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Biomedical subjects

P C Elmes

Publications and source records attributed to P C Elmes.

At least 19 recordsLinked to original sources
PubMed1982

Lung function and radiographic change in chrysotile workers in Swaziland.

The effect on lung function and radiographic indices of exposure to chrysotile asbestos was investigated by cross-sectional studies in two groups of men at Havelock Mine, Swaziland. The first group consisted of 214 employees and ex-employees, mean age 52, who had been employed for at least 10 years, and whose dust exposure ranged from minimal for surface workers to very heavy for those in the grading and bagging sections of the mill. In this group 29% had category 1 or more simple pneumoconiosis and 4.5% category 2 or more. For surface and mine workers, the estimated annual deterioration in FEV1 and FVC and the increase in category of pneumoconiosis was similar to that due to age alone, while the heaviest exposure almost doubled the decline in lung function and trebled the rate of progression of pneumoconiosis. The second group consisted of 224 men, mean age 33, all currently working in the mill and having been employed there for at least a year. In this group 30% had category 1 or more simple pneumoconiosis, and 2.7% category 2. Exposure in the dustiest sections of the mill more than doubled the estimated annual decline in lung function and doubled the rate of progression of pneumoconiosis.

Adult↗
PubMed1981

Relative importance of cigarette smoking in occupational lung disease.

Since 1900 respiratory disease has remained a constant serious cause of chronic ill health and premature death in Britain. The falling importance of tuberculosis and pneumonia has been off-set by the rise in lung cancer. Bronchitis morbidity and mortality have fallen only slightly since 1935. To produce any real improvement in the future existing information as to cause must be studied. The relative contribution of occupational exposure is compared with the importance of cigarette smoking. Relevant information is scanty and has been produced to emphasise the existence of occupational diseases rather than assess their importance to the community as whole. In Britain the evidence is that within the coal mining and iron and steel industries conditions are now such that dust exposure contributes little to the morbidity or mortality compared with the workers' smoking habits. Similar results have been shown by a cross-sectional survey of many dusty occupations in Western Germany. Only in the disappearing Welsh slate industry has dust disease been at least as important as smoking. Until the current regulations were introduced conditions existed among asbestos workers such that the combined effect of cigarette smoking and dust exposure led to a loss of life expectation of over 10 years in moderate smokers. Since the new regulations were introduced the risk for asbestos workers should approximate to that for other industrial workers. While control of occupational exposure to respiratory hazards remains important, a far greater improvement to respiratory health would be produced by controlling tobacco smoking.

Age Factors↗
PubMed1977

Insulation workers in Belfast. A further study of mortality due to asbestos exposure (1940-75).

A follow-up study of 162 men already working as insulators (laggers) in 1940 has been extended from 1965 to 1975. By the end of 1975 there were 40 survivors when 108 had been expected. Until 1965 there had been an overall excess of deaths; these were due to asbestosis with or without tuberculosis and to alimentary cancer, as well as to bronchial carcinoma and mesothelioma. From 1965 onwards the overall death rate among survivors is not so excessive but there is still a marked excess of deaths from bronchial cancer and mesothelioma. The continued risk of death attributable to malignancy after asbestosis had ceased to contribute directly, does not appear to be caused by any changes which occurred before 1940 in the conditions at work.

Adult↗
PubMed1976

The clinical aspects of mesothelioma.

Three hundred and twenty-seven cases of mesothelioma accepted by a panel of pathologists have been used to construct a clinical picture of the disease. The cases analysed died between 1 January 1960 and 31 December 1969 and consisted of 267 pleural, 37 peritoneal, and 23 cases which could have arisen in either site. Two hundred and sixty-eight were in men and 59 in women and the disease appeared to be the same in women as in men. The mean age at death was 59-37 (+/- SD 9-89) years but ranged from 29 to 88 years. The mode of onset was insidious in all but a few cases and the mean interval before reaching the hospital was 3-39 (+/- SD 4-64) months for pleural and 3-08 (+/- SD 3-22) for peritoneal cases. Patients usually noticed a dull non pleuritic pain first but suffered some breathlessness, lassitude and weight loss by the time they reached hospital. On examination there was little evidence of disease apart from the signs of pleural effusion or thickening or ascites. Clubbing and signs of asbestosis were rare except in the peritoneal cases who more frequently gave an occupational history of heavy exposure and showed the radiological consequences of this. At the time when these patients were investigated diagnostic procedures were unrewarding and many patients were only diagnosed in retrospect. The prognosis was somewhat better for patients shown to have mainly epithelial cell tumours, 17-89 (+/- SD 18-26) months, predominantly spindle cell lesions surviving on the average only 7-98 (+/- SD 8-55) months and mixed tumours 11-3 months. The criteria for the early clinical diagnosis are described with a view of facilitating the search for effective treatment.

Adult↗