Paul Blanc, MD, MSPH

Division Chief

Occupational and Environmental Medicine

Dr. Paul D. Blanc MD MSPH is Professor of Medicine and holds the Endowed Chair in Occupational and Environmental Medicine at the University of California San Francisco, where he has been on faculty since 1988. He received his BA from Goddard College (Plainfield, Vermont), where he first became interested in health and the environment, later training at the Harvard School of Public Health (in industrial hygiene), the Albert Einstein School of Medicine, and Cook County Hospital (in a joint Occupational Medicine and Internal Medicine Residency). He was a Robert Wood Johnson Clinical Scholar at UCSF from 1985-7 and a Fulbright Senior Research Scholar at the Ben Gurion University of the Negev in 1987-8. He has been a resident scholar at the Rockefeller Bellagio Center (Bellagio, Italy) and the American Academy in Rome. In 2011, he was elected as a fellow of the Collegium Ramazzini, an international honorific society of occupational health leaders. He has authored numerous scholarly publications in his field. He also is the author of two books: How Everyday Products Make People Sick (University of California Press, 2009) and Fake Silk: The Lethal History of Viscose Rayon (Yale University Press, 2016).

Education
2018 - Diversity, Equity, and Inclusion Champion Training, University of California
Post-Doc Fellow/Scholar, 1986 - Medicine, University of California, San Francisco
M.D., 1982 - Medicine, Albert Einstein School of Medicine
MSPH, 1977 - Industrial Hygiene, Harvard School of Public Health
BA, 1974 - Liberal Arts, Goddard College
Websites
Publications
  1. Cycle Threshold to Test Positivity in COVID-19 for Return to Work Clearance in Health Care Workers.
  2. Primary graft dysfunction attenuates improvements in health-related quality of life after lung transplantation, but not disability or depression.
  3. Gamma-Butyrolactone Overdose Potentially Complicated by Co-Ingestion of Industrial Solvent N-Methyl-2-pyrrolidone.
  4. Inhaled Corticosteroids Use and Risk of Invasive Pneumococcal Disease Risk in a Population-based Study.
  5. Military Deployment and Respiratory Symptoms: Some Answers, Many Questions.
  6. Frailty after lung transplantation is associated with impaired health-related quality of life and mortality.
  7. Occupational exposure to dust and to fumes, work as a welder and invasive pneumococcal disease risk.
  8. Reply to: Occupational Burden in Chronic Respiratory Disease: Call for Recognition, Training and Data Capture.
  9. Tacrolimus trough monitoring guided by mass spectrometry without accounting for assay differences is associated with acute kidney injury in lung transplant recipients.
  10. What has been done will be done again.
  11. Shoulder Injury Related to Vaccine Administration (SIRVA): An Occupational Case Report.
  12. Prevalence of Arthritis and Rheumatoid Arthritis in Coal Mining Counties of the U.S.
  13. Respiratory Health after Military Service in Southwest Asia and Afghanistan. An Official American Thoracic Society Workshop Report.
  14. The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement.
  15. Gene signatures common to allograft rejection are associated with lymphocytic bronchitis.
  16. Frailty trajectories in adult lung transplantation: A cohort study.
  17. Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: the European Community Respiratory Health Survey.
  18. Occupational Exposures Influence CT Imaging Characteristics in the SPIROMICS Cohort.
  19. Pulmonary toxicity associated with pomalidomide.
  20. Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality - A prospective study.
  21. Off the Courts: Occupational "Tennis Leg".
  22. Notes from the Field: Toxic Leukoencephalopathy Associated with Tianeptine Misuse - California, 2017.
  23. Exposure to second-hand tobacco smoke and respiratory symptoms in non-smoking adults: cross-sectional data from the general population of Telemark, Norway.
  24. EBUS-TBNA is Sufficient for Successful Diagnosis of Silicosis with Mediastinal Lymphadenopathy.
  25. Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.
  26. Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey.
  27. Improvement in patient-reported outcomes after lung transplantation is not impacted by the use of extracorporeal membrane oxygenation as a bridge to transplantation.
