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Biomedical subjects

R S Carel

Publications and source records attributed to R S Carel.

At least 19 recordsLinked to original sources
PubMed2004

[The role of occupational exposures in the etiology of bladder cancer].

In a case-control study in southern Israel, 150 male subjects with histologically proven transitional cell cancer (TCC) of the bladder were matched with 150 controls. Both groups were interviewed regarding past occupational exposures, lifestyle habits, and co-morbidities. Significant associations were demonstrated between certain occupational exposures and the risk to develop TCC. These exposures were (a) organic solvents (OR 3.5, 95% CI = 1.4-8.4), (b) aromatic amines and\or paints (OR = 2.7, 95% CI = 1.1-6.3) and (c) PAHs (OR = 1.9, 95% CI = 1.2-4.3). Similarly, significant associations were found between certain occupations (jobs) and the risk of future TCC, such as metal workers and welders. In conclusion, certain types of occupational exposures and industrial jobs bear extra risk for the future development of TCC (in addition to the well established risk of smoking). Thus, better identification and control of these occupational risk factors (chemicals and work processes) is required in order to reduce the risk for this relatively common cancer and improve protection for the relevant groups of workers.

Case-Control Studies↗
PubMed2001

Assessment of work-related risks factors for carpal tunnel syndrome.

BACKGROUND: The association of carpal tunnel syndrome with occupational risk factors is well established. However, in clinical practice these factors are only rarely considered and evaluated. Managing these risk factors could prevent the occurrence of future cases and alleviate treatment of the afflicted individuals. OBJECTIVES: To estimate the role of occupational risk factors in a large group of patients diagnosed by electrophysiological studies as suffering from CTS. METHODS: A group of 396 subjects (204 women, 165 men) who were tested in one laboratory by electrophysiological studies were further evaluated (by questionnaire) to determine the possible role of occupational and other risk factors in the etiology of their syndrome. RESULTS: Persons employed in high force--low repetitive or low force--high repetitive jobs, harbor an extra risk for developing CTS as compared with controls, OR = 3.21 (95% C1 = 1.5-6.9) and OR = 4.72 (95% C1 = 1.8-12.5), respectively. These jobs include typists/secretaries, nursing personnel, production workers and housewives. CONCLUSION: Evaluation of a general group of examinees referred for electrophysiological studies on sympathology compatible with CTS may show that occupational risk factors play a substantial role in the development of symptoms. By increasing the awareness of clinicians and the public to these risk factors, appropriate preventive measures can be introduced and the burden of the disease reduced.

Adult↗
PubMed2001

Regional occupational health service - an assessment.

AIM: To present, partially in quantitative terms, the basic characteristics of a regional occupational health service in southern Israel. METHOD: Records of the annual activities of the regional occupational health service were analyzed over a period of about 10 years. RESULTS: Overall there were about 25,000 contacts per year, such that about 15,000-16,000 different individuals were examined each year (out of a population of about 150,000 workers). About 45% of the examinations performed were surveillance (statutory), 38% fitness-to-work, and 15% pre-employment examinations. These proportions were quite stable over the whole study period, even though services are provided to hundreds of work-sites of markedly different sizes, exposures, and technological development. As expected, the type and rate of abnormal findings differ significantly among the 3 categories: 7% for pre-employment examinations, 18% for surveillance, and 53% for fitness-to- work examinations. CONCLUSION: In order to provide adequate occupational health services to a large, non-uniform population of workers, a clear understanding of the "occupational map" of the region is needed. A good insight into the characteristics, aims, and scope of the 3 main categories of examinations used in occupational health could assist in forecasting, planning, and providing adequate regional occupational health service.

Humans↗
PubMed1998

Herbicide (Roundup) pneumonitis.

