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Biomedical subjects

E D Acheson

Publications and source records attributed to E D Acheson.

16 recordsLinked to original sources
PubMed1979

Record linkage and the identification of long-term environmental hazards.

The long-term effects of toxic substances in man that have been discovered so far have involved gross relative risks or bizarre effects, or have stumbled upon by chance or because of special circumstances. These facts and some recent epidemiological evidence together suggest that a systematic approach with better methods would reveal the effects of many more toxic substances, particularly in manufacturing industry. Record linkage is a powerful tool because it makes possible the correlation of indicators of exposure with indicators of the biological effect of such exposure in the same persons or in their progeny even after considerable periods of time have elapsed. A system of linked records exists in England and Wales which is at present used by research workers to follow up samples of persons defined in various ways, e.g. in respect of exposure to a suspected toxic factor. In this way hypotheses about substances causing cancer or other lethal effects can be tested. It is suggested that there are two additional ways in which record linkage techniques could be used to identify substances with long-term toxic effects: the first would be by setting up a register of women employed in industry during pregnancy and linking this register to records of the occurrence of congenital malformations and of stillbirth or death in their children; the second would be to follow samples of workers in manufacturing industry, notably those engaged in the manufacture of products from raw materials including the chemical industry, to death and to the development of cancer. Regular analyses of material from these two systems of linked records would provide the basis for a monitoring system for certain gross effects of long-term toxic substances in man. There are two principal obstacles to further progress in this field. The first is the lack of a clear statement of public policy concerning the issues of confidentiality and informed consent in the use of identifiable personal records for medical research. A settlement is needed which defines the proper limits of their use in the interests of health with safeguards to privacy. The second obstacle is a lack of resources to improve the quality, accessibility and organization of the appropriate data.

Animals↗
PubMed1979

Variation in hospital stay after inguinal herniorrhaphy.

A study was carried out of 1086 men aged 16-65 inclusive who were admitted under nine consultants to eight hospitals in Wessex for elective repair of an inguinal hernia. The mean postoperative stay was 5.7 +/- SD 2.7 days. For different consultants operating at any one hospital the mean postoperative stays were similar, whereas for consultants who operated at more than one hospital they were significantly different. The postoperative stay was also significantly related to the size of the hospital, development of postoperative complications, time spent on the waiting list, type of repair used, bilateral herniorrhapy, and the use of convalescent facilities. The hospital therefore appears to exercise a greater influence in determining the mean postoperative stay than does the individual consultant.

Adolescent↗
PubMed1979

Sickness absence after inguinal herniorrhaphy.

Eight hundred and ninety-nine men were studied, aged 16-65 inclusive, who underwent an elective inguinal herniorrhaphy during 1970 and 1971 in eight hospitals in Wessex, and under nine consultant surgeons. There was a significant variation in postoperative inpatient stay and total sickness absence between hospitals and between consultants. The physical activity involved in the patient's occupation, his age at operation, previous sickness absence, bilateral herniorrhaphy, attendance at follow-up outpatients' clinic, type of repair, and the influence exerted by three hospitals and two consultants accounted for only 21% of the variation in total sickness absence. The general practitioners who had referred patients to the hospitals for herniorrhaphy, and the consultant surgeons who carried out the operations, were sent a questionnaire to ascertain their attitudes towards follow-up outpatient appointments and the various factors identified in the first part of the study as significantly influencing total sickness absence. A higher proportion of GPs who felt that an outpatient appointment was necessary before return to work was found in relation to the patients who had the longest mean total sickness absences than among the GPs who looked after the patients with shorter total sickness absences.

Adolescent↗
PubMed1976

Study of disease associations from linked records.

Comparisons are made between the principal diagnosis on discharge from hospital in successive periods of inpatient care for persons in the Oxford Record Linkage Study area admitted over a period of years. The observed numbers of pairs of diagnoses are compared with expected numbers computed to take account of the discharge rates in the population by age and sex and the number of man years of exposure. Three topics have been selected to display some of the types of analysis possible with the very extensive material: mental disorder and diseases of the central nervous system, hospital discharges preceding those for neoplasm, and discharges following those for tuberculosis. The details of the method of calculation of the observed and expected numbers and the assumptions and approximations involved are given in an Appendix.

Breast Neoplasms↗
PubMed1975

Peripheral neuropathy and indomethacin.

A patient with seronegative inflammatory polyarthritis developed a predominantly motorperipheral neuropathy associated with the use of indomethacin. Three other cases of peripheral neuropathy associated with indomethacin treatment have been reported to the Committee on Safety of Medicines. In all cases the neuropathy regressed when indomethacinwas stopped. Peripheral neuropathy should be recognized as a rare complication of indomethacin therapy and considered in the differential diagnosis of a neuropathy accompanyingrheumatoid arthritis.

Aged↗
PubMedDate not supplied

Mesothelioma and exposure to mixtures of chrysotile and amphibole asbestos.

This paper provides a new analysis of previously published work and draws attention to the possibility that mixtures of amphiboles and chrysotile appear more commonly in the lungs of mesothelioma patients compared to controls than do either of the main types of fiber alone. The possibility that these results may indicate a synergistic interaction between chrysotile and the amphiboles is discussed in the light of the epidemiological data.

Asbestos↗