  28. Bismuth Subgallate Toxicity in the Age of Online Supplement Use.
  29. Impact of Rhinitis on Work Productivity: A Systematic Review.
  30. Occupation and Obstructive Sleep Apnea: A Meta-Analysis.
  31. The early history of manganese and the recognition of its neurotoxicity, 1837-1936.
  32. Fatigue and sleepiness determine respiratory quality of life among veterans evaluated for sleep apnea.
  33. Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States.
  34. Survival following lung transplantation for artificial stone silicosis relative to idiopathic pulmonary fibrosis.
  35. Effect of Lung Transplantation on Health-Related Quality of Life in the Era of the Lung Allocation Score: A U.S. Prospective Cohort Study.
  36. Spirometry reference values for a Kyrgyz population.
  37. High-altitude alpine therapy and lung function in asthma: systematic review and meta-analysis.
  38. COPD and occupation: resetting the agenda.
  39. Pneumoconiosis Redux. Coal Workers' Pneumoconiosis and Silicosis Are Still a Problem.
  40. Obesity and Functioning Among Individuals with Chronic Obstructive Pulmonary Disease (COPD).
  41. Frailty Phenotypes, Disability, and Outcomes in Adult Candidates for Lung Transplantation.
  42. Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India.
  43. Is Smoking a Predictor for Acute Mountain Sickness? Findings From a Meta-Analysis.
  44. From silicosis to silica hazards: An experiment in medicine, history, and the social sciences.
  45. An official American Thoracic Society Workshop Report: presentations and discussion of the fifth Jack Pepys Workshop on Asthma in the Workplace. Comparisons between asthma in the workplace and non-work-related asthma.
  46. "Acute" silicosis at the 1930 Johannesburg Conference on silicosis and in its aftermath: Controversies over a distinct entity later recognized as silicoproteinosis.
  47. Outbreak of autoimmune disease in silicosis linked to artificial stone.
  48. Lung transplantation for hypersensitivity pneumonitis.
  49. Prospective risk of rheumatologic disease associated with occupational exposure in a cohort of male construction workers.
  50. Psychosocial work factors in new or recurrent injuries among hospital workers: a prospective study.
  51. Smoking increases the risk of acute mountain sickness.
  52. Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease.
  53. Hospital nurses working wounded: motivations and obstacles to return to work as experienced by nurses with injuries.
  54. Determinants of health-related quality of life among residents with and without COPD in a historically industrialised area.
  55. Defining novel health-related quality of life domains in lung transplantation: a qualitative analysis.
  56. Role of delta-aminolevulinic acid in the symptoms of acute porphyria.
  57. Airflow obstruction among street vendors who refill cigarette lighters with liquefied petroleum gas.
  58. Health care worker exposures to the antibacterial agent triclosan.
  59. Risk factors for occupational acute mountain sickness.
  60. Secondhand Tobacco Smoke and COPD Risk in Smokers: A COPDGene Study Cohort Subgroup Analysis.
  61. The feasibility of lung transplantation in HIV-seropositive patients.
  62. Annual average ambient particulate matter exposure estimates, measured home particulate matter, and hair nicotine are associated with respiratory outcomes in adults with asthma.
  63. Development and validation of a lung transplant-specific disability questionnaire.
  64. Five-year lung function observations and associations with a smoking ban among healthy miners at high altitude (4000 m).
  65. Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II.
  66. Risk adjustment for health care financing in chronic disease: what are we missing by failing to account for disease severity?
  67. Illness in returned travelers.
  68. COPD causation and workplace exposures: an assessment of agreement among expert clinical raters.
  69. Adverse respiratory effects associated with cadmium exposure in small-scale jewellery workshops in India.
  70. Response.
  71. Predictors of respiratory sickness absence: an international population-based study.
  72. A thematic analysis of quality of life in lung transplant: the existing evidence and implications for future directions.
  73. Higher environmental relative moldiness index values measured in homes of adults with asthma, rhinitis, or both conditions.
