Showing papers by "Frank E. Speizer published in 1969"
TL;DR: These pollutants, as they have been measured in epidemiological investigations, can only be considered as indirect indices of general air pollution and in many cases cannot be separated from each other.
Abstract: This review has attempted to evaluate the present state of our knowledge of the effects on health in man of environmental exposure to oxides of sulfur, sulfates, and particulate matter. There has been a great deal of activity in this field over the last 15 years, and therefore any collation of this material will represent the selected biases of the reviewer. The conclusions reached can be summarized as follows: (1) These pollutants, as they have been measured in epidemiological investigations, can only be considered as indirect indices of general air pollution and in many cases cannot be separated from each other. Therefore, we cannot incriminate a specific source of any one pollutant as the producer of the most harmful substance to reach the ambient air. Conversely, we cannot excuse any specific source of one pollutant because that specific pollutant has not been found to cause disease at a given concentration. The measurements in ambient air are the net results from all sources of pollution in combinati...
12 citations
TL;DR: It is conceivable that "pre-disease" detection, or the detection of risk factors, could reduce the chances for the development of the cycle of tissue damage that characterizes already established disease.
Abstract: A pressing need in the field of chronic pulmonary disease is the development of methods to detect predisposition to pulmonary disease. During the 1950's, the epidemiologist identified the many etiologic factors in chronic pulmonary disease by utilizing a few simple clinical and physiologic tools. These tools, however, are good enough to detect only established disease. It is now apparent that current therapy is not terribly effective in altering the long term course of already established disease.1 Although progress has been made in reducing the morbidity and mortality of acute exacerbations, treatment does not seem to have significantly influenced the inexorable progression of such disease. The idea is being increasingly accepted that chronic pulmonary disease has its origin years before the development of symptoms or even detectable physiologic abnormalities. It is conceivable that "pre-disease" detection, or the detection of risk factors, could reduce the chances for the development of the cycle of tissue damage that characterizes already established disease.
2 citations
TL;DR: Apart from assisting the setting of priority in health planning, cost-benefit analysis is important in understanding the law of diminishing returns in expanding programs.
Abstract: The practice of weighing the cost of preventive programs against the expected benefits is probably as old as prevention itself. The number of preventive programs has proliferated in the past few years and has forced a competition for limited funds. The need to set priorities for public health funding of such programs has, therefore, required a more detailed breakdown of both cost and benefit. For example, the benefits include the reductions in future mortality, hospitalization and sickness absenteeism resulting from the preventive program, each benefit being expressed in terms of dollars saved. The value of the reduction in the mortality of males is estimated from tables compiled by economists showing the average future productivity of males at various ages. Defining the value of a housewife is more difficult, however, and an arbitrary figure must be used. For this reason some program planners prefer to refer to the number of lives that will be saved and do not apply a monetary value. Because of the lack of agreement about the effectiveness of most preventive procedures in renal disease, and because many intangibles among the benefits defy precise evaluation, one may well ask what purpose is served in attempting to calculate the cost-benefit of any program. Apart from assisting the setting of priority in health planning, cost-benefit analysis is important in understanding the law of diminishing returns in expanding programs. Contrary to folklore that expanded programs automatically provide greater benefits, an analysis of the cost-benefit of several hypothetical programs of varying sizes will indicate the point at which further expansion leads to diminishing benefits.
1 citations