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Biomedical subjects

P Harber

Publications and source records attributed to P Harber.

At least 19 recordsLinked to original sources
PubMed1992

Upper extremity symptoms in supermarket workers.

Upper extremity symptoms in supermarket workers, particularly those who performed checking using laser scanners, were evaluated using a questionnaire administered by trained interviewers to 124 supermarket workers. Summary indices of exposure (short-term and long-term) as well as indices of past personal illnesses and personal activities were employed. Outcome data were summarized by four composite symptom indices. Chi square and logistic regression analyses demonstrated that hours of checking work in the preceding 2 weeks and cumulative weighted years of work were associated with adverse upper extremity symptoms. Symptoms involved both the proximal and distal parts of the upper extremities.

Adult↗
PubMed1992

Assessing occupational disability from asthma.

Asthma is receiving increased attention as a cause of occupational disability, both by virtue of occupational causation and by interactions between work and pre-existing asthma. Reasons for the failure of pneumoconiosis-related disability evaluation systems to be applicable to asthma are discussed, including the inherent variability of asthma, its responsiveness to treatment, and its variable time course with respect to occupational exacerbation. A distinction is made between the trait of airway hyperresponsiveness and the disease of asthma. A scheme for organizing reports about asthma-related disability clearly specifies the questions that need to be addressed.

Airway Resistance↗
PubMed1992

Respiratory disability. The uncoupling of oxygen consumption and disability.

In the past it was believed that respiratory disability could be objectively assessed by comparing the measured O2 consumption requirement of the job with the subjects' measured or estimated maximal oxygen consumption. More recently, it has become clear that this "classic" paradigm does not completely apply to all situations. This article reviews recent aspects of respiratory disability assessment.

Asthma↗
PubMed1992

The new workplace accommodation guidelines.

The Scientific Board of the California Medical Association presents the following inventory of items of progress in occupational medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in occupational medicine that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Occupational Medicine of the California Medical Association, and the summaries were prepared under its direction.

Persons with Disabilities↗
PubMed1992

The ergonomic challenge of repetitive motion with varying ergonomic stresses. Characterizing supermarket checking work.

Many jobs leading to a risk of cumulative trauma do not have highly stereotyped motions. This study developed and employed a novel method of ergonomic characterization to describe quantitatively the actions associated with grocery checking. Fifty workers were videotaped for three 15-minute segments each. Eight object types were selected to represent the variety of items in a supermarket. Nine types of motion were coded for each of the eight objects for 10 replications for each subject. The motions coded were: grip type (power versus pinch), wrist flexion, wrist extension, radial deviation, ulnar deviation, supination, pronation, body (lumbar) flexion, and drag versus lift. The results were then weighted according to relative frequency of the object type. In this manner, an ergonomic risk index can be assigned to each specific object type. This method permits identification of objects presenting the greatest risk. It also allows specificity of preventive interventions (object redesign, work practice change) as well as providing a quantitative measure to evaluate work station redesign. Furthermore, it has the potential of quantitatively describing the risk of each individual worker.

Cumulative Trauma Disorders↗
PubMed1991

The structure of expert diagnostic knowledge in occupational medicine.

Development of an artificial intelligence expert system for diagnosing occupational lung disease requires explicit specification of the structure of knowledge necessary in clinical occupational medicine independent of the process by which the knowledge is utilized. Furthermore, explicit recognition of sources of uncertainty is necessary. Seven categories of knowledge define the diagnostic knowledge base in occupational pulmonary medicine. These include four objects (jobs, industries, exposures, and diseases) and three relationships between pairs of objects. This analysis demonstrates some of the unique aspects of occupational medicine expertise.

Algorithms↗
PubMed1991

Physiologic and subjective effects of respirator mask type.

The effect of alternate airflow path designs on full-face mask air-purifying respirators was assessed in 14 healthy volunteers during submaximal exercise. Respirator designs included no respirator (N), full-face mask, dual-cartridge with no nasal deflector (FN), full-face mask respirator with nasal deflector (FD), and a powered air-purifying respirator (PA). Physiologic effects were measured by using respiratory inductive plethysmography and subjective responses by two visual analog scales. There were significant effects of airflow path design upon the physiologic parameters of ventilation, tidal volume, and mean flow rate. There were no significant physiologic or subjective differences between the full-face mask respirators with and without the nasal deflector in place. The PA had less physiologic impact than the nonpowered models but did not show significant subjective benefit. The study suggests that both subjective and objective physiologic responses must be utilized in assessing respirator design.

Adult↗
PubMed1991

Respirator physiology research: answers in search of the question.

Adverse effects of respirators have been the focus of considerable research over the past decade. Individual research projects have generally focused on one specific category of effects: ventilatory, respiratory control, work limitation, subjective discomfort, psychologic effects, thermal loading, and cardiovascular changes. Most were studied in experimental laboratory situations rather than in actual worksites. Very little attention has been given to compliance with use and actual effectiveness in preserving health. Inasmuch as many types of effects have been demonstrated, there is a need to carefully define which type(s) of effects is/are most important for respirator design selection and worker medical certification in particular situations. In general, respirators should be assessed for their effect on all relevant variables.

Adaptation, Physiological↗
PubMed1991

Artificial intelligence-assisted occupational lung disease diagnosis.

An artificial intelligence expert-based system for facilitating the clinical recognition of occupational and environmental factors in lung disease has been developed in a pilot fashion. It utilizes a knowledge representation scheme to capture relevant clinical knowledge into structures about specific objects (jobs, diseases, etc) and pairwise relations between objects. Quantifiers describe both the closeness of association and risk, as well as the degree of belief in the validity of a fact. An independent inference engine utilizes the knowledge, combining likelihoods and uncertainties to achieve estimates of likelihood factors for specific paths from work to illness. The system creates a series of "paths," linking work activities to disease outcomes. One path links a single period of work to a single possible disease outcome. In a preliminary trial, the number of "paths" from job to possible disease averaged 18 per subject in a general population and averaged 25 per subject in an asthmatic population. Artificial intelligence methods hold promise in the future to facilitate diagnosis in pulmonary and occupational medicine.

