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Railroad workers with pleural plaques: II. Small airway dysfunction among asbestos-exposed workers.

Increased volume of trapped gas (VTG) was found in 87 asbestos-exposed railroad repair shop workers, divided into three subgroups according to smoking habits. All the examined subjects had pleural plaques. Determination of VTG was used to study function of small airways. Increased VTG was found among asbestos-exposed smokers as well as nonsmokers. In both groups the VTG:TLC ratio was elevated compared with controls. Increased VTG is a sign of small airways dysfunction. In asbestos-exposed subjects, it might be caused by an early peribronchial reaction to inhaled asbestos fibers.

Adult↗

Exploring barriers to 'respondent driven sampling' in sex worker and drug-injecting sex worker populations in Eastern Europe.

Respondent driven sampling (RDS) has been used in several counties to sample injecting drug users, sex workers (SWs) and men who have sex with men and as a means of collecting behavioural and biological health data. We report on the use of RDS in three separate studies conducted among SWs between 2004 and 2005 in the Russian Federation, Serbia, and Montenegro. Findings suggest that there are limitations associated with the use of RDS in SW populations in these regions. Findings highlight three main factors that merit further investigation as a means of assessing the feasibility and appropriateness of RDS in this high risk population: the network characteristics of SWs; the appropriate level of participant incentives; and lack of service contact. The highly controlled and hidden nature of SW organizations and weak SW social networks in the region can combine to undermine assumptions underpinning the feasibility of RDS approaches and potentially severely limit recruitment. We discuss the implications of these findings for recruitment and the use of monetary and non-monetary incentives in future RDS studies of SW populations in Eastern Europe.

Data Collection↗

Assessment of respondent driven sampling for recruiting female sex workers in two Vietnamese cities: reaching the unseen sex worker.

Respondent driven sampling (RDS) is a relatively new method to sample hard-to-reach populations. Until this study, female sex workers (FSWs) in Vietnam were sampled using a variety of methods, including time location sampling (TLS), which may not access the more hidden types of FSWs. This paper presents an analysis from an HIV biological and behavioral surveillance survey to assess the feasibility and effectiveness of RDS to sample FSWs, to determine if RDS can reach otherwise inaccessible FSWs in Vietnam and to compare RDS findings of HIV risk factors with a theoretical TLS. Through face-to-face interviews with FSWs in Ho Chi Minh City (HCMC) and Hai Phong (HP), data were collected about the venues where they most often solicit their clients. These data were used to create three variables to assess whether FSWs solicit their clients in locations that are visible, semi-visible and non-visible. For this analysis, the visible group simulates a sample captured using TLS. Survey results in HIV prevalence and related risk factors and service utilization, adjusted for sampling methodology, were compared across each of the three FSW visibility groups to assess potential bias in TLS relative to RDS. The number of self-reported visible FSWs (HCMC: n=311; HP: n=162) was much larger than those of the semi-visible (HCMC: n=65; HP: n=43) and non-visible (HCMC: n=37; HP: n=10) FSWs in HCMC and HP. Non-visible FSWs in both cities were just as likely as visible and semi-visible FSWs to be HIV positive (HCMC: visible 14.5%, semi-visible 13.8%, non-visible 13.5%, p value = 0.982; HP: visible 35.2%, semi-visible 30.2%, non-visible 30.0%, p value = 0.801), to practice behaviors that put them at risk for contracting and transmitting HIV (injecting drug use-HCMC: visible 13.8%, semi-visible 12.3%, non-visible 5.4%, p value = 0.347; HP: visible 38.9%, semi-visible 23.3%, non-visible 30.0%, p value = 0.378, to have no condom use in the past month -HCMC only: visible 52.7%, semi-visible 63.1%, non-visible 48.6%, p value = 0.249) and to have symptoms of a sexually transmitted infection (STI) in the past year (HCMC: visible 16.1%, semi-visible 12.3%, non-visible 16.2%, p value = 0.742; HP: visible 13.6%, semi-visible 18.6%, non-visible 20.0%, p value = 0.640). There was a difference found among the visible, semi-visible and non-visible groups in HP for no past month condom use (visible 53.1%, semi-visible 79.1%, non-visible 60.0%, p value = 0.009). This study found that RDS was successful at recruiting hidden types of FSWs in Vietnam. Past reports of FSWs in Vietnam have assessed the more visible FSWs as being the most vulnerable and at risk for HIV. Although the number of visible FSWs is much higher than those of the semi and non-visible groups, this study found that the non-visible FSWs are very vulnerable to HIV infection. If prevention programs are targeting and responding to those who are most likely to be assessed (e.g., more visible types of FSWs) then this analysis indicates that a significant proportion of the FSW population at risk for HIV may not be receiving optimal HIV information and services.

Data Collection↗

Overuse syndromes of the upper limb and the upper limb tension test: a comparison between patients, asymptomatic keyboard workers and asymptomatic non-keyboard workers.

