The work situation and fatigue-related complaints of employees with diabetes (N = 141) were compared with "healthy" employees (N = 8946) and employees with other chronic diseases (N = 1883). Baseline data from a Dutch Cohort Study on Fatigue at Work were used to test differences in background variables, work characteristics, lifestyle factors, and fatigue-related complaints. Odds ratios were calculated for prolonged fatigue, the need for recovery, burnout, and psychological distress. Results showed that employees with diabetes work more daytime hours and work less overtime than the other groups. If they have no comorbidity, they are no more likely to report fatigue-related complaints than "healthy" employees, except for a depressed mood. Comorbidity (the presence of one or more additional chronic diseases) is associated with increased fatigue-related complaints. Therefore, this group will need special attention from professionals.
Allyl isothiocyanate (AITC) has been used as a food additive for paste-type wasabi (Japanese horseradish) and karashi (Japanese mustard) almost only in Japan, even though it has been reported to be carcinogenic and mutagenic. In the present paper, the capacities for DNA damage and the intracellular generation of reactive oxygen species (ROS) by AITC were examined by a ‘rec-lac assay’ and a ‘kat-sod assay’ by using E. coli mutants lacking DNA repair capacities and ROS scavenging enzymes, respectively. Both assays were developed by Nishioka et al. and consist of a streak test, a survival test and a β-galactosidase test. The results show strong DNA damaging capacity, and intracellular generation of ROS by AITC. These results indicate the possibility that intracellular ROS performs some role in DNA damage in bacterial cells treated with AITC. Copyright © 1999 John Wiley & Sons, Ltd.
This review addresses the evidence on the health effects of exposure to emissions of NO2 from gas stoves, covering findings of 45 epidemiological studies. These studies had addressed diverse outcome measures, including the risks of acute respiratory illness, decreased pulmonary function, respiratory symptoms and asthma exacerbation. Although most studies have focused on schoolchildren, studies of adults and more recently, prospective studies of infants have also been carried out. The findings have not been consistent across all studies in showing adverse effects. We conclude that the evidence does not support a causal relationship between exposure NO2 or use of a gas stove and increased risk for respiratory morbidity at the levels of NO2 typically associated with gas stoves. Some studies do show increased risk for respiratory health effects, however, and the evidence does not support the conclusion that NO2 emitted by gas stoves is risk-free. Further research would be indicated if populations receiving exposures in a range of interest can be identified. Copyright © 1999 John Wiley & Sons, Ltd. This review addresses the evidence on the health effects of exposure to emissions of NO2 from gas stoves, covering findings of 45 epidemiological studies. These studies had addressed diverse outcome measures, including the risks of acute respiratory illness, decreased pulmonary function, respiratory symptoms and asthma exacerbation. Although most studies have focused on schoolchildren, studies of adults and more recently, prospective studies of infants have also been carried out. The findings have not been consistent across all studies in showing adverse effects. We conclude that the evidence does not support a causal relationship between exposure NO2 or use of a gas stove and increased risk for respiratory morbidity at the levels of NO2 typically associated with gas stoves. Some studies do show increased risk for respiratory health effects, however, and the evidence does not support the conclusion that NO2 emitted by gas stoves is risk-free. Further research would be indicated if populations receiving exposures in a range of interest can be identified. Copyright © 1999 John Wiley & Sons, Ltd.
Journal of Environmental MedicineVolume 1, Issue 4 p. 259-259 Editorial Mini-symposium on the effects of particles on Health: Introduction RL Maynard, RL MaynardSearch for more papers by this author RL Maynard, RL MaynardSearch for more papers by this author First published: 28 February 2001 https://doi.org/10.1002/jem.45AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue4October/December 1999Pages 259-259 RelatedInformation
Movement up the household energy ladder from smoke-producing biomass fuels to relatively clean liquid, gaseous and electric fuels is commonly part of the economic transition and thus plays a role in the accompanying health transition. Here, we analyse the relationship between type of cooking fuel and the prevalence of partial and complete blindness in India using data on 173 520 persons age 30 and over from the 1992–93 National Family Health Survey. Logistic regression is used to estimate the net effects of biomass fuel (wood or dung) use on prevalence of partial and complete blindness after controlling for availability of a separate kitchen, house type, crowding, age, gender, urban-rural residence, education, religion, caste/tribe and geographical region. Persons living in biomass fuel-using households are found to have a considerably higher prevalence of blindness (partial or complete) than those living in households using cleaner fuels (OR 1.32; 95% CI 1.16–1.50). The effects are large and statistically significant for both men (OR 1.31; 95% CI 1.12–1.52) and women (OR 1.30; 95% CI 1.12–1.50) and for urban areas (OR 1.22; 95% CI 1.01–1.49) and rural areas (OR 1.49; 95% CI 1.23–1.80). The effects are strong and significant for partial blindness (OR 1.34; 95% CI 1.17–1.53), but not for complete blindness (OR 1.09; 95% CI 0.79–1.51). The level of risk and extent of biomass fuel use in India indicate that 18% of partial and complete blindness among persons age 30 and older may be attributed to biomass fuel use. The results strongly suggest that smoke exposure from the use of biomass fuels for cooking substantially increases the risk of partial blindness. Copyright © 1999 John Wiley & Sons, Ltd.
The study assessed peripheral sensory function and its relation to self-reported wartime exposures to potentially neurotoxic substances in Gulf War veterans with chronic fatigue syndrome (CFS). Male Gulf veterans fulfilling the 1994 CDC diagnostic criteria for CFS were compared with matched controls. Quantitative sensory testing was performed to establish thresholds of perception for the sense of light touch and radiant heat. The Devens survey was used to collect data on self-reported exposures to by-products of combustion and organophosphate compounds. Gulf veterans with CFS had elevated tactile but normal thermal thresholds compared with their controls. Sick veterans had greater rates of self-reported exposures and/or noxious side effects for all assessed toxicants. Interestingly, both Gulf veteran groups, including those reporting no symptoms, had impaired perception of light touch when compared with age-matched samples of non-Gulf war veteran men. The results of this study are consistent with a hypothesis that Gulf veterans with CFS have a subtle neurological deficit that might reflect underlying peripheral neuropathy. The association between this deficit and self-report of multiple potentially neurotoxic exposures suggests that war zone pollutants may be possible contributing factors. Copyright © 1999 John Wiley & Sons, Ltd.
Journal of Environmental MedicineVolume 1, Issue 1 p. 57-57 Meeting Report Carbon monoxide: The unnoticed poison of the 21st century C Pulce, C PulceSearch for more papers by this authorJ Descotes, J DescotesSearch for more papers by this author C Pulce, C PulceSearch for more papers by this authorJ Descotes, J DescotesSearch for more papers by this author First published