Database

These draft guidelines cut through the unfounded professional attitudes to back pain including: bogus diagnoses, illegitimate statements about causation, alarmist prognoses, prognoses based on bio mechanical models and so on. Application of the guidelines should see greater accuracy of medical care and reductions in liability exposure, but only if they are used. Evidence from: N Bogduk. Draft- Evidence-Based Clinical Guidelines For The Management Of Acute Low Back Pain Table 6.1  of the draft guidelines is reproduced in the Radar report. It details which factors really do influence prognosis. The Radar report is available to subscribers: 1#12 1

In principle, the NHS+ service will broaden reasonably practicable access to health screening, pre placement medicals , rehabilitative expertise and guidance on prevention. There will be less acceptance of SME’s not doing the right thing. A small change in liability insurance exposure is foreseeable. NHS+ Launch 19th November 2001 NHS+ is an Occupational Health service now being offered by NHS Trusts to their local communities in exchange for money. Any profits should be reinvested in the local service, there is no central organisation taking money out of the local schemes. When the NHS was established, occupational health services were not included in the core requirements, even though the health/work link was a strong feature of the debate at the time. For many years, NHS staff had limited occupational health support for their own needs, but staff shortages, under performance, sickness absence and ill health retirement costs have led to the creation of comprehensive services wh

The HSE consultation document CD 173 outlines how the Chemical Agents Directive (98/24/EC) modifies the duties under COSHH and the Control of Lead at Work Regulations. HSC propose to retain the UK conditional “So far as is reasonably practicable”  despite objections from the EC and there are potential confusions concerning material contribution and addition to risk. The Radar report is available to subscribers: 1#11 15

The new duties extend the explicit  responsibility of property owners and occupiers. There are also changes to health surveillance regimes. Surveillance could result in insurers being put on notice of the risk of serious disease in 20 to 40 years time. This would create a data management problem. Evidence from: HSE Con Doc CD 176. The Radar report is available to subscribers: 1#11 13 Evidence from: Managing asbestos in premises. rev. ed., HSE, 2001. (INDG223 (rev2)) ISBN 07176209214 Aimed at people who own, occupy, manage or have responsibilities for premises which may contain asbestos and explains a new duty to manage these premises under the revised Control of Asbestos at Work Regulations (due to come into force in 2002). It advises how to identify, assess and manage any asbestos-containing materials in premises to protect the health of workers or others who may use the premises. A checklist is included. Comment Health surveillance organised in this way should be effective in setting

Human exposure to SV 40 was not widespread but did occur by means of contaminated polio vaccine in the early 1960’s. For the present, links between SV40 and mesothelioma would appear to remain speculative. Evidence from: C Carroll-Pankhurst et al. British Journal of Cancer. November (2001) Vol.85 #9 p 1295. The Radar report is available to subscribers: 1#11 12

IARC classified crystalline silica as a probable carcinogen in 1987, however, significant doubts remain. This study suggests that silicosis is not a cause of lung cancer. By chance the study also finds that silica is associated with death from diseases of the urinary system (kidney disease). Evidence from: P Carta et al. Occupational and Environmental Medicine. December (2001) Vol.58 # 12 p 786. The Radar report is available to subscribers: 1#11 11