Occupational Medicine Forum: Cancer and coal tar epoxy resins

Article Abstract:

The evidence of several past studies indicates that pipe coaters exposed on the job to coal tar epoxy resin face a greater risk of cancer. Coal tar epoxy resins are a combination of coal tar and epoxy. Coal tars and coal tar pitches vary in composition; the source of the coal tar and its processing method determine the particular composition of a coal tar and its chemical characteristics. More than 300 compounds have been identified in coal tars. Included are potent cancer-causing substances such as methylcholanthrene, 3,4-benzypyrene and 1,2:5,6-dibenzanthracene. Epoxy resins are a class of thermosetting plastics that are based on ethylene oxide or its derivatives. Fillers, such as asbestos, may be added to the resin or the coal tar, and some epoxy resin systems utilize such solvents as xylene and methyl isobutyl ketone. Workers generally use solvents such as acetone, alcohol, trichloroethylene and methyl ethyl ketone to clean up coal tar epoxy splatters and droplets. A search of the medical and scientific literature does not yield references to animal or human studies of cancer associated with epoxy resins. There is, however, substantial literature on coal tars and the formation of cancer. Documentation of skin cancer associated with coal tars dates back over 200 years. Studies of workers exposed to coal tar have suggested an association with lung, kidney, prostate, bladder, colon, stomach, esophagus, sino-nasal, oral and pancreatic cancers. Some studies have shown an association between coal tars and leukemia and multiple myeloma (a tumor growth, often leading to cancer, in bone marrow). Most of these findings have not been verified; many involve asbestos or benzene exposure that occurred simultaneously with coal tar exposure. The National Institute for Occupational Safety and Health has concluded that coal tar and coal tar pitch are carcinogenic, increasing the risk of lung and skin cancer in workers.

Analysis, Physiological aspects, Carcinogenesis, Carcinogens, Benzopyrene, Epoxy resins, Coal tar, Coal-tar

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Medication-induced performance deficits: analgesics and narcotics

Article Abstract:

The most commonly reported medical complaint is simply pain, and a recent poll surveyed the most frequently given causes of pain in Americans. For short-term pain, 68 percent of the respondents reported dental pain, 54 percent had stomach pain, 41 percent suffered from headaches, 40 percent reported join or muscle pain, and 39 percent had backaches. Among the most frequently cited reasons for chronic pain were joint pains (19 percent), backaches (16 percent), muscle pain (10 percent), and headaches (seven percent). Approximately 42 percent of all pain complaints are associated with premenstrual or menstrual pain. Several approaches exist for treating both chronic and short-term pain. Nonnarcotic analgesics are the most commonly used drug for relief of pain; common nonprescription compounds are aspirin and acetaminophen. Narcotic analgesics have an effect on the central nervous system and therefore produce neuropsychological symptoms. Cognitive impairments occur, as well as motor and sensory deficits, and general intellectual functioning may be affected by narcotics. The pharmacological effects of some of the more common compounds are discussed. Some therapeutic techniques that do not involve drugs are relaxation training, hypnosis, and physical therapy. These methods may be especially helpful in treating chronic pain when continuous use of narcotics is not advisable. As the most frequent patient complaint, pain is responsible for absenteeism, chronic disability, and job performance impairment from drug therapy. The consequences of drug-related impairments should be anticipated in the work environment to help minimize occupational risk. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Pain

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Therapeutic narcotics in the workplace

Article Abstract:

The appropriate therapeutic use of narcotics in the workplace must be critically assessed by occupational physicians. The occupational physician's first obligation is to the individual patient, and this includes the disposition of any work limitations imposed as part of treatment. Although narcotics have definite medical uses, they have a well-known range of side-effects such as decreased alertness, impaired judgment, potential for addiction and allergic reactions. There may be some forms of narcotic use (particularly for pain reduction) that allow the patient to remain on the worksite. In these cases it is important for an occupational medicine physician to closely assess and monitor the condition of the patient and remain aware of the potential problems caused by narcotic medications. Accurate recording of treatment is essential in order to prevent accidents, and physicians should cooperate completely with government and safety workers to maximize accident prevention. The physician should never consider accident statistics as bearing on the delivery of anything but the optimal treatment for each individual patient.

Workplace accidents, Statistics, Employee drug abuse

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