Paediatric CT scan usage and referrals of children to computed tomography in Germany-a cross-sectional survey of medical practice and awareness of radiation related health risks among physicians

<p>Abstract</p> <p>Background</p> <p>Computed tomography (CT) is a major source of ionizing radiation exposure in medical diagnostic. Compared to adults, children are supposed to be more susceptible to health risks related to radiation. The purpose of a cross-sectional survey among office-based physicians in Germany was the assessment of medical practice in paediatric CT referrals and to investigate physicians' knowledge of radiation doses and potential health risks of radiation exposure from CT in children.</p> <p>Methods</p> <p>A standardized questionnaire was distributed to all paediatricians and surgeons in two defined study areas. Furthermore, the study population included a random sample of general practitioners in the two areas. The questionnaire covered the frequency of referrals for paediatric CT examinations, the medical diagnoses leading to paediatric CT referrals, physicians' knowledge of radiation doses and potential health risks of radiation exposure from CT in children.</p> <p>Results</p> <p>A total of 295 (36.4%) physicians responded. 59% of the doctors had not referred a child to CT in the past year, and approximately 30% referred only 1-5 children annually. The most frequent indications for a CT examination in children were trauma or a suspected cancer. 42% of the referrals were related to minor diagnoses or unspecific symptoms. The participants underestimated the radiation exposure due to CT and they overestimated the radiation exposure due to conventional X-ray examinations.</p> <p>Conclusions</p> <p>In Germany, the frequency of referrals of children to computed tomography is moderate. The knowledge on the risks from radiation exposure among office-based physicians in our sample varied, but there was a tendency to underestimate potential CT risks. Advanced radiological training might lead to considerable amendments in terms of knowledge and practice of CT referral.</p

Cohort study of occupational cosmic radiation dose and cancer mortality in German aircrew, 1960-2014.

Dreger S, Wollschlager D, Schafft T, Hammer GP, Blettner M, Zeeb H. Cohort study of occupational cosmic radiation dose and cancer mortality in German aircrew, 1960-2014. Occupational and environmental medicine. 2020:oemed-2019-106165.OBJECTIVES: To determine cancer mortality compared with the general population and to examine dose-response relationships between cumulative occupational radiation dose and specific cancer outcomes in the German aircrew cohort.; METHODS: For a cohort of 26846 aircrew personnel, standardised mortality ratios (SMR) were calculated. Dose-response analyses were carried out using Poisson regression to assess dose-related cancer risks for the period 1960-2014. Exposure assessment comprises recently available dose register data for all cohort members and newly estimated retrospective cabin crew doses for 1960-2003.; RESULTS: SMR for all-cause, specific cancer groups and most individual cancers were reduced in all aircrew groups. The only increases were seen for brain cancer in pilots (n=23, SMR 2.01, 95%CI 1.15 to 3.28) and for malignant melanoma (n=10, SMR 1.88, 95%CI 0.78 to 3.85). Breast cancer mortality among female cabin crew was similar to the general population (n=71, SMR 1.06, 95%CI 0.77 to 1.44). Overall median cumulative effective dose was 34.2mSv (max: 116mSv) for 1960-2014. No dose-response associations were seen in any of the models. For brain cancer, relative risks were elevated across dose categories. An indicative negative trend with increasing dose category was seen for large intestine cancer in female cabin crew (n=23).; CONCLUSIONS: There was no evidence for significant dose-response patterns for the considered cancer types. Interpretation of results remains difficult as cumulative dose is closely related to age. Future work should focus on investigating radiation jointly with other risk factors that may contribute to risks for specific cancers among aircrew. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ

Estimated radiation exposure of German commercial airline cabin crew in the years 1960-2003 modeled using dose registry data for 2004-2015

