Biomedical subjects

G Pransky

Publications and source records attributed to G Pransky.

25 records · Page 2Linked to original sources

PubMed1990

Radiologic detection of pleural thickening.

The purpose of this study was to investigate four aspects of the radiologic detection of pleural thickening: the specificity of chest X-rays read by B readers, the effects of threshold definitions of positivity, the extent of variability among different X-ray readers, and the effect of film quality. A series of 421 chest X-rays corresponding to consecutive autopsies was reviewed by six B readers working independently and using modified International Labour Organization forms. The prevalence of true pleural thickening was approximately 6%. Using a strict definition of positivity, the average specificity was 0.85. Specificity decreased when a more liberal definition was used. (The average sensitivity was 0.32, which appeared to increase with a more liberal definition of positivity; because of small numbers of true positives, the sensitivity estimates were unstable.) Kappa statistics for interreader agreement ranged from 0.06 to 0.40, suggesting considerable interreader variability. Decreasing film quality was associated with decreasing sensitivity, but specificity was not affected by film quality. Because the chest X-ray has suboptimal test characteristics in the diagnosis of pleural thickening and because there is considerable interreader variability, we conclude that caution is required in interpreting radiologic detection of pleural thickening using ILO procedures.

Asbestosis↗

PubMed1990

Occupational medicine specialists in the United States: a survey.

Although a shortage of occupational medicine experts has been suggested, no accurate enumeration of actively practicing physicians who are Board-certified in occupational medicine is available. A survey of all such physicians and recent occupational medicine residency graduates was conducted to determine practice type and level of activity. Older physicians tended to practice in industry-based settings, whereas younger physicians were more likely situated in clinic settings serving a variety of employees. Projecting from our responses, we estimate that about 650 occupational medicine specialists were actively practicing at the time of the survey and that about half are available to the community physician for consultation. Fewer than two thirds of recent residency graduates had pursued Board certification; this trend will lead to a gradual decline in the number of Board-certified occupational physicians.

Certification↗

PubMed1990

Illness and the workplace: a study of physicians and employers.

Seven million patients with work-related injuries are seen annually in the United States, the majority by primary care physicians. The number of such patients seen in a typical community practice may be significant but has never been studied. Most community-based physicians have little or no formal training in occupational health care. This study consisted of a survey of practicing physicians and major industrial employers in a city of 39,000 with a strong manufacturing base. The purpose was to assess physician skills, attitudes, and practices that might influence the optimal management of patients with work-related conditions, and to assess employer attitudes about this management. Eighty-three percent of physicians and 68% of employers responded to the written surveys. Low numbers of patients with work-related conditions were reported except by orthopedists and a neurologist. Few physicians communicated directly with employers, citing time and confidentiality as factors. Twenty-five percent were unaware of specific legal guidelines for such contact. Administrative and legal complexities were cited by 97% of the respondents as barriers to effective management of such cases. Eight percent of employers sought more contact with physicians, including site visits and more detailed work restriction guidelines. The education of primary care physicians may improve their understanding of work-related conditions and the optimal management and rehabilitation of these patients.

Communication↗

PubMed1989

Ocular infections and the industrial use of microscopes.

A cluster of ocular infections occurred in one area of a computer fabrication facility that relied on the use of industrial microscopes. A questionnaire was administered to all employees in this area. Microscope oculars were cultured and compared with control microscopes from a nonindustrial setting. Risk of infection was correlated with the number of hours of microscope use per day and subjective indicators of cleanliness. Bacterial cultures confirmed increased colony counts in industrial oculars compared with control oculars. Hygienic practices were instituted similar to those employed in medical settings. No further outbreaks of conjunctivitis have been reported in a 1-year follow-up.

Conjunctivitis↗

PubMedDate not supplied

Special populations in occupational health.

This introductory chapter lays the groundwork for the in-depth examination of special populations that follows. Drs. Frumkin and Pransky discuss what makes a population special, health disparities over the generations, and the evolving recognition of special populations in occupational health.

Health Priorities↗

PubMedDate not supplied

Workers with disabilities.

Individuals with disabilities constitute a sizable portion of the workforce and represent the majority of working-age persons who are unable to work. Historically, barriers to employment have included attitudinal discrimination by employers, lack of workplace accommodations, and inadequate job training. The disability rights movement has achieved considerable success in promoting legislation to remove these barriers and uphold equal employment. Research suggests that many employers actively attempt to incorporate persons with disabilities into the workforce and gain substantial economic benefit from their participation, without incurring burdensome expenses. Occupational health providers are asked by employers and others to provide input on feasibility and safety, a difficult task given the lack of scientific study on the occupational abilities and risks associated with specific disabilities. Providers have an important role in promoting the equal employment of disabled persons, by providing objective opinions on their ability and risks on the job and suggesting workplace accommodations and treatments that enhance the ability to work.

Civil Rights↗

PubMedDate not supplied

Genetically and medically susceptible workers.

The likelihood of an individual becoming ill from a hazardous material or condition is strongly influenced by both their genetic makeup and their underlying state of health. Although the past decade has seen great advances in understanding human variation in health and genetic polymorphisms and in the diagnosis and treatment of disease, much less progress has been made in effectively using this information to protect worker health. Scientific evidence for increased susceptibility often is weak and rarely satisfies legal thresholds for sufficient risk to warrant exclusion from a particular job. When public safety is a major concern, many legally mandated exclusions are not well justified. Medical opinions about fitness to work should be based upon a systematic and credible analysis of the condition, its relationship to ability and risk for a particular job, and knowledge of possible accommodations. Conclusions should reflect the limitations of scientific knowledge and guidance from antidiscrimination legislation.

Disability Evaluation↗