British Journal of Industrial Medicine最新文献

{"title":"Incidence of cancer and exposure to toluene diisocyanate and methylene diphenyldiisocyanate: a cohort based case-referent study in the polyurethane foam manufacturing industry.","authors":"L Hagmar,&nbsp;U Strömberg,&nbsp;H Welinder,&nbsp;Z Mikoczy","doi":"10.1136/oem.50.11.1003","DOIUrl":"https://doi.org/10.1136/oem.50.11.1003","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between occupational exposure to toluene diisocyanate or methylene diphenyldiisocyanate and risk of cancer.</p><p><strong>Design: </strong>A cohort based case-referent study. STUDY BASE: 7023 subjects employed during the period 1958 to 1987 in nine Swedish polyurethane foam manufacturing plants.</p><p><strong>Main outcome measures: </strong>Odds ratios adjusted with respect to the matching factors (age at risk, calendar year at risk, sex, and plant), calculated from the conditional logistic regression model.</p><p><strong>Results: </strong>A non-significant association was found between high exposure to isocyanates and prostate cancer (OR 2.66, 90% confidence interval (90% CI) 0.39-18.1), which was not enhanced when an induction latency period of 10 years was applied. An association between isocyanate exposure and colon cancer was even weaker. No associations were seen for non-Hodgkin's lymphoma and rectal cancer.</p><p><strong>Conclusions: </strong>The tentative associations, derived from a previous cohort study, between isocyanate exposure and excess risk for non-Hodgkin's lymphoma and rectal cancer were not supported. Instead, non-significant associations with prostate cancer, and possibly colon cancer, were seen.</p>","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1003-7"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and incidence of cancer among a cohort of self employed butchers from Geneva and their wives.","authors":"E Gubéran,&nbsp;M Usel,&nbsp;L Raymond,&nbsp;G Fioretta","doi":"10.1136/oem.50.11.1008","DOIUrl":"https://doi.org/10.1136/oem.50.11.1008","url":null,"abstract":"<p><p>To investigate whether specific cancers are associated with the occupation of butcher, as has been reported from other countries, a historical prospective cohort study was undertaken. The cohort consisted of all self employed butchers (n = 552) and pork butchers (n = 310) born since 1880 who set up a shop in the canton of Geneva from 1901 to 1969, and of their wives (n = 887). The study group was followed up from 1901 to 1990 for general mortality, from 1942 to 1990 for cause specific mortality, and from 1970 to 1989 for incidence of cancer. There was no trace of 45 men (5%) and 52 women (6%). Compared with the general population of the canton of Geneva, butchers and pork butchers experienced a significant increase, taking into account 15 years of latency, in mortality from all causes (observed deaths (Obs) 540, expected deaths (Exp) 445.5, standardised mortality ratio (SMR) 121, 90% confidence interval (90% Cl) 113-130). There were significant excesses in incidence and mortality from colorectal cancer, cancer of the prostate, and all malignant neoplasms, and in incidence of cancer of the liver. The risk of lung cancer was significantly increased among pork butchers (SMR 176, 90% Cl 114-262; standardised incidence ratio (SIR) 231, 90% Cl 137-368) but not among butchers (SMR 92, 90% Cl 59-138; SIR 113, 90% Cl 67-179). There was also a significant increase in mortality from cancer of the larynx among butchers. For non-malignant causes of death significant excesses were found among all men for ischaemic heart disease, motor vehicle accidents, and cirrhosis of the liver. Analysis of subgroups showed a cluster of deaths from leukaemia among older butchers born between 1880 and 1899 (Obs 5, Exp 0.6, p < 0.0001). Exposure of pork butchers to polycyclic aromatic hydrocarbons during meat smoking, which was assessed in a contemporary study, might have contributed to their increased risk of lung cancer. The possible role of other factors, especially cigarette smoking, nitrosamines, and oncogenic viruses was discussed. Moreover, there was evidence from another contemporary study that butchers and pork butchers ate more animal fat, and probably more animal protein, than the average male population of Geneva. These results suggest that dietary factors could be implicated in the excesses of colorectal cancer, cancer of the prostate, and ischaemic heart disease. An increased risk for alcohol abuse might explain the excesses of liver cirrhosis, cancer of the liver, cancer of the larynx and motor vehicle accidents. Among all wives overall mortality was similar to that expected (SMR 100, 90% Cl 93-108) and there was no significant excess risk for any specific cancer nor for any non-malignant cause of death. Results for cancer of the cervix uteri, especially among subgroups, suggest an increased risk consistent with previous findings from other countries.