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Biomedical subjects

C E Ross

Publications and source records attributed to C E Ross.

At least 19 recordsLinked to original sources
PubMed1992

A prospective study of morbidity patterns in a petroleum refinery and chemical plant.

This study examined the morbidity experience from 1981 to 1988 of a prospective cohort of 3422 refinery and petrochemical plant employees from the Shell Deer Park manufacturing complex. The morbidity data for this study, which include all illness and absence records in excess of five days, were extracted from the morbidity section of the Shell health surveillance system. Standardised morbidity ratios (SMRs) of disease prevalence in this cohort were calculated using an internal comparison group of all manufacturing employees of the Shell Oil Company. Among production employees, the overall morbidity was statistically significantly higher (SMR = 109) than that of the comparison group. Illness due to hypertension (SMR = 144), haemorrhoids (SMR = 149), diseases of the nervous system (SMR = 120), respiratory system (SMR = 108), and digestive system (SMR = 117) were also raised for this group. The increased risk due to these medical conditions does not appear to be associated with occupational factors. Lymphatic and haematopoietic tissue neoplasms were raised (SMR = 124), but were based on only four cases.

Acute Disease↗
PubMed1992

Age and depression.

In this study, the relationship between age and depression is analyzed, looking for effects of maturity, decline, life-cycle stage, survival, and historical trend. The data are from a 1990 sample of 2,031 U.S. adults and a 1985 sample of 809 Illinois adults. The results show that depression reaches its lowest level in the middle aged, at about age 45. The fall of depression in early adulthood and rise in late life mostly reflects life-cycle gains and losses in marriage, employment, and economic well-being. Depression reaches its highest level in adults 80 years old or older, because physical dysfunction and low personal control add to personal and status losses. Malaise from poor health does not create a spurious rise of measured depression in late adulthood. However, some of the differences among age groups in depression reflect higher education in younger generations, and some reflect different rates of survival across demographic groups that also vary in their levels of depression.

Activities of Daily Living↗
PubMed1992

Personal and job characteristics of musculoskeletal injuries in an industrial population.

A cross-sectional study was conducted of 10,350 full-time regular employees who worked at Shell Oil Company's manufacturing facilities between 1987 and 1989. Two hundred seventy-five employees with low-back and 456 with nonlow-back musculoskeletal injuries were compared with 8295 employees who did not have musculoskeletal injuries during this period. Based on morbidity data collected from a prospective health surveillance system, this study shows that estimated relative risks (RRs) for low-back injuries are significantly higher among smokers (RR = 1.54, P less than .01) and overweight persons (RR = 1.42, P less than .01). This observation is also true for nonlow-back musculoskeletal injury (RR = 1.23, P = .05 for smokers and RR = 1.53, P less than .01 for overweight persons). In addition, persons in potentially more physically demanding jobs (primarily maintenance job titles) had an increased RR for both low-back and nonlow-back musculoskeletal injuries (RR = 1.57, P less than .01 and RR = 1.35, P = .02, respectively). The findings of this study suggest that it may be possible to reduce the impact of musculoskeletal injury through implementation of an integrated injury prevention program. Such programs would include not only the traditional elements of job factors evaluation and modifications, employee education and training, and an overall increased attention to ergonomics but also medical counseling and support for personal fitness programs, workplace smoking cessation programs, and weight-reduction programs.

Accidents, Occupational↗
PubMed1991

Prospective morbidity surveillance of Shell refinery and petrochemical employees.

