Papers by Alexandra Farrow
Work-a Journal of Prevention Assessment & Rehabilitation, 2013
International Journal of Epidemiology, 1996
Background. The Avon Longitudinal Study of Pregnancy and Childhood Is a prospective study of wome... more Background. The Avon Longitudinal Study of Pregnancy and Childhood Is a prospective study of women who were resident In Avon and who were expected to deliver a baby between April 1991 and December 1992. Methods. The study provided an opportunity to test the repeatability of responses from 220 women who experienced a miscarriage and who reported exposure to occupational substances and common household products and appliances in two questionnaires. The first questionnaire was completed in the early part of the pregnancy and the second after the miscarriage. Women were asked to score their frequency of exposure on a five-point scale from 'dally 1 to 'never". Their responses were analysed to assess the degree of agreement between replies to identical questions in the two questionnaires using the kappa statistic. A new frequency variable was created which compared the replies for the two questionnaires; this was analysed for all exposures by cross-tabulation with possible explanatory variables (age of mother, social class, history of miscarriage and the time lag between questionnaires). Results. In general there was good agreement in the reported exposures to 48 substances and products. The results showed a small and consistent pattern of reporting exposures less frequently in the second questionnaire, I.e. after miscarriage. This was not explained by the analysis of possible confounding variables. Given the literature, the authors had expected to find a shift in the opposite direction. Conclusion. The study reinforces the need to be cautious when using the results from single surveys of retrospective self-reported exposure.
Pediatric Health, Jun 1, 2008
PubMed, 1989
This paper describes a case-control study of the occupational and environmental exposures of pati... more This paper describes a case-control study of the occupational and environmental exposures of patients with myelodysplasia. The methodology, first described in Canada for solid tumors, estimates lifetime exposures to a number of potential toxic hazards or carcinogens. This pilot study confirms that the methodology, with the use of questionnaires and interviews, can estimate exposures to specific chemicals and shows some significant associations with myelodysplasia, including exposure to petrol or diesel compounds.
Leukemia Research, Feb 1, 1995
Background: Over the past few decades, there has been a decline in cancers attributable to enviro... more Background: Over the past few decades, there has been a decline in cancers attributable to environmental and occupational carcinogens of asbestos, arsenic, and indoor and outdoor air pollution in high-income countries. For low-to middle-income countries (LMICs), however, these exposures are likely to increase as industrialization expands and populations grow. Objective: The aim of this study was to review the evidence on the cancer risks and burdens of selected environmental and occupational exposures in less-developed economies. Findings: A causal association has been established between asbestos exposure and mesothelioma and lung cancer. For arsenic exposure, there is strong evidence of bladder, skin, lung, liver, and kidney cancer effects. Women are at the highest risk for lung cancer due to indoor air pollution exposure; however, the carcinogenic effect on the risk for cancer in children has not been studied in these countries. Cancer risks associated with ambient air pollution remain the least studied in LMICs, although reported exposures are higher than World Health Organization, European, and US standards. Although some associations between lung cancer and ambient air pollutants have been reported, studies in LMICs are weak or subject to exposure misclassification. For pulmonary cancers, tobacco smoking and respiratory diseases have a positive synergistic effect on cancer risks. Conclusions: A precise quantification of the burden of human cancer attributable to environmental and occupational exposures in LMICs is uncertain. Although the prevalence of carcinogenic exposures has been reported to be high in many such countries, the effects of the exposures have not been studied due to varying country-specific limitations, some of which include lack of resources and government support.
Journal of the Chemical Society, 1981
Orthopaedic Proceedings, Feb 21, 2018
Purpose and background of the study The occupational health department for the London Ambulance S... more Purpose and background of the study The occupational health department for the London Ambulance Service (LAS) had numbers of employees reporting low back pain (LBP). The purpose of the study was to determine the lifetime, and point prevalence of LBP and to report the Fear Avoidance Beliefs of this study population within the LAS. Summary of the methods used and the results The cross-sectional study involved 2448 Accident & Emergency (A&E) operational employees (Paramedics and Qualified Ambulance Technicians). A questionnaire with covering letter was posted to a randomly selected number of A&E staff (n=1000). The questionnaire included a validated version of the Fear Avoidance Beliefs Questionnaire (FABQ) and the General Health Questionnaire (GHQ). The response rate was 50% (n= 504). 91% of the responding sample had a lifetime prevalence of LBP and also answered the modified FABQ questions. The mean of the activity fears scale was 4.18 (SD = 1.14) and the mean of the work fears was 4.91 (SD = 1.08), indicating that most respondents held very negative beliefs regarding LBP in relation to work and activities. Those who had experienced LBP reported more psychological problems on the GHQ. Statement of conclusion The prevalence of low back pain amongst responding A&E staff is high compared to National surveys. This population also demonstrated very negative fear avoidance beliefs for LBP. Responses to the GHQ indicated the sample population to be just on the positive side of mid-point. The reporting of LBP was significantly associated with psychological problems.
