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Biomedical subjects

J L Weeks

Publications and source records attributed to J L Weeks.

At least 19 recordsLinked to original sources
PubMed1991

Occupational health and safety regulation in the coal mining industry: public health at the workplace.

The strategy for preventing occupational disease and injury in the coal mining industry employs several elements. Standards are set and enforced; technical assistance, research, and development are provided; and surveillance is conducted. Compensation for black lung is a vivid reminder of the consequences of failure to prevent disease. And, workers are represented by a union that encourages active participation in all aspects of this strategy. There are significant problems in each of these elements. Regulatory reform threatens to weaken many standards, there is a decline in government research budgets, surveillance is not well monitored, and compensation for black lung is significantly more difficult to obtain now than in the past. Moreover, the conservative governments of the past decade are not friendly towards unions. Nevertheless, the fundamental structure of disease and injury prevention remains intact and, more importantly, it has a historical record of success. The Mine Safety and Health Act provided for a wide array of basic public health measures to prevent occupational disease and injury in the mining industry. These measures have been effective in reducing both risk of fatal injury and exposure to respirable coal mine dust. They are also associated with temporary declines in productivity. In recent years, however, productivity has increased, while risk of fatal injury and exposure to respirable dust have declined. At individual mines, productivity with longwall mining methods appear to be associated with increases in exposure to respirable dust. These trends are not inconsistent with similar trends following implementation of regulations by OSHA. When OSHA promulgated regulations to control exposure to vinyl chloride monomer, enforcement of the standard promoted significant efficiencies in vinyl chloride production (5). Similarly, when OSHA promulgated its standard regulating exposure to cotton dust, this effort provoked modernization in the cotton textile industry (14). It is not inevitable that occupational health and safety regulations are associated with negative economic performance. On the contrary, in some instances, public health on the job and productivity are complementary.

Accidents, Occupational↗
PubMed1990

Occupational medicine in Canada: an end or a new beginning?

Occupational medicine is frequently described in the broad context of the provision of occupational health services as a whole. Although this approach reflects the concepts currently underlying the delivery of occupational health services in Canada and in other countries, it is sometimes necessary to consider the problems that relate specifically to occupational medicine and to those who practise in this field. In this article some of these problems are discussed and suggestions made as to the way in which occupational medical practice may develop in Canada.

Canada↗
PubMed1989

New kidneys.

Explore the source record for details and available documents.

Ethics↗
PubMed1989

Epidemic of "shocks" in telephone operators: lessons for the medical community.

In January 1986 two brief power failures occurring within an hour of each other affected the operation of visual display terminals in a section of the Manitoba Telephone System. After the power failures three operators reported an alarming tingling sensation in their arms and one side of their body, which they called "shocks". Other operators then began to report incidents of numbness and tingling in their limbs, face or head as well as other, diffuse symptoms. During the next 2 weeks 92 such incidents were reported by 55 operators. The media carried alarming headlines, and medical practitioners perpetuated the label of "electric shock". Despite extensive investigation, which revealed no electrical fault, the section was closed by the regulatory authority, and an independent medical panel was convened to review the findings. The panel concluded that there was no immediate hazard to life or health and recommended continued workplace assessment and follow-up of affected operators; however, because the panel lacked electrical engineering expertise, uncertainty persisted as to the cause of the events. The reports of incidents persisted, peaking in association with continued rumours of diagnoses of "nerve damage". In the fall of 1987 a multidisciplinary committee ruled out as causative factors all known hazards other than electrostatic shock and occupational stress. This costly and lengthy investigation underlines the danger in regarding collective stress reaction as a diagnosis of exclusion. It highlights the need to scrutinize objective evidence before validating potentially unfounded concerns and underlines the desirability of considering the psychosocial effects of technology and regimented tasks.

Disease Outbreaks↗
PubMed1989

The use of epidural bupivacaine following total knee arthroplasty.

