphenyldiisocyanate) Hexamethylene diisocyanate and others | Polyurethane manufacture; resinbinding systems in foundries; coating materials for wires; used in certain types of paint | Inhalation of vapor | Predominantly lower respiratory tract | Asthmatic reaction and accelerated loss of pulmonary function | Chest x ray, pulmonary function tests | Isocyanates are both respiratory tract “sensitizes” and irritants in the conventional sense. |
| Asphyxiant gases Simple asphyxiants: nitrogen hydrogen, methane, and others | Enclosed spaces in a variety of industrial settings | Inhalation of gas | CNS | Anoxia | O2 in environment | No specific toxic effect; act by displacing O2 |
| Chemical Asphyxiants | ||||||
| Carbon monoxide | Incomplete combustion in foundries, coke ovens, refineries, furnaces, and more | Inhalation of gas | Blood (hemoglobin) | Headache, dizziness, double vision | Carboxyhemoglobin | |
| Hydrogen sulfide | Used in manufacturing of sulfur-containing chemicals; produced in petroleum production; byproduct of petroleum product use; decay of organic matter | Inhalation of gas | CNS | Respiratory center paralysis, hypoventilation | PaO2 | |
| Pulmonary | Respiratory tract irritation | |||||
| Cyanide | Metallurgy, electroplating | Inhalation of vapor, percutaneous absorption, ingestion | Cellular metabolic enzymes (especially cytochrome oxidase) | Enzyme inhibition with metabolic asphyxia and death | SCN− in urine | |
| Pesticides | ||||||
| Organophophates: malathion, parathion, and others | Inhalation, ingestions, percutaneous absorption | Neuromuscular | Cholinesterase inhibition, cholinergic symptoms: nausea and vomiting, salivation, diarrhea, headache, seating, meiosis, muscle fasciculations, seizures, unconsciousness, death | Refractoriness to atropine; plasma or red cell cholinesterase | As with many acute toxins, rapid treatment of organophosphate toxicity is imperative. Thus, diagnosis is often made based on history and a high index of suspicion rather than on biochemical tests. Treatment is atropine to block cholinergic effects and 2-PAM (2-pyridine-alsoxine methiodide) to reactivate cholinesterase. | |
| Carbamates: carbaryl (Sevin) and others | Inhalation, ingestion, percutaneous absorption | Neuromuscular | Same as organophosphates | Plasma cholinesterase; urinary 1-naphthol (index of exposure) | Treatment of carbamate poisoning is the same as that of organophosphate poisoning except that 2-PAM is contra-indicated. | |
| Chlorinated hydrocarbons: chlordane, DDT, heptachlor, chlordecone (Kepone), aldrin, dieldrin, uridine | Ingestion, inhalation, percutaneous absorption | CNS | Stimulation or depression | Urinary organic chlorine, or p-chlorophenol acetic acid | The chlorinated hydrocarbons may accumulate in body lipid stores in large amounts. | |
| Bipyridyls: paraquat, diquat | Inhalation, ingestion, percutaneous absorption | Pulmonary | Rapid massive fibrosis, only following paraquat ingestion | An interesting toxin in that the major toxicity, pulmonary fibrosis, apparently occurs only after ingestion. | ||
SOURCE: Principles and Practice of Environmental Health, A.B.Tarcher, ed., Plenum, New York, 1992.