Medicine and Science in Sports and Exercise, May 1, 2003
International Journal of Occupational and Environmental Health, Jul 1, 2005
Prevalence of hand dermatitis was investigated in 60 U.K. hairdressing salons. Exposure variables... more Prevalence of hand dermatitis was investigated in 60 U.K. hairdressing salons. Exposure variables and individual characteristics were examined for associations with prevalence. 38.6% of respondents reported prevalent hand dermatitis and 72.7% of prevalent cases reported interdigital symptoms. Trainee hairdressers reported an increased risk of hand dermatitis, (RR = 2.95, 95% CI = 1.13-7.66), as did those with < or =2 years in the profession (RR = 4.91, 95% CI = 1.09-22.22). There was a positive association between prevalence and frequent use of protective measures (p = 0.04), suggesting that use of protective measures may be a reaction to incidence rather than a precaution. Wet work was significantly associated with prevalence, and RR was increased in those who performed more frequent wet work, i.e., trainee hairdressers. Prevalence was far higher than suggested by the surveillance schemes in the U.K.
Occupational Medicine, Dec 26, 2011
Background: In the UK, increasing numbers of paid employees are over 60 years with further increa... more Background: In the UK, increasing numbers of paid employees are over 60 years with further increases expected as the state pension age rises. Some concern surrounds possible increased work-related illness and accidents for people working beyond the age of 60. Aims: To identify the available evidence for health and safety risks of workers over age 60 years with respect to factors associated with injuries and accidents. Methods: Databases searched included PUBMED, OSHUpdate, National Institute for Occupational Safety and Health (NIOSHTIC-2), SafetyLit, the UK The Health and Safety Executive (HSELINE) and the Canadian Centre for Occupational Health and Safety until December 2009. Inclusion criteria were workers aged over 60 years. Findings were grouped into occupational accidents and injuries and individual and workplace factors that may have influenced risk of injury to the over-60s. Results: Very little direct evidence was found concerning safety practices and health risks of workers over age 60. Some safety risks were associated with specific physical declines such as age-related hearing loss. Overall, these workers had fewer accidents and injuries but these were more likely to be serious or fatal when they occurred. There was no strong evidence that work patterns, including shift work or overtime, affected safety. Protective, compensatory strategies or experience may maintain safe working practices. Conclusions: Implications for health and safety risks cannot be assessed without longitudinal research on workforces with substantial numbers of workers over age 60 in order to address the healthy worker effect.
Journal of Bone and Joint Surgery-british Volume, Apr 1, 2005
Purpose and background of the study The occupational health department for the London Ambulance S... more Purpose and background of the study The occupational health department for the London Ambulance Service (LAS) had numbers of employees reporting low back pain (LBP). The purpose of the study was to determine the lifetime, and point prevalence of LBP and to report the Fear Avoidance Beliefs of this study population within the LAS. Summary of the methods used and the results The cross-sectional study involved 2448 Accident & Emergency (A&E) operational employees (Paramedics and Qualified Ambulance Technicians). A questionnaire with covering letter was posted to a randomly selected number of A&E staff (n=1000). The questionnaire included a validated version of the Fear Avoidance Beliefs Questionnaire (FABQ) and the General Health Questionnaire (GHQ). The response rate was 50% (n= 504). 91% of the responding sample had a lifetime prevalence of LBP and also answered the modified FABQ questions. The mean of the activity fears scale was 4.18 (SD = 1.14) and the mean of the work fears was 4.91 (SD = 1.08), indicating that most respondents held very negative beliefs regarding LBP in relation to work and activities. Those who had experienced LBP reported more psychological problems on the GHQ. Statement of conclusion The prevalence of low back pain amongst responding A&E staff is high compared to National surveys. This population also demonstrated very negative fear avoidance beliefs for LBP. Responses to the GHQ indicated the sample population to be just on the positive side of mid-point. The reporting of LBP was significantly associated with psychological problems.
ABSTRACT Thesis (Ph. D.)--University of Bristol, 1995. In 2 vols.
Occupational and Environmental Medicine, 1998
Objective-To study the relation between birthweight of term infants and maternal occupation. Meth... more Objective-To study the relation between birthweight of term infants and maternal occupation. Methods-Information on job titles since the age of 16, and sociodemographic and other lifestyle factors were obtained by means of questionnaires as part of the Avon longitudinal study of pregnancy and childhood (ALSPAC), from a cohort of 14 000 pregnant women. The British 1990 standard occupational classification was used to code jobs within nine major job groups. Results-For 9282 women who delivered term infants and reported a job for the relevant period, there was a significant diVerence in mean birthweight among the nine major job groups. A 148 g diVerence was found between the mean birthweight of infants born to women with professional occupations and those with plant and machine operative jobs. Multiple regression analysis adjusted for sex of infant, parity, maternal height, smoking, caVeine consumption, and race. After adjustment the maternal job was no longer significantly associated with birthweight. Conclusion-Despite the absence of a significant association between birthweight and job after adjustment, there were several findings which agreed with publications on maternal occupation and pregnancy outcome. The major job groups with the lowest birthweights included the following jobs: metal forming or welding, electric or electronic work, jobs in the textile trade, and assembling and working with equipment (mobile and stationary). The lack of an association may indicate that the study was of insuYcient power to detect a small diVerence; it may indicate the presence of confounding variables that were not adjusted for or it may indicate that no association exists.