Results for a prospective morbidity study of 14,170 refinery and chemical workers from 1981 through 1988 are presented. Illness/absence data for this study were extracted from the morbidity section of the Shell Health Surveillance System which includes records of all illness/absences in excess of five days. Age adjusted annual morbidity frequency rates and annual durations of absence are presented by age, sex, job, and work status. Generally, rates and durations of absence were highest for older age groups, women, and production workers. Increased risk was associated with the presence of known disease risk factors. Overall, 48% of the employees had at least one illness/absence in excess of five days during the eight year period. Twelve per cent of the employees had four or more absences, which accounted for 54% of the total number of absences and 52% of the total work days lost. Among men, the five most common conditions accounted for 72% of all illness/absences. In descending order they were injuries (25%), respiratory illnesses (17%), musculoskeletal disorders (14%), digestive illnesses (9%), and heart disease (7%). Similar patterns were noted among women. These findings may be useful in setting priorities and directing efforts such as health education programmes and other strategies for the prevention of disease.

Absenteeism↗
PubMed1991

Morbidity patterns among employees at a petroleum refinery.

This study examined the morbidity experience of a prospective cohort of 2132 male employees who worked at a petroleum refinery from 1981 through 1988. The morbidity data included all illness-absence episodes in excess of 5 days during the study period. Standardized morbidity ratios (SMRs) of disease prevalence were calculated using data from all manufacturing employees of the Shell Oil Company as an internal comparison group. As such, there is no potential bias associated with the "healthy worker effect" in this type of study design. Morbidity for all causes combined was virtually the same as that for the comparison group with 2,311 observed and 2,318 expected disease prevalence events. However, there were statistically increased prevalence of musculoskeletal system disorders (SMR = 136) and injuries (SMR = 125) among staff employees and skin and subcutaneous tissue disorders (SMR = 138) among production employees. A review of the original morbidity reports for these skin conditions revealed that none were due to exposure to chemical products or solvents. The SMR for neoplasms of the lymphatic and hematopoietic tissue among production employees was slightly elevated but was based on only three cases (2.4 expected). Of the three cases, none was due to leukemia.

Adult↗
PubMed1991

Medical surveillance for leukemia at a petrochemical manufacturing complex: four-year summary.

Four-year results are presented on 2086 participants of a medical surveillance program of current and retired employees at a manufacturing complex in Illinois. Annual complete blood cell count testing and intensive follow-up of all out-of-normal-range results began in 1985 on a voluntary basis. The program to date has not identified any evidence for an unusual distribution of out-of-range complete blood cell count results. Active employees with out-of-range complete blood cell count values had no increase in adverse health outcomes compared with those with in-range values. Retired employees with out-of-range values were more likely to have a serious underlying medical condition, but this appeared to be more a function of age than of occupational exposure. Four cases of myelodysplastic syndrome were brought to our attention as a result of the program, but there is no similarly followed population available for comparison to determine whether this represents an increase over expected cases. The lack of correlation of out-of-range complete blood cell count results in active employees with serious hematologic disease raises significant questions about the utility of such surveillance for chemically exposed groups (eg, benzene-exposed workers) when exposure levels are low and well controlled.

Adult↗
PubMed1990

Smoking and morbidity frequency in a working population.

As part of Shell's health surveillance program, morbidity frequency and severity by smoking status (current smoker, exsmoker, nonsmoker) were compared for the 3-year period 1985 through 1987. Morbidity data for this study were extracted from the morbidity section of the Shell Health Surveillance System, which included all illness and absence events in excess of 5 days. Statistically significant positive associations were seen between smoking habits and overall morbidity, diseases of the circulatory system, and diseases of the respiratory system for both male and female employees. In addition, a significantly increased association between smoking and both non-motor vehicle accidents and motor vehicle accidents among current smokers was noted. Current smokers had a greater than 60% higher frequency rate (P less than .05) for non-motor vehicle accidents than nonsmokers for both men and women. Male smokers also had a 75% increased (P less than .05) motor vehicle accident rate. These results suggest that it may be possible to reduce overall illness and injury morbidity through implementation of successful smoking cessation programs.

Accidents, Occupational↗
PubMed1990

An assessment of the effects of impaired renal function and haemodialysis on the pharmacokinetics of fluconazole.

