This study was undertaken to evaluate the feasibility of using commercial control materials in a regional external quality assessment scheme (EQAS) for serum carcinoembryonic antigen (CEA) measurement. We have assessed the commutability of 12 commercial control materials using five automated immunochemical systems. We compared the intermethod behavior of the materials with that of 12-14 patient serum pools. In a total of 48 comparisons (12 materials x 4 pairs of analytical systems), seven instances of non-commutability were apparent, as shown by normalized residuals falling outside the +/-3 interval. The use of non-commutable materials generates two negative effects. In EQAS, the interlaboratory variation recorded is not representative of the variation expected in the assay of patient sera; in interlaboratory harmonization programs, recalibration with non-commutable materials increases, instead of decreasing, the interlaboratory variation. Both these effects were shown to occur in CEA measurement with the tested materials and systems. The materials planned to be used in our EQAS turned out to be commutable: this gave us the guarantee of measuring realistic interlaboratory variation values, although the check for commutability should be extended to all the analytical systems used by the participants in the scheme.
Data regarding 11,541 cases of school accidents (from kindergarten to senior high school) that required hospital attention for treatment were examined. The information was obtained from the records of the "School Medicine Service of the City of Milan", and covered five school years (from 1980-81 to 1984-85). The surveyed population included over 160,000 subjects for each year. After computer processing, data regarding type of school, year, age of the victim, place of the accident and type of lesions were obtained. The frequency of accidents was highest (about 2%) among kindergarten pupils, while in senior high school the lowest frequency (less than 1%) was accompanied by the greatest percentage of hospitalizations (about 6%). From our results it appears that most accidents occur in school gyms (around 50%), and that the percentage of sprains and fractures is also highest in this area. School gyms can therefore be considered as a primary target for any prevention activity.
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