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Biomedical subjects

D Coggon

Publications and source records attributed to D Coggon.

At least 91 records · Page 5Linked to original sources
PubMed1997

Mortality in employees of a Scottish paper mill.

To assess possible health risks associated with the manufacture of paper, we carried out a retrospective analysis of mortality among 4,242 men and women employed at a Scottish paper mill between 1955 and 1992. During follow-up to 1994, 959 subjects had died giving an SMR of 0.85 (95% CI 0.80-0.90) in comparison with the national population. Mortality from all cancer (SMR 0.77, 95% CI 0.68-0.88) and particularly from lung cancer (SMR 0.64, 95% CI 0.50-0.81) was lower than expected. An excess of lymphatic and hematopoietic cancer (11 deaths, SMR 2.17) was observed in the making department. These findings do not support an occupational hazard of lung cancer as suggested by several earlier studies. The excess of lymphatic and hematopoietic cancer in the making department was unexpected, and may be a chance occurrence.

Cause of Death↗
PubMed1997

Planning research.

The starting point for any research project should be a question. Once this has been defined and the relevant scientific literature reviewed, a protocol should be drawn up. This will be used not only as a guide to the conduct of the study and in the preparation of the final report, but also in seeking any financial support and approvals that are required for the investigation. A protocol is normally arranged in sections covering the background to the study, the question(s) that it will address, the methods that will be used for the collection and analysis of data, the statistical power of the investigation (where relevant), any ethical considerations, and the financial input that will be needed. A pilot study is often helpful where aspects of the study method are untried or of uncertain validity.

Occupational Medicine↗
PubMed1997

Mortality from aortic aneurysm in migrants between counties of England and Wales: evidence for causes acting early in life.

We assessed whether the causes of aortic aneurysm underlying its distinctive geographical distribution in England and Wales act early or later in life from the OPCS data on deaths in England and Wales during April 1969-December 1972. From these data, we calculated proportional mortality ratios (PMRs) for aortic aneurysm by county of birth and county of death, for men and women aged 45-74. Among people resident in the county of their birth, PMRs for aortic aneurysm by county ranged from 31 in Pembrokeshire to 194 in Surrey. Among 'migrants', who died in a different county from that in which they were born, PMRs by place of death varied from 85 in the group of counties which had the lowest mortality in non-migrants to 111 in those with the highest mortality in non-migrants, and PMRs by place of birth varied from 74 in counties with lowest mortality in non-migrants to 113 in those with highest mortality in non-migrants. After adjustment for place of residence at death, the relation of mortality to place of birth was highly significant statistically (P < < 0.001). These findings indicate important causes of aortic aneurysm acting early in life, perhaps related to the formation of elastin in the arterial wall.

Aged↗
PubMed1997

Markers of internal dose: chemical agents.

Biomarkers of internal dose measure the level of a carcinogen or one of its metabolites in a tissue or a body fluid such as urine or blood. The choice of a biomarker of internal dose for a particular epidemiological study or type of study requires careful consideration of the period of exposure to which the biomarker relates, host factors related to carcinogen metabolism, invasiveness of sampling, reliability and cost of the biomarker. Before a new biomarker is adopted, it is important to assess these characteristics in transitional studies to ensure that the biomarker will be applied appropriately. Biomarkers of internal dose have been applied most successfully in ecological studies and nested case-control studies, and are especially useful when they provide information about long-term carcinogen exposure.

Biomarkers, Tumor↗
PubMed1996

Exposure to styrene and mortality from nervous system diseases and mental disorders.

