Rheumatoid "pneumoconiosis" (Caplan's syndrome) in an asbestos worker: a 17 years' follow-up.
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Adult↗
Biomedical subjects
I A Greaves
Publications and source records attributed to I A Greaves.
Exponential analysis of elastic recoil and aging in healthy males and females.
To examine the effects of aging on the elasticity of the lungs a single exponential function (V = A - B exp (-KP)), where V is lung volume, P is recoil pressure, and A, B, and K are constants) and a fourth-order polynomial were fitted to the static pressure-volume data from 124 healthy nonsmokers (83 males). K, the index of compliance, was independent of sex and increased with age. B/A and recoil pressures at various lung volumes were higher in males than females, but decreases with age were similar in both sexes. Static compliance (expressed as percent of total lung capacity/cmH2O), derived from the polynomial expression, was the same in males and females and increased with age. The results show that the lungs of males and females have the same intrinsic elasticity, and differences in recoil pressure depend on differences in lung size and in maximum distending forces. Loss of elasticity with age is consistent with an increase in the unstressed dimensions of alveoli and a decrease in their elastic fibers.
Adolescent↗
A school-based strategy to assess children's environmental exposures and related health effects in economically disadvantaged urban neighborhoods.
The School Health Initiative: Environment, Learning, Disease (SHIELD) study is a novel school-based investigation of children's environmental health in economically disadvantaged urban neighborhoods of Minneapolis. This article describes the study design and summarizes lessons learned about recruiting and monitoring this historically understudied population. The SHIELD study focused on measuring children's exposures to multiple environmental stressors [volatile organic chemicals (VOCs), environmental tobacco smoke, allergens, bioaerosols, metals, pesticides, polychlorinated biphenyls (PCB), phthalates] and exploring related effects on respiratory health (e.g., lung function) and learning outcomes (e.g., standardized test scores, academic achievement). It involved intensive exposure monitoring, including environmental measurements inside and outside the children's schools and inside their homes, personal measurements with passive dosimeters worn by the children, and biological marker measurements in blood and urine. The SHIELD participants comprised a stratified random sample of 153 "index" children and 51 of their siblings enrolled in grades 2-5 at two adjacent elementary schools. The Minneapolis Public Schools (MPS) assisted with identifying, contacting, recruiting, and monitoring this population, which traditionally is difficult to study because families/children are highly mobile, speak a diversity of languages, frequently do not have a telephone, endure economic hardships, often do not trust researchers, and have a spectrum of unconventional lifestyles and living arrangements. Using a school-based approach, the overall SHIELD enrollment (response) rate was 56.7%, with a wide disparity between English-speaking (41.7%) and non-English-speaking (71.0%) families/children. Most children remained involved in the study through both monitoring sessions and exhibited an acceptable degree of compliance with study protocols, including providing blood and urine samples. Results indicate that it is both practical and affordable to conduct probability-based exposure studies in this population, but that it is also important to improve our understanding of factors (e.g., cultural, economic, psychological, social) affecting the willingness of families/children to participate in such studies, with special emphasis on developing cost-effective recruitment methods.
Air Pollution, Indoor↗
Lessons learned and unsolved public health problems after large-scale disasters.
BACKGROUND: This paper examines the considerable medical and psychological problems that ensue after disasters in which massive populations are affected for extended and sometimes unknown time periods. The organization of disaster response teams after large-scale disasters is based on experiences as a medical specialist at Chernobyl immediately after this catastrophe. Optimal ways of dealing with the immediate medical and logistical demands as well as long-term public health problems are explored with a particular focus on radiation disasters. Other lessons learned from Chernobyl are explained. ISSUES: Current concerns involve the constant threat of a disaster posed by aging nuclear facilities and nuclear and chemical disarmament activities. The strategies that have been used by various groups in responding to a disaster and dealing with medical and psychological health effects at different disaster stages are evaluated. The emergence of specialized centers in the former Soviet Union to study long-term health effects after radiation accidents are described. Worldwide, there has been relatively little attention paid to mid- and long-term health effects, particularly the psychological stress effects. Problems in conducting longitudinal health research are explored. RECOMMENDATIONS: The use of a mobile diagnostic and continuously operating pre-hospital triage system for rapid health screening of large populations at different stages after a large-scale disaster is advisable. The functional systems of the body to be observed at different stages after a radiation disaster are specified. There is a particularly strong need for continued medical and psychosocial evaluation of radiation-exposed populations over an extended time and a need for international collaboration among investigators.
Disasters↗
Evaluation of the ATS respiratory diseases questionnaire among French-speaking silicon carbide workers.
The American Thoracic Society (ATS) respiratory disease questionnaire for adults was translated by two fluently bilingual Quebec health professionals into simple, everyday French easily understood by an adult population of varying age and educational background. After independent assessment by professional translators, it was field-tested on 165 silicon carbide production workers. Responses to the ATS cough questions were significantly related to those obtained by a semiquantitative estimate of cough frequency. ATS questions on cough and phlegm were significantly associated with the physical sign of productive cough on request. A significant association was found between answers to questions on mild or moderate breathlessness and self-evaluation of breathing on a linear scale. Workers with cough, wheeze, or breathlessness had significantly lower percent-predicted FEV1, and FEV1 decreased as the severity of breathlessness increased. Highly significant, dose-dependent associations with current cigarette smoking habit were found for cough, phlegm and wheeze. Significant, dose-dependent associations with phlegm, wheeze and mild breathlessness also occurred with exposure to sulfur dioxide. All of these relationships are similar to findings from studies of English-speaking populations. Minor problems with the original English ATS questionnaire were discovered on translation, and suggestions for improvements were made. Preliminary experience with this French translation suggests that it is a useful, comparable version of the English ATS questionnaire.
Adult↗
Pulmonary distensibility and ventilatory function in smokers.
To define the increase in pulmonary distensibility preceding the development of emphysema, we studied 101 cigarette-smoking volunteers, 73 males and 28 females between the ages of 18 yr and 60 yr (mean 42 yr), who were not disabled. A single exponential function fitted to deflation static pressure-volume data gave the exponent K, an index of distensibility. Total lung capacity (TLC) was measured with a body plethysmograph. Values for VC, FEV1 and mid-expiratory flow were only slightly less than values obtained in nonsmokers. K was increased in smokers and increased with age at a greater rate than in nonsmokers, but smokers were unevenly affected. In relation to height, TLC was increased in male smokers and the increase was directly related to the increase in K. The findings show that increased pulmonary distensibility may be identified in smokers without airway obstruction. Because K is directly related to the size of peripheral airspaces, increased pulmonary distensibility in smokers implies an increase in the size of airspaces caused by an action of cigarette smoke, and taking place in asymptomatic subjects.
Adolescent↗