PubMed Health⌕ Search

Biomedical subjects

Alan M Ducatman

Publications and source records attributed to Alan M Ducatman.

8 recordsLinked to original sources
PubMed2006

Corpus callosum volume in railroad workers with chronic exposure to solvents.

OBJECTIVE: Changes to cognition and behavior have been reported after long-term exposure to solvents. Solvents are hypothesized to affect brain white matter. To test this, we examined the volume of the corpus callosum in workers with a history of exposure to solvents. METHODS: We manually traced (blind to group membership) the volume of the corpus callosum in 31 railroad workers and 31 matched controls. RESULTS: There was a decrease in the genu of the corpus callosum in the solvent-exposed workers compared with controls. A smaller volume of the genu of the corpus callosum was associated with greater exposure and worse performance on cognitive tasks. CONCLUSIONS: This study supports the hypothesis that occupational exposure to solvents affects the anterior white matter of the brain and is related to extent of exposure and degree of cognitive change.

Brain Diseases↗
PubMed2006

Longitudinal case-based evaluation of diagnostic competency among pathology residents: a statistical approach.

CONTEXT: Accreditation Council for Graduate Medical Education guidelines require the evaluation of residents in 6 competencies. Pathology residents demonstrate medical knowledge, patient care, communication, and practice-based learning competencies in their attainment of competency in surgical pathology diagnosis. OBJECTIVE: To implement a prospective case-based approach to longitudinally evaluate the acquisition of competency in surgical pathology diagnosis by trainees. DESIGN: Each resident made his or her surgical pathology diagnosis on cases before faculty review of the cases. Faculty members scored each resident diagnosis as to whether they agree, partially agree, or disagree with the diagnosis. Forty-three months of surgical pathology reports (August 2001 through January 2005) and 22,252 surgical pathology cases were analyzed. SETTING: Pathology residency program. PARTICIPANTS: Thirteen faculty members and 21 trainees. MAIN OUTCOME MEASURE: Time and training year trends for the number of cases reviewed and the percent agreement between faculty and trainees on the diagnoses. RESULTS: A mean of 146 cases (range, 12-327 cases) was reviewed during each month-long rotation. The number of cases reviewed increased through postgraduate year 4. The percent agreement on the diagnoses was 78% (range, 56%- 99%) for all trainees, with improvement by postgraduate year, although the improvement attenuated by postgraduate year 3. Residents were less likely to preview the most complex cases. Faculty rank and sex and resident sex did not significantly affect outcomes. The overall agreement on the diagnoses increased over time. Residents experiencing difficulty could be identified clearly and early. CONCLUSIONS: Individual resident performance was easily tracked over time. The review of hundreds of reports increases systems accountability and allows more objectivity than traditional evaluations. The use of case-based evaluation fosters earlier identification and remediation of deficiencies.

Case Management↗
PubMed2004

Occupational carbon monoxide poisoning among West Virginia workers' compensation claims: diagnosis, treatment duration, and utilization.

Incidence rates and characterizations of occupational carbon monoxide (CO) poisoning in terms of sources of exposures, diagnosis, treatment, and health care utilization are critical for public health planning. We identified 182 CO poisoning cases occurring over a 6-year period (IR = 4.3/100000 worker-years) in the West Virginia workers' compensation data. Frequent sources of poisoning were gas-powered engines (28%) and furnaces (20%). Minimum treatment duration ranged from 1 day to 8 years with significant differences in mental health comorbidities between cases treated within 1 year compared with cases treated for more than 1 year (OR = 20.75; 95% CI = 3.5-128.4). The average cost (medical and wage loss replacement) for CO claims was dollars 2130 and median lost time was 45 days. CO poisoning could lead to prolonged disability and treatment in patients with mental health comorbidities, suggesting a possible role for early intervention.

Adult↗
PubMed2003

Risk factors for physical assault. State-managed workers' compensation experience.

BACKGROUND: The estimation of incidence and evaluation of risk factors associated with nonfatal occupational assault injuries have rarely been documented in a statewide population context. A state-managed workers' compensation system can provide estimates of incidence of such injuries and allow evaluation of risk factors. METHODS: Using claims data from the state-managed West Virginia Workers' Compensation, the incidence rates of workplace injuries resulting from physical assault were estimated for the period 1997-1999. Data on potential risk factors were obtained from the claim-related electronic data files, and the risk associated with each factor was assessed using proportional injury ratios (PIRs). RESULTS: During the study period, 2122 compensated injuries were associated with workplace violence. The incidence of assault injuries was 108.2 cases per 100,000 employee years. Women sustained a higher incidence than men. Healthcare workers, public safety workers, and teachers accounted for almost 75% of all assault injuries. Workers in these occupations also differed from each other with regard to seasonality and timing of assault, perpetrator-victim relationship, and types of injury. Evidence of gender-occupation interaction indicated higher risk of assault injury in men compared to women across the three leading occupations. Nighttime work shifts were associated with greater risk of assault for female healthcare workers (PIR=1.8; 95% confidence interval, 1.09-2.87). CONCLUSIONS: The healthcare sector sustained the bulk of assault injuries in West Virginia. Although the majority of healthcare-sector employees were women, the risk of assault injuries was higher in male employees. Risk factors and injury characteristics identified in this study, particularly for three high-risk occupations, should help develop strategies for preventing workplace violence. Protecting female healthcare workers on night-shift duty, especially in nursing home settings, appears to be an important target for intervention.

Female↗
PubMed2003

Quantification of lead in telephone cord: use of x-ray photoelectron spectroscopy technique.

There have been historic concerns that lead has existed as a plasticizer in telephone lines, causing health hazards, especially for children, who frequently mouth, chew, and swallow non-food items. The acid environment of the mouth may leach lead from the surface into the saliva under non-destructive conditions. Thus, distinguishing the amount of lead in the surface versus the inside of the polyvinyl chloride (PVC) material covering the phone cord line is very important in assessing health hazards. Using X-ray Photoelectron Spectroscopy (XPS), we measured lead in the PVC covers of telephone cords that connect the handheld part of the phone to the base. Lead was detected in both the inner and outer surface of an older (approximately 12 years) cord (1.3 atomic percent in inner surface; 0.4 atomic percent in the outer surface). However, when we tested four popular brands of newer cords (currently available in the market), there was no detectable lead. This study demonstrates that XPS is a useful technique that can distinguish lead contents between surface versus inner core of plasticized telephone cords. Telephone cords and other plasticized materials that may leach lead should be screened to establish safety.

Environmental Monitoring↗