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Biomedical subjects

R S Schilling

Publications and source records attributed to R S Schilling.

At least 19 recordsLinked to original sources
PubMed1993

A university's contribution to occupational health.

The first Chair of Occupational Health in the United Kingdom was established by Manchester University in 1945 and held by Ronald Lane, a consultant physician and experienced factor doctor. In his department, occupational medicine was taught as a clinical discipline to both undergraduates and postgraduates. Research was based mostly on clinical observation of workpeople in the field or as hospital outpatients. Although work has become less hazardous, with major risks like pneumoconiosis and lead poisoning brought under control by better occupational hygiene and more effective epidemiology, there is still much work related illness and injury. Promoting occupational health in its broadest sense still depends on clinical skills to assess fitness for work and to identify responses to adverse factors in the environment. A university department, through its teaching and research, needs to ensure that occupational health is practised as a clinical discipline. Opportunities for research are extensive and include: (1) identifying the extent and severity of injury and illness due to adverse environmental agents and psychosocial factors; (2) assessing fitness among the disabled and the elderly in an aging population enabling them to be gainfully or otherwise employed, (3) improving techniques for measuring work exposures and human responses to adverse work factors, and (4) evaluating intervention procedures. To fulfil its teaching and research commitments, an occupational health department has to maintain contacts with other disciplines in the university and with the industrial world outside. Isolation can be fatal. Academic departments of occupational health offer information to employers, trade unions, and health professionals seeking advice on health and safety problems. Such an Information and Advisory service provides topics for research and earns an income. It should not become the main activity otherwise teaching and research will suffer.

Communication↗
PubMed1991

Occupational medicine for one and all.

In the 1930s in Britain, industrial medicine was a clinical discipline, the main purposes of which were to diagnose disability in applicants for work, to identify industrial disease in the dangerous trades, and to provide first aid treatment for those injured or taken sick in the workplace. Following rapid developments in epidemiology and occupational hygiene and with more emphasis on "group health" and less on "individual care", occupational medicine has tended to become less of a clinical discipline; yet clinical skills are needed to assess fitness for work, to identify adverse effects of work, and to undertake consultations on a variety of health problems. Although care of the individual worker is a major task, an occupational health service has a responsibility for the health of the workforce as a whole, using epidemiology to plan and administer health care, to identify and control work related disorders, and to promote health by identifying positive factors in the organisation that induce a sense of well being; and by health screening and education programmes. Academic occupational health should not lose its identity as a clinical discipline in any merger with environmental health. Medical skills are needed to assess fitness for work and to identify human responses to adverse factors in the environment and to evaluate control measures.

Coronary Disease↗
PubMed1990

Occupational health at the London School of Hygiene & Tropical Medicine.

The London School of Hygiene and Tropical Medicine, founded in 1929 to study all aspects of public health, set up an occupational health unit in 1956 funded by the Rockefeller Foundation. With financial aid from the Trades Union Congress it expanded into an institute with an information and advisory service. Employers and trade unions sought advice on health problems which led to research projects and enriched teaching. Postgraduate courses in occupational medicine and hygiene attracted many students from all over the world. If the threat to close the institute takes place it will deprive the western world of a major centre for teaching and research in occupational health.

History, 20th Century↗
PubMed1989

Health protection and promotion at work.

Official United Kingdom figures record annually 1400 deaths and 145,000 sufferers from chronic effects of occupational injury and disease. Evidence indicates that occupational disease directly due to work is underestimated. With more understanding of the multiple causes of disease, the concept of work related disorders has broadened to include four categories: work as a direct cause, a contributory cause, or an aggravating factor, and work offering easy access to potential dangers (alcohol). As an example, work factors that increase the risk of coronary heart disease are discussed. Evidence for work stress as a causal factor and the role of leadership are considered. Prevention depends on identifying risks, preferably before anyone is exposed, but more commonly through recognition of adverse effects on workers. The need for occupational health services to have health promotion programmes that include screening for disease and its precursors, counselling and education, is considered. The positive effects of work itself as a protector and promoter of health are discussed. Responsibility for improving health has to be shared by government, management, trade unions, health professionals, and the individual worker.

