No abstract

Blunt trauma to the head results in acceleration of the brain within the skull. This takes 2 forms: linear or translational acceleration which produces focal lesions, and rotational acceleration which results in 'sheering stresses' with stretching of nerves and bridging veins. Deceleration of the brain within the skull occurs when the head strikes a stationary object (e.g. floor, ring post). Cerebrovascular events are not infrequently encountered. The most common vascular sequalae is the subdural haematoma, which is also the most frequent cause of death in boxers. Epidural bleeds rare, and are generally due to deceleration of the brain. Subarachnoid bleeds have been rarely reported, but, like intraparenchymal haemorrhages, they do occur. Sudden flexion/extension of the neck is suggested as the mechanism of the occasional brainstem haemorrhage reported in boxing. Thrombosis of the internal carotid artery can occur secondary to direct blows to the neck or stretching of the contralateral carotid artery. The best known sequalae of boxing is traumatic encephalopathy--the 'punch drunk' syndrome. This is most common in second-rate and slugging type fighters. Severity correlates with the length of a boxer's career and total number of bouts, with an incidence of approximately 18%. Three stages of clinical deterioration are seen, the encephalopathy may be progressive or may remain clinically stable at any level. The first stage consists of affective disturbances with psychiatric symptoms being most marked. During the second stage an accentuation of the psychiatric symptoms occurs and signs/symptoms of Parkinsonism develop. The final stage consists of a decrease in general cognitive function together with pyramidal tract disease. Generally 2 to 3 years elapse between the first and final stages. Neuropathological studies reveal abnormalities of the septum pellucidum, scarring of the cerebellar and cerebral cortices, and loss of pyramidal neurons in the substantia nigra with neurofibrillary tangles in the absence of senile plaques. A 'groggy state' can occur in some fighters with confusion, impaired active attention and alteration of consciousness. During this period the boxer is at greater risk to suffer brain injury as defensive reflexes are frequently lost. Other neurological syndromes have been reported in addition to the 'groggy state'. These include a midbrain syndrome, headaches and cervical spinal injuries. Additionally, boxing appears to be a significant risk factor for the development of meningiomas.(ABSTRACT TRUNCATED AT 400 WORDS)

No abstract

Research that has attempted to examine the relationship between work exposures to magnetic fields and health effects has suffered from limited exposure information. Power-frequency electric and magnetic (EM) field exposures vary substantially between industries, occupations, and individuals. In this study magnetic field data were collected for a variety of occupational categories within an electric utility. The sampling procedures emphasized craft occupations that were presumed to have higher exposures to magnetic fields. The objectives were to provide better exposure information for an ongoing cancer mortality study, examine the relationship between different summary measures of magnetic field exposure, and make available descriptive information useful for exposure reduction and worker education. Principal components analysis (PCA) and Varimax rotation were used to explore the relationships between the different summary measures among all utility workers and among the subset of electrical craft occupations. Discriminant analysis was used to assess summary measures of exposure that differentiated occupational groups. Measurements for 770 days generated a total of 42378 hours of magnetic field data. Eleven summary indices of exposure were calculated for specific occupational groups. These include arithmetic mean, geometric mean, median, 95th and 99th percentiles, and fraction of measurements exceeding .5, 1, 5, 10, and 100 microT. Electrical craft occupations had higher work exposures than non-craft occupations. Electricians and substation operators had the highest exposures among craft occupations. We identified subsets of summary measures that were intercorrelated. The first PCA axis included the geometric mean, median, and the fractions exceeding 0.5 and 1.0 microT. This set of measures also were best at discriminating occupational groups. The relevance of these findings may become more important if consistent associations are found between particular occupations and disease and particular occupations and magnetic field summary measures. Further research is needed to evaluate these exposure assessment findings.