bluuebunny/crossref_metadata_2025_split huggingface dataset:
Daily deaths are associated with combustion particles rather than SO2in Philadelphia
Authors: Schwartz Joel 
Published: July 2002

OBJECTIVESTo assess whether the association between SO2and daily deaths in Philadelphia during the years 1974–88 is due to its correlation with airborne particles, and vice versa.METHODSThere is a significant variation in the relation between total suspended particulate (TSP) and SO2in Philadelphia by year and season. Firstly, 30 separate regressions were fitted for each pollutant in the warm and cold season of each year. These regressions controlled for weather, long term temporal patterns, and day of the week. Then a meta–regression was performed to find whether the effect of SO2was due to TSP, or vice versa.RESULTSControlling for TSP, there was no significant association between SO2and daily deaths. By contrast, in periods when TSP was less correlated with SO2, its association with daily deaths was higher. However, all of the association between TSP and daily deaths was explained by its correlation with extinction coefficient, a measurement of the scattering of light by fine particles, which has been shown to be highly correlated with fine combustion particles in Philadelphia.CONCLUSIONSThe association between air pollution and daily deaths in Philadelphia is due to fine combustion particles, and not to SO2.
Mortality surveillance and occupational hazards: the Solutia mortality experience 1980–94
Authors: Collins James J , Riordan Susan G 
Published: July 2002

OBJECTIVESSeveral investigators argue that company wide mortalities for recent workers allow early identification of potential workplace hazards. Mortalities for recent workers were compared with published studies of workers with specific exposures in the same company to find whether mortality surveillance results could be used to identify previously unknown health effects from workplace hazards.METHODSRelative risks for causes of death in published substance specific studies at the plants were compared with the relative risks in the mortality surveillance of workers 20 or more years after first being employed.RESULTSAs reported by other companies, low mortalities were found among workers in the mortality surveillance. The mortality surveillance reports often found no increased risk of disease at plants in which substance specific studies had found no effects. However, disease specific relative risks were not found by the mortality surveillance predictions of relative risks in the substance specific studies with increased risk.CONCLUSIONMortality surveillance is of limited use for identifying health effects from past workplace exposures to specific materials. The healthy worker and survivor effects, the failure to identify subsets of workers exposed to potentially toxic substances, the typically long induction period between exposure and disease, and the inability of recent mortality levels to reflect historical conditions all may make it difficult to use mortality surveillance to identify workplace hazards. Combining mortality surveillance with studies of workers with potentially toxic exposures helps identify occupational hazards.
Prevalence and pattern of occupational exposure to whole body vibration in Great Britain: findings from a national survey
Authors: Palmer Keith T , Griffin Michael J , Bendall Holly , Pannett Brian , Coggon David 
Published: July 2002

OBJECTIVESTo estimate the number of workers in Great Britain with significant occupational exposure to whole body vibration (WBV) and to identify the common sources of exposure and the occupations and industries where such exposures arise.METHODSA postal questionnaire was posted to a random community sample of 22 194 men and women of working age. Among other things, the questionnaire asked about exposure to WBV in the past week, including occupational and common non-occupational sources. Responses were assessed by occupation and industry, and national prevalence estimates were derived from census information. Estimates were also made of the average estimated daily personal dose of vibration (eVDV).RESULTSFrom the 12 907 responses it was estimated that 7.2 million men and 1.8 million women in Great Britain are exposed to WBV at work in a 1 week period if the occupational use of cars, vans, buses, trains, and motor cycles is included within the definition of exposure. The eVDV of >374 000 men and 9000 women was estimated to exceed a proposed British Standard action level of 15 ms-1.75. Occupations in which the estimated exposures most often exceeded 15 ms-1.75included forklift truck and mechanical truck drivers, farm owners and managers, farm workers, and drivers of road goods vehicles. These occupations also contributed the largest estimated numbers of workers in Great Britain with such levels of exposure. The highest estimated median occupational eVDVs were found in forklift truck drivers, drivers of road goods vehicles, bus and coach drivers, and technical and wholesale sales representatives, among whom a greater contribution to total dose was received from occupational exposures than from non-occupational ones; but in many other occupations the reverse applied. The most common sources of occupational exposure to WBV are cars, vans, forklift trucks, lorries, tractors, buses, and loaders.CONCLUSIONSExposure to whole body vibration is common, but only a small proportion of exposures exceed the action level proposed in British standards, and in many occupations, non-occupational sources are more important than those at work. The commonest occupational sources of WBV and occupations with particularly high exposures have been identified, providing a basis for targeting future control activities.
Sensitisation to enzymes in the animal feed industry
Authors: Vanhanen M , Tuomi T , Tiikkainen U , Tupasela O , Tuomainen A , Luukkonen R , Nordman H 
Published: July 2002

