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Biomedical subjects

J Ribak

Publications and source records attributed to J Ribak.

At least 73 records · Page 4Linked to original sources
PubMed1995

Needlesticks in medical students in university hospitals.

The incidence of needlesticks and the effect of experience and other personal characteristics on the risk of needlesticks in medical students are unknown. Eighty-nine medical students were given a self-administered questionnaire. The questionnaire was completed by 86 students, and there were 91 sticks in 43 students. The incidence of needlesticks was 5.8/1000 procedures on the first rotation and 0.1/1000 during the second 4-month period (relative risk, 6.5, with 95% confidence interval (CI) of 3.4-125; P < 0.001). Personal characteristics were not associated with needlesticks except for tension felt while drawing blood and accident proneness. Those who were stuck during the first rotation were more likely to be stuck subsequently (odds ratio, 9.0, with 95% CI of 1-422; P < 0.05). We conclude that experience decreases the risk for needlesticks and therefore effective instructional intervention may have the biggest impact during the first medical student ward experience. Emphasis may have to be placed on those students who are accident prone or have been stuck in the past. Further studies are warranted to substantiate our findings and to test the effectiveness of various interventional approaches.

Adult↗
PubMed1995

Seasonal changes in ambulatory blood pressure in employees under different indoor temperatures.

OBJECTIVE: The effect of indoor temperature control on summer and winter ambulatory blood pressure levels at work was studied. METHOD: Ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored once in summer and once in winter in 101 healthy normotensive subjects aged 28-63 years, engaged in similar physical work, from two plants with and three without air conditioning. Subjects were interviewed about health related habits, and measurements of environmental and occupational conditions were obtained. RESULTS: After controlling for possible confounders, mean SBP and DBP during work were significantly higher in winter than in summer (delta SBP = 3.4 mm Hg, P = 0.035; delta DBP = 3.3 mm Hg, P < 0.003). The seasonal change in SBP and DBP showed an independent association with the presence or absence of air conditioning of the industrial plants (SBP: beta = 0.194, P < 0.0001; DBP: beta = 0.054, P = 0.038). The percentage of subjects with increases of more than 10 mm Hg from summer to winter was higher in plants without than with air conditioning. CONCLUSIONS: (1) In normotensive subjects ambulatory working BP varies by season, with higher values in winter. If validated for hypertensive subjects, it may be necessary to tailor drug treatment to these variations. (2) The findings make it clear that drawing valid conclusions from comparisons of BPs between groups requires controlling for several factors, particularly season of the year. (3) Climatic conditions in the industrial plant influence the magnitude of seasonal variations in BP. Work in plants without air conditioning places a considerable added load on the employee's cardiovascular system.

Adult↗
PubMed1995

Heart rate variability in health and disease.

Beat-to-beat fluctuations in heart rate (HR) or instantaneous HR is mainly determined by activity of the cardiac sympathetic and parasympathetic systems. Despite the need for standardization in methodology to facilitate the interpretation and comparison of results, the data presented in this review clearly show that there are individual differences in heart rate variability (HRV) and that these differences partly reflect differences in the degree of parasympathetic and sympathetic stimulation of the heart. HRV and its spectral components can be easily and noninvasively assessed and can provide valuable information to the occupational physician. Measurements of HRV and the quantification of its spectral components are powerful predictors of cardiovascular morbidity and mortality. Therefore, it may help assess the return to work of patients with ischemic heart disease. Studies in the workplace can also indicate the effects of various stresses of the work environment on such patients and even on asymptomatic workers.

Arrhythmias, Cardiac↗
PubMed1995

Use of asbestos in expected and unexpected places in Israel.

The main human exposures to asbestos in Israel were in manufacturing and processing of asbestos-cement products, removing and fixing brakes and clutches for vehicles, removing old insulation containing asbestos in various plants, and in preparing and using textile products containing asbestos. Asbestos is still used in Israel, even though its health hazards are well described in the medical literature. In this paper current asbestos use in Israel is described. We emphasize the "less expected" places where asbestos was found in Israel. The detection of asbestos in unexpected places requires that we stay alert and constantly search for asbestos in every workplace and residence and in the environment.

Asbestos↗
PubMed1995

Common accidents among airport ground personnel.

