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Biomedical subjects

B S Levy

Publications and source records attributed to B S Levy.

At least 55 records · Page 3Linked to original sources
PubMed1984

Boilermakers' bronchitis. Respiratory tract irritation associated with vanadium pentoxide exposure during oil-to-coal conversion of a power plant.

Severe respiratory tract irritation occurred in at least 74 of 100 boilermakers who were exposed to high levels of vanadium pentoxide fume during oil-to-coal conversion of a utility company power plant in a rural area of western Massachusetts. Many were welders working in confined areas with inadequate ventilation. Most frequent symptoms were productive cough, sore throat, dyspnea on exertion, and chest pain or discomfort. The illness was severe enough to cause 70 workers to consult physicians and most of them to lose time from work (median, five days). Wheezing (in 39%) was the most frequent finding on physical examination. Mild hypoxemia was noted in several workers; most (72%) had normal chest x-ray films. Expiratory flow rate over the middle 50% of the forced vital capacity was the pulmonary function test most remarkably affected (median, 57% of predicted for 24 workers tested). The Occupational Safety and Health Administration documented levels of vanadium pentoxide fume at or above the permissible exposure limit in all eight air samples taken from inside the boiler; it cited the company for inadequate mechanical ventilation and an inadequate respiratory protection program for workers. The report of this outbreak may help prevent future problems by drawing attention of physicians, workers, and managers to the potential pulmonary hazards in power plant conversion.

Adult↗
PubMed1981

Infective endocarditis: an analysis based on strict case definitions.

Strict case definitions were applied to 123 clinically diagnosed cases of infective endocarditis. Cases were categorized as definite (19), probable (44), or possible (41) endocarditis or were rejected (19). Compared to other published studies, our patients had an advanced mean age (57), high incidence of underlying valvular disease (66%), short mean duration of symptoms (27 days), and 15% mortality, the lowest reported for a large series. Most cases were caused by viridans streptococci, Staphylococcus aureus, or enterococci; Enterobacteriacae were absent, and negative cultures infrequent (5%). Subgroups included nosocomial endocarditis (13%), usually with underlying valvular disease and invasive procedures; prosthesis endocarditis (12%); and cases requiring cardiac surgery (18%). Deaths were caused by heart failure, neurologic events, or superinfection. Strict definitions are useful in managing suspect cases, and are essential in comparing clinical studies. Early recognition and treatment should be the focus of efforts to reduce mortality from endocarditis.

Adolescent↗
PubMed1980

The teaching of occupational health in American medical schools.

A questionnaire survey of the 112 U.S. medical schools was conducted to determine the content and format of occupational health teaching during the 1977--78 academic year. In only 46 (50 percent) of the 92 responding institutions was occupational health specifically taught; and only 28 (30 percent) required it in their curricula, usually in the preclinical years. Among these 28, the median required curriculum time was four hours. Thirty-five (38 percent) of the responding schools offered a variety of elective courses or clerkships, mainly in the clinical years and taken by few students. Given the extent of work-related medical problems in the United States and the frequency with which almost all physicians see patients with work-related problems, much more of the core curriculum of medical schools should be devoted to occupational health.

Curriculum↗
PubMed1980

Smoking policies and smoking cessation programs of large employers in Massachusetts.

To assess the current extent of programs and policies to facilitate smoking cessation among employees, we queried 128 large employers in Massachusetts in mid-1978. Eighty-four (66 per cent) responded. Fifty-four (64 per cent) of the respondents had designated jobs or work areas in which smoking was prohibited usually because of potential danger to products or equipment. Seven (8 per cent) of the employers provided counseling, and 10 (12 percent) provided smoking cessation programs for those employees who desired to quit smoking. There is a clear need for the development and evaluation of workplace policies and programs aimed at reducing smoking.

Health Education↗
PubMed1979

A diagnostic strategy for myocardial infarction.

In attempting to make the diagnosis of myocardial infarction, the family physician has available an increasing array of enzyme and nuclear imaging techniques to add to the clinical and electrocardiographic findings. In this review several of the new diagnostic tests are described, and their role is discussed both in supplementing and replacing older diagnostic tests. A general strategy for employing both old and new tests is proposed, with a goal of achieving both increased diagnostic accuracy and reduced charges for laboratory tests.

Creatine Kinase↗
PubMed1977

Intensive hepatitis surveillance in Minnesota: methods and results.

After a large foodborne outbreak of hepatitis A in April 1974, the Minnesota Department of Health attempted to improve ongoing hepatitis surveillance with a system based on 1) a large centralized blood bank, which reports results of tests for hepatitis B surface antigen (HBsAg) on suspected hepatitis patients; 2) private physicians, who are encouraged to report cases; and 3) an epidemiology aide, who contacts all detected patients and their physicians. During the first year of this system, we detected 932 cases (24.5 per 100,000), a threefold increase over previous years, and obtained detailed epidemiologic data on each case. Although physicians diagnosed 61% of these cases as hepatitis A (or non-B) and 39% as hepatitis B, they tested only 53% of all patients for HBsAg. Sixty-seven per cent of the tested patients were HBsAg-positive, but only 17% of the untested patients had illnesses diagnosed by physicians as hepatitis B. This suggests that many patients with clinically-diagnosed viral hepatitis who are not tested for HBsAg may be erroneously diagnosed by physicians as having non-B hepatitis. Thirty-three per cent of HBsAg-positive patients with known occupations, not including housewives and students, worked in meidcally-related occupations. For 51% of the HBsAg-positive patients, we could not identify recent parenteral exposure to hepatitis B.

