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PubMed1984

Occupational hazards to health care workers: report of a conference.

Health care workers are exposed to an array of physical, chemical, biological, and psychosocial hazards. At a national conference in Seattle May 11-13, 1983, hospital occupational medicine programs were characterized as lagging far behind those in industries with comparable illness and injury rates. Participants and speakers recommended that health care workers be trained to recognize occupational hazards; that epidemiologic, laboratory, and clinical studies be undertaken to discern trends and establish the mechanisms of effects from hazardous exposures; and that adequate employee health and safety programs be established in health care settings.

Back Injuries↗
PubMed1991

An experimental study on the laryngeal electromyography and visual observations in varying types of surgical injuries to the unilateral recurrent laryngeal nerve in the neck.

A series of varying types of surgical injuries to the recurrent laryngeal nerve, including half section, double crush, suture ligation, and complete section of the nerve, was investigated in dogs by correlating clinical and electromyographic findings. The state of recovery from palsy was evaluated by recording the electromyography from the affected laryngeal muscles as well as by observing the movements of the vocal cords. Six electromyography patterns were recorded from the affected muscles following injuries to the recurrent laryngeal nerve. There is a close relationship between the electromyography patterns and the types of nerve injuries. Within 3 months after injuries of the recurrent laryngeal nerve, the electromyography motor unit potentials in the involved intrinsic laryngeal muscles and vocal cord movements on the side of the nerve injury were back to normal in the groups of dogs in which the recurrent laryngeal nerves were partially sectioned and doubly crushed; the electromyography potentials and vocal cord motion on the affected side did not return to normal in the group of dogs in which the recurrent laryngeal nerves were permanently ligated with suture. In the group of dogs which had had a complete section of the recurrent laryngeal nerve, no recovery of both electromyography and vocal cord function on the affected side was observed 6 months after injury of the recurrent laryngeal nerve. This study showed that the frequency of the regenerated potentials recorded from the affected muscles is related to the types and degrees of injuries to the recurrent laryngeal nerve. Recovery from recurrent laryngeal nerve palsy is complete within 3 months after nerve impairment if over half of the nerve fibers of the impaired nerve are maintained intact without degeneration. Moreover, the period from onset to complete recovery from palsy was remarkably short, less than 2 months. The most appropriate time for the electromyography examination to evaluate the degrees of the nerve injury and to anticipate the prognosis of recurrent laryngeal nerve palsy was proposed.

Animals↗
PubMed1967

Acute necrotic myelitis and perivenous encephalomyelitis associated with hypertension and renal infection.

The case reported showed acute necrotic myelopathy and acute perivenous encephalomyelitis against a background of renal infection, malignant hypertension, and a history of injury. Death from renal disease and pneumonia halted the neurological pathology in the acute stage, thus allowing a more detailed histological examination than is possible in the later stages. The pathogenesis of acute necrotic myelopathy, together with the effects of oedema and vascular compression in the cord, are discussed briefly.

Acute Disease↗
PubMed1985

Disabilities caused by road traffic accidents and their relation to severity scores.

The disabilities incurred by 2502 road accident patients admitted in three separate years to an Accident Hospital have been analysed. There were about equal numbers of disabled among pedestrians, motorcyclists and vehicle occupants. This corresponds to the high relative frequency and severity of injuries among motorcyclists. Most of the serious disabilities were caused by head or lower limb injuries. Different severities of disability were not closely correlated with Abbreviated Injury Scale (AIS), (ISS) or (PI) scores or with treatment periods but useful threshold values are described which separate groups with high and low rates of disability. For given severities of injury, disabilities were less severe among young casualties. Comparisons with other studies show rather wide variations in estimates of the incidence of slight disabilities. There is fair agreement with the present findings that serious disabilities occur in about 3% of inpatient hospital cases or in about 1% of total casualties.

Accidents, Traffic↗
PubMed1996

[Stress fractures. Spondylolysis and spondylolisthesis of the lumbar vertebrae among young athletes with back pain].