Artificial Intelligence↗
PubMed1991

Relative effects of flow-resistive and pressure-biased respiratory loading.

The effects of pressure-biased breathing (PBB), which simulates positive pressure respirator use, were studied in 15 volunteer subjects during laboratory exercise. PBB was compared with inspiratory resistance: dead space (ID) load and a no-load (N) situation. PBB had adverse subjective effects comparable with those of ID. Physiologically, PBB led to a small decrease in inspiratory time and an increase in expiratory time as well as an increase in the intensity of ventilatory effort as measured by the mean inspiratory flow rate. It is postulated, based on these findings, that PBB has significant effects on the resting lung volume, leading to both physiologic and subjective consequences.

Adult↗
PubMed1991

Work coding: beyond SIC and SOC, BOC and DOT.

Traditional coding schemes for occupational health related factors (eg, SIC, SOC, CAS) are structured similarly as hierarchical, exclusive, and exhaustive systems. Each is limited to information of one particular type (eg, industry) and, therefore, the relationships implicit in the coding scheme are limited. This study empirically determined that "natural" coding schemes used by occupational health professionals do not share these characteristics but are more akin to semantic network data bases. There is therefore a need to re-evaluate how occupational data are to be coded.

Databases, Factual↗
PubMed1991

Asbestosis: diagnostic dilution.

The term "asbestosis" usually has been applied to a disease characterized by diffuse pulmonary interstitial fibrosis. It was often associated with a significant adverse impact on the individual. A review of case definitions employed in published research studies show stability of the criteria for asbestosis case definitions over the past decade. Nevertheless, additional modalities have been suggested for the early diagnosis of asbestosis. It is probable that the significance of such abnormalities may be different from that of usual asbestosis, and there is therefore a need to carefully define the manner in which the terms are used. Additional anomalies may be seen in asbestos-exposed individuals including small airway physiologic abnormality, pathologic evidence of inflammation near the airways, positive gallium scan, abnormal lung compliance, exercise test abnormalities, CAT scan findings, and high-resolution CAT scan findings.

Asbestosis↗
PubMed1990

Effect of exercise level on ventilatory adaptation to respirator use.

The effect of exercise on the adaptation to an air-purifying respirator type load (dead space + inspiratory resistance) was studied in a group of 13 volunteers with a rapidly incremental exercise protocol. The difference between loaded and unloaded breathing at each exercise level was determined for each subject for a series of parameters describing the ventilatory work to overcome the respirator load pattern of breathing and metabolic work. Linear regression and t tests determined the average effect of the respirator load and the extent to which this effect was affected by the level of exercise. The inspiratory time and duty cycle were increased by the load, and exercise did not significantly affect the magnitude of this adaptation. High exercise did, however, increase the magnitude of the effect of the respiratory load on ventilatory work. These findings suggest that constraints to respiratory pattern adjustment, which may decrease respirator tolerance, occur at high exercise levels.

Adaptation, Physiological↗
PubMed1989

Effects of respirator dead space, inspiratory resistance, and expiratory resistance ventilatory loads.

The effects of respiratorlike inspiratory resistance (IR), expiratory resistance (ER), and dead space (DS) were assessed in a group of 11 normal volunteers during moderate steady-state (SS) and rapidly incremented (RI) exercise. The physiologic effects of IR were predominant, increasing inspiratory time, duty cycle, and several measures of ventilatory work. Effects of DS appear related to increased minute ventilation and include increasing flow rates and duty cycle and requiring greater ventilatory work; during RI exercise, the DS effect became relatively smaller at higher exercise levels. ER compressed expiratory time. These results characterize the response to IR, ER, and DS loads and suggest that DS may be relatively less physiologically significant than IR.

Airway Resistance↗
PubMed1989

Noninvasive measurement of respirator effect at rest and during exercise.

Ventilation and respiratory timing during rest and exercise were measured in normal volunteers by pneumotachograph and by respiratory inductive plethysmography (RIP) to determine if RIP is accurate and to determine if the usual methods of ventilation measurement during respirator research lead to artifacts. Data were collected with a mouthpiece, a sham mouthpiece, and no mouthpiece. A dead space and inspiratory resistance load similar to respirators were employed also. The study showed that no significant artifact is produced, particularly during exercise, by measurements using a mouthpiece. RIP is sufficiently accurate and precise for use in unobtrusively measuring ventilation during respirator studies when traditional methods cannot be used.

Humans↗
PubMed1989

Relationship of subjective tolerance of respirator loads to physiologic effects and psychophysical load sensitivity.

The degree to which subjective tolerance of respirator loads is related to physiologic effects and to psychophysical load sensitivity was investigated in this study. Fifty-two normal volunteers walked on a treadmill while breathing through a variety of respirator-type resistance and dead-space loads. Visual analog scales measuring perceived time limit of exercise and discomfort were both related to the ventilatory work imposed by the loads. Respiratory timing was related to discomfort but not to time limit. Psychophysical sensitivity to added resistive loads (LSS) was measured by the magnitude estimation method. Persons with higher objectively measured LSS had greater subjective intolerance induced by respirator use than persons of lower LSS. These findings suggest that subjective respirator tolerance is related to a person's psychophysical characteristics and to the actual physiologic effects. Furthermore, discomfort may be dissociated from actual exercise limitation.

Efficiency↗