TABLE D-2Selected Work-Related Diseases, Disorders, and Conditions Associated with Various Agents, Industries, or Occupations: Infections, Malignant Neoplasms, and Hematological, Cardiovascular, Pulmonary, Neurological, and Miscellaneous Disorders
| Diseases, Disorders, and Conditions | Industry or Occupation | Agent |
|---|---|---|
| Infections | ||
| Anthrax | Shepherds, farmers, butchers, handlers of imported hides or fibers, veterinarians, veterinarian pathologists, weavers | Bacillus anthraces |
| Brucellosis | Farmers, shepherds, vets, lab and slaughterhouse workers | Brucella abortus, suis |
| Plague | Shepherds, farmers, ranchers, hunters, field geologists | Yersinia pestis |
| Hepatitis A | Day-care center, orphanage, and mental retardation institution staff, medical personnel | Hepatitis A virus |
| Hepatitis B | Nurses and aides, anesthesiologists, orphanage and mental institution staffs, medical lab workers, general dentists, oral surgeons, physicians | Hepatitis B virus |
| Hepatitis C (formerly included in non-A, non-B) | Same as hepatitis A and B | Hepatitis C virus |
| Ornithosis | Psittacine bird breeders, pet shop and zoo workers, poultry producers, vets | Chlamydia psittaci |
| Rabies | Veterinarians, game wardens, lab workers, farmers, ranchers, trappers | Rabies virus |
| Rubella | Medical personnel | Rubella virus |
| Tetanus | Farmers, ranchers | Clostridium tetani |
| Tuberculosis Pulmonary | Physicians, medical personnel, medical lab workers | Mycobacterium tuberculosis |
| Tuberculosis Silicotuberculosis | Quarrymen, sandblasters, silica processors, miners, foundry workers, ceramic industry | Silicon dioxide (silica), M. tuberculosis |
| Tularemia | Hunters, fur handlers, sheep industry, cooks, veterinarians, ranchers, veterinarian pathologists | Francisella tularensis |
| Malignant Neoplasms | ||
| Bladder | Rubber and dye workers | Benzidine, 1- and 2-naphthylamine, auramine, magenta, 4-aminobiphenyl, 4-nitrophenyl |
| Bone | Dial painters, radium chemists and processors | Radium |
| Kidney and other urinary organs | Coke oven workers | Coke oven emissions |
| Liver | Vinyl chloride polymerization industry | Vinyl chloride monomer |
| Liver hemangiosarcoma | Vintners | Arsenical pesticides |
| Lung, bronchial, tracheal | Asbestos industry, users Topside coke oven workers Uranium and flourspar miners Chromium producers, processors, users Smelters Mustard gas formulators Ion-exchange resin makers, chemists | Asbestos Coke oven emissions Radon daughters Chromates Arsenic Mustard gas Bis(chloromethyl)-ether, chloromethyl methyl ether |
| Nasal cavity | Woodworkers, furniture makers Boot and shoe industry Radium chemists and processors, dial painters Chromium producers, processors, users Nickel smelting and refining | Hardwood dusts Unknown Radium Chromates Nickel Asbestos |
| Peritoneal, pleural mesothelioma | Asbestos industry, users | Asbestos |
| Scrotal | Automatic lathe operators, metalworkers Coke oven workers, petroleum refiners, tar distillers | Mineral, cutting oils Soots and tars, tar distillates |
| Hematological Disorders | ||
| Agranulocytosis or neutropenia | Workers exposed to benzene Explosives, pesticide industries Pesticide, pigment, pharmaceutical industries | Benzene Phosphorous Inorganic arsenic |
| Anemia Aplastic | Explosives manufacturing Workers exposed to benzene Radiologists, radium chemists, dial painters | TNT Benzene Ionizing radiation |
| Anemia Hemolytic, nonautoimmune | Whitewashing and leather industry Electrolytic processes, arsenical ore smelting Plastics industry Dye, celluloid, resin industries | Copper sulfate Arsine Trimellitic anhydride Naphthalene |
| Leukemia Acute lymphoid | Rubber industry Radiologists | Unknown Ionizing radiation |
| Leukemia Acute myeloid | Workers exposed to benzene Radiologists | Benzene Ionizing radiation |
| Leukemia Erythroleukemia | Workers exposed to benzene | Benzene |
| Methemoglobinemia | Explosives, dye industries | Aromatic amino and nitro compounds (e.g., aniline, TNT, nitroglycerin) |
| Cardiovascular Disorders | ||
| Angina | Auto mechanics, foundry workers, wood finishers, traffic control, driving in heavy traffic | Carbon monoxide |
| Arrhythmias | Metal cleaning, solvent use, refrigerator maintenance | Solvents, fluorocarbons |
| Raynaud's phenomenon (secondary) | Lumberjacks, chain sawyers, grinders, chippers Vinyl chloride polymerization | Whole-body or segmental vibration Vinyl chloride monomer |
| Pulmonary Disorders | ||
| Alveolitis (extrinsic, allergic) | Farmer's lung bagassosis, bird-breeder's lung, suberosis, maltworker's lung, mushroom worker's lung, maple bark disease, cheese-washer's lung, coffee-worker's lung, fish-meal-worker's lung, furrier's lung, sequoiosis, woodworker's lung, miller's lung | Various agents |
