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Biomedical subjects

P J Baxter

Publications and source records attributed to P J Baxter.

At least 37 records · Page 2Linked to original sources
PubMed1991

Research in occupational health. The UK National Health Service.

The creation of over fifty consultant posts in occupational medicine in the National Health Service in the last few years has paved the way for the development of occupational health research in the health services in the United Kingdom. General research topics that await further study include: health inequalities amongst health care workers, the Sick Doctor and Sick Nurse; job stress, back problems, pregnancy, and infection risks from blood. Topical specific hazards include glutaraldehyde, cytotoxic drugs, nuclear magnetic resonance imaging, and implications of new technology in surgery. The coordination of databases across different district health authorities would create large populations for epidemiological research, such as the surveillance of sentinel diseases, the delivery of occupational health services and vaccination strategies. Occupational health should be seen as an integral part of delivering health care and adequate funding for occupational health research should be made available.

Occupational Medicine↗
PubMed1991

Factors relating to the development of respiratory symptoms in coffee process workers.

After several cases of occupational asthma had been reported in a coffee processing factory in England, 197 coffee workers representing 80% of the production workforce were studied to determine the factors affecting the development of work related respiratory symptoms of wheeze, cough, and dyspnoea. Two computer administered questionnaires concerning the presence of respiratory symptoms and the occurrence of work related respiratory symptoms were used. Workers underwent skin prick testing to green coffee bean extract (GCB) and 11 common inhalant allergen extracts and bronchial provocation testing with methacholine. The presence of specific immunoglobulin E (IgE) antibodies to GCB and castor bean extract (CAB) were determined by a radioallergosorbent test (RAST). The prevalence of work related respiratory symptoms was 12.7%, bronchial hyperresponsiveness 30%, atopy 54%, positive GCB skin prick test 14.7%, positive GCB RAST 14%, and positive CAB RAST 14.7%. None of the workers was sensitised to fungi present in the factory and the numbers of certain species of fungi, despite being greater than may be found out of doors or in an uncontaminated indoor environment, were fewer than are generally associated with the presence of work related respiratory symptoms among agricultural workers. Storage mites were not isolated. Green coffee bean extract and CAB RAST were significantly correlated using the McNemar test but there was limited allergenic cross reactivity in RAST inhibition studies of the two extracts. The only factors that were significantly and independently associated with work related symptoms were CAB RAST and duration of employment. Bronchial hyperresponsiveness was not independently associated with work related respiratory symptoms. The significant independent associations of bronchial hyperresponsiveness included GCB RAST, duration of employment, and resting forced expiratory volume in one second. Exposure to CAB, a highly potent antigen, may be overriding the effects of other factors such a GCB, atopy, bronchial hyperresponsiveness, and smoking. This study suggests that CAB contamination remains a potential problem in the coffee processing industry and all efforts to eliminate it from the working environment should continue.

Adolescent↗
PubMed1990

Responding to major toxic releases.

Major releases of hazardous substances into the community are a preventable cause of disaster. Despite the impetus given by recent legislation to emergency planning the problems of mounting an adequate response to a chemical disaster are considerable. The successful medical management of a major incident depends upon a rapid and complete evaluation of the acute and possible long-term health hazards and this is likely to require the urgent deployment to the scene of specialists from the key disciplines. Some of the lessons of previous major incidents are highlighted; these are similar regardless of the route of human exposure (air, food and drink, water) or whether the release is from an industrial or natural source.

Air Pollutants↗
PubMed1990

Infection risks in hospital staff from blood: hazardous injury rates and acceptance of hepatitis B immunization.

A questionnaire survey of 1800 clinical health care staff was undertaken to determine hazardous injury rates and uptake of hepatitis B vaccination. The overall sharps injury rate was 116 injuries per 100 staff per year. Full-time doctors had the highest rates. Surgical procedures were the commonest cause of accidental injury (58 per cent) and 30 per cent of all sharps injuries were attributable to careless handling. Injuries caused by bites and scratches from patients occurred mainly in nurses and auxilliaries in psychiatric and geriatric wards (115/100 staff per year). Twenty-four per cent of respondents had received a full course of hepatitis B vaccine and 51 per cent of the remainder were planning to have, or were in the process of receiving, a course. The most frequent reason given for not being vaccinated was lack of information about vaccination. This survey reveals injury rates higher than those observed in previous reports, particularly in doctors, and shows a need for more information and advice about hepatitis B infection and vaccination to be targeted to health care workers at risk.

Accidents, Occupational↗
PubMed1989

Lake Nyos disaster, Cameroon, 1986: the medical effects of large scale emission of carbon dioxide?

Carbon dioxide was blamed for the deaths of around 1700 people in Cameroon, west Africa, in 1986 when a massive release of gas occurred from Lake Nyos, a volcanic crater lake. The clinical findings in 845 survivors seen at or admitted to hospital were compatible with exposure to an asphyxiant gas. Rescuers noted cutaneous erythema and bullae on an unknown proportion of corpses and 161 (19%) survivors treated in hospital; though these lesions were initially believed to be burns from acidic gases, further investigation suggested that they were associated with coma states caused by exposure to carbon dioxide in air. The disaster at Lake Nyos and a similar event at Lake Monoun, Cameroon, two years previously provide new information on the possible medical effects of large scale emissions of carbon dioxide, though the presence of other toxic factors in these gas releases cannot be excluded.

