The Experts below are selected from a list of 61248 Experts worldwide ranked by ideXlab platform
David Ring - One of the best experts on this subject based on the ideXlab platform.
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the quality and strength of evidence for etiology example of carpal tunnel syndrome
Journal of Hand Surgery (European Volume), 2008Co-Authors: Santiago A Lozanocalderon, Shawn G Anthony, David RingAbstract:Purpose The purpose of this investigation was to evaluate the quality and strength of scientific evidence supporting an etiologic relationship between a disease and a proposed risk factor using a scoring system based on the Bradford Hill criteria for causal association. Methods A quantitative score based on the Bradford Hill criteria (qBHs) was used to evaluate 117 articles presenting original data regarding the etiology of carpal tunnel syndrome: 33 (28%) that evaluated biological (structural or genetic) risk factors, 51 (44%) that evaluated Occupational (Environment or activity-related) risk factors, and 33 (28%) that evaluated both types of risk factors. Results The quantitative Bradford Hill scores of 2 independent observers showed very good agreement, supporting the reliability of the instrument. The average qBHs was 12.2 points (moderate association) among biological risk factors compared with 5.2 points (poor association) for Occupational risk factors. The highest average qBHs was observed for genetic factors (14.2), race (11.7), and anthropometric measures of the wrist (11.3 points) with all studies finding a moderate causal association. The highest average qBHs among Occupational risk factors was observed for activities requiring repetitive hand use (6.5 points among the 30 of 45 articles that reported a causal association), substantial exposure to vibration (6.3 points; 14 of 20 articles), and type of occupation (5.6 points; 38 of 53 articles), with the findings being much less consistent. Conclusions According to a quantitative analysis of published scientific evidence, the etiology of carpal tunnel syndrome is largely structural, genetic, and biological, with Environmental and Occupational factors such as repetitive hand use playing a minor and more debatable role. Speculative causal theories should be analyzed through a rigorous approach prior to wide adoption. Type of study/level of evidence Diagnostic III.
Jeroen Douwes - One of the best experts on this subject based on the ideXlab platform.
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0164 metagenomic detection of bacteria in aerosol samples in animal slaughterhouses to develop exposure profiles for an epidemiological analysis
Occupational and Environmental Medicine, 2014Co-Authors: David Mclean, Patrick J Biggs, Mily Leblancmaridor, Richard J Hall, N P French, Neil Pearce, Jeroen DouwesAbstract:Objectives Significant excess risks of lung cancer and haematologic neoplasms have been observed in slaughterhouse workers in eight New Zealand studies, and numerous studies conducted elsewhere. No specific causal agents have been identified, although a biological aetiology is suggested as the risk is highest in those areas where workers are exposed to live animals or to biological material containing animal urine, faeces or blood. This study aimed to assess the airborne bacterial microflora in the slaughterhouse Environment in order to develop exposure categories for reanalysis of a meat workers’ cohort. Method Bulk air samples (n = 31) were collected for between 5 and 8 h in five areas in both sheep and beef slaughterhouses using a SASS3100 sampler (fitted with a proprietary SASS filter) located between 0.5 and 2 metres from the worker. Nucleic acid was extracted from each filter and amplified using commercially available kits, then sequenced on an Illumina MiSeq instrument. Bioinformatics analyses conducted included comparative taxonomic analyses, gene function (including virulence factor) analyses, and principal component analyses to compare profiles in samples taken in different areas. Results Of the bacteria identified over 95% were in the classes Actinobacteria, Firmicutes and Proteobacteria. Clear differences in all parameters were apparent in the different areas, however, and the full results of the comparative analyses and the development of exposure profiles will be presented. Conclusions Metagenomic analysis of bioaerosol samples represents a promising method for the development of exposure categories for the epidemiological analysis of the effect of biological exposures in an Occupational Environment.
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bioaerosol health effects and exposure assessment progress and prospects
Annals of Occupational Hygiene, 2003Co-Authors: Jeroen Douwes, Neil Pearce, Peter S Thorne, Dick HeederikAbstract:Exposures to bioaerosols in the Occupational Environment are associated with a wide range of health effects with major public health impact, including infectious diseases, acute toxic effects, allergies and cancer. Respiratory symptoms and lung function impairment are the most widely studied and probably among the most important bioaerosol-associated health effects. In addition to these adverse health effects some protective effects of microbial exposure on atopy and atopic conditions has also been suggested. New industrial activities have emerged in recent years in which exposures to bioaerosols can be abundant, e.g. the waste recycling and composting industry, biotechnology industries producing highly purified enzymes and the detergent and food industries that make use of these enzymes. Dose-response relationships have not been established for most biological agents and knowledge about threshold values is sparse. Exposure limits are available for some contaminants, e.g. wood dust, subtilisins (bacterial enzymes) and flour dust. Exposure limits for bacterial endotoxin have been proposed. Risk assessment is seriously hampered by the lack of valid quantitative exposure assessment methods. Traditional culture methods to quantify microbial exposures have proven to be of limited use. Non-culture methods and assessment methods for microbial constituents [e.g. allergens, endotoxin, beta(1-->3)-glucans, fungal extracellular polysaccharides] appear more successful; however, experience with these methods is generally limited. Therefore, more research is needed to establish better exposure assessment tools and validate newly developed methods. Other important areas that require further research include: potential protective effects of microbial exposures on atopy and atopic diseases, inter-individual susceptibility for biological exposures, interactions of bioaerosols with non-biological agents and other potential health effects such as skin and neurological conditions and birth effects.
