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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health D Environmental Health Resources: Agencies, Organizations, Services, General References, and Tables of Environmental Health Hazards Contents     INTRODUCTION   149     GOVERNMENT AGENCIES   149     Federal Agencies,   149     State Agencies,   162     ASSOCIATIONS AND ORGANIZATIONS   173     SELECTED TOPICAL RESOURCES   197     COMPUTERIZED INFORMATION SERVICES   199     GENERAL REFERENCES   208     TABLES OF ENVIRONMENTAL AGENTS AND HEALTH EFFECTS, WORK-RELATED DISEASES AND CONDITIONS, AND SELECTED JOB CATEGORIES AND ASSOCIATED DISEASES AND CONDITIONS   211     Table D.1: Environmental Agents, Their Sources and Potential Exposures, and Adverse Health Effects,   212     Table D.2: Selected Work-Related Diseases, Disorders, and Conditions Associated with Various Agents, Industries, or Occupations,   230     Table D.3: Selected Job Categories, Exposures, and Associated Work-Related Diseases and Conditions,   237

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health INTRODUCTION For those interested in learning more about environmental health and the resources available that are related to environmental health, Appendix D 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. Agencies, associations, and organizations related to nursing and/or the environment are specifically highlighted. Finally, three tables are presented (pp. 214–240) 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 for use in actual nursing practice. 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,

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health 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; 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health 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/nonnuclear 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health 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 (DHHS) is the Cabinet-level department of the federal executive branch most concerned with people and most involved with the nation's human concerns. In one way or another—whether it is mailing out social security checks or making health services more widely available—DHHS 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 Avenue, 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health 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) 4-CANCER 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.

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health National Institute for Occupational Safety and Health 200 Independence Avenue, S.W. Washington, DC 20201 (800) 356-4674 The 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 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.

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health ALABAMA University of Alabama in Birmingham School of Nursing University of Starion Birmingham, AL 35294-1210 Kathleen Brown, RN, Ph.D. Director, Occupational Health Nursing Degree: MSN, DNS (205) 934-6858 MARYLAND The Johns Hopkins University School of Hygiene and Public Health 615 N. Wolfe Street Baltimore, MD 21205 Jacqueline Agnew, RN, Ph.D. Director, Occupational Health Nursing Program Degree: MPH, DrPH, Ph.D. (410) 955-4082 CALIFORNIA UCLA School of Nursing 10833 LeConte Avenue Los Angeles, CA 90024-1702 Linda Glazner, DrPH, RN Program Director, Occupational Health Nursing Degree: MSN (310) 206-3838 MASSACHUSETTS Harvard University Harvard School of Public Health Department of Environmental Science and Physiology 665 Huntington Avenue Boston, MA 02115 Carol Love, Ph.D. Director, Occupational Health Nursing (Simmons) Degree: MS (617) 738-2255 University of California, San Francisco School of Nursing Department of Mental Health and Community Nursing N505Y San Francisco, CA 94143 Julia Faucett, RN, Ph.D. Program Director, Occupational Health Nursing Degree: MS, DNS (415) 476-5312 MICHIGAN University of Michigan School of Nursing Department of Community Health Nursing 400 N. Ingalls, Room 3340 Ann Arbor, MI 48109 Sally Lusk, RN, Ph.D. Director, Occupational Health Nursing Program Degree: MS (313) 747-0347 ILLINOIS University of Illinois at Chicago College of Nursing 845 South Damen Street Chicago, IL 60612 Karen Conrad, Ph.D., RN Director, Occupational Health Nursing Program Degree: MS, Ph.D. (312) 996-7974  

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health MINNESOTA University of Minnesota School of Public Health 420 Delaware Street, SE, Box 197 Minneapolis, MN 55455 Patricia McGovern, RN, MPH Program Director, Occupational Health Nursing Degree: Ph.D., MS, MS/MPH (612) 625-7429 OHIO University of Cincinnati College of Nursing and Health 200 Proctor Hall 3110 Vine Cincinnati, OH 45219-0038 Sue Davis, Ph.D. Acting Program Director, Occupational Health Nursing Degree: MSN, Ph.D. (513) 558-5280 NEW YORK/NEW JERSEY University of Medicine and Dentistry of New Jersey School of Nursing 30 Bergen Street ADMC 119 Newark, NJ 07107-3000 Gail Buckler, RN, MPH, COHN Program Director, OHN Program Degree: MSN (908) 445-0123 TEXAS University of Texas The University of Texas Health Science Center at Houston School of Public Health P.O. Box 20186 Houston, TX 77225 Mary Kay Garcia, RN, DrPH Director, Occupational Health for Nurses Program Degree: MPH (713) 792-7456 NORTH CAROLINA University of North Carolina at Chapel Hill School of Public Health Rosenau Hall Chapel Hill, NC 27514 Bonnie Rogers, RN, DrPH Program Director, Occupational Health Nursing Degree: MPH, MS (919) 996-1030 UTAH University of Utah RMCOEH, Building 512 Salt Lake City, UT 84119 Darlene Meservy, RN, MPH, DrPH Director, Occupational Health Nursing Degree: MSPH, Ph.D., MPH (801) 581-8214

