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Biomedical subjects

M McDiarmid

Publications and source records attributed to M McDiarmid.

14 recordsLinked to original sources
PubMed2004

Detection of depleted uranium in urine of veterans from the 1991 Gulf War.

American soldiers involved in "friendly fire" accidents during the 1991 Gulf War were injured with depleted-uranium-containing fragments or possibly exposed to depleted uranium via other routes such as inhalation, ingestion, and/or wound contamination. To evaluate the presence of depleted uranium in these soldiers eight years later, the uranium concentration and depleted uranium content of urine samples were determined by inductively coupled plasma mass spectrometry in (a) depleted uranium exposed soldiers with embedded shrapnel, (b) depleted uranium exposed soldiers with no shrapnel, and (c) a reference group of deployed soldiers not involved in the friendly fire incidents. Uranium isotopic ratios measured in many urine samples injected directly into the inductively coupled plasma mass spectrometer and analyzed at a mass resolution m/delta m of 300 appeared enriched in 235U with respect to natural abundance (0.72%) due to the presence of an interference of a polyatomic molecule of mass 234.81 amu that was resolved at a mass resolution m/delta m of 4,000. The 235U abundance measured on uranium separated from these urines by anion exchange chromatography was clearly natural or depleted. Urine uranium concentrations of soldiers with shrapnel were higher than those of the two other groups, and 16 out of 17 soldiers with shrapnel had detectable depleted uranium in their urine. In depleted uranium exposed soldiers with no shrapnel, depleted uranium was detected in urine samples of 10 out of 28 soldiers. The median uranium concentration of urines with depleted uranium from soldiers without shrapnel was significantly higher than in urines with no depleted uranium, though substantial overlap in urine uranium concentrations existed between the two groups. Accordingly, assessment of depleted uranium exposure using urine must rely on uranium isotopic analyses, since urine uranium concentration is not an unequivocal indicator of depleted uranium presence in soldiers with no embedded shrapnel.

Firearms↗
PubMed2000

Male and female rate differences in carpal tunnel syndrome injuries: personal attributes or job tasks?

Carpal tunnel syndrome (CTS) exacts a significant toll on the health and productivity of American workers. In 1996, 29,937 workers lost time from work due to CTS. Half of these were out for more than 25 days, compared to a median of 5 days for all injuries/illnesses. There are striking gender disparities in CTS rates. Overall, three times more women suffer from CTS than men. While some authors have emphasized the role of gender attributes in this risk disparity, the multifactoral causes of CTS, and the sex segregation of women into jobs with high-risk tasks, may be obscuring the work-related contributions to CTS risk. We argue here that men and women doing the same work tasks will have similar rates of CTS. To examine this premise, we used Bureau of Labor Statistics injury counts (numerator) and census data from the Current Population Survey (denominator) to determine injury rates of CTS for both men and women in six high-risk occupations: (1) assembler, (2) laborer-nonconstruction, (3) packaging and filling machine operators, (4) janitors and cleaners, (5) butchers and meat cutters, and (6) data entry keyers. Variable job tasks exist within five of the six high-risk occupational titles. Among those five, the male to female (M:F) risk rate ratio ranged from 0.29 to 0.50. However, the sixth occupational title, data entry keyers, which requires a single physical task, had a risk rate ratio of 1.06. This suggests that an equal risk between genders exists when the occupational tasks (exposure) are truly similar. Job task analysis unmasks potential biases that may wrongly attribute disproportionate CTS rates to gender attributes. This focus on gender attributes fails all workers because preventive interventions in the workplace are deferred. It fails women disproportionately because they are overrepresented in jobs at high risk for CTS.

Carpal Tunnel Syndrome↗
PubMed2000

Determination of the isotopic composition of uranium in urine by inductively coupled plasma mass spectrometry.

A simple method based on inductively coupled plasma mass spectrometry (ICP-MS) was developed to identify exposure to depleted uranium by measuring the isotopic composition of uranium in urine. Exposure to depleted uranium results in a decreased percentage of 235U in urine samples causing measurements to vary between natural uranium's 0.72% and depleted uranium's 0.2%. Urine samples from a non-depleted uranium exposed group and a suspected depleted uranium exposed group were processed and analyzed by ICP-MS to determine whether depleted uranium was present in the urine. Sample preparation involved dry-ashing the urine at 450 degrees C followed by wet-ashing with a series of additions of concentrated nitric acid and 30% hydrogen peroxide. The ash from the urine was dissolved in 1 M nitric acid, and the intensity of 235U and 238U ions were measured by ICP-MS. After the samples were ashed, the ICP-MS measurements required less than 5 min. The 235U percentage in individuals from the depleted uranium exposed group with urine uranium concentrations greater than 150 ng L(-1) was between 0.20%-0.33%, correctly identifying depleted uranium exposure. Samples from the non-depleted uranium exposed individuals had urine uranium concentration less than 50 ng L(-1) and 235U percentages consistent with natural uranium (0.7%-1.0%). A minimum concentration of 14 ng L(-1) uranium was required to obtain sufficient 235U to allow calculating a valid isotopic ratio. Therefore, the percent 235U in urine samples measured by this method can be used to identify low-level exposure to depleted uranium.