Wollschlaeger D, Hammer GP, Schafft T, Dreger S, Blettner M, Zeeb H. Estimated radiation exposure of German commercial airline cabin crew in the years 1960-2003 modeled using dose registry data for 2004-2015. JOURNAL OF EXPOSURE SCIENCE AND ENVIRONMENTAL EPIDEMIOLOGY. 2018;28(3):275-280.Exposure to ionizing radiation of cosmic origin is an occupational risk factor in commercial aircrew. In a historic cohort of 26,774 German aircrew, radiation exposure was previously estimated only for cockpit crew using a job-exposure matrix (JEM). Here, a new method for retrospectively estimating cabin crew dose is developed. The German Federal Radiation Registry (SSR) documents individual monthly effective doses for all aircrew. SSR-provided doses on 12,941 aircrew from 2004 to 2015 were used to model cabin crew dose as a function of age, sex, job category, solar activity, and male pilots' dose; the mean annual effective dose was 2.25 mSv (range 0.01-6.39 mSv). In addition to an inverse association with solar activity, exposure followed age- and sex-dependent patterns related to individual career development and life phases. JEM-derived annual cockpit crew doses agreed with SSR-provided doses for 2004 (correlation 0.90, 0.40 mSv root mean squared error), while the estimated average annual effective dose for cabin crew had a prediction error of 0.16 mSv, equaling 7.2% of average annual dose. Past average annual cabin crew dose can be modeled by exploiting systematic external influences as well as individual behavioral determinants of radiation exposure, thereby enabling future dose-response analyses of the full aircrew cohort including measurement error information

Geodinámica, monitoreo geodésico y prospección geofísica del deslizamiento de Pie de Cuesta - Vítor, Arequipa

El Instituto Geológico, Minero y Metalúrgico (INGEMMET), en colaboración con el Instituto de Investigación para el Desarrollo (IRD), mediante la actividad 5: Monitoreo Geofísico y Geodésico de Movimientos en Masa Activos, de la Dirección de Geología Ambiental y Riesgos Geológicos, vienen realizando trabajos de monitoreo geodésico del deslizamiento Pie de Cuesta desde noviembre de 2017, con la finalidad de entender el comportamiento de uno de los fenómeno dinámicamente activo sobre el valle de Vítor . Para ello se cuenta con una red de monitoreo de 34 puntos de control GNSS distribuidos estratégicamente en la masa deslizante y alrededores, monitoreados trimestralmente (hasta la fecha se realizaron 3 campañas de reiteración de datos de monitoreo sobre el deslizamiento de Pie de Cuesta). Se presenta este informe n respuesta a los oficios Nº 317-2017-A-MDV; Nº 335-2018-MP-1FPPD y 136-2018-MP-1FPPD, emitidos por la municipalidad distrital de Vítor, la comisión de regantes de Ramo Socabón, de Vítor, el Ministerio Público de Arequipa y el Gobierno Regional de Arequipa. Se realizaron trabajos de prospección geofísica aplicando el método de Tomografía Eléctrica sobre la zona inestable del movimiento, para identificar anomalías geofísicas que estén relacionadas a la presencia de filtraciones y/o saturación hídrica en profundidad y, como informe complementario al informe técnico A6722 “Evaluación geológica y geodinámica de deslizamientos en el flanco izquierdo del valle de Vítor” proporcionado por el INGEMMET en agosto del 2016. El presente informe se pone a disposición de los interesados a fin de que sea un instrumento técnico para la toma de decisiones para las medidas de mitigación y reducción de riesgo de las instituciones correspondientes

Job analysis for a changing workplace

Job analysis sits at the heart of all human resource practices, making it a critically important management activity in every organization. However, with increasing competition, shorter product life-cycles, rapid technological innovations, and the changing nature of organizational structures, its underlying assumptions are becoming increasingly questionable in today's dynamic work environment. Moreover, the methods used by traditional job analysis are simply not applicable to many new and emerging jobs and some authors feel it may even be an obstacle to organizational success. This has led to calls for a more proactive and strategic approach to job analysis so that the procedures will continue to be relevant. In this article, I emphasize the need for a strategic approach to job analysis, present a strategic job analysis framework, and discuss implications for organizations