Adolescent↗
PubMed1977

Hepatitis B in ward and clinical laboratory employees of a general hospital.

After a sharp increase in viral hepatitis cases, mostly type B, among the 2000 employees of a general hospital during three years, we conducted an investigation which consisted of obtaining data on employee cases and surveying many current employees. Of the 38 cases, 22 occurred in non-physician, ward employees. Of 189 current ward employees, 8% had antibody to hepatitis B surface antigen (anti-HBS) and 1% had hepatitis B surface antigen (HBSAg). Hepatitis B virus (HBV) seropositivity was highest for employees who worked closely with hemodialysis and renal transplant patients and for those who claimed that their ward was understaffed. Nine of the 38 cases occurred in clinical lab workers. Of 70 current lab employees, 17% were positive for anti-HBS and none for HBSAg. HBV seropositivity was highest for those working in the chemistry section (highest there among those performing blood-gas determinations and those working with the multi-channel autoanalyzers) and those who routinely got blood on their skin and clothes at work. All seropositive employees worked routinely with blood. These data support the hypotheses that many hospital employees contract hepatitis B from exposure to HBSAg-positive patients and many clinical laboratory employees contract it from exposure to HBV-contaminated blood.

Carrier State↗
PubMed1977

Chronic occupational exposure to lead: an evaluation of the health of smelter workers.

After receiving reports of lead poisoning in two workers at a secondary lead smelter, we evaluated the health status of 38 current smelter workers and 87 of their household contacts by questionnaires, physical examinations, and laboratory tests. Fatigue, cough, and diarrhea were the most frequent symptoms in plant employees; each occurred in at least a third. The most frequent physical finding, hand tremor, occurred in 10 of 33 plant employees. Twelve employees had blood lead concentrations at or above 80 microgram/100 ml, and 17 others had blood lead concentrations at or above 60 microgram/100 ml. All physical signs possibly due to excess lead absorption were manifested by employees with blood lead levels of 60 microgram/100 ml or greater, with one exception. Household contacts of employees had few symptoms suggestive of excess lead absorption.

Adult↗
PubMed1976

Investigating possible effects of abestos in city water: surveillance of gastrointestinal cancer incidence in Duluth, Minnesota.

The recent discovery of over one million asbestos-like fibers per liter of Duluth tap water and the suggestive evidence of a link between certain gastrointestinal (GI) cancers and work exposure to asbestos fibers in the air prompted this study. GI cancer incidence data were gathered for Duluth in the same manner as data previously gathered for comparison cities, Minneapolis and St. Paul. Although some differences in GI cancer incidence occurred among the three cities in 1969-1971, there was no consistent pattern of statistically significant differences observed. The number of GI cancers diagnosed in Duluth residents in 1972 was similar to that in each of the previous three years. This study represents the start of ongoing cancer surveillance in Duluth.

Age Factors↗
PubMed1975

A large food-borne outbreak of hepatitis A. Possible transmission via oropharyngeal secretions.

In Minneapolis, 107 cases of hepatitis A were identified and traced primarily to consumption of cold sandwiches served for lunch in a department store's popular basement restaurant. A sandwich-maker in the restaurant was the index patient. The date of onset of her illness and the dates of food consumption and onset of illness of infrequent restaurant patrons were consistent with accepted periods of infectivity and incubation for hepatitis A. Because the sandwich-maker frequently touched her hands to her mouth when she worked, and because we could not find evidence for fecal, airborne, or other modes of transmission, we believe that she may have contaminated food with infectious oropharyngeal secretions. The secondary attack rate was much lower among household contacts who received immune serum globulin than among those who had not.

Disease Outbreaks↗
PubMed1975

The Middleton outbreak: 125 cases of foodborne salmonellosis resulting from cross-contaminated food items served at a picnic and a smorgasbord.

One hundred and twenty-five of 173 people who ate at a picnic and/or a smorgasbord prepared by a bar-restaurant in a Midwestern town in September 1973 developed diarrhea, abdominal cramps, and other symptoms 23 hours (median time) later. Eleven were hospitalized. Stool cultures from 18 ill individuals grew Salmonella infantis, Salmonella agona, and Salmonella schwarzengrund. Stool cultures from 5 of 8 restaurant employees grew S. infantis or S. agona. Cultures of remaining foods and food-contact surfaces were negative. Food-specific attack rates, based on interviews with 121 eaters, implicated potato salad and chicken dressing as vehicles of transmission, both likely contaminated when prepared in pans that shortly before contained uncooked, chicken pieces suspected to have harbored salmonellae. Chickens were eventually traced to 3 farms where feed samples were found to contain Salmonella typhimurium and Salmonella cubana, raising the possibility that other feed samples may have contained the serotypes responsible for the outbreak. The main control measure was temporarily closing the food service, which was to have catered a large church picnic the next day. The outbreak had an economic impact estimated at $28,733.

Adult↗