ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The 1993 revision of the American College of Occupational and Environmental Medicine (ACOEM) Code of Ethical Conduct is insufficiently demanding of physicians in important areas, such as conflicts of interest, reporting unethical or incompetent colleagues, and confidentiality of medical information. The International Commission on Occupational Health's International Code of Ethics, drafted for all occupational health professionals worldwide, does not apply well to American legal and economic relationships. The best way to revise the 1993 ACOEM Code is to incorporate key provisions of the American Occupational Medical Association's 1976 Code. A proposed revised ACOEM Code is presented combining elements of the 1993 ACOEM and 1976 AOMA Codes. The resulting code is a clearer description of individual standards of conduct and group ideals.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This study used the postural stability technique to investigate the neurological effects of cumulative low-level exposure to raw JP-8 jet fuel vapor on aircraft maintenance personnel. All subjects performed two sets of four 30-second postural sway tests. The results of mean cumulative exposure levels (in parts per million ± standard error of mean) were the following: naphthas, 1308 ± 292; benzene, 21.2 ± 5.7; toluene, 23.8 ± 6.1; and m-,o-, p-xylene, 22.7 ± 5.4. Covariate adjusted regression analysis of the exposed group data showed a statistically significant association (P > 0.05) between the solvents (benzene, toluene, and xylene) and increased postural sway response. For all solvent exposures, the "eyes closed, on foam" test provided the strongest association between sway length and JP-8 benzene (r2range, 0.45 to 0. 52), implying subtle influence on vestibular/proprioception functionalities.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Data from nationwide registry-based cohorts of patients hospitalized for silicosis in Sweden from 1965 to 1983 and Denmark from 1977 to 1989 were linked to national cancer registries in both countries and to mortality data in Sweden to evaluate the risk of cancer and other disorders among hospitalized silicotic patients. The overall cancer standardized incidence ratio (SIR) was 1.5 (95% confidence interval [CI], 1.3 to 1.7) in Sweden and 1.7(95% CI, 1.2 to 2.3) in Denmark, primarily because of elevations in primary lung cancer in both Sweden (SIR, 3.1; CI, 2.1 to 4.2) and Denmark (SIR, 2.9; CI, 1.5 to 5.2). For Sweden, the all-causes standardized mortality ratio (SMR) was 2.0 (1.9 to 2.2). The SMR for all malignancies was 1.5 (1.2 to 1.7), primarily because of excesses of lung cancer (SMR, 2.9; CI, 2.1 to 3.9). The significant increase in mortality for all infectious and parasitic conditions (SMR, 11.2) was primarily due to tuberculosis (SMR, 21.8). Significant excesses in mortality from silicosis (SMR, 523), bronchitis (SMR, 2.6) and emphysema (SMR, 6.7) contributed to the elevation in nonmalignant respiratory deaths (SMR, 8.8), whereas excess mortality from musculoskeletal disorders (SMR, 5.9) was due to six deaths from autoimmune diseases. Despite limitations of the available data, our findings are consistent with previous reports indicating that silicotic patients are at elevated risk of lung cancer, nonmalignant respiratory diseases, tuberculosis, and certain autoimmune disorders.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

In this study, we summarize 47 epidemiologic studies related to formaldehyde exposure and use meta-analytic techniques to assess findings for cancers of the lung, nose/nasal sinuses, and nasopharynx. Our analyses indicate that workers with formaldehyde exposure have essentially null findings for lung cancer and a slight deficit of sinonasal cancer. Nasopharyngeal cancer rates were elevated moderately in a minority of studies. Most studies, however, did not find any nasopharyngeal cancers, and many failed to report their findings. After correcting for underreporting, we found a meta relative risk of 1.0 for cohort studies. Case-control studies had a meta relative risk of 1.3. Our review of the exposure literature indicated that the nasopharyngeal cancer case-control studies represented much lower and less certain exposures than the cohort studies. We conclude that the available studies do not support a causal relation between formaldehyde exposure and nasopharyngeal cancer. This conclusion conflicts with conclusions from two previous meta-analyses, primarily because of our consideration of unreported data.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Benefit and occupational health managers need information on whether new treatments, such as sumatriptan, for migraine headache improve organizational or individual performance. A work productivity outcomes assessment was conducted among sumatriptan-using employees of an Independent Practice Association-health maintenance organization population. Of the 164 sumatriptan users, 101 full-time employees were surveyed by telephone once in an open-label, before-after design. The results revealed that lost labor costs, a function of days missed from work and reduced productivity at work as a result of migraine, were decreased after sumatriptan treatment initiation. Incremental benefit of this reduction in lost productivity is valued at $435/month per employee. The sumatriptan cost associated with this benefit is $43.78/month. The benefit-to-cost ratio is 10:1. Other costs and benefits were excluded. In conclusion, the availability of sumatriptan for migraine headache treatments in this IPA-HMO resulted in improved work productivity and had a net benefit for the employer.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Studies of adults, children, and laboratory animals suggest an association between lead exposure and hearing loss. A causal relationship might direct mandated medical surveillance of lead-exposed workers to include audiometric testing. A cross-sectional, computerized dataset was obtained from a private occupational health screening company to examine the relationship between blood lead level and hearing loss. Audiometry and blood lead results were available for 183 workers. A statistically significant correlation was found between blood lead level and an elevated hearing threshold at 400 Hz (P = 0.03); no other frequencies showed such a correlation. This finding suggests either an interaction between nose exposure and lead, interaction of other exposure factors (such as cigarette smoking), or that factors other than biomechanical ones render the organ of Corti more susceptible at 4000 Hz. Further evaluation of these questions should be undertaken. Computerized databases created for worker surveillance may be a source for data useful for examining other causal connections in occupational settings.

ISSN:1076-2752    

出版商:OVID    

年代:1997

数据来源: OVID