OBJECTIVESTo assess the prevalence of enzyme sensitisation in the animal feed industry.METHODSA cross sectional study was conducted in four animal feed factories, where several enzymes had been used in powder form for 7–9 years. Before this study, enzymes in liquid form had started to be used. Sensitisation to enzymes was examined by skin prick and radioallergosorbent (RAST) tests. Altogether 218 workers were tested; 140 people in various tasks in manufacturing, where exposure to various organic dusts and to enzymes was possible, and 78 non-exposed office workers. The workers were interviewed for work related respiratory and skin symptoms. Total dust concentrations were measured by a gravimetric method. The concentrations of protease and α-amylase were measured with catalytic methods and that of xylanase with an immunological method.RESULTSTen workers (7%) were sensitised to enzymes in the exposed group of 140, whereas none were sensitised in the non-exposed group. Six of the sensitised people had respiratory symptoms at work: two of them especially in connection with exposure to enzymes. Enzyme concentrations in the air varied greatly: xylanase from less than 0.8 ng/m3up to 16 ng/m3, α-amylase from less than 20 ng/m3up to 200 ng/m3, and protease from less than 0.4 ng/m3up to 2900 ng/m3. On average, highest xylanase and α-amylase concentrations were found in the various manufacturing sites, whereas the highest protease concentrations were found in areas of high total dust.CONCLUSIONSIndustrial enzymes may cause allergies in the animal feed industry. There is a need to assess exposure to enzymes at various phases of production, and to minimise exposures.
Predictors of DMSA chelatable lead, tibial lead, and blood lead in 802 Korean lead workers
Authors: Todd A C , Lee B-K , Lee G-S , Ahn K-D , Moshier E L , Schwartz B S 
Published: July 2002

OBJECTIVESTo examine the interrelations among chelatable lead (by dimercaptosuccinic acid, DMSA), tibial lead, and blood lead concentrations in 802 Korean workers with occupational exposure to lead and 135 employed controls with only environmental exposure to lead.METHODSThis was a cross sectional study wherein tibial lead, DMSA chelatable lead, and blood lead were measured. Linear regression was used to identify predictors of the three lead biomarkers, evaluating the influence of age, job duration, sex, education level, alcohol and tobacco use, creatinine clearance rate, and body mass index.RESULTSDMSA chelatable lead concentrations ranged from 4.8 to 2102.9 μg and were positively associated with age, current smoking, and creatinine clearance rate. On average, women had 64 μg less DMSA chelatable lead than men. When blood lead and its square were added to a model with age, sex, current smoking, body mass index, and creatinine clearance rate, blood lead accounted for the largest proportion of the variance and sex became of borderline significance. Tibial lead concentrations ranged from −7 to 338 μg/g bone mineral and were positively associated with age, job duration, and body mass index. Women had, on average, 9.7 μg/g less tibial lead than men. Blood lead concentrations ranged from 4.3 to 85.7 μg/dl and were positively associated with age and tibial lead, whereas current smokers had higher blood lead concentrations and women had lower blood lead concentrations.CONCLUSIONSThe data suggest that age and sex are both predictors of DMSA chelatable lead, blood lead, and tibial lead concentrations and that tibial lead stores in older subjects are less bioavailable and may contribute less to blood lead concentrations than tibial lead stores in younger subjects. Although blood lead concentrations accounted for a large proportion of the variance in DMSA chelatable lead concentrations, suggesting that measurement of both in epidemiological studies may not be necessary, the efficacy of each measure in predicting health outcomes in epidemiological studies awaits further investigation.
Public health response to an incident of secondary chemical contamination at a beach in the United Kingdom
Authors: Goodfellow F J L , Murray V S G , Ouki S K , Iversen A , Sparks A , Bartlett T 
Published: July 2002

