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J W Osterman

Publications and source records attributed to J W Osterman.

11 recordsLinked to original sources
PubMed1995

Beyond universal precautions.

Universal precautions have gained wide acceptance in the literature and are promoted by major health care regulatory bodies as a measure to prevent nosocomial transmission of bloodborne diseases. Nevertheless, Dr. James G. Wright and associates (see pages 1089 to 1095 of this issue) provide evidence of the infrequent use of universal precautions by surgeons in Toronto. Their findings are consistent with those of similar studies and point to the limitations of any safety approach that relies on the active compliance of individuals rather than on passive, environmental controls. Successful approaches to optimizing workplace safety should first emphasize passive measures for risk abatement, including firm policies, the use of safer equipment and techniques, procedural safeguards and regular monitoring. Routine voluntary screening of patients undergoing procedures that pose a high risk of contamination may improve compliance to safety procedures by health care personnel. Further study is required.

Attitude of Health Personnel↗
PubMed1992

Revaccination of children during school-based measles outbreaks: potential impact of a new policy recommendation.

OBJECTIVE: To evaluate the potential impact of revaccination on measles outbreak control during school-based epidemics. DESIGN: Retrospective cohort study. SETTING: Thirty-two public elementary and high schools in 14 communities on the west island of Montreal. PARTICIPANTS: All 19,439 children attending these schools during the 1989 measles epidemic in Quebec. INTERVENTION: After notification of a case children with provider-verified records of vaccination on or after their first birthday were identified; the remaining children were vaccinated or excluded from school. OUTCOME MEASURE: Clinical or confirmed measles cases not prevented by this intervention that could have been prevented had revaccination been included during the outbreak. RESULTS: Of the 88 measles cases (74 confirmed) proof of one adequate vaccination was present in 48 (55%). Intervention generally occurred within 5 school days after case notification. The nonpreventable cases involved 75 children who had measles onset before the intervention and 11 (7 vaccinated) who had onset within 8 days after the intervention. The two remaining cases occurred 20 and 25 days after the intervention among nonvaccinated students who refused to be vaccinated. Except for these two cases measles was eliminated at every school. Application of the new Canadian guidelines for measles outbreak control would have required the administration of at least 10,000 additional doses during the outbreak to students vaccinated before 1980; implementation of the new US guidelines would have required the administration of 16,629 additional doses to children previously vaccinated only once. Well-enforced provincial regulations ensuring vaccination of every student upon school entry might have prevented 38 (43%) of the cases. The US recommendation of two routine doses of vaccine before school entry might have prevented 86 (98%) of the cases. However, revaccination during the outbreak would not have prevented a single additional case. CONCLUSION: Revaccination of previously vaccinated students during a measles outbreak would have been costly and of little benefit.

Adolescent↗
PubMed1991

Comparison of French and English versions of the American Thoracic Society respiratory questionnaire in a bilingual working population.

Standardized French and English versions of the American Thoracic Society (ATS) respiratory disease questionnaire were administered to 204 English-speaking and 406 French-speaking male blue-collar aviation workers unexposed to occupational respiratory hazards. After adjusting for smoking status, age, years of education, foreign birth and maternal language other than French or English, no significant differences between the two questionnaires were found for response rates to usual cough, usual phlegm, mild or moderate dyspnoea, and chronic bronchitis. French-speaking workers reported significantly less wheeze with colds (OR = 0.60, p less than 0.02) and wheeze apart from colds (OR = 0.55, p less than 0.05) than the English-speaking group, but, the occurrence of wheeze on most days or nights was similar for both groups (OR = 1.02, NS). For 66 bilingual workers who completed both French and English questionnaires at a time interval of approximately two months, highly consistent results were found for sociodemographic data, smoking habits, cough, phlegm, breathlessness and chronic bronchitis, but not for wheeze with or apart from colds (agreement less than 90%; Kappa less than 0.50). These results reflect the difficulties in translating the concept of 'wheeze' from English to French. We conclude that most symptoms elicited by the French questionnaire may be generalized to English-speaking populations, but that questions pertaining to wheeze on most days or nights may be preferable to other questions concerning wheeze.

Data Collection↗
PubMed1990

Evaluating the impact of municipal water fluoridation on the aquatic environment.

Although highly beneficial for dental health, low concentrations of fluoride in environmental waters may be toxic to several organisms. In an era of heightened public awareness about the environment, this may lead city officials to withhold implementing water fluoridation for environmental reasons. This paper presents a mass balance approach to evaluate this perceived risk. Generally speaking, fluoridated water loss during use, dilution of sewage by rain and ground water infiltrate, fluoride removal during secondary sewage treatment, and diffusion dynamics at effluent outfall combine to eliminate fluoridation-related environmental effects. In Montreal, water fluoridation would raise average aquatic fluoride levels in the waste water plume immediately below effluent outfall by only 0.05-0.09 mg/l. Downstream, these changes would be only 0.02-0.05 mg/l at 1 km, and 0.01-0.03 mg/l at 2 km below outfall. Overall river fluoride concentrations theoretically would be raised by 0.001-0.002 mg/l, a value not measurable by current analytical techniques. All resulting concentrations would be well below those recommended for environmental safety and would not exceed natural levels found elsewhere in Quebec. A literature review did not reveal any examples of municipal water fluoridation causing recommended environmental concentrations to be exceeded, although excesses occurred in several cases of severe industrial water pollution.

Animals↗
PubMed1989

Work related decrement in pulmonary function in silicon carbide production workers.

