RESUMO
To assess the accuracy of BMI compared to directly measured dual-energy X-ray absorptiometry percent body fat (DEXA %BF) among a worker compensation population. Methods: The agreement between BMI and DEXA %BF was assessed by the Pearson correlation coefficient among 1394 evaluable patients over a 5-year period. Sensitivity and specificity were calculated to measure how well BMI can identify true obese and nonobese individuals. Results: Using at least 30kg/m2 to identify obesity, BNI had a specificity of 0.658 and a sensitivity of 0.735. The correlation was better in females at 0.66, compared to males at 0.55, and weaker in older age groups at 0.42, as compared to the youngest age group at 0.59. Overall, 29.8% of the population was reclassified based on their DEXA %BF measures. Conclusions: In a 5-year cohort worker compensation population, BMI was an inaccurate measure of true obesity.
RESUMO
: COVID-19 illness can cause multiorgan illness. Some States have passed legislation granting a rebuttable presumption of causation by workplace exposure in certain occupations. This paper summarizes methodology for evaluating claimants utilizing known science and as well as information from the American Medical Association Guides resources.
Assuntos
Betacoronavirus , Infecções por Coronavirus/economia , Doenças Profissionais/economia , Exposição Ocupacional , Pandemias/economia , Pneumonia Viral/economia , Indenização aos Trabalhadores/organização & administração , COVID-19 , Infecções por Coronavirus/etiologia , Infecções por Coronavirus/terapia , Humanos , Doenças Profissionais/etiologia , Doenças Profissionais/terapia , Pneumonia Viral/etiologia , Pneumonia Viral/terapia , SARS-CoV-2 , Estados UnidosRESUMO
OBJECTIVE: Summarize developed evidence-based diagnostic and treatment guidelines for work-related asthma (WRA). METHODS: Comprehensive literature reviews conducted with article critiquing and grading. Guidelines developed by a multidisciplinary expert panel and peer-reviewed. RESULTS: Evidence supports spirometric testing as an essential early test. Serial peak expiratory flow rates measurement is moderately recommended for employees diagnosed with asthma to establish work-relatedness. Bronchial provocation testing is moderately recommended. IgE and skin prick testing for specific high-molecular weight (HMW) antigens are highly recommended. IgG testing for HMW antigens, IgE testing for low-molecular weight antigens, and nitric oxide testing for diagnosis are not recommended. Removal from exposure is associated with the highest probability of improvement, but may not lead to complete recovery. CONCLUSION: Quality evidence supports these clinical practice recommendations. The guidelines may be useful to providers who diagnose and/or treat WRA.
Assuntos
Asma Ocupacional/diagnóstico , Asma Ocupacional/terapia , Asma Ocupacional/etiologia , Asma Ocupacional/metabolismo , Biomarcadores/metabolismo , Testes de Provocação Brônquica , Humanos , Testes Cutâneos , EspirometriaRESUMO
OBJECTIVE: To assess the accuracy of body mass index (BMI) as a measure of obesity compared with percent body fat (%BF) directly measured by dual energy x-ray absorptiometry among retired football players. METHODS: The level of agreement between BMI and %BF as measures of obesity was assessed by sensitivity, specificity, and the kappa statistic among 129 retired football players. Logistic regression was used to investigate the association between obesity and selected comorbidities. RESULTS: Using BMI 30 kg/m or higher to identify obesity had poor specificity (0.36): 87 of 129 subjects were classified as obese, yet only 13 were truly obese based on %BF. Although BMI did not reliably indicate true %BF-obesity, BMI-obesity was significantly correlated with lineman position (P < 0.0001), years played (P = 0.03), and obstructive sleep apnea (P = 0.0005). CONCLUSIONS: Percent body fat measured by dual energy x-ray absorptiometry provides a more accurate measure of obesity than does BMI among retired football players.