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Biomedical subjects

T C Aw

Publications and source records attributed to T C Aw.

At least 55 records · Page 3Linked to original sources
PubMed1995

Audit of pre-employment assessments by occupational health departments in the National Health Service.

Pre-employment health assessment of applicants to the National Health Service (NHS) is one of the functions of occupational health departments in the NHS. This paper describes the results of a process and outcome audit of this activity, concentrating on the current practice of occupational health departments. The audit was carried out by 40 NHS occupational health units who provided information on a standard questionnaire on all pre-employment assessments undertaken over a three-month period. This produced 9139 questionnaire returns. The analysis showed that the most common method of assessment was the use of a self-administered questionnaire alone (49.4%). A self-administered questionnaire followed by a nurse interview as standard practice was the next most common method (34.1%), but referral to a physician was uncommon. The outcome of the assessments for 98% of all applicants was 'fit for work'. A total of 120 individuals (1.3%) were assessed as 'fit to work, but with some restriction' and 65 individuals (0.7%) were considered 'unfit'. The most common reasons for rejection were abnormal body mass index (40%), skin conditions (21.5%) and psychiatric conditions (10.8%). The most common reasons for restriction were musculoskeletal conditions (27.5%), skin conditions (15%) and abnormal body mass index and psychiatric conditions (both 10.8%). The audit identified wide variation between occupational health departments in the NHS in the practice of restriction and rejection. A decision on the value of pre-employment assessment in the NHS mus take into consideration the ability of the process to achieve its aim, the time and manpower involved in the process, and the probability of low restriction and rejection rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Employment↗
PubMed1995

Delta bilirubin changes following phototherapy for neonatal jaundice.

The effect of phototherapy for neonatal jaundice on the serum concentrations of total, unconjugated, conjugated and delta bilirubins were studied in 91 infants. Only unconjugated bilirubin concentration declined during phototherapy, from 254.7 +/- 7.0 mumol/l (mean +/- SD) at start to 161.4 +/- 37.4 mumol/l at cessation after 50.2 +/- 22.1 hours of exposure. Conjugated and delta bilirubin concentrations, initially already very low, were not significantly affected. Phototherapy was only efficacious for unconjugated bilirubin and did not have any effect on delta or conjugated bilirubin.

Bilirubin↗
PubMed1994

Comparison of perceived occupational health needs among managers, employee representatives and occupational physicians.

The aim of this study was to assess how occupational health providers view the importance of different occupational health functions compared with their customers (managers and union representatives). A postal survey was undertaken requesting that managers of medium and large companies, union representatives and occupational physicians rank in order of importance 13 listed functions of an occupational health service which have appeared in the published literature. The results were analysed and tabulated to allow comparison of the responses among the four groups. The two functions ranked as most important by all four groups were advice on the work environment and advice on medical retirement. Dental services as an occupational health service function were ranked as least important by all four groups, with provision of physiotherapy services by occupational health departments also perceived as relatively unimportant by managers of medium and large companies. A wide discrepancy of views was revealed between physicians, managers and unions over the importance of immunization for travel and work and the rehabilitation and resettlement of sick and injured workers. The physicians ranked these functions as more important than the managers or union representatives. Managers of medium-sized companies also ranked counselling in the workplace much higher than the other respondents. The study shows the dilemma that occupational health services may face in deciding what functions should be provided compared to what their customers wish to be provided.

Administrative Personnel↗
PubMed1994

Use of molecular epidemiological techniques in a pilot study on workers exposed to chromium.

