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D McElvenny

Publications and source records attributed to D McElvenny.

7 recordsLinked to original sources
PubMed2001

Self-reported skin problems among physical processors in the chemical industry in Great Britain.

Contact dermatitis is common in the chemical industry. A cross-sectional study was conducted to investigate the prevalence of self-reported skin problems in employees involved in the drying, blending, milling, grinding and filling/bagging end of chemical manufacture in small- to medium-sized contract manufacturing/processing chemical companies in Great Britain. There were several secondary aims. Twenty-three per cent of the employees interviewed reported having had a skin problem in the previous 12 months. Of those reporting problems, 46% were always/nearly always involved in blending and 56% were always/nearly always involved in filling and bagging. These same processes were also more commonly associated with continuous or recurring skin problems. Seventy-five per cent reported a problem involving the upper limbs; most had more than one body area affected. Forty-three per cent had consulted a doctor (67% their general practitioner) and 9% took time off work as a result of their skin condition. Skin problems seemed to peak (34% employees) in those who had spent between 1 and 2 years in their current job. Solvents, known skin irritants, were the most frequent, single category of chemicals encountered in the study. Over 92% had been told how to avoid skin problems; 85% reported that they always/almost always wore protective clothing. Despite these measures, a significant number had reported having had a skin problem related to their work in the previous 12 months. Particular attention to control measures based on risk assessment is recommended for these physical processors in the chemical industry. Further research is also recommended into the whole area of personal protective clothing and the individual worker's perception of risks to health in the workplace.

Adult↗
PubMed2001

Update of the follow-up of mortality and cancer incidence among European workers employed in the vinyl chloride industry.

Although vinyl chloride is an established cause of liver angiosarcoma, the evidence is inconclusive on whether it also causes other neoplastic and nonneoplastic chronic liver diseases as well as neoplasms in other organs. Furthermore, the shape of the dose-response relation for angiosarcoma is uncertain. We have extended for approximately 8 years the mortality and cancer incidence follow-up of 12,700 male workers in the vinyl chloride industry in four European countries. All-cause mortality was lower than expected, whereas cancer mortality was close to expected. A total of 53 deaths from primary liver cancer (standardized mortality ratio 2.40, 95% confidence interval = 1.80-3.14) and 18 incident cases of liver cancer were identified, including 37 angiosarcomas, 10 hepatocellular carcinomas, and 24 liver cancers of other and unknown histology. In Poisson regression analyses we observed a marked exposure response for all liver cancers, angiosarcoma, and hepatocellular carcinoma. The exposure-response trend estimated for liver cancer in analyses restricted to cohort members with cumulative exposures of <1,500 parts per million-years was close to that estimated for the full cohort (relative risk of 2.0 per logarithmic unit of cumulative dose). No strong relation was observed between cumulative vinyl chloride exposure and other cancers. Although cirrhosis mortality was decreased overall, there was a trend with cumulative exposure.

Carcinogens↗
PubMed2000

Some practical issues in the design, monitoring and analysis of a sequential randomized trial in pressure sore prevention.

A sequential double blind (assessor and patient) triangular design was used to compare the incidence of pressure sores following elective major surgery among patients lying on a standard foam mattress with those on a dry visco-elastic polymer pad during their operation. A total of 446 patients were recruited into the trial between 1994 and 1996. Interim analyses were carried out after 181 patients were entered into the trial and then subsequently after approximately every 100 patients recruited. The trial unexpectedly reached a stopping boundary at the first interim analysis, however the Independent Data Monitoring Committee recommended continuation of the trial. They were concerned that there was a need for a larger definitive trial and about an apparent treatment by centre interaction. They required a substudy to be undertaken to further validate the subjective endpoint, and that further sensitivity analyses of the main trail endpoint should be carried out in the second interim analysis. The trial was stopped at the third interim analysis when again a stopping boundary was crossed indicating that the gel pad was associated with significantly fewer pressure sores than the standard mattress (log odds ratio -0.7, (95 per cent confidence interval (CI), -1.28, -0.11), p=0.02) (estimate CI, p-value adjusted for group sequential conduct). The design, monitoring and analysis of this trial will be presented as an example of the practical problems or non-problems encountered for the local hospitals, for the trials unit, for the data monitoring committee and for the funding committee.

Beds↗
PubMed2000

Prognostic factors associated with pressure sore development in the immediate post-operative period.

The purpose of this study was to identify variables associated with post-operative pressure sore incidence. The data were derived from a sequential, double triangular, randomised, blinded, controlled trial of the intra-operative use of a visco-elastic polymer pad conducted at two centres. Of 446 surgical patients recruited the main endpoint was assessed for 416 patients of whom 65 (15.6%) had a post-operative pressure sore. Analysis determined that the probability of a patient developing a pressure sore was associated with increased number of hypotensive episodes and mean core temperature during surgery, and reduced mobility Day 1 post-operatively. The development of a probability equation illustrates the future potential of prognostic factor research in the development of risk assessment tools and their application within clinical settings.

Aged↗
PubMed1998

A sequential randomised controlled trial comparing a dry visco-elastic polymer pad and standard operating table mattress in the prevention of post-operative pressure sores.

Four hundred and forty-six general, vascular and gynaecological surgical patients were recruited to a two centre, double triangular sequential randomised controlled trial to compare the post-operative pressure sore incidence in patients positioned on the standard operating table mattress with those positioned on the dry visco-elastic polymer pad (Action Products Inc.). Two hundred and twenty two patients were randomised to the experimental group and 224 to the standard mattress. The main endpoint failure rate (a pressure sore) was found to be 11% (22/205) for patients allocated to the dry visco-elastic polymer pad and 20% (43/211) for patients allocated to the standard operating table mattress. There was a significant reduction in the odds of developing a pressure sore on the dry visco-elastic polymer pad as compared to the standard, [symbol see text] = 0.46 with 95% confidence interval of (0.26, 0.82), P = 0.010. The adjusted point estimates of the probability of developing a pressure sore on the dry visco-elastic polymer pad and the standard operating table mattress were 0.11 and 0.21 respectively.

Aged↗
PubMed1993

Geographical distribution of preconceptional radiation doses to fathers employed at the Sellafield nuclear installation, West Cumbria.

OBJECTIVE: To examine whether the geographical distribution of births associated with preconceptional exposure of fathers to radiation at the Sellafield nuclear installation is consistent with the suggestion that this exposure explains the excess of childhood lymphoid malignancy in the adjacent village of Seascale. DESIGN: Retrospective birth cohort study. SETTING: Cumbria, West Cumbria health district, and Seascale civil parish. SUBJECTS: The 10,363 children born in Cumbria during 1950-89 to fathers employed at Sellafield. MAIN OUTCOME MEASURES: The doses of external whole body ionising radiation received by fathers at Sellafield in the total time and in the six months before conception of their children; the proportions of the collective doses associated with Seascale and the rest of West Cumbria. RESULTS: 9256 children were born to fathers who had been exposed to radiation before the child's conception. Of these, 7318 had fathers who were exposed in the six months before conception. Overall 7% (38 person-Sv) of the collective total preconceptional dose and 7% (3 person-Sv) of the collective dose for the six months before conception were associated with children born in Seascale. Of all the children whose fathers worked at Sellafield, 842 (8%) were born in Seascale. The mean individual doses before conception were consistently lower in Seascale than in the rest of West Cumbria. CONCLUSIONS: The distribution of the paternal preconceptional radiation dose is statistically incompatible with this exposure providing a causal explanation for the cluster of childhood leukaemias in Seascale.

Adult↗