Publications by authors named "Paul D Blanc"

Determine performance characteristics and safety outcomes of two rapid COVID-19 screening methods to inform immediate return to work (RTW) decisions while (health care personnel) HCP await results of pending confirmatory laboratory test. Retrospective, occupational health quality improvement study comparing screening with rapid SARS-CoV-2 nucleic acid amplification (NAAT) and antigen test. 531 mildly symptomatic HCP screened over 16 months.

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Background: Post-9/11 veterans were exposed to environmental and occupational pollutants during deployment.

Objective: Our aim was to determine associations between deployment-related exposures and sinusitis and rhinitis.

Methods: Between April 2018 and March 2020, veterans with land-based deployment after 9/11 who were living within 25 miles of 6 Department of Veteran Affairs medical centers were randomly chosen by using a Defense Manpower Data Center roster.

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  • Coal miners in Appalachia show higher rates of depression and anxiety compared to other occupations, with 16.3% of surveyed individuals having mining experience.
  • The study used comprehensive surveys to assess PTSD, depression, and anxiety among men aged 50 and older, adjusting for various factors like trauma and smoking.
  • While coal mining correlated with increased depression (OR 1.6) and anxiety (OR 1.7), it was not directly linked to higher PTSD risk, emphasizing the need for targeted public health interventions for this population.
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  • The study aimed to compare patient surveys on arthritis conditions and medication with physician records to enhance the accuracy of epidemiological research on autoimmune arthritis.
  • Rheumatologists recruited men aged 50 and older with rheumatoid arthritis, and both patients and clinicians provided data through interviews and chart abstractions, respectively.
  • Results showed complete agreement on RA diagnoses and varied levels of agreement for medication usage, indicating that patient self-reports can effectively contribute to epidemiological studies on arthritis.
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  • The study investigates the reliability of self-reported acute respiratory exacerbation episodes (AECOPD) among individuals with chronic obstructive pulmonary disease (COPD), suggesting that self-reports may not accurately reflect actual health records.
  • The researchers compared self-reported incidents of AECOPD with electronic health records from 511 participants, focusing on current or former heavy smokers, including those with and without COPD.
  • Findings revealed discrepancies, with a notable percentage of individuals documented in health records as having severe AECOPD not reporting such incidents themselves, highlighting the need for improved methods of identifying exacerbation tendencies in COPD patients.
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  • The study investigates the impact of smoking on lung function among post-9/11 Veterans, particularly those deployed in areas with high levels of particulate matter.
  • Data was collected from 1,836 Veterans, revealing that 44.8% were ever-smokers, with most starting before deployment and smoking more during deployment.
  • Results showed a negative correlation between the number of pack-years smoked and lung function measurements, indicating that higher smoking intensity, regardless of deployment status, adversely affects lung health.
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Background: Hybrid immunity, from COVID-19 vaccination followed by SARS-CoV-2 infection acquired after its Omicron variant began predominating, has provided greater protection than vaccination alone against subsequent infection over 1-3 months of observation. Its longer-term protection is unknown.

Methods: We conducted a retrospective cohort study of COVID-19 case incidence among healthcare personnel (HCP) mandated to be vaccinated and report on COVID-19-associated symptoms, high-risk exposures, or known-positive test results to an employee health hotline.

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  • This study focused on analyzing inhalational exposures of US Veterans during their deployments to Afghanistan and Southwest Asia, examining their effects on respiratory health.
  • It involved nearly 2000 participants who reported their exposure to various harmful substances, such as burn pit smoke and other combustion-related pollutants, with results indicating significant exposure levels.
  • The findings revealed that exposure to burn pit smoke and military job-related vapors was linked to higher rates of respiratory symptoms, like dyspnoea and chronic bronchitis, among the Veterans.
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The first modern description linking rheumatoid arthritis to occupational dust exposure is generally attributed to the British physician Anthony Caplan. In 1953, Caplan reported on a "peculiar" nodular pattern on chest radiographs of Welsh coal miners with rheumatoid arthritis that differed from the typical coal workers' pneumoconiosis. However, as early as 1950, the Belgian rheumatologist Émile Colinet described a similar case of rheumatoid arthritis and concomitant pulmonary opacities in a 30-year-old woman with silica exposure.

