Biomedical subjects

G Pransky

Publications and source records attributed to G Pransky.

28 records · Page 2Linked to original sources

PubMed1995

Recruiting the occupational and environmental medicine physicians of the future: results of a survey of current residents.

In July 1994, current occupational and environmental medicine (OEM) residents (n = 180) were surveyed about their motivation for decisions to enter OEM residencies, near-term and long-term career goals, and their opinions on various strategies for recruitment to the field. A total of 151 persons responded (84%), representing all 40 accredited OEM residencies in the United States and Canada. A total of 16% first learned about OEM in medical school, and 11% were first exposed during residency training. Most respondents (62%) decided to enter OEM residency training after beginning their professional working careers. Only 11% of respondents decided to enter OEM residency training before (2%) or during (9%) medical school, whereas 24% made their decision during internship or residency. Respondents were attracted to several aspects of OEM, but the prevention focus of the field (64%), lifestyle (56%), and worker and labor issues (53%) were most commonly cited. Although only 25% of respondents stated that a role model had a significant impact on their decision to pursue training in OEM, persons influenced by a role model were more likely to have made the decision to pursue a career in OEM during medical school or clinical residency training (odds ratio = 2.4; 95% CI, 1.0-5.4; Fisher's exact two-tailed P value = 0.04). In the short term, residents were most often interested in working for industry (32%), whereas over the long term, careers in consulting were most often preferred (39%). The data have important implications for strategies to increase recruitment to residency training programs in OEM and to increase staffing in the field.

Canada↗

PubMed1994

Development of a multidisciplinary research clinic for patients with work-related upper extremity disorders.

The health care reform debate has focused attention on the need for outcomes research performed in ambulatory care settings. In this article, the authors describe the development of a research clinic focusing on symptomatic, functional, and vocational outcomes of patients with work-related upper extremity disorders. The authors describe the programmatic and research challenges associated with performing such research and emphasize the need for balancing the research and clinical agendas. Research efforts in this setting require careful consideration of the patient selection process and allocation of sufficient time for the clinical staff to collect and record essential research data.

Academic Medical Centers↗

PubMed1991

Business analysis in occupational health and safety consultations.

We present a method for incorporating business analysis into comprehensive health and safety consultations using as an example a plant with an elevated incidence of cumulative trauma disorders. Business information, including product and management history, short- and long-term corporate goals, functional analysis, profit history, organizational structure with respect to health and safety, and personnel and labor-management relationships are evaluated simultaneously with traditional ergonomic factors. The additional business data allow consultants to identify the full scope of etiologies and make practical, credible recommendations that are more likely to be adopted by management and labor. We propose that techniques of "business analysis" be routinely incorporated into occupational health and safety consultations. However, because collection and interpretation of these data require business skills outside the occupational safety and health expert's usual repertoire, the consulting team must include participants with business expertise. We have found that occupational health medical personnel with an understanding of business analysis concepts can be very effective advocates for changes in health and safety practices. We strongly recommend incorporating methods of business analysis into the occupational health and safety curriculum.

Accidents, Occupational↗

PubMed1990

Radiologic detection of pleural thickening.

The purpose of this study was to investigate four aspects of the radiologic detection of pleural thickening: the specificity of chest X-rays read by B readers, the effects of threshold definitions of positivity, the extent of variability among different X-ray readers, and the effect of film quality. A series of 421 chest X-rays corresponding to consecutive autopsies was reviewed by six B readers working independently and using modified International Labour Organization forms. The prevalence of true pleural thickening was approximately 6%. Using a strict definition of positivity, the average specificity was 0.85. Specificity decreased when a more liberal definition was used. (The average sensitivity was 0.32, which appeared to increase with a more liberal definition of positivity; because of small numbers of true positives, the sensitivity estimates were unstable.) Kappa statistics for interreader agreement ranged from 0.06 to 0.40, suggesting considerable interreader variability. Decreasing film quality was associated with decreasing sensitivity, but specificity was not affected by film quality. Because the chest X-ray has suboptimal test characteristics in the diagnosis of pleural thickening and because there is considerable interreader variability, we conclude that caution is required in interpreting radiologic detection of pleural thickening using ILO procedures.

Asbestosis↗

PubMed1990

Occupational medicine specialists in the United States: a survey.

