Database

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

The research investigates whether or not physical trauma can aggravate or accelerate rheumatoid arthritis. Evidence from: AWAl-Allaf et al. Rheumatology. March (2001) Vol.40 #3 p 262. A high proportion of people with newly diagnosed RA could recall significant physical trauma in the 6 months preceding diagnosis. Rates of severe trauma are known. If a causal link is found, the number of RA cases could be estimated. The Radar report is available to subscribers: 1#5 4

Evidence from: TRDJ Radstake et al. Journal of Rheumatology. May (2001) Vol. 28 #5 p 962. A study of genetic anticipation among families with Rheumatoid Arthritis (RA) in Europe. Genetic anticipation describes a phenomenon where the age of onset of a genetically determined illness decreases with successive generations. The effect is that diseases that are normally associated with old age can manifest surprisingly early. The result of this may be that the illness is misdiagnosed or the symptoms are attributed to a cause, which is in fact innocent. The paper demonstrated that a small proportion (4%) of cases of RA had a parent with the same condition (28/683) and were diagnosed in advance of the age of diagnosis of the parent. Typically the anticipation was of the order of 16 years. Comment Although the proportion of cases with apparent genetic anticipation is small (4%) it may be worth keeping this possibility in mind when assessing cases of upper limb disorder.

This was a prospective study of new recruits with no previous pain in the preceding month. Ergonomic factors were independently observed as well as reported by questionnaire. Risk factors for new reports of pain lasting more than a day were identified. Evidence from: CM Pritchard (GJMacfarlane) Occupational and Environmental Medicine. June (2001) Vol.58 #6 p 374. Psychosocial factors were not predictive. The work reported here suggests that eliminating unbalanced and heavy lifting at work would improve, self-reported, employee comfort. A sense of what is meant by “heavy” can be gleaned from the detailed results. None of those reporting new pain had taken any time off work because of it. The Radar report is available to subscribers: 1#5 2

Genetic differences must be accounted for in studies of smoking risk of renal cell cancer. Innate risk of  cancer varies with the ability to metabolise environmental toxins, some of which may be carcinogenic. Evidence from: JC Semenza et al. American Journal of Epidemiology. May (2001) Vol. 153 #9. p 851. In this study there were clear differences of rsik between those with a high capacity to acetylate toxins and those with an impaired capacity, regardless of smoking history. Innate vulnerability is not a defence but may be used to discover and bolster causation arguments. The Radar report is available to subscribers: 1#5 1