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Biomedical subjects

P Harber

Publications and source records attributed to P Harber.

At least 73 records · Page 4Linked to original sources
PubMed1987

Importance of non-patient transfer activities in nursing-related back pain: II. Observational study and implications.

To determine the low back stressor exposures of hospital nursing staff members, the daily activities of 63 staff members were observed and coded. In addition to direct patient contact activities, non-patient contact activities were common. Many patient contact actions were static (isometric), requiring maintenance of an antigravity position which stresses the low back. These findings suggest the need to expand the focus of work practice training, equipment redesign, and future research activities.

Adult↗
PubMed1986

Alternative partial respiratory disability rating schemes.

There is no standardized method for rating "percentage partial disability" for persons with respiratory impairment of a degree less than totally disabling. Twelve alternative schemes for using results of clinical physiologic testing for "rating" partial respiratory disability are compared by examining their effects on "ratings" of 650 actual asbestos lung disease compensation claimants. The schemes differ by basis (function remaining or function lost), presence of a quantitative "threshold," and "standard" for comparison; some estimate future disability rather than current. Large differences in performance between schemes were noted. The average ratings ranged from 17 to 57 "% Disability." The relative effects on subjects with high versus low degree of physiologic impairment differed between rating schemes. The ratings were different for subjects with different patterns of physiologic abnormality.

Disability Evaluation↗
PubMed1986

Obstructive airway disease as a risk factor for asbestos-associated malignancy.

A case-control study of a heavily asbestos-exposed group was performed to determine if obstructive airway disorder is an independent risk factor for developing asbestos-associated malignancies. From a group of 1,500 asbestos workers who had previously undergone careful evaluation, 18 case employees were identified. Each case employee was matched by smoking status, pack-years, age, and years of asbestos exposure to a single referent, a member of the same exposed population known to be free of malignancy. The spirometry results, obtained prior to the clinical manifestation of the cancer, were compared. The FEV1/FVC ratio and the FEV1/height3 ratio were lower (P less than .05, P less than .10, respectively) in the case employees. These results suggest that obstructive airway disease may be an independent risk factor for cancer.

Adult↗
PubMed1985

Is the MVV:FEV1 ratio useful for assessing spirometry validity?

The ratio between the maximal voluntary ventilation (MVV) and the forced expiratory volume in one second (FEV1) has been proposed as an indicator of the adequacy of a subject's efforts in disability determinations and other spirometry applications. Data from a large population of industrial workers tested in a university pulmonary function laboratory were examined and a smaller clinical population was used to validate the conclusions. The MVV:FEV1 ratio was not affected to a clinically significant degree by age, degree of functional abnormality, or administration of an aerosolized bronchodilator. The ratio was too variable to be of use in determining whether an individual's results are reliable, but the determination of the average ratio for a large group of subjects may be useful in evaluating the overall performance of a spirometry laboratory.

Adult↗
PubMed1985

Value based interpretation of pulmonary function tests.

Two contrasting errors in spirometric interpretation are the inappropriate conclusion of "normality" (type I) and of "abnormality" (type II). A survey of 67 health professionals showed major interpersonal and intersituational differences in opinion about the optimal relative proportions of type I and type II errors. This suggests the need for caution in the commonly employed practice of interpretation based on a 5 percent false positive rate.

False Positive Reactions↗
PubMed1985

Occupational low-back pain in hospital nurses.

A survey of hospital staff nurses of a large tertiary care hospital was performed to investigate occupational low-back pain. Attack rates of 41% (37% "occupational") and 52% (occupational) were found using recall periods of two weeks and six months, respectively. Comparison with a control group suggests the validity of the work-relatedness of low-back pain in nurses. Factors associated with the disorder were also investigated, with results showing no differences due to nursing division assignment but significant association with specific tasks.

Adult↗
PubMed1985

Clinical decision analysis in occupational medicine. Choosing the optimal FEV1 criterion for diagnosing occupational asthma.

Clinical decision analysis techniques may be particularly valuable in occupational medicine. A simple decision analysis model for choosing the "best" criterion for change in forced expiratory volume in 1 s (FEV1) for diagnosing occupational asthma is presented. Unlike the traditional statistical approach to selecting criterion values, it considers more of the factors that affect clinical decision making, including the value of possible outcomes. This also illustrates the effect of alternate administrative goals such as maximizing benefit to the individual, minimizing cost, or optimizing the cost-benefit ratio.

Asthma↗
PubMed1984

Effects of exercise using industrial respirators.

Respirators (respiratory personal protective devices), used for protection against occupational toxic exposures, may impose flow resistance and dead space respiratory loading. Effects of exercise level, a 300 mL deadspace and single respirator cartridge inspiratory load were determined in ten healthy volunteers. Subjects tended to limit peak work rate (pressure generated and pressure X flow) and to prolong the inspiratory portion of the respiratory cycle due to respirator use. O2 consumption and heart rate were not significantly affected. The qualitative response was not affected by exercise level. During submaximal exercise, normal subjects did not reach their compensation limits for the variables studied.