| Asbestosis | Asbestos workers, users | Asbestos |
| Asthma (extrinsic) | Jewelry, alloy, catalyst makers Polyurethane, adhesive, paint workers Alloy, catalyst, refinery workers Solderers | Platinum Isocyanates Chromium, cobalt Aluminum soldering flux Phthalic anhydride Formaldehyde Gum arabic Nickel sulfate Flour Trimellitic anhydride Red cedar, wood dusts Bacillus-derived exoenzymes Animal dander |
| Plastic, dye, insecticide makers Foam workers, latex makers, biologists Printing industry Nickel platers Bakers Plastics industry Woodworkers, furniture makers Detergent formulators | ||
| Animal handlers | ||
| Beryllium disease (chronic) | Beryllium alloy, ceramic, cathode-ray tube, nuclear reactor workers | Beryllium |
| Bronchitis, pneumonitis, pulmonary edema (acute) | Refrigeration, fertilizer, oil-refining industries Alkali, beach industries Silo fillers, arc welders, nitric acid workers Paper, refrigeration, oil-refining industries Cadmium smelters, processors Plastics industry | Ammonia Chlorine Nitrogen oxides Sulfur dioxide Cadmium Trimellitic anhydride |
| Byssinosis | Cotton industry | Cotton, flax, hemp, cotton-synthetic dusts |
| Pneumoconiosis | Coal miners, bauxite workers | Coal dust, bauxite fumes |
| Silicosis | Mining, metal, and ceramic industries, quarry men, sand blasters, silica processors | Silica |
| Talcosis | Talc processors | Talc |
| Neurological Disorders | ||
| Cerebellar ataxia | Chemical industry Electrolytic chlorine production, battery manufacturing, fungicide formulators | Toluene Organic mercury |
| Encephalitis (toxic) | Battery, smelter, foundry workers Electrolytic chlorine production, battery manufacturing, fungicide formulators | Lead Organic, inorganic mercury |
| Neuropathy (toxic and inflammatory) | Pesticide, pigment, pharmaceutical industries | Arsenic, arsenic compounds Hexane Methyl butyl ketone TNT Carbon disulfide Tri-o-cresyl phosphate Inorganic lead Inorganic mercury Organic mercury Acrylamide |
| Furniture refinishers, degreasers Plastic-coated-fabric workers Explosives industry Rayon manufacturing Plastics, hydraulics, coke industries Battery, smelter, foundry workers Dentists, chloralkali workers Chloralkali, fungicide, battery workers Plastics, paper manufacture | ||
| Parkinson's disease (secondary) | Manganese processors, battery manufacturing, welders Internal combustion engine industries | Manganese Carbon monoxide |
| Miscellaneous | ||
| Abdominal pain | Battery manufacturing, enamelers, smelter, painters, ceramics workers, plumbers, welders | Lead |
| Cataract | Microwave, radar technicians Explosives industry Radiologists Blacksmiths, glass blowers, bakers Moth repellent formulators, fumigators Explosives, dye, herbicide, pesticide industries | Microwaves TNT Ionizing radiation Infrared radiation Naphthalene Dinitrophenol, dinitro-o-cresol |
| Dermatitis (contact, allergic) | Adhesives, sealants, and plastics industries, leather tanning, poultry dressing, fish packing, boat building and repair, electroplating, metal cleaning, machining, housekeeping | Irritants (cutting oils, solvents, phenol, acids, alkalies, detergents, fibrous glass), allergens (nickel, epoxy resins, chro mates, formaldehyde, dyes, rubber products) |
| Headache | Firefighters, foundry workers, wood finishers, dry cleaners, traffic control, driving in heavy traffic | Carbon monoxide, solvents |
| Hepatitis (toxic) | Solvent users, dry cleaners, plastics industry | Carbon tetrachloride, chloroform, tetrachloroethane trichloroethylene Phosphorous, TNT Chloronaphthalene 4,4-Methylene-dianiline Ethylene dibromide Cresol |
| Explosives and dye industries Fire and waterproofing additive formulators Plastics formulators | ||
| Fumigators, gasoline and fire-extinguishers formulators Disinfectant, fumigant, synthetic resin formulators | ||
| Inner ear damage | Various | Excessive noise |
| Infertility (male) | Formulators Producers, formulators, applicators | Kepone 1,2-Dibromo-3-chloropropane |
| Psychosis (acute) | Gasoline, seed, and fungicide workers, wood preservation, rayon manufacturing | Lead (especially organic), mercury, carbon disulfide |
| Renal failure (acute, chronic) | Battery manufacturing, plumbers, solderers Electrolytic processes, arsenical ore smelting Battery manufacturing, jewelers, dentists Fluorocarbon, fire-extinguisher formulators Antifreeze manufacturing | Inorganic lead Arsine Inorganic mercury Carbon tetrachloride Ethylene glycol |
SOURCE: Principles and Practice of Environmental Medicine, Tarcher, AB, ed., Plenum, New York, 1992.