Environmental Technology, Mar 1, 1995
ABSTRACT To determine the feasibility of postal methods to measure indoor and outdoor levels of n... more ABSTRACT To determine the feasibility of postal methods to measure indoor and outdoor levels of nitrogen dioxide without technical intervention of trained staff. Postal distribution of Palmes diffusion tubes to the householder to measure nitrogen dioxide levels inside the baby's bedroom and outside homes followed by a questionnaire ascertaining possible sources of nitrogen dioxide. Setting: Three health districts in Avon during two weeks in November 1992; 100 women, randomly selected from those with infants 46 months of age, currently participating in the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Outcome measures: Response rate and evidence of understanding and implementation of the method by the householder; the comparability of results to those obtained from studies using visits by trained staff, for ratios of nitrogen dioxide outdoors/indoors and in homes with and without a gas cooker. There was a 91% response rate with all but one family carrying out the measurements successfully. The ratio of outdoor:indoor NO2 levels was similar to that found using other methodology (approximately 2:1). Households with gas cookers had indoor NO2 levels 1.8 times those of households without gas cookers, similar to those reported in the literature. This study successfully demonstrates a very efficient method for simultaneously obtaining estimates of air pollutant levels on large numbers of homes.
The European respiratory journal, Mar 1, 2008
The aims of the present study were to assess the effects of maternal use of domestic chemicals du... more The aims of the present study were to assess the effects of maternal use of domestic chemicals during pregnancy on wheezing and lung function in children aged f8.5 yrs and to explore the potential modifying effect of atopy. In the Avon Longitudinal Study of Parents and Children, a cohort study, a maternal composite household chemical exposure (CHCE) score was derived. Wheezing phenotypes from birth to age 7 yrs were assigned on the basis of reported wheeze. Lung function (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced midexpiratory flow between 25 and 75% of FVC (FEF25-75%)) was measured at age 8.5 yrs; and atopy by skin-prick tests at age 7.5 yrs. Multinomial logistic and linear regression models assessed the relationship between wheezing outcomes, lung function and CHCE score, and interactions with atopy. Increased CHCE score was associated with early-(,18 months) and intermediate-(18-30 months) persistent and late-onset (.30 months) wheezing in nonatopic children (adjusted odds ratio per z-score of CHCE (95% confidence interval) 1.41 (1.13-1.76), 1.43 (1.02-2.13) and 1.69 (1.19-2.41), respectively). Increasing CHCE score was associated with decrements in FEV1 and FEF25-75%. Higher domestic chemical exposure during pregnancy was associated with persistent wheeze and lung function abnormalities in nonatopic children. This may result from pre-natal developmental effects or post-natal irritant effects on the developing airway, but is unlikely to be mediated through increased hygiene in the home.
Archives of Environmental Health, Oct 1, 2003
The authors sought to determine whether reported symptoms of mothers and infants were associated ... more The authors sought to determine whether reported symptoms of mothers and infants were associated significantly with the use of household products that raised indoor levels of total volatile organic compounds (TVOCs). Data collected from 170 homes within the Avon Longitudinal Study of Parents and Children (ALSPAC: a large birth cohort of more than 10,000) had determined which household products were associated with the highest levels of TVOCs. The latter data were collected over a period that approximated 6 mo of pregnancy and the infants' first 6 mo of life. This paper presents (a) the mothers' self-reports of the use of these products in their homes and (b) self-reported medical symptoms of mothers and infants postnatally. Higher TVOC levels were associated with air freshener and aerosol use. Infant diarrhea and earache were statistically significantly associated with air freshener use, and diarrhea and vomiting were significantly associated with aerosol use. Headache experienced by mothers 8 mo after birth was significantly associated with the use of air fresheners and aerosols; maternal depression was significantly associated with the use of air fresheners. The results of the study suggest a link between the use of products that raise indoor levels of TVOCs and an increased risk of certain symptoms among infants and their mothers.
Environmental Technology, Jun 1, 1997
The study objective was to assess the length of time spent inside the home for each family member... more The study objective was to assess the length of time spent inside the home for each family member in a sample population in the southwest of England. Such information is vital in any study concerned with exposure to pollutants in the home environment, in order to calculate a dose response for a specific health effect in the individual. The design was a longitudinal observational study which started in pregnancy and was carried out for one week in each month over a 12 month period. The setting was a sample of 170 families within the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) where indoor air pollutants were being measured. The number of hours spent in the home each day for each family member was obtained from self-report using weekly diary sheets‥ The results indicated that mothers, fathers and young infants spent an average of 18.4 (76.7%), 14.7 (61.3%) and 19.3 (80.4%) hours per day, respectively, in the home. In winter, infants spent longer in the home than in the summer months. At week...
Fertility and Sterility, Oct 1, 2000
Uploads
Papers by Alexandra Farrow