The concern is that if inflammation is a potent cause of lung cancer then any negligent cause of inflammation could be cited as a potential contributor to outcome. This research studied the effect on lung cancer risk of chronic inflammation arising from infection with a bacterium that causes mild pneumonia. Evidence from: H Koyi et al. APMIS. September (2001) Vol. 109, #9 p 572. Inflammation is such a common response to environmental exposures that the need for specific carcinogens to cause cancer would be greatly reduced. The Radar report is available to subscribers: 1#9 11

At the end of the study, High extraversion (women only) was predictive of new cases OR = 1.86 (95% CI = 1.16 to 2.96). Life woes and stress were not predictive. Evidence from: E Huovinen et al. Allergy. October (2001) Vol. 56 # 10 p 971. The potential to link occupational stress to incident allergy seems to be reduced by this finding. The Radar report is available to subscribers: 1#9 10

Outcome of interest = brain cancer. No increased risk was found for either lifetime exposure or the most recent 5 years of exposure. No Dose Response effect was found. Evidence from: T Sorahan et al. Occupational and Environmental Medicine. October (2001) Vol.58 # 10 p 626. The report includes data on the emfs exposure profile and electricity generation workers. The Radar report is available to subscribers: 1#9 8 Evidence from: DA Savitz. Occupational and Environmental Medicine. October (2001) Vol.58 # 10 p 617. The commentator seriously doubts the need for any more expenditure and effort on epidemiology in this area until some new biologically credible mechanism has been proposed. Even then, the new studies would need to quantitatively account for why previous studies had not established a significant risk. 1#9 9

A strong but uncertain association between solvent exposure and low sperm count was determined. Evidence from: N Cherry et al. Occupational and Environmental Medicine. October (2001) Vol.58 # 10 p 635. The Radar report is available to subscribers: 1#9 7

General fitness was not protective against non-recreational causes of musculoskeletal disorders. Evidence from: CA Macera et al. American Journal of Epidemiology. July (2001) Vol. 154#3 p 251. The Radar report is available to subscribers: 1#9 2

Evidence from: P Boffeta et al. Scandinavian Journal of Work, Environment and Health. August (2001) Vol.27 #4 p 227. A case control study of a proposed association between exposure to titanium dioxide dust and lung cancer. This was a small study, the main result was: for those classified with high exposure for 5 years OR = 1.0 (95% CI = 0.3 to 2.7). Comment Although not a powerful study, the result provides some confidence that any association between Titanium dioxide exposure and lung cancer is very weak.

The most significant source of exposure is exhaust from combustion engines; especially in confined spaces. However, carbon black is also used as an ingredient in composite materials and as such is handled in huge quantities. This study sought associations between exposure to carbon black and bladder cancer in long shore men. Evidence from: R Puntoni et al. The Lancet. August (2001) Vol. 358 #9281 p 562. A study of a proposed association between occupational exposure to carbon black and, bladder cancer. Carbon black has been assessed by IARC as being a possible human carcinogen. 2286 long shore men (Dockers) employed between 1933 and 1980 were the subjects of this study. Of these 596 spent a significant time carrying paper sacks full of carbon black. The work was very dusty. Cases were identified using the local cancer registry for a period between 1986 and 1996. Occupational hygienists assessed exposure as having been: 858 low, 709 moderate and 534 high for members of this population.

Claims that shoulder pain is a sign of injury are plausible if there has been an impact event or similar. Gradually emerging pain however can have many potential causes, some of which are addressed by ergonomics standards. But is breach material? This would depend on context and degree of breach. Evidence from: H Miranda et al. Occupational and Environmental Medicine. Aug (2001) Vol.58 #8 p 528. It is tempting to assume that breach of duty must imply a material contribution. However, standards developed for regulation may not meet the standards required by the common law. The Radar report is available to subscribers: 1#7 8

This very powerful study found evidence that smoking is associated with a higher risk of multiple sclerosis. If so, the proposed link between physical injury and multiple sclerosis would be less confidently assigned among smokers. Evidence from: MA Hernan et al. American Journal of Epidemiology. July (2001) Vol. 154 #1 p 69. The Radar report is available to subscribers: 1#7 7