1. The oral pharmacokinetics of fluconazole were studied in three groups of volunteers (n = 5) with various degrees of renal function (GFR greater than 70 ml min-1; 20-70 ml min-1; less than 20 ml min-1) and in a group of patients with chronic end-stage renal failure requiring regular haemodialysis. 2. The pharmacokinetics of fluconazole were markedly affected by impaired renal function with the elimination of half-life in Group III (GFR less than 20 ml min-1) being approximately three times that observed in normal volunteers (Group I). 3. Fluconazole renal clearance was positively correlated with GFR. 4. Non-renal clearance of fluconazole decreased with decreasing renal function. 5. Approximately 38% of the 50 mg dose of fluconazole was removed by haemodialysis extending over a 3 h period.

Adult↗
PubMed1990

Morbidity prevalence study of workers with potential exposure to epichlorohydrin.

This study examined the morbidity experience from 1981 to 1988 of two cohorts (Shell cohort and Enterline cohort) of workers who had potential exposure to epichlorohydrin (ECH). The morbidity prevalence data for this study were extracted from the morbidity section of the Shell health surveillance system which included all illness and absence records in excess of five days. For both cohorts, the standardised morbidity ratios (SMRs) for all causes and all neoplasms were similar to an internal comparison group. There were no increases in heart disease morbidity for the Shell cohort (SMR = 97) or the Enterline cohort (SMR = 90). The SMRs for heart disease in the lower exposure group of the Shell cohort were 101 and 93 for the corresponding Enterline cohort. They were 92 and 87, respectively, in the higher exposure group. The increased risk of heart disease mortality reported by Enterline et al in workers more heavily exposed to ECH was not confirmed in this morbidity study. Morbidity from skin and subcutaneous tissue disorders, however, was found to be increased significantly in the Shell cohort. The SMR was 98 for the lower exposure group and 195 for the higher exposure group. A review of the original morbidity reports for each case suggested that factors unrelated to exposure to ECH such as the physical demands of a particular job, amount of time outside--for example, exposure to poison ivy--and other underlying medical conditions may be of greater importance than exposure to ECH.

Adult↗
PubMed1990

Control or defense? Depression and the sense of control over good and bad outcomes.

Defense theory holds that defensive illusions guard well-being. People supposedly are least depressed if they claim responsibility for good outcomes and deny responsibility for bad ones. Control theory states that active, effective problem solving builds well-being; thus a sense of personal control and responsibility for both success and failure is associated with low levels of depression. Which theory is right? Regression analyses of the self-reports of 809 randomly selected Illinois residents show that a sense of responsibility for both successes and failures (instrumentalism) is associated with low levels of depression. There is no measurable benefit from claiming responsibility for the good things while denying responsibility for the bad (self-defense). Depression is associated with not feeling in control of good outcomes, or of bad outcomes, or of both. The sense of control reflects the reality of social and economic status. It explains part of the relationship between status and depression. We infer that defensive illusions are no substitute for genuine control.

Adolescent↗
PubMed1989

Psychiatric diagnosis as reified measurement.

Throughout the 1980s, psychiatry has promoted diagnosis--with its language of categories--as the preeminent measure of psychological problems. In clinical psychiatry, the decade opened with the publication of the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III). In psychiatric epidemiology, the decade saw the development of the Diagnostic Interview Schedule (DIS) and its use in the large-scale Epidemiologic Catchment Area (ECA) surveys. Proponents of the diagnostic approach herald the DIS as a breakthrough. We argue, on the contrary, that diagnosis as a form of measurement hinders understanding. If the ECA studies provide new insight into the patterns and causes of psychological problems, they will do so despite the use of diagnostic measurement. We present here a critical analysis of the inherent weaknesses of diagnosis as a form of measurement, particularly as a means of representing psychological problems. First, we describe the weaknesses: diagnosis treats attributes as entities; it reduces the signal but not the noise; and it collapses the structural relationships. Second, we offer an interpretation of why psychiatry promotes a form of measurement poorly suited to its subject: the linguistic legacy of nineteenth-century biology and epidemiology; the social construction of the need for mental health services; and the enclosure of a scientific and professional domain. Third, we conclude that diagnostic measurement impedes understanding. We recommend eliminating diagnosis from research on the nature, causes, and consequences of mental, emotional, and behavioral problems.

