Whether HSE is genuine or not in the evidence of difference in the potential health hazard between workers at the two operations

    Whether HSE is genuine or not in the evidence of difference in the potential health hazard between workers at the two operations

    Test book : Author : Dytham C, 1999, Choosing and using statistics: a biologist’s guide. Blackwell science: oxward (ebook)
    Test book: Author: Aveyard H, 2010, Doing a literature review in health and social care. A practical guide. Maidenhead: McGraw-Hill open university press (ebook)
    The Health and Safety Executive (HSE), commissions you to analyse information obtained from a
    study by the Health and Safety Laboratory (HSL) of workers from brick and tile industries. The HSE
    wants to know if there is any cause for concern that the worker
    s may potentially be affected by
    silicosis (see below). Data for two sectors has been provided which the HSE hope may shed light
    on any potential problems.
    There are
    two key questions
    which the HSE require you to address:

    Is there any difference in th
    e health (as indicated by cell damage) of the workers in the two
    operations?

    What associations exist, if any, between length of service and recorded health effect?
    Background
    The problem
    Brick and tile manufacturing along with many other industrial activ
    ities in the ceramics sector use
    quartz (a form of crystalline silica [CS]), feldspar and china clay as typical raw materials. Fine dusts
    formed during brick and tile production activities, however, are a potential health hazard. One of
    the reasons for thi
    s is that the smallest particles in fine dusts may contain Respirable Crystalline
    Silica (RCS) formed from the quartz component of the raw materials. It is known that prolonged
    and excessive exposure to RCS

    containing dusts may cause silicosis, a particula
    r form of
    pulmonary fibrosis leading to incapacity and premature death. As such the HSE takes the issue
    seriously and has undertaken a preliminary study via the agency of the HLS to look into any
    potential problems and it is the results of this study that
    you are commissioned to analyse.
    The use of LDH as a warning sign
    Lactate dehydrogenase (LDH) is an intracellular enzyme. It oxidizes lactate in the presence of
    NADH
    (reduced form of nicotinamide adenine dinucleotide)
    or reduces pyruvate in the presence o
    f
    NAD (oxidised form of
    NADH)
    . It is used clinically to determine cell damage in a number of organs
    including heart, liver, muscle and blood. Elevations in LDH release are known to be associated
    with increased levels of cell membrane permeability and its m
    easurement is therefore considered a
    good indicator of the extent of cell damage. It is deemed to be a useful indicator of the initial stages
    of cell damage caused by trauma from introduction of alien particles to cells including RCS

    containing dusts. In t
    he data presented herein, LDH release in blood cells has been recorded and
    the results have been calculated to produce a % cell damage figure.
    The study group and the data collected
    The HSL in undertaking the study stipulated three key criteria for work
    ers to take part in the study,
    namely:

    They must not have worked in both brick and tile works.

    They worked in areas of tile or brick production (i.e. not in an office or other areas away
    from the industrial activity).

    They did not smoke.
    From the popula
    tion satisfying these criteria, a sub

    sample of 65 workers
    was
    randomly selected
    for blood testing, 38 from brick operations, and 27 from tile operations.
    In the Minitab worksheet the results of the study are shown in 5 columns of data.
    C1

    A worker
    ID, identifying the sector (letter B or T) and the individual (3 digit number)
    C2

    The sector in which the employee worked (brick or tile)
    C3

    Length of service of each employee in the sector (in years)
    C4

    Age of each employee (in years)
    C5

    The perce
    ntage of damaged cells for each employee as calculated by results of the LDH
    assay (%)
    Your task
    You a required to produce a coherent, concise, well presented and well structured
    report that
    informs the HSE
    whether or not there is genuine evidence of diff
    erence in the potential health
    hazard between workers at the two operations.
    Further, you are required to report on
    whether there is any association between worker length of
    service in the industry and the potential damage to their health.
    In concluding
    the report you cannot
    assume that the HSE understands statistical methods in detail and you will therefore have to
    summarise your findings in plain non

    technical language. The length of the report should be
    in the
    region of 4 to 8
    pages.
    You are expected
    to:

    introduce the type of question you are facing including
    an explanation of
    hypothesis testing

    produce appropriate descriptive/graphical summaries of the data

    justify your choice and undertake the correct statistical tests

    interpret any p

    values and con
    fidence intervals
    and correlation co
    efficients correctly

    arrive at brief and clear conclusions that directly answer the problem

    finally, you are free to explore and will be credited for any further analyses of the data you
    deem worthy of investigation

    a
    re the HSE asking exactly the right questions?

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