Efficacy of measures of hygiene in workers sensitised to acid anhydrides and the influence of selection bias on the results.
OBJECTIVES: Organic acid anhydrides are potential sensitisers and cause occupational airway diseases. In an intervention study the efficacy of measures of hygiene at the workplace and possible selection bias were investigated. METHODS: A first investigation with 110 workers exposed to hexahydrophthalic acid anhydride (HHPA) and methyltetrahydrophthalic acid anhydride (MTHPA) was carried out in July 1991. The results (skin prick test, specific serum IgE) showed that 20 people were sensitised, and in a challenge test the clinical relevance of the sensitisation was confirmed in six subjects. In December 1991, the hygiene conditions at the plant were improved. In November 1995 a second investigation of 84 people was performed (anamnesis, skin prick test, specific IgE, spirometry, and ambient and biological monitoring). The 27 people who had left the plant in the meantime were asked their reasons for leaving. RESULTS: The relative risk of people sensitised in 1991 of leaving the plant between 1991 and 1995 was 2.6 (95% confidence interval (95% CI) 1.4 to 4.9) compared with people without any sign of sensitisation. The percentage of people identified as sensitised in 1991, who were still working at the plant and came to the second investigation, was higher than for people without evidence of sensitisation (10/10 v 47/73; p < 0.05). In all the 10 sensitised people in 1991 the findings of the first investigation were confirmed in 1995. The rate of sensitisation in 1995 was 21%. None of the six people employed after 1991 showed evidence of sensitisation. Of the six people with clinically relevant sensitisation confirmed by a challenge test in 1991, five were still at their workplace. From 1991 they were only exposed to MTHPA at a reduced concentration (< 0.5-36 micrograms/m3 in 1995). All of them reported fewer symptoms than in 1991. No signs of bronchial obstruction were detected by spirometry at the workplace. CONCLUSIONS: In cross sectional studies there is a selection bias with a risk of underestimating the incidence of allergic diseases. The results further suggest that the improved hygiene conditions probably had a positive effect on the symptoms in sensitised people. (+info)
Firing shrinkage of porcelain-resin composites prepared by laser lithography.
Using porcelain and resin-mixed composites as experimental materials, cubic polymerized composites were prepared by the accumulation of thin slices cured by laser scanning. The composites were then fired, and bulk ceramic bodies were made. The optimal firing conditions of polymerized composites and firing shrinkage were investigated. The results showed that cubic ceramic bodies in a form homologous to that before firing could be reproduced. The volume shrinkage of fired ceramic bodies consisting of 1 g of ceramic powders and 0.3 g of epoxy resin was about 30% under all firing conditions, and there were no significant differences between specimens. It was suggested that with further research and development, three-dimensional forms for clinical use in dentistry could be manufactured by the proposed method. (+info)
Electron microscopic examination of subcellular fractions. I. The preparation of representative samples from suspensions of particles.
A method is described for preparing, by filtration on Millipore filters, very thin (about 10 micro) pellicles of packed particles. These pellicles can be embedded in Epon for electron microscopic examination. They are also suitable for cytochemical assays. The method was used with various particulate fractions from rat liver. Its main advantages over the usual centrifugal packing techniques are that it produces heterogeneity solely in the direction perpendicular to the surface of the pellicle and that sections covering the whole depth of the pellicle can be photographed in a single field. It thus answers the essential criterion of random sampling and can be used for accurate quantitative evaluations. (+info)
Restoration of endodontically treated teeth with carbon fibre posts--a prospective study.
BACKGROUND: A prospective study was started in 1995 to evaluate the success of carbon fibre reinforced epoxy resin (CFRR) posts used to restore endodontically treated teeth. All the teeth in the study had lost more than 50% of their coronal structure. METHODS: Fifty-nine carbon fibre Composiposts cemented with Metabond and built up with Core Paste cores were placed into the teeth of 47 patients. Each tooth received a full-coverage restoration (porcelain fused to metal crown) and was followed for 6.7-45.4 months (average = 28.0 months, standard deviation = 10.7). RESULTS: Results for 52 teeth in 42 patients were analyzed. There were no fractures. The overall failure rate was 7.7% and the cumulative survival rate was 89.6% at the end of the follow-up period. The only statistically significant finding (p = 0.04) was that posts in lower premolars were at higher risk of failure. CONCLUSION: CFRR posts are among the most predictable systems available today. CFRR posts in the upper anterior teeth are associated with a higher success rate and longer life than those placed in premolars, especially lower premolars. This study contributes to the growing body of evidence that supports the use of CFRR posts in the restoration of endodontically treated teeth. (+info)
Total plasma protein adducts of allergenic hexahydrophthalic and methylhexahydrophthalic anhydrides as biomarkers of long-term exposure.
OBJECTIVES: The aim of this study was to evaluate the applicability of total plasma protein adducts (TPPA) of 2 sensitizing low-molecular-weight allergens, hexahydrophthalic anhydride (HHPA) and methylhexahydrophthalic anhydride (MHHPA), as biomarkers of long-term exposure. METHODS: Urine samples from occupationally exposed workers were analyzed for the levels of urinary metabolites of HHPA and MHHPA, and the levels were used as the index of exposure. In addition, blood samples were obtained from the same persons, and the levels of TPPA were determined. Reversed solid phase extraction, derivatization using pentafluorobenzyl bromide, and gas chromatography-mass spectrometry analysis in the negative ion chemical ionization mode were used to quantify the exposure. To assess the suitability of TPPA as a biomarker of exposure to the anhydrides, the TPPA levels were correlated to urinary metabolite levels and hemoglobin (Hb) adducts. The toxicokinetics of TPPA were also studied to determine the elimination half-time of the adducts. RESULTS: The levels of TPPA correlated exceptionally well with the metabolite levels in the urine sampled repeatedly, giving r=0.97 for HHPA and r=0.92 for MHHPA. The TPPA of HHPA correlated highly with the Hb adducts with r=0.86. There were also good correlations between single urinary determinations and the TPPA levels (r(s)=0.71 and 0.81, respectively, for HHPA and MHHPA). The in vivo decay of TPPA gave an elimination half-time of 22 days for HHPA and 24 days for MHHPA. CONCLUSIONS: TPPA levels of HHPA and MHHPA are excellent biomarkers of long-term exposure to anhydrides. (+info)
Exposure to hexahydrophthalic and methylhexahydrophthalic anhydrides--dose-response for sensitization and airway effects.
