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PubMed1991

Drake Chemical Workers' Health Registry Study: I. Notification and medical surveillance of a group of workers at high risk of developing bladder cancer.

A medical surveillance program and epidemiologic study of 408 former workers of the Drake Chemical Company (now a Superfund waste site) was established in 1986. The Drake Health Registry Study was initiated because these workers had probable past exposures to beta-naphthylamine (BNA), a potent bladder carcinogen. The registry is widely viewed as a model for notification of workers at high risk of disease due to past occupational exposures. By the 40th month, 90% of the 366 living workers had been notified of the existence of the registry; 262 had been enrolled in the annual or semi-annual screening for bladder cancer. Among these, 27 persons have had abnormal screening results indicating moderate to high risk of bladder cancer and have been made eligible for further diagnostic tests. While no invasive bladder tumors were found among 18 persons completing the extended diagnostic evaluation, two diagnoses of moderate to severe dysplasia have been made. The registry has also identified three living and three deceased cases of bladder cancer in the cohort; a mortality analysis showed a 20- to 30-fold excess of bladder cancer. An incidence projection, based on the six identified cases, reveals that between six and ten new bladder cancer cases are likely to occur among the Drake cohort over the next 20 year period.

2-Naphthylamine↗
PubMed1993

Worker notification: viewpoint of the employer.

Prior to notifying workers of risk exposure, employers should first consider and weigh the psychological, physiological, and social costs as well as the potential negative impact on labor-management relations, community resources, and the costs of false negatives and false positives. Only if the contributions of notification override and outweigh the composite costs should employers feel compelled to notify workers.

Communication↗
PubMed1993

Content of worker notification.

This article summarizes discussions held during the workshop on the issue of the content of worker notification messages and related topics. The workshop itself involved a number of sessions where participants formed small groups. This article represents a distillation of the summary reports by the rapporteurs from each group. It is not intended as a complete review of this issue. Rather, it presents some of the concerns that arose during freewheeling discussions, with the idea that the points raised may help others to think about some of the issues involved.

Communication↗
PubMed1993

Beyond notification: a case study from Cloquet, Minnesota.

All members of Local 158 of the United Paperworkers International Union in Cloquet, Minnesota, were invited to attend a meeting to notify them about the outcome of the Union's study concerning exposure to asbestos fiber. Union members and their families were contacted by letter, radio and television announcements, area newspapers, and word of mouth. They were informed about the medical screening that was being planned and about other information on asbestos-related diseases. During the meeting, they were asked to attend one of the educational sessions, to schedule an appointment for the screening, and to fill out a medical history. It was determined that paperworkers with asbestos-related disease might have rights to at least two types of compensation: worker's compensation from their employers and/or court- or jury-awarded compensation from asbestos manufacturers. Other sources of compensation such as social security of disability pensions might also be available to eligible individuals. The Union did not have a complete listing of all the individuals who worked at plants or in operations where asbestos exposure may have occurred. The Union solicited the aid of the Minnesota Department of Health to help identify former asbestos-exposed workers and to develop an ongoing screening and medical program for workers who were exposed but did not develop symptoms of asbestos-related disease; these illnesses usually take 20 years or more to develop. However, the Union was able to follow-up the notification and subsequent screening by sending members and their families the results of the initial screenings and other information concerning the status of any legal actions taken on behalf of the exposed.(ABSTRACT TRUNCATED AT 250 WORDS)

Asbestos↗
PubMed1995

Surveillance and prevention of work-related carpal tunnel syndrome: an application of the Sentinel Events Notification System for Occupational Risks.

In response to limitations in state-based, occupational disease surveillance, the California Department of Health Services developed a model for provider- and case-based surveillance of work-related carpal tunnel syndrome. The objectives were to enhance case reporting, identify risk factors and high-risk work sites, and link preventive interventions to work sites and the broader community. Using elements from surveillance of communicable diseases and sentinel health events, a model was integrated into the pre-existing reporting system in one California county. Between 1989 and 1991, 54 Santa Clara County health care providers reported 382 suspected cases, of which 365 from 195 work sites met reporting guidelines. Risk factors were profiled from interviews of 135 prioritized cases and 38 employers. Of 24 work sites prioritized for a free, voluntary, nonenforcement inspection, 18 refused and 6 completed an on-site visit. Sentinel Event Notification System for Occupational Risks (SENSOR) captured many cases not reported to the pre-existing reporting system. Case interviews indicated a profile of symptoms and signs, treatment, and exposure to uncontrolled occupational risk factors, including a lack of training on ergonomics hazards. Employer health insurance, rather than workers' compensation, was the apparent source of payment for most medical bills. Employers lacked knowledge and motivation to reduce ergonomic risks. Governmentally mandated occupational ergonomics standards are urgently needed.

Adolescent↗
PubMed1999

Tailored risk notification for women with a family history of breast cancer.

