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Clifford S Mitchell

Publications and source records attributed to Clifford S Mitchell.

7 recordsLinked to original sources
PubMed2005

Risk of tuberculosis in correctional healthcare workers.

OBJECTIVE: The objective of this study was to determine the prevalence, incidence, and risk factors for occupational infection with tuberculosis among healthcare workers employed in correctional facilities. METHODS: The authors conducted a self-administered survey, clinical interview, and tuberculin skin testing. RESULTS: The overall tuberculin skin test point prevalence rate was 17.7%, the reactivity rate was 2.2%, and the annual incidence was 1.3%. At the multivariate level, after controlling for bacille Calmette-Guérin vaccination, only origin of birth remained significantly associated with prevalence of tuberculosis infection. CONCLUSIONS: Although the prevalence of tuberculin reactivity was high in this population, the risk factors were predominantly demographic rather than occupational. Nevertheless, continued vigilance to control occupational exposure to this and other respiratory pathogens is warranted, given the potential for future outbreaks of tuberculosis, as well as other known and emerging airborne pathogens.

Adult↗
PubMed2004

Worker training for new threats: a proposed framework.

BACKGROUND: In an effort to identify health and safety training needs for various groups of workers related to weapons of mass destruction, including chemical, biological, radiological, and nuclear weapons and high yield explosives (CBRNE), a conference, "Worker Training in a New Era: Responding to New Threats," was held at the Johns Hopkins Bloomberg School of Public Health in October 2002. METHODS: Two questions were addressed: Which general skills and knowledge are common to all workers who might be exposed to terrorist threats from CBRNE weapons? What are the particular skills and knowledge relevant to these threats that are specific to workers in different sectors? RESULTS: Thirteen core components for pre- and post-event training were identified. Pre-event training applies to all workers. Post-event training applies to selected personnel including first responders, skilled support personnel, and other workers involved in these operations. Recommendations to improve worker safety training related to preparedness include: identify specific competencies for worker pre- and post-event training; coordinate Federal policy on worker training for CBRNE hazards; adopt federal guidelines or standards on worker training for new CBRNE threats, based on the competencies and coordinated Federal policy; conduct an inventory of training programs and other resources that could be used or adapted for use for new threats; and develop new training content and methods for pre- and post-event training to address specific competencies. CONCLUSIONS: Given the possibility for the introduction of CBRNE threats into the workplace, all workers need some training in the potential hazards involved: the individual worker's specific role in an emergency; incident command; activation of the emergency notification system; use of personal protective equipment (PPE); and safe evacuation of the workplace. While some occupational sectors have developed effective training related to these new threats, there is a need to develop, implement, and evaluate training programs across many different sectors of the workforce.

Disaster Planning↗
PubMed2004

Human exposure to the jet fuel, JP-8.

INTRODUCTION: This study investigates anecdotal reports that have suggested adverse health effects associated with acute or chronic exposure to jet fuel. METHODS: JP-8 exposure during the course of the study day was estimated using breath analysis. Health effects associated with exposure were measured using a neurocognitive testing battery and liver and kidney function tests. RESULTS: Breath analysis provided an estimate of an individual's recent JP-8 exposure that had occurred via inhalation and dermal routes. All individuals studied on base exhaled aromatic and aliphatic hydrocarbons that are found in JP-8. The subject who showed evidence of the most exposure to JP-8 had a breath concentration of 11.5 mg x m(-3) for total JP-8. This breath concentration suggested that exposure to JP-8 at an Air Guard Base is much less than exposure observed at other Air Force Bases. This reduction in exposure to JP-8 is attributed to the safety practices and standard operating procedures carried out by base personnel. The base personnel who exhibited the highest exposures to JP-8 were fuel cell workers, fuel specialists and smokers, who smoked downwind from the flightline. DISCUSSION: Although study-day exposures appear to be much less than current guidelines, chronic exposure at these low levels appeared to affect neurocognitive functioning. JP-8-exposed individuals performed significantly poorer than a sample of non-exposed age- and education-matched individuals on 20 of 47 measures of information processing and other cognitive functions.

Adult↗
PubMed2003

Reproducibility of immunological tests used to assess multiple chemical sensitivity syndrome.

Whether persons with multiple chemical sensitivity syndrome (MCS) have immunological abnormalities is unknown. To assess the reliability of selected immunological tests that have been hypothesized to be associated with MCS, replicate blood samples from 19 healthy volunteers, 15 persons diagnosed with MCS, and 11 persons diagnosed with autoimmune disease were analyzed in five laboratories for expression of four T-cell surface activation markers (CD25, CD26, CD38, and HLA-DR) and in four laboratories for autoantibodies (to smooth muscle, thyroid antigens, and myelin). For T-cell activation markers, the intralaboratory reproducibility was very good, with 90% of the replicates analyzed in the same laboratory differing by < or = 3%. Interlaboratory differences were statistically significant for all T-cell subsets except CD4+ cells, ranging from minor to eightfold for CD25+ subsets. Within laboratories, the date of analysis was significantly associated with the values for all cellular activation markers. Although reproducibility of autoantibodies could not be precisely assessed due to the rarity of abnormal results, there were inconsistencies across laboratories. The effect of shipping on all measurements, while sometimes statistically significant, was very small. These results support the reliability of fresh and shipped samples for detecting large (but perhaps not small) differences between groups of donors in the T-cell subsets tested. When comparing markers that are not well standardized, it may be important to distribute samples from different study groups evenly over time.

Antigens, Differentiation, T-Lymphocyte↗
PubMedDate not supplied

Confidentiality in occupational medicine.

Confidentiality of personal medical information is a serious concern in occupational medicine. New regulations issued under the Health Insurance Portability and Accountablility Act (HIPAA) significantly alter procedures for protecting and managing confidential medical information. There are still questions about how much the new regulations will affect occupational medicine practices, but there will be significant changes in the collection, storage, and dissemination of personal medical information in the near future. The implications of increased confidentiality concerns on research are also considered.

Confidentiality↗