The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P
To determine the acute injury profile in each of six sports and compare the injury rates between the sports.
Analysis of national sports injury insurance registry data.
Finland during 1987-91.
621,691 person years of exposure among participants in soccer, ice hockey, volleyball, basketball, judo, or karate.
Acute sports injuries requiring medical treatment and reported to the insurance company on structured forms by the patients and their doctors.
54,186 sports injuries were recorded. Injury rates were low in athletes aged under 15, while 20-24 year olds had the highest rates. Differences in injury rates between the sports were minor in this adult age group. Overall injury rates were higher in sports entailing more frequent and powerful body contact. Each sport had a specific injury profile. Fractures and dental injuries were most common in ice hockey and karate and least frequent in volleyball. Knee injuries were the most common cause of permanent disability.
Based on the defined injury profiles in the different sports it is recommended that sports specific preventive measures should be employed to decrease the number of violent contacts between athletes, including improved game rules supported by careful refereeing. To prevent dental injuries the wearing of mouth guards should be encouraged, especially in ice hockey, karate, and basketball.
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The effect of inorganic acid fumes from the work environment on the erosion of teeth was studied blindly. A sample of 186 workers was drawn from four factories. Among the 157 dentulous participants, 76 were working in departments containing acid fumes, and 81 had never worked under such conditions and were used as referents. Of the acid workers 18.4% had one or more teeth with erosion, and the corresponding figure for the referents was 8.6%. With a longer duration of exposure the proportion of subjects with erosion increased. The acid workers had more teeth with erosion than the referents, especially upper anterior teeth. The findings suggest that even today exposure to inorganic acid fumes from the work environment may increase the erosion of teeth, especially the upper anterior teeth, which are not continuously protected by saliva and the lips.
Helicobacter pylori screening may markedly reduce mortality and morbidity in the decades ahead.
This study explores the costs and benefits of population-based H. pylori screening in terms of health care cost taking into account all relevant H. pylori-related diseases.
The computer-based decision analysis compared two strategies: (1) screen for H. pylori and treat those individuals who test positive, and (2) do not screen for H. pylori, and test and treat H. pylori only if related clinical symptoms appear. The model estimated the discounted H. pylori-related accumulative health care costs from screening age to death in both strategies. The baseline case estimates cost-benefit for screenees aged 15-45 years. The main outcome measure is the incremental health care cost per case in the screening compared with the no-screening alternative. The probability estimates were obtained from the Finnish Vammala H. pylori screen and treat project, including 5288 subjects in the years 1996-1998, published studies, national statistics and hospitals' internal accounts.
The incremental cost per case was 26 US dollars in the screening compared with the no-screening alternative. It was lowest in the group aged 45 years, where H. pylori screening showed cost savings per case.
H. pylori screening is more favourable in the older age cohorts. The estimated cost per screenee can be considered to be very acceptable if the current pathophysiological evidence on the potential effects of H. pylori eradication are confirmed in the future. However, there is uncertainty about the possible negative effect of eradicating H. pylori infection on gastro-esophageal reflux disease and esophageal adenocarcinoma. This could change the balance of benefits against risks of eradicating H. pylori infection.
The aim of this study was to evaluate the cost-effectiveness, from a societal perspective, of the Finnish nationwide breast carcinoma screening program.
The effects were measured in life-years saved from 1987 to 2020, using data from the nationwide program to the end of 1992. A total of 90,000 women ages 50-59 were invited for screening during the years 1987-89. The total number of participants screened was 76,000. The screening interval was 24 months, with follow-up to the end of 1992. From the beginning of 1993, the estimation model used parameters based on published studies and national cancer statistics. Data on health care and non-health care costs and time costs were obtained from internal accounts of screening units, published studies, national statistics, health market sources, and a questionnaire completed by a sample of 1400 screening attendees. The discount rate, the annual rate of time preference over future costs and life-years saved, was 3%. The main outcome measure was the cost per life-year saved.
The estimated number of life-years of life saved was 578, of which 8% occurred 1987-1992. The estimated life-years saved per 1000 screenings was 3.2. The total costs were $11 million in U.S. dollars, i.e., $14.3 million per 100,000 participants.
The cost of breast carcinoma mammographic screening per life-year saved was $18,955 in the base case, ranging from $15,502 to $40,308 according to the different models used in analysis.
The objective of this study was to evaluate, in a controlled clinical trial, the costs of standardized one-stage ultrasound screening in pregnancy in relation to the reduction in perinatal mortality. A trial population of 9310 pregnant women was randomly allocated to ultrasound screening or a control group. Two obstetric hospitals and 64 recruiting antenatal health centers were involved. The costs included actually realized costs, i.e. positive costs, and gains, i.e. negative costs, resulting from lower health-care use. Cost-accounting data were obtained by a questionnaire to all attenders and measurements at the screening, and later complemented by a questionnaire to a random sample of 534 screened women. Internal accounting and other hospital data, national statistics and health-market sources were also used. The actually realized cost of each avoided perinatal death was FIM 84 378 ($21,938), while the net overall estimate combining all positive and negative costs showed a cost saving of FIM 65 680 ($17,077). The total positive unit cost of ultrasound screening was FIM 393 ($102). Longer ultrasound examination time and more numerous advanced examinations were rewarded by clearly fewer perinatal deaths and a better cost-effectiveness ratio. One-stage second-trimester ultrasound screening is cost-effective when all significant costs and effects are taken into account.
The occurrence of dental erosion and the relative importance of some related factors were explored in a cross-sectional study, using blind dental examinations. A sample of 186 workers from four factories was drawn. Among the 157 dentate participants 76 were working in departments containing acid fumes and 81 controls had never worked under such conditions. Out of the dentate participants, 20 (12.7% had erosion). Anterior teeth were affected more often than posterior ones. Exposure to acid fumes, increasing age and frequency of intake of fruits increased the probability of dental erosion. It can be concluded that exposure to acid fumes in the work environment is associated with dental erosion especially on anterior teeth.
In industrialized countries various dental benefit schemes have been implemented to improve the utilization of dental services, though few studies have demonstrated that effect. Prior to a comprehensive clinical study in southern Finland, a postal questionnaire survey of male industrial workers (age 38-65 yrs) was conducted to investigate knowledge and attitudes concerning oral health care and whether access to an employer-provided dental benefit scheme was associated with the utilization of dental services. The response rate was 81% (n = 325) in the subsidized group and 69% (n = 174) in the control group. In both groups, 60% of the subjects had had their last dental visit within a year but 91% of the subsidized workers compared to 79% of the controls had visited a dentist in the past two years (P