Pain relief and maximization of knee joint range of motion (ROM) are the two major goals in the postoperative management of the total knee arthroplasty (TKA) patient. Epidural bupivacaine infusions have been reported to be safe and effective for pain control in obstetric anesthesia, chronic pain management, and postoperative pain relief. The purpose of this study was to evaluate the effect of continuous epidural bupivacaine on postoperative pain and progressive knee ROM as well as to record the incidence of urinary retention and other side effects or complications. Continuous epidural bupivacaine infusion was found to provide safe, effective analgesia for TKA patients in the immediate postoperative period. Excellent pain relief with reduced narcotic requirements was observed in the patients as compared to intramuscular narcotic analgesia. No complications occurred and serum bupivacaine levels remained well below toxic levels. Short term clinical orthopaedic outcome was improved, and patient, surgeon, and nurse acceptance of the technique was excellent.

Aged↗
PubMed1986

Compensation for occupational disease with multiple causes: the case of coal miners' respiratory diseases.

Many diseases associated with occupational exposures are clinically indistinguishable from diseases with non-occupational causes. Given this, how are fair decisions made about eligibility for compensation? This problem is discussed in relation to the federal black lung program. Conflicting definitions of terms--coal workers' pneumoconiosis as defined by the medical profession, pneumoconiosis as defined by the United States Congress, and the popular term, black lung--are important considerations in this discussion. Each is embedded in different logical interpretations of the causes of occupational disease and of disability. Alternative views are presented and critically discussed.

Bronchitis↗
PubMed1985

Measles reimmunization in children immunized before 1 year of age.

An outbreak of measles presented an opportunity to examine the immune response of children initially immunized with measles vaccine before 1 year of age to reimmunization at 15 months of age with measles, mumps, and rubella vaccine. Eighteen previously immunized children had higher acute and convalescent hemagglutination inhibition titers than 13 control children. None of the previously immunized children had measles-specific IgM appear in convalescent serum samples. These results indicate a brisk secondary immune response to measles reimmunization in children immunized before 1 year of age. They support the recommendation of the American Academy of Pediatrics of reimmunization at 15 months of age for those children whose initial measles immunization was before 1 year of age.

Humans↗
PubMed1985

Chronic hazards and acute enforcement: dilemma for occupational health enforcement policy.

It is a well-understood principle of public health--and of disease control in general--that preventive efforts must be consistent with the natural history of a targeted disease. Governmental standards-setting and enforcement policies in occupational health confuse short-term strategies for safety hazard control with long-term disease control. Recent decisions in mining to rely on "significant and substantial" acute risk are incompatible with medical and epidemiological evidence on the nature and progress of chronic disease in many industries.

Dust↗
PubMed1983

Fatality rates and regulatory policies in bituminous coal mining, United States, 1959-1981.

In the eleven years prior to the passage of the Federal Coal Mine Health and Safety Act of 1969, fatality rates changed little for underground miners and were increasing for surface miners. Following implementation of the 1969 Act, both rates decreased. Beginning in 1979, and continuing into the first six months of 1982, both rates increased. These associations suggest that current relaxation of regulations and policies for coal mine safety are unwarranted.

Accident Prevention↗
PubMed1981

Screening for occupational health hazards in the rubber industry. Part I.

Multiphasic health testing (MHT) is often offered to populations of workers usually with the objective of identifying individuals who may be ill. Results are typically not analyzed in relation to estimates of workplace exposure. We describe the results of combining MHT with industrial hygiene assessment of workplace exposures as a method of identifying possible health hazards rather than merely potentially ill individuals. MHT was offered to all production and maintenance workers employed at a tire manufacturing plant. Of 954, 744 participated. We measured worker exposure to respirable particulates, solvent vapor, and noise. We computed the frequency of positive screens among workers classified by exposure and compared these frequencies with expected values adjusted for confounding variables including age, sex, race, and smoking and drinking habits. Workers exposed to higher concentrations of respirable particulates exhibited signs of respiratory and gastrointestinal morbidity. Workers exposed to emissions from heated, uncured rubber undergoing plastic deformation reported chest tightness on return to work. We conclude that combining MHT with assessment of workplace exposure is a valid method for identifying possible occupational health hazards.

Environmental Exposure↗