Although a shortage of occupational medicine experts has been suggested, no accurate enumeration of actively practicing physicians who are Board-certified in occupational medicine is available. A survey of all such physicians and recent occupational medicine residency graduates was conducted to determine practice type and level of activity. Older physicians tended to practice in industry-based settings, whereas younger physicians were more likely situated in clinic settings serving a variety of employees. Projecting from our responses, we estimate that about 650 occupational medicine specialists were actively practicing at the time of the survey and that about half are available to the community physician for consultation. Fewer than two thirds of recent residency graduates had pursued Board certification; this trend will lead to a gradual decline in the number of Board-certified occupational physicians.

Certification↗

PubMed1990

Illness and the workplace: a study of physicians and employers.

Seven million patients with work-related injuries are seen annually in the United States, the majority by primary care physicians. The number of such patients seen in a typical community practice may be significant but has never been studied. Most community-based physicians have little or no formal training in occupational health care. This study consisted of a survey of practicing physicians and major industrial employers in a city of 39,000 with a strong manufacturing base. The purpose was to assess physician skills, attitudes, and practices that might influence the optimal management of patients with work-related conditions, and to assess employer attitudes about this management. Eighty-three percent of physicians and 68% of employers responded to the written surveys. Low numbers of patients with work-related conditions were reported except by orthopedists and a neurologist. Few physicians communicated directly with employers, citing time and confidentiality as factors. Twenty-five percent were unaware of specific legal guidelines for such contact. Administrative and legal complexities were cited by 97% of the respondents as barriers to effective management of such cases. Eight percent of employers sought more contact with physicians, including site visits and more detailed work restriction guidelines. The education of primary care physicians may improve their understanding of work-related conditions and the optimal management and rehabilitation of these patients.

Communication↗

PubMed1989

Ocular infections and the industrial use of microscopes.

A cluster of ocular infections occurred in one area of a computer fabrication facility that relied on the use of industrial microscopes. A questionnaire was administered to all employees in this area. Microscope oculars were cultured and compared with control microscopes from a nonindustrial setting. Risk of infection was correlated with the number of hours of microscope use per day and subjective indicators of cleanliness. Bacterial cultures confirmed increased colony counts in industrial oculars compared with control oculars. Hygienic practices were instituted similar to those employed in medical settings. No further outbreaks of conjunctivitis have been reported in a 1-year follow-up.

Conjunctivitis↗

PubMedDate not supplied

Special populations in occupational health.

This introductory chapter lays the groundwork for the in-depth examination of special populations that follows. Drs. Frumkin and Pransky discuss what makes a population special, health disparities over the generations, and the evolving recognition of special populations in occupational health.

Health Priorities↗

PubMedDate not supplied

Workers with disabilities.

Individuals with disabilities constitute a sizable portion of the workforce and represent the majority of working-age persons who are unable to work. Historically, barriers to employment have included attitudinal discrimination by employers, lack of workplace accommodations, and inadequate job training. The disability rights movement has achieved considerable success in promoting legislation to remove these barriers and uphold equal employment. Research suggests that many employers actively attempt to incorporate persons with disabilities into the workforce and gain substantial economic benefit from their participation, without incurring burdensome expenses. Occupational health providers are asked by employers and others to provide input on feasibility and safety, a difficult task given the lack of scientific study on the occupational abilities and risks associated with specific disabilities. Providers have an important role in promoting the equal employment of disabled persons, by providing objective opinions on their ability and risks on the job and suggesting workplace accommodations and treatments that enhance the ability to work.

Civil Rights↗

PubMedDate not supplied

Genetically and medically susceptible workers.

The likelihood of an individual becoming ill from a hazardous material or condition is strongly influenced by both their genetic makeup and their underlying state of health. Although the past decade has seen great advances in understanding human variation in health and genetic polymorphisms and in the diagnosis and treatment of disease, much less progress has been made in effectively using this information to protect worker health. Scientific evidence for increased susceptibility often is weak and rarely satisfies legal thresholds for sufficient risk to warrant exclusion from a particular job. When public safety is a major concern, many legally mandated exclusions are not well justified. Medical opinions about fitness to work should be based upon a systematic and credible analysis of the condition, its relationship to ability and risk for a particular job, and knowledge of possible accommodations. Conclusions should reflect the limitations of scientific knowledge and guidance from antidiscrimination legislation.

Disability Evaluation↗