Reflex sympathetic dystrophy can be a devastating condition. This report provides data for reserving and cost benefit calculation of mitigation measures. Evidence from: A Zyluk. Journal of Hand Surgery. April (2001) Vol. 26B #2 p 151 A study of outcomes, following treatment for Reflex Sympathetic Dystrophy. 146 cases were assessed for functional capacity and pain, both before treatment and again at 11 months after treatment. Diagnosis was confirmed in the presence of diffuse pain and at least three of: swelling, discolouration, abnormal skin temp, limited ROM. 64% of cases were described as having a good outcome. Of these only a third were completely free of pain, but 100% had full range of motion restored and 80% had some reduction in grip strength compared to normal values. Comment Of the 46% with poor outcomes it is not known how many were misdiagnosed. Patient attitudes were not recorded. Some loss of comfort can be expected a year after treatment even for good outcomes. However it

This report of a public meeting involving officials, academics and campaigners. Evidence from: HSC/DETR At-work Road Safety Conference. The Barbican, London. 5th April 2001. Campaigners are intent on blurring the distinction between Motor and EL insurance when the driver or passengers are “at work”. The Radar report is available to subscribers: 1#4 1

The research finds support for a new technique to distinguish acquired from innate Raynaud’s disease. Early detection could lead to better prevention, differential diagnosis leads to more accurate claiming (or not claiming). Evidence from: HJAnders et al. Annals of Rheumatic Diseases April (2001) Vol. 60 #4 p. 407 Proof of principle must be followed up by representative research before it can be used in the field or in medico-legal examination. The Radar report is available to subscribers: 1#3 2

The research investigated whether there were any obvious pre-placement risk factors that could be used to reduce the risk of back pain. Evidence from: P. Lee et al. The Journal of Rheumatology. Feb (2001) Vol.28 #2 p. 346. A cross-sectional study of 1,562 employees, using a back pain questionnaire and measurements of abdominal muscle strength. Lifetime and point prevalences were 60% and 11% respectively. There was no correlation with body mass index or height. Prevalence was slightly higher among married subjects. Comment It is well established that pre employment screening based on physical characteristics is not effective in preventing reports of low back pain. Prevalences were not linked to occupation. It would appear that primary prevention measures are unlikely to be effective (except for impact injuries), secondary prevention would be a sensible response.

The standard test for BSE agent involves contaminating live mice and waiting several months to examine brain tissue samples. A new test, which could take less than a day, has been developed to proof-of-principle stage. Evidence from: JP Deslys, et al. Nature. (2001) Vol. 409 6819, p 476-7 A cheap accurate test could enable rapid testing of cattle nearing slaughter. More work is needed before this test permits case by case decision-making for individual cattle. The Radar report is available to subscribers: 1#2 6

This academic study suggests that physical work demands delay return-to-work following absence with occupational back pain. The greater the demands, the longer the delay. Causation may not be explained by prevailing orthodoxies concerning injury and breach of duty. Evidence from: M.Mahmud et al. Journal of Occupational and Environmental Medicine (2000) Vol. 42 #12. p 1178. At the time of publication it was widely assumed that work was a direct cause of back pain and that pain must be an indication of injury. Neither of these is a fact but Worker’s Compensation administrators have adopted this line of thinking. This research used scans to see if degree of abnormality was predictive of outcome. It wasn’t. Neither was injury severity. In the absence of a violent event, such as being struck or falling from height, back pain may not be an indication of breach of duty or causation. Length of absence is not explained by injury factors. Radar opinion at the time was that psychosoci

This academic paper reports the annual frequency of newly diagnosed occupational asthma and provides the leading identified causes. It has become clear that a task focussed approach to prevention may be more successful than an industry focussed approach. Evidence from: JC McDonald et al, Occupational and Environmental Medicine (2000), Vol. 57 #12 p 823. Radar report is available to subscribers: 1#1 4

The draft ACoP records the state of knowledge in 2001. It lays emphasis on health surveillance where there is any suspicion of risk – in addition to compliance with official exposure controls. Early signs of sensitisation should be managed. The key distinction between ‘caused or made worse‘ and, ‘made more symptomatic‘ is recorded here. Evidence from: HSE CD 164 (2001) ‘An Approved Code of Practice for Occupational Asthma.’ Radar report is available to subscribers: 1#1 1