Accidents, Occupational↗
PubMed1988

A survey into the respiratory effects of prolonged exposure to pulverised fuel ash.

Previous studies of respiratory disorders in workers exposed to pulverised fuel ash (PFA) have been confined to radiological effects that were found to be minimal. The present survey included 268 men (88% of the defined population) with a history of more than 10 years exposure to PFA in six power stations in the south east of England. Respiratory questionnaires with full occupational histories were obtained from all of these subjects, of whom 207 were actively employed and 61 had retired; 243 had lung function tests and 208 had chest x ray examinations. The men were grouped, using their occupational histories, into high, medium, and low exposure categories. Dust concentrations were obtained by personal sampling on a representative sample of men from the three exposure categories. Lung function tests showed that a modest effect on forced vital capacity, vital capacity, forced expiratory volume in one second, peak flow, and gas transfer (DCO) was associated with prolonged heavy exposure to PFA. The men with prolonged heavy exposure also showed higher prevalences of respiratory symptoms. No definite relation between exposure and x ray changes was established. The results of this cross sectional survey indicate that exposures to PFA should not exceed the limits recommended by the Health and Safety Executive for low toxicity dusts.

Adult↗
PubMed1986

The role of medical examination in protecting worker health.

Work-related disease is the product of multiple factors, including host susceptibility, the external environment, and individual behavior. The concept of multiple causality is relevant to the etiology of diseases, in which work and exposures are contributory agents, and of diseases that have a single necessary cause, eg, lead poisoning. The objectives of medical screening in the control of work-related diseases are the subjects of this paper. Screening procedures include questionnaires, diagnostic tests, function measurements, and biological tests of exposure levels to environmental agents. Achieving the objectives of medical examinations depends on selecting appropriate tests that are acceptable to workers; discarding tests that cannot meet requirements with respect to reproducibility, specificity, and sensitivity; and periodically reviewing health surveillance programs as a whole, and modifying or abandoning them as necessary in the light of improved working conditions.

Behavior↗
PubMed1982

A prospective study of chronic lung disease in cotton textile workers.

A cohort of both active and retired older cotton textile workers was examined prospectively over a 6-year period to establish the nature and extent of chronic lung disease. Respiratory symptoms and lung function were studied in these workers and in a group of similarly aged controls. The cotton textile workers had higher prevalence and attack rates of respiratory symptoms than did controls even with smoking habits taken into account. Chronic bronchitis developed in 16% of all cotton textile workers compared to 1% of controls over the follow-up period (p less than 0.001). The cotton workers suffered a larger loss of lung function over 6 years than did controls. Male workers lost 42 mL/yr of forced expiratory volume in 1 second, although male controls lost only 25 mL/yr (p = 0.001). Similar differences were seen in women, and in both men and women who were nonsmokers. Retired cotton textile workers had more symptoms and disability than active workers. We conclude that chronic lung disease is not only irreversible but may progress even after exposure to cotton dust has ended.

Byssinosis↗
PubMed1977

Lung function, respiratory disease, and smoking in families.

Respiratory symptoms, disease and lung function were studied in 376 families with 816 children who participated in a survey in three USA towns. Parental smoking had no effect on children's symptoms and lung function. Also, there was no evidence that passive smoking affected either lung function or symptoms of adults. There was no association between prevalence of self-reported cough and/or phlegm in parents and their children. There was a highly significant association between the prevalence of wheeze in parents and their younger children, for whom parents reported this symptom. Wheeze in children was also significantly associated with a parental history of asthma, and lung function was lower in children with a family history of asthma. Even after accounting for height, weight, age, sex and race, children's lung function correlated significantly with parents' lung function. However, the contribution of familial factors (i.e., parents' lung function, smoking, and history of asthma) to children's lung function is small compared to the effects of height, weight and age.

Adolescent↗