Chronic low-dose exposure to solvents has been associated in epidemiologic studies with chronic neurotoxicity, but the evidence is not consistent. Styrene causes acute disturbances in the central and peripheral nervous systems. To determine if exposure to styrene may contribute to chronic diseases of the central nervous system, the authors examined mortality from nervous system diseases, mental disorders, and suicide in relation to styrene exposure in an international historical cohort study. The cohort involved 35,443 workers employed during 1945-1991 in the reinforced plastics industry, where high exposures to styrene occur. Indicators of exposure were reconstructed through job histories and environmental and biologic monitoring data. Poisson regression was used for internal comparisons. Mortality from diseases of the central nervous system (27 deaths) increased with time since first exposure, duration of exposure, average level of exposure, and cumulative exposure to styrene. A quadratic model described best the dose-response shape for cumulative exposure and duration of exposure with the highest risks at around 300 ppm-years and 5 years, respectively, and a subsequent decrease in risk in the highest exposure categories. Mortality from epilepsy increased monotonically with all styrene exposure indicators, while associations for degenerative diseases of the central nervous system were generally weaker. Mortality from mental disorders and suicide decreased with increasing duration of exposure and cumulative exposure, while there was no trend with time since first exposure and average exposure to styrene. These findings suggest that, in addition to the known acute effects, exposure to styrene may contribute to chronic diseases of the central nervous system.

Cause of Death↗
PubMed1996

Mortality pattern among biological research laboratory workers.

A cohort study was conducted to investigate the mortality of individuals employed by biological research institutes in the UK. The inclusion criteria were met by 12,703 individuals, of whom 95% were traced (11,502 alive, 395 deaths, 246 embarkations). All-cause mortality was significantly reduced in men (standardised) mortality ratio (SMR) 55 and women (SMR 52). Mortality was also significantly reduced for circulatory and respiratory diseases, and overall there was low mortality from malignant neoplasms. SMRs exceeded 100, but were not statistically significant, for infective and parasitic diseases. There were no statistically significant raised SMRs for any cancer site. Workers were categorised as ever worked in a laboratory (laboratory workers) and never worked in a laboratory (non-laboratory workers). The all-cause SMR was significantly reduced in both groups, as was mortality from circulatory and respiratory diseases. The SMR for malignant neoplams was also significantly reduced in laboratory workers. On the basis of follow-up to 31 December 1994, there is no evidence of any overall increased risk of mortality in biological research laboratory workers. However, the power of the analysis is limited by the young age of many cohort members and short duration of follow-up. Follow-up is continuing and the data will be reanalysed once more deaths have accumulated.

Agriculture↗
PubMed1996

Health surveillance for hospital employees exposed to respiratory sensitizers.

Seventy-eight National Health Service occupational health departments were invited to take part in an audit of health surveillance for employees exposed to respiratory sensitising agents. Most of the departments had responsibility for workers using glutaraldehyde, formaldehyde, methyl methacrylate and X-ray processing chemicals, but the extent to which health surveillance was provided for these employees varied. Many departments had no written policies for surveillance, and the methods used were often unnecessarily labour intensive. Only a minority of departments had made arrangements for communicating the collective results of screening to employees, failure to do so indicating a breach of statutory duty. There were major discrepancies between departments in criteria for excluding employees from work with respiratory sensitising agents. Occupational physicians caring for hospital staff should discuss and establish guidelines for effective surveillance of people working with the commonly encountered sensitisers.

Asthma↗
PubMed1996

Mortality from scrotal cancer in metal machinists in England and Wales, 1979-80 and 1982-90.

The hazard of scrotal cancer from cutting oils was first recognized in the 1950s, and led to various control measures including the introduction of solvent refined oils, use of splash guards, provision of protective clothing and washing facilities and education of workers to encourage early detection and treatment of tumours. To assess how effective these controls have been, we have analyzed occupational mortality from scrotal cancer in England and Wales during 1979-80 and 1982-90. Over this 11-year period 85 deaths were attributed to the disease in man aged 20-74. This represents a reduction in mortality from the 1960s. Significantly elevated proportional mortality ratios (PMRs) were found in press and machine tool setters (PMR 1,678, five deaths), centre lathe turners (PMR 1,099, three deaths) and machine tool operators (PMR 303, eight deaths), but all of the metal machinists who died of scrotal cancer had been born before 1930, and could have worked with cutting oils before controls were introduced. These findings are reassuring, but continued monitoring of scrotal cancer incidence and mortality is required.

Adult↗
PubMed1996

A survey of the prevalence of biting by the Blandford fly during 1993.

