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Christopher R. Brigham
,
Stephen L. Demeter
, and
E. Ranolph Soo Hoo

, resulting in significant morbidity and mortality. It is the leading risk factor for several respiratory diseases, including chronic obstructive pulmonary disease (COPD) and lung cancer. 2 COPD encompasses emphysema and chronic bronchitis, characterized by persistent respiratory symptoms and airflow limitation owing to airway and/or alveolar abnormalities. The primary cause of COPD is exposure to tobacco smoke (either active smoking or second-hand smoke), contributing to 85% to 90% of all cases. 3 In these conditions, tobacco smoke leads to chronic inflammation of the

in AMA Guides® Newsletter
Marcos Iglesias

, needless disability can be harmful to the individuals who are away from work: financially, emotionally, socially, and from the perspective of health. The topic of worklessness has been addressed elsewhere. 13 Being off work can be harmful to an individual's well-being. When individuals are absent from work, they are more likely to experience depressed mood, increased pain, irregular sleep, and aerobic deconditioning. Workless populations experience a 2- to 3-fold increased risk of poor general health, including higher rates of cardiovascular disease, lung cancer

in AMA Guides® Newsletter
Stephen L. Demeter

cardiopulmonary exercise stress test (diminished V o O 2 max) Severe hypoxemia (PaO 2 < 50 torr on room air at rest when stable) Lung cancer Breathing abnormalities during sleep It was recommended that spirometry be performed after the use of a bronchodilator in the presence of wheezing. Regarding the rating for an asthmatic, the Second Edition stated: Finally, an asthmatic patient is considered to be severely impaired (class 4) if the examiner can document attacks of bronchospasm severe enough to require treatment in an emergency room of a hospital

in AMA Guides® Newsletter
Robert B. Snyder
and
James B. Talmage

asymptomatic individuals, these three criteria have not been supported by accurate data at present. BOX 1. Bradford Hill Criteria In 1965, the English statistician Sir Austin Bradford Hill proposed a set of nine criteria to provide epidemiologic evidence of a causal relationship between a presumed cause and an observed effect. (For example, he demonstrated the connection between cigarette smoking and lung cancer.) The list of the criteria 1 is as follows: Strength (effect size): A small association does not mean that there is not a causal effect, though the

in AMA Guides® Newsletter
James B. Talmage

review, the problem is not merely one of association. On the balance of the evidence, the authors conclude that unemployment causes, contributes to, or accentuates the following negative health impacts: ▪ Increased rates of overall mortality and, specifically, increased mortality from cardiovascular disease and suicide; ▪ Poorer general health; ▪ Poorer physical health, including increased rates of cardiovascular disease, lung cancer, and of susceptibility to respiratory infections; ▪ Poorer mental health and psychological well-being; ▪ Somatic complaints

in AMA Guides® Newsletter
Jay Blaisdell
,
James B. Talmage
, and
Stephen Demeter

) FEV 1 percentage predicted. Both have the footnote “b” denoting “key factor” in Table 5-5. Individuals with lung cancer when the tumor is still present, automatically receive class 4 impairment. Lung Function Testing: General Considerations The European Respiratory Journal offers “general considerations for lung functioning testing” formulated by a task force composed of the American Thoracic Society and European Respiratory Society (ERS). 2 -4 This joint statement may serve as an international standard for lung function testing. The following summary

in AMA Guides® Newsletter