(17/7118) 1998 and beyond--Legge's legacy to modern occupational health.
Thomas Legge achieved much in his professional lifetime. The purpose of this lecture is to highlight some of these achievements in the light of what we have achieved since then. In other words, if Legge was in the audience today, how would he feel we have performed? On 'industrial maladies', progress has been made in reducing poisoning by heavy metals but our success with chrome ulceration and lead depends on surveillance and control. Room for improvements remain. For asbestos related diseases, Legge would be disappointed with our progress. Two areas of particular concern to Legge were upper limb disorders and 'occupational neurosis'. Much remains to be done. As a member of the 1st Committee on Compensatable Diseases, a review of the Scheme to date will focus on the common diseases now being prescribed and on the threats to the Scheme from the Benefits review. For the future, there are many challenges in the newer workplaces and the changing workforces. The HSE initiatives for a new occupational strategy and the Government Green Paper on Public Health provide great opportunities for the occupational health professional to influence the nature and shape of future public health strategy. Above all we must have some of Legge's characteristics to achieve this-vision, passion and commitment. (+info)
(18/7118) Mechanisms and mediators in coal dust induced toxicity: a review.
Chronic inhalation of coal dust can cause several lung disorders, including simple coal workers pneumoconiosis (CWP), progressive massive fibrosis (PMF), chronic bronchitis, lung function loss, and emphysema. This review focuses on the cellular actions and interactions of key inflammatory cells and target cells in coal dust toxicity and related lung disorders, i.e. macrophages and neutrophils, epithelial cells, and fibroblasts. Factors released from or affecting these cells are outlined in separate sections, i.e. (1) reactive oxygen species (ROS) and related antioxidant protection mechanisms, and (2) cytokines, growth factors and related proteins. Furthermore, (3) components of the extracellular matrix (ECM), including the modifying role of ROS, cytokines, proteases and antiproteases are discussed in relation to tissue damage and remodelling in the respiratory tract. It is recognised that inhaled coal dust particles are important non-cellular and cellular sources of ROS in the lung, and may be significantly involved in the damage of lung target cells as well as important macromolecules including alpha-1-antitrypsin and DNA. In vitro and in vivo studies with coal dusts showed the up-regulation of important leukocyte recruiting factors, e.g. Leukotriene-B4 (LTB4), Platelet Derived Growth Factor (PDGF), Monocyte Chemotactic Protein-1 (MCP-1), and Tumor Necrosis Factor-alpha (TNF alpha), as well as the neutrophil adhesion factor Intercellular Adhesion Molecule-1 (ICAM-1). Coal dust particles are also known to stimulate the (macrophage) production of various factors with potential capacity to modulate lung cells and/or extracellular matrix, including O2-., H2O2, and NO, fibroblast chemoattractants (e.g. Transforming Growth Factor-beta (TGF beta), PDGF, and fibronectin) and a number of factors that have been shown to stimulate and/or inhibit fibroblast growth or collagen production such as (TNF alpha, TGF beta, PDGF, Insulin Like Growth Factor, and Prostaglandin-E2). Further studies are needed to clarify the in vivo kinetics and relative impact of these factors. (+info)
(19/7118) An expert system for the evaluation of historical asbestos exposure as diagnostic criterion in asbestos-related diseases.
Compensation schemes for asbestos-related diseases have developed different strategies for attributing a specific disease to occupational exposure to asbestos in the past. In the absence of quantitative exposure information that allows a valid estimate of an individual's historical exposure, general guidelines are required to retrospectively evaluate asbestos exposure. A risk matrix has been developed that contains qualitative information on the proportion of workers exposed and the level of exposure in particular industries over time. Based on this risk matrix, stepwise decision trees were formulated for decisions regarding the decisive role of historical asbestos exposure in case ascertainment of asbestosis and mesothelioma. Application of decision schemes will serve to speed up the process of verifying compensation claims and also contribute to a uniform decision-making process in legal procedures. (+info)
(20/7118) Occupational human immunodeficiency virus infection in health care workers: worldwide cases through September 1997.
