Linda Rosenstock

Linda Rosenstock
University of California, Los Angeles | UCLA · Health Policy and Management, medicine, and Environmental Health Sciences

MD, MPH

About

114
Publications
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4,708
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Publications

Publications (114)
Article
Full-text available
It was against a background of no formal career path for public health officers that, in 1915, the seminal Welch-Rose Report 1 outlined a system of public health edu-cation for the United States. The first schools of public health soon followed, but growth was slow, with only 12 schools by 1960. With organization and growing numbers, accreditation...
Conference Paper
Dr. Rosenstock will focus on those provisions of the Affordable Care Act and what needs to be done to assure they are funded to improve health and wellness
Article
We evaluated the cost and yield of a general health surveillance program emphasizing the identification of occupationally related diseases among workers in a high-risk trade. Of approximately 4,000 eligible members of two local plumbers and pipefitters unions, 639 were screened in this program. Screening tests indicated either by specific occupatio...
Article
Full-text available
FORECASTAs a result, today's public health workforce, faced with daunting public health challenges, has been forced to do more with fewer people. For example, in the U.S. in the year 2000, there were about 50,000 fewer public health employees than in 1980.5,6 While the 1980 workforce ratio (220 per 100,000) may in fact be an underestimate of the id...
Article
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Among the approximately 1.1 million firefighters in the United States (of whom about 70% are volunteers and 30% are paid career personnel), about 100 die each year in the line of duty.1 With the exception of 2001, when 344 firefighters died as a result of the events of September 11 at the World Trade Center in New York City, the number of deaths pe...
Article
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Without fanfare or debate, a member of Congress places a rider on the omnibus appropriations bill enacted at the end of the Clinton Administration in late 2000.¹ A new 2-sentence law, now known as the Data Quality Act (DQA),² directs the administration's Office of Management and Budget (OMB) to provide a potent mechanism for interested parties to c...
Chapter
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Workers around the world—despite vast differences in their physical, social, economic, and political environments—face virtually the same kinds of workplace hazards. These hazards are traditionally categorized into four broad types: chemical, biological, physical, and psychosocial. What emerges from our incomplete knowledge of their risk, however,...
Article
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The relation between asbestos exposure and colorectal cancer remains controversial. The authors of this 1984–2004 US study examined the association among 3,897 occupationally exposed participants in the Beta-Carotene and Retinol Efficacy Trial (CARET) for chemoprevention of lung cancer, followed prospectively for 10–18 years. When a Cox stratified...
Article
Working conditions in the developing world seldom meet the minimum standards required by international agencies. This article addresses some of the major obstacles to occupational and environmental health and suggests methods by which they can be overcome. International agencies such as the World Health Organization (WHO) and the International Labo...
Article
Full-text available
Despite numerous published studies, debate continues regarding the risk of developing lung cancer among men exposed occupationally to asbestos, particularly those without radiographic or functional evidence of asbestosis. The beta-Carotene and Retinol Efficacy Trial (CARET), a study of vitamin supplementation for chemoprevention of lung cancer, has...
Article
Comprehensive and updated throughout, this new edition makes it easy to detect, diagnose, and treat the full spectrum of problems caused by occupational or environmental factors, including physical, chemical, and biologic agents. An international cast of experts offers in-depth, authoritative guidance on clinical problems as well as the legal and r...
Book
Comprehensive and meticulously updated throughout, this new edition makes it easy to detect, diagnose, and treat the full spectrum of problems caused by occupational or environmental factors, including physical, chemical, and biologic agents. An international cast of experts offers in-depth, authoritative guidance on clinical problems as well as th...
Article
Jocelyn Kaiser's article about the reorganization of the Centers for Disease Control and Prevention (CDC) describes problems of morale, confusion, and uncertainty (“Reorganization plans roil staff scientists at CDC,” 30 Apr., p. [662][1]). She does not examine how the reorganization may affect
Article
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Article
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As government agencies, academic centers, and researchers affiliated with them provide an increasing share of the science base for policy decisions, they are also subject to efforts to politicize or silence objective scientific research. Such actions increasingly use sophisticated and complex strategies that put evidence-based policy making at risk...
Article
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Organophosphate poisoning has been associated with chronic neurobehavioral dysfunction, but no epidemiologic data exist with regard to long-term consequences from carbamate poisoning. This cross-sectional study evaluated the neurobehavioral performances of 81 banana workers who, on average 27 months earlier, had received medical attention not requi...