</p>","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1008-16"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality study of workers employed at a plant manufacturing chemicals for the rubber industry: 1955-86.","authors":"T Sorahan,&nbsp;D Pope","doi":"10.1136/oem.50.11.998","DOIUrl":"https://doi.org/10.1136/oem.50.11.998","url":null,"abstract":"ion had been thorough, but a review of all original records was necessary to obtain further identifying particulars for tracing the study popula tion (full names rather than initials, and addresses that were not available in the computerised data). Several sources were used for tracing and vital sta tus for some 98% of the cohort was determined (see table 1). Cause of death was ascertained for some 98% of the identified deaths. Job histories were available in terms of some 300 job and department titles. A former occupational hygienist from the plant provided assessments of eight hour time weighted average exposures to both MBT and MBT derivatives for different years and for each job and department title. Jobs attracted either zero exposure, very low (0-1 mg/m3), low This content downloaded from 157.55.39.238 on Sat, 02 Jul 2016 05:25:12 UTC All use subject to http://about.jstor.org/terms Mortality study of workers employed at a plant manufacturing chemicals for the rubber industry: 1955-86 999 Table 1 Vital status at closing date of study (31 December 1986)","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"998-1002"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.998","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toluene diisocyanate induced asthma: outcome according to persistence or cessation of exposure.","authors":"G M Liss,&nbsp;S M Tarlo","doi":"10.1136/oem.50.11.1055","DOIUrl":"https://doi.org/10.1136/oem.50.11.1055","url":null,"abstract":"Sir,-We read with interest the article by Pisati et al (1993;50:60-4) regarding outcome according to persistence or cessation of exposure to toluene diisocyanate. In a recent analysis of asthma compensation claims in Ontario, we have also found (data submitted for publication), as have some of the other reports referenced by Pisati et al, that duration of symptoms before leaving exposure and initial pulmonary function measures were important predictors of outcome. In explaining the poor state of group A who were still exposed, is it possible that Pisati et al could further sort out the role of continued exposure to toluene diisocyanate v the initial circumstances such as long duration of exposure and long duration of symptoms before diagnosis? In particular, among the nonimproved subjects within group B (subgroup III) who were no longer exposed, the baseline PDI5 of 424 was similar to that among group A who were still exposed (425). Moreover, as the authors point out, subgroup III had a long mean duration of exposure (15-9 years), and mean duration of symptoms before diagnosis (5 4 years), again similar to those among group A (25 and 6-3 years, respectively). The baseline FEV, was somewhat lower, however, among group A than subgroup III (86-8% v 94%). The authors indicated that it was not possible to analyse group A in this way (because no subjects recovered). Whereas removal from exposure is probably the only effective way of preventing deterioration, it would be of interest if the authors could look at subgroups or examine the relative importance of duration of exposure and symptoms before diagnosis v persistent exposure as predictors of outcome in comparing group A and subgroup III, as they were similar at baseline. GARY M LISS Ontanro Ministry of Labour SUSAN M TARLO The Gage Research Institute, Toronto, Ontanro, Canada","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1055"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19127324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of ferruginous bodies in bronchoalveolar lavage from foundry workers.","authors":"R F Dodson,&nbsp;M O'Sullivan,&nbsp;C J Corn,&nbsp;J G Garcia,&nbsp;J M Stocks,&nbsp;D E Griffith","doi":"10.1136/oem.50.11.1032","DOIUrl":"https://doi.org/10.1136/oem.50.11.1032","url":null,"abstract":"<p><p>Classical ferruginous bodies in tissue samples are considered to be markers of past exposure to asbestos. Recent studies have shown that the presence of ferruginous bodies in bronchoalveolar lavage (BAL) fluid correlates with past exposure to asbestos and offers a more sensitive reference than occupational history. Lavage samples from five subjects who had worked in foundries were evaluated by light microscopy for the presence of ferruginous bodies and by transmission electron microscopy for both characterisation of the uncoated fibre burden and analysis of the cores of the ferruginous bodies. All samples at lower magnification (light microscopy (200 x)) contained ferruginous bodies that were externally consistent with asbestos bodies. At higher magnification (400 x), a separate population from this group could be identified by the presence of a thin black ribbon. Transmission electron microscopy of the core materials of ferruginous bodies and comparable uncoated particulates supported the reliability of higher magnification light microscopy for distinguishing most of those non-asbestos cores; however, a population of transparent non-asbestos cored ferruginous bodies were also shown to exist.