BACKGROUND: Evidence indicates that although first-degree relatives of breast cancer cases are at increased risk of developing the disease themselves, they may be underutilizing screening mammography. Therefore, interventions to increase the use of mammography in this group are urgently needed. METHODS: A randomized two-group design was used to evaluate an intervention to increase mammography use among women (N = 901) with at least one first-degree relative with breast cancer. A statewide cancer registry was used to obtain a random sample of breast cancer cases who identified eligible relatives. The mailed intervention consisted of personalized risk notification and other theoretically driven materials tailored for high-risk women. RESULTS: An overall significant intervention effect was observed (8% intervention group advantage) in mammography at post-test. There was an interaction of the intervention with age such that there was no effect among women <50 years of age and a fairly large (20% advantage) effect among women 50+ and 65+. Health insurance, education, and having had a mammogram in the year before baseline assessment were positive predictors of mammography at post-test. Perceived risk, calculated risk, and relationship to index cancer case were not associated with mammography receipt. CONCLUSION: The intervention was successful in increasing mammography rates among high-risk women 50+ years of age. Further work is needed to determine why it was ineffective among younger women.

Adult↗
PubMed1989

An evaluation of the notification of birth form.

Data on 108 Notification of Birth Forms, from a total of 6 hospitals, have been compared with hospital case notes, for both accuracy and completeness. Items related to socio-demographic features of mothers were reliable. However, certain items related to past obstetric history, such as date of last birth and number of previous live births, were less than 90% reliable. Data on index pregnancy were poorest, with three items, first visit to doctor during pregnancy, first visit to hospital during pregnancy and rubella immune status all less than 75% reliable. Data from one hospital were of poorer quality than others, principally because the information on the form is not obtained directly from the mother. Data on forms related to travellers (N = 29) were also of poorer quality.

Birth Certificates↗
PubMed1991

Estimation of a preference matrix for women's choice of male sexual partner according to rate of partner change, using partner notification data.

Data from a study of partner notification for venereal chlamydial infection are used to estimate the contact preference matrix, according to sexual contact activity levels of the male partners, of young heterosexual women. A method for correcting data for the bias introduced by studying infected women only is presented. Results indicate that an overall proportional mixing model is not an adequate description of the mixing pattern.

Bias↗
PubMed1995

Drug-related fatal anaphylactic shock in Denmark 1968-1990. A study based on notifications to the Committee on Adverse Drug Reactions.

Based on notifications to the Danish Committee on Adverse Drug Reactions and to the Central Death Register, 30 cases of fatal drug-induced anaphylactic shock were identified during the period 1968-1990. The most frequent causes were contrast media for X-ray examinations, antibiotics, and extracts of allergens. Nine cases occurred outside hospital; they were mainly caused by the use of allergen extracts of moulds for desensitization in general practice. Fatal drug-induced anaphylactic shock is rare, estimated in the present study at 0.3 case per million inhabitants per year.

Adolescent↗
PubMed2004

Failure of family-planning referral and high interest in advanced provision emergency contraception among women contacted for STD partner notification.

BACKGROUND: Few data are available on the risk of unintended pregnancy in women with STD or how contraceptive services can be integrated into STD control activities. OBJECTIVE: To define the risk for unintended pregnancy and assess the effectiveness of family-planning (FP) referral and interest in advanced provision emergency contraception (APEC) among women with gonorrhea or chlamydial infection. METHODS: Female participants in a randomized trial of different approaches to partner notification were interviewed, offered referral for FP services and asked if they would want APEC. RESULTS: Among participants ages 14-24, the observed past pregnancy rate and age-adjusted anticipated past pregnancy rate were, respectively, 196 and 72 per 1000 women-years. Of 474 nonpregnant participants who did not desire pregnancy, 127 (34%) were using no contraception or condoms alone, of whom 8 (6%) requested a FP appointment and 81% wanted APEC. CONCLUSIONS: Women treated for STD are at high-risk for unintended pregnancy. Although referral for FP was ineffective, interest in APEC was very high.

Adolescent↗
PubMed2005

Patient notification exercise following a dentist's admission of the periodic use of unsterilized equipment.

During 2001, Greater Glasgow National Health Service (NHS) Board undertook a patient notification exercise in a Glasgow dental practice following the admission, by the dentist, of the use of unsterilized dental equipment on patients. Four thousand and eighty-nine exposed patients were identified; of these, 1696 contacted the NHS helpline and 1005 were counselled and screened for hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus. One patient showed evidence of previous HBV infection and 13 had antibodies to HCV. Molecular investigation of the HCV isolates indicated no significant associations. The investigation found no evidence of patient-to-patient transmission of HCV among patients attending the practice of a dentist who admitted periodically using unsterilized equipment.

Contact Tracing↗
PubMed2005

Changes in notification and demographics of deceased donors during the past decade in the state of Michigan, USA.

