Silicosis not a disease of the past. It is an irreversible, fibrotic lung disease specifically caused by exposure to respirable crystalline silica (RCS) dust. Over 20,000 incident cases of silicosis were identified in 2017 and millions of workers continue to be exposed to RCS. Identified case numbers are however a substantial underestimation due to deficiencies in reporting systems and occupational respiratory health surveillance programmes in many countries. Insecure workers, immigrants and workers in small businesses are at particular risk of more intense RCS exposure. Much of the focus of research and prevention activities has been on the mining sector. Hazardous RCS exposure however occurs in a wide range of occupational setting which receive less attention, in particular the construction industry. Recent outbreaks of silicosis associated with the fabrication of domestic kitchen benchtops from high‐silica content artificial stone have been particularly notable because of the young age of affected workers, short duration of RCS exposure and often rapid disease progression. Developments in nanotechnology and hydraulic fracking provide further examples of how rapid changes in technology and industrial processes require governments to maintain constant vigilance to identify and control potential sources of RCS exposure. Despite countries around the world dealing with similar issues related to RCS exposure, there is an absence of sustained global public health response including lack of consensus of an occupational exposure limit that would provide protection to workers. Although there are complex challenges, global elimination of silicosis must remain the goal.
In two-phase sampling, the second-phase sample is often a stratified sample based on the information observed in the first-phase sample. For the total of a population characteristic, either the double-expansion estimator or the reweighted expansion estimator can be used. Given a consistent first-phase replication variance estimator, we propose a consistent variance estimator that is applicable to both the doubleexpansion estimator and the reweighted expansion estimator. The proposed method can be extended to multiphase sampling.
BackgroundA total of 2,514,346 metric tons (Mt) of asbestos were imported into Spain from 1906 until the ban on asbestos in 2002. Our objective was to study pleural cancer mortality trends as an indicator of mesothelioma mortality and update mortality predictions for the periods 2011–2015 and 2016–2020 in Spain.MethodsLog-linear Poisson models were fitted to study the effect of age, period of death and birth cohort (APC) on mortality trends. Change points in cohort- and period-effect curvatures were assessed using segmented regression. Fractional power-link APC models were used to predict mortality until 2020. In addition, an alternative model based on national asbestos consumption figures was also used to perform long-term predictions.ResultsPleural cancer deaths increased across the study period, rising from 491 in 1976–1980 to 1,249 in 2006–2010. Predictions for the five-year period 2016–2020 indicated a total of 1,319 pleural cancer deaths (264 deaths/year). Forecasts up to 2020 indicated that this increase would continue, though the age-adjusted rates showed a levelling-off in male mortality from 2001 to 2005, corresponding to the lower risk in post-1960 generations. Among women, rates were lower and the mortality trend was also different, indicating that occupational exposure was possibly the single factor having most influence on pleural cancer mortality.ConclusionThe cancer mortality-related consequences of human exposure to asbestos are set to persist and remain in evidence until the last surviving members of the exposed cohorts have disappeared. It can thus be assumed that occupationally-related deaths due to pleural mesothelioma will continue to occur in Spain until at least 2040.
NO-DO, the Spanish official newsreel produced by Franco's dictatorship (1939–1975), held a 30-year monopoly over audio-visual information in Spain from 1943 to 1975. This paper reports on an analysis of the coverage of medical technologies by the Spanish Cinematic Newsreel Service, NO-DO, from 1943 to 1970. The study focuses on the changing roles played by cultural representations of medical technologies deployed in NO-DO. Our analysis shows how these representations offered a new space for the legitimization of the regime and, more importantly, played a key role in the attempts to construct and enforce a hegemonic national identity after the Spanish Civil War (1936–1939). During the period of isolationist autocracy that ended in the mid-1950s, the images of medical technologies reinforced the idea of a self-sufficient “national space” and deepened the break with the historical past. Once the international isolation of the regime was overcome in the late 1950s and the 1960s, the representation of medical technologies contributed to establishing a Spanish national identity that mirrored the outside world, the foreign space. Finally, gender representations in NO-DO are also explored.
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