TABLE D-3Selected Job Categories, Exposures, and Associated Work-Related Diseases and Conditions
| Job Categories | Exposures | Work-Related Diseases and Conditions |
|---|---|---|
| Agricultural workers | Pesticides, infectious agents, gases, sunlight | Pesticide poisoning, “farmers' lung,” skin cancer |
| Anesthetists | Anesthetic gases | Reproductive effects, cancer |
| Animal handlers | Infectious agents, allergens | Asthma |
| Automobile workers | Asbestos, plastics, lead, solvents | Asbestosis, dermatitis |
| Bakers | Flour | Asthma |
| Battery makers | Lead, arsenic | Lead poisoning, cancer |
| Butchers | Vinyl plastic fumes | “Meat wrappers' asthma” |
| Caisson workers | Pressurized work environments | “Caisson disease,” “the bends” |
| Carpenters | Wood dust, wood preservatives, adhesives | Nasopharyngeal cancer, dermatitis |
| Cement workers | Cement dust, metals | Dermatitis, bronchitis |
| Ceramic workers | Talc, clays | Pneumoconiosis |
| Demolition workers | Asbestos, wood dust | Asbestosis |
| Drug manufacturers | Hormones, nitroglycerin, etc. | Reproductive effects |
| Dry cleaners | Solvents | Liver disease dermatitis |
| Dye workers | Dyestuffs, metals, solvents | Bladder cancer, dermatitis |
| Embalmers | Formaldehyde, infectious agents | Dermatitis |
| Felt makers | Mercury, polycyclic hydrocarbons | Mercuralism |
| Foundry workers | Silica, molten metals | Silicosis |
| Glass workers | Heat, solvents, metal powders | Cataracts |
| Hospital workers | Infectious agents, cleansers, radiation | Infections, accidents |
| Insulators | Asbestos, fibrous glass | Asbestosis, lung cancer, mesothelioma |
| Jack hammer operators | Vibration | Raynaud phenomenon |
| Lathe operators | Metal dusts, cutting oils | Lung disease, cancer |
| Laundry workers | Bleaches, soaps, alkalies | Dermatitis |
| Lead burners | Lead | Lead poisoning |
| Miners (coal, hard rock, metals, etc.) | Talc, radiation, metals, coal dust, silica | Pneumoconiosis, lung cancer |
| Natural gas workers | Polycyclic hydrocarbons | Lung cancer |
| Nuclear workers | Radiation, plutonium | Metal poisoning, cancer |
| Office workers | Poor lighting, poorly designed equipment | Joint problems, eye problems |
| Painters | Paints, solvents, spackling compounds | Neurologic problems |
| Paper makers | Acids, alkalies, solvents, metals | Lung disorders, dermatitis |
| Petroleum workers | Polycyclic hydrocarbons, catalysts, zeolites | Cancer, pneumoconiosis |
| Plumbers | Lead, solvents, asbestos | Lead poisoning |
| Railroad workers | Creosote, sunlight, oils, solvents | Cancer, dermatitis |
| Seamen | Sunlight, asbestos | Cancer, accidents |
| Smelter workers | Metals, heat, sulfur dioxide, arsenic | Cancer |
| Steel workers | Heat, metals, silica | Cataracts, heat stroke |
| Stone cutters | Silica | Silicosis |
| Textile workers | Cotton dust, fabrics, finishers, dyes, carbon disulfide | Byssinosis, dermatitis, psychosis |
| Varnish makers | Solvents, waxes | Dermatitis |
| Vineyard workers | Arsenic, pesticides | Cancer, dermatitis |
| Welders | Fumes, nonionizing radiation | Lead poisoning, cataracts |
SOURCE: Principles and Practice of Environmental Medicine, A.B.Tarcher, ed., Plenum, New York, 1992.
Footnotes
- *
Murdock, BS, ed. 1991. Environmental Issues in Primary Care. Minnesota: Minnesota Department of Health.
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