Humans↗
PubMed1998

Tuberculosis risk in funeral home employees.

In order to estimate the risk of tuberculosis infection among employees in the funeral service industry, we conducted a risk-assessment study of a convenience sample of funeral home employees. Study participants completed a risk-assessment questionnaire and underwent tuberculin skin testing. Of 864 employees tested, 101 (11.7%) had a reactive tuberculin skin test. Reactivity to the tuberculin skin test was significantly associated with job category; funeral home employees with a present or past history of embalming deceased-human remains were twice as likely to be reactive as were non-embalming personnel (14.9% versus 7.2%, P < 0.01). Reactivity was also associated with age, gender, race, past history of close contact with a person diagnosed with tuberculosis, and work history. After controlling for age and other factors, tuberculin reactivity was found to be associated in embalming personnel with the number of years spent performing embalmings (> or = 20), and, in non-embalming personnel, with a history of close contact with infected individuals. Based on these results, it is recommended that funeral home employees who routinely embalm cadavers undergo annual tuberculin skin testing, receive initial training on tuberculosis prevention, and wear respiratory protection when preparing known tuberculosis cases.

Adult↗
PubMed1996

Tuberculosis in the workplace: OSHA's compliance experience.

OBJECTIVE: Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission. DESIGN: Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results. SETTING/PARTICIPANTS: Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term-care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB. METHODS: The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires. RESULTS: Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB. CONCLUSION: Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.

Facility Regulation and Control↗
PubMed1996

Dental treatment and the alcoholic.

Practising dentists must include in their diagnostic skills the ability to identify the patient with a high intake of alcohol. Dental status can often reflect the patient's perception of health and disease. The development of an appropriate treatment plan for these patients needs to take into account their generally unreliable nature. Appointments are often not kept; there is poor compliance with general health-care information, and compliance with preventive advice on dental care is achieved with difficulty. Symptomatic presentation is common with the alcoholic patient. The dentist should avoid "rushing in" to treat the presenting acute problem without appropriate investigation of the medical history. This should include consultation with the patient's medical advisor and other involved health professionals. A careful review of the oral mucosa for pre-cancerous or cancerous changes should be systematically included in the examination of any patient. Patients with a high intake of alcohol, and especially those who smoke, need to be carefully screened.

Aged↗
PubMed1995

Deaths from acute exposure to trichloroethylene.

Trichloroethylene (TCE) is a commonly used halogenated hydrocarbon in industry. We report on deaths attributed to TCE exposure that occurred between 1975 and 1992. In addition, we present a case report from the most recent death, including tissue concentration modeling. The deaths shared a number of features. All occurred in young men who were usually working in confined spaces without adequate ventilation. These preventable deaths suggest that safety precautions are not being observed by workers and employers. Employers should ensure that their employees are adequately trained in the dangers of working with TCE, that adequate ventilation of the working environment is provided, that the proper personal protective equipment (PPE) is available to their workers, and that workers should not work alone or unobserved when using TCE in confined spaces.

Accidents, Occupational↗
PubMed1990

Termination of health benefits for Pittston mine workers: impact on the health and security of miners and their families.

Mine workers represented by the United Mine Workers of America (UMWA) have had comprehensive medical care coverage since 1950. On February 1, 1988, UMWA employees of the Pittston Coal Group had their health care benefits abruptly terminated. Renewal of these benefits became a major reason for the subsequent UMWA strike against Pittston. In December, 1989, physician interviewers were organized to document the human experience of this termination of health care benefits. This report summarizes these interviews, and concludes that the UMWA experience in the Pittston coal fields is one example of the barriers to health care experienced by an increasing proportion of the United States population.

Adolescent↗
PubMed1988

Acute occupational exposure to antineoplastic agents.

Antineoplastic agents may exhibit effects not only in patients therapeutically exposed, but also in health workers who prepare and administer these drugs. Concern to date has focused on long-term health consequences, including adverse reproductive outcomes, altered immunity, and increased cancer risk. The burgeoning use of these drugs for non-malignant illnesses has enlarged the health worker population at risk beyond oncology personnel to include professionals in immunology, rheumatology, nephrology, and dermatology. We report here two cases of hospital workers who experienced acute adverse health effects resulting from occupational exposure to antineoplastic drugs. We believe such acute events are under-reported, and that they demonstrate the need for physician awareness regarding their management.

Adult↗
PubMed1986

Cefotetan versus cefoxitin as prophylaxis in hysterectomy.

Seventy hospitalized women were entered into an open, randomized, parallel study of antimicrobial prophylaxis for abdominal and vaginal hysterectomy with the use of either cefotetan, a new long-acting cephalosporin, or cefoxitin. Ninety-four percent of cefotetan recipients and 83% of cefoxitin recipients did not develop clinical signs or symptoms of infection. The satisfactory bacteriologic response rates were significantly different: 91% satisfactory (43 of 47 patients) for cefotetan and 74% satisfactory (17 of 23 patients) for cefoxitin. The two treatment groups demonstrated no significant differences in postoperative temperature changes, duration of hospitalization, or grading of surgical wounds. Neither drug was associated with significant side effects.

Adult↗
PubMedDate not supplied

Salud Ocupacional.

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Academies and Institutes↗