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Complex visual hallucinations are known to occur in individuals with impaired vision yet whose emotional and intellectual functions are within the normal range. These hallucinations, which were first reported by Charles Bonnet in 1760, have been described in many case studies, but have not been analyzed empirically to determine their major properties. In the present study, sixty complex hallucinators labeled as Charles Bonnet hallucinators were administered a questionnaire to determine the properties of their hallucinations. Combined use of multiple-correspondence analysis and hierarchical cluster analysis reveals a set of features that characterize the 'typical' Charles Bonnet hallucinatory experience: the hallucinators' experience occurs while they are alert and with the eyelids open; a sharply focused image appears suddenly, without any apparent trigger or voluntary control; the hallucination is present for seconds, does not move during this time, then suddenly vanishes. These features are discussed in terms of a 'dimension' of hallucinatory/perceptual experience, which ranges from discrete perceptual experiences to multiple, changing experiences. Possible mechanisms that underlie the Charles Bonnet hallucinations are discussed.

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Loss of vision is a common physical impairment in America today. Comprehensive low vision rehabilitation programs can have dramatic results in increasing the independence and productivity of affected persons. Rehabilitation efforts must be tailored to the type of vision loss and to specific functional implications. Every effort should be made to enhance the residual vision. Activities of daily living, orientation and mobility, and psychological concerns must be addressed.

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The effects of diabetes upon a person's emotional and physical health are complex and unique to each individual. This paper gives an overview of the psychological and social issues raised by a severe disability such as diabetes and diabetic retinopathy, and how its effects are mitigated by the timing of disease onset and progression, significant events in the course of treatment, concurrent medical concerns, coping skills, and the vision care professional's attitude in dealing with people having disabilities. The goal is to have vision care professionals become more aware of their potentially powerful positive and negative influences upon the psychological health of these individuals.

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A prospective mortality study was conducted of the 800 employees who worked 3 months or more during the period January 1946 through June 1985, in the only plant in the US where the termiticide chlordane has been produced. The study covers the entire period of chlordane production to date and includes 7,347 person-years of employment at the chlordane plant and 21,585.5 person-years of follow-up since commencement of employment. All but three former employees considered to be alive at the end of the study period were either contacted directly or were identified as alive by a variety of reliable sources. Death certificates were obtained for 161 of the 181 decedents and reliable causes of death were reported for an additional 11 cases. Overall death rate was slightly less than expected but not to the level of statistical significance. Production workers with higher pesticide blood levels had lower standardized mortality ratios for cancer than nonproduction employees, and there appears to be an inverse relationship of cancer mortality to length of employment. An unexplained excess of cerebrovascular deaths was observed, offset by a lesser degree of cardiovascular deaths.

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A prospective study was conducted of 2,646 employees who worked three months or more during the period January, 1957, through July, 1983, in a manufacturing plant that used trichlorethylene as a degreasing agent throughout the study period. Ninety-eight percent of the study cohort were traced; they accounted for 16,388 person-years of employment and 38,052 person-years of follow-up. Mortality experience was found to be generally more favorable than that of the comparable segment of the U.S. population over the same period of time. For the white male cohort there were fewer deaths than expected from heart disease, cancer, and trauma (standard mortality rate for all causes = 0.79, p less than .01). Reports by current and former employees of health problems requiring medical treatment showed that there were only one third as many persons with heart disease or hypertension as were reported in a comparable reference population studied over the past five years.

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This article defines the terms and concepts applied to the teaching of clinical preventive medicine by the Curriculum Development Project--a joint venture of the Center for Educational Development in Health (CEDH) at Boston University and the Association of Teachers of Preventive Medicine Foundation (ATPMF).

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There is no question that exposure to specific substances is associated with an increased risk of developing specific neoplasms. Exposure to soot by chimney sweeps was found to be responsible for scrotal cancer by Sir Percival Pott over 200 years ago. More recently we have obtained evidence of the adverse effect of asbestos fibers, benzene, vinyl chloride, arsenicals, beryllium, and other substances that have been addressed frequently in recent literature. NIOSH publishes a handbook entitled "Pocket Guide to Chemical Hazards," which contains 450 chemicals with varying degrees of toxicity, and these represent but a small number of the substances we deal with daily. In this article, the symptoms of short-term overexposure are set forth. What is not presented here, or contained, to a very limited degree, is the risk of low-level exposure over a long period of time. The reason this kind of information is not presented is because we have limited information on this question. In most instances we just do not know what the risks are of long-term exposure or low-level exposure. But we should know this and, the fact is, we do know how to find out.

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The data available on mortality of the white population of the United States from 1940 to 1975 do not confirm the presence of an epidemic of cancer in our society. Overall death rates and non-respiratory cancer death rates are declining in these groups over a wide spectrum of ages for both sexes. Respiratory cancer death rates have been increasing, but appear to show a current decline in the younger age groups. The need for objective mortality data by specific cause of death and geographic area is evident. Measures to protect the environment should be undertaken within the context of a generally improving mortality experience of the U.S. population.

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Workers in five chemical plants with diverse characteristics were studied by attempting to locate all white male employees who worked at least 12 months over a 25 to 30 year period. Former employees were contacted directly, rather than using questionnaires or Social Security Administration files. The data were analyzed by comparing observed mortality to expected mortality based on age-sex-race specific death rates in the U.S. population. The results indicate that the mortality experience of the chemical workers studied is essentially that of the general population. It is suggested that the "healthy worker effect" may be due to methods frequently employed in searching for death claims which understate the true experience of the employee group studied, or if present, does not affect mortality rates for neoplastic or cardiovascular disease.

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