Article
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It is plausible that neurodegenerative processes of aging might have a contributing role in the development of chronic effects of exposure to organic solvents. This study evaluated the risk for neuropsychological deficits among retired workers, relative to their histories of exposure to occupational solvents. This cross sectional study evaluated re...
Article
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No single organization has the resources necessary to conduct occupational safety and health research to adequately serve the needs of workers in the United States. The National Institute for Occupational Safety and Health (NIOSH) undertook the task of setting research priorities in response to a broadly perceived need to systematically address tho...
Article
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In a ten-year period at the Occupational and Environmental Medicine Program (OEMP) of the University of Washington in Seattle, 71 patients were determined by attending physicians to have work-related asthma. In this cross-sectional descriptive study, we describe these patients. Data were obtained from a database maintained by the OEMP and from char...
Article
The Carotene and Retinol Efficacy Trial (CARET) was a double-blind, placebo-controlled trial of the daily administration of 25,000 IU vitamin A and 30 mg beta-carotene for the prevention of lung cancer. Of close to 18,500 participants, more than 4,000 were asbestos-exposed men recruited from shipyard and construction trades at five study centers in...
Article
The Carotene and Retinol Efficacy Trial (CARET) was a double-blind, placebo-controlled trial of the daily administration of 25,000 IU vitamin A and 30 mg β-carotene for the prevention of lung cancer. Of close to 18,500 participants, more than 4,000 were asbestos-exposed men recruited from shipyard and construction trades at five study centers in th...
Article
For 25 years, the National Institute for Occupational Safety and Health (NIOSH) has conducted and sponsored laboratory, field, and epidemiological studies that have helped define the role of work organization factors in occupational safety and health. Research has focused on the health effects of specific job conditions, occupational stressors in s...
Article
We undertook to estimate the degree of underreporting to a regional pesticide poisoning registry, and to estimate the true incidence of poisoning in an agricultural region of Nicaragua. We surveyed 633 workers at 25 of 33 agricultural cooperatives and any nearby private forms in a area geographically convenient to the regional health headquarters w...
Article
The National Institute for Occupational Safety and Health (NIOSH) has recently made a commitment to increase both extramural and intramural support of control technology and intervention research. It is important for NIOSH to use intervention research more aggressively because it provides a mechanism to go beyond investigation, identification, and...
Article
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Studies investigating the relation between respiratory symptoms and change in ventilatory function have been limited by use of reported symptoms at a single point in time. To assess the relation between the longitudinal pattern of reported cough, phlegm, wheeze, and dyspnea and ventilatory loss, we prospectively investigated changes in FVC and FEV1...
Article
Workers' compensation claims filed for occupational illness are generally more complicated to resolve than are injury claims, and they may therefore face higher likelihood of rejection. This study analyzed outcomes and predictive factors for claims filed from one clinic in Washington State between 1982 and 1986 by 157 male patients for nonmalignant...
Article
The current system of compensation for the medical costs of occupational illnesses and injuries, a component of health insurance coverage for most workers in the United States, has recently come under scrutiny in the national health care reform debate. The cost of treatment of these conditions is significant, and there exist numerous disincentives...
Article
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CARET is a multicenter, two-armed, double-masked randomized chemoprevention trial in Seattle, Portland, San Francisco, Baltimore, Connecticut, and Irvine, to test whether oral administration of beta-carotene (30 mg/day) plus retinyl palmitate (25,000 IU/day) can decrease the incidence of lung cancer in high risk populations, namely, heavy smokers a...
Article
To evaluate chronic effects of acute organophosphate pesticide poisoning, quantitatively determined vibrotactile thresholds were measured as an index of peripheral neuropathy among agricultural workers in Nicaragua. Thirty-six male workers were evaluated between 10 and 34 months after hospitalization for acute organophosphate poisoning and compared...
Article
In order to determine if exposure to carcinogens in fire smoke increases the risk of cancer, we examined the incidence of cancer in a cohort of 2,447 male firefighters in Seattle and Tacoma, (Washington, USA). The study population was followed for 16 years (1974–89) and the incidence of cancer, ascertained using a population-based tumor registry, w...
Article
To examine the role of immunologic, psychological, and neuropsychological factors in multiple chemical sensitivity. Case-control comparison. Community allergy practice (cases), university-based clinics for musculoskeletal injuries (controls). Forty-one patients with chemical sensitivity and 34 control patients with chronic musculoskeletal injuries....
Article
CARET is a chemoprevention trial of β-carotene and vitamin A with lung cancer as the primary outcome. Participants at high risk for lung cancer are drawn from two populations: asbestos-exposed workers and heavy smokers. The intervention is a daily combination of 30 mg β-carotene and 25,000 IU vitamin A as retinyl palmitate. Nearly 18,000 participan...
