Database

Whiplash cases were compared with asymptomatic persons. For common law purposes this is the wrong control group unless, on the balance of probabilities, the claimant can show they had above average health prior to the index event. This choice of asymptomatic control group is of some interest to medics but even here the choice has limited application. It would be useful if a specific lesion can be identified in whiplash cases and ruled out in all other neck pain cases. Evidence from: PT Dall’Alba. Spine. October (2001) Vol. 26 #19 p 2090. A report of a study of Range of Movement (ROM) for whiplash neck injury victims who are symptomatic after 3 months but before two years from the date of injury. Reduced range of motion was detected vs. control group. Comment Although a computerised measurement system was deployed, the technique could be criticised for failing to ensure there could be no contribution from torso rotation. A more complete study would have measured fear of movement and, at

If the standard biomechanical model of causation doesn’t have any practical utility, why is it so popular? It may be that no credible alternative has been proposed, but that doesn’t mean a defectice model should be adhered to. Defective models lead to defective assumptions and defective claims handling. Evidence from: R Ferrari. Spine. October (2001) Vol. 26 #19 p 2063. An editorial on the subject of research into whiplash neck injury. There is consensus that direction of vehicle impact is not prognostic of acute or chronic problems or litigation status. So if direction doesn’t matter, protection in vehicle is irrelevant. So why continue to focus research into protection from just one direction? The best treatments take no account of detailed pathology, so why study it any more? Good treatments such as nonspecific exercise regimens and general advice do not require deep understanding of pathology. Identification of an acute lesion would not explain why some develop ch

This Radar report collates a number of relevant findings in response to the Stewart report. Topics addressed include: Planning-related liability. Causation. Exposure control guidelines – duty of care. Childhood leukaemia – incidence. Risks to fire fighters. The Radar report is available to subscribers: 1#11 2  

Evidence from: A Conference held on the 29th November 2001 Notes on a presentation by: Julie McLean Speech and Language therapist Voice Care Network UK Voice and speech are controlled by a complex arrangement of muscles. These muscles are subject to the same aches and pains that can affect any other muscle. Habitual tension in the voice muscles can be the result of body posture, head posture and facial tension. Tension may have its origins in lack of general well being, poor seating and poor equipment arrangement. As a result, some people develop a syndrome called dysphonia (voice loss) which has features in common with diffuse RSI. In her opinion, emotions, ergonomics and habits conspire to produce a chronic pain/tension syndrome which results in voice loss. Good practice

Detailed examination of research findings showed that WBV can (at very high levels) aggravate organic conditions but its action as an initiator of injury remained uncertain.The clearest finding was that high levels of exposure to WBV made work uncomfortable / too difficult for a significant proportion of people who have back pain. They then report back pain as the reason for work absence. The Radar report is available to subscribers: 1#10 22

HSE has been vigorously promoting interventions where workplace causation is in doubt. This choice may cause HSE some difficulty meetings its agreed targets. One solution would be to accept that causation was rather too easily being assigned. Evidence from: D Coggon. Occupational and Environmental Medicine. November (2001) Vol.58 # 11 p 691. HSE activity on occupational health has been challenged by the setting of targets to be met within 5 and 10 years (from 2000). However, the actual targets and baselines have caused considerable debate. This paper brings some of the more scientific arguments into the open, they illustrate the difficulties HSE have in deciding what an occupational disease is. Revitalising H&S set targets: “a 20% reduction in the incidence of work related ill health to be achieved by the year 2010”. Considerable doubt remains about the definition and measurement of current levels and what proportion of these really can be eliminated by better practice. [Andrew Aut