There are many risk factors for asthma. Identifying the significance of a guilty exposure must be set in the context of competing risk factors. Causation research should be corrected for known risk factors. Childhood asthma increases the risk of adult asthma. Evidence from: MM Haby et al. Thorax. August (2001) Vol.56 #8 p 589. Risk factors and their statistical strengths were reported in this paper. The Radar report is available to subscribers: 1#7 6

Silica exposure is well known for its effect on lung fibrosis. An unexpected link to autoimmune disease could be a result of fibrosis or of silica exposure. Either way, the impact on liability exposure would be significant. In this research there is good evidence for an association between silica exposure and renal disease and rheumatoid arthritis. It would be worth keeping a close eye on the effects of other fibrosis conditions. Evidence from: K Steenland et al. Epidemiology. July (2001) Vol. 12 #4 p 405. The Radar report is available to subscribers: 1#7 5

If successful, denervation would tend to support the view that back pain was a result of injury or degeneration. This RCT tested the effect of denervation surgery. Evidence from: R Leclaire et al. Spine. July (2001) Vol. 26 #13 p 1411. The Radar report is available to subscribers: 1#7 4

Causation is highly informed by previous history. Back pain is episodic. Back pain in adolescence is very common. Evidence from: DE Feldman et al. American Journal of Epidemiology. July (2001) Vol. 154 #1 p 30. A study of proposed risk factors for the development of LBP in adolescence. It is well established that previous episodes of LBP are prognostic of further problems. LBP in childhood increases the probability of LBP in subsequent years. Identification of risk factors for childhood LBP may lead to more effective prevention measures. 502 adolescents from Montreal were studied between 1995 and 1996 and followed up a year later. LBP was defined as substantial , at least once a week within the past 6 months. Assessment was made at 0, 6 months and 1 year. At time zero 377 out of 502 had no LBP within the past 6 months but 65 of these developed LBP during the year. Growth spurt (>5 cm a year) was a risk factor as was smoking and poor mental health. Activity was not a risk factor. Mus

Responses to injury should include steps aimed at preventing recurrence. If the cause was at work, then this serves as a prompt for the employer to adapt or modify the system of work. It would also act as a prompt for a compensation claim. The authors have developed a set of tools for deciding whether or not an injury is work-related. Evidence from: Peter Buckle, A Kilbom, A Grieco, Keith Palmer, Cyrus Cooper, Malcolm Harrington et al. Scandinavian Journal of Work, Environment and Health Supplement. June (2001) Vol.27 suppl 1. Although very simple in summary: Step 1 “Did the symptoms begin, recur or worsen after the current job (task) was started”. Step 2 “Are there exposures factors known (believed by the authors) to be (significant) risk factors for that part of the body?” Step 3 “Ask whether or not there are non occupational origins for the symptoms” Step 4 “Make a decision about the level of work relatedness” in practice each of these must be set in the correct context for regulato

Tobacco smoke is an irritant which excavation asthma in asthmatics. But does it also cause or aggravate asthma? Literature review. Evidence from: J Bousquet and AM Vignola. Allergy. June (2001) Vol. 56 # 6 p 466. None of the reports can demonstrate with any certainty that new cases of asthma were not simply cases that no-one had noticed before. The Radar report is available to subscribers: 1#6 10

A study of a proposed association between exposure to trihalomethanes in water and birth defects. Chemicals are added during drinking-water treatment. Evidence from: LDodds and WDKing. Occupational and Environmental Medicine. July (2001) Vol.58 #7 p 443. Chemicals of interest were: Chloroform (CLF), bromodichloromethane (BDCM), bromoform and chlorodibromomethane. The Radar report is available to subscribers: 1#6 9

