A train passenger with pulmonary tuberculosis: evidence of limited transmission during travel.
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In January 1996, smear- and culture-positive tuberculosis (TB) was diagnosed for a 22-year-old black man after he had traveled on two U.S. passenger trains (29.1 hours) and a bus (5.5 hours) over 2 days. To determine if transmission had occurred, passengers and crew were notified of the potential exposure and instructed to undergo a tuberculin skin test (TST). Of the 240 persons who completed screening, 4 (2%) had a documented TST conversion (increase in induration of > or = 10 mm between successive TSTs), 11 (5%) had a single positive TST (> or = 10 mm), and 225 (94%) had a negative TST (< 10 mm). For two persons who underwent conversion, no other risk factors for a conversion were identified other than exposure to the ill passenger during train and/or bus travel. These findings support limited transmission of Mycobacterium tuberculosis from a potentially highly infectious passenger to other persons during extended train and bus travel. (+info)
Injuries among railroad trespassers--Georgia, 1990-1996.
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Railroad trespassers are persons on railroad property whose presence is prohibited or unlawful. Most trespassers are walking along or across railroad tracks. In 1997, fatalities to railroad trespassers became the leading cause of railroad-related deaths in the United States. In 1998, 513 persons were injured and 536 persons were killed while trespassing (Federal Railroad Administration, unpublished data, 1999). This report presents three incidents in which trespassers were injured or killed and summarizes a study of fatal and nonfatal injuries to railroad trespassers in Georgia from 1990 through 1996. (+info)
Determining disability. Railroad Retirement Board. Final rule.
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The Railroad Retirement Board (Board) hereby amends its disability regulations to discontinue the current policy of conducting continuing disability reviews (CDR's) for medical recovery of disability annuitants in medical improvement not expected (MINE) cases. The Board has found that these reviews have not been cost effective and impose an unnecessary burden on the annuitant. (+info)
Does hyperuricemia affect mortality? A prospective cohort study of Japanese male workers.
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A positive association between hyperuricemia and cardiovascular disease has been reported, but no study has evidenced yet the precise role of serum uric acid in the development of cardiovascular disease. In addition, no epidemiological studies have so far documented a decreased risk of cancer among people with hyperuricemia, even though the antioxidant action of uric acid has recently been stressed to inhibit DNA damage. The present prospective cohort study investigates the relationship between hyperuricemia and health hazards in a Japanese working population. The subjects were 49,413 Japanese male railroad workers, aged 25-60 years at enrollment. Serum uric acid and other baseline data were provided by annual health-survey records from 1975 to 1982. The vital status of the subjects was traced until the end of 1985 for those who remained alive. During an average 5.4-year study period, 984 deaths were recorded. Those with serum uric acid over 8.5 mg/dl showed elevated relative risks (RRs) of death in all causes (RR 1.62, p<0.01), coronary heart disease ( RR 1.52), stroke (RR 2.33, p<0.01), hepatic disease (RR 3.58, p<0.01), and renal failure ( RR 8.52, p<0.01), as compared with those with serum uric acid levels of 5.0-6.4mg/dl. The RR of death in all causes still remains statistically significant when adjusted by age and serum total cholesterol (2.00, p<0.01), age and alcohol intake (1.85, p<0.001), age and smoking (1.69, p<0.001), age and gout treatment (1.61, p<0.05), and also age and BMI (1.50, p< 0.05). On the other hand, the RR of all causes decreased but was still above 1.0 when adjusted by age and blood glucose (1.62), age and systolic blood pressure (1.32), age and GOT (1.23), and also age and history of cardiovascular disease (1.17). These results showed that hyperuricemia has a strong association with the RRs of death in all causes, coronary heart disease, stroke, hepatic disease and renal failure, and indicated that serum uric acid seems to be a considerable risk factor for reduced life expectancy. (+info)
Childhood acute leukaemia and residential 16.7 Hz magnetic fields in Germany.
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We observed a moderate but statistically non-significant association between magnetic fields (MF) and childhood leukaemia. This is the first such study to cover residential exposure to 16.7 Hz (railway frequency) MF though based on few exposed subjects. Our study does not exclude a small excess risk, but the attributable risk must be very low. It is reassuring that neglecting 16.7 Hz MF in childhood cancer studies appears to have little effect on findings. (+info)
A special courage: dealing with the Paddington rail crash.
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Supporting traumatized employees requires special skills and techniques if it is to be effective. Unfortunately, there is little to inform or guide organizations on how this should be achieved. The present controversy over the use of trauma management systems and debriefing has not been helpful in informing organizations on the best way to take care of employees who become traumatized during the course of their work. This paper looks at how Sainsbury's Supermarkets Ltd managed traumatization through the activation of its Violence at Work policy and procedures, and finally presents the results of an evaluation exercise that was undertaken following the Paddington rail crash. (+info)
Leukemia, brain tumors, and exposure to extremely low frequency electromagnetic fields in Swiss railway employees.
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Railway engineers provide excellent opportunities for studying the relation between exposure to extremely low frequency magnetic fields and leukemia or brain tumors. In a cohort study of Swiss railway personnel with 2.7 x 10(5) person-years of follow-up (1972--1993), the authors compared occupations with high average exposures (line engineers: 25.9 microT) to those with medium and low exposures (station masters: 1 microT). The mortality rate ratio for leukemia was 2.4 (95% confidence interval (CI): 1.0, 6.1) among line engineers (reference category: station masters). The mortality rate ratio for brain tumors was 1.0 (95% CI: 0.2, 4.6) among line engineers and 5.1 (95% CI: 1.2, 21.2) among shunting yard engineers (compared with station masters). Two exposure characteristics were evaluated: cumulative exposure in microT-years and years spent under exposure to magnetic fields of > or =10 microT. There was a significant increase in leukemia mortality of 0.9% (95% CI: 0.2, 1.7) per microT-year of cumulative exposure to extremely low frequency magnetic fields. The increase by years spent under exposure of > or =10 microT was even stronger: 62% per year (95% CI: 15, 129). Brain cancer risk did not show a dose-response relation. This study contributes to the evidence for a link between heavy exposure to extremely low frequency magnetic fields and leukemia. Its strengths include reliable measurements and reliable historical reconstruction of exposures. (+info)
Invited commentary: electromagnetic fields and cancer in railway workers.
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The ideal study of occupational exposure to electromagnetic fields and cancer risk would have a clear exposure source, historically stable exposures, and comparable groups of exposed and unexposed workers. Cohorts of railway workers have marked exposure contrasts and limited job changes and provide marginally adequate study sizes, but there have been important changes in their exposures over time, and the field frequency involved is unusual. The results of Minder and Pfluger's study (Am J Epidemiol 2001;153:825--35) add modest support for an association between electromagnetic field exposure and leukemia. However, given the large size and high quality of a number of previous studies of occupational electromagnetic field exposure and cancer, additional studies similar to past ones are unlikely to yield important new insights. (+info)