Occupational Coccidioidomycosis in California Outbreak Investigation, Respirator Recommendations, and Surveillance Findings
Occupational Coccidioidomycosis in California Outbreak Investigation, Respirator Recommendations, and Surveillance Findings
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DOI：
10.1097/jom.0b013e3182480556
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发表时间：
2012-05-01
影响因子：
3.2
通讯作者：
Materna, Barbara
中科院分区：
文献类型：
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作者：
Das, Rupali;McNary, Jennifer;Materna, Barbara
目的：描述 2007 年加利福尼亚州职业性球孢子菌病暴发的调查情况，推荐预防措施，并评估全州疾病负担。方法：我们评估了工作场所，观察了工作实践，采访了工人和雇主，审查了医疗记录，提供了预防建议，包括基于风险的呼吸器选择，并分析了全州工人的赔偿索赔。结果：12名工人中有10名患上急性肺球孢子菌病；没有人使用呼吸防护装置。我们建议工程、工作实践和行政控制、电动空气净化呼吸器的使用和医疗护理。 2000 年至 2006 年间，加利福尼亚州的职业球孢子菌病发病率几乎翻了两番，其中建筑工人和农业工人的发病率最高。结论：建筑工人存在职业性球孢子菌病的风险。这次疫情的高发病率是由于缺乏认识、降雨模式、土壤破坏以及未能采取适当的控制措施造成的。需要采取多种基于风险的措施来控制流行地区的职业性球孢子菌病。
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.