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Purpose Of Review: Military personnel deployed to Southwest Asia and Afghanistan were potentially exposed to high levels of fine particulate matter and other pollutants from multiple sources, including dust storms, burn pit emissions from open-air waste burning, local ambient air pollution, and a range of military service-related activities that can generate airborne exposures. These exposures, individually or in combination, can have adverse respiratory health effects. We review exposures and potential health impacts, providing a framework for evaluation.

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Background: The diagnosis of constrictive bronchiolitis (CB) in previously deployed individuals, and evaluation of respiratory symptoms more broadly, presents considerable challenges, including using consistent histopathologic criteria and clinical assessments.

Research Question: What are the recommended diagnostic workup and associated terminology of respiratory symptoms in previously deployed individuals?

Study Design And Methods: Nineteen experts participated in a three-round modified Delphi study, ranking their level of agreement for each statement with an a priori definition of consensus. Additionally, rank-order voting on the recommended diagnostic approach and terminology was performed.

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Importance: Respirable silica exposure has been strongly and consistently linked to rheumatoid arthritis (RA) among foundry workers, persons in the construction trades, stone crushers and drillers, and coal miners. However, risk of RA in hard rock mining has not been thoroughly investigated.

Objective: To analyze occupational risk of RA in hard rock miners in Colorado, New Mexico, and Utah.

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Objective: Most health care personnel (HCP) reporting symptoms consistent with COVID-19 illness are assessed by high-accuracy SARS-CoV-2 assays performed in clinical laboratories, but the results of such assays typically are not available until the following day.

Methods: This is an observational study over 16 weeks of a rapid nucleic acid amplification test (NAAT) performed at point of contact. The benchmark for comparison was a simultaneously obtained specimen assayed by a routine NAAT assay performed in a clinical laboratory.

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Alveolar hemorrhage associated with physical exertion, known as exercise-induced pulmonary hemorrhage (EIPH), is a rare condition linked to strenuous exertion. This can be an unusual form of respiratory and occupational illness. We present the case of a healthy firefighter who developed fatal pulmonary hemorrhage after participating in a strenuous physical training exercise regimen.

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Mitigating bloodborne pathogen exposure (BBPE) risk among healthcare workers is a major focus of hospital-based occupational health programs. The COVID-19 pandemic has placed added demands on occupational health services for healthcare workers. Its impact on BBPE incidence is unreported.

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There is limited literature exploring the relationship between military exposures and idiopathic pulmonary fibrosis (IPF). To evaluate whether exposure to Agent Orange is associated with an increased risk of IPF among veterans. We used Veterans Health Administration data to identify patients diagnosed with IPF between 2010 and 2019.

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Objective: Most studies observing an association between depressive symptoms following lung transplantation and mortality are limited to depressive symptom measurement at a single time point, unrelated to allograft function. We aimed to test the association of depressive symptoms over multiple assessments with allograft dysfunction and with mortality.

Methods: We assessed depressive symptoms before and serially up to 3 years after lung transplantation in lung transplant recipients.

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The objectives of this study are to elucidate the early history of risk for pneumococcal pneumonia from occupational exposure to metal fumes and dusts, and to demonstrate the importance of searching older literature when performing reviews. We performed manual searching for articles in the Library of the Surgeon General's Office (the precursor to Index Medicus), in the Hathi Trust database, in PubMed, andby screening reference lists in literature appearing before the introduction of PubMed. An early body of literature, from the 1890s onward, recognized that pneumonia was linked to "Thomas slag," a steel industry byproduct containing iron, manganese, and lime.

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Purpose: Occupational exposure to inorganic dust and fumes in the year preceding disease has been associated with increased pneumococcal pneumonia risk, but the impact of prior cumulative exposure has not been characterized.

Methods: We studied 3184 cases of invasive pneumococcal disease with pneumonia. The case index date was the day the infection was diagnosed.

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