  74. The association between occupation and the incidence of knee disorders in young military recruits.
  75. Mediators of the socioeconomic gradient in outcomes of adult asthma and rhinitis.
  76. Lung diseases associated with occupational and environmental exposures subsume a wide spectrum of conditions.
  77. The role of social support in anxiety for persons with COPD.
  78. Chest wall shrapnel-induced beryllium-sensitization and associated pulmonary disease.
  79. Effects of commercial air travel on patients with pulmonary hypertension air travel and pulmonary hypertension.
  80. Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease.
  81. Artificial stone silicosis [corrected]: disease resurgence among artificial stone workers.
  82. Chronic obstructive pulmonary disease among residents of an historically industrialised area.
  83. Multifocal inflammatory leukoencephalopathy associated with cocaine abuse: is levamisole responsible?
  84. Both pulmonary and extra-pulmonary factors predict the development of disability in chronic obstructive pulmonary disease.
  85. Relationship of obesity with respiratory symptoms and decreased functional capacity in adults without established COPD.
  86. Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes.
  87. A patient on RIPE therapy presenting with recurrent isoniazid-associated pleural effusions: a case report.
  88. Survival following lung transplantation for silicosis and other occupational lung diseases.
  89. 5-oxoprolinemia causing elevated anion gap metabolic acidosis in the setting of acetaminophen use.
  90. Occupation and COPD: a brief review.
  91. The impact of pretransplant mechanical ventilation on short- and long-term survival after lung transplantation.
  92. Fungal chitin from asthma-associated home environments induces eosinophilic lung infiltration.
  93. The role of physical inactivity in increasing disability among older adults with obstructive airway disease.
  94. Alpha-1-antitrypsin deficient man presenting with lung function decline associated with dust exposure: a case report.
  95. Matrix metalloproteinase-9 predicts pulmonary status declines in a1-antitrypsin deficiency.
  96. Respiratory and skeletal muscle strength in chronic obstructive pulmonary disease: impact on exercise capacity and lower extremity function.
  97. Cutaneous nerve transection for the management of intractable upper extremity pain caused by invasive squamous cell carcinoma.
  98. Comparison of cardiac and pulmonary-specific quality-of-life measures in pulmonary arterial hypertension.
  99. Evaluating quality of life in patients with asthma and rhinitis: English adaptation of the rhinasthma questionnaire.
  100. Development of disability in chronic obstructive pulmonary disease: beyond lung function.
  101. COPD and cognitive impairment: the role of hypoxemia and oxygen therapy.
  102. Onset of depressive symptoms among adults with asthma: results from a longitudinal observational cohort.
  103. Functional recovery following musculoskeletal injury in hospital workers.
  104. Supratherapeutic anticoagulation from low-molecular-weight heparin in lung transplant recipients.
  105. Topical antacid therapy for capsaicin-induced dermal pain: a poison center telephone-directed study.
  106. An integrated model of environmental factors in adult asthma lung function and disease severity: a cross-sectional study.
  107. Disability in valued life activities among individuals with COPD and other respiratory conditions.
  108. Influence of anxiety on health outcomes in COPD.
  109. Measurement of COPD severity using a survey-based score: validation in a clinically and physiologically characterized cohort.
  110. Screening for depression in chronic obstructive pulmonary disease.
  111. The impact of disability on depression among individuals with COPD.
  112. Socioeconomic status, race and COPD health outcomes.
  113. The COPD Helplessness Index: a new tool to measure factors affecting patient self-management.
  114. How to diagnose and treat work-related asthma: key messages for clinical practice from the American college of chest physicians consensus statement.
  115. Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults.
  116. Depression and health-related quality of life in chronic obstructive pulmonary disease.
  117. Longer term exposure to secondhand smoke and health outcomes in COPD: impact of urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.
  118. Further exploration of the links between occupational exposure and chronic obstructive pulmonary disease.
  119. Obstructive sleep apnea: a risk factor for work disability.
  120. The impact of SHS exposure on health status and exacerbations among patients with COPD.
  121. Asthma caused by occupational exposures is common - a systematic analysis of estimates of the population-attributable fraction.