OBJECTIVES: Molecular epidemiological techniques, capable of detecting damage to DNA, were used to see if such damage occurred in the lymphocytes of a group of workers exposed to chromium. The two aims of this pilot study were to see if these new techniques might make useful biological monitoring tools for workers exposed to chromium and also, to help assess whether the current occupational exposure limit for chromium (VI) was sufficiently protective in this specific working situation. METHODS: Volunteer groups of 10 workers exposed to chromium and 10 non-exposed workers provided urine and blood samples towards the end of the working week. Chromium concentrations were measured in whole blood, plasma, lymphocytes, and urine. Lymphocytes were used to examine two forms of DNA damage in the two groups; these were the level of DNA strand breakage and, the production of 8-hydroxydeoxyguanosine. RESULTS: Chromium concentration in whole blood, plasma, and urine of workers exposed to chromium was significantly raised (P < 0.01) compared with non-exposed controls, but in isolated lymphocytes, there was only a modest but significant (P < 0.05) increase in chromium in the group exposed to chromium. There was no difference in the levels of DNA strand breaks or 8-hydroxydeoxyguanosine between the groups. Air monitoring for chromium was not undertaken but current levels for the group exposed to chromium were reported to be around 0.01 mg/m3, which is 20% of the current United Kingdom occupational exposure limit. CONCLUSIONS: We were unable to detect any damage in lymphocytic DNA due to exposure to chromium. This may have been due to the low chromium exposure (< 20% of the United Kingdom occupational exposure limit), the ability of plasma to detoxify chromium (VI) to chromium (III) before it reached the lymphocytes, or perhaps the insensitivity of the molecular techniques used. It is now important to test these and other such techniques on groups exposed to levels closer to the United Kingdom occupational exposure limit.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed1994

Options for provision of occupational health services in developing countries.

Different models of occupational health care are available for developing countries to consider in developing their provisions for occupational health services. Even in developed countries there are differences between legal requirements for personnel and services, and voluntary provision of services. The range of activities covered by occupational health services can be extensive. Developing countries often focus on the provision of clinical care and treatment facilities at the workplace with less emphasis on preventive services. This may be related to the perceived value of the clinical skills of the doctor and nurse available at the workplace, plus the lack of other occupational health personnel, and the limited access to occupational hygiene and laboratory facilities. For future occupational health provisions, developing countries have to consider the balance between preventive services versus other clinical and non-clinical services. There will be benefits in reviewing the experience of developed countries in terms of the essential skills and training of occupational health personnel, and the contribution this would make to the health of the workforce in developing countries.

Developing Countries↗
PubMed1993

Evaluation of high performance liquid chromatography for routine estimation of haemoglobins A2 and F.

AIMS: To compare high performance liquid chromatography (HPLC) with conventional methods for the estimation of blood haemoglobin A2 (HbA2) and haemoglobin F (HbF) concentrations in routine thalassemia screening. METHODS: An HPLC system (the VARIANT Hemoglobin Testing System) was tested for precision and reproducibility in the measurement of HbA2 and HbF, and reference ranges were obtained for a local healthy adult population. HPLC was compared with column anion exchange chromatography for HbA2 measurement, and radial immunodiffusion, or alkaline denaturation for HbF measurement. The reliability of HbA2 measurement by HPLC for the detection of beta thalassaemia and HbE was assessed in 200 consecutive samples for routine thalassaemia screening. RESULTS: HPLC was rapid, technically easy, and gave good precision and reproducibility. In all comparisons linear regression analysis showed good correlation between HbA2 or HbF concentrations determined by HPLC and by the respective conventional methods. All beta thalassaemia or haemoglobin E carriers presumptively identified by conventional methods in 200 consecutive samples were detected by HbA2 measurement using HPLC, without any false positive or false negative results. CONCLUSIONS: The measurement of HbA2 and HbF by HPLC is rapid, reproducible, and precise. It is as reliable as column chromatography for the measurement of HbA2 and radial immunodiffusion or alkaline denaturation for the measurement of HbF. HPLC may be an appropriate method for rapid screening in population surveys for beta thalassaemia and HbE carriers.

Adolescent↗
PubMed1993

Free thyroxine as a supplement to thyrotropin in cord screening for hypothyroidism.

