Glanders in a military research microbiologist.
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Biomedical subjects
Publications and source records attributed to S Deitchman.
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After lagging behind health services research in general health care, research is now examining health services provided to workers suffering occupational injuries and illnesses. The National Institute for Occupational Safety and Health, the Robert Wood Johnson Foundation Workers' Compensation Health Initiative, the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality), and the Canadian Institute for Work and Health co-sponsored a June, 1999, conference to explore research needs in this area. Fundamental tenets for advancing occupational health services research include: adopting the goal of improving occupational health care, including better integration of preventive and curative care; creating standardized interstate occupational health care data sets that include medical, economic, and patient perspectives; better defining quality in occupational care and developing appropriate performance measures; in addition to medical costs, assessing social, economic, medical and functional outcomes of care; considering the connections between work and health, including general health services; and addressing the need to train qualified occupational health services researchers. Am. J. Ind. Med. 40:291-294, 2001. Published 2001 Wiley-Liss, Inc.
BACKGROUND: Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients. METHODS: MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included. RESULTS: Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention. CONCLUSIONS: Research is needed to improve and promote clinical occupational health preventive services.
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We describe an incident of carbon monoxide (CO) poisoning caused by CO migrating through soil after nearby detonation of explosive charges. Employees worked in a newly installed, unconnected manhole without incident and finished shortly before underground explosives were detonated 50 feet south of the manhole to break up rock and soil. A worker entering the manhole 45 minutes after the explosion collapsed within minutes, as did two coworkers who rescued him. One worker died, and all had elevated levels of carboxyhemoglobin. Air samples collected from the manhole 2 days after the incident showed 1,910 ppm CO; in laboratory detonations, sample explosive yielded 27 L CO per kilogram detonated. We believe the CO in this incident was released from the nearby explosion and migrated through soil and fractured rock into the manhole. The blasting and construction industries should be made aware of this previously unrecognized route of CO exposure. Additionally, confined-space procedures and training are needed to prevent future accidents.
In evaluations of children's diseases, pediatricians should consider the occupations of their patients' parents. Attempts to prevent occupational musculoskeletal disorders must assess both physical and psychosocial factors in the workplace. The most common cause of death in the workplace among women was homicide.
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