  122. An international prospective general population-based study of respiratory work disability.
  123. Exposure to traffic: lung function and health status in adults with asthma.
  124. Area-level socioeconomic status in relation to outcomes in gamma-hydroxybutyrate intoxication.
  125. The COPD severity score: a dynamic prediction tool for health-care utilization.
  126. Occupational exposures and COPD: an ecological analysis of international data.
  127. Performance of self-reported occupational exposure compared to a job-exposure matrix approach in asthma and chronic rhinitis.
  128. COPD as a systemic disease: impact on physical functional limitations.
  129. Diagnosis and management of work-related asthma: American College Of Chest Physicians Consensus Statement.
  130. Valued life activity disability played a significant role in self-rated health among adults with chronic health conditions.
  131. Occupational exposures and the risk of COPD: dusty trades revisited.
  132. Risk factors for death in adults with severe asthma.
  133. Systematic assessment of gamma hydroxybutyrate (GHB) effects during and after acute intoxication.
  134. Predictors of asthma medication nonadherence.
  135. Pulmonary function and the risk of functional limitation in chronic obstructive pulmonary disease.
  136. Assessing productivity loss and activity impairment in severe or difficult-to-treat asthma.
  137. Socioeconomic gradients in tiotropium use among adults with COPD.
  138. Is giant cell interstitial pneumonitis synonymous with hard metal lung disease?
  139. Effect of race on asthma management and outcomes in a large, integrated managed care organization.
  140. Impact of perceived neighborhood problems on change in asthma-related health outcomes between baseline and follow-up.
  141. Exposure to substances in the workplace and new-onset asthma: an international prospective population-based study (ECRHS-II).
  142. Asthma control, severity, and quality of life: quantifying the effect of uncontrolled disease.
  143. The association of socioeconomic status and psychosocial and physical workplace factors with musculoskeletal injury in hospital workers.
  144. Designing a gamma hydroxybutyrate (GHB) structured telephone-administered survey instrument.
  145. Occupation in chronic obstructive pulmonary disease and chronic bronchitis: an update.
  146. Occupational risk factors for asthma among nurses and related healthcare professionals in an international study.
  147. Body composition and functional limitation in COPD.
  148. High-risk behaviors and hospitalizations among gamma hydroxybutyrate (GHB) users.
  149. Epidemiology and costs of COPD.
  150. Risk factors for work disability in severe adult asthma.
  151. Negative life events and quality of life in adults with asthma.
  152. TENOR risk score predicts healthcare in adults with severe or difficult-to-treat asthma.
  153. Directly measured secondhand smoke exposure and COPD health outcomes.
  154. Measuring disease-specific quality of life in obstructive airway disease: validation of a modified version of the airways questionnaire 20.
  155. Perceived neighborhood problems and quality of life, physical functioning, and depressive symptoms among adults with asthma.
  156. Work life of persons with asthma, rhinitis, and COPD: a study using a national, population-based sample.
  157. Occupational and environmental "orphan" respiratory diseases.
  158. Area-level socio-economic status and health status among adults with asthma and rhinitis.
  159. Trends in gamma-hydroxybutyrate (GHB) and related drug intoxication: 1999 to 2003.
  160. Evaluating change in health-related quality of life in adult rhinitis: responsiveness of the Rhinosinusitis Disability Index.
  161. Measuring the physical demands of work in hospital settings: design and implementation of an ergonomics assessment.
  162. Functioning and psychological status among individuals with COPD.
  163. Exposure to vapors, gas, dust, or fumes: assessment by a single survey item compared to a detailed exposure battery and a job exposure matrix.
  164. Development and validation of a survey-based COPD severity score.
  165. Lifetime environmental tobacco smoke exposure and the risk of chronic obstructive pulmonary disease.
  166. Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis.
  167. Impact of the home indoor environment on adult asthma and rhinitis.
  168. Integrating qualitative research into occupational health: a case study among hospital workers.
  169. Health-related quality of life in adult rhinitis: the role of perceived control of disease.
  170. The association between occupational factors and adverse health outcomes in chronic obstructive pulmonary disease.
  171. Why quality of life should matter to occupational health researchers.
  172. The psychosocial work environment and musculoskeletal disorders: design of a comprehensive interviewer-administered questionnaire.