</p>","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1032-8"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of occupational lung cancer in asbestos factories in China.","authors":"H Zhu,&nbsp;Z Wang","doi":"10.1136/oem.50.11.1039","DOIUrl":"https://doi.org/10.1136/oem.50.11.1039","url":null,"abstract":"<p><p>A retrospective cohort study (1972-81) of occupational cancers in asbestos (chrysotile) factories has been previously published. In this paper the results of continued tracing and interviewing of members of this cohort from 1982 to 1986 is reported. The cohort included 5893 persons (45,974 person-years for men and 39,445 person-years for women). Malignant tumours played a large part in causes of death (36.9%). There were 183 cancers and 67 lung cancers among 496 deaths. The mortality due to lung cancer had a tendency to increase. By comparison with a control group, the RR of lung cancer was 5.32 (p < 0.01), and the SRR of lung cancer was 4.2 (p < 0.01), significantly higher than those of a control group. Among 148 cases of death from asbestosis there were 33 cases complicated with lung cancer (22.3%). The dose-response relations between exposure to asbestos and incidence of asbestosis and lung cancer were also studied in one asbestos factory. There was a positive correlation. A synergistic effect was found between cigarette smoking and lung cancer. Preventive and control measures and exposure limits for asbestos dust in the air of workplaces were recommended.</p>","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1039-42"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact allergens in registered cleaning agents for industrial and household use.","authors":"M A Flyvholm","doi":"10.1136/oem.50.11.1043","DOIUrl":"https://doi.org/10.1136/oem.50.11.1043","url":null,"abstract":"<p><p>Cleaning work is a common cause of both irritant and allergic contact dermatitis. Cleaning agents for industrial and household use are registered in the Danish Product Register Data Base (PROBAS) according to a special notification rule issued by the Danish Environmental Protection Agency. About 2350 registered washing and cleaning agents containing about 1250 different chemical substances were marketed in Denmark in February 1992. The occurrence of 49 contact allergens in 16 different product types within washing and cleaning agents were listed. Preservatives and surface active agents made up the main part of contact allergens. Isothiazolinones and formaldehyde releasers were the most commonly registered preservatives, and coconut diethanolamide the most commonly registered surface active agent. The major product types registered as containing contact allergens were general cleaners, skin cleaners, hair shampoos, and floor polishes.</p>","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1043-50"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coal mining, emphysema, and compensation revisited.","authors":"W K Morgan","doi":"10.1136/oem.50.11.1051","DOIUrl":"https://doi.org/10.1136/oem.50.11.1051","url":null,"abstract":"Seaton, in his editorial, relied mainly on three publications to support his thesis that coal mining may lead to disabling impairment in the absence of progressive massive fibrosis and cigarette smoking.2It is well established that the category of simple coal workers' pneumoconiosis is linearly related to the coal content of the lungs.5 6 In this context Ruckley et al have shown that the extent of emphysema found at postmortem increases with the amount of coal present in the lung and also with lifetime dust exposure.4 If this is so, and there seems little doubt that it is, then increasing category of simple coal workers' pneumoconiosis and its associated emphysema should be associated with a significant decrease in the forced expiratory volume in one second (FEV1). Thus it should follow that the more dust present in the lungs, the more emphysema, and the worse the lung function. This is not the case, there being no difference in lung function in those with and without simple coal workers' pneumoconiosis.7 8 Further evidence in support of the hypothesis is said to come from an examination of the lungs of a group of 95 non-smoking miners, which showed a clear inverse relation between the extent of the emphysema and the FEV1.' The evidence for this statement is said to be contained in a technical report,4 which was not available to us at the time Gee and I questioned the validity of certain conclusions in Seaton's editorial.9 The report has since become available to us, but nowhere in the report is there any evidence to support the claim that there is an inverse relation between emphysema and the FEV, in non-smoking miners. Of the lungs obtained from the 95 non-smoking miners only 40 (42%) showed the presence of emphysema, centriacinar, panacinar or both. In this connection, the study showed that panacinar emphysema was entirely unrelated to dust exposure.4 Of the 40 subjects whose lungs showed emphysema, only 33 (35%) had centriacinar emphysema, of whom 23 also had progressive massive fibrosis, an acknowledged cause of centriacinar emphysema. This left only 10 subjects whose lungs showed centriacinar emphysema in the absence of progressive massive fibrosis. Of these 10, eight had fibrotic nodulessimple coal workers' pneumoconiosis-whereas the other two did not. The authors concluded that because there were only two non-smoking subjects who had emphysema in the absence of coal workers' pneumoconiosis, no conclusions could be drawn as to the effect of dust in the induction of emphysema in