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Biomedical subjects

B D Dinman

Publications and source records attributed to B D Dinman.

At least 19 recordsLinked to original sources
PubMed2000

Education for the practice of occupational medicine: knowledge, competence, and professionalism.

The multistep process of education is delineated by the sequential phases: (1) Knowledge Transfer, (2) Competence Development, and (3) Professional Inculcation. The realities of practice modes and curricular time constraints are important determinants of the breadth and depth of the information provided in the Knowledge Transfer process. Accordingly, it is proposed that Phase 1, the Knowledge Acquisition Process, be organized into two components: (1) Core Knowledge, requiring both significant breadth and depth; and (2) Augmentive Knowledge, providing wide breadth and appropriate but variable depth. This curricular organizing proposition recognizes that: (1) the wide breadth of multiple stores of knowledge inherent in the practice of PM and EOM considerably exceeds many other medical specialities; (2) the duration of training is inherently shorter; and (3) its practitioners generally operate as members of teams consisting of other professionals (e.g., attorneys, engineers, business administrators, industrial hygienists, sociologists, psychologists). Obviously, it is unreasonable to expect the members of such teams to each have comparable depth and breadth of knowledge. A broad knowledge base, implicit in Augmentive Knowledge, provides the capacity for recognition, understanding, and application of capabilities brought by other professionals. Facilitating communications between team members, each possessing a broad knowledge base, enhances the effectiveness of the knowledge, competence, and professionalism of collaborative efforts. Phase 2, Competency, consists of the coherent integration of multiple stores of information applicable to the management of a clearly defined task with a clearly measurable outcome. The accomplishment of true competency is not based on the simple possession of multiple stores of knowledge; rather it depends on the facility and effectiveness with which information bases are marshaled, integrated, and communicated. Clearly, the effectiveness of this process increases with its interaction; it is unreasonable to expect a significant degree of competence immediately upon graduation from a training program. Phase 3, Professionalism, and its basic ethos provides the governing context for the sound application of competencies. Although it is difficult to teach, only with its accomplishment can the educational process be considered whole, albeit never complete.

Clinical Competence↗
PubMed1988

Radiographic abnormalities in relation to total dust exposure at a bauxite refinery and alumina-based chemical products plant.

A cross-sectional study of 788 male employees of an aluminum production company examined the relationship of radiographic abnormalities to smoking and dust exposure from the mining and refining of bauxite to alumina. Among the aluminas produced were low temperature range transitional forms. The present analyses were limited to nonsmokers and current smokers. Two National Institute of Occupational Safety and Health (NIOSH)-certified "B" readers interpreted the radiographs. The predominant radiographic abnormalities noted were scanty, small, irregular opacities in the lower zones of profusion 0/1 to 1/1. Rounded opacities were rare. Among nonsmokers with low dust exposures, the prevalence of opacities greater than or equal to 1/0 showed no trend with increasing age and duration of exposure, suggesting no relationship between age and prevalence of opacities of Category 1 or more in this cohort (p greater than 0.10). Nonsmokers who had accumulated higher dust exposures showed a trend of increasing prevalence of opacities with increasing duration, suggesting an effect of occupational exposure at higher cumulative exposure levels (p less than 0.05). In most exposure categories, smokers exceeded nonsmokers in their prevalence of opacities greater than or equal to 1/0; the overall prevalence among smokers being 12 and 11% according to Readers A and B, respectively, compared with 4% in nonsmokers (p less than 0.01). In conclusion, 7 to 8% of aluminum workers in this cohort had radiographic findings of scanty, small, irregular opacities, the prevalence of which was increased among smokers (p less than 0.01). There was a moderate increase in the prevalence of opacities with increasing tenure in nonsmokers with high cumulative exposures (p less than 0.05).

Aging↗
PubMed1988

Alumina-related pulmonary disease.

A review of experimental studies suggests that the catalytically active low temperature transitional forms of alumina produces irreversible fibronodular change only when administered by intratracheal insufflation. Other aluminas not catalytically active but also broadly identified as "gamma" for different reasons also appear capable of inducing pulmonary fibrosis in the same model. Under conditions of human exposure, occupational exposure to a broad range of aluminas indicates--at most--minimal pulmonary nodular response.

Aluminum↗
PubMed1987

Aluminum in the lung: the pyropowder conundrum.

Pulmonary aluminosis is a disease first seen in Germany between 1938 and 1945 which then reappeared in the United Kingdom between 1952 and 1959. All cases were associated with exposure to a submicron-sized aluminum pyrotechnic flake which was lubricated with a non-polar aliphatic oil. Ordinarily, stearic acid, which chemically combines with aluminum to form aluminum stearate, was used as a lubricant to retard surface oxidation during milling of such flake. This new aliphatic lubricant, which simply physically coated the flakes to prevent elemental aluminum oxidation, could be easily washed off of such flakes. In the intracellular milieu, removal of such surface oil permits exposure of oxygen to elemental aluminum; this results in a vigorous exothermic reaction and the potential for tissue damage. It appears that cases occurred only where this oily lubricant was used to manufacture near submicron-sized pyrotechnic flake (ie, United Kingdom, Germany, Sweden), but never where similar flake has been manufactured for almost a century using polar lubricants.

Aluminum↗
PubMed1987

Impact of the International Labor Organization on occupational health and safety laws and practice.

The International Labor Organization (ILO) represents an historic, negotiated solution of sociopolitical problems arising from World War I. Among its functions, it develops international standards designed to improve conditions of employment. Its tripartite structure involving governments, labor, and employers inevitably impacts upon the philosophy and substance of the occupational health and safety instruments it develops. Understanding this standard-setting process provides insights into these instruments' underlying quasi-political character. The effects of these standard-setting actions upon national law and practice are broad in theory; however, their actual application reflects national human and material resources. Although ILO health and safety standards are directed toward the enhancement of occupational health and safety practice, political issues impede their widespread application despite individual national ratifications.

Humans↗
PubMed1984

Heat disorders in industry. A reevaluation of diagnostic criteria.

Morbidity rates associated with occupationally induced heat syndromes have been infrequently reported. In part this results from the inconsistency of diagnostic criteria for heat syncopy, exhaustion, and cramps. This problem is augmented by inconstant administration and completion of population survey instruments. With due regard for these shortcomings, we can provide only estimates of heat-induced morbidity, ranging between 0.12 and 1.4 cases per 1,000 man-years. To facilitate diagnosis of occupational heat stress disorders, a series of algorithms is presented for diagnosis of heat-induced syncopy, exhaustion, and cramps. A differentiation between heat-induced and heat-aggravated clinical states is proposed, and a heat disorder questionnaire with instructions for use is presented.

Heat Exhaustion↗
PubMed1976

Prevention of bony fluorosis in aluminum smelter workers. Excretion of fluorides during a seven-day workweek -- Pt. 2.

1. The excretion of fluoride is examined among aluminum smelter workers over the course of a seven-day workweek. The data for the first three days of work is best described by the first cycle of a parabolic curve. Each curve is characteristic of the level of exposure associated with specific jobs and individual smelter hygienic conditions. 2. The variability associated with the post-shift values after apparent equilibrium is attained is extreme. Such variability is probably due in large part to differences in exposure occurring during the last few hours of that work-day. This is further augmented as essentially all the absorbed fluoride is excreted as the near-equilibrium state is attained. 3. Because of this variability, the use of the post-shift urinary fluoride concentration as an indicator of exposure conditions should be limited to groups of workers, rather than individuals, at possible risk. 4. It appears that a urinary fluoride sample taken any day after the third day of the shift is an adequate post-shift fluoride exposure indicator among these groups of workers.

Aluminum↗
PubMed1976

Prevention of bony fluorosis in aluminum smelter workers. A five-year study of fluoride absorption and excretion -- Pt. 3.

1. A study of over 52,000 urinary fluoride determinations collected over a 5-year period among aluminum smelter workers is described. The pre-shift urinary fluoride concentration (representative of bony burden) appears to increase less rapidly than the post-shift concentration. This slow rate of bony buildup of pre-shift urinary fluoride concentrations reflects the relatively slow uptake of fluoride by osseous tissues at these levels of exposure. 2. The utility of post-shift urinary fluoride analysis is reflected by its close correlation with improvement or deterioration in work practices which determines the degree of potential fluoride exposure. 3. Over 16,000 urinary tests for protein were performed in aluminum smelter workers. The absence of correlation between urinary fluoride concentrations and the presence of albuminuria indicates the absence of renal alteration among these workers.

Aluminum↗
PubMed1976

Prevention of bony fluorosis in aluminum smelter workers. A 15-year retrospective study of fluoride excretion and bony radiopacity among aluminum smelter workers -- Pt. 4.

1. Fifty six aluminum smelter workers with 10 to 43 years' occupational exposure, and who had been previously studied medically, were re-x-rayed. Average urinary fluoride concentrations since 1960 were estimated to range from 2.78 mg/liter preshift and 7.71 mg/liter postshift. 2. Roentgenographic studies in 1960-66 and 1974 failed to reveal any evidence of fluoride associated bony change. 3. Although these workers represent a self-selected group, their magnitude and duration of exposure far outweighs any other group working at present or in the past at this plant. The implication that they have uniformly self-selected as fluoride resistant individuals is improbable. 4. These data indicate that group post-shift ur a long period is not associated with enhanced risk of bony fluorosis. If preshift urinary fluoride concentrations are less than 4 mg/l, the same results appears to apply.

Adult↗