SUMMARY. Overuse syndromes of the upper limb (OSUL), also known as repetitive strain injury (RSI) remains a contentious issue that affects a large number of keyboard workers. This research used the results of a modified upper limb tension test (ULTT) performed on three independent groups to look for any similarities or discrepancies between them. The subjects were all female aged between 25-40 years, with groups consisting of 12 OSUL patients, 20 asymptomatic keyboard users and 19 asymptomatic non-keyboard users. The ULTT was positive in 100% of the patient group supporting several hypotheses that state that the pathology of OSUL is neurogenic in origin. The results of the two asymptomatic control groups were predicted to be the same, however this was not found to be the case. Unrelated t-tests were used to analyse the data showing that the keyboard users had a significantly positive ULTT compared to non-keyboard users, which were viewed as a normal control group. This suggests that a subclinical pathological state exists in the keyboard user group. Various subclinical physiological changes caused by prolonged sitting and keyboard use are suggested as possible causes for these results. This research highlights the need for intervention in an office environment to prevent further cases of OSUL from developing. Copyright 1997 Harcourt Publishers Ltd.

Journal Article↗

Influenza vaccination of healthcare workers and vaccine allocation for healthcare workers during vaccine shortages.

Influenza causes substantial morbidity and mortality annually, particularly in high-risk groups such as the elderly, young children, immunosuppressed individuals, and individuals with chronic illnesses. Healthcare-associated transmission of influenza contributes to this burden but is often under-recognized except in the setting of large outbreaks. The Centers for Disease Control and Prevention has recommended annual influenza vaccination for healthcare workers (HCWs) with direct patient contact since 1984 and for all HCWs since 1993. The rationale for these recommendations is to reduce the chance that HCWs serve as vectors for healthcare-associated influenza due to their close contact with high-risk patients and to enhance both HCW and patient safety. Despite these recommendations as well as the effectiveness of interventions designed to increase HCW vaccination rates, the percentage of HCWs vaccinated annually remains unacceptably low. Ironically, at the same time that campaigns have sought to increase HCW vaccination rates, vaccine shortages, such as the shortage during the 2004-2005 influenza season, present challenges regarding allocation of available vaccine supplies to both patients and HCWs. This two-part document outlines the position of the Society for Healthcare Epidemiology of America on influenza vaccination for HCWs and provides guidance for the allocation of influenza vaccine to HCWs during a vaccine shortage based on influenza transmission routes and the essential need for a practical and adaptive strategy for allocation. These recommendations apply to all types of healthcare facilities, including acute care hospitals, long-term-care facilities, and ambulatory care settings.

Communicable Disease Control↗

Occupational continuity and international migration of skilled workers: the case of Mersey Port workers.

"As part of a current concern among geographers to identify the local specificity of labour markets...and the regional impacts of international migration from [the United Kingdom], this paper considers one case of regional specificity--the Port of Liverpool--and how the traditional skills of the port and associated activities, on and off-shore, have provided important linkages with international demand for skills in these occupations, and have spontaneously maintained international but non-permanent flows of skilled workers from Merseyside." (SUMMARY IN FRE AND SPA)

Demography↗

The teaching social worker in family medicine: a prototype for the hospital social worker?

The need for physicians to receive training in interpersonal skills as well as in preventive medicine to aid them in recognizing and addressing the psychosocial aspects of illness and to facilitate the delivery of more comprehensive care to patients, has been addressed in the Department of Family Medicine and several other specialties. In January, 1978 the author surveyed social work members of the Society of Teachers of Family Medicine to determine their activities and responsibilities and to identify the experiences which have proven most helpful as a preparation for their positions on medical school faculties. Results of the survey are reviewed in light of possible implications for the future hospital social worker as a medical educator.

Adult↗

[Exploration of workers' opinions as a source of knowledge of working conditions and their impact on workers' health].

The present system and the range of assessing working conditions with their historical background do not reveal reality as they neither cover the whole working population nor take account of a growing importance of psychosocial and organizational factors characteristic of the work environment and affecting workers' health. The studies carried out on representative samples of different occupational groups may substantially contribute to the advancement of knowledge in this area. This kind of studies have already been carried out in a number of West European countries. The author tries to justify the need for performing such studies in Poland.

Attitude to Health↗

[Early detection of scleroderma in quartz dust exposed workers and workers with silicosis by determining serum beta-galactosidase activity].

Progressive systemic sclerosis (PSS) is a rare disease belonging to the collagen diseases. PSS is frequently observed in workers with an intensive exposure to crystalline silica and with silicosis in the GDR. The recognition as an occupational disease is regulated by law. The elevated beta-galactosidase activity in the serum of patients with silicosis and beginning PSS can be used for detecting of early stages of PSS. References are given to medical care of patients with silicosis and exposure to quartz.

Adolescent↗