Stephen D. Walter

The Silver Valley Lead Study:The Relationship between Childhood Blood Lead Levels and Environmental Exposure

This paper is directed to those persons concerned with the relationship between blood lead levels and environmental exposures to lead. Information presented in this paper represents one of the largest collections of epidemiologica! data relating blood lead levels to environmental exposures. The observed annual average ambient air lead concentration ranged from approximately 0.5 ng Pb/m3 to 23 ng Pb/m3, while lead in soil ranged from 50-24,600 ppm. Blood lead levels of children (ages 1-9 years) are related to a host of environmental variables via regression techniques. Blood lead levels were found to be most influenced by five variables. These variables are: ambient air lead, soil lead, age of the child, dustiness of the home, and occupational status of the parents. It is concluded, based upon the results of this study, that any environmental control strategy should address both the air and the soil. Soil levels in excess of 1000 ppm lead as well as air lead levels greater than 2 jug Pb/m3, 30 day average,...

An epidemiological study of acute prolapsed cervical intervertebral disc.

In this epidemiological study of acute prolapsed cervical intervertebral disc, we found that people in the fourth decade of life were affected somewhat more frequently than individuals in other age groups, and men with a prolapsed cervical disc outnumbered women by a ratio of 1.4 to one. Factors that were associated relatively strongly with this diagnosis were frequent lifting of heavy objects on the job that was held around the time of the onset of symptoms, cigarette-smoking, and frequent diving from a board. Positive associations that were of borderline statistical significance or were not statistically significant were found with operating or driving vibrating equipment and time spent in motor vehicles. Variables that did not appear to affect the risk for a prolapsed cervical disc included participation in certain sports other than diving, frequent wearing of shoes with high heels, the number of pregnancies or live births, frequent twisting of the neck on the job, time spent sitting on the job, and smoking cigars or a pipe.

Errors in kinematic parameters of a planar joint: Guidelines for optimal experimental design☆

Kinematic characteristics of a body joint performing planar motion are precisely defined by the centers and angles of rotation as the joint undergoes its full range of physiological movement. These potentially (clinically) useful non-invasive kinematic parameters are, however, highly sensitive to input coordinate measurement errors and the experimental design. This paper compares results of an experimental study and a statistically based mathematical model of the errors in the centers and angles of rotation. Guidelines are provided to design optimal kinematic experiments so that, for given measurement equipment, the highest possible precision may be achieved in the results.

Age-specific risk factors for lead absorption in children

The relationship of blood lead levels to environmental and individual characteristics is analyzed in a large sample of children residing near a lead smelting complex, with particular emphasis on the identification of age-related risk factors. Exceptional variation in both blood leads and its determinants within the study region facilitated the simultaneous detection of several significant risk factors for each year of age from 1 to 9 yr. The strongest predictor of blood lead at all ages was air lead, but the secondary risk factors were age dependent. Household dustiness was significantly related to blood lead in young children, especially those under 2 yr of age; soil lead may be an important source of ingested lead for children between 2 and 7 yr. Other significant effects included that of pica at about 2 yr of age, a slight effect of the occupational category of the fathers of 5- to 8-yr-old children, and a tendency for 8- and 9-yr-old boys to have higher blood leads than girls of the same age. Lead concentration in household paint was not a significant risk factor. These results suggest that a multifactorial approach to the prevention of excessive lead absorption by children is required.

Effect of pressurization on methylmethacrylate-bone interdigitation: An in vitro study of canine femora

Aseptic mechanical loosening of the femoral and acetabular components is a major long term complication of total hip arthroplasty. Pressurized injection of bone cement (polymethylmethacrylate) has been advocated for increasing cement-bone interlock. To determine the relationship between cement intrusion pressure and its penetration into cancellous bone, an in-vitro study of paired, fresh frozen canine femora was conducted. Methacrylate cement was injected at predefined constant pressures from 0.11 to 1.23 MPa (16-175 psi). The penetration was quantified for each injection pressure. The results showed a positive logarithmic relationship between the relative penetration and the intrusion pressure, the former reaching a near asymptotic value at approximately 0.70 MPa (100 psi). Unequal radial distribution of cement within the metaphysis was demonstrated. Greater penetration was observed into the proximal postero-lateral cancellous bone bed as compared to other regions. The relationship between cement penetration and bone size was explored at a single-constant pressure of 0.35 MPa (50 psi). Although absolute cement penetration was found to be linearly related to the bone size, the relative penetration remained nearly constant with bone size.

Berkson's bias and its control in epidemiologic studies

Abstract The direction and magnitude of Berksons bias is discussed for the situation where the factors (risk exposures and/or diseases) involved may not be independently distributed (as has been assumed in previous literature). It is shown that the bias may be negligible if the risk factor in a retrospective study is not a direct cause of hospitalisation, or if the case and control groups are mutually exclusive.

Variola minor in Braganca Paulista County, 1956: household aggregation of the disease and the influence of household size on the attack rate

Household aggregation of cases, one possible characteristic of person-to-person transmitted disease, was formally tested in one epidemic of variola minor by using a pair statistic. A significant result was found for all households as well as for households grouped by the type of environment, or by the phase of the epidemic growth in time. Secondary attack rates, when related to household size (number of susceptibles) showed only a marginal trend in rural households but no trend in urban or semi-rural households.