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Biomedical subjects

Lesley Rushton

Publications and source records attributed to Lesley Rushton.

11 recordsLinked to original sources
PubMed2007

Intervention implementation research: an exploratory study of reduction strategies for occupational contact dermatitis in the printing industry.

BACKGROUND: Occupational dermatitis is a problem in the printing industry but can be avoided through adequate protective measures. Research into intervention implementation is fundamental to the success of a formal intervention effectiveness trial. OBJECTIVES: The preliminary testing of four risk reduction strategies for occupationally caused dermatitis, which represent a range of approaches and cost implications. PATIENTS/METHODS: The strategies, the provision of (i) skin checks plus treatment advice; provision of (ii) gloves of the correct type/size plus use of an after-work cream; provision of (iii) information highlighting the problem of occupational dermatitis and (iv) development of a best practice skin care policy, were evaluated over 3 months in two non-randomly selected companies. A post-intervention evaluation into the effectiveness and efficacy of the intervention was also carried out. RESULTS AND CONCLUSIONS: All interventions were found to be acceptable to some extent. No single intervention appeared to be completely effective. The most practical intervention appeared to be the regular use of gloves of the correct type and size. This preliminary intervention study has demonstrated an improvement in the skin condition of workers examined and points towards the need for further testing of risk reduction strategies for the prevention of dermatitis in the printing industry on a much larger scale.

Dermatitis, Occupational↗
PubMed2006

Carbon in airway macrophages and lung function in children.

BACKGROUND: Epidemiologic studies indirectly suggest that the inhalation of carbonaceous particulate matter impairs lung function in children. Using the carbon content of airway macrophages as a marker of individual exposure to particulate matter derived from fossil fuel, we sought direct evidence of this association. METHODS: Airway macrophages were obtained from healthy children through sputum induction, and the area of airway macrophages occupied by carbon was measured. Lung function was measured with the use of spirometry. We modeled the exposure to primary particulate matter (PM) that is less than 10 mum in aerodynamic diameter (PM10) at or near each child's home address. Linear regression was used to evaluate associations between carbon content of alveolar macrophages and variables that may affect individual exposure. To determine whether lung function that is reduced for other reasons is associated with an increase in the carbon content of airway macrophages, we also studied children with severe asthma. RESULTS: We were able to assess the carbon content of airway macrophages in 64 of 114 healthy children (56 percent). Each increase in primary PM10 of 1.0 microg per cubic meter was associated with an increase of 0.10 microm2 (95 percent confidence interval, 0.01 to 0.18) in the carbon content of airway macrophages, and each increase of 1.0 microm2 in carbon content was associated with a reduction of 17 percent (95 percent confidence interval, 5.6 to 28.4 percent) in forced expiratory volume in one second, of 12.9 percent (95 percent confidence interval, 0.9 to 24.8 percent) in forced vital capacity, and of 34.7 percent (95 percent confidence interval, 11.3 to 58.1 percent) in the forced expiratory flow between 25 and 75 percent of the forced vital capacity. The carbon content of airway macrophages was lower in children with asthma than in healthy children. CONCLUSIONS: There is a dose-dependent inverse association between the carbon content of airway macrophages and lung function in children. We found no evidence that reduced lung function itself causes an increase in carbon content.

Adolescent↗
PubMed2006

Comparison of two methods to detect publication bias in meta-analysis.