From 1993 to 2003 there have been significant changes in the number and demographics of deceased donors referred to the organ procurement organization (OPO) in the state of Michigan (USA). It was the aim of this study to document the magnitude of these changes and attempt to explain them. There has been a 26-fold increase in the number of reported in-hospital deaths from 1993 to 2003. Most of these calls (96%) concerned patients who were already dead and thus not suitable for organ donation. There has also been a 72% increase in the number of antemortem calls, but there has been only a 30% increase in the number of organ donors, primarily because the majority of the deceased individuals referred for donation (57% in 2003) do not meet the criteria for brain death. The median age of donors over the past 10 years has increased from 31 to 45. The proportion of African-American donors increased from 9.8% in 1993 to 21.3% in 2003. An increase in the age of donors and the increased frequency of cerebrovascular accidents as the cause of death of donors may be a reflection of changes in criteria for donation. Mandatory reporting of hospital deaths has resulted in an increase in notification to the OPO but has not had a major impact on the number of organ donors. On the other hand, increased donation from African-Americans indicates that public information programs may be contributing to the increased donation from this segment of the population.

Adult↗
PubMed2005

The use of structure-activity relationship analysis in the food contact notification program.

Food contact substances (FCS) include polymers, paper and paperboard, and substances used in their manufacture, that do not impart a technical effect on food. Moreover, FCSs are industrial chemicals generally consumed at dietary concentrations (DC) of less than 1mg/kg food (ppm), and more commonly at less than 0.05 ppm (50 ppb), in the daily diet. As such, many industrial chemicals have been analyzed for toxicological concern, some of which may share structural similarity with FCSs or their constituents, and the majority of these studies are available in the public domain. The DCs of these compounds lend themselves to using structure-activity relationship (SAR) analysis, as the available "expert systems" and use of analogs allows for prediction and management of potential carcinogens. This paper describes the newly implemented food contact notification (FCN) program, the program by which FDA reviews FCSs for safe use, the administrative review of FCSs, the SAR tools available to FDA, and qualitative and quantitative risk assessments using SAR analysis within the regulatory framework of reviewing the safety of FCSs.

Carcinogenicity Tests↗
PubMed1992

Challenges of worker notification in neurotoxic studies of the central nervous system.

Researchers who study the central nervous system (CNS) face special challenges in notifying study participants about the research results. There are human research guidelines regarding the communication of information to subjects at the outset of a CNS research study. Yet there are few guidelines on how to communicate to the subject the research findings and the interpretation of individual results at the study's conclusion. The research subjects may desire detailed information, unequivocal conclusions, understandable interpretations, and clear suggestions about what to do next. Fulfilling these needs, however, is not a simple task for the researcher because outcomes are predicated on statistical uncertainty and the research tests may not be appropriate for individual assessment. We describe methods we have used to communicate with research subjects in two CNS neurotoxic field studies. We suggest that further research examine this important notification process.

Central Nervous System Diseases↗
PubMedDate not supplied

Death anxiety, locus of control, and purpose in life of physicians. Their relationship to patient death notification.

This study explored gender and specialty differences in death anxiety, locus of control, and purpose in life of physicians, and if these variables might influence the clinical behavior of physicians regarding death notification. The subjects were 155 attending and house staff physicians who responded to mailed questionnaires. The female physicians scored higher in death anxiety than the male physicians. The psychiatrists scored higher in death anxiety than surgeons. There was a trend for the internists to have scores indicating a more external locus of control. Purpose in life was inversely correlated with death anxiety and external locus of control. Death anxiety was related to the physicians' preferred mode of conveying the news of an unexpected patient death to the next of kin.

Adult↗
PubMed1994

Local notification of infectious diseases--a neglected tool.

A country-wide survey of consultants in communicable disease control (CCDCs) was conducted to assess the use of Section 16 of the Public Health (Control of Disease) Act, 1984 for the local notification of infectious diseases. A response rate of 84% was achieved. The results indicate that, although the power is generally little used, 24 local authorities have locally notifiable diseases and at least eight CCDCs are actively considering the use of Section 16. The power may be particularly valuable as an additional tool in the surveillance of 'clinically diagnosed' and locally troublesome infections such as scabies.

Communicable Disease Control↗
PubMed1999

Prediction of the fish acute toxicity from heterogeneous data coming from notification files.

Four descriptors (Molecular weight, log(Pow), hardness and free energy of solvation) were selected to predict, on a training set of heterogeneous chemical compounds, the fish acute toxicity. The data were extracted from 523 notification files of new chemicals stored at the French Department of the Environment. The selection of the descriptors was carried out by using a statistical technique coupling OLS regression and genetic algorithm. The limits of validity for the final equation are discussed by comparing the actual and predicted activities on several compounds.

Algorithms↗
PubMed1982

Telephone notification of relatives of emergency and critical care patients.

Inconsistency in contacting the families of acutely ill patients can negatively affect relatives and induce stress in emergency department staff. Role clarification and performance guidelines are discussed in the context of a telephone notification of relatives checklist, with staff advised in six specific interventions to facilitate consistency; promote clarity; and prevent fears and fantasies, potential misunderstanding, reckless driving, and feelings of helplessness.

Adaptation, Psychological↗