Frequency of spondylolysis is higher among athletes who perform movements involving repeated flexion and extension of the spine than in the normal population. This article describes 50 patients (30 women, 20 men) with spondylolysis/spondylolisthesis grade 1 who were examined at the Norwegian Institute of Sports Medicine. Handball, followed by soccer, were the dominating sports in our study. Most of the patients were 15-19 years old; 20 patients had had low back pain for more than 12 months from onset till the first examination. In 45 patients the defect was found in the fifth lumbar vertebra, in three in L3 and in two in L4. This study indicates that stress fracture is the most dominating cause of spondylolysis in athletes.

Adolescent↗
PubMed1987

Low back pain in athletes: an overuse syndrome.

Back ache in athletes is exceedingly common. Fortunately, most of these pain syndromes are self-limiting. A precise analysis of the patient will allow an accurate diagnosis, which leads to an understanding of the natural history of that particular problem. Surgical intervention is very rarely necessary and reserved strictly for those problems that are completely recalcitrant to nonsurgical measures.

Athletic Injuries↗
PubMedDate not supplied

Significance of lumbar spondylolysis in college football players.

We reviewed the records of 506 consecutive college football players over an eight-year period. Of these athletes, 135 (27%) had low-back pain. Because of persistent low-back symptoms, 58 players had roentgenograms of the lumbosacral spine; 12 cases of lumbar spondylosis were observed. From the 58 players for whom roentgenograms were available, two groups were compared with respect to time lost from games and practices. One group (N = 8) had low-back pain complaints with lumbar spondylosis. The randomly selected control group (N = 12) had low-back pain with no evidence of spondylolysis on roentgenograms. There was no significant difference in time loss between these two groups (4.8% versus 4.0%). It appears that lumbar spondylolysis is of minimal clinical significance over a short (four-year) period. The long-term implications of lumbar spondylolysis are clearly important but are not addressed in this study.

Athletic Injuries↗
PubMed2001

Injury patterns among female field hockey players.

PURPOSE: To examine injury patterns among female field hockey players and to broaden the current base of knowledge by identifying the injury rates of different playing positions. It was hypothesized that goalkeepers would have the highest rate of injury, followed by forwards. METHODS: High school, university, and national level female field hockey players (N = 158) completed an anonymous questionnaire. They reported personal characteristics (age, height, weight); field hockey information (level, years of experience, surface); injury history (type, site, cause, severity); and back pain information. Injury rates were calculated per athlete-year. RESULTS: The most frequently injured site of the body was the lower limb (51%), followed by the head/face (34%), upper limb (14%), and torso (1%). The most prevalent types of injuries were ankle sprains, followed by hand fractures and head/face injuries. Goalkeepers had the highest rate of injury (0.58 injuries/athlete-year), whereas midfielders were the most injured field players (0.36 injuries/athlete-year). Back pain was reported by 59% of the sample, and the lower back was the most common site of this pain. CONCLUSION: There are differences in the rates of injury among playing positions in field hockey and in the types of acute injury sustained at each position. The high number of injuries to the head and face region is also cause for concern. Although most of these injuries are minor, the serious injuries that do occur can be very severe. Now that these patterns have been identified, further examination of the playing situations that lead to injury should be undertaken.

Adolescent↗
PubMed1983

'Compensation neurosis': a review of the literature.

This review examines the literature on psychological reactions, often referred to as 'compensation neurosis', which occur after an accident and which are thought to be produced or maintained by a compensation claim. Theories and research are examined. The area is complicated and research so far is limited in scope and design. Few accident cases involve compensation claims and the incidence of psychological difficulties across the whole range of cases is unknown. Researchers have considered a number of background factors--severity of injury, pre-existing neurotic traits, social class, sex and age--but there has been little investigation of attitudinal, family, social and employment factors or of progress of the condition and follow-up after settlement. The review identifies a major research need for more adequate screening and sampling of cases and for more systematic investigation of personal and family factors.

Accidents, Traffic↗
PubMed2002

[Sacroiliac joint blockage caused by bedding after spinal anaesthesia can simulate a neurological complication].