Work-related accidents at the airport are common, but the incidence and type of such events occurring in aviation ground personnel have not been reported previously. Information regarding the most common ground accidents at the airport is essential in order to implement prevention programs. The purpose of this study was to examine the descriptive epidemiology of injury-producing accidents among ground personnel at a modern airline. In this study we recorded all reported accidents occurring over a 5-year period (1988-92) to workers of a major airline in Israel that resulted in 3 d or more of absence from work. During the study period 523 work-related accidents occurred in 2000 ground workers. The most common accidents were due to slips, trips and falls (n = 211, 40.3%), lifting and carrying accidents (n = 107, 20.4%), and machinery accidents (n = 98, 18.7%). Work transport accidents and accidents from physical and chemical exposures were less common (n = 67, 12.8%, and n = 40, 7.5%, respectively). The accident rate decreased from 71 accidents/1,000 worker-years in 1988 to between 40-56 accidents/1,000 worker-years in the subsequent 4-year period (p = 0.0002). We conclude that slips, trips and falls are the most common cause of accidents in airport ground personnel. Further studies in other airports are warranted to confirm our findings.

Accidents, Occupational↗
PubMed1994

Teaching stress management skills to occupational and environmental health physicians and practitioners. A graduate-level practicum.

The World Health Organization Study Group on Training and Evaluation in Occupational Medicine has emphasized recently the importance of incorporating theoretical and practical aspects of primary and secondary prevention of stress in the professional training of occupational health practitioners. This paper describes such a course developed for the Tel-Aviv University Medical School graduate program in occupational health. The course objectives are consistent with the current call for improved training in psychosocial issues in medical care. Twenty-three occupational health practitioners (physicians, nurses, hygienists, and social workers) participated in a bisemester course. The first part included a stress management and prevention program based on the Rational-Emotive Training model. The main aim was to reduce irrational or dysfunctional thinking, which is considered a causal factor in stress and burnout. The second part involved the development and implementation of a field project on primary and secondary prevention of stress and its outcomes. Precourse, midcourse, and postcourse questionnaires showed a significant improvement in participants' psychosocial ability and a reduction in dysfunctional thinking compared with the control group. Such antistress resources may benefit practitioners and clients or patients alike, both potential victims of occupational stress.

Adult↗
PubMed1994

Teaching interpersonal skills to occupational and environmental health professionals.

An innovative course for teaching communication and interpersonal relationships was delivered to 29 environmental and occupational health professionals. This course aimed to highlight interpersonal and emotional aspects in the professional-client interaction and incumbent communication aspects when consulting team members, colleagues, and nonprofessionals in the occupational arena. Various experiential and other teaching techniques were used. Assessment showed that participants reported the positive features of such a course although few changes in either psychosocial abilities or awareness were evident. Possible ramifications of the findings are discussed.

Adult↗
PubMed1994

Treatment of post-traumatic stress disorders: an applied rear-echelon approach.

This paper presents an applied innovative rear-echelon approach for the treatment of recalcitrant soldiers suffering from post-traumatic stress disorder in the 1982 Lebanon-Israel War. This was used as an alternative to psychiatric hospitalization. Use was made of a short-term, goal-directed, multidisciplinary treatment approach within the confines of a clear military setting. Reintegration into military and civilian life was an integral part of the program. Results indicated that at discharge, all soldiers showed a markedly improved clinical picture. Follow-up results 2.5 years later indicated that the percentage of regulars who returned to combat units doubled, whereas the reservists showed a slight tendency toward deterioration. Follow-up 6 years later showed the continuation of the same tendency. Ramifications of our findings are extensively discussed.

Adolescent↗
PubMed1994

Developing psychosocial mindedness and sensitivity to mental health issues among primary care nurses using the Balint group method.

This study empirically evaluated the impact of a Balint group for primary care nurses on awareness of mental health and psychosocial issues and professional psychosocial efficacy. Thirteen female primary care nurses working in community clinics participated in a year-long fortnightly Balint group led by two psychologists at a regional school of nursing. Cases were presented and analyzed to highlight emotional and cognitive components and processes. Changes in professional psychosocial efficacy were assessed with the Psychological Medical Inventory (PMI). Efficacy components were (a) psychosocial abilities, (b) psychosocial sensitivity. Changes in these components and in perceived mental health topics were assessed over three time points: at initial interview, midway through group and at the end. Significant positive changes were found on both efficacy components at the final measure compared to baseline. This study indicates the beneficial effects of this method in training primary care nurses in psychosocial efficacy. It also highlights the importance of ongoing long-term training programs for mental health and psychosocial efficacy in this professional group.

Adult↗
PubMed1993

The correlation between blood and urine level of cadmium and nasal and paranasal sinuses disorders.

