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Biomedical subjects

E Drucker

Publications and source records attributed to E Drucker.

54 records · Page 3Linked to original sources
PubMed1989

Acquired immunodeficiency syndrome among adolescents. Case surveillance profiles in New York City and the rest of the United States.

Adolescents engaging in certain sexual or drug-related behavior are at risk of contracting the human immunodeficiency virus infection in endemic locales. Local and national surveillance data were analyzed to determine the characteristics of the acquired immunodeficiency syndrome (AIDS) epidemic on adolescents. Of the 605 cases of AIDS in people aged 13 to 21 years reported through 1987, 518 were males (83 from New York City [NYC], NY), and 87 were females (28 from NYC). Over half of all adolescent males with AIDS reported homosexual contact. Transfusion/blood product-related human immunodeficiency virus acquisitions (especially in males with hemophilia) represented 11% of adolescent cases from NYC (1% of NYC adults) and 22% of adolescent cases in the United States (US) outside of NYC (4% of adults in the US). Intravenous drug use was more frequently reported among adolescents with AIDS from NYC (23%) than among adolescents outside NYC (14%). In females, heterosexual transmission accounts for about half of all adolescent AIDS cases and 29% of all adult cases. Age-appropriate services and behavioral interventions are urgently needed for high-risk adolescents.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Asbestos disease in sheet metal workers: II. Radiologic signs of asbestosis among active workers.

A review of chest x-rays of 707 currently employed New York metropolitan area sheet metal workers found that 29.3% of the workers with 20 years or more of union membership (a surrogate for years of exposure) had radiologic abnormalities characteristic of parenchymal and/or pleural asbestosis, with 18.6% having abnormalities characteristic of parenchymal asbestosis (International Labor Organization [ILO] classification 1/0 or higher) and 17.4% of pleural asbestosis. The prevalence of abnormalities characteristic of either parenchymal and/or pleural asbestosis in the group as a whole was 16.4%, with 10.9% exhibiting signs of parenchymal asbestosis and 9.2% of pleural asbestosis. There was a strong, statistically significant relationship between years in the trade and the prevalence of radiologic abnormalities. These findings underscore the need for medical surveillance of all asbestos-exposed construction workers, including retirees and workers who have had past exposure but who are no longer exposed.

Adult↗
PubMed1987

Exposure of sheet-metal workers to asbestos during the construction and renovation of commercial buildings in New York City. A case study in social medicine.

New York City sheet-metal workers have a history of significant exposure to asbestos. Prior to 1972 when the use of sprayed asbestos insulation was banned in New York City, sheet-metal workers involved in building construction were exposed as they worked adjacent to spraying operations. Subsequent to that date, exposure continued as they renovated these same buildings. In 1982 the Occupational Health Program of Montefiore Medical Center and the Albert Einstein College of Medicine initiated a multidimensional asbestos evaluation and intervention program for the sheet-metal industry and union in New York. The long-term goal of the program was to eliminate asbestos exposure through the safe, systematic removal of asbestos in New York City buildings, most likely a legislated solution. In the short term, we attempted to assess and reduce asbestos exposure in the sheet-metal trade by a series of steps consisting of: mortality and morbidity studies; a medical audit of clinical screening services provided to sheet-metal workers; a comprehensive health education program; development of safe work practices; evaluation of personal protective equipment; and investigation into and support of legislative and regulatory solutions to the problem of asbestos contamination of commercial buildings. This intervention can be seen as a case study in the practice of social medicine.

Asbestos↗
PubMed1987

A prospective longitudinal study of neuropsychological and psychosocial factors in asymptomatic individuals at risk for HTLV-III/LAV infection in a methadone program: preliminary findings.

To test the hypothesis that cognitive impairment may be present early in the course of HTLV-III/LAV infection, intravenous drug abusers (IDVAs) without overt symptoms of AIDS related illness were tested with standard neuropsychological and psychosocial measures. This study is the baseline for a prospective longitudinal study of the natural history of HTLV-III/LAV infection in this high risk population. Of 211 subjects initially evaluated, 70 (33%) were HTLV-III/LAV seropositive and 141 (67%) were seronegative. At the baseline, by univariate analysis, the seropositive IVDAs were significantly (p less than .05) more impaired than seronegatives on 4 of 8 measures: Finger Tapping--dominant, hand, Digit Span Forward, Trail making A and WAIS-Similarities. However, by multivariate analysis the seropositives were significantly more impaired only on the WAIS-Similarities and Wechsler--Associative Learning tests. Multiple factors such as drug use and psychological stress may have influenced test performance. These preliminary results, however, suggest that seropositive IVDAs may show evidence of impaired neuropsychological function even in the absence of AIDS related symptoms and are consistent with the hypothesis of the early neurotropism of HTLV-III/LAV.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Asbestos disease screening by non-specialists: results of an evaluation.