those","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1051-3"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semen quality in welders exposed to radiant heat.","authors":"L W Raymond","doi":"10.1136/oem.50.11.1055-b","DOIUrl":"https://doi.org/10.1136/oem.50.11.1055-b","url":null,"abstract":"Sir,-We read with interest the article by Pisati et al (1993;50:60-4) regarding outcome according to persistence or cessation of exposure to toluene diisocyanate. In a recent analysis of asthma compensation claims in Ontario, we have also found (data submitted for publication), as have some of the other reports referenced by Pisati et al, that duration of symptoms before leaving exposure and initial pulmonary function measures were important predictors of outcome. In explaining the poor state of group A who were still exposed, is it possible that Pisati et al could further sort out the role of continued exposure to toluene diisocyanate v the initial circumstances such as long duration of exposure and long duration of symptoms before diagnosis? In particular, among the nonimproved subjects within group B (subgroup III) who were no longer exposed, the baseline PDI5 of 424 was similar to that among group A who were still exposed (425). Moreover, as the authors point out, subgroup III had a long mean duration of exposure (15-9 years), and mean duration of symptoms before diagnosis (5 4 years), again similar to those among group A (25 and 6-3 years, respectively). The baseline FEV, was somewhat lower, however, among group A than subgroup III (86-8% v 94%). The authors indicated that it was not possible to analyse group A in this way (because no subjects recovered). Whereas removal from exposure is probably the only effective way of preventing deterioration, it would be of interest if the authors could look at subgroups or examine the relative importance of duration of exposure and symptoms before diagnosis v persistent exposure as predictors of outcome in comparing group A and subgroup III, as they were similar at baseline. GARY M LISS Ontanro Ministry of Labour SUSAN M TARLO The Gage Research Institute, Toronto, Ontanro, Canada","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"1055-6"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.1055-b","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19267949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethylene oxide: an assessment of the epidemiological evidence on carcinogenicity.","authors":"R E Shore,&nbsp;M J Gardner,&nbsp;B Pannett","doi":"10.1136/oem.50.11.971","DOIUrl":"https://doi.org/10.1136/oem.50.11.971","url":null,"abstract":"<p><p>Mortality from cancer among workers exposed to ethylene oxide (EtO) has been studied in 10 distinct cohorts that include about 29,800 workers and 2540 deaths. This paper presents a review and meta-analysis of these studies, primarily for leukaemia, non-Hodgkin's lymphoma, stomach cancer, pancreatic cancer, and cancer of the brain and nervous system. The magnitude and consistency of the standardised mortality ratios (SMRs) were evaluated for the individual and combined studies, as well as trends by intensity or frequency of exposure, by duration of exposure, and by latency (time since first exposure). Exposures to other workplace chemicals were examined as possible confounder variables. Three small studies by Hogstedt initially suggested an association between EtO and leukaemia, but in seven subsequent studies the SMRs for leukaemia have been much lower. For the combined studies the SMR = 1.06 (95% confidence interval (95% CI) 0.73-1.48). There was a slight suggestion of a trend by duration of exposure (p = 0.19) and a suggested increase with longer latency (p = 0.07), but there was no overall trend in risk of leukaemia by intensity or frequency of exposure; nor did a cumulative exposure analysis in the largest study indicate a quantitative association. There was also an indication that in two studies with increased risks the workers had been exposed to other potential carcinogens. For non-Hodgkin's lymphoma there was a suggestive risk overall (SMR = 1.35, 95% CI 0.93-1.90). Breakdowns by exposure intensity or frequency, exposure duration, or latency did not indicate an association, but a positive trend by cumulative exposure (p = 0.05) was seen in the largest study. There was a suggested increase in the overall SMR for stomach cancer (SMR = 1.28, 95% CI 0.98-1.65 (CI 0.73-2.26 when heterogeneity among the risk estimates was taken into account)), but analyses by intensity or duration of exposure or cumulative exposure did not support a causal association for stomach cancer. The overall SMRs and exposure-response analyses did not indicate a risk from EtO for pancreatic cancer (SMR = 0.98), brain and nervous system cancer (SMR = 0.89), or total cancer (SMR = 0.94). Although the current data do not provide consistent and convincing evidence that EtO causes leukaemia or non-Hodgkin's lymphoma, the issues are not resolved and await further studies of exposed populations.</p>","PeriodicalId":9254,"journal":{"name":"British Journal of Industrial Medicine","volume":"50 11","pages":"971-97"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/oem.50.11.971","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19268633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}