CONTEXT: Egger's regression test is often used to help detect publication bias in meta-analyses. However, the performance of this test and the usual funnel plot have been challenged particularly when the summary estimate is the natural log of the odds ratio (lnOR). OBJECTIVE: To compare the performance of Egger's regression test with a regression test based on sample size (a modification of Macaskill's test) with lnOR as the summary estimate. DESIGN: Simulation of meta-analyses under a number of scenarios in the presence and absence of publication bias and between-study heterogeneity. MAIN OUTCOME MEASURES: Type I error rates (the proportion of false-positive results) for each regression test and their power to detect publication bias when it is present (the proportion of true-positive results). RESULTS: Type I error rates for Egger's regression test are higher than those for the alternative regression test. The alternative regression test has the appropriate type I error rates regardless of the size of the underlying OR, the number of primary studies in the meta-analysis, and the level of between-study heterogeneity. The alternative regression test has comparable power to Egger's regression test to detect publication bias under conditions of low between-study heterogeneity. CONCLUSION: Because of appropriate type I error rates and reduction in the correlation between the lnOR and its variance, the alternative regression test can be used in place of Egger's regression test when the summary estimates are lnORs.

Meta-Analysis as Topic↗
PubMed2006

A systematic review of systematic reviews and meta-analyses of animal experiments with guidelines for reporting.

To maximize the findings of animal experiments to inform likely health effects in humans, a thorough review and evaluation of the animal evidence is required. Systematic reviews and, where appropriate, meta-analyses have great potential in facilitating such an evaluation, making efficient use of the animal evidence while minimizing possible sources of bias. The extent to which systematic review and meta-analysis methods have been applied to evaluate animal experiments to inform human health is unknown. Using systematic review methods, we examine the extent and quality of systematic reviews and meta-analyses of in vivo animal experiments carried out to inform human health. We identified 103 articles meeting the inclusion criteria: 57 reported a systematic review, 29 a systematic review and a meta-analysis, and 17 reported a meta-analysis only. The use of these methods to evaluate animal evidence has increased over time. Although the reporting of systematic reviews is of adequate quality, the reporting of meta-analyses is poor. The inadequate reporting of meta-analyses observed here leads to questions on whether the most appropriate methods were used to maximize the use of the animal evidence to inform policy or decision-making. We recommend that guidelines proposed here be used to help improve the reporting of systematic reviews and meta-analyses of animal experiments. Further consideration of the use and methodological quality and reporting of such studies is needed.

Animal Experimentation↗
PubMed2006

Pesticides and Parkinson's disease--is there a link?

Parkinson's disease (PD) is an idiopathic disease of the nervous system characterized by progressive tremor, bradykinesia, rigidity, and postural instability. It has been postulated that exogenous toxicants, including pesticides, might be involved in the etiology of PD. In this article we present a comprehensive review of the published epidemiologic and toxicologic literature and critically evaluate whether a relationship exists between pesticide exposure and PD. From the epidemiologic literature, there does appear to be a relatively consistent relationship between pesticide exposure and PD. This relationship appears strongest for exposure to herbicides and insecticides, and after long durations of exposure. Toxicologic data suggest that paraquat and rotenone may have neurotoxic actions that potentially play a role in the development of PD, with limited data for other pesticides. However, both the epidemiology and toxicology studies were limited by methodologic weaknesses. Particular issues of current and future interest include multiple exposures (both pesticides and other exogenous toxicants), developmental exposures, and gene-environment interactions. At present, the weight of evidence is sufficient to conclude that a generic association between pesticide exposure and PD exists but is insufficient for concluding that this is a causal relationship or that such a relationship exists for any particular pesticide compound or combined pesticide and other exogenous toxicant exposure.

Environmental Pollutants↗
PubMed2004

Health surveillance mechanisms used by armed forces worldwide.

Health surveillance is an essential tool in monitoring health in an armed force and in helping to protect the health of service personnel. This study used a literature search and direct contacts with individual countries to identify and evaluate health surveillance mechanisms used by armed forces worldwide. The study identified several health surveillance mechanisms ranging from periodic health assessments of personnel to complex databases of medical data linked to demographic and other supporting data. Essential elements of an effective health surveillance system are outlined, including the requirement that systems are adequately supported and allow the routine monitoring of health at the population level consistently throughout an armed force and consistently during times of peace and during operations. Areas for further research and development include linking of data on hazardous exposures, jobs and the locations of personnel with medical data, and the follow-up of personnel beyond their military service.