OBJECTIVES: This study clarified the exposure-response relationships for the organic acid anhydrides (OAA) hexahydrophthalic (HHPA) and methylhexahydrophthalic (MHHPA) anhydrides and the development of specific immunoglobulin (IG) E and G antibodies and work-related symptoms. METHODS: In an epoxy resin-using factory, air levels of OAA were determined by gas chromatography-mass spectrometry. Occupational, smoking, and medical histories (questionnaire) were obtained for 154 exposed workers and 57 referents. Work-related symptoms of the eyes and airways were recorded, and OAA metabolites were analyzed in urine. A skin-prick test with common allergens and conjugates of OAA were performed. Specific IgE (radioallergosorbent test) and IgG (enzyme-linked immumosorbent assay) antibodies were determined in serum, and spirometry was performed. RESULTS: Air levels of the OAA were low (HHPA < 1 to 94, MHHPA < 3 to 77 microg/m3) and associated with the concentrations of the OAA metabolites in urine. Furthermore, for the exposed workers, there were high prevalences of sensitization (IgE 22%, IgG 21%), which correlated with the exposure. Neither atopy nor smoking increased this risk significantly. Furthermore, work-related symptoms were more prevalent among the exposed workers than among the referents (eyes 23% versus 14%, nose 28% versus 16%, nose bleeding 8% versus 0%, lower airways 10% versus 4%), and they were related to the exposure (adjusted prevalence odds ratios (POR) in the highest group 7.7, 3.6 and 17, respectively) and the IgE levels (POR 4.9, 3.1 and 5.6, respectively). CONCLUSIONS: In spite of the very low OAA levels in the air and metabolites in the urine, there were high and exposure-related risks of specific IgE and IgG sensitization and of work-related symptoms for the eyes, nose (especially bleeding), and lower airways. (+info)
Occupational contact urticaria caused by airborne methylhexahydrophthalic anhydride.
Acid anhydrides are low-molecular weight chemicals known to cause respiratory irritancy and allergy. Skin allergy has on rare occasions been reported. A total of 3 subjects with occupational exposure to methylhexahydrophthalic anhydride (MHHPA) and hexahydrophthalic anhydride (HHPA) from an epoxy resin system were studied to evaluate the nature of their reported skin and nose complaints (work-related anamnesis, specific IgE, contact urticaria examinations, and ambient monitoring). Using a Pharmacia CAP system with a HHPA human serum albumin conjugate, specific IgE antibody was detected in serum from 1 (33.3%) out of the 3 workers. One unsensitized worker displayed nasal pain and rhinorrhea only when loading liquid epoxy resins into the pouring-machine (2.2 mg MHHPA/m3 and 1.2 mg HHPA/m3), probably being an irritant reaction. Two workers had work-related symptoms at relatively low levels of exposure (geometric mean 32-103 microg MHHPA/m3 and 18-59 microg HHPA/m3); one complained of only rhinitis, and the other was sensitized against HHPA and displayed both rhinitis and contact urticaria (the face and neck). The worker's skin symptoms were evidently due to airborne contact, since she had not had any skin contact with liquid epoxy resin or mixtures of MHHPA and HHPA. These urticaria symptoms were confirmed by a 20-min closed patch test for MHHPA, but not by that for HHPA. The causative agent was considered to be MHHPA, although the specific IgE determination to MHHPA was not performed. (+info)
A cross-sectional survey of 32 workers exposed to hexahydrophthalic and methylhexahydrophthalic anhydrides.
The relation between exposure and sensitization or the appearance of symptoms of the eyes and airways was investigated in a cross-sectional study on 32 workers from a plant using epoxy resin with a mixture of hexahydrophthalic anhydride (HHPA) and methylhexahydrophthalic anhydride (MHHPA) as a hardener. The main component in the hardener was HHPA, and the geometric mean concentrations of HHPA in the workplaces were extremely low (<40 microg/m3) in recent years, compared to the Occupational Exposure Limit-Ceiling for phthalic anhydride (2 mg/m3). However, specific IgE antibody to HHPA was detected in serum from 8 (25%) out of the workers: of those, 5 workers experienced symptoms of the eyes and nose during work (group sensitized symptomatic (SS)) and 3 workers did not (group sensitized nonsymptomatic (SN)). The other 24 workers had no signs of sensitization and did not complain of work-related symptoms. Based on occupational history and anamnestic data, it was concluded that one subject in the SS group and all the subjects in the SN group had been sensitized by higher exposures in the past. The symptoms of 4 subjects in the SS group occurred only when carrying out short-time, particular tasks (15-30 min) a few times a day, such as the resin mixing procedures, manual application of the resin, or opening of ovens. High peak exposures were estimated to have occurred during the particular tasks. Our results suggest that short-time peak exposures may have a great impact on the development of specific IgE or work-related symptoms. Therefore, to minimize the risk of sensitization and work-related symptoms, a reduction of exposure during particular tasks with high peak exposures, along with a decrease in mean 8-h time-weighted average exposure, should be achieved. (+info)