To assess the frequency of bites by the Blandford fly, a postal survey was carried out at the end of the 1993 biting season. Questionnaires were sent to a random sample of 1,500 people, selected from the lists of the two general practices in Blandford Forum, and satisfactory replies were obtained from 1203 (80%). Altogether, 194 (16%) of subjects reported one or more insect bites, during the 2-month season, that had led to skin swelling more than 2.5 cm across. Of these, more than a quarter had suffered associated systemic symptoms, in the form of fever or joint pain. One hundred and forty-nine had used medications for bites, 20 had consulted a doctor, and seven had taken time off work or school. Bites were more common in females (22%) than males (9%). This difference was due largely to a higher frequency of bites on the legs. Risk might be reduced substantially in women by wearing trousers, especially in those who spend a lot of time outdoors.

Adolescent↗
PubMed1996

Carpal tunnel syndrome: evaluation of a new method of assessing median nerve conduction at the wrist.

OBJECTIVE: To compare median nerve conduction velocity measured using a new, portable electroneurometer with measurements made using conventional hospital nerve conduction apparatus. METHODS: Twenty five patients were studied who were consecutively referred to a hospital neurophysiology department with a clinical diagnosis of carpal tunnel syndrome. Sensory and motor latencies for the median nerve at the wrist were measured bilaterally using the portable electroneurometer and a Medilec MS 92 hospital apparatus operated by a trained technician. RESULTS: There was strong agreement between motor latency values obtained by the two techniques (r = 0.89, p < 0.001; mean difference -0.03 ms, limits of agreement -0.33 to 0.27 ms). Sensory latencies were less easy to detect with the electroneurometer, and correlated less well with the hospital apparatus (r = 0.78, p < 0.001; mean difference -0.16 ms, limits of agreement -0.50 to 0.18 ms). CONCLUSION: The portable electroneurometer provides a convenient, rapid, and inexpensive means of assessing median nerve conduction velocity at the wrist. Measurements of motor latency obtained with this new instrument agree more strongly with those made by conventional apparatus than do measurements of sensory latency. Although the utility of the instrument in clinical practice will be limited, it provides a helpful tool in epidemiological studies of carpal tunnel syndrome.

Adult↗
PubMed1996

Mortality of farmers and farmers' wives in England and Wales 1979-80, 1982-90.

OBJECTIVES: To examine the mortality patterns of male and female farmers and farmers' wives in England and Wales. METHODS: Information on all deaths in England and Wales at ages 20-74 during the periods 1979-80 and 1982-90 was obtained from the Office of Population Censuses and Surveys. Proportional mortality ratios (PMRs) and proportional cancer mortality ratios (PCMRs) were used to compare the mortality of farmers with that of the general working population, and of farmers' wives with wives of all working men. RESULTS: Farmers and farmers' wives had high mortality from accidents and suicide and from certain respiratory diseases. Mortality from hernia was also raised. Deaths from cancer were generally below expectations, but the PMR for prostatic cancer was 112 (95%CI 106-118). The PMRs and PCMRs for oesophageal cancer were significantly increased in male farmers from two counties where cider is produced. CONCLUSIONS: The occupational hazards of farming continue to be associated with excess mortality, and most of the risks extend also to farmers' wives. Action is needed to reduce deaths, particularly from accidents and suicide.

Accidents, Occupational↗
PubMed1996

Distribution and determinants of personal exposure to nitrogen dioxide in school children.

OBJECTIVES: To assess the distribution of personal exposures to nitrogen dioxide (NO2) in school children, and to investigate factors that might influence personal exposure. METHODS: NO2 exposures were assessed by use of passive diffusion tubes for 46 children aged 9-11 years, selected from two Southampton schools. The tubes were worn for seven days, and parallel measurements were made with static samplers in the child's kitchen, living room, classroom, and playground. Information about potential exposures was collected by questionnaire. RESULTS: Personal exposures to NO2, averaged over seven days, ranged from 11 to 257 micrograms/m3 (6 to 137 ppb) with a geometric mean of 36 micrograms/m3 (19 ppb). Exposures correlated with concentrations of NO2 recorded in the home, but the relation was far from exact. Factors associated with increased personal exposure included the use of gas appliances in the home, living with one or more smokers, and travel to school by means other than a car. However, together these variables only explained a small part of the variation in personal exposures. CONCLUSIONS: These findings reinforce the need for personal monitoring of exposure in studies investigating potential health effects of NO2 in children.

Child↗