  173. The impact of managed care on health care utilization among adults with asthma.
  174. Leukotriene modifier use and asthma severity: how is a new medication being used by adults with asthma?
  175. Performance of valued life activities reflected asthma-specific quality of life more than general physical function.
  176. Gas stove use and respiratory health among adults with asthma in NHANES III.
  177. Health and socioeconomic impact of work-related asthma.
  178. The occupational burden of chronic obstructive pulmonary disease.
  179. The prevalence and predictors of respiratory-related work limitation and occupational disability in an international study.
  180. A comprehensive study of the direct and indirect costs of adult asthma.
  181. Effects of physician-related factors on adult asthma care, health status, and quality of life.
  182. Proceedings of the first Jack Pepys Occupational Asthma Symposium.
  183. Exposure to indoor combustion and adult asthma outcomes: environmental tobacco smoke, gas stoves, and woodsmoke.
  184. Environmental tobacco smoke exposure during travel among adults with asthma.
  185. Perceived control of asthma and quality of life among adults with asthma.
  186. The influence of chronic respiratory conditions on health status and work disability.
  187. ED utilization of computed tomography in a poisoned population.
  188. A national study of medical care expenditures for respiratory conditions.
  189. An evaluation of selected herbal reference texts and comparison to published reports of adverse herbal events.
  190. Alternative therapies among adults with a reported diagnosis of asthma or rhinosinusitis : data from a population-based survey.
  191. Measurement of environmental tobacco smoke exposure among adults with asthma.
  192. The work impact of asthma and rhinitis: findings from a population-based survey.
  193. Asthma and smoking status in a population-based study of California adults.
  194. Beta agonists, inhaled steroids, and the risk of intensive care unit admission for asthma.
  195. Acknowledgement and corrections for flawed data.
  196. Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity.
  197. Elevated liver enzymes in asymptomatic patients.
  198. Predictors of cigarette smoking and smoking cessation among adults with asthma.
  199. Reanalysis of Blanc PD et al, "Use of herbal products, coffee or black tea, and over-the-counter medications as self treatments among adults with asthma".
  200. Asthma on the job: work-related factors in new-onset asthma and in exacerbations of pre-existing asthma.
  201. Asthma-related work disability in Sweden. The impact of workplace exposures.
  202. How much adult asthma can be attributed to occupational factors?
  203. Husker days and fever nights: counting cases of organic dust toxic syndrome.
  204. Measurement of fibroblast proliferative activity in bronchoalveolar lavage fluid in the analysis of obliterative bronchiolitis among lung transplant recipients.
  205. The Marks Asthma Quality of Life Questionnaire: further validation and examination of responsiveness to change.
  206. The legacy of war gas.
  207. The association between occupation and asthma in general medical practice.
  208. Work dynamics of adults with asthma.
  209. Persistent increases of BAL neutrophils as a predictor of mortality following lung transplant.
  210. Bartenders' respiratory health after establishment of smoke-free bars and taverns.
  211. Assessment of asthma severity in adults with asthma treated by family practitioners, allergists, and pulmonologists.
  212. Predictors of rate of return to work after surgery for carpal tunnel syndrome.
  213. Environmental tobacco smoke and adult asthma. The impact of changing exposure status on health outcomes.
  214. Tumor necrosis factor-alpha and interleukin-8 release from U937 human mononuclear cells exposed to zinc oxide in vitro. Mechanistic implications for metal fume fever.
  215. Acute-onset persistent olfactory deficit resulting from multiple overexposures to ammonia vapor at work.
  216. Pulmonary and allergy subspecialty care in adults with asthma. Treatment, use of services, and health outcomes.
  217. Use of herbal products, coffee or black tea, and over-the-counter medications as self-treatments among adults with asthma.
  218. Human pulmonary responses to experimental inhalation of high concentration fine and ultrafine magnesium oxide particles.