Over exposure to cadmium may produce numerous adverse health effects, including changes in the nasal mucosa. Cadmium levels were measured in blood and urine samples taken from 106 workers who were exposed to high levels of cadmium and nickel in a cadmium nickel battery plant. Pathological results were observed in 46% and 51% of the blood and urine samples respectively. A positive association was found between clinical nasal complaints and pathological levels of cadmium in blood (P = 0.006) and urine (P = 0.045) samples. All the workers underwent sinus X-rays and 63% of them were abnormal. No correlation was found between pathological sinus X-rays and pathological cadmium level in blood and urine samples. A positive correlation was found between clinical nasal complaints and abnormal sinus X-rays. The prevalence of sinus X-ray abnormalities in an asymptomatic general population is 33% as compared to 63% in our study. This difference is highly significant statistically (P < 0.0001). Our result shows a possible harmful effect of cadmium on the paranasal sinuses.

Adult↗
PubMed1993

Heat stress and helicopter pilot errors.

Helicopter pilots are subjected to degrees of heat stress that under laboratory conditions result in decreased performance. However, the effect of heat stress on the frequency of helicopter pilot errors is uncertain. The purpose of this study is to determine whether there is an association between ambient heat stress and pilot error. The records of 500 helicopter accidents and incidents due to pilot error during the months May through October were selected at random. On the day of the event, ambient dry bulb and wet bulb temperatures were recorded and compared to temperature and humidity readings on 1000 days chosen at random over the same time period, after eliminating days where events occurred. There was a significant difference between the dry temperature distributions of the days with pilot error compared with the control group (chi 2 = 47.54, P < .0001). A dose-response relationship was found, with a significantly lower risk when ambient dry bulb temperatures were 25 to 29 degrees C (odds ratio, 0.6; 95% confidence interval, 0.5 to 0.8, P < .0001), an increased risk of 1.6 (1.3 to 2.0, P < .0001) at 30 to 34 degrees C, and the highest risk at 35 degrees C or more (6.2, 95% confidence interval, 2.1 to 21.8, P < .0002). There is a dose-response relationship between ambient heat stress and pilot error in Israel military helicopter pilots. This is the first study outside the laboratory showing a connection between heat stress and accidents due to human error. Further studies are required to substantiate our findings and to determine whether extrapolation to other settings is warranted.

Accidents, Aviation↗
PubMed1992

[Occupational scleroderma due to organic solvent exposure].

Progressive systemic sclerosis (PSS; scleroderma) is a multisystem disease characterized by inflammation, fibrosis and degeneration of the integument, with similar changes and vascular lesions in the heart, lungs, kidneys, gastrointestinal tract and synovia. Its etiology is not clear. Several occupational exposures have been implicated as potential causes of PSS and scleroderma-like diseases. Among them are vinyl chloride monomer, silica dust, epoxy resin, and benzene and other solvents, aromatic and aliphatic, specifically chlorinated (trichloroethylene, perchloroethylene and trichloromethane). We present a patient whose illness was diagnosed as occupationally induced PSS. During 13 years of work renovating carburetors he was heavily exposed to trichloromethane. To the best of our knowledge this is the first reported case of PSS due to exposure to organic solvents in Israel; very few cases have been reported from abroad.

Adult↗
PubMed1992

Adverse health effects in workers exposed to cadmium.

One hundred fifty-two workers who had been exposed to different levels of cadmium (Cd) absorption (blood Cd mean 16.34 micrograms/L, median 11.0 micrograms/L) in a factory making nickel-cadmium batteries were studied. A physical evaluation, as well as blood and urine cadmium and N-acetyl-beta-D-glucosaminidase (NAG), and other routine laboratory tests were performed in order to assess the relationship between different levels of exposure to occupational cadmium and potential cadmium-induced renal damage and other adverse health effects. We found significant correlation between levels of cadmium exposure and a selected group of symptoms and signs. The best predictor of this group of symptoms and signs was an indicator called internal dose index (Cd x exposure time). This indicator appears as the strongest, even after control by confounding factors, such as age and smoking. It is concluded that this index can be used for biological monitoring.

Adult↗
PubMed1992

Survival of asbestos insulation workers with mesothelioma.

Malignant mesothelioma is a lethal disease. It is rare in the general population; however, workers exposed to asbestos suffer significant burdens of the neoplasm. The survival time of 457 consecutive fatal cases of pleural and peritoneal mesothelioma that occurred among 17,800 asbestos insulation workers observed prospectively from 1 January 1967 to 1 January 1987 was studied. Mean survival time from initial presentation of the disease to death was 11.4 months for the pleural mesothelioma patients compared with 7.4 months for the peritoneal group. This difference was statistically significant. Mean survival time from diagnosis to death was shorter for both groups of patients: 8.4 months for pleural mesothelioma v 5.8 months for the peritoneal cases. In conclusion, survival time in mesothelioma patients is short; most die within a year from the onset of the initial symptoms. No effective therapy is yet available.

Age Factors↗