April 24, 2002
He's not exactly Erin Brockovich. He describes his work as "not sexy." But his career has been dedicated to making work a safer place for those who spend their days in industrial and manufacturing facilities. Henry Glindmeyer, professor of medicine in the section of pulmonary, critical care and environmental medicine, is principal investigator of two major ongoing studies of chronic obstructive pulmonary disease in industrial workers.
"This is truly multidisciplinary research," he said. It's work that began with Hans Weill, Glindmeyer's mentor, who is now retired but founded the section's research unit, and has continued with collaborators from both the medical school and the school of public health.
They include pulmonary specialists Robert Jones and Mitchell Friedman, industrial hygienist Roy Rando, biostatistician John Lefante and data analyst Laurie Freyder. Their job is to study the particles, fibers and chemicals that workers can inhale on the job, and to determine safe levels of exposure. It's a straightforward mission but not an easy one.
"Regulations are listed for many, though not all, potentially harmful inhalants," explained Glindmeyer. "But often workers are exposed to combinations of inhalants, more of a chemical gumbo. Current regulations use only the additive effects of regulated inhalants to restrict exposure, but don't consider synergistic effects, smoking or the possible effects of inhalants that aren't currently regulated."
One of his current studies is an examination of the respiratory effects, if any, associated with exposure to wood-dust particles. The other is newer and broader-based, looking across eight different industries at a variety of inhalants that are not currently regulated. The study is huge, covering 44 plants and 25,000 people, of which about 25 percent are black and 25 percent are women.
"We want to learn, based on the historical data we have on hand, whether certain industries are associated with higher prevalence or incidence of chronic obstructive pulmonary disease (COPD), characterized by symptoms of cough, sputum production or shortness of breath," Glindmeyer said.
COPD is the fourth-leading cause of death in the United States. It is usually associated with smoking but can be caused by exposure to particulates, fibers and gases. In addition, the effect of smoking and exposure can be synergistic, resulting in much greater effects than the added individual effects of smoking and exposure.
"Not only is mortality attributable to COPD on an increase, but we see it disproportionately increasing in African-Americans and women," Glindmeyer said.
A third study, to begin this fall, will look at mortality from COPD among workers in the chemical manufacturing and cotton textile industries. Glindmeyer and his colleagues have been collecting data on these populations since the late 1970s. This study will investigate COPD in 12,000 workers and, in those who have died, will also investigate COPD mortality from death certificates and information on exposure and smoking.
The point of all the group's research is to find out what levels of exposure should be safe over a working lifetime, 40 hours a week for a 40-year work life. That information is used to set federal workplace exposure standards. Since some individuals may be more susceptible and experience adverse effects at lower levels of exposure than the average population, standards also require a medical surveillance program to identify those workers.
But things go wrong despite the checks that are in place. Sometimes it's because the rules are ignored, as when inspectors from the Occupational Health and Safety Administration repeatedly gave a plant in Texas advance notice of inspections, even after several workers died of silicosis. In other instances, employers have disregarded the standards.
Sometimes, manufacturers of respirators make false claims regarding the protective capability of their products. Even conscientious employers can end up jeopardizing the health of their workers because the standards issued by different governmental agencies, or from the same agency for similar work activities in different industries, can be inconsistent and confusing. And sometimes the exposure standards themselves are inadequate.
The standard for asbestos, for example, was equivalent to 177 fibers per cubic centimeter in 1970. Today, it's 0.1 fibers per cubic centimeter, and it's clear that the older standard was not fully protective. The inadequacies of past standards have led to a glut of lawsuits, some serious and justifiable and some frivolous.
Glindmeyer often testifies as an expert witness in these cases. "Many of these cases are driven by greed, although some are truly meritorious. Unfortunately, they all end up in the mix," he said. "A relatively small number of individuals get very large and sometimes justifiable awards, but many individuals, some equally deserving, get only a token."
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