Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada.
We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data.
One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with =1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date.
We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance.
The level and qualitative spectrum of spontaneous chromosomal aberrations (CA) were comparatively analyzed in the lymphocytes of 655 children and adolescents from the Kemerovo Region. The presented sample was divided into 3 groups according to the type of an inhabited locality: 1) small miner's towns; 2) large industrial towns; and 3) rural localities. The maximum frequency of CA (3.77 +/- 0.22%) was noted in a group of dwellers in the miner's towns; its minimum frequency (2.68 +/- 0.17%) among the rural inhabitants. The significant clastogenic effects (including the markers of radiation exposure) were detected in the miner's towns located in the southern part of the region, which represented mountain and submountain areas. At the same time, in the northern and western parts of the Kemerovo Region, the average frequencies of CA in children and adolescents did not exceed the control background values. Thus, the residence in the inhabited localities specializing in mining is not a factor of absolute toxicogenetic risk.
The utilisation of data mining methods has become common in many fields. In occupational accident analysis, however, these methods are still rarely exploited. This study applies methods of data mining (decision tree and association rules) to the Finnish national occupational accidents and diseases statistics database to analyse factors related to slipping, stumbling, and falling (SSF) accidents at work from 2006 to 2007. SSF accidents at work constitute a large proportion (22%) of all accidents at work in Finland. In addition, they are more likely to result in longer periods of incapacity for work than other workplace accidents. The most important factor influencing whether or not an accident at work is related to SSF is the specific physical activity of movement. In addition, the risk of SSF accidents at work seems to depend on the occupation and the age of the worker. The results were in line with previous research. Hence the application of data mining methods was considered successful. The results did not reveal anything unexpected though. Nevertheless, because of the capability to illustrate a large dataset and relationships between variables easily, data mining methods were seen as a useful supplementary method in analysing occupational accident data.
A plant processing radium and uranium ores has been operating in the town of Port Hope since 1932. Given the nuclear industry located in the community and ongoing public health concerns, cancer incidence rates in Port Hope were studied for a recent 16 year period (1992-2007) for continued periodic cancer incidence surveillance of the community. The cancer incidence in the local community for all cancers combined was similar to the Ontario population, health regions with similar socio-economic characteristics in Ontario and in Canada, and the Canadian population. No statistically significant differences in childhood cancer, leukaemia or other radiosensitive cancer incidence were observed, with the exception of statistically significant elevated lung cancer incidence among women. However, the statistical significance was reduced or disappeared when the comparison was made to populations with similar socio-economic characteristics. These findings are consistent with previous ecological, case-control and cohort studies conducted in Port Hope, environmental assessments, and epidemiological studies conducted elsewhere on populations living around similar facilities or exposed to similar environmental contaminants. Although the current study covered an extended period of time, the power to detect risk at the sub-regional level of analysis was limited since the Port Hope population is small (16,500). The study nevertheless indicated that large differences in cancer incidence are not occurring in Port Hope compared to other similar communities and the general population.
Presented are the results of antioxidant status of inhabitants of Yakutia. The intensity of lipid peroxydation depends on professional factors: influence of the quartz dust and smoking. Miners and smokers have high concentration of malonil dialdegide in blood. The SOD and catalase levels did not statistically depend on sex and nationality, but increased in miners and smokers. Insufficiency of vitamins C, A and E combined with immunoglobulins deviations. It should be noticed that country-people have more deviations in vitamin and immune status than towns-people.
This study was carried out to assess Future Workshop (FW) regarding its usefulness as a participatory ergonomics method, using a descriptive evaluation design analysed by phenomenographical approach. The study was conducted among professional cleaners, health care personnel and miners, with a sample of 105 participating subjects in 8 different FWs. Multiple methods, giving a combination of both qualitative and quantitative data, were used for data collection. Good involvement of participants was observed during workshops. Evaluations immediately after FWs and 3 months later showed a strong relationship with high correlation, indicating that the perception of FW participants was very positive. Interviews revealed conformity between developed problem identification and proposed changes. Participants' own perceptions of FW's influence on creativity depict their belief of developed ideas and solutions in order to identify and solve workplace problems. FW is considered to be a useful ergonomics tool, and its qualities are related to structure and practical performance.
The authors studied autoantibodies in sera from 214 individuals in an oil sands community by indirect immunofluorescence, an addressable laser bead immunoassay, and the Crithidia luciliae assay. They compared results with exposure data that included urinary metabolites, health questionnaires, and overt disease as recorded by visits to a physician or hospitalization. The prevalence of autoantibodies was 13%, compared with 10% in 30 controls from a distant community (p > 0.05). The study group had higher autoantibody titers and some disease-specific autoantibodies, but these were not associated with reported autoimmune diagnoses. There was no evidence of increased autoimmune disease or response in this petroleum development population with low levels of exposure.
The authors studied benz(a)pyrene-specific secretory and serum antibody ratios (Ka) in 249 workers of the Kemerovo Power Station, by applying their modified enzyme immunoassay technique. There were 37 (20.5%) and 4 (5.8%) cases with Ka >2 at the preset immunoassay parameters of the 180 and 69 workers of mainline production and auxiliary units, respectively. A Ka value of >2 was found in 35 (21.6%) of the 162 males and only in 6 (6.9%) of the 87 females of the whole sample, in 29 (26.1%) of the 111 smokers and in 12 (8.7%) of the 138 non-smokers. The technique is proposed to study specific immune reactions and exposure to carcinogens primarily in workers of the enterprises processing coal and other types of fuel.