Back pain after spinal anaesthesia is often attributed to the spinal anaesthesia and the accompanying puncture. We demonstrate two cases where this problem was not caused by spinal anaesthesia but was due to sacroiliac joint blockage caused by bedding. As far as we know, this complication has not been described yet. When taken into account, it can be treated easily and with success.

Anesthesia, Spinal↗
PubMed2000

Preventing injuries to competitive and recreational adult golfers: what is the evidence?

Although injuries to golfers are not common, both survey studies and hospital emergency department records have provided objective evidence that golfers are sometimes at risk of injury. While many golf injury studies describe the associated mechanisms and types of injuries, less attention has been given to research relating to the various injury prevention measures for this sport. This paper provides a critical review of the range of countermeasures to prevent golf injuries and highlights areas to be considered for future research, development, and implementation. In particular, it focuses on the strength of the evidence for the effectiveness of these measures. This review concludes that there needs to be more formal evaluation of the suggested countermeasures to prevent golf injuries. Particular attention should be given to evaluations of the golf swing and its relationship to particular injuries such as low-back, wrist, and shoulder problems. These countermeasures and associated strategies are recommended to reduce the incidence of injury in this popular and accessible sport.

Adult↗
PubMed2002

Perception of illness: nonspecificity of postconcussion syndrome symptom expectation.

A growing number of studies show postconcussion syndrome (PCS) symptom report is influenced by factors other than head injury, suggesting symptoms typically associated with PCS may not be specific to head injury. Given the role that symptom expectation has been hypothesized to play in PCS symptom etiology, a comparison of symptoms expected for various disorders seems overdue. The present study asked 82 undergraduates to report the symptoms they currently experience, and then to report the symptoms they would expect to experience if they had had suffered either a head injury, an orthopedic injury, posttraumatic stress, or depression. No current differences in overall symptoms or in symptom subscales emerged. Results showed individuals portraying head injury, posttraumatic stress, and depression expected an increase in total symptoms, though individuals portraying an orthopedic injury did not expect such an increase. Results also showed simulators of head injury, posttraumatic stress, and depression expected equivalent rates of overall symptoms, memory/cognitive complaints, somatic concerns, and distracter symptoms, though head-injured individuals reported fewer affective symptoms than those portraying psychological disorders. In all, these findings suggest that individuals have a relative lack of specificity in symptom expectation for various disorders, with the implication that symptom checklists for "PCS" may not be useful for diagnosis.

Accidents, Traffic↗
PubMed1991

Lumbar spine, sport and actual treatment.

Low back pains are very frequent in athletes by microtraumatisms and sudden efforts. The prolapse of the nucleus pulposus is created. After the failure of correct medical treatment, some new technics give good results: chemonucleolysis, trans-cutaneous nucleotomy, microdiscectomy. These techniques permit a faster and more active return to effort. The choice must be perfect: clinical examination and imagery manage this advance.

Athletic Injuries↗
PubMedDate not supplied

Disc degeneration in young gymnasts. A magnetic resonance imaging study.

Magnetic resonance imaging (MRI) was performed on 35 young competitive gymnasts and 10 control subjects in order to detect the number of degenerated discs and other lumbar spinal disorders. Lumbar radiographs were obtained from all gymnasts who showed evidence of disc abnormality on MRI. Eleven gymnasts had suffered from episodes of low back pain during exercises and eight were found to have evidence of back trauma. Only 3 of the 35 gymnasts had MRI evidence of degenerated discs associated with Scheuermann's manifestations and spondylolysis. Lumbar radiographs confirmed the diagnosis in these three cases. The results indicate that despite the excessive range of motion and strong axial loading of the lumbar spine that are associated with gymnastic maneuvers, incurable primary damage to the intervertebral discs is uncommon in young gymnasts during growth.

Adolescent↗
PubMed1998

Soft tissue tumors following traumatic injury: two observations of interest for the medicolegal causality.

Two cases of tumors of the soft tissues developing at the site of a previous traumatic injury occurring a few years earlier are reported. One was finally diagnosed as aggressive fibromatosis and the other as low-grade fibrosarcoma. Among the pathogenic mechanisms and the etiologic factors involved in such tumors, the posttraumatic causality is discussed, and in addition to the initial trauma, the role of iterative surgery in the first case and mineral muscular inclusions in the second case are examined. The different therapeutic approaches of such lesions are also reviewed.

Back Injuries↗
PubMed1979

Discriminatory aspects of pre-employment screening: low-back X-ray examinations in the railroad industry.

In screening the majority of job applicants, most of this nation's railroads administer a low-back X-ray examination in an attempt to ascertain the likelihood that the applicant will sustain future work-related low-back pain or injury. Many applicants are rejected for employment on the basis of the X-ray findings. The railroads apparently perceive this screening program as a cost-effective means (1) of decreasing the incidence of compensation claims for work-related injuries, brought against the railroads under the Federal Employers' Liability Act (FELA), (2) of reducing the number of lost workdays resulting from low-back pain or injury, and (3) of protecting particularly susceptible workers from job-related hazards. The authors of this Article submit that low-back X-ray examinations are poor predictors of future low-back pain or injury. They assert that the railroads' use of such examinations misclassifies a substantial number of job applicants as being at increased risk for such pain or injury, and, in consequence, unfairly denies them employment. Furthermore, the authors claim, the screening program has other negative consequences. For example, applicants rejected for railroad employment on the basis of X-ray findings may as a result have difficulty finding jobs in other industries. In addition, they state, there is a potential radiation hazard to examinees. Moreover, both the railroads and those applicants accepted for employment may inappropriately be reassured by normal findings. On balance, the authors conclude, the screening program has a negative social value. The authors suggest that the program, in effect, erraneously labels many applicants as handicapped, and then denies them employment. Such persons might have legal recourse under federal and state statutes prohibiting employment discrimination against the handicapped.

Back Pain↗
PubMed1999

Effects of a participatory ergonomics team among hospital orderlies.

BACKGROUND: High rates of work-related injuries are seen among health care workers involved in lifting and transferring patients. We studied the effects of a participatory worker-management ergonomics team among hospital orderlies. METHODS: This prospective intervention trial examined work injuries and other outcomes before and after the intervention, with other hospital employees used as a concurrent control. All orderlies in a 1,200-bed urban hospital were studied using passively collected data (mean employment during study period 100-110 orderlies); 67 orderlies (preintervention) and 88 orderlies (postintervention) also completed a questionnaire. The intervention was the formation of a participatory ergonomics team with three orderlies, one supervisor, and technical advisors. This team designed and implemented changes in training and work practices. RESULTS: The 2-year postintervention period was marked by decreased risks of work injury (RR = 0.50, 95% CI 0.35-0.72), lost time injury (RR = 0.26, 95% CI 0.14-0.48), and injury with three or more days of time loss (RR = 0.19, 95% CI 0.07-0.53). Total lost days declined from 136.2 to 23.0 annually per 100 full-time worker equivalents (FTE). Annual workers' compensation costs declined from $237/FTE to $139/FTE. The proportion of workers with musculoskeletal symptoms declined and there were statistically significant improvements in job satisfaction, perceived psychosocial stressors, and social support among the orderlies. CONCLUSION: Substantial improvements in health and safety were seen following implementation of a participatory ergonomics program.

Back Injuries↗
PubMedDate not supplied

Worker safety training in public hospitals in Costa Rica.

To develop a worker safety training program for its public hospital system, the Costa Rican Social Security System entered into a collaborative agreement with the University of Texas School of Public Health. A national survey to assess safety in the public hospitals revealed high rates of injury and under-reporting of injuries, as well a lack of worker safety training. A program developed based on the results of the survey was implemented using a training-of-trainers model. The program created opportunities for human resource development in occupational health in the hospital system, allowed for the sustainability of the training effort, and reduced dependency on external funding. Over 3700 workers were trained in its first three years, and 57 trainers were established in local hospitals and clinics.

Back Injuries↗