The relation between pulmonary function, cigarette smoking, and exposure to mixed respirable dust containing silicon carbide (SiC), hydrocarbons, and small quantities of quartz, cristobalite, and graphite was evaluated in 156SiC production workers using linear regression models on the difference between measured and predicted FEV1 and FVC. Workers had an average of 16 (range 2-41) years of employment and 9.5 (range 0.6-39.7) mg-year/m3 cumulative respirable dust exposure; average dust exposure while employed was 0.63 (range 0.18-1.42) mg/m3. Occasional, low level (less than or equal to 1.5 ppm) sulphur dioxide (SO2) exposure also occurred. Significant decrements in FEV1 (8.2 ml; p less than 0.03) and FVC (9.4 ml; p less than 0.01) were related to each year of employment for the entire group. Never smokers lost 17.8 ml (p less than 0.02) of FEV1 and 17.0 (p less than 0.05) of FVC a year, whereas corresponding decrements of 9.1 ml (p = 0.12) in FEV1 and 14.4 ml (p less than 0.02) in FVC were found in current smokers. Similar losses in FEV1 and FVC were related to each mg-year/m3 of cumulative dust exposure for 138 workers with complete exposure information; these findings, however, were generally not significant owing to the smaller cohort and greater variability in this exposure measure. Never smokers had large decrements in FEV1 (40.7 ml; p less than 0.02) and FVC (32.9 ml; p = 0.08) per mg-year/m3 of cumulative dust exposure and non-significant decrements were found in current smokers (FEV1: -7.1 ml; FVC: -11.7 ml). A non-significant decrement in lung function was also related to average dust exposure while employed. No changes were associated with SO(2) exposure or and SO(2) dust interaction. These findings suggest that employment in SiC production is associated with an excessive decrement in pulmonary function and that current permissible exposure limits for dusts occurring in this industry may not adequately protect workers from developing chronic pulmonary disease.

Adult↗
PubMed1989

Respiratory symptoms associated with low level sulphur dioxide exposure in silicon carbide production workers.

Relations between pulmonary symptoms and exposure to respirable dust and sulphur dioxide (SO2) were evaluated for 145 silicon carbide (SiC) production workers with an average of 13.9 (range 3-41) years of experience in this industry. Eight hour time weighted average exposures to SO2 were 1.5 ppm or less with momentary peaks up to 4 ppm. Cumulative SO2 exposure averaged 1.94 (range 0.02-19.5) ppm-years. Low level respirable dust exposures also occurred (0.63 +/- 0.26 mg/m3). After adjusting for age and current smoking status in multiple logistic regression models, highly significant, positive, dose dependent relations were found between cumulative and average exposure to SO2, and symptoms of usual and chronic phlegm, usual and chronic wheeze, and mild exertional dyspnoea. Mild and moderate dyspnoea were also associated with most recent exposure to SO2. Cough was not associated with SO2. No pulmonary symptoms were associated with exposure to respirable dust nor were any symptoms attributable to an interaction between dust and SO2. Cigarette smoking was strongly associated with cough, phlegm, and wheezing, but not dyspnoea. A greater than additive (synergistic) effect between smoking and exposure to SO2 was present for most symptoms. These findings suggest that long term, variable exposure to SO2 at 1.5 ppm or less was associated with significantly raised rates of phlegm, wheezing, and mild dyspnoea in SiC production workers, and that current threshold limits for SO2 may not adequately protect workers in this industry.

Adult↗
PubMed1983

The Compendium of Pharmaceuticals and Specialties: a critical analysis.

The Compendium of Pharmaceuticals and Specialties (CPS) is the most widely used source of drug information in Canada, and is heavily financed by the pharmaceutical industry. A close examination of its contents comparing a computer-drawn, randomized sample of monographs from its "White Pages" to standard pharmacological reference works demonstrates certain of its characteristics: it uncritically includes many inadequate preparations; it overstates the benefits and understates the adverse qualities of many preparations; and it contains little or no information on relative indications, efficacy, or price. These characteristics serve to promote the marketing goals of the drug manufacturers and severely limit the volume's usefulness as an objective source of drug information. The role of the CPS and similar publications in the overall context of current drug company marketing strategies is discussed. Finally, suggestions for improvements are made involving the elimination of direct manufacturer financing, and the creation of an objective, independent, nonprofit publishing agency supported by professional and governmental organizations.

Canada↗
PubMedDate not supplied

Evaluation of the ATS respiratory diseases questionnaire among French-speaking silicon carbide workers.

The American Thoracic Society (ATS) respiratory disease questionnaire for adults was translated by two fluently bilingual Quebec health professionals into simple, everyday French easily understood by an adult population of varying age and educational background. After independent assessment by professional translators, it was field-tested on 165 silicon carbide production workers. Responses to the ATS cough questions were significantly related to those obtained by a semiquantitative estimate of cough frequency. ATS questions on cough and phlegm were significantly associated with the physical sign of productive cough on request. A significant association was found between answers to questions on mild or moderate breathlessness and self-evaluation of breathing on a linear scale. Workers with cough, wheeze, or breathlessness had significantly lower percent-predicted FEV1, and FEV1 decreased as the severity of breathlessness increased. Highly significant, dose-dependent associations with current cigarette smoking habit were found for cough, phlegm and wheeze. Significant, dose-dependent associations with phlegm, wheeze and mild breathlessness also occurred with exposure to sulfur dioxide. All of these relationships are similar to findings from studies of English-speaking populations. Minor problems with the original English ATS questionnaire were discovered on translation, and suggestions for improvements were made. Preliminary experience with this French translation suggests that it is a useful, comparable version of the English ATS questionnaire.

Adult↗