Article
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Pilot studies are an essential component for major chemoprevention trials. Prior to initiating the multicenter Carotene and Retinol Efficacy Trial to assess the effectiveness of beta-carotene and retinol for preventing lung cancer, we conducted pilot studies in Seattle between 1985 and 1988 in two high risk populations: current and former heavy smo...
Article
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Studies of respiratory questionnaire efficacy have emphasized reliability of responses; few have validated symptom response with objective measures of pulmonary function. To determine whether respiratory symptoms are associated with diminished pulmonary function, symptoms reported on the American Thoracic Society (ATS-DLD-78A) questionnaire were co...
Article
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A cross sectional study to evaluate symptom reporting and neuropsychological test performance among a cohort of car body repair workers (n = 124) was performed using a computer-administered test system. Subjects with high and medium current exposures to solvent and paint (n = 39 and 32), and low exposure subjects who formerly painted (n = 29) repor...
Article
In the clinical setting, a patient's chronic respiratory complaints often provide the first clue of underlying lung disease. Chronic symptoms may themselves be important or may complement objective measures of spirometry in assessing respiratory status. This chapter focuses on one aspect of chronic symptom reporting--the efficacy of standardized sy...
Article
Studies of cancer incidences among occupational cohorts are rarely performed in the United States because of incomplete registration and a limited time period available for follow-up. This study used data from concurrent studies of cancer mortality and incidence among a cohort of 4,528 fire fighters and police officers employed by the cities of Sea...
Article
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Occupational and environmental diseases are underrecognized. Among the barriers to the successful diagnosis, treatment, and prevention of these conditions are inadequate consultative and information resources. We describe the 10-year clinical and training experiences of an academically affiliated referral center that has as its primary goal the ide...
Article
To assess the potential effects on neuropsychiatric performance of chronic occupational exposure to organophosphate insecticides, we performed a prospective longitudinal study of a cohort of apple orchard pesticide applicators and a comparison cohort of beef slaughter-house workers. The study group consisted of 49 applicators and 40 comparison subj...
Article
As part of a study to investigate the potential for organophosphates to cause chronic neurologic sequelae, we assessed the pesticide exposure experience of a group of Washington State apple orchard applicators. Seasonal monitoring of cholinesterase activity for 48 regular organophosphate applicators and a control group of 40 slaughterhouse workers...
Article
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To explore whether exposure among firefighters to fire smoke could lead to an increased risk of cancer, lung disease, and heart disease, the mortality of 4546 firefighters who were employed by the cities of Seattle and Tacoma, WA and Portland, OR for at least one year between 1944 and 1979 were compared with United States national mortalities and w...
Article
This article expands on an earlier series of three patients with a neurologic syndrome, who had all worked in an aluminum smelting plant. Twenty-five symptomatic workers from the same plant were referred for a standardized evaluation, including completion of a health questionnaire, neurologic examination, and neuropsychologic evaluation. An exposur...
Article
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In Washington state 29,451 workers' compensation claims were filed by farm workers between 1982 and 1986. Five percent of claimants were under 18 years of age, including 1.3% under the age of 16. Agricultural workers were found to be at higher risk than other workers in the state for fatal injury (relative risk [RR] = 2.5, 95% confidence interval [...
Article
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In 1983 the Washington State Supreme Court ruled unconstitutional a unique exemption that excluded farm workers from workers' compensation if they had not earned $150 in continuous work with the same employer. In order to examine the effect of removing this restriction, workers' compensation data were analyzed to examine the number of farm workers...
Article
Bromochlorodifluoromethane (halon 1211, a fire extinguisher), like other fluorocarbons, has been linked with ventricular arrhythmias and myocardial depression. Ten healthy firefighters, aged 40-50, were exposed to 1,000 ppm halon while exercising, in a double-blind, placebo-controlled crossover experiment, and were monitored during and after exposu...
Article
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Sumario: In 1984 it began a retrospective cohort study of Seatle firefighters to explore the relation between exposure to fire smoke and mortality. Later it was expanded the study to include two other major cities in the region and to collect data on police from the same cities as a comparison group. This is a report of the results of the expanded...
Article
Acute organophosphate pesticide poisonings cause substantial morbidity and mortality world wide; however, whether organophosphates cause chronic neurological sequelae has not been established. To see whether single episodes of acute unintentional organophosphate intoxication lead to chronic neuropsychological dysfunction, we carried out a retrospec...