OBJECTIVESTo gather enough data from a large scale investigation involving two health authorities, to assess the possible concentrations and routes of exposure and the consequent health implications.To use the data to decide whether a polluted beach should remain open to the public. In Spring 1997, a chemical incident came to light at a beach on the south coast of England when a local resident reported a sulphurous smell, visible signs of oil, and reduced numbers of fishing bait. The beach was situated adjacent to a former gasworks site and was accessible to the public. The incident was reported to the local authority and was initially investigated by the Environment Agency and the local authority. An Environment Agency report confirmed contamination of the beach with cyanide, ammonia, and polycyclic aromatic hydrocarbons (PAHs) with associated potential health risks. The incident was then referred to the local health authorities for investigation.METHODSThe investigation was carried out in four stages: comprehensive sampling and analysis to identify the extent of contamination, followed by an assessment of risk to health; establishment of a long term monitoring programme to identify any changes in contaminant concentrations; investigation of the effects of the contamination on shellfish; and review of the routine monitoring data and current sampling strategy.RESULTSThe initial investigation confirmed that the beach was contaminated, with the most likely source being the adjacent former gasworks site. The level of contamination was not found to be likely to pose a hazard to users of the beach. However, subsequent investigation of shellfish in the area led to warning signs being erected on the beach to prevent human consumption of mussels contaminated with PAHs.CONCLUSIONSSeveral lessons can be learnt from this investigation, which can be applied to incident management more generally: the importance of collaboration and coordination; the need for early involvement of the health authority; and the importance of carrying out appropriate sampling and analysis as soon as possible, to assess the risk to health and the environment.
What is “powder free”? Characterisation of powder aerosol produced during simulated use of powdered and powder free latex gloves: Table 1
Authors: Phillips M L , Meagher C C , Johnson D L 
Published: July 2002

OBJECTIVESTo characterise the distribution of particle size and mass of glove powder aerosol released from powdered and powder free non-sterile latex gloves under controlled conditions.METHODSGravimetric sampling and aerodynamic particle size analysis were performed during simulated use of gloves on a prosthetic hand in a chamber designed to minimise background particle concentrations.RESULTSAerosol was detectable for both powdered and powder free gloves under both aggressive and non-aggressive handling conditions. Most of the particles detected had aerodynamic diameter less than 10 μm.CONCLUSIONPowder free gloves were not entirely free of powder aerosol. Particles from both powdered and powder free gloves are sufficiently fine to penetrate into the thoracic region of the respiratory tract.
The risk to the United Kingdom population of zinc cadmium sulfide dispersion by the Ministry of Defence during the “cold war”
Authors: Elliott P J , Phillips C J C , Clayton B , Lachmann P J 
Published: July 2002

