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Occupational coccidioidomycosis in California: outbreak investigation, respirator recommendations, and surveillance findings.

Authors
Das-R; McNary-J; Fitzsimmons-K; Dobraca-D; Cummings-K; Mohle-Boetani-J; Wheeler-C; McDowell-A; Iossifova-Y; Bailey-R; Kreiss-K; Materna-B
Source
J Occup Environ Med 2012 May; 54(5):564-571
NIOSHTIC No.
20040730
Abstract
OBJECTIVE: To describe the investigation of a 2007 occupational coccidioidomycosis outbreak in California, recommend prevention measures, and assess statewide disease burden. METHODS: We evaluated the worksite, observed work practices, interviewed the workers and employer, reviewed medical records, provided prevention recommendations including risk-based respirator selection, and analyzed statewide workers' compensation claims. RESULTS: Ten of 12 workers developed acute pulmonary coccidioidomycosis; none used respiratory protection. We recommended engineering, work practice, and administrative controls, powered air-purifying respirator use, and medical care. Occupational coccidioidomycosis incidence nearly quadrupled in California from 2000 to 2006, with the highest rates in construction and agricultural workers. CONCLUSIONS: Construction workers are at risk for occupational coccidioidomycosis. The high attack rate in this outbreak was due to lack of awareness, rainfall patterns, soil disruption, and failure to use appropriate controls. Multiple risk-based measures are needed to control occupational coccidioidomycosis in endemic areas.
Keywords
Disease-incidence; Disease-control; Disease-prevention; Respiratory-system-disorders; Surveillance-programs; Health-surveys; Respirators; Pulmonary-system-disorders; Air-purifying-respirators; Construction-workers; Personal-protective-equipment; Work-practices; Engineering-controls; Administration; Control-methods; Control-systems; Medical-care; Medical-monitoring; Agricultural-workers; Outdoors; Fungal-diseases; Fungal-infections
Contact
Dr Rupali Das, MD, MPH, Environmental Health Investigations Branch, California Department of Public Health, 850 Marina Bay Parkway, P-3, Richmond, CA 94804
CODEN
JOEMFM
Publication Date
20120501
Document Type
Journal Article
Email Address
Rupali.das@cdph.ca.gov
Fiscal Year
2012
NTIS Accession No.
NTIS Price
Identifying No.
B05102012
Issue of Publication
5
ISSN
1076-2752
NIOSH Division
DRDS
Source Name
Journal of Occupational and Environmental Medicine
State
CA; WV; GA
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