A case of acute intoxication presented as toxic pneumonitis after exposure to Roundup (glyphosate) (Solaris Group, Monsanto; San Ramon, CA) herbicide in an agriculture worker. The correct etiologic factor causing this specific clinical picture was identified only 2 weeks later, after a thorough occupational history was taken and meticulous delineation of the working conditions and exposures of the involved worker were made. As a rule, occupational related diseases are not readily elucidated by nonoccupational physicians. However, most acute intoxication events are first encountered by such physicians. In these situations, rapid and comprehensive evaluation is necessary in order to clearly identify the causative agent(s) and to initiate the appropriate treatment. Consulting occupational physicians at this early stage may facilitate early and accurate diagnosis.

Adult↗
PubMed1998

Periodical multiphasic screening and lung cancer prevention.

The purpose of this work is to evaluate the utilization of information gathered by multiphasic screening with respect to lung cancer detection and smoking cessation techniques. A cohort (follow-up) study is reported in which cancer incidence and factors affecting its occurrence are evaluated in a group of about 20,000 presumably healthy adults along a period of approximately 10 years following comprehensive multiphasic health examinations. Lung cancer occurrence is primarily related to smoking. The risk is higher in smokers and is dose-dependent; OR = 0.21, (CI = 0.08, .53) in never smokers, OR = 1.53 (CI = 0.8, 3.2) in past and current moderate smokers, OR = 4.92 (CI = 2.18, 11.11) in current heavy smokers. Moreover, smokers with compromised pulmonary function (FEVI/FVC < 75%) are at an even higher risk of developing lung cancer OR = 4.22 (CI = 2.2, 8.2) for past and current moderate smokers; and OR = 10.7 (CI-2.5, 38.6) in current heavy smokers. Information gathered in periodical multiphasic health examinations could be utilized by health professionals to encourage smoking cessation and smoking prevention in the appropriate screenees. Various elements of the multiphasic test results could contribute to such prevention efforts. While every smoker should receive appropriate evaluation and consultation regarding nicotine dependence, smokers with reduced pulmonary function represent an extra high risk group to which special attention should be given.

Adult↗
PubMed1997

Effects of work overload and burnout on cholesterol and triglycerides levels: the moderating effects of emotional reactivity among male and female employees.

The effects of objective and subjective overload, and of physical and emotional burnout, on cholesterol and triglycerides levels were studied in a quasiprospective design. The possible moderating effects of emotional reactivity on these relationships were also investigated. The study's hypotheses were tested separately for male and female employees. Time 1 (T1) data were collected from 665 healthy employees (30% women) while they were undergoing periodic health examinations in a health-screening center. Time 2 (T2) measures of cholesterol and triglycerides were collected 2 to 3 years after T1. The hypotheses were tested by regressing each T2 criterion on its T1 level; the control variables of age, obesity, diet, alcohol consumption, and smoking; and the other predictors. For female employees, the T2-T1 changes in the serum lipids were positively predicted by emotional burnout, as expected, but negatively predicted by physical fatigue. For male employees, both types of T1 burnout were positive predictors of the T2-T1 change in total cholesterol.

Adult↗
PubMed1996

[Annual activities of a regional occupational health service].

The scope and content of the services provided by a regional, occupational health service are described in quantitative terms. Many of its activities are in compliance with state regulations. In this respect this service differs greatly from other, regular, clinical services. About 22,000 examinations are performed annually, and there are about 140,000 employed persons in the region, so that about 1 in 5 workers is examined by the service annually. The 3 main activities of the clinic are pre-employment examinations, periodic surveillance of certain groups of workers and evaluating work capacity. Most of the abnormal findings identified in such examinations relate to musculo-skeletal disorders, noise-induced hearing loss and, to a much lesser degree, lung and skin problems. Some of the ways in which service is provided in remote and small work sites are described, and issues of availability and accessibility presented. Based on the data collected, suggestions are made with respect to future changes, including computerization and quality assurance methods.

Humans↗
PubMed1996

Biological monitoring of workers' exposure to bromine.