Objectives: To estimate exposures to cadmium (Cd) received by the United Kingdom population as a result of the dispersion of zinc Cd sulfide (ZnCdS) by the Ministry of Defence between 1953 and 1964, as a simulator of biological warfare agents.Methods: A retrospective risk assessment study was carried out on the United Kingdom population during the period 1953–64. This determined land and air dispersion of ZnCdS over most of the United Kingdom, inhalation exposure of the United Kingdom population, soil contamination, and risks to personnel operating equipment that dispersed ZnCdS.Results: About 4600 kg ZnCdS were dispersed from aircraft and ships, at times when the prevailing winds would allow large areas of the country to be covered. Cadmium released from 44 long range trials for which data are available, and extrapolated to a total of 76 trials to allow for trials with incomplete information, is about 1.2% of the estimated total release of Cd into the atmosphere over the same period. “Worst case” estimates are 10 μg Cd inhaled over 8 years, equivalent to Cd inhaled in an urban environment in 12–100 days, or from smoking 100 cigarettes. A further 250 kg ZnCdS was dispersed from the land based sites, but significant soil contamination occurred only in limited areas, which were and have remained uninhabited. Of the four personnel involved in the dispersion procedures (who were probably exposed to much higher concentrations of Cd than people on the ground), none are suspected of having related illnesses.Conclusion: Exposure to Cd from dissemination of ZnCdS during the “cold war” should not have resulted in adverse health effects in the United Kingdom population.
Effect of air pollution and environmental tobacco smoke on serum hyaluronate concentrations in school children
Authors: Fuji Y , Shima M , Ando M , Adachi M , Tsunetoshi Y 
Published: July 2002

Objectives: To evaluate serum hyaluronate concentrations relative to air pollution, environmental tobacco smoke (ETS), and respiratory health in Japanese school children.Methods: Respiratory symptoms and serum IgE concentrations were examined in 1037 school children living in four communities in Japan with differing levels of air pollution. Serum hyaluronate concentrations were assayed in 230 children, consisting of all the children who had symptoms of either asthma or wheeze (65 and 50 subjects, respectively) and normal controls adjusted for sex, school grade, and school without these symptoms (115 subjects).Results: Although serum hyaluronate concentrations did not differ for either asthma or wheeze, the concentrations were significantly higher in children living in communities with higher levels of air pollution. Children with asthma or wheeze and those with serum IgE concentrations of 250 IU/ml or above showed differences in hyaluronate concentrations that related to the degree of air pollution in the communities. In children with higher serum IgE concentrations, the hyaluronate concentrations among subjects exposed to ETS were significantly higher than among those without exposure to ETS.Conclusions: The present results suggest that serum hyaluronate concentration is related to the degree of air pollution and exposure to ETS. Children with asthma or wheeze and children with higher IgE concentrations are considered to be more susceptible to environmental factors.
Advanced testicular cancer presenting with phlegmasia cerulea dolens
Authors: Mulatero C , Brogan G , Oliver R T D 
Published: July 2002

Abstract
A case of fulminating deep venous thrombosis secondary to invasion of the inferior vena cava is described in a 45 year old man presenting with a germ cell tumour. Despite aggressive supportive care and emergency chemotherapy his late presentation caused his death. The case highlights the necessity for increased public education of the attendant risks in delayed presentation with a testicular lump.
A case of cerebral haemorrhage—can Ginkgo biloba be implicated?
Authors: Benjamin J , Muir T , Briggs K , Pentland B 
Published: July 2002

Abstract
The case of a 56 year old man who suffered a spontaneous intracerebral haemorrhage after regular self medication with the herbal preparation, Ginkgo biloba leaf extract is described, and the possible association is discussed. Key pointsThe herbal preparation Ginkgo biloba leaf extract is promoted as a remedy for a wide range of conditions (for example, dementia, erectile dysfunction, tinnitus)There are grounds to suspect an association with intracranial haemorrhage as described in this caseAwareness of these suspicions should encourage proper documentation of all herbal remedies used when patients present to medical staff
Do computer generated ECG reports improve interpretation by accident and emergency senior house officers?
Authors: Goodacre S , Webster A , Morris F 
Published: July 2002

Abstract

OBJECTIVES
To determine whether access to a computer generated electrocardiogram (ECG) report can reduce errors of interpretation by senior house officers (SHOs) in an accident and emergency department.

METHODS
Ten SHOs were asked to interpret 50 ECGs each: 25 with computer generated reports, 25 without. Their answers, and the computer generated reports, were compared with a “gold standard” produced by two experienced clinicians. The primary outcome measure was the proportion of major errors of interpretation.