The average estimated risk of human immunodeficiency virus (HIV) infection for health care workers following a percutaneous or mucous exposure is <0.5% in incidence studies, although a case-control study suggests it is much higher for highest-risk percutaneous exposure. To characterize exposures resulting in HIV transmission, we reviewed available data on occupational cases reported worldwide, identifying 94 documented and 170 possible cases. The majority of documented infections occurred in nurses, after contact with the blood of a patient with AIDS by means of percutaneous exposure, with a device placed in an artery or vein. High-exposure job categories, e.g., midwives and surgeons, are represented mostly among possible cases. Transmission occurred also through splashes, cuts, and skin contaminations, and in some cases despite postexposure prophylaxis with zidovudine. Health care workers could benefit if these data were incorporated in educational programs designed to prevent occupational bloodborne infections. (+info)
(21/7118) High prevalence of hepatitis G virus (HGV) infections in dialysis staff.
BACKGROUND: Patients on renal replacement therapy, haemodialysis (HD), or after kidney transplantation (TX), are known to be at risk of acquiring blood-borne infections (HBV, HCV). GBV-C/Hepatitis G virus (HGV) has been described recently and is considered to cause blood-borne infections. The aim of this study was to analyse the risk for the medical staff of HD and TX patients to acquire HGV infection. METHODS: Eighty-five HD patients and 86 TX recipients were compared with 49 health-care workers and 64 blood donors as controls. The HGV prevalence was determined by RT-PCR and antibodies to E2 protein. RESULTS: A high prevalence of HGV was found in the medical staff (24%) which nearly corresponded to the prevalence of the patients (TX 36%, HD 25%) but not to the controls (9%). In contrast, the prevalence of HCV was low in the medical staff (2%) and controls (0%) but high in HD (13%) and TX (13%). Age and duration of employment in the department did not significantly influence the HGV prevalence in staff. The number of viraemic subjects in staff was high, possibly indicating a more recent infection. CONCLUSION: An occupational risk for HGV exists in medical staff of dialysis and transplant patients. Further routes of transmission than only parenteral may play a role in this setting. (+info)
(22/7118) Blastomycosis acquired occupationally during prairie dog relocation--Colorado, 1998.
On August 31, 1998, two suspected cases of fungal pneumonia were reported to the Boulder County (Colorado) Health Department (BCHD). Both patients were immunocompetent, otherwise healthy adults working for the City of Boulder Open Space (CBOS) program on a prairie dog relocation project. This report summarizes the epidemiologic investigation by BCHD, the Colorado Department of Public Health and Environment, and CDC; the findings indicate that these two persons acquired blastomycosis in Colorado, which is outside the area where the disease is endemic. (+info)
(23/7118) Farm worker illness following exposure to carbofuran and other pesticides--Fresno County California, 1998.
In California, suspected pesticide-related illnesses and suspected work-related illnesses and injuries are reportable conditions. On July 31, 1998, the Occupational Health Branch of the California Department of Health Services (CDHS) received a report from the California Department of Pesticide Regulation (CDPR) of a pesticide exposure incident in Fresno County involving 34 farm workers. CDHS investigated this incident by reviewing medical records of the 34 workers and interviewing 29. The findings indicated that the workers became ill after early reentry into a cotton field that had been sprayed with a cholinesterase-inhibiting carbamate pesticides (+info)
(24/7118) Disease patterns of the homeless in Tokyo.
In recent years, homelessness has been recognized as a growing urban social problem in various countries throughout the world. The health problems of the homeless are considerable. The purpose of this study was to elicit, with sociodemographic profiles, the disease patterns among Tokyo's homeless. The subjects were 1,938 men who stayed at a welfare institution from 1992 to 1996. Diagnosed diseases/injuries and sociodemographic profiles were analyzed. The disease patterns of the homeless were compared to those of the male general population. Of the subjects, 8.3% were admitted to the hospital; 64.0% received outpatient care. Their observed morbidity rates by disease category were greater than those of the male general population in both Japan and Tokyo. Comorbidity of alcoholic psychosis/alcohol-dependent syndrome to both liver disease and pulmonary tuberculosis were greater than the average (P < .01). Construction work brought a higher risk of pulmonary tuberculosis (odds ratio = 2.0) and dorsopathies (odds ratio = 1.4) than did other jobs (P < .05). Disease patterns among the homeless in Tokyo were characterized by alcoholic psychosis/alcohol-dependence syndrome; liver disease; pulmonary tuberculosis; diabetes mellitus; fractures, dislocations, sprains, strains; hypertension; and cerebrovascular disease. Although the sociodemographic backgrounds of Tokyo's homeless have become more diverse, the principal occupation of the homeless was unskilled daily construction work, which underlay the characteristics of their disease patterns. (+info)