The use of serum bromine concentration (SeBr) as a measure of exposure was examined in an occupational cohort. Associations with work site, department type, chemical handling, and occupation, as proxy measures of exposure, were studied. SeBr was associated with all of these measures. SeBr was also associated with various demographic characteristics (age, country of origin, and education) in men. In women, there was no association between SeBr and age, country of origin, or education. The use of SeBr as a measure of exposure is discussed. The conclusion is that the exposure to bromine can be assessed by regular monitoring of SeBr.

Adult↗
PubMed1994

Factors affecting long-term sick leave in an industrial population.

Factors affecting long-term absenteeism for non-accident-related sickness leave in a large, remotely located factory (Dead Sea Industry, Israel) were evaluated. About 10% (89 persons) of the workers were found to be on sick leave for more than 20 days/year. This group was designated as high absence workers (HAW). Most of the sickness absence were for repeated short-term leaves due to intercurrent diseases, rather than for continuous periods related to a major or single illness. Average cumulative duration of sick leave in this group was 54 days/year. The average number of spells was 11 per year (4.9 days/spell). There were significantly more HAW among skilled (relative risk, R.R. = 1.6) workers or shift workers (R.R. = 1.3), compared to white collar workers. There were significantly fewer HAW among workers 35-49 years of age (7.6%) than among younger (12.5%) or older workers (13.8%). Except for possible hearing loss in one worker, no occupationally related illness was identified. Sixty-six percent of the HAW took many sick leaves, over 20 days during the year following the study year, and 52% of this group took over 20 days in the preceding year (usually for minor diseases or complaints). This pattern of long-term sickness absence indicates that various socio-economic factors determine HAW to a greater extent than immediate occupational risks or health problems.

Adult↗
PubMed1994

"Souvenir" casting silicosis.

A case of silicosis in a 47-year-old worker who was employed for many years in a small souvenir casting shop is described. This work site demonstrates many unfavorable characteristics of small industries, such as lack of awareness of the need for safety measures, exposure control, protection of workers, and lack of compliance with environmental and medical-legal standards.

Humans↗
PubMed1993

Repeated multiphasic screening examinations: evaluating the process.

There are sound clinical and epidemiological reasons to promote and emphasize early detection efforts and disease prevention services. A large body of scientific literature supports the notion that detection and intervention early in the course of many diseases is beneficial both to the afflicted individual and to society at large. Several publications deal with the evaluation of multiphasic screening examinations (MSE) as a tool for simultaneous early detection and prevention of multiple risk factors and various diseases. Usually, this technology is evaluated based on data from a single (cross-sectional) comprehensive screening study. However, frequently MSE are performed periodically, resulting in repeated test results of the same individuals. The health impact of such repeated (longitudinal) MSE has not been studied extensively. Similarly, many of the unique theoretical, technical, and epidemiological features characteristic of consecutive (periodical) comprehensive screening examinations are not well-documented. The purpose of this study was to compare the test results of two MSE, performed 3.5 years apart, in order to demonstrate certain characteristics of multiphasic health testing (MHT) technology related to repeated (longitudinal) multiphasic examination of the same individuals.

Humans↗
PubMed1992

Delayed health sequelae of accidental exposure to bromine gas.

The delayed health effects from accidental exposure to bromine vapors in a group of six people were evaluated. During the acute exposure, they had only some respiratory symptoms and skin burns of first to second degree involving small areas. All were treated in one hospital and released within 1-4 d. Six to 8 wk later, some still had health complaints such as cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, and memory, sleep, and sexual disturbances, but no objective laboratory or clinical evidence of effects. Mechanisms that might have led to manifestations of such complaints 1-2 mo after the accident are discussed and possible ways to alleviate similar situations are suggested.

Accidents, Traffic↗
PubMed1991

Comparison of two pre-admission testing methods for elective surgery patients.

