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PubMed1997

Cost of latex device-related occupational illness, workmen's compensation and legal issues.

In the United States, health care workers who become sensitised to latex face substantial problems. Their careers may prematurely come to an end, leaving them with a long struggle to achieve adequate compensation. This paper outlines some of those problems, and the actions necessary by employers, employees and worker disability groups to prevent future problems.

Career Mobility↗
PubMed1992

[Primary malignant pleural neoplasms. Diagnostic code 163.09].

The code 163.09 indicates a primary malignant pleural neoplasma-malignant mesothelioma. We have reinvestigated 173 patients, who were discharged from a department of pulmonary medicine with this code number during a 8 1/2 year period. A revision during which repeated biopsies, course of the disease and, in some cases, autopsy were considered, revealed that 63 were confirmed as having a malignant mesothelioma, 94 had neoplastic disease secondary to malignancy elsewhere, 13 had benign changes and in three cases the records were missing. Malignant mesothelioma entitles the patient to compensation if he has worked with asbestos. An occupational history was present in 94% of those suffering from mesothelioma and in 71% of the remaining patients. Among patients with mesothelioma a history of asbestos exposure was obtained in 44%, a history of no exposure in 22% and no specific mention of asbestos in 34%. In the group of patients who did not have mesothelioma 14% had known exposure to asbestos, eight none and in 78% no specific information concerning asbestos was available. Twenty-three of the 63 patients with mesothelioma had been notified to the workmens' compensation board. Retrospectively, we found that 12 more patients should have been notified. Eight patients who did not fulfil the criteria for malignant mesothelioma had erroneously been notified to the board for compensation. We find that code 163.09 frequently has been used as a working diagnosis, which could not invariably be substantiated. Although malignant mesothelioma had been suspected, previous history concerning asbestos exposure was often incomplete or absent. A correct occupational history and aggressive bioptical procedures are essential in all cases where malignant mesothelioma is suspected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Occupational health services in South African manufacturing industries: a pilot survey.

A pilot survey of the distribution and content of occupational health services in South African manufacturing industries was carried out in the Germiston area of the Witwatersrand using the records of the Workmens' Compensation Commissioner as a sampling frame. All establishments with 50 or more workers and a stratified random sample of smaller ones (495 in all) were contacted. The overall response rate was 56% and was positively related to work force size, the larger establishments showing higher response rates. The offering of health services, defined minimally as at least a part-time nurse or doctor employed on the premises, was reported in 11% of work places employing 52% of the work force and was also positively related to work force size. Seventeen percent of establishments had ever monitored environmental conditions, and all classes of industry in the study area fell short of government recommendations. The advantages of the study approach used here, based on a countrywide sampling frame and a mail questionnaire, include 1) the relatively modest cost; 2) the creation of an information framework to which can be added additional information obtained from other sources e.g., factory visits; and 3) the use of a database for sampling that is countrywide, regularly updated, and versatile, with the potential for extending the observations with a similar (geographic) or different focus, for instance, by industrial class or work force size.

Employment↗
PubMedDate not supplied

[Long-term results following percutaneous facet coagulation].

UNLABELLED: 93 patients with a mean follow up of 73 months (30-133 months) after lumbar percutaneous radiofrequency denervation (PRFD) were evaluated. Mean age of the patients at time of surgery was 47 years (18-76 years). 54 patients had no lumbar spine surgery prior to facet denervation, 32 patients had one or multiple disc surgery prior to denervation, and 7 patients had spinal fusions. 51 patients were in the process of early retirement or already retired at time of surgery. Out of all 93 patients only 50% had significant pain relief immediately after PRFD. 3 months after PRFD the success rate dropped down to 38%. 6 years after surgery only 25% of all patients had long lasting good results. Patients who were pain free after facet infiltration had significant better initial results, but were similar to the others after 6 years. 6 out of 7 patients after lumbar spinal fusions demonstrated bad results. The worst results had those patients who had applied for early retirement (workmens compensation cases). In this group the recurrence rate was 74% 6 years after surgery. We found no correlation between the surgeon and the outcome. CLINICAL RELEVANCE: Without pain reduction after facet infiltration the success rate after PRFD is low. Spinal surgery prior to PRFD significantly reduces the success rate. The worst prognosis have workmans compensation cases. The recurrence rate is high within the first 6 months after PRDF.

Adolescent↗
PubMed1978

Legal ramifications of the medical definition of back disease.

Back pain occurring without external force is extraordinarily prevalent in all segments of society. The practicing internist is often faced with the complaint, a need to define its cause, and a request to render an opinion as to whether the patient is disabled in the context of his employment. This opinion will have some weight in determining compensability under workmen's compensation law. This essay examines the inferences, as regards back pain, upon which compensation law is based. These inferences are then tested in light of our current understanding of the pathophysiology of back pain. A number of fallacies become apparent that may provide impetus for remedial legislation and clearly mandate further clinical investigation.

Back Pain↗
PubMed2002

Dynamic footprints: adjuvant method for postoperative assessment of patients after calcaneal fractures.

BACKGROUND: Open reduction and internal fixation are the current trends of treatment for comminuted calcaneal fractures. Assessing treatment results is often difficult due to discrepancy between objective parameters such as range of movement, and subjective results such as pain. OBJECTIVES: To test the reliability of footprint analysis as an adjuvant method of postoperative assessment of patients who sustained calcaneal fractures. METHODS: Dynamic and static footprint analysis was used as an adjuvant additional method to objectively assess operative results. This method is simple and is independent of the patient's initiatives. This modality was used in 22 patients followed-up 9-90 months postoperatively. RESULTS: We found a good correlation between footprint analysis and objective and subjective parameters of results expressed by American Orthopedic Foot and Ankle Society hind foot score. In certain cases, this method can be used to distinguish between uncorrelated parameter results, such as malingering, and workmens' compensation claims. CONCLUSION: We recommend the use of this simple, non-invasive objective test as an additional method to assess the results of ankle and foot surgery treatment.

Adolescent↗