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health WASHINGTON University of Washington Community Health Care Systems, SM-24 Seattle, WA 98195 Mary Salazar, Ph.D. Director, Occupational Health Nursing Program Degree: MN, Ph.D., MN/MPH (206) 685-0857   Training Project Grants University of Pennsylvania School of Nursing 420 Service Drive Philadelphia, PA 19104 Winifred Hayes, RN, Ph.D. Director, Occupational Health Nursing Program Degree: MSN (215) 898-1794 University of South Florida College of Nursing Health Science Center Box 22 12901 Bruce B. Downs Boulevard Tampa, FL 33612-4799 Dr. Candace Burns Director, Occupational Health Nursing Program (813) 974-9160 The 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Agent Exposure Route of Entry Systems(s) Affected Chlorinated hydrocarbons: chlordane, DDT, heptachlor, chlor-decone (Kepone), aldrin, dieldrin, uridine   Ingestion, inhalation, percutaneous absorption CNS Bipyridyls: paraquat, diquat   Inhalation, ingestion, percutaneous absorption Pulmonary a Occupational and medical histories are in most instances, the most important aids in diagnosis. b Zinc oxide is a prototype of agents that cause metal fume fever. c The less water-soluble the gas, the deeper and more delayed its irritant effect.

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Primary Manifestations Aids in Diagnosisa Remarks Stimulation or depression Urinary organic chlorine, or p-chloro-phenol acetic acid The chlorinated hydro-carbons may accumulate in body lipid stores in large amounts. Rapid massive fibrosis, only following paraquat ingestion   An interesting toxin in that the major toxicity, pulmonary fibrosis, apparently occurs only after in gestion. d Pulmonary function tests are useful aids in diagnosis of irritant effects if the patient is subacutely or chronically ill. SOURCE: Reprinted, with permission, from Principles and Practice of Environmental Health, A.B. Tarcher, ed. Copyright 1992 by Plenum Publishing Co.

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health TABLE D-2: Selected 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Diseases, Disorders, and Conditions Industry or Occupation Agent 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 fluorspar 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Diseases, Disorders, and Conditions Industry or Occupation Agent 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 Phosphorus Inorganic arsenic Anemia Aplastic Explosives manufacturing Worker 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 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 Leukemia Erythroleukemia Workers exposed to benzene Benzene Methemoglobinemia Explosives, dye industries Aromatic amino and nitro compounds (e.g., aniline, TNT, nitroglycerin)

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Diseases, Disorders, and Conditions Industry or Occupation Agent 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 Plastic, dye, insecticide makers Foam workers, latex makers, biologists Printing industry Nickel platers Bakers Plastics industry Woodworkers, furniture makers Detergent formulators Animal handlers 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Diseases, Disorders, and Conditions Industry or Occupation Agent 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, quarrymen, 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 Furniture refinishers, degreasers Plastic-coated fabric workers Explosives industry Rayon manufacturing Plastics, hyrdraulics, coke industries Arsenic, arsenic compounds Hexane Methyl butyl ketone TNT Carbon disulfide Tri-o-cresyl phosphate

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Diseases, Disorders, and Conditions Industry or Occupation Agent Neuropathy (toxic and inflammatory) Battery, smelter, foundry workers Dentists, chloralkali workers Chloralkali, fungicide, battery workers Plastics, paper manufacture Inorganic lead Inorganic mercury Organic mercury Acrylamide 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 Explosive industry Radiologists Blacksmiths, glass blowers, bakers Moth repellant 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, chromates, 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Diseases, Disorders, and Conditions Industry or Occupation Agent Hepatitis (toxic) Explosives and dye industries Fire and waterproofing additive formulators Plastics formulators Fumigators, gasoline and fire-extinguisher formulators Disinfectant, fumigant, synthetic resin formulators Phosphorus, TNT Chloronaphthalene 4,4-Methylene-dianiline Ethylene dibromide Cresol 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: Reprinted, with permission, from Principles and Practice of Environmental Medicine, Tarcher, AB, ed. Copyright 1992 by Plenum Publishing Co.

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health TABLE D-3: Selected 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, ''farmer's 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

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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health Job Categories Exposures Work-Related Diseases and Conditions 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: Reprinted, with permission, from Principles and Practice of Environmental Medicine, A.B. Tarcher, ed. Copyright 1992 by Plenum Publishing Co.