Jytte Roedpetersen - One of the best experts on this subject based on the ideXlab platform.
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rapid increase in skin problems among dental technician trainees working with acrylates
Contact Dermatitis, 1995Co-Authors: Ann J L Murer, Finn Tüchsen, Otto Melchior Poulsen, Jytte RoedpetersenAbstract:A panel of trainees at The Danish School of Dental Technicians was asked to fill in questionnaires 2 × a year, to elucidate whether the prevalence of skin problems on their hands increased during the study and to compare the results to the general population. At the beginning of the study, trainees had a prevalence of skin problems not statically significantly different from that in the general population. 8 months later, an increase of 23% in the prevalence was observed. Compared to the general population the stadardized prevalence ratio (SPR) increased to 4.78, and compared to dental technicians at work, and SPR of 0.71 was found after 1 year of study. Very few trainees experienced relief in symptoms during the 1st year of study (5%), whereas 33% developed worse symptoms. The results demonstrate that trainees shortly after beginning their education have the same very high magnitude of skin problems as dental technicians at work. Trainees were exposed to acrylates more extensively than dental technicians. It is far from acceptable that this educational experience involves such a great risk to individuals with no experience or knowledge of the hazards of their Occupational Environment. Preventive actions are called for, e.g., increased use of encapsulated systems, use of gloves with a well documented protective effect and mandatory courses on the hazardous effects of dental materials.
Santiago A Lozanocalderon - One of the best experts on this subject based on the ideXlab platform.
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the quality and strength of evidence for etiology example of carpal tunnel syndrome
Journal of Hand Surgery (European Volume), 2008Co-Authors: Santiago A Lozanocalderon, Shawn G Anthony, David RingAbstract:Purpose The purpose of this investigation was to evaluate the quality and strength of scientific evidence supporting an etiologic relationship between a disease and a proposed risk factor using a scoring system based on the Bradford Hill criteria for causal association. Methods A quantitative score based on the Bradford Hill criteria (qBHs) was used to evaluate 117 articles presenting original data regarding the etiology of carpal tunnel syndrome: 33 (28%) that evaluated biological (structural or genetic) risk factors, 51 (44%) that evaluated Occupational (Environment or activity-related) risk factors, and 33 (28%) that evaluated both types of risk factors. Results The quantitative Bradford Hill scores of 2 independent observers showed very good agreement, supporting the reliability of the instrument. The average qBHs was 12.2 points (moderate association) among biological risk factors compared with 5.2 points (poor association) for Occupational risk factors. The highest average qBHs was observed for genetic factors (14.2), race (11.7), and anthropometric measures of the wrist (11.3 points) with all studies finding a moderate causal association. The highest average qBHs among Occupational risk factors was observed for activities requiring repetitive hand use (6.5 points among the 30 of 45 articles that reported a causal association), substantial exposure to vibration (6.3 points; 14 of 20 articles), and type of occupation (5.6 points; 38 of 53 articles), with the findings being much less consistent. Conclusions According to a quantitative analysis of published scientific evidence, the etiology of carpal tunnel syndrome is largely structural, genetic, and biological, with Environmental and Occupational factors such as repetitive hand use playing a minor and more debatable role. Speculative causal theories should be analyzed through a rigorous approach prior to wide adoption. Type of study/level of evidence Diagnostic III.
Chrisanne Gordon - One of the best experts on this subject based on the ideXlab platform.
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a profile of fibromyalgia in Occupational Environments
American Journal of Physical Medicine & Rehabilitation, 1994Co-Authors: George W Waylonis, Patrick G Ronan, Chrisanne GordonAbstract:The effect of the Occupational Environment on fibromyalgic patients has not been well studied. Individuals (321) from across the United States completed a questionnaire regarding effects of their current and past occupations on their fibromyalgia. Occupations with a high percentage of responders were general office workers (20%), health care providers (14%) and educators (11%). Of the respondents, 8% were unemployed. Activities reported to aggravate the symptoms of fibromyalgia were computer or typing (37%), prolonged sitting (37%), prolonged standing and walking (27%), stress (21%), heavy lifting and bending (19%) and repeated moving and lifting (18%). Activities that did not appear to exacerbate the symptoms of fibromyalgia included walking (19%), variable light sedentary work (15%), teaching (8%), light desk work (6%) and phone work (6%). Patients with fibromyalgia report that they do not tolerate prolonged, repetitive activities, maintaining any one position for sustained periods of time and jobs with high stress. Light sedentary occupations that allow varied tasks and changing positions appear to be tolerated the best.
