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Biomedical subjects

K Ringen

Publications and source records attributed to K Ringen.

29 records · Page 2Linked to original sources
PubMed1985

Notification of a cohort of workers at risk of bladder cancer.

Surviving members of occupational cohorts studied in retrospective analyses of mortality usually are not notified individually of positive study results. However, concern has arisen that such results may contain risk information pertinent to study subjects. To evaluate the effects and implications of individually notifying survivors of such cohorts, we conducted a pilot notification study. Members of a cohort of 1,385 chemical workers who had handled carcinogenic amines were notified by mail that they were likely to be at increased risk of bladder cancer. Also a bladder cancer screening and follow-up program was established. The study demonstrated that notification is a complex action and that much care needs to be taken when communicating information on risk. Notification requires development of (1) criteria as to what constitutes a notifiable risk and (2) programs to meet the medical and social needs of the various parties involved in notification.

Carcinogens↗
PubMed1985

Risk assessment of a cohort exposed to aromatic amines. Initial results.

A cohort of 1,385 workers potentially exposed to carcinogenic amines was evaluated to determine the extent of its risk for bladder cancer. The cumulative incidence of bladder cancer was determined from death certificates, from interviews with community urologists, and from a screening program. A total of 13 confirmed cases of bladder cancer were identified at the conclusion of the first year of study. The entire cohort has approximately a fourfold excess risk of bladder cancer; however, black workers with more than 10 years of employment had a risk ratio of 111 (based on three cases). The onset of disease occurred, on the average, 15 years earlier in these black workers than in the general U.S. population. The cumulative incidence of bladder cancer increased with the duration of employment, ranging from 0.4% for workers with five or fewer years of employment to 36% for those with greater than 20 years. No significant differences were found between cases and noncases for cigarette smoking, coffee drinking, use of artificial sweeteners, or prior employment in high-risk occupations. More cases of bladder cancer are expected in this cohort because many members have not yet achieved the average latency found for the confirmed cases.

Adolescent↗
PubMed1984

Notification of workers at high risk: an emerging public health problem.

During the last two decades, an increasing number of epidemiologic studies have found cohorts of workers to be at high risk of work-related chronic diseases, especially cancers. These studies frequently have led to the broad recognition of occupational hazards and eventually to the prevention of exposures to such hazards. Generally, however, the individual cohort members found to be at high risk have not been notified of study results, and programs of medical intervention or of palliative services directed at these individual workers have not been developed. Recently, the issue of whether or not workers have a right to be notified more directly about known health hazards to which they may have been exposed has emerged as a major, unresolved question in public health policy. Issues of concern include the criteria that should guide notifications; whom, when, and how to notify; and who should pay for notification and follow-up services. This commentary discusses the scientific, ethical, economic, and institutional aspects of worker notification, and describes three new demonstration projects that have provided notification and intervention for workers at high risk of bladder, colon, and lung cancer.

Ethics, Medical↗
PubMed1979

Edwin Chadwick, the market ideology, and sanitary reform: on the nature of the 19th-century public health movement.

This article is an attempt to place the origin of sanitary legislation in England, and its chief proponent, Edwin Chadwick, in the overall dynamics of 19th-century social development. It examines the public health movement in light of the transition of English society into the domination of the market ideology, and the effect that this had on health. Emphasis is placed on explaining the utilitarian movement, of which Chadwick was an instrumental part, and its role in promoting the market system through the enactment of the New Poor Law in 1834. The article suggests that the enactment of sanitary reform in the 1848 Public Health Act was the unplanned reaction to the detrimental effects that the market ideology had on health in the industrial centers. The main intent of this article is to go beyond the prevailing belief that sanitary reform was a humane contribution of publicly spirited men. It concludes that this state intervention was materially necessitated: it was forced by the contradictions inherent in the market system.

England↗
PubMedDate not supplied

Why construction is different.

Construction differs markedly from many other types of manufacturing in that the nature of the work exacerbates the safety and health risks faced by workers. Even for workers who have health care coverage, the authors point out, the transient nature of the industry makes it difficult to trace an individual's exposure to health hazards.

Accidents, Occupational↗
PubMedDate not supplied

Health insurance and workers' compensation: the delivery of medical and rehabilitation services for construction workers.

The construction industry has one of the highest proportions of workers without health insurance. The authors review the two types of insurance systems that are generally used to cover the cost of health care for construction workers in the U.S.: health and welfare funds and workers' compensation. Recent developments in health care delivery in the U.S. are discussed, as are the more comprehensive occupational medicine services offered in France, Germany, The Netherlands, and Sweden.

Delivery of Health Care↗
PubMedDate not supplied

Perspectives on the future.

There is a growing trend toward new forms of labor-management cooperation, through negotiated agreements involving job-site safety and health, workers' compensation, and preventive medicine (see chapter 14). These developments are likely to change safety and health in the industry. At the same time, they provide opportunities for practitioners and researchers in occupational safety and health. If we can venture to express a professional wish, it would be to find answers to the following: How can we, as the professions concerned with the well being of workers, help preserve the characteristics of construction work that are positive while reducing the aspects of the industry's functioning that are so deleterious to health? How do we preserve the crafts with their fostering of self-esteem: through individual freedom on the job, team work, or empowerment? Meanwhile, how do we reduce the destructive patterns of work, not just on the work site, but also involving the pressures and lifestyle associated with intermittent and uncertain employment? The rewards for safety and health professionals in the construction industry are immediate and striking. Whether through the practice of safety and health or through research, results can be measured in short order. That is a professional benefit afforded by few other industries. To structure occupational safety and health programs for construction workers, the safety and health professions need to engage in the labor-management processes that are changing the industry. In construction, it is not enough to think about what needs to be done in individual workplaces. In construction, we must think industry-wide, because that is how workers are employed.(ABSTRACT TRUNCATED AT 250 WORDS)

Ergonomics↗