摘要:

Sputum cytopathologic monitoring detects squamous cell lung cancers at an extremely early stage (x-ray negative). It holds further potential for preventing disease by detecting epithelial alterations which reflect environmental hazards. The addition of sputum cytology screening to screening by chest x-ray film does not significantly reduce mortality from all types of lung cancer, but preliminary analysis of Johns Hopkins Lung Project data suggests that mortality from squamous cell carcinoma is reduced. Quantitative automated cytopathology systems and biochemical/immunological cell markers enhance understanding of these precursors and offer great promise for increasing capacity, accuracy, and usefulness in cytopathology screening of workers. Cytological specimens collected over years of screening workers considered at risk may beimportant to eventually understanding development and prevention of major occupational diseases.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

In response to a union request, a cancer screening program was conducted for the Pattern Makers' League of North America. Ten colon cancer cases were detected among the 1,465 white men screened with a flexible sigmoidoscope. The difficulties in obtaining appropriate “expected” numbers were that (1) prevalent detectable preclinical colon cancer is not equivalent to incident disease, and (3) the flexible sigmoidoscope yields results not directly comparable to those of the rigid sigmoidoscope used previously. The “expected” number of cancers was obtained by using an independent estimate of 5 years for the mean duration of the detectable preclinical phase. This implied that the expected number of colon cancer cases should be based on the age-specific incident rates among white men in the next-older 5-year age group and that the annual expected number should be multiplied by five. Therefore, the ten observed cases of colon malignancies represented an approximately threefold increase. For invasive cancer only, there was a slightly less than twofold cancer increase. Fifteen percent of the men had one or more colorectal polyps.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Fecal Hemoccult testing and flexible sigmoidoscopy have been proposed as means of screening for colorectal cancer in the general population, as well as in identified high-risk groups. A colorectal cancer screening program was conducted for the Pattern Makers' League of North America. A total of 1,473 white males were screened with fecal Hemoccult testing and flexible sigmoidoscopy during the period 1981 to 1983. The fecal Hemoccult test after diet restriction was positive in 38 workers (3.6%). Among 12 colorectal cancers, including in situ cases, only three were positive by this test. The sensitivity of this test for picking up cancer is only 25%. The positive predictive value was 7.9%. It is concluded that the Hemoccult test for the detection of colorectal cancer and polyps is not a valuable tool because of low sensitivity, whereas flexible sigmoidoscopy has a significant role in colorectal cancer screening of an asymptomatic population at risk.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Strategies to prevent or reverse cancer promotion are described. One strategy, involving the screening and prompt treatment of small lung cancers, is proposed as a study to be tested in occupational groups with very high risk, specifically asbestos-exposed shipyard workers who smoke cigarettes. The relative risk can be assigned on the basis of(l) age, (2) years since first asbestos exposure, and (3) cigarette smoking amount, recency of cessation and age at onset. Proposed surveillance would be chest x-ray films at 4-month intervals and sputum cytology in current smokers and those within 10 years of cessation. Means of detection, such as monoclonal antibody tests for adenocarcinoma and other marker molecules, would be explored. Prompt conventional treatment would be assured. Other inquiries would be directed at new treatment, such as using targeted molecules directed at surface antigens.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

In 1980, the Workers' Institute for Safety and Health began a demonstration project designed to develop a model program of community-based intervention in three cohorts with different workplace exposures and target cancer sites. Program components included identification, notification, medical surveillance, education, social support services (eg, psychosocial, legal, financial, etc), and evaluation. The three cohorts included (1) the Augusta cohort, a group at risk for bladder cancer due to workplace exposure to -naphthylamine; (2) the Port Allegany cohort, a group at high risk of cancer associated with a workplace exposure to asbestos; and (3) the Pattern Makers cohort, a group shown to be at increased risk of colorectal cancer. Together, these three projects give a cross-sectional view of possible approaches to educational and medical intervention strategies in diverse situations.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Low birth weight, largely in the form of intrauterine growth retardation, has been used in animal studies as a sensitive indicator of adverse reproductive outcomes to suspect toxic agents. Methodological problems have severely curtailed studies of low birth weight for human risk assessment. For white and black births, we explore the use of statistical techniques to adjust for maternal risk factors and to isolate US counties having a significantly elevatea rate of unexplained low-birth-weight births in 1979. The data are derived from individual birth certificate information made available by the National Center for Health Statistics. Removing variation due to socioeconomic and other intrinsic factors available on birth certificates, clusters of high-risk counties appear. This paper discusses the methodology used to identify these counties.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The National Institute for Occupational Safety and Health administers the X-ray Screening Program for underground coal miners, a program mandated by the Federal Mine Health and Safety Act of 1969. The screening file, with over 200,000 x-ray films, affords an excellent source for the study of prevalence and progression of Coal Workers' Pneumoconiosis. Two epidemiological analyses have recently been completed. One, a prevalence study of miners with 10 or fewer years of mining tenure, converted screening readings to median epidemiological readings. Converted prevalences were 0.44% for the group with 0 to 1 year tenure and 0.79% for the group with 1 to 9 years tenure. This result is similar to prevalence observed in a study of nonexposed blue collar workers. A second analysis reread x-ray films of a subgroup of 1,834 repeat miners with roughly 9years exposure only under mandated dust standards. Net progression from category 0/0 was observed to be 1.8%. This value is consistent with 1.9%, based on an average dust exposure, predicted by British research. Results must be interpreted in light of several possible sources of bias.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The National Cancer Institute has sponsored three randomized controlled trials of screening for early lung cancer in large, high-risk populations to determine whether (1) lung cancer detection can be improved by adding sputum cytological screening every 4 months to chest roentgenography done either yearly or every 4 months; and (2) lung cancer mortality can be significantly reduced by this type of screening program, followed by appropriate treatment. Results of the three trials suggest that (1) sputum cytology alone detects 15% to 20% of lung cancers, almost all of which are squamous cancers with a favorable prognosis; and (2) chest roentgenography may be a more effective test for early-stage lung cancer than previous reports have suggested. Neverthless, results of the randomized trial conducted at the Mayo Clinic showed that offering both procedures to high-risk outpatients every 4 months conferred no mortality advantage over standard medical practice that included recommended annual testing.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This paper discusses medical screening from an economist's perspective. The beneiits and costs of testing are described, including health benefits, direct costs of testing, and labor market impacts. The paper then discusses how workplace characteristics unrelated to worker health can affect the value to employers of medical screening. As a result, employers who maximize the benefits to them of medical screening may reduce the net social benefits of screening. The differences between the private and social benefits of medical screening suggest some areas where medical screening should be used with great care and others that may be the appropriate subjects of regulation.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Measuring the economic impact of notification and intervention programs for workers at high risk of disease from workplace exposure has been virtually nonexistent for several reasons, which will be discussed, and should include a comprehensive view of costs and benefits. A framework for analysis is proposed denning four major clients: the business community, workers and their families, the local and regional public sector, and the federal government. For each client, the positive and negative, quantitative and nonquantitative, direct and indirect, short-run and long-run effects are probed and a summary analysis is made. To illustrate the process, the notification and screening program conducted by the National Institute for Occupational Safety and Health and the Workers' Institute for Safety and Health, Augusta, Georgia, for workers exposed to naphthylamine is described.

ISSN:0096-1736    

出版商:OVID    

年代:1986

数据来源: OVID