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(c) 2010-2026 Jon L Gelman, All Rights Reserved.

Thursday, September 5, 2013

Probability of Cancer in Pulmonary Nodules Detected on First Screening CT

Today's post was shared by NEJM and comes from www.nejm.org


Major issues in the implementation of screening for lung cancer by means of low-dose computed tomography (CT) are the definition of a positive result and the management of lung nodules detected on the scans. We conducted a population-based prospective study to determine factors predicting the probability that lung nodules detected on the first screening low-dose CT scans are malignant or will be found to be malignant on follow-up.

Methods

We analyzed data from two cohorts of participants undergoing low-dose CT screening. The development data set included participants in the Pan-Canadian Early Detection of Lung Cancer Study (PanCan). The validation data set included participants involved in chemoprevention trials at the British Columbia Cancer Agency (BCCA), sponsored by the U.S. National Cancer Institute. The final outcomes of all nodules of any size that were detected on baseline low-dose CT scans were tracked. Parsimonious and fuller multivariable logistic-regression models were prepared to estimate the probability of lung cancer.

Results

In the PanCan data set, 1871 persons had 7008 nodules, of which 102 were malignant, and in the BCCA data set, 1090 persons had 5021 nodules, of which 42 were malignant. Among persons with nodules, the rates of cancer in the two data sets were 5.5% and 3.7%, respectively. Predictors of cancer in the model included older age, female sex, family history of lung cancer, emphysema, larger nodule size, location of the nodule in the...
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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Italian Plant’s Abrupt Shutdown Stirs a Debate

Today's post was shared by The New York Times and comes from www.nytimes.com


Like it or not, Italy’s labor force recognizes that the long manufacturing slump may make factory closings inevitable. But this, they say, is no way to do it.

At the start of August, the 30 workers of Hydronic Lift, an elevator components company, wished one another well and left on long-planned summer vacations. But when they returned to work three weeks later, they found the gates bolted with chains and padlocks. The company has not disclosed its plans.

“Not to be emotional, but if a worker goes on holiday with the fear that he might not come back to a job, well, that can cause serious damage to one’s peace of mind,” Alberto Larghi of the metalworkers’ trade union said. “Events like this can ruin vacations for all workers.”

It was only the latest in a headline-grabbing series of factory closures in Italy that the metalworkers’ union, FIOM-CGIL, which represents the workers at Hydronic Lift, denounced as the “popular sport among businessmen in the summer of 2013: transforming the summer shutdown into a definitive termination, with no forewarning, taking advantage that the employees are absent.”

Summer sport is a bit of an overstatement; there have been only a handful of cases, including a factory near Modena where the boss moved the production line for electronic components to Poland under the cover of the August doldrums. But they have stirred a national debate in a country struggling to...
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Study: Healthcare-linked infections cost US $10 billion a year

Today's post was shared by CIDRAP and comes from www.cidrap.umn.edu


Five of the most common, costly, and preventable healthcare-associated infections (HAIs) cost the United States nearly $10 billion per year, according to a meta-analysis of 27 years' worth of data by a team from Harvard Medical School and affiliated institutions.

The team reviewed data spanning 1986 to 2013 concerning surgical site infections (SSIs), central line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonia (VAP), and Clostridium difficile infections (CDIs), according to their report, released yesterday by JAMA Internal Medicine.

For HAI incidence estimates, the investigators used the National Healthcare Safety Network of the Centers for Disease Control and Prevention (CDC), which includes 1,700 reporting sites. By conducting a systematic literature review, the team found 26 studies that provided "reasonably robust" estimates of attributable costs and/or length of stay for HAIs.

The overall cost of the HAIs was estimated at $9.8 billion annually.  On a per-case basis, CLABSIs were found to be the most expensive HAI at $45,814 each, followed by VAP, $40,144; SSIs, $20,785; CDIs, $11,285; and CAUTIs, $896, the report says.

SSIs, however, accounted for the largest share of costs, at 33.7%. The second largest contributor was VAP, at 31.6%, followed by CLABSIs, 18.9%; CDIs, 15.4%; and CAUTIs, less than 1%.
"While quality improvement initiatives have decreased HAI...
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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UNITED STATES REACHES SETTLEMENT WITH SAFEWAY TO REDUCE EMISSIONS OF OZONE-DEPLETING SUBSTANCES NATIONWIDE

Today's post was shared by US EPA News and comes from yosemite.epa.gov


In a settlement agreement with the United States, Safeway, the nation’s second largest grocery store chain, has agreed to pay a $600,000 civil penalty and implement a corporate-wide plan to significantly reduce its emissions of ozone-depleting substances from refrigeration equipment at 659 of its stores nationwide, estimated to cost approximately $4.1 million, announced the U.S. Environmental Protection Agency (EPA) and Department of Justice today. 

 The settlement involves the largest number of facilities ever under the Clean Air Act’s regulations governing refrigeration equipment.