The low specificity of cord serum T4 levels for detecting hypothyroidism, the need to reduce recall rates and the availability of a reliable and quick assay system led to this study designed to determine the advantages of using cord serum free thyroxine levels over total thyroxine levels as a supplement to cord thyroid stimulating hormone (TSH) determination. Sixty-eight out of 75 newborns with a cord TSH > 23 mU/l had both free thyroxine (fT4) and T4 levels measured in the cord serum. All were recalled within the first month of life for reevaluation of their thyroid status. In the majority of cases (46), the fT4 and T4 values corresponded. Hypothyroidism was diagnosed in eight cases; both fT4 and T4 were below the mean in five cases and above the mean in one case; only T4 was below the mean in one and in the remaining one, only fT4 was below the mean. Recall rates were 0.9% with TSH alone and 0.7% when either a fT4 or T4 level that was less than 1 sd above the mean was used as a supplement to TSH. In this cohort, using the fT4 levels instead of the T4 levels brought no change to the specificity or the sensitivity of the screening. The diagnostic sensitivity would have dropped from 100% to 75% if either T4 or fT4 values below the mean were used as a cut-off point for recall.

Congenital Hypothyroidism↗
PubMed1992

Fiberglass dermatitis from printed circuit boards.

Seven cases of fiberglass dermatitis among production operators in the electronics industry are reported. This was due to the repeated daily handling of printed circuit boards (PRCBs). The predominant complaint of the workers was itch of the lateral aspects of the fingers and finger webs. In six workers, unroofed vesicles, pinhead areas of postinflammatory hyperpigmentation, and excoriation marks were noted at these sites. Skin stripping of the affected sites confirmed the presence of fiberglass spicules in all cases. The glass fibers had diameters of 11-16 microns. Patch testing of six of the workers with the European Standard series of allergens revealed no relevant work-related contact sensitizers. Microscopic examination of the free edges and scrapings from the PRCBs showed glass fibers of similar fiber length and diameter to those found in the workers' skin. Fiberglass can be used as a reinforcement filling material in some types of PRCBs. Free edges of such PRCBs have easily detached fiberglass spicules. Workers in frequent contact with these PRCBs can have a fiberglass-induced irritant dermatitis. Preventive measures could include the use of PRCBs with less free fiberglass at its edges, vacuuming of the newly cut boards, use of dusting powder, protective devices and emollients, and improved personal hygiene of the workers.

Adult↗
PubMed1992

Audit of pre-employment health assessment in the National Health Service.

Seventeen (77 per cent) of the 22 NHS occupational health departments in the West Midlands Region replied to a postal questionnaire about pre-employment health assessment. In only 5 departments (29 per cent) was the decision whether to interview and examine a prospective employee dependent on the results of a self-administered questionnaire. All departments were asked how many prospective employees had been screened and how many rejected/restricted over a 2 week period. Departments which interviewed/examined all prospective employees tended to have higher rejection/restriction rates than departments operating a selective policy: 6 (2.6 per cent) out of 232 versus 16 (1.4 per cent) out of 1140, relative risk 1.6, 95 per cent confidence interval 0.8 to 3.4, P = 0.31. In departments which did not automatically interview/examine prospective employees, the median proportion seen by nurses was 56 per cent, and by doctors was only 12 per cent. Within one NHS Region we have documented wide variation in what constitutes a pre-employment health assessment. A selective approach would release a significant amount of occupational health staff time.

Employment↗
PubMed1992

Should prospective NHS employees have routine blood counts?

The results of pre-employment haematological screening from 958 prospective National Health Service (NHS) workers were reviewed. Although many abnormalities were found, few were judged to be clinically significant. In only one case did the examination affect employment. Haematological screening is an unnecessary part of the pre-employment medical assessment of prospective NHS employees.

Adult↗
PubMed1991

Mortality study of British pathologists.

Pathologists eligible for inclusion in the study were identified from the membership lists of the Royal College of Pathologists from 1974 to 1987, establishing a population of 4,512 members. Overall mortality was lower among the study group compared with the general population of England and Wales, although there were significantly more deaths due to suicide (observed 13, expected 4.9, SMR 265, 95% CI 141-454). Excess deaths due to cancer of the lymphatic and hemopoietic system were noted but they were not significantly increased. An excess of brain cancer death was marginally significant for male pathologists (observed 6, expected 2.5, SMR 240, 95% CI 88-522). Six of the 9 (66.7%) cases of all types of brain tumors reported in total were among hematologists, although this sub-specialty comprises approximately 16% of all pathologists.

Adult↗