Search

Background We became aware of concern about cancer at a Scottish semiconductor manufacturing facility in 1998. Aim To compare cancer experience among current and former workers at the facility, with an appropriate comparison population, making use of any readily available exposure information. Method We obtained personnel and employment episode information from four sources within the company. Workers were flagged for death and cancer registrations at the National Health Service Central Register in Edinburgh. We constructed standardized registration and mortality ratios (SRRs and SMRs), using Scotland as the comparison, with and without an adjustment for deprivation. Results The main mortality analysis included 4388 workers, with a mean length of follow-up of 12.5 years. Overall mortality was substantially below that expected for men, and for women was slightly below expected. Total cancer registrations were close to expected levels for men and women. Four cancers produced noteworthy findings: malignant neoplasm of the trachea, bronchus and lung in women—deprivation adjusted SRR [95% confidence interval (CI), number of cases] 273 (136–488, 11 cases); malignant neoplasm of the stomach in women—adjusted SRR 438 (90–1281, three cases); and malignant neoplasm of the female breast—adjusted SRR 134 (82–206, 20 cases). The unadjusted SMR for male brain cancer was 401 (83–1172, three cases) and there was an additional non-fatal case. Conclusion These findings, particularly those relating to lung cancer, though inconclusive, point to the possibility of a work-related risk of cancer that justifies further investigation.

To investigate whether recent Australian practice conforms to the draft 2009 National Health and Medical Research Council (NHMRC) guidelines on the management of attention deficit hyperactivity disorder.Data from the 2007 Special Review on Attention Deficit Hyperactivity Disorder in Children and Adolescents in New South Wales (NSW) were examined.Two hundred seven approved stimulant prescribers in NSW responded to a detailed survey on treatment practice (including 121 paediatricians and 67 psychiatrists). Overall, the practice identified in this survey of NSW approved stimulant prescribers was consistent with that recommended in the draft NHMRC guidelines. Paediatricians were more likely to inform families of developmental therapies. Most prescribers (67%) considered stimulants to be the first line of treatment for at least half of their patients. Psychiatrists were more likely to use stimulants as first-line treatments, while those recently qualified were less likely to prescribe. Half of the prescribers were willing to consider prescribing for children 4 years of age and younger. Paediatricians were more likely to consider prescribing to this age group, while those recently qualified were less likely. There were no significant differences in prescribing practice between child and adult psychiatrists. Most prescribers (67-97%) routinely monitored patients on stimulants for weight, height, blood pressure and academic progress. Psychiatrists were less likely to review these parameters than paediatricians, with this difference being largely due to adult psychiatrists.There are significant differences in prescribing practice between paediatricians and psychiatrists. These variations may reflect differing training programs and patient populations, and merit close consideration in any review arising from the publication of the recent NHMRC guideline.

The overall prevalence of eating disorders among children and adolescents is rising - the younger age group are more likely to present with anorexia nervosa (AN), while the older adolescent can present with either AN or bulimia nervosa (BN). However, eating disorders exist as part of a spectrum and general practitioners will encounter many adolescents that have an eating disorder that do not yet fulfil diagnostic criteria for either AN or BN.This article aims to provide an overview of assessment and principles of management of eating disorders in the adolescent patient.General practitioners are key in recognising and offering early intervention in cases of incipient eating disorders or problem dieting behaviour. The physical findings of AN are those of protein calorie malnutrition, while in BN, they reflect chronic purging. Failure of outpatient management requires hospitalisation for nutritional rehabilitation with close monitoring of fluid and electrolyte status to prevent the development of refeeding syndrome. Family involvement is vital, particularly in the younger patient, with ongoing family therapy offering the best outcomes.

Objectives The Health & Safety Executive is the national independent watchdog for work-related health, safety and illness in Great Britain (GB), and is looking to improve the evidence base for prioritisation of resources. The aim of this project is to estimate the burden of work-related ill health and injury in GB based on current occupational exposures, in order to aid the decision process. This poster discusses the methodology and challenges involved. Methods Disability Adjusted Life Years (DALYs) were identified as an appropriate measure to compare work-related conditions with varying severities (eg, asbestos-related cancer, stress, and slip/trip injuries). To bring conditions with different time profiles onto a comparable basis, DALYs are computed for the steady state annual number of cases that would be generated by the indefinite continuation of current working conditions. Results Various challenges in this study will be discussed along with methods to address them and their effect on final results. These include: 1) The difficulty with estimating current case generation for conditions with a latency period; 2) The World Health Organisation produced a list of disability weights used in DALY calculations, but the categories do not always directly match those used in this study; and 3) Data must be gathered from various sources, all of which have their own strengths and limitations. Conclusions This study could be a valuable tool to aid prioritisation of health and safety resources. However, before this can happen, there must be confidence in the underlying methodology and assumptions made. © Crown Copyright (2011).