Reliable, sensitive and specific skin prick tests are on the way. However, some allergens are present in the environment as well as in the suspected sensitiser. Sensitisation can occur innocently. Evidence from: PS Grendelmeier et al. International archives of Allergy and Immunology. June (2001) Vol.125 #2 p 96. Tests for allergic sensitisation often rely on skin prick tests using preparations of suspect allergens. Standardisation of such preparations is difficult. This article reviews the success, so far, of producing recombinant allergens using the example of latex allergy. Latex (produced from Heveae Brasiliensis (Hev b)) contains more than 10 known allergens, some of which are identical to ones found in some fruits and moulds. Isolated artificial proteins – Hev b 5,6 and 7 when combined into a test preparation have been used to diagnose latex allergy with 93% sensitivity and 100% specificity. Such mixtures can be accurately and reliably reproduced. Comment Reliable, sensitive

Popular culture has it that back pain is a result of injury. Disability is a result of pain and injury. Objective records of actual activity during a normal day were compared with questionnaires designed to measure disability and pain. Evidence from: JA Verbunt et al. Archives of Physical Medicine and Rehabilitation. June (2000) Vol. 82 #6 p 726. There was no significant correlation between any of the three questionnaire scores and objective activity measures. There was no significant difference in objectively measured activity between cases and controls. The Radar report is available to subscribers: 1#6 4 Evidence from: T Jacob et al. Archives of Physical Medicine and Rehabilitation. June (2000) Vol. 82 #6 p 735. There was no correlation between high disability scores and low activity scores. The Radar report is available to subscribers: 1#6 5 Evidence from: JM Stevenson et al. Spine. June (2001) Vol. 26 #12 p 1370. Physical activity is protective against back pain. The Radar report i

The study found evidence of a statistical association between exposure to 16.6 Hz emfs and leukaemia and brain cancer. Evidence from: CE Minder et al. American Journal of Epidemiology. May (2001) Vol. 153 #9 p 825. This was a well designed study. Clearer evidence of a dose-response relationship would have strengthened the case that there is a genuine association. Other factors were not fully accounted for. The Radar report is available to subscribers: 1#5 11

The study suggests a moderate association between work in the SiC industry and three forms of cancer. Evidence from: P Romundstad et al. American Journal of Epidemiology. May (2001) Vol. 153 #10 p 978. If there had been no other exposure to carcinogens this research would be a strong indicator of causation but with several details to be worked out. The Radar report is available to subscribers: 1#5 10

The origin of pleural plaques can be quite varied. Association with heart disease would provide a potential link between asbestos exposure and heart disease. Evidence from: O Korhola et al. Scandinavian Journal of Work, Environment and Health Apr (2001) Vol.27 #2 p 154. The Radar report is available to subscribers: 1#5 8

Pain, Psychological distress, fear-avoidance beliefs, efficacy in coping were moderately good predictors of disability prior to therapy. Improvements in strength and endurance were made in all three treatments, but these were unrelated to improvements in ability or reductions in pain. Evidence from: AFMannion et al. Spine. April (2001) Vol. 26 #8 p 897 The Radar report is available to subscribers: 1#5 7

The prospective study measured cholesterol levels before and after changes to shift work patterns were agreed by consensus. Some reductions in risk level were observed. the effect of these reductions could not be projected into reductions of actual disease but lend support to the idea that shift work changes risk. Evidence from: H Boggild et al. Scandinavian Journal of Work, Environment and Health. Apr (2001) Vol.27 #2 p 87. The Radar report is available to subscribers: 1#5 6

The study provides evidence that early signs of thrombosis can be prevented in healthy people. there is implied support for the use of surgical stockings in high risk travellers. Exactly what it is about long distance flights that leads to early signs of thrombosis in the calf is not known but there is speculation that prolonged sitting at a desk could have the same effect. Evidence from: JHScurr et al Lancet. May (2001) Vol. 357 #9267 p 1485. A study of the development of deep vein thrombosis during long distance flights (>8hours). 89 males and 142 females aged over 50 with no recorded history of thromboembolism volunteered in response to an advert. All were scheduled to undertake a journey involving continuous flight for more than 8 hours. 30 of them were used as controls by making measurements 2 weeks and then 2 days before travel. In this way the potential for development of signs of DVT in absence of air travel could be tentatively assessed. Those volunteers that were retained