Humans↗
PubMed1989

Explaining the social patterns of depression: control and problem solving--or support and talking?

Research on the social patterns of depression in the community finds consistently that high levels of education and income, being male, and being married are associated with lower levels of depression. We attempt to explain these patterns as the result of two essential social perceptions: the sense of controlling one's own life rather than being at the mercy of powerful others and outside forces, and the sense of having a supportive and understanding person to talk to in times of trouble. In theory, the sense of control reduces depression because it encourages active problem solving, and the sense of support reduces depression because it provides others to talk to. We find evidence for the first proposition: persons who feel in control of their lives are more likely to attempt to solve problems. Perceived control and problem solving decrease depression and largely explain the effects of income and education on depression. We find, however, that support has mixed effects. Support decreases depression, but talking to others when faced with a problem, which increases with the level of support, increases depression. Support explains a small part of the effect of marriage on depression. Control and support have an interactive effect on depression, suggesting that control and support can substitute for one another to decrease depression: a high level of one reduces the need for the other, and a low level of one is remedied by a high level of the other.

Adolescent↗
PubMed1988

A study to assess the anticholinergic activity of rolipram in healthy elderly volunteers.

Rolipram is an antidepressant with a novel mechanism of action: enhanced noradrenaline (first messenger) synthesis and release, and inhibition of cAMP (second messenger) breakdown. This study was aimed at objectively assessing potential anticholinergic effects of rolipram in healthy elderly volunteers by measurement of saliva production and pupil size. Eight male volunteers between 67 and 77 years of age first received in a randomized manner either a single dose of 50 mg amitriptyline or a placebo control. After a minimum washout period of seven days, they then received a multiple dosing regimen of a) 0.75 mg and b) 1.5 mg rolipram given every eight hours over a 5-day period with a two day washout between a) and b). Whereas no changes at all in pupil size could be observed, amitripyline significantly reduced salivary flow. Rolipram however had no effect on saliva production after either single or repeated administration of 0.75 or 1.5 mg. The results are discussed in connection with pharmacokinetic parameters obtained in the study.

Aged↗
PubMed1988

Exercise and psychologic well-being in the community.

In a representative sample of 401 adults in Illinois in 1984, the authors found that increased participation in exercise, sports, and physical activities is associated with improved psychologic well-being. Part of this association is through improved subjective physical health. The authors controlled for potentially confounding factors, including sociodemographic characteristics, instrumentalism, and overweight. They concluded that exercise is associated with decreased symptoms of depression (feelings that life is not worthwhile, low spirits, etc.), anxiety (restlessness, tension, etc.), and malaise (rundown feeling, trouble sleeping, etc.) in the general population, most of which is not severely depressed, and in which many persons are engaged in moderate, nonaerobic exercise.

Adolescent↗
PubMed1988

Bkm sequences from the human X chromosome contain large clusters of GATA/GACA repeats.

In order to determine whether the regional localizations of Bkm repeats detected on the human X chromosome consisted of typical GATA/GACA repeats, clones were isolated, mapped, and sequenced. Nine Bkm-hybridizing clones from Kunkel's fluorescent-activated, cell-sorted X-chromosome library were all unique. Five were mapped in detail with restriction enzymes and the Bkm-hybridizing segments were localized. Confirmation of X chromosomal homology was obtained for 2 of the clones and Bkm segments from these 2 clones were sequenced. Seventeen contiguous GATA repeats were found in each clone and the overall repeat arrangement showed relatively few differences from previously sequenced Bkm sequences. These are the first sequences of human Bkm repeats. The results, when compared with previously published results, suggest that there may be significant differences between the organization of Bkm repeats on the human X and on the human Y chromosome.

Base Sequence↗