Health Status↗
PubMed2003

Evaluating evidence on environmental health risks.

The assessment of adverse health effects from environmental hazards involves integration of evidence from a variety of sources, including experimental studies, both in animals and humans, in vitro studies, and epidemiological research. It requires an understanding of the sources, nature and levels of exposure to which humans may be subjected, the nature of the health outcome or toxic effect and the mechanisms by which this might occur, the relationship between dose and response, and a knowledge of the variability and susceptibility of potentially exposed populations. After outlining the process of risk assessment, this paper gives an overview of the most relevant human study methods used to investigate environment and health effects and discusses issues such as confounding and effect modification, that are important to consider when interpreting the results from such studies. Future challenges are outlined, such as increasing responsibility required by scientists to the sensitive issue of data protection and confidentiality, and also new opportunities, such as the increasing availability of computerized data, the incorporation of molecular epidemiological methods to aid the investigation of mechanistic pathways and gene-environment interactions, and the development and utilization of sophisticated statistical approaches.

Environmental Exposure↗
PubMed2003

Health hazards and waste management.

Different methods of waste management emit a large number of substances, most in small quantities and at extremely low levels. Raised incidence of low birth weight births has been related to residence near landfill sites, as has the occurrence of various congenital malformations. There is little evidence for an association with reproductive or developmental effects with proximity to incinerators. Studies of cancer incidence and mortality in populations around landfill sites or incinerators have been equivocal, with varying results for different cancer sites. Many of these studies lack good individual exposure information and data on potential confounders, such as socio-economic status. The inherent latency of diseases and migration of populations are often ignored. Waste management workers have been shown to have increased incidence of accidents and musculoskeletal problems. The health impacts of new waste management technologies and the increasing use of recycling and composting will require assessment and monitoring.

Environmental Exposure↗
PubMed2003

Health effects of a sulphur dioxide air pollution episode.

BACKGROUND: A sulphur dioxide (SO(2)) episode occurred in the United Kingdom in 1998. The worst affected area was the city of Nottingham. METHODS: Emergency hospital admissions in Nottingham in the episode week were compared with those in the previous week. RESULTS: A statistically significant increase in admissions for all respiratory diseases occurred in the episode week (odds ratio (OR) = 1.40, 95 per cent confidence interval (CI) = 1.00-1.94). Ten of the 25 excess admissions were for asthma, although the excess for asthma alone was not statistically significant (OR = 1.90, 95 per cent CI = 0.87-4.15). CONCLUSIONS: The excess admissions for respiratory diseases could have been caused by exposure to SO(2), to other pollutants present in increased concentrations during the pollution episode, or by seasonal variations in the frequency of asthma symptoms, or prevailing weather conditions. This study shows how simple analyses of routinely collected health data can be used to assess public health impacts of pollution episodes.

Adolescent↗
PubMedDate not supplied

Health impact of environmental tobacco smoke in the home.

Environmental tobacco smoke (ETS) can be a major constituent of air pollution in indoor environments, including the home. Regulation on smoking in the workplace and public places has made the home the dominant unregulated source of ETS, with important potential impacts on children. Between 40% and 60% of children in the United Kingdom are exposed to ETS in the home. Many experimental and human and studies have investigated the adverse health effects of ETS. Substantial evidence shows that in adults ETS is associated with increased risk of chronic respiratory illness, including lung cancer, nasal cancer, and cardiovascular disease. In children, ETS increases the risk of sudden infant death syndrome, middle ear disease, lower respiratory tract illness, prevalence of wheeze and cough, and exacerbates asthma. Although banning smoking in the home would be the optimal reduction strategy, several barrier and ventilation methods can be effective. Nevertheless, such methods are not always practical or acceptable, particularly when social pressures contribute to a lack of support for ETS control in the home. Smoking cessation interventions have had limited success. Research is needed to explore the barriers to adopting ETS risk-reducing behaviors.

Adult↗