Occupational Aspects of Diabetes

This thesis is a report of six studies on diabetes and employment. Four of these studies (Studies 1-4) relate to insulin treated diabetic patients registered with the diabetic clinic, Gartnavel General Hospital, Glasgow who were surveyed between January and April 1987. The fifth study is a survey of occupational physicians employed in major United Kingdom businesses. The final study is an analysis of early retiral cases from Strathclyde Regional Council during 1987

Improving spatial nitrogen dioxide prediction using diffusion tubes: a case study in West Central Scotland

It has been well documented that air pollution adversely affects health, and epidemiological pollutionhealth studies utilise pollution data from automatic monitors. However, these automatic monitors are small in number and hence spatially sparse, which does not allow an accurate representation of the spatial variation in pollution concentrations required for these epidemiological health studies. Nitrogen dioxide (NO2) diffusion tubes are also used to measure concentrations, and due to their lower cost compared to automatic monitors are much more prevalent. However, even combining both data sets still does not provide sufficient spatial coverage of NO2 for epidemiological studies, and modelled concentrations on a regular grid from atmospheric dispersion models are also available. This paper proposes the first modelling approach to using all three sources of NO2 data to make fine scale spatial predictions for use in epidemiological health studies. We propose a geostatistical fusion model that regresses combined NO2 concentrations from both automatic monitors and diffusion tubes against modelled NO2 concentrations from an atmospheric dispersion model in order to predict fine scale NO2 concentrations across our West Central Scotland study region. Our model exhibits a 47% improvement in fine scale spatial prediction of NO2 compared to using the automatic monitors alone, and we use it to predict NO2 concentrations across West Central Scotland in 2006

How robust are the estimated effects of air pollution on health? Accounting for model uncertainty using Bayesian model averaging

The long-term impact of air pollution on human health can be estimated from small-area ecological studies in which the health outcome is regressed against air pollution concentrations and other covariates, such as socio-economic deprivation. Socio-economic deprivation is multi-factorial and difficult to measure, and includes aspects of income, education, and housing as well as others. However, these variables are potentially highly correlated, meaning one can either create an overall deprivation index, or use the individual characteristics, which can result in a variety of pollution-health effects. Other aspects of model choice may affect the pollution-health estimate, such as the estimation of pollution, and spatial autocorrelation model. Therefore, we propose a Bayesian model averaging approach to combine the results from multiple statistical models to produce a more robust representation of the overall pollution-health effect. We investigate the relationship between nitrogen dioxide concentrations and cardio-respiratory mortality in West Central Scotland between 2006 and 2012

Potential for Blood and Body Fluid Exposure Reduction among Healthcare Workers by the Use of Alternative Safety Devices

No abstract available

Influenza immunisation: attitudes and beliefs of UK health care workers

AIMS: To explore attitudes to influenza immunisation and rates of uptake among staff working in acute hospitals in the UK. Method: Among 6302 responders (54% of those mailed), 19% had taken up influenza immunisation during winter 2002/3. Vaccination was well tolerated, with a low prevalence of side effects (13%) and associated time off work (2%). The majority of subjects who accepted vaccination (66%) were most strongly influenced by the personal benefits of protection against influenza. Prevention of sickness absence and protection of patients were the prime motivation for only 10% and 7% of subjects respectively. Among 3967 who declined vaccination, the most common primary de-motivators were concern about safety (31%) and efficacy (28%). Twenty two per cent were most strongly deterred by lack of time to attend for vaccination. Free text answers indicated that 37% were resistant to uptake because of a perceived low ratio of personal benefit to adverse effects. Subjects said they would be persuaded to take up vaccination in future by easier access (36%), more information about personal benefit/risk (34%), and more information about effects on staff absence (24%). CONCLUSIONS: These findings indicate that the uptake of influenza immunisation among UK health care workers remains low. There is some scope for increasing uptake by improving accessibility and encouragement from professional peers. However, our results suggest that perception of small personal benefit in relation to risk mitigates importantly against higher uptake of routine annual influenza vaccination by health care workers. Thus, resource might better be allocated to ensuring efficient targeted immunisation in epidemic years. Although the prevention of infection in patients and sickness absence in staff were not strong motivators for health care workers in this study, this might change if more supporting evidence became available.<br/