 The settlement resolves allegations that Safeway violated the federal CAA by failing to promptly repair leaks of HCFC-22, a hydro-chlorofluorocarbon that is a greenhouse gas and ozone-depleting substance used as a coolant in refrigerators, and failed to keep adequate records of the servicing of its refrigeration equipment. Safeway will now implement a corporate refrigerant compliance management system to comply with stratospheric ozone regulations.

  In addition, Safeway will reduce its corporate-wide average leak rate from 25 percent in 2012 to 18 percent or below in 2015. The company will also reduce the aggregate refrigerant emissions at its highest-emission stores by 10 percent each year for three years. “Safeway’s new corporate...
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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WORK SCHEDULES: SHIFT WORK AND LONG WORK HOURS

Shift work is a focus of increased concern for workers as reports continue to emerge of increased health risks. Today's post was shared by NIOSH Transportation and comes from www.cdc.gov


A tired man, a man working in a hospital, and a taxi driver.
A tired man, a man working in a hospital, and a taxi driver.
According to 2004 data from the Bureau of Labor Statistics, almost 15 million Americans work full time on evening shift, night shift, rotating shifts, or other employer arranged irregular schedules.

The International Labor Office in 2003 reports that working hours in the United States exceed Japan and most of western Europe. Both shift work and long work hours have been associated with health and safety risks.

This page provides links to NIOSH publications and other resources that address demanding work schedules.

NIOSHTIC-2 Search

NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by NIOSH.
NIOSHTIC-2 search results on work schedules

NIOSH Publications and Guidance

NIOSH DEEPWATER HORIZON RESPONSE Key Safety and Health Topics, Fatigue Prevention
http://www.cdc.gov/niosh/topics/oilspillresponse/
keytopics.html#fatigue
NIOSH OSHA Interim Guidance for Protecting Deepwater Horizon Response Workers and Volunteers, Fatigue Prevention
NIOSH Blog: Sleep and Work
http://blogs.cdc.gov/niosh-science-blog/2012/03/sleep-and-work/
NIOSH Blog: NIOSH Research on Work Schedules and Work-related Sleep Loss
http://blogs.cdc.gov/niosh-science-blog/2012/03/sleep/
Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries and Health Behaviors
DHHS (NIOSH) Publication No. 2004-143
Presents a review of the methods...
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Sleep, Pain, and Hospital Workers

The health care employment sector is increasing as the US becomes an "aging nation" of seniors. Safety of health care workers is a growing concern. Today's post was shared by NIOSH Transportation and comes from blogs.cdc.gov



We know that decreased sleep duration and extended shifts in healthcare workers are linked to workplace injuries.  The effects of decreased sleep on pain in the workplace are less clear. 

New research from the Harvard Center for Work, Health and Wellbeing  –one of four NIOSH Centers of Excellence funded to explore and research the concepts of Total Worker Health™- examines the question: Does lack of sleep increase pain and limit function among hospital care workers?   


The study, published in the American Journal of Occupational and Environmental Medicine, finds that sleep deficiency (including short sleep duration, insomnia symptoms, sleep insufficiency, or all three) is significantly associated with pain, functional limitations of daily living tasks due to that pain, and difficulty performing work tasks due to that pain, among hospital care workers. These effects may impact productivity or the ability to perform demanding health care work such as patient handling.

This study is in agreement with a growing body of research linking poor sleep with pain. For example, laboratory studies have shown that restricting sleep duration can increase reports of new pain, consistent with the higher pain reports associated with insomnia. Other studies have shown that sleep-deprived persons respond differently to a standard pain...
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To Promote Wellness, Public Health Departments Are Launching Apps. Will They Work?

Employee health concerns will soon be advanced by technology. Knowledgeable use of "apps" will assist workers' in identifying occupational conditions and hazards. Today's post was shared by RWJF PublicHealth and comes from healthland.time.com

Courtesy of Alabama Department of Public Health
Courtesy of Alabama
Department of Public Healt

The Alabama Department of Public Health is venturing into the mobile universe as the first state with a health app for residents.

“Normally Alabama comes in last when it comes to health indicators, but we were one of the first states to be on Facebook and Twitter and YouTube. This is just another goal for us,” says Jennifer Pratt Sumner, the director of the digital media branch of the department.

The app, which is free to download from Google Play or iTunes, brings all of the social media feeds put out by the various public health divisions into one place. It also provides health news alerts and information about wellness events, such as the annual Alabama Youth Rally. Some recent tips included educational conferences open to the public, and tips on safely consuming shellfish in the state.

(MORE: Two-Faced Facebook: We Like It, but It Doesn’t Make Us Happy)
“As more and more Americans use their smartphones to gather health information, I think we’ll see a greater number of health departments rolling out their own apps,” says Alexandra Hughes, an account director at Ogilvy Public Relations Worldwide, who wrote an analysis on social media effects entitlted “Using Social Media Platforms to Amplify Public Health Messaging” [PDF].

“Consumers are already flocking to apps to do things like count calories, prepare healthier...
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