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Biomedical subjects

Ken Silver

Publications and source records attributed to Ken Silver.

4 recordsLinked to original sources
PubMed2006

Ethical considerations in testing workers for the -Glu69 marker of genetic susceptibility to chronic beryllium disease.

OBJECTIVE: The most compelling real-world example of genetic testing for susceptibility to a workplace exposure involves those industries that process or fabricate beryllium. We examined ethical issues associated with testing for susceptibility to chronic beryllium disease. METHODS: Using ethical and clinical criteria, we examined voluntary employer-sponsored testing programs in which individual results are reported directly to workers in a confidential manner. RESULTS: Under reasonable assumptions, the longitudinal positive predictive value of the HLA-DPB1-Glu69 marker of susceptibility to beryllium disease is 12%. Interpretive challenges further limit the utility of the test and may inadvertently suggest a false sense of safety among workers. Concerns about confidential participation and pressures to be tested also must be addressed. CONCLUSIONS: Difficulties surrounding the interpretation of the HLA-DPB1-Glu69 marker, lack of assurance regarding the protection of worker confidentiality, and the potential lowering of social barriers to the implementation of mandatory worker screening combine to make testing beryllium workers inappropriate at this time.

Berylliosis↗
PubMed2006

Environmental surveillance at Los Alamos: an independent reassessment of historical data.

Since 1971, a series of annual Environmental Surveillance ... reports have served as the official public record of Los Alamos National Laboratory's (LANL) environmental performance. In northern New Mexico, where past LANL emissions are a public health concern, there is public skepticism over the accuracy of information contained in these reports. To test the hypothesis that LANL Environmental Surveillance ... reports systematically understate past emissions, we compared the data on releases in LANL's own internal Occurrence Reports Collection (ORC) to the data reported to the public in the Environmental Surveillance ... reports. A data set of 89 environmental occurrences recorded in the ORC in the time period from 1971 through 1980 was assembled. We did not find a systematic pattern of quantitative underreporting of source terms. However, 17 of the 89 (19%) environmental occurrences recorded in the ORC were not reported to the public in the Environmental Surveillance ... reports. The observed discrepancies are discussed in terms of their relevance to public health concerns. Methodological caveats dictate restraint in applying these findings beyond the scope of the relative comparison performed here. Possible social origins for the rejected hypothesis are discussed. Areas for further consideration by the Centers for Disease Control's dose reconstruction study of LANL are identified.

Environmental Monitoring↗
PubMed2005

The Energy Employees Occupational Illness Compensation Program Act: new legislation to compensate affected employees.

Nurses make a bureaucracy work on behalf of clients. Occupational health nurses who are already versed in basic concepts applicable to EEOICPA--confidence intervals, occupational histories, exposure assessment, and dose response--can play constructive, caring roles in assisting claimants in securing benefits under this landmark program. Occupational health nurses know that chronically ill employees have a finite number of hours a week to make phone calls, visit providers, and advocate on their own behalf. Thoughtful referrals to occupational health providers who are both experienced and supportive can come from an occupational health nurse or a family physician. Involvement of university-based programs in projects to empower organizations representing EEOICP claimants would be a welcome development.

Berylliosis↗