Heart Rate↗
PubMed1984

Static ergonomic strength testing in evaluating occupational back pain.

Quantitatively describing work limitation due to occupational back pain is difficult. Static ergonomic strength testing (SEST) was employed as part of a multidisciplinary evaluation program for occupational back pain, providing a quantitative description of lift ability in several positions. Comparison of intrasubject with intersubject variation confirmed that SEST did truly measure a personal characteristic. The expected degree of intrasubject variability is independent of the degree of impairment and provides a guide for detecting inadequate subject efforts. The technique allows worker-specific work restriction limitations to be recommended.

Back Pain↗
PubMed1984

Estimation of the exertion requirements of coal mining work.

The work requirements of coal mining work were estimated by studying a group of 12 underground coal miners. A two level (rest, 300 kg X m/min) test was performed to estimate the linear relationship between each subject's heart rate and oxygen consumption. Then, heart rates were recorded during coal mining work with a Holter type recorder. From these data, the distributions of oxygen consumptions during work were estimated, allowing characterization of the range of exertion throughout the work day. The average median estimated oxygen consumption was 3.3 METS, the average 70th percentile was 4.3 METS, and the average 90th percentile was 6.3 METS. These results should be considered when assessing an individual's occupational fitness.

Adult↗
PubMed1984

Medical evaluation for respirator use.

Medical certification for respirator use should be based on understanding of their respiratory, cardiac, mechanical, psychological, and other effects. Work environmental factors (e.g., level of hazard and work load of the job), respirator characteristics, and personal characteristics of the worker should determine the evaluative procedures used; a three-level scheme is suggested.

Humans↗
PubMed1983

Statistical "biases" in respiratory disability determinations.

The manner in which pulmonary function test results are employed in the assessment of respiratory disability may be affected by 4 statistical choices: (1) choice of prediction equation(s), (2) adjustment factors (such as sex and race), (3) criterion values, and (4) method of comparison of observed to predicted normal test values. The records of 900 respiratory disability applicants were employed to estimate the direction and magnitude of the effect of these choices on the overall number of persons who would be declared "disabled" and upon the manner in which personal characteristics (e.g., sex, race, height, age) affect the likelihood of being declared "disabled." Choice of prediction equation had minor effects, and adjustment for race and sex had more significant effects. Choice of criterion value affected the overall number and, in certain instances (e.g., Social Security Disability Insurance), the distribution of "disability" declarations. Method of comparison (percent of predicted, difference of predicted minus observed or minimal value criterion) had major effects upon the distribution of "disability" declarations between population subgroups. Preliminary analysis therefore suggests that these statistical choices should be carefully manipulated in the design of a disability system to facilitate achievement of the system's goals.

Age Factors↗
PubMed1982

Physiologic effects of respirator dead space and resistance loading.

Air-purifying respirators impose several loads on breathing. The effects of inspiratory flow resistance, respiratory dead space such as that of a full-face mask, and moderate exercise and maximal exercise were assessed alone and in combination in nine normal volunteers. There were significant effects on respiratory timing variables (e.g., inspiratory time, inspiratory: expiratory time ratio), peak mouth pressure and peak inspiratory flow rate. Only minimal effects on heart rate were noted. These results suggest that prospective workers who must utilize respirators should be observed during exercise as well as at rest and that a respirator dead space and inspiratory resistance should not produce a significant heart rate change but should lead to adaptation of the inspiratory: expiratory time ratio. Workers who show atypical responses should be assessed particularly carefully.

Adult↗
PubMed1981

Prevention and control of occupational lung disease.

Prevention is the ultimate purpose of efforts to identify and understand occupational lung diseases. A major challenge for this decade will be the effective implementation of preventive programs which allow utilization of the developing information base on incidence and pathogenesis. Much of the basic methodology for prevention has yet to be developed, and many basic social and philosophic decisions will be forthcoming. It is clear that prevention of occupational lung disease will require a cooperative effort among pulmonary physicians, occupational physicians, epidemiologists, industrial hygienists, basic researchers, toxicologists, government regulators and members of many other disciplines.

Dust↗
PubMed1981

Fatal lung abscesses: review of 11 years' experience.

A review of the outcome of 440 patients hospitalized between 1967 and 1977 because of lung abscess showed that 41 died (case fatality rate = 9.3%). Major predisposing factors were present in many of the fatal and nonfatal cases. Advanced age and concomitant diseases were associated with a higher risk of death. Aspiration of contents of large cavities may have played a major role in the death of seven patients.

Adult↗