Occupational Health Branch, California Department of Public Health, CA, USA.
J Occup Environ Med. 2012 May;54(5):564-71. doi: 10.1097/JOM.0b013e3182480556.
To describe the investigation of a 2007 occupational coccidioidomycosis outbreak in California, recommend prevention measures, and assess statewide disease burden.
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.
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.
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.
描述 2007 年加利福尼亚州职业球孢子菌病暴发的调查情况，提出预防措施，并评估全州疾病负担。
我们评估了工作场所，观察工作实践，采访工人和雇主，审查医疗记录，提供基于风险的呼吸防护选择等预防建议，并分析了全州范围内的工人赔偿索赔。
12 名工人中有 10 名患有急性肺球孢子菌病；没有人使用呼吸防护。我们建议采用工程、工作实践和管理控制、动力空气净化呼吸器的使用和医疗保健。2000 年至 2006 年，加利福尼亚州的职业球孢子菌病发病率几乎翻了两番，建筑和农业工人的发病率最高。
建筑工人有患职业球孢子菌病的风险。这次暴发的高发病率是由于缺乏意识、降雨模式、土壤扰动和未能使用适当的控制措施造成的。在流行地区，需要采取多种基于风险的措施来控制职业球孢子菌病。
