ISSN:0271-3586    

DOI:10.1002/ajim.4700080202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

ISSN:0271-3586    

DOI:10.1002/ajim.4700080203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

ISSN:0271-3586    

DOI:10.1002/ajim.4700080204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractSystematic studies in occupational deafness were first carried out in the late 19th century, in America, Germany, Russia, and Scotland. The studies by Gottstein and Kayser, in 1881 in Germany, and by Barr, in 1886 in Scotland, are identified as the two principal landmarks. The physicians who carried them out should be seen as occupying a place in the mainstream of development of industrial medicine.Gottstein and Kayser's study of personnel in a railway works reflected a contemporary concern about railway safety; Barr's, of boilermakers, a feeling for the difficulties in hearing in the everyday world experienced by the victims of occupational deafness. Barr's evaluation of such difficulties through self‐report, we argue, reveals more of the quality of hearing handicap than the present century's apparently objective tests.Both studies relied on occupation‐based epidemiology, which was able to identify occupational deafness, distinguish its etiology, and locate the site of its pathology. We argue that occupation‐based epidemiology has since been neglected in favour of dose‐response epidemiology to the detriment of research in occupational deafness and in industrial medicine generally. Dose‐response epidemiology seems the more scientific but, in practice, it is afflicted by even more uncertainty than occupation‐based epidemiology. To compound the uncertainty, there are two incompatible mathematical expressions for the dose‐response relation for noise, both separately enshrined in legislation in various parts of the world.We conclude by advocating more secondary research in industrial medicine. Barr points us to a further topic for such research, the place of temporary threshold shift in the development of knowledge about occupational deafness as a problem for indust

ISSN:0271-3586    

DOI:10.1002/ajim.4700080205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractIn an earlier report [Feldman and Lessell, 1967], neurologic fndings following acute intoxication to trichloroethylene were presented. Facial anesthesia, asymmetric pupillary responses, and electrical evidence of sensorimotor neuropathy accompanied neuropsy‐chological deficits, manifested by difficulty in solving sequential problems and poor memory affecting the acquisition of new information. Twelve years after the initial exposure, patches of hypalgesia over the malar eminences persisted and corneal reflexes remained absent, although sensation in the snout region was totally normal. Neuropsy‐chological test results continued to demonstrate impaired attention and short‐term memory as well as diminished visuospatial organization and sequencing, 16 years after exposure. In addition, MMPI profile and interview suggested continued depressive symptomatology. Eighteen years after exposure, findings included paresthesia and hypalgesia in the malar area of the face as well as myokymia of the facial muscles. Facial nerve latency studies were normal as were pattern shift visual evoked responses. The patient continued to have large pupils that reacted asymmetrically to light. In the right eye, contraction was synchronous in all segments of the sphincter. In the left eye, there was segmental contraction, suggestive of a tonic pupil. This report offers evidence of long‐term residual oculomotor and ciliary reflex dysfunction as well as impaired neuropsychological performance as a result of acute TCE intox

ISSN:0271-3586    

DOI:10.1002/ajim.4700080206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractAn environmental and medical survey was undertaken in the slate‐pencil industry in the central part of India. The industrial hygiene survey revealed that concentrations of free silica dust were very high. The medical survey, involving 593 workers, revealed that the prevalence of silicosis in this industry was 54.6%. Of these, 17.7% of workers had conglomerate silicosis (progressive massive fibrosis, PMF). The radiologic appearance of simple and conglomerate silicosis resembled closely the simple pneumoconiosis and progressive massive fibrosis (PMF) among other occupational groups exposed to free silica and also found in coal workers. The pulmonary lesions were detectable after a relatively short duration of exposure. The short latent period of development and the high prevalence of silicosis observed among these workers are related to exposure to high concentrations of siliceous dust in the work environmen

ISSN:0271-3586    

DOI:10.1002/ajim.4700080207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractFindings of the follow‐up examination of slate‐pencil workers after 16 months are described. The progression of silicosis with this short duration was very rapid with high mortality among those who had conglomerate silicosis at the initial examination. Twenty‐three workers had died during this period at a mean age of only 34.7 years, with a mean duration of exposure of 11.9 years. This high mortality is attributed to exposure to high concentrations of silica dust leading to early onset of PMF at a relatively young age. The progression of silicosis within this period was related to the intensity and duration of dust exposure, and also to the severity of silicosis found at the initial examination. Smoking habits had an adverse, though statistically nonsignificant, effect on the evolution of sili

ISSN:0271-3586    

DOI:10.1002/ajim.4700080208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractThis paper compares three analytical methods that may be considered for monitoring workers who are exposed to carbon disulphide (CS2). An estimate of the uptake of CS2was assessed by the measurement of “bound” CS2in blood, CS2in expired alveolar air, and 2‐thiothiazolidine‐4‐carboxylic acid (TTCA), in urine. The concentration of TTCA in end‐of‐shift urine samples was related to exposure and appears to be a good measure of

ISSN:0271-3586    

DOI:10.1002/ajim.4700080209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractOccupational health care services are changing in response to rapid changes in health care organization generally; this trend is not reflected in the occupational medicine literature. San Diego is a large and rapidly developing metropolitan area with a balance of heavy, light, and service industries and is relatively isolated and self‐contained in health services, making it useful for monitoring health services trends. We examined local trends in the supply of health services as reflected by facilities, manpower, and other indicators between 1974 to 1984. We also assembled findings of local market surveys and certain other sources into a profile of occupational health care resources in the metropolitan area. Corporate medical departments did not keep up with the growth of industry over the decade; freestanding “industrial medicine clinics,” by contrast, began with a single facility and proliferated to 13. In the last three years, freestanding “urgent care centers” entered the health care market in force and now outnumber industrial medicine clinics. Despite an overall massive increase in the number of physicians in the area, occupational physicians with specialty credentials or eligibility remained few and primarily based in institutions, while the number of uncertified physicians and of medical groups accepting occupational medicine referrals increased considerably. Employers reported approval of acute care, traditional screening, and employee assistance services far more often than of preventive services, but if they approved of a service, they usually provided it, except in the case of employee assistance services. We conclude that the role of preventive services and of trained personnel in delivering occupational health care is declining, rather than increasing, in the face of competition and changes in the general health care system. Corporate and in‐plant medical services are not keeping up with the growth of industry, and no class of health facility matched the growth of industrial medical clinics except urgent care centers, with which they are beginning to compete. The implications of this study for occupational medicine as a specialty, for the standards of patient care, and for the role of prevention is a matter of grave concern if they reflect national trends. Further studies of occupational health services are urgently needed to assess the significance of the

ISSN:0271-3586    

DOI:10.1002/ajim.4700080210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

ISSN:0271-3586    

DOI:10.1002/ajim.4700080201

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY