In search of the pathogenesis of refractory cervicobrachial pain syndrome.
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Biomedical subjects
Publications and source records attributed to B Hocking.
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OBJECTIVE: To assess the impact of Telecom's "Cover yourself against skin cancer" campaign, which used marketing techniques to promote sun protection behaviour. METHOD: Quasi-experimental design assessing change from before to after the campaign in intervention versus control groups. The unit of observation was a team of lines staff. Use of hats, shirts and shade were observed and prevailing weather conditions were noted. The major results are based on 525 observations before the campaign and 460 after it. RESULTS: The campaign led to a significant improvement in shirt use (P = 0.02), and to an improvement in overall protection (P = 0.02). The campaign had no effect on hat use, or on use of shade. CONCLUSIONS: The "Cover yourself against skin cancer" campaign was demonstrated to be an effective tool for getting outdoor staff to increase their sun protection. The implications for health and safety education are discussed.
This paper reports data on changes in smoking behaviour after the introduction of a total workplace smoking ban in Telecom Australia. A sample of 1089 Telecom staff were surveyed in the months before the introduction of the ban and 620 were resurveyed six months after the ban had been implemented. A further sample of 1424 was drawn from the same parts of the organisation 18 months after implementation. Among the smokers in these samples, the bans produced a reduction in workday cigarette consumption of between three and four cigarettes a day and this reduction was maintained at 18 months. Over the two-year period from six months before the ban to 18 months after it, smoking prevalence dropped about 5 per cent, which we estimate is about twice the decline found in the general community. Workplace smoking bans can produce public health and can assist individual smokers to regulate their habit.
This paper discusses the management of radio-frequency radiation workers who have implanted medical devices which may be adversely affected by such radiation fields. The implants include orthopedic devices, cardiac pacemakers, and cochlear implants, but exclude dental work. The effect of radio-frequency radiation on the devices may be to increase heat load and/or produce signal interference. The mechanics of interaction are outlined and protocols for managing cases are described. The implications for safety standards are discussed.
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The acceptability and effectiveness of a total workplace smoking ban in Telecom Australia was evaluated in a series of studies. Staff in a sample of representative areas were surveyed prior to the introduction of the bans, then 6 and 18 months afterward. By 18 months 81% of all staff, including 53% of smokers, approved of the bans. Sixty-six percent of staff reported a total ban was operative, and 31% reported a total ban except for a smoking room, leaving only 3% reporting lesser restrictions. Smokers were smoking between three and four less cigarettes per work day, and the numbers of smokers had decreased by about double the community rate. The policy had little perceived effect on productivity but resulted in some tension between staff that progressively decreased and now is limited to the few areas where there were problems with compliance. A subsample of managers and staff were interviewed and factors relevant to successful implementation of the policy were identified. These included a clear statement of policy, strong managerial support via equipping managers with leadership and negotiating skills, and the use of occupational health nurses. It is important to provide assistance to affected staff to help them adjust to the ban both before as well as in the months after implementation.
In January and February 1987 an epidemic of a strange illness involving 31 members of the staff in the Calcutta Telephone Exchange occurred. It commenced in the "operator services" on the 4th floor and after involving 21 members of the staff, progressed to the 6th floor where a further 10 members of the staff were involved. The symptoms varied and included a burning feeling on the face, weakness of the limbs, noises in the ear and heaviness of the head. In most cases no physical injury was found and a psychological disorder occurred subsequently in a few cases. Extensive investigation of the network did not reveal any specific electronic causes although some defects were found. The likely causative factors were poor ventilation causing a mild excess of CO2 as well as a mild heat load, overlaid on a background of work stress. The epidemic was exacerbated by erroneous reports in the media and by rumour that the members of the staff admitted to hospital were permanently injured. The epidemic abated in conjunction with steps to improve the work environment and to improve medical communication. The epidemic is discussed with regard to mass sociogenic illness.
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The health aspects of an accident involving nine men exposed to 4.1 GHz radio-frequency radiation (RFR) is described. Two were exposed to levels of 4.6 mW/cm2 for up to 90 minutes, which exceeds the current Australian standard of 1 mW/cm2, while the other seven were exposed to lower levels. For staff in the high-exposure group, the dose rate was calculated for the whole body, skin, eyes, and pituitary. Comprehensive medical examinations were performed on all staff, including follow-up ophthalmological examinations over a period of nine months. Various abnormalities were found in all staff but, with the possible exception of hair loss, there was no consistent gradient of effect in the occurrence of abnormality between the groups. Various problems in conducting the investigation are discussed. It was concluded that the exposure had not resulted in harmful effects.
A protocol is proposed for the assessment of health effects following a radio-frequency radiation accident. The protocol is intended to ensure uniform recording of exposure and medical data. This should meet the requirements of the individuals exposed as well as contributing to scientific knowledge. Difficult aspects about the collection of exposure and medical data are discussed and the need to consider the feelings of the exposed individual(s) is emphasized.
An epidemic of "repetition strain injury" ("RSI") in Telecom Australia is described. In the years 1981-1985, there have been 3976 reports of "RSI". The occupation that was most affected was that of telephonist, with 1886 reports and a rate of 343 per 1000 keyboard staff members over five years; among other occupations that were affected were clerical workers (1421 reports; rate, 284 per 1000 keyboard staff members); telegraphists (17 reports; rate, 34 per 1000 staff members); and process workers (235 reports; rate, 116 per 1000 staff members). Women accounted for 3330 (83%) of all reports; in the telephonist group, 27% of female and 20% of male staff members were affected (P less than 0.001); for women, younger staff members were more affected. There was a significant difference among states in the prevalence of "RSI" in telephonists. There was a high morbidity, and 644 (16%) subjects were affected for more than 26 weeks; the cost-effectiveness of treatment and rehabilitation varied appreciably among state administrations. The costs of the epidemic exceed $15 million, including $1.8 million in medical costs. Reasons for the rise and decline of the epidemic are discussed.
The anthropologic distinction between disease and illness is used to give insight into the nature of certain medically puzzling occupational epidemics, including mass psychogenic illness. Four representative epidemics from America, Europe, Asia, and the Pacific are described. Illness is a phenomenon socially defined by a group and these epidemics of illness are hypothesized to be a form of group protest about the work circumstances comparable to possession states. Some of the implications for resolving these epidemics by physicians and others are discussed.
The case of a man who was injured by a stroke of lightning while using the telephone is reported. The patient sustained paralysis, sensory symptoms, otological disturbance and pathognomonic dendriform cutaneous marks (Lichtenberg figures). The relevant literature is reviewed, and the epidemiology and preventive measures are discussed.