Blister↗
PubMed1989

Monumental masons: lead and other hazards of an old trade re-visited.

A survey of lead exposure amongst gravestone inscription writers was undertaken in 12 firms of monumental masons in London and one in the East Midlands. The mean blood lead concentration in the 25 men studied was 35 micrograms/dl, with six workers exceeding 40 micrograms/dl. The four highest levels were 49, 57, 78 and 89 micrograms/dl respectively, indicating that substantial occupational exposure to lead was occurring. The men were unaware of the risks of lead exposure and the importance of not smoking or eating in their workshops. The stonemasons understood the hazards of granite stone dust, but an unexpected and common finding was an unacceptably high exposure to marble dust.

Dust↗
PubMed1989

Medical planning for toxic releases into the community: the example of chlorine gas.

Emergency planning for a major accidental release of chlorine gas from industrial installations into the community is outlined for emergency services and hospitals. Realistic planning has been made possible with the advent of computer models for gas dispersion which may be used to estimate the numbers of deaths and casualties, according to their severity. For most purposes sufficient accuracy may be obtained by using a small number of computer analyses for the most serious reasonably foreseeable events under typical day and night weather conditions, and allowing for the emergency response to be scaled up or down according to the size of an actual release. In highly populated areas triage should be preplanned to deal with a large number of victims; field stations will be needed for the treatment and observation of minor casualties. The management and treatment of casualties is summarised. The best protection against a gas cloud is afforded by buildings whose windows, doors, and ventilation systems have been closed. Hospitals in the vicinity of an installation should draw up plans to protect patients and staff. Coordination in a disaster will require toxicological and epidemiological expertise and hospital plans should allow for this.

Accidents, Occupational↗
PubMed1988

Biological monitoring of occupational exposure in the chromate pigment production industry.

A survey of occupational exposure to hexavalent chromium in chromate pigment production was undertaken in factories producing lead chromate (PbCrO4) and strontium chromate (SrCrO4). Sampling pre and post-shift in a factory where SrCrO4 production had just started showed the optimum strategy for biological monitoring is the measurement of urinary chromium, in urine samples taken at the end of Friday shift and pre-shift the following Monday. However, short-term uptake may be assessed under these circumstances by the increase in urinary chromium over a shift. Body burden, representing long-term chromate exposure is best assessed by measuring chromium in whole blood or pre-shift urinary chromium at the beginning of the working week. Exceptionally high levels of chromium in blood (387-4160 nmol l-1) and urine (41-1250 nmol nmol-1 creatinine) as well as skin and nasal lesions, were discovered amongst the workforce at the strontium chromate plant. These contrasted with occupationally unexposed levels of less than 20 nmol l-1 and less than 1 nmol nmol-1 creatinine, respectively, and led to the continuation of the biological monitoring programme. At the same time, improved working practices and respiratory protection equipment were introduced. A steady elimination of chromium from whole blood with a half-life of approximately 24 days was found. This elimination rate was confirmed over a 14 day period when the workforce were completely removed from exposure. The study confirms the usefulness of biological monitoring in assessing the uptake of hexavalent chromium and control of exposure.

Chromates↗
PubMed1988

Laboratory animal allergy in a pharmaceutical company.

A cross sectional survey was carried out on 138 workers exposed to laboratory animals. Sixty (44%) had symptoms in a self completed questionnaire that were consistent with laboratory animal allergy (LAA) of whom 15 (11%) had chest symptoms. There was a positive skin prick test to one or more animal urine extracts (rat, mouse, guinea pig, rabbit) in 13% and 38% had a positive radioallergosorbent test to urine extract. LAA chest symptoms were almost five times more common in atopic than non-atopic subjects (who were distinguished by skin test response to common, non-animal aeroallergens). A positive skin test to animal urine was associated with LAA chest symptoms and with atopy. Nose, eye, or skin symptoms without chest symptoms were not associated with atopy. There was an inverse relation between duration of employment at the firm and LAA chest symptoms, suggesting selection of affected people out of employment with animals.

Adult↗
PubMed1986

Occupation and cancer in London: an investigation into nasal and bladder cancer using the Cancer Atlas.

The Atlas of Cancer Mortality for England and Wales showed pronounced excesses of male mortality from nasal and bladder cancer in certain London boroughs. These excesses were investigated by case-referent studies using death certificate data for male deaths, 1968-78. Nasal cancer was found to be significantly associated with occupations involving heavy exposure to wood dust. Bladder cancer was significantly associated with occupations in road transport driving and in the handling of leather, whereas consistently raised relative risk ratios were also found for wood-workers, engineering fitters, printers, machinists, plumbers, and motor mechanics. These findings highlight the potential role of occupational factors in cancer causation in London.

Humans↗