Search PubMed⌕ Search

Biomedical subjects

H Frumkin

Publications and source records attributed to H Frumkin.

At least 55 records · Page 3Linked to original sources
PubMed1991

Occupational health and safety in Brazil.

BACKGROUND: Brazil is the world's fifth largest and sixth most populous nation. Its economy is varied, with strong manufacturing, agriculture, mining, and service sectors. Therefore, a wide variety of workplace hazards confronts its work force. This paper describes Brazil's occupational safety and health regulatory scheme, workers' compensation system, plant-level practices, training, and data collection. METHODS: We reviewed and analyzed Brazilian regulatory legislation and government and non-governmental organization (NGO) activity in occupational safety and health, as well as the structure and function of the workers' compensation system. We also reviewed available data on injuries and diseases from major sources, including the now-defunct Instituto Nacional do Previdencia Social (INPS) and the workers' compensation scheme, Seguro de Acidente de Trabalho (SAT). RESULTS: The incidence of workplace injuries has decreased in recent years and is now reported to be about 5 per 100 workers per year. The case fatality rate has been constant at about 5 fatalities per 1000 injuries. Less than 6% of reported injuries are classified as "diseases." Brazil's rates are comparable to those of Mexico and Zimbabwe, and two to four times higher than in most industrialized countries. CONCLUSIONS: Brazil has a high incidence of occupational injuries and diseases; these injuries and diseases are underreported; there is a large informal sector at special risk; and Brazil illustrates the disparity that exists in many countries between legislation on the books and legislation that is actually implemented.

Accidents, Occupational↗
PubMed1991

Costs of occupational injury and illness in Pennsylvania.

A variety of state and federal data sources are used to estimate two critical components of the annual economic costs of occupational injuries and illnesses in Pennsylvania: foregone earnings of affected workers and medical costs. Foregone earnings costs resulting from occupational injuries and illnesses are estimated at between $1.22 billion and $2.02 billion in 1988. A number of potential adjustments to these estimates widen the range considerably. Estimates of medical costs range from $740 million to $797 million. Combining these two estimates gives total estimated costs of $1.96 billion to $2.82 billion.

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↗
PubMed1989

Asthma in respiratory therapists.

STUDY OBJECTIVE: To test the hypothesis that work as a respiratory therapist is associated with an increased risk of developing asthma. DESIGN: Cross-sectional questionnaire study comparing respiratory therapists with controls (physical therapists and radiologic technologists). Subsequent validation of reported asthma with methacholine challenge studies. SUBJECTS: All respiratory therapists and physical therapists and a random 50% sample of radiologic technologists working in the state of Rhode Island as of June 1986. METHODS: All subjects received a mail questionnaire with questions about the presence or absence of asthma, time of onset, and important covariates. Responses were analyzed for all subjects, and again after excluding those subjects with pre-existing asthma. Subjects who reported physician-diagnosed asthma were asked to have methacholine challenge testing. RESULTS: Respondents included 194 respiratory therapists (response rate, 69.5%) and 517 controls (response rate, 75.3%). After excluding respiratory therapists from the hospital at which the hypothesis was generated, there were 34 respiratory therapists (18.7%) and 30 controls (5.8%) reporting physician-diagnosed asthma. After controlling for age, smoking status, family history, atopic history, and other covariates using logistic regression, respiratory therapy carried an odds ratio of 3.2 (95% CI, 1.9 to 5.5). With analysis restricted to those who developed asthma after entering their profession, the odds ratio for respiratory therapy was 4.6 (95% CI, 2.0 to 10.4). In the validation study, 10 of 14 respiratory therapists (71%) and 6 of 10 controls (60%) had evidence of bronchial hyperreactivity. CONCLUSIONS: These results suggest a previously unrecognized excess of asthma in respiratory therapists. The excess develops after entry into the profession, and does not appear to be explained by confounding, information bias, or selection bias.

Adult↗
PubMed1988

Asbestos exposure and gastrointestinal malignancy review and meta-analysis.

The epidemiologic literature linking asbestos exposure with gastrointestinal malignancy is reviewed. Problems in comparing studies are discussed, appropriate strategies for comparison are developed, and study results are pooled using a model which accounts for both intrastudy and interstudy variability. Stratification of cohorts by dose reveals that significant asbestos exposure, as indicated by a lung cancer standardized mortality ratio (SMR) of at least 200, is associated with an elevated gastrointestinal cancer of SMR for five of six points examined [corrected].

Asbestos↗
PubMed1988

An overview of Japanese occupational health.

This paper provides an overview of Japanese occupational health and evaluates the current situation from three perspectives. Major occupational health hazards are assessed using four sources of data, showing patterns similar to those found in other advanced industrial societies. Institutional structures for occupational health policy are then examined, illustrating strengths and weaknesses of the Japanese legal and administrative systems. Trade union activities are presented, indicating the constraints of enterprise unions, and the tendency for a greater orientation toward compensation than prevention. Significant occupational health problems persist among marginal workers in Japan, including women and various minority groups. The analysis demonstrates a record for occupational health in Japan considerably more mixed than the conventional view.

Accidents, Occupational↗
PubMed1987

Cancer clusters in the workplace: an approach to investigation.

The investigation of cancer clusters has received much recent attention. In this paper we present the approach used by one company. We emphasize the need for a methodical, stepwise procedure that includes both epidemiology and industrial hygiene input, and for communication with workers throughout the investigation. Cluster investigations are expected to be most useful not in etiologic research, but rather in addressing worker concerns and as part of larger surveillance efforts.

Data Collection↗
PubMedDate not supplied

Neurobehavioral test methods for environmental health studies of adults.

The Agency for Toxic Substances and Disease Registry convened a workshop in Atlanta, GA, that evaluated approaches and methods to ascertain whether there are neurobehavioral sequelae to children and adults exposed to hazardous substances in the environment. This article, developed from that Workshop, recommends testing methods [to identify neurotoxic insult] for immediate use in environmental health field studies of adults. A list of broad functional domains or modalities affected by chemicals was identified from the occupational and related literature (learning and memory, coding, sustained attention, higher intellectual function, strength, coordination, speed, vision, somatosensory, and affect). A core set of tests was selected that should assess those functions with the greatest demonstrated sensitivity to established neurotoxic chemicals, and a secondary set was selected to assess a broader group of functions. The core tests should be used in all investigations where neurotoxic effects would be targeted for identification; secondary tests would be used where suggested by questionnaire or symptom data or by knowledge of the effects of chemicals at the hazardous waste site.

Adult↗