Mens Workplace Hazards

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Mens Workplace Hazards

• LM Frazier, MD, MPH
• University of Kansas School of Medicine-Wichita
• Margaret A.K. Ryan, MD, MPH
• Naval Health Research Center, San Diego
• Melissa McDiarmid, MD, MPH, DABT
• University of Maryland School of Medicine,
  Baltimore

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Moving research to practice in workplaces
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Topics

• Mens contribution to couples risk
• Reducing exposures
• Who seeks preconception care?
• Public health communication

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Fathers Down syndrome
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Fathers chemicals

• Effects on sperm
• Take home toxicants

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DBCP Dibromochloropropane

• 1977
• Decreased or absent sperm
• Permanent infertility
• Fewer male offspring

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Men who smoke

• Pregnancy loss
• Adjusted OR 1.81
• (1.0-3.29)
• Am J Epidemiol 2004159993-1001
• Limb defects
• Teratology 199653261-7

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Men pesticides

• Miscarriages
• Father did not use protective equipment like
  gloves
• OR 5.0, 95 CI 0.7-36.2
• Epidemiology 199910752-60
• Environ Health Perspect 2001109851-7

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Men pesticides

• Musculoskeletal or skin defects
• Father is a licensed pesticide applicator, mother
  is over age 30
• OR 2.52, 95 CI 1.58-4.01
• Scand J Work Environ Health
• 200026193-8

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Men pesticides

• Factory exposures
• Ethyl parathion, methamdidophos
• Effects on sperm
• Decreased concentration, motility
• J Occup Environ Med 200042982-92
• Wrong of chromosomes 18, X and Y
• Am J Indust Med 199936230-8

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Men pesticides

• Spraying exposures
• Ethylparathion, methamdidophos, others
• Wrong of chromosomes 18, X and Y
• Environ Health Perspect 20011091237-40

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Men solvents

• Anencephaly
• Children of painters
• Am J Epidemiol 1990131517-31
• Low birth weight
• 60 increase, solvent-intensive jobs
• Br J Ind Med 198845193-7

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Male exposures rodents

• Birth defects
• Ethylnitrosourea,
• 1,3-butadiene

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Which men are at risk?

• Exposure data are sparse
• Businesses with minimal safety programs
• Low income
• Language barriers
• Minority?

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Do men seek preconception care?

• Occupational reproductive hazards clinic
• Femalemale ratio
• 501
• JAMWA 2000 5580-4

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Who seeks preconception information?

• Telephone consultations
• 17 teratogen information services
• Birth Defects Res
• 200470944-7

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What kind of calls come in?

• Two months
• 11,265 calls
• Chemicals
• 919 calls (9.2 of total)
• Most were women
• 711 were pregnant women
• 711 / 919 77.3
• Birth Defects Res 200470944-7

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Public Health Communication

• Workplace hazards can affect infants,
  reproductive health of men and women
• Hazardous drugs
• Material safety data sheets

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NIOSH Alert

• September 2004
• Preventing Occupational Exposures to
  Antineoplastic and Other Hazardous Drugs in
  Health Care Settings

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Health effects

• Infertility, spontaneous abortion,
• congenital malformations
• Skin rashes
• Possibly leukemia and other cancers

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Applies to

• Men and women
• Drug handling circumstances

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List of drugs

• Antineoplastic agents
• Antivirals
• e.g. Ribavirin
• Hormones
• Others

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Employers should

• Assure that workers use sound procedures for
  handling certain drugs
• Policies and procedures
• Equipment
• Training

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Which workers?

• Receiving, storing drugs
• Preparing drugs
• Ventilated cabinets
• Air flow and exhaust
• Maintenance
• Administering drugs
• Cleaning and decontaminating
• Disposing of wastes

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Dissemination

• Stakeholder participation
• NIOSH Hazardous Drug Safety Working Group
• Joint Commission on Accreditation of
  Healthcare Organizations, Pharmaceutical Research
  and Manufacturers of America, Service Employees
  International Union, Oncology Nursing Society,
  International Academy of Compounding Pharmacists,
  Containment Technologies Group, Inc., FDA, EPA
  and others

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Dissemination

• Example
• Joint Commission on Accreditation of Healthy
  Care Organizations
• -- Newsletter
• -- Incorporate into site visits, reviews

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Material safety data sheets

• OSHA-mandated
• Health effects include
• Reproductive problems
• Fetal toxicity
• Safe handling procedures
• Other information

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MSDS information

• Reproductive effects
• MSDS for lead or glycol ethers
• Can affect male or female reproduction
• 60-65 listed reproductive health effects
• If listed, female effects were described more
  often than male effects
• Am J Ind Med 199425403-15

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MSDS comprehensibility

• 100 workers, manufacturing industries
• MSDS written at 12th grade level
• Quiz
• Results 1/3 of info incomprehensible
• Am J Ind Med 199323134-41

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MSDS comprehensibility

• 160 workers, atomic industry
• MSDS in three formats
• Quiz
• Results 1/3 of info not absorbed
• J Safety Res 199930113-22

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Toxicology journal

• DBCP is a specific male gonadotoxicant in humans
  and laboratory animals, leading at high doses to
  azoospermia which may not be reversible.
• Words per sentence 22
• Syllables per word 2.18
• Reading grade level
• 18.7 PhD level

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Readability of materials

• Literacy in US
• Low skills 25
• Marginal skills another 27
• Health literacy often worse than general literacy
• CA Cancer J Clin 200252134-49

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Conclusions Reaching the audience

• Plan ahead for a healthy baby
• Workplace hazards affect men and women

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Conclusions Reaching the audience

• Combination of approaches is needed
• Improve workplaces
• Improve information available to workers
• Research
• -- Methods, effectiveness
• -- Barriers

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Conclusions Reaching the audience

• Combination of approaches is needed
• Include hazardous exposures in preconception
  counseling
• Include men in public awareness campaigns
• Research
• -- Training for health professionals
• -- How to reach men

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Thank you