  219. Early pulmonary cytokine responses to zinc oxide fume inhalation.
  220. Nonprescription bronchodilator medication use in asthma.
  221. Toxic effects of nefazodone.
  222. The history of pulp and paper bleaching: respiratory-health effects.
  223. Pulmonary responses after wood chip mulch exposure.
  224. The protective effect of beta-carotene and retinol on ventilatory function in an asbestos-exposed cohort.
  225. Incorrect overdose management advice in the Physicians' Desk Reference.
  226. Perceived control of asthma: development and validation of a questionnaire.
  227. Dose-dependent cigarette smoking-related inflammatory responses in healthy adults.
  228. Causes of pulmonary impairment in asbestos-exposed individuals with diffuse pleural thickening.
  229. Self-reported carpal tunnel syndrome: predictors of work disability from the National Health Interview Survey Occupational Health Supplement.
  230. A woman with "atypical" atypical pneumonia.
  231. Occupation and asthma. Through a glass, darkly.
  232. Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of the literature.
  233. Asthma, employment status, and disability among adults treated by pulmonary and allergy specialists.
  234. Occupational asthma in a community-based survey of adult asthma.
  235. Exaggerated responses to chlorine inhalation among persons with nonspecific airway hyperreactivity.
  236. Reflections of an armchair tribologist. The potential importance of "machine operator's lung".
  237. Pulmonary responses to purified zinc oxide fume.
  238. Health care cost effects of public use of a regional poison control center.
  239. Underreporting of fatal cases to a regional poison control center.
  240. Welding helmet airborne fume concentrations compared to personal breathing zone sampling.
  241. Respiratory effects of occupational exposure to aerosolized pentamidine.
  242. CT quantification of interstitial fibrosis in patients with asbestosis: a comparison of two methods.
  243. Linking surveillance to prevention.
  244. Mortality risk among elderly workers.
  245. Chemical inhalation injury and its sequelae.
  246. Occupational factors in work-related inhalations: inferences for prevention strategy.
  247. Seizures associated with poisoning and drug overdose.
  248. Preventing occupational illness and injury: nurse practitioners as primary care providers.
  249. Clearing the air: the links between occupational and environmental air pollution control.
  250. Drug detection and trauma cause--a case control study of fatal injuries.
  251. Osmolar gap with minimal acidosis in combined methanol and methyl ethyl ketone ingestion.
  252. Work disability among adults with asthma.
  253. Symptoms, lung function, and airway responsiveness following irritant inhalation.
  254. Chlorine gas exposure and the lung: a review.
  255. Cytokines in metal fume fever.
  256. Surveillance of poisoning and drug overdose through hospital discharge coding, poison control center reporting, and the Drug Abuse Warning Network.
  257. Occupational health planning in Israel: a U.S. perspective.
  258. Unusual occupationally related disorders of the lung: case reports and a literature review.
  259. Pulmonary manifestations of the eosinophilia-myalgia syndrome associated with tryptophan ingestion.
  260. Effects of a major earthquake on calls to regional poison control centers.
  261. Microgranulomatous aspergillosis after shoveling wood chips: report of a fatal outcome in a patient with chronic granulomatous disease.
  262. Cigarette smoking, asbestos, and parenchymal opacities revisited.
  263. The use of medicinal herbs by human immunodeficiency virus-infected patients.
  264. Morbidity following acute irritant inhalation in a population-based study.
  265. An experimental human model of metal fume fever.
  266. Pathogenesis of pulmonary edema during interleukin-2 therapy: correlation of chest radiographic and clinical findings in 54 patients.
  267. Radiographic distribution of Pneumocystis carinii pneumonia in patients with AIDS treated with prophylactic inhaled pentamidine.
  268. Occupational illness and poison control centers. Referral patterns and service needs.
  269. Occupational illness: case detection by poison control surveillance.
  270. Cigarette smoking and pneumoconiosis: structuring the debate.
  271. Occupational health in the Negev: a model for regional planning.
  272. The effect of cigarette smoking on the detection of small radiographic opacities in inorganic dust diseases.
  273. Asbestos exposure-cigarette smoking interactions among shipyard workers.
  274. Occupational asthma in a national disability survey.
  275. Occupationally related illness reported to a regional poison control center.
  276. Herbal tea asthma.