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- af Klint, Erik, et al.
(author)
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Evaluation of arthroscopy and macroscopic scoring.
- 2009
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In: Arthritis Research & Therapy. - : Springer Science and Business Media LLC. - 1478-6362 .- 1478-6354. ; 11:3
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Arthroscopy is a minimally invasive technique for retrieving synovial biopsies in rheumatology during the past 20 years. Vital for its use is continual evaluation of its safety and efficacy. Important for sampling is the fact of intraarticular variation for synovial markers. For microscopic measurements scoring systems have been developed and validated, but for macroscopic evaluations there is a need for further comprehensive description and validation of equivalent scoring systems.METHODS: We studied the complication rate and yield of arthroscopies performed at our clinic between 1998 and 2005. We also created and evaluated a macroscopic score set of instructions for synovitis.RESULTS: Of 408 procedures, we had two major and one minor complication; two haemarthrosis and one wound infection, respectively. Pain was most often not a problem, but 12 procedures had to be prematurely ended due to pain. Yield of biopsies adequate for histology were 83% over all, 94% for knee joints and 34% for smaller joints. Video printer photographs of synovium taken during arthroscopy were jointly and individually reviewed by seven raters in several settings, and intra and inter rater variation was calculated. A macroscopic synovial scoring system for arthroscopy was created (Macro-score), based upon hypertrophy, vascularity and global synovitis. These written instructions were evaluated by five control-raters, and when evaluated individual parameters were without greater intra or inter rater variability, indicating that the score is reliable and easy to use.CONCLUSIONS: In our hands rheumatologic arthroscopy is a safe method with very few complications. For knee joints it is a reliable method to retrieve representative tissue in clinical longitudinal studies. We also created an easy to use macroscopic score, that needs to be validated against other methodologies. We hope it will be of value in further developing international standards in this area.
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| 2. |
- Elfman, Lena, et al.
(author)
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Acute Health Effects on Planters of Conifer Seedlings Treated with Insecticides
- 2009
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In: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 1475-3162 .- 0003-4878. ; 53:4, s. 383-390
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to assess acute health effects on planters caused by planting conifer seedlings treated with two insecticides, with active ingredients imidacloprid and cypermethrin, in comparison with untreated seedlings. Methods: The investigation was a double-blind crossover study, which included a follow-up of 19 planters over a 3-week period. During Week 1, the 19 planters handled untreated conifer seedlings while they planted imidacloprid- and cypermethrin-treated seedlings during study Week 2 and 3, respectively. Signs and symptoms of acute health effects were documented by a questionnaire, administered by the field staff, during these 3 weeks. Inflammation markers in the nasal mucous membrane were also measured as an objective test. Exposure to cypermethrin was further assessed by measuring 3-phenoxybenzoic acid (3-PBA) in urine. No validated biomarker was available to assess internal exposure to imidacloprid. Results: No clear, acute adverse health effects could be found in planters during the week of exposure to conifer seedlings treated with imidacloprid (Merit Forest) or cypermethrin (Forester), as compared to during the week of planting untreated seedlings. During the week of cypermethrin exposure, the individuals had 3-PBA values that were 12-54% higher (P < 0.05), depending on the worker, than those observed during the untreated week. There were no statistically significant correlations between the raised levels of 3-PBA and self-reported health problems. These results have been obtained during planting in late summer/early autumn and with good use of protective clothing. Conclusions: No clear, acute adverse health effects could be found in planters after exposure to conifer seedlings treated with imidacloprid (Merit Forest) or cypermethrin (Forester), as compared with planting untreated seedlings. The metabolite, 3-PBA, was found in low levels in urine and was increased after exposure to cypermethrin. However, no clear relationships could be found between exposure and reported symptoms or between elevated 3-PBA levels and reported symptoms.
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| 4. |
- Eriksson, Kåre, et al.
(author)
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Should styrene be sampled on the left or right shoulder? : An important question in employee self-assessment.
- 2005
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In: Annals of Occupational Hygiene. - : Oxford University Press (OUP). - 0003-4878 .- 1475-3162. ; 49:6, s. 529-533
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Journal article (peer-reviewed)abstract
- A self-operated personal sampling technique called 'self assessment of exposure' (SAE) has been suggested as an easy method for collecting inhalation exposure data, as the workers themselves are performing the sampling. Employers and employees have raised the question of whether a different estimate of the air concentration is likely to be obtained depending on whether the sampler is fastened at the left or the right shoulder. In order to answer this question, the exposure to styrene vapour in two different small enterprises within the reinforced plastics industry was measured. Seven workers participated and the air sampling was performed by diffusive sampling. We observed no statistically significant difference in the determined air concentration of styrene between the left and right shoulder (P = 0.878). The results strongly indicate that the fastening of a sampler on the left or right shoulder does not produce a difference in the estimation of the inhalation exposure. SAE can thus be used to collect reliable exposure data of styrene vapour. The reliability of SAE will most certainly inspire occupational hygienists, physicians and other experts to involve the workers in repeated exposure measurements. Taking the exposure variability into account, repeated measurements are crucial when evaluating acute and chronic health effects following inhalation exposure to gases and vapours from chemical hazards.
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| 5. |
- Lampa, Erik G., et al.
(author)
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Optimizing occupational exposure measurement strategies when estimating the log-scale arithmetic mean value : An example from the reinforced plastics industry
- 2006
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In: Annals of Occupational Hygiene. - Oxford : Pergamon Press. - 0003-4878 .- 1475-3162. ; 50:4, s. 371-377
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Journal article (peer-reviewed)abstract
- When assessing occupational exposures, repeated measurements are in most cases required. Repeated measurements are more resource intensive than a single measurement, so careful planning of the measurement strategy is necessary to assure that resources are spent wisely. The optimal strategy depends on the objectives of the measurements. Here, two different models of random effects analysis of variance (ANOVA) are proposed for the optimization of measurement strategies by the minimization of the variance of the estimated log-transformed arithmetic mean value of a worker group, i.e. the strategies are optimized for precise estimation of that value. The first model is a one-way random effects ANOVA model. For that model it is shown that the best precision in the estimated mean value is always obtained by including as many workers as possible in the sample while restricting the number of replicates to two or at most three regardless of the size of the variance components. The second model introduces the ‘shared temporal variation’ which accounts for those random temporal fluctuations of the exposure that the workers have in common. It is shown for that model that the optimal sample allocation depends on the relative sizes of the between-worker component and the shared temporal component, so that if the between-worker component is larger than the shared temporal component more workers should be included in the sample and vice versa. The results are illustrated graphically with an example from the reinforced plastics industry. If there exists a shared temporal variation at a workplace, that variability needs to be accounted for in the sampling design and the more complex model is recommended.
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