RESULTS
The computer reading system made two major errors (4%, 95% confidence interval (CI) 1.1% to 13.5%) compared with the gold standard. Access to the computer report did not significantly reduce major errors among SHOs (46 (18.4%) with report v 56 (22.4%) without, odds ratio 0.64, 95% CI 0.36% to 1.14%, p=0.13) or improve the proportion completely correct (104 (41.6%) with report v 91 (36.4%) without, odds ratio 1.43, 95% CI 0.88 to 2.33, p=0.15).

CONCLUSIONS
SHOs have a high error rate when interpreting ECGs, which is not significantly reduced by access to a computer generated report. Junior doctors should continue to seek expert senior help when they have to interpret a difficult ECG.
Why do some people look older than they should?
Authors: Bulpitt C J , Markowe H L J , Shipley M J 
Published: July 2002

Abstract

BACKGROUND
As a component of studies on biological age, the age of subjects from their appearance (perceived age) was estimated.

OBJECTIVE
To determine the factors associated with looking older.

METHODS
Cross sectional study of London civil servants (318 men, 129 women) in the Department of the Environment study. Perceived age was recorded by an observer and the difference between this age and chronological age was analysed according to 20 different variables.

RESULTS
Men had an average perceived age of 0.37 years older than their actual age and women a perceived age of 0.54 years younger. In men, looking older was related to greying of the hair, grade of arcus senilis, and grade of baldness. Less expected, looking older was positively related to total serum cholesterol (p=0.03) and blood haemoglobin (p&lt;0.01). In women, looking older was related to greying of the hair, positively to blood erythrocyte sedimentation rate (ESR), and negatively to serum bilirubin (p=0.01). Looking older was not related to alcohol consumption, employment grade, serum high density lipoprotein cholesterol, glucose, albumin, and calcium in either sex.

CONCLUSION
The relationships between looking older and total cholesterol and haemoglobin in men and ESR and bilirubin in women, require further investigation.
Changing thyroid status related to pregnancy
Authors: Shankar P , Kilvert A , Fox C 
Published: July 2002

Abstract
A case of post-thyroidectomy hypothyroidism is reported. The patient became euthyroid in three consecutive pregnancies, reverting to hypothyroid within three months of delivery on each occasion. The alteration in thyroid status is attributed to pregnancy related changes in antibody titres, though the laboratory data to confirm this are not available.
Formal education programmes for senior house officers: comparison of experience in three hospital specialties
Authors: Flett A , Baker M , Williams J 
Published: July 2002

Abstract
This study was designed to compare the attendance rate of senior house officers (SHOs) in three specialties at formal educational events, examine experiences of protected time, use of educational objectives, and perceived barriers to attendance and evaluate differences found in the context of variations in training practice within each specialty. A quantitative questionnaire survey was completed by Trent region SHOs in obstetrics and gynaecology, general medicine, and accident and emergency posts. An independent researcher visited a selection of educational programme events over a two month span, recorded attendances, and administered the questionnaire. Attendance rates ranged from 40.8% of those in obstetrics and gynaecology jobs to 55.4% of those in accident and emergency jobs. The questionnaire findings found that service commitments were a major obstacle to attendance for the majority of those in obstetrics and gynaecology and general medicine jobs, while relatively few of the accident and emergency SHOs specified any barriers. SHOs in accident and emergency jobs had significantly more protected time for education and found educational objectives to be more widely used by senior staff. The findings suggest that the planned integration of formal education programmes with appropriate working pattern systems—in this case full shifts within accident and emergency departments—will result in SHOs receiving a better deal in terms of provision and structure of education.
Acute respiratory failure in a middle aged woman
Authors: McGuigan C , McDonnell G , Mirakhur M , Morrow J I 
Published: July 2002

Abstract
A 61 year old woman presented with a one week history of headache, drowsiness, and shortness of breath. Initial examination revealed bilateral ptosis, which the patient stated had been present for three to four years before this admission. She also reported that her father had died suddenly, shortly after developing “drooping eyelids”. There was restriction in the range of eye movements in all directions. The remaining cranial nerves were intact.