Patients admitted for elective surgery (inguinal hernia, varicose veins and hemorrhoids) were studied in order to evaluate the impact of performing pre-admission testing (PAT) by utilizing an automated multiphasic health testing (AMHT) technology on the rate of repeating the pre-operative routine laboratory tests during hospitalization. A slightly lower but statistically significant rate of repeated tests was found among patients who performed PAT by AMHTS compared with those who performed the tests via the conventional ambulatory system. This result suggests that performing routine tests before hospitalization in a single authorized AMHTS facility is preferred since it saves the patient time and reduces the need for repeated tests.

Adolescent↗
PubMed1991

Changes in smoking patterns in young military recruits in relationship to psychosocial characteristics.

We followed 295 young infantry recruits during their first 14 weeks of basic training. The prevalence of smoking increased by 50%. About half of this increase was accounted for by ex-smokers, 57% of whom had resumed the habit. Average education and military psychometric measures of both the baseline smokers and the new smokers were significantly lower than those of the abstaining never-smokers. Asian and North African origin and a lower peer group evaluation score were also risk factors. These relationships were not demonstrated among resuming ex-smokers. The rise in the smoking rate accounts for most of the known rise during full military service. We suggest early preventive measures, especially for the two groups at risk.

Adolescent↗
PubMed1990

[Late health sequelae of accidental bromine exposure].

Health and environmental assessment of the consequences of accidental contamination of an area in the Negev desert is described and the effects of exposure to bromine vapor in 6 persons evaluated. They were only mildly affected during the acute spillage of the bromine, with some respiratory symptoms and first and second degree skin burns of small exposed areas on the legs. All were treated in hospital and were released within 1-4 days. 6-8 weeks later they demonstrated a complex array of complaints, including cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, memory disturbances, sleep and sexual disturbances. These complaints could not be substantiated by objective clinical or laboratory examination. There was thus obvious magnification of the complaints 1-2 months after the accident.

Accidents↗
PubMed1990

Occupational stress and well-being: do seafarers harbor more health problems than people on the shore?

The popular image of life at sea is one of stress: often difficult physical conditions, dislocation, isolation and less than ideal personal habits. In order to determine whether this stressful way of life is manifested when seamen's health status is assessed by standard measurements, we studied 144 sea captains and marine chief engineers as compared with a group of ordinarily employed men. The referent men were matched for age, ethnic origin, and level of education with the seamen. Outcome measures included a wide spectrum of physiological, psychological and behavioral indices. The comparisons revealed only mild differences between the two groups. Captains and chief engineers tend to harbor slightly higher levels of certain biochemical or physiological parameters (risk factors), such as serum cholesterol and uric acid, hemoglobin level and leukocyte count. Certain behavioral risk factors were more dominant among the seamen than among the control group (smoking level, alcohol consumption and lack of leisure-time physical activity). The study group did not exhibit a greater prevalence of overt disease or a higher degree of psychological symptoms. It is suggested that the group under study represents a self-selected group of persons well adjusted to their job and their special way of life.

Adult↗
PubMed1988

Smoking, leukocyte count, and ventilatory lung function in working men.

Results of a cross-sectional study of ventilatory lung function (VLF) in a group of 307 working men showed that the leukocyte count in peripheral blood is more closely associated with the relative position (percentile) of a person in the frequency distribution of VLF than is smoking intensity. Leukocyte count is significantly (and inversely) correlated with VLF in nonsmokers as well as in smokers. A multiple regression analysis indicated that, after accounting for the effect of height and age, white blood cell (WBC) count explains more of the VLF variance than many other health determinants. Moreover, WBC count is the only variable, apart from height and age, that contributes significantly to the regression. Current smokers with elevated leukocyte count in peripheral blood may constitute a defined high-risk group because they demonstrate more negative regression age coefficients when compared with smokers without elevated WBC or with nonsmokers. Mechanisms that may explain these findings are discussed.

Adult↗