Article
Acute organophosphate pesticide poisonings cause substantial morbidity and mortality world wide; however, whether organophosphates cause chronic neurological sequelae has not been established. To see whether single episodes of acute unintentional organophosphate intoxication lead to chronic neuropsychological dysfunction, we carried out a retrospec...
Article
Full-text available
Carpal tunnel syndrome is a common disorder marked by pain and dysesthesias of the upper extremities. As a test of the hypothesis that carpal tunnel syndrome is associated with occupational risk factors, jobs at a ski assembly plant were classified as repetitive and nonrepetitive. The prevalence of carpal tunnel syndrome among 106 employees with re...
Article
CARET is a two-armed, double-blind, randomized chemo-prevention trial to test the hypothesis that oral administration of beta-carotene 30 mg/day plus retinyl palmitate 25,000 IU/day will decrease the incidence of lung cancer in high-risk populations: heavy smokers and asbestos-exposed workers who have smoked. The agents combine anti-oxidant and nuc...
Article
CARET is a two-armed, double-blind, randomized chemoprevention trial to test the hypothesis that oral administration of beta-carotene 30 mg/day plus retinyl palmitate 25 000 IU/day will decrease the incidence of lung cancer in high-risk populations: heavy smokers and asbestos-exposed workers who have smoked. The agents combine anti-oxidant and nucl...
Article
To determine future training needs for physicians in occupational and environmental medicine based on goals established by the Institute of Medicine (IOM) for clinical practice in the field. A critical review of previously published estimates of the need and supply of physicians with clinical training in occupational and environmental medicine with...
Article
Training and education of workers in order to prevent occupational lung diseases represent a challenge to employers, unions, clinicians, and other interested groups. Programs attempting to meet this need range from simple programs in respiratory protection fundamentals and smoking cessation to programs that teach workers to understand and demand th...
Article
Pleural thickening is the most common roentgenographic manifestation of past asbestos exposure. In addition to pleural thickening serving as a specific market of exposure, discrete (plaques) and diffuse pleural fibrosis are important abnormalities because they have been found to be associated with increased risk for other asbestos-related sequelae...
Article
Full-text available
Although firefighters have been shown in some studies to suffer chronic respiratory morbidity from their occupational exposures, an increased risk for dying from non-malignant respiratory diseases has not been documented in any previous retrospective cohort mortality study. In order to assess the possibility that an unusually strong "healthy worker...
Article
Considerable controversy surrounds the question of whether cigarette smoking has the potential to increase the prevalence of small opacities on chest roentgenographs among asbestos-exposed workers. To compare the relative contribution of smoking with other predictors of the presence of roentgenographic small opacities, we examined 661 men enrolled...
Article
This article has no abstract; the first 100 words appear below. THE clinical discipline of occupational medicine, largely unstudied, untaught, and unpracticed in major medical centers as recently as a decade ago, underwent unprecedented rejuvenation in the 1980s. Spurred by national regulatory programs and requirements, widespread litigation concer...
Article
In the course of economic development from the pre-industrial to the post-industrial stages, human communities go through major social and economic transitions. The demographic transition, a long established concept, refers to the change from a stage of high birth rates and mortality rates to one of low birth rates and mortality rates. The mortalit...
Article
Fire fighters are known to be occupationally exposed to many toxic substances. However, the limited number of previous studies has not demonstrated any consistent excess mortality from diseases of a priori concern, such as lung cancer, non-malignant respiratory disease, and cardiovascular disease. We studied 2,289 Seattle fire fighters from 1945 th...
Article
The early (immediate and delayed) neurotoxic effects of acute organophosphate intoxication are well documented in the scientific literature; lack of recognition and inappropriate treatment of occupational poisonings continue. Less well understood is the potential development of chronic neuropsychological sequelae from exposures to insecticides. We...
Article
Asbestos-induced pulmonary fibrosis is thought to result from a series of cellular interactions involving the alveolar macrophage and the lung fibroblast. Although a dose-response relation has been established between asbestos exposure and the development of interstitial fibrosis, the majority of workers exposed even to high concentrations of asbes...
Article
The acute effects of the products of combustion and pyrolysis on airway responsiveness among firefighters are poorly documented. To study this relationship, spirometry and methacholine challenge testing (MCT) were performed on 18 active Seattle firefighters before and 5 to 24 h after firefighting. Body plethysmography was used to measure changes in...
Article
Using a mailed survey questionnaire directed toward division chiefs of general internal medicine, we have confirmed that despite increased interest among faculty, few medical residents currently receive required or elective training in occupational medicine. However, recent changes in societal perceptions about environmental risks, corporate health...