We performed a medical audit of an asbestos disease screening program offered to New York City sheet metal workers by a corporate medical service. The screening program purported to evaluate the health status of workers exposed to asbestos in the past and present during construction and renovation of commercial buildings. Using current Occupational Safety and Health Administration (OSHA) regulations as a benchmark, medical records for more than 800 workers who took the examination between 1982-83 were reviewed; x-ray interpretations of the staff radiologist were compared with the interpretations of specialists in occupational lung diseases. The audit found inadequate record-keeping procedures, a lack of a comprehensive occupational history, poor notification and absence of any form of health education. Further, there was an extreme lack of concordance between the staff radiologist and the specialist readers in the interpretation of x-rays (kappa = .14 for pleural disease and .26 for asbestosis). To an increasing extent, occupational clinical services are being provided by corporate medical groups; such groups may not be familiar with occupational health problems.

Adult↗
PubMed1986

AIDS and addiction in New York City.

The association between AIDS and intravenous drug abuse is emerging as a critical component of the AIDS epidemic due to several factors: the high rate of infection of this group with the HTLV-III virus-approximately 50%; the risk of infection to others through shared needles, sexual contact, and intrauterine transmission to the fetus; and the impact of large numbers of new cases of AIDS among addicts on the health care services of a few urban areas. This paper outlines the projected dimensions of the AIDS epidemic among intravenous drug abusers in New York City and its implications for hospital utilization and local health care expenditures. These considerations indicate the urgent need for a rapid expansion of addiction treatment services and modification of treatment objectives to deal with this new problem.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Mercury poisoning in Nicaragua: a case study of the export of environmental and occupational health hazards by a multinational corporation.

Pennwalt Inc., a multinational chemical and pharmaceutical firm based in the United States, operates a chloralkali plant in Managua, Nicaragua. This plant utilizes elemental mercury in the production of chlorine and caustic soda for markets throughout Central America. The plant was recently found to be contaminating the waters of Lake Managua (on which the plant is located) with 2 to 4 tons of inorganic mercury effluent per year-over 40 tons in the 13-year history of the plant. Examination of the 152 workers employed in the plant showed that 56(37 percent) were suffering symptoms and signs of mercury poisoning, including tremors (in 45), memory and attention deficits (in 45) and paresthesias (in 52). Levels of airborne mercury vapor in the plant were found to range as high as 600 microgram/m3. (The airborne standard set by the U.S. Occupational Safety and Health Administration is 100 microgram/m3.) Workers in the plant had never been alerted to the hazards of mercury. The plant was found to be in deteriorated condition, with no recent investments in maintenance or modern safety equipment. It is reported that the parent corporation, Pennwalt, has been withdrawing capital from the operation (and from Nicaragua) since the fall of the Somoza regime.

Air Pollutants, Occupational↗
PubMedDate not supplied

Correlates of occasional cigarette and marijuana use: are teens harm reducing?

This paper examines characteristics that distinguish heavy and occasional cigarette and marijuana use among U.S. high school seniors. High school seniors who completed the 1994 Monitoring the Future survey (N = 15,929) were classified as nonusers, occasional users, and heavy users of cigarettes and marijuana. Level of use was examined with regard to degree of perceived risk of regular use, perceived risk of occasional use as well as several psychosocial factors previously shown to be associated with use (e.g., peer use, close friends' approval of use, and self-esteem). Involvement with other drugs and high-risk behaviors across levels of use was also examined. Heavy users of cigarettes or marijuana reported significantly lower perceived risk of regular use of each substance compared to occasional users. Heavy and occasional users did not generally differ with regard to perceived risk of occasional use. Compared to heavy users, occasional cigarette or marijuana users reported significantly lower rates of illicit drug use, heavy alcohol use, and high-risk driving behaviors as well as fewer problem behaviors and higher grades. Some adolescents may moderate their cigarette and marijuana use to minimize harmful effects they associate with heavier use (i.e., they may be practicing harm reduction). Additional research is needed to better understand controlled substance use, and incorporate this information into prevention and cessation programs.

Adolescent↗
PubMedDate not supplied

Drug prohibition and public health: 25 years of evidence.

FOR THE PAST 25 YEARS, the US has pursued a drug policy based on prohibition and the vigorous application of criminal sanctions for the use and sale of illicit drugs. The relationship of a prohibition-based drug policy to prevalence patterns and health consequences of drug use has never been fully evaluated. To explore that relationship, the author examines national data on the application of criminal penalties for illegal drugs and associated trends in their patterns of use and adverse health outcomes for 1972-1997.Over this 25-year period, the rate at which criminal penalties are imposed for drug offenses has climbed steadily, reaching 1.5 million arrests for drug offenses in 1996, with a tenfold increase in imprisonment for drug charges since 1979. Today, drug enforcement activities constitute 67% of the $16 billion Federal drug budget and more than $20 billion per year in state and local enforcement expenditures, compared with $7.6 billion for treatment, prevention, and research.Despite an overall decline in the prevalence of drug use since 1979, we have seen dramatic increases in drugrelated emergency department visits and drug-related deaths coinciding with this period of increased enforcement.Further, while black, Hispanic, and white Americans use illegal drugs at comparable rates, there are dramatic differences in the application of criminal penalties for drug offenses. African Americans are more than 20 times as likely as whites to be incarcerated for drug offenses, and drug-related emergency department visits, overdose deaths, and new HIV infections related to injecting drugs are many times higher for blacks than whites.These outcomes may be understood as public health consequences of policies that criminalize and marginalize drug users and increase drug-related risks to life and health.

Cross-Sectional Studies↗