Research Activities

Overview of ongoing research in Occupational and Environmental Medicine

Research activities include epidemiologic, clinical and experimental laboratory investigations. Resources include the Adult Clinical Research Center, inhalation exposure chambers and laboratories at the John B. Pierce laboratory, and the specialized laboratories of principal investigators throughout the medical center. Collaborations are ongoing with investigators in many departments at Yale as well as outside institutions.

Current research interests

• The environmental sentinel studies project of the Yale Occupational and Environmental Medicine Program
• Biological markers and determinants of fibrosis and carcinogenesis in workers with asbestosis
• Chemoprevention trial for lung cancer in asbestos-exposed workers using vitamin A and beta-carotene
• The causes and effects of lead poisoning in bridge construction workers
• Respiratory risks of isocyanate exposure in auto body spray painters (mechanisms of isocyanate asthma):
  Survey of Painters and Repairers of Autobodies by Yale (SPRAY)
• Pathogenesis of isocyanate asthma
• Workplace intervention study: Safe Methods for Autobody Shop Health (SMASH)
• Strategies for control of tuberculosis and other occupational risks among health care workers

Ongoing research projects

1. Noise and Hearing Loss

• Noise induced hearing loss in migrant agricultural workers

This field project assesses the prevalence of noise-induced hearing loss in migrant workers. It is funded by the Northeast Center for Agricultural and Occupational Health.
 

• Identifying Risk Factors for Noise Induced Hearing Loss

An ongoing work analyzing audiometric databases to investigate why some persons are more susceptible than others to developing noise induced hearing loss. Funded by National Institute of Occupational Safety and Health (NIOSH).
 

• Glutathione-S-Transferase Polymorphism and Noise Induced Hearing Loss

Ongoing work looking at gene markers for susceptibility to noise-induced hearing loss, focusing on the family of Glutathione-S-transferase enzymes which form an important part of the body's antioxidant defenses.

• Otoacoustic Emissions For Early Detection of Noise-induced Hearing Loss

Ongoing work to explore the utility of using sensitive emissions from the cochlea to detect early losses of hearing due to noise exposure.

2. Wildlife As Sentinels for Environmental Health Hazards

An ongoing research exploring the health of wildlife populations as sentinels for environmental hazards which could pose health threats to humans.

3. Isocyanate and Asthma

• SPRAY Follow-up Study

This is a newly funded 5 year prospective epidemiologic study on the current SPRAY population. The specific aims are to: 1) Characterize the natural history of isocyanate exposure by following SPRAY subjects over the next 5 years with repeated exposure measurement and measurements of respiratory and immunologic function; 2) Address healthy worker effect by supplementing the existing cohort with an inception cohort of new workers hired during the follow-up period; and 3) Confirm all cases developing new onset asthma by specific inhalation challenge to establish the exposure patterns, pre-clinical physiologic and immunologic features and host factors which confer risk for isocyanate asthma. Funded by NIOSH/CDC.

• Survey of Painters and Repairers of Autobodies by Yale (SPRAY)

This is a 5 year cross-sectional epidemiologic study. The specific aims are: 1) Develop an algorithm for the diagnosis of isocyanate asthma using widely available questionnaire and physiologic measures validated against specific bronchial challenge; 2) Characterize isocyanate exposure patterns in auto body shops and determine the relationships between exposures and risk for development and progression of isocyanate asthma; and 3) Identify potential acquired and genetic host susceptibility factors which may modify risk for the disease. Funded by NIOSH/CDC.

• Isocyanate Exposure Intervention Study in Body Shops

  This is a newly funded 3-year isocyanate exposure intervention study in auto body shops (Safe Methods for Autobody Shop Health or SMASH). The specific aims are to: 1) Implement an educational training program and assess the effectiveness of training; 2) Implement a product (process) change and engineering control program and evaluate their effectiveness in exposure reduction; 3) Implement an administrative program to supply more protective equipment and evaluate its effectiveness in exposure reduction; 4) Implement a behavioral intervention program and evaluate its effect on work practices; 5) Evaluate the overall effectiveness of this intervention program with feedback from shop management and workers and using urinary biological monitoring tools. The overall study design is a prospective field experimental study with 10 shops each in the intervention group and control group and about 120 workers in total. The intervention effectiveness is evaluated at baseline, six months and one year. The overall goal is to identify effective exposure intervention strategies, recommend them for wide application in the collision industry and other similar industries, and contribute significantly to a better prevention of asthma in auto body shop workers. Funded by NIOSH/CDC.

• Assessing Isocyanate Dermal Exposure in Auto Body Shops

Specific aims are to: 1) Qualitatively and quantitatively assess surface and skin contamination of hexamethylene diisocyanate (HDI); 2) Identify modifiers that affect surface and skin contamination, and specifically evaluate the effectiveness of PPE in protecting the skin from isocyanate contamination; 3) Evaluate urinary hexane diamine (HDA) as a biomarker for assessing exposures to HDI; 4) Explore the relationships of dermal exposure with airborne exposure, biomarkers of systemic absorption and skin sensitization, and asthma-developing risk. Funded by National Heart, Lung and Blood Institute (NHLBI).

• SCOR in Cellular and Molecular Mechanisms od Asthma

This project is designed to investigate the inflammatory mechanisms that underlie isocyanate-induced asthma and compare these mechanisms to those in antigen-sensitive individuals. Funded by NHLBI.
 

• Isocyanate Antigens & T-Cells That Cause Asthma

Specific aims are to: 1) Generate and characterize HDI antigens; 2) Evaluate the T-cell antigenicity of the HDI antigens; 3) Establish T-cell lines from the skin, lung and peripheral blood of HDI asthma patients and characterize the phenotype, antigen specificity, cytokine production and TCR expression of isocyanate responsive T-cells; 4) Compare isocyanate responsive T-cells found in the skin, lung and blood and correlate with clinical sensitivity to determine characteristics associated with exposure and sensitization leading to clinical asthma. Funded by NHLBI.

4. Health and Socioeconomic Consequences of NSBRI

The primary goal of this project is to determine the health and socioeconomic consequences of nonspecific building-related illness (NSBRI) (or sick building syndrome) in workers diagnosed with this prevalent disorder. Funded by NIOSH.

5. Injury and Muskulo-Skeletal Disorders (MSD) Among Aging Workers in an Industrial Workforce

Specific aims of this project are to: 1) Determine the frequency of injury and MSD at the job specific level in older workers; 2) Determine the severity of injuries and MSD's for each job type in older workers; 3) Determine the characteristics at the job level with higher and lower relative risks for older workers compared to younger workers; 4) Determine the potential modifying effects of demographic factors and health status on injury and MSD risk among older workers at the individual level; 5) Determine the potential modifying effect of work organization and culture on risks for older workers at the location level. Funded by NIOSH.

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Last modified: April 30, 2002 (SW)