[A rare tumor-like lesion of the pancreatic head with bile duct obstruction]. / Pankreassarkoidose als seltene Ursache einer Gallengangsobstruktion.

Tumors of the pancreatic head commonly consist of carcinomas whereas other entities are rare exceptions. Extrapulmonary sarcoidosis is well-known but is extremely rare when detected as a mass in the pancreatic head. In general the diagnosis of sarcoidosis requires histologic examination with verification of non-caseous, epithelioid cell-like granulomas. Systemic therapy consists of steroids when the patient exhibits symptoms or in the case of progression of the disease. However, in some cases extended abdominal resections are also required to confirm the diagnosis and/or to treat symptoms.

The impact of roster changes on absenteeism and incident frequency in an Australian coal mine.

BACKGROUND: The occupational health and safety implications associated with compressed and extended work periods have not been fully explored in the mining sector. AIMS: To examine the impact on employee health and safety of changes to the roster system in an Australian coal mine. METHODS: Absenteeism and incident frequency rate data were collected over a 33 month period that covered three different roster schedules. Period 1 covered the original 8-hour/7-day roster. Period 2 covered a 12-month period under a 12-hour/7-day schedule, and period 3 covered a 12-month period during which a roster that scheduled shifts only on weekdays, with uncapped overtime on weekends and days off (12-hour/5-day) was in place. Data were collected and analysed from the maintenance, mining, and coal preparation plant (CPP) sectors. RESULTS: The only significant change in absenteeism rates was an increase in the maintenance sector in the third data collection period. Absenteeism rates in the mining and CPP sectors were not different between data collection periods. The increase in the maintenance sector may be owing to: (1) a greater requirement for maintenance employees to perform overtime as a result of the roster change compared to other employee groups; or (2) greater monotony associated with extended work periods for maintenance employees compared to others. After the first roster change, accident incident frequency decreased in the CPP sector but not in the other sectors. There was no effect on incident frequency after the second roster change in any sector. CONCLUSIONS: The current study did not find significant negative effects of a 12-hour pattern, when compared to an 8-hour system. However, when unregulated and excessive overtime was introduced as part of the 12-hour/5-day roster, absenteeism rates were increased in the maintenance sector. The combination of excessive work hours and lack of consultation with employees regarding the second change may have contributed to the overall negative effects.

The effects of a roster schedule change from 8- to 12-hour shifts on health and safety in a mining operation.

The current study examined the impact on employee health and safety of changes to the roster system of an Australian coal mine. Absenteeism and incident frequency rate data were collected over a 33-month period that covered three different roster schedules, an 8-hour system, a 12-hour system and a 12-hour system incorporating unregulated overtime. The first change was implemented after consultation with the employee population, whereas the second was not. There were no significant negative effects of the 12-hour pattern, when compared to the 8-hour system. However, when unregulated and excessive overtime was introduced as part of the second round of changes, absenteeism rates were increased in one sector of the mine. The maintenance sector was subject to a significant increase in absenteeism rates, which may have been attributable to the excessive overtime required of the workers in that area. It is important that overtime be strictly monitored and that the employee population are involved in the process of roster change.