Biomedical subjects

C Needleman

Publications and source records attributed to C Needleman.

7 recordsLinked to original sources

PubMed1997

Applied epidemiology and environmental health: emerging controversies.

This review article assesses the state of the science in environmental epidemiology, not by summarizing current scientific findings but rather by examining conceptual controversies in the study of how environmental factors influence human health. This approach seems necessary because environmental epidemiology presently stands at a crossroads-in fact, at a number of overlapping crossroads. The field teems with epistemologic debates concerning appropriate paradigms for framing research questions, interpreting data, and applying research findings to policy. The present review focuses on emerging controversies related to three questions: What is considered "environmental"? What counts as credible research in environmental epidemiology? And what does "applied epidemiology" mean in the context of environmental health? The goal is to organize the presently fragmented critical literature on these issues and to promote productive dialogue by identifying central themes in current conceptual debates.

Environmental Health↗

PubMed1996

Qualitative methods for intervention research.

Intervention research takes place in field settings and requires understanding of social meanings and social processes. These are tasks for which qualitative research methods are well suited. The purpose of this paper is to provide a starting point for those who would like to learn more about the qualitative research methods used in disciplines where the study of social phenomena in naturalistic settings is common-particularly sociology, cultural anthropology, and human services program evaluation. The paper discusses some ways that qualitative and quantitative methodologies can usefully work together, outlines four key differences in the initial premises of quantitative and qualitative research approaches, briefly reviews some methodological techniques useful in gathering and analyzing qualitative data, and provides suggestions for further reading on various aspects of qualitative research.

Anthropology, Cultural↗

PubMed1996

Overcoming practical challenges in intervention research in occupational health and safety.

In addition to more familiar research issues, intervention research projects in naturalistic settings present the investigator with a number of practical challenges including gaining access to potentially resistant populations, maximizing participation rates in the face of weak incentives for cooperation, getting valid answers to sensitive questions, and meeting ethical obligations when health or legal problems are discovered in the course of study. Generalizable approaches to these challenges are addressed in the context of a retrospective evaluation of the implementation of OSHA's 1984 ethylene oxide standard in Massachusetts hospitals. In the evaluation study, enthusiastic cooperation was secured, a 96% participation rate was realized, sensitive questions were posed successfully, and worker health risks discovered in the course of study received attention without having to wait for the write-up of the study results. Key elements in the study population's receptivity appear to have been (I) the investigator's familiarity with the hazard, its setting, respondent concerns and needs, and (2) reciprocity in the form of providing follow-up consulting services as an integral part of the research process, delivered to each hospital at the conclusion of data collection. Specific techniques used in the study are presented in the hopes of aiding other investigators facing similar practical challenges in occupational health and safety intervention research.

Air Pollutants, Occupational↗

PubMed1994

Occupational impairment and disability among applicants for Social Security disability benefits in Pennsylvania.

OBJECTIVE: The study goal was to assess the extent of workplace-related disease and injury among Social Security Disability Insurance applicants. METHODS: A convenience sample of 240 consecutive applicants to the Pennsylvania Bureau of Disability Determination was studied to assess the prevalence of work-related disorders. An applicant had a work-related condition if there was a clear statement of a workplace illness or injury associated with the impairment, or if the applicant had worked at an occupation with a high likelihood of exposures known or suspected to contribute to the condition of interest. RESULTS: Of the 240 applicants, 166 (69%) were awarded disability insurance benefits; a total of 27 (11%) had work-related conditions, including 14 of the 166 (8%) who were found to be disabled. Forty percent of the 27 had a disorder that was musculoskeletal in origin. Of 59 applicants with cancer, 10.2% had some work-related etiological component. Of an estimated 71,680 adult disability insurance applicants in Pennsylvania in 1990, 5134 new insurance beneficiaries had a projected occupationally related disability. CONCLUSIONS: A substantial number of applicants for disability insurance benefits suffer from an impairment caused or exacerbated by prior workplace exposures. These individuals may serve as sentinel events for initiating follow-up surveillance and prevention activities.

Accidents, Occupational↗

PubMed1993

Worker notification: lessons from the past.

The methodological choices being made in current worker notification programs are influenced in both obvious and subtle ways by certain ground-breaking notifications carried out during the 1970s and 1980s. A lore has built up concerning these cases. Their names are heavy with implied meaning. As worker notification gains in acceptance and frequency, some of those newly interested in the area will be unfamiliar with these early cases, their significance, and their lessons. To help provide a context for these proceedings, six landmark worker notifications are briefly described here. Different cases might have been chosen; more cases might have been added. However, these six give a flavor of the struggles, trials, triumphs, and insights that have marked worker notification's passage through recent history.

Communication↗

PubMed1993

Social aspects of high-risk notification among chromium-exposed workers.

This study, based on 169 telephone interviews, explores how a sample of chromium-exposed workers responded to notification of their cohort's elevated risk of lung cancer. It is important to recognize that notified workers do not react as isolated individuals. Their responses are social, actively constructed through interaction with others, unfolding over time within a context of relationships and shared symbols that mediate the risk information. This report illustrates some of the ways that socially-based beliefs and interaction with the social environment can influence worker response, and suggests a more sociologically sophisticated concept of notification to fit the realities of workers' lives.

Adult↗

PubMed1991

Costs of occupational injury and illness in Pennsylvania.

A variety of state and federal data sources are used to estimate two critical components of the annual economic costs of occupational injuries and illnesses in Pennsylvania: foregone earnings of affected workers and medical costs. Foregone earnings costs resulting from occupational injuries and illnesses are estimated at between $1.22 billion and $2.02 billion in 1988. A number of potential adjustments to these estimates widen the range considerably. Estimates of medical costs range from $740 million to $797 million. Combining these two estimates gives total estimated costs of $1.96 billion to $2.82 billion.

Accidents, Occupational↗