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Biomedical subjects

R L Langley

Publications and source records attributed to R L Langley.

18 recordsLinked to original sources

Occupational fatalities due to animal-related events.

OBJECTIVE: To better understand the extent of animal-related fatalities in the workplace. METHODS: This study utilized Census of Fatal Occupational Injuries files from the US Department of Labor for the years 1992-1997 to describe the events surrounding human workplace fatalities associated with animals. RESULTS: During the 6-year time period, 350 workplace deaths could be associated with an animal-related event. Cattle and horses were the animals primarily involved, and workers in the agricultural industry experienced the majority of events. Many deaths involved transportation events, either direct collision with the animal or highway crashes trying to avoid collision with an animal. Exotic animals, primarily elephants and tigers, were responsible for a few deaths. A small number of workers died of a zoonotic infection. CONCLUSIONS: We found that approximately 1% of workplace fatalities are associated with an animal-related event. Methods to decrease the frequency of an animal injury are suggested.

Accidents, Occupational↗

Analysis of tractor-related deaths in North Carolina from 1979 to 1988.

This descriptive study examined 342 fatalities involving tractors and attachments that occurred during a 10-year period in North Carolina from 1979 to 1988. Reports of the North Carolina Office of the Chief Medical Examiner and medical examiner's certificates of death were reviewed using the public health model of causation. Data were collected on characteristics of thefatally injured (host), including age, occupation, blood alcohol concentration and length of survival; characteristics of the injury event (environment), including type of accident, weather conditions and terrain; and characteristics of the agent, including both the tractor and attachments, if any, in place at the time of injury. Ninety-eight percent of the victims were male. Victims ages 65 and older accounted for 38 percent of fatal injuries, and 11 percent were 18 years of age or younger. Only slightly more than one-half of the victims (54 percent) were full- or part-time farmers. Forty-four percent of the deaths were to nonfarmers who were not in the act of farming. Nineteen percent of tested victims had a detectable blood alcohol level. Almost three-fourths of the victims died in the first hour after injury and 87 percent within the first 24 hours. In the majority of accidents, the tractor operator was a victim of a rollover or runover. This study provided detailed characterization of the fatally injured and, to the extent possible, the tractor involved and the injury event itself. However, additional methods of data collection are needed to provide further characterization of the injury event and the injury agent to design and support prevention programs for tractor users.

Accidents, Occupational↗

Occupational injuries and illnesses reported by zoo veterinarians in the United States.

A 14-page comprehensive survey was mailed to all 565 United States members of the American Association of Zoo Veterinarians to identify the frequency of physical injuries, radiation exposures, chemical exposures, allergic or irritant reactions, infections, and use of preventive measures, and 315 (55.8%) veterinarians responded. Significant findings include major animal-related injury (61.5%), back injury (55%), necropsy injury (44.1%), adverse formalin exposure (40.2%), animal allergy (32.2%), zoonotic infection (30.2%), and insect allergy (14.2%). We also found that gender, length of experience, and practice type affected the number and type of incidents encountered in practice. Females reported a higher rate of zoonotic infection, insect allergy, and adverse exposure to anesthetic gas, formalin, and disinfectants/sterilants. Zoo veterinarians with more years of experience were more likely to receive major animal-related injury and associated hospitalization, back injury, and lost work time associated with back injury. Full-time zoo veterinarians were more likely to report back injury and inadequate knowledge of occupational hazards. Results are compared with hazards reported by veterinarians working in other fields. The frequency of injuries reported demonstrates a greater need for comprehensive health and safety programs for zoo veterinarians.

Accidental Falls↗

Deaths resulting from animal attacks in the United States.

The objective of this study was to elucidate the etiology and frequency of deaths in the United States from encounters with animals. The number of deaths from venomous and nonvenomous animals is reported annually to the US Department of Health and Human Services and published in Vital Statistics of the United States. This study is a survey of all animal-related fatalities listed as E-codes 905-906 reported in the Vital Statistics of the United States from 1979 through 1990. Data were extracted uniformly from the annual reports and analyzed using descriptive statistics. From 1979 through 1990, there were 1882 animal-related deaths in the United States. Venomous animals caused 718 deaths; nonvenomous animals caused 1164 deaths. Most deaths occurred among white males. The home site was the location of injury for the majority of deaths. The majority of venomous animal-related deaths were from hymenoptera; "other specified animal" caused the majority of nonvenomous deaths. An annual average of 157 deaths from animal attacks occurred in the United States between 1979 and 1990. Both fatal and nonfatal animal-related injuries are under-recognized public health hazards. Health care providers should educate their patients on exercising caution around animals, seeking medical care after an animal injury, carrying epinephrine kits if they have a history of systemic reactions to insect stings, and wearing helmets and other protective equipment when riding or working around large animals.

Black or African American↗

Fatal animal attacks in North Carolina over an 18-year period.

Injuries from animals are very common, but fortunately deaths are rare. Few studies, however, have evaluated human deaths due to both venomous and nonvenomous animals. Utilizing the Medical Examiner's Data Base, this study examines deaths due to venomous and nonvenomous wild and domestic animals in North Carolina. During 1972-1989, there were 92 deaths reported. Seven categories of "type of animal" involved in the attack were developed. Deaths were most likely to occur from June through November. Victims ranged in age from 1 to 93 (average, 46.1) years and 75% were male. Injuries occurred at the worksite in 18 cases, and 10 victims had detectable alcohol levels. Most deaths were due to insect stings, and several victims had a previous history of insect allergy. The majority of victims were injured at their residence. Although rare, many deaths were potentially preventable. Methods to decrease the number of injuries resulting from animals are discussed.

Accidents, Occupational↗

Cardiac tamponade and pericardial disorders in connective tissue diseases: case report and literature review.

Pericardial disorders occurring in connective tissue diseases are not uncommon and may present as acute or chronic pericarditis with or without an effusion. In many instances, a diagnosis of pericardial involvement is not found until autopsy. Echocardiography and other currently employed radiographic techniques have enhanced the ability to make a diagnosis. Approximate frequencies of common connective tissue disorders with pericardial involvement include scleroderma (59%), systemic lupus erythematosus (44%), mixed connective tissue disease (30%), rheumatoid arthritis (24%), and polymyositis/dermatomyositis (11%). Cardiac tamponade or constriction is rare. This article describes a patient with clinical features consistent with mixed connective tissue disease that presented with a pericardial effusion and cardiac tamponade. In addition, a review of pericardial involvement in connective tissue diseases and the occurrence of cardiac tamponade or constriction is included.

Adult↗

Assessing personal occupational safety and health training for students at U.S. medical schools.

Medical students potentially are exposed to numerous occupational hazards. This study examined the training and preventive measures medical schools use to protect the health and safety of students. In late 1990, questionnaires were mailed to the 126 schools in the United States. One hundred (79%) responded, reporting numerous incidents of illness and injury. Of the 100 schools, 60 agreed with the statement that their students were adequately prepared to work safely; 11 disagreed, and 24 gave neutral responses (five did not respond to the statement). However, 36 indicated that they planned to revise health and safety training. The authors recommend that schools adopt policies, procedures, and a uniform curriculum regarding students' occupational safety and health.

Curriculum↗

Lightning fatalities in North Carolina 1972-1988.

Individuals who are outdoors during thunderstorms are at risk for death from direct and indirect lightning hits. Death is more likely from 3:00 p.m. to 8:00 p.m. during the months of May through September. The fatality pattern in North Carolina is similar to that reported for the nation as a whole. Physicians are urged to discuss with their patients simple strategies for reducing exposure to lightning.

Adolescent↗

Multiple subdural hematomas associated with breakdancing.

A 17-year-old, previously healthy, male breakdancer presented with a three-month history of crescendo headache and newly identified papilledema. The patient was found to have four separate, unilateral extracranial collections. At surgery, three were subdural hematomas, and one was a probable arachnoid cyst containing a hematoma. These were removed, and the patient made an uneventful recovery with no neurosurgical sequelae. The possibility of serious head injury must be considered when evaluating headache in youngsters who engage in this new and apparently popular dance form.

Adolescent↗

Using the cooperative extension service in agricultural health education.

In summary, the North Carolina experience of cooperation and health education using the Cooperative Extension Service has been very successful. Agriculture and medicine have found a common ground where responsibilities can be shared. By discovering the special capabilities and contributions of the Cooperative Extension Service, medical professionals may more closely address preventive medicine in an agricultural setting.

Agriculture↗

Giant cell interstitial pneumonia in a hard-metal worker. Cytologic, histologic and analytical electron microscopic investigation.

A case of biopsy-proven giant cell interstitial pneumonia in a patient with occupational exposure to hard-metal dust is reported. Bronchial washings performed several days prior to open-lung biopsy yielded an almost exclusive population of nonpigmented alveolar macrophages and pleomorphic, phagocytic multinucleated giant cells. Microorganisms, viral inclusions in the giant cells, epithelioid histiocytes and well-formed granulomas were not seen. This cytologic picture strongly suggests the presence of giant cell interstitial pneumonia in a patient with restrictive lung disease, particularly when exposure to hard-metal dust is known or suspected. A specific diagnosis early in the course of the disease may facilitate removal of the individual from the workplace and forestall the development of end-stage interstitial fibrosis. Additionally, the working environment may be modified to minimize inhalational exposure. Recognition of this entity by the cytopathologist may direct diagnostic efforts toward accurate histologic evaluation and the identification of particulates by microprobe analysis of either cellular or biopsy material.

Adult↗