Aim: To explore attitudes to influenza immunisation and rates of uptake among staff working in acute hospitals in the UK. Method: A cross-sectional survey of 11 670 healthcare workers in six UK hospitals was carried out using a postal questionnaire. Results: Among 6302 responders (54% of those mailed), 19% had taken up influenza immunisation during winter 2002/3. Vaccination was well tolerated, with a low prevalence of side effects (13%) and associated time off work (2%). The majority of subjects who accepted vaccination (66%) were most strongly influenced by the personal benefits of protection against influenza. Prevention of sickness absence and protection of patients were the prime motivation for only 10% and 7% of subjects, respectively. Among 3967 who declined vaccination, the most common primary demotivators were concern about safety (31%) and efficacy (29%). 22% were most strongly deterred by lack of time to attend for vaccination. Free text answers indicated that 37% declined because of a perceived low ratio of personal benefits to adverse effects. Subjects said they would be persuaded to take up vaccination in future by easier access (36%), more information about personal benefit and risk (34%) and more information about effects on staff absence (24%). Conclusions: These findings indicate that the uptake of influenza immunisation among UK healthcare workers remains low. There is some scope for increasing uptake by improving accessibility and encouragement from professional peers. However, the results suggest that perception of small personal benefit in relation to risk mitigates, importantly, against higher uptake of routine annual influenza vaccination. Thus, resource might better be allocated to ensuring efficient management in epidemic years. The effect of publicity about pandemic influenza on risk perception and vaccine uptake among healthcare workers during winter 2005/6 warrants further study.

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This systematic review found low-quality evidence of an association between PF and weight-bearing tasks such as walking and standing on hard surfaces. The only occupations specifically identified as having higher risk were those associated with the engine assembly plant. Further research is required to fully determine the association between weight bearing and PF.

Background People with type 1 diabetes may find diabetic control more difficult when working shifts. AimsTo investigate the proportion of people with type 1 diabetes in employment undertaking shift work and diabetic control as assessed by glycosylated haemoglobin (HbA1c) among individuals undertaking shift work compared to those not doing so. MethodsA postal questionnaire sent to all those aged 16-65 attending two city hospitals for type 1 diabetes care. HbA1c results were used to assess diabetic control. ResultsTwenty-two per cent (296 of 1370 eligible patients) responded. Sixty-seven (23%) respondents were involved in shift work. Shift workers had higher mean HbA1c values than non-shift workers (9.02 versus 8.35; P < 0.01).

This study reviews all histologically proved cases ofmalignant pleural mesothelioma seen in the western district of Glasgow during 1980-6. Sixty eight cases were identified (three female) with an age range at presentation of48-85 (mean 68-9) years. Asbestos exposure was identified in 54 (80%) ofthe patients, most ofwhom had been shipyard workers. Pain and dyspnoea were the most common presenting symptoms. Pleural effusion was found in 57 (84%) of the patients, in a ratio of 2-6 right:left. The median survival was only 30 weeks from the time of presentaton. Prognosis was significantly better for those presenting with dyspnoea than for those with pain (median survival 44 v 22 weeks). Postmortem examination was performed in 40 cases and metastatic disease found in more than three quarters. There was no significant difference between the incidence of the various tumour cell types or any relation between cell type and survival or the incidence of metastatic disease. A substantial increase in cases of malignant pleural mesothelioma has been found in an area of already high incidence. The use of rigorous histological criteria to determine histological cell type has shown that this previously valued variable is of no discriminatory value with regard to disease activity or survival.