5 Page report including creations of graphs in excel, any health concepts will be explained in notes.
AN INVESTIGATION INTO PNEUMONIA AT AN AUSTRALIAN DIAMOND MINE
You are the staff OH&S specialist at a large diamond mine in a remote region of Australia. On occasion, high performing workers are offered the choice to take the day away from their usual work and instead spend the day watching for forest fires in the very comfortable, high tech watchtower. During early January, the company medical centre reports several cases of fever, pneumonia and abdominal pain in workers who had all been given this duty. Many have been hospitalized. It is uncertain if the cases are related to this activity or if it may be a more widespread problem due to chemical exposure. Human and environmental samples have been taken but they have to be flown to the laboratory for analysis and will not be available for about a week. As all the patients are workers for the company, and the infections occurred while on the job, you (as the OH&S specialist with some knowledge of epidemiology) are working alongside the company’s medical assistants to investigate the problem. Reports for the entire group of workers for the previous several months show roughly 1-2 cases of this type of pneumonia every month.
1. Plot the time of onset for each person (the "epidemic" curve), using one-day intervals for each day of the month. The histogram should be clearly-labelled (title, y and x axis) and easily read, and should clearly show the time of onset.
2. Next, plot the "elapsed time" curve which shows a time of 'zero' for each person's tower shift, and the distribution of marks for each person following the shift (Use the same 1-day intervals). This has the effect of accumulating everyone together relative to their own tower shift day as if it were the same moment.
3. What does this tell you about the range of the incubation period as well as the median incubation period?
4. Is there evidence of propagation in this outbreak? Why or why not?
5. Does this constitute an "epidemic"? Why or why not?
6. Some workers who took a watchtower shift regularly work in multiple locations. Table 1 shows the work locations of each watchtower shift employee. Is there an association between exposure to any particular work location and the illness? Interpret your results [2x2 tables needed with odds ratios]
7. You have asked for the incidence of reports of this type of pneumonia in the general worker community who did not have a tower shift during January but the cases are very few, and none directly traceable to the tower workers. What statement can you make about clustering in 'place'?
8. Is there a relationship between gender and illness among the tower workers during January? Interpret your results [2x2 analysis needed with odds ratios]
9. Is there a relationship between age group (i.e. 16-20, 21-25, etc.) and illness in the volunteers during January? Interpret your results [2xN analysis needed]
10. Is there a relationship between the occupation and the illness? Interpret your results [2xN analysis needed]
11. What was the overall attack (incidence) rate among the patients during January?
12. Two (patient #17 and #43) unfortunately succumbed to respiratory failure a week after the illness. Make a symptom profile table showing the percentage of the ill persons who demonstrate the symptoms. Describe the symptom profile.
NOTE: SYMPTOM DATA IS NOT DISPLAYED IN EXCEL FILE: The symptoms are limited to pneumonia (=all patients), with fever (=7 patients), cough (=4 patients), and abdominal pain (=3 patients).
13. Given ALL the evidence you have thus far, and after consulting information sources, try to eliminate as many as possible of the agents on the following list.
• Streptococcus Group A
rest of instructions will be sent.
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