Use of hospital discharge data for surveillance of chemical-related respiratory disease.
Arch Environ Health 1995 Jan; 50(1):26-30
Exposures to chemical fumes and vapors requiring hospitalization in Michigan in 1989 and 1990 were surveyed. The International Classification of Diseases (ICD) diagnosis code 506 was used to identify hospital discharges for chemically related respiratory disease from the Michigan Hospital Association (MHA) Service Corporation Michigan Inpatient Database. Medical records were examined for 329 patients. Occupational exposure accounted for one third of the cases, with chlorine (7782505) and sulfur-dioxide (7446095) (13.6%) the most common agents. The mixing of industrial cleaners (9.7%) and single industrial cleaners (5.8%) were also noted as frequent agents. Exposures to grain dusts, molds, and agricultural chemicals in farm work accounted for 11.7%. Nonwork related exposures included fires (26.9%), petroleum products (18.1%), mixing of household products (12.9%) and household cleaning products (11.1%). Michigan Occupational Safety and Health Administration (MIOSHA) inspections at 23 of the patient workplaces found three facilities with exposure to the suspected substance above the NIOSH recommended levels, two of which exceeded the enforceable MIOSHA permissible exposure levels. Seven facilities were cited for other OSHA violations, including noise and hazard communication standards. A standardized health questionnaire was administered to 261 coworkers at 14 of the inspected facilities. New onset asthma or occupational asthma were reported by 23% of the workers. The authors conclude that hospital discharge data are useful tools in identifying both work and nonwork related respiratory hazards.
NIOSH-Publication; NIOSH-Cooperative-Agreement; Health-surveys; Occupational-exposure; Occupational-respiratory-disease; Respiratory-system-disorders; Epidemiology; Toxic-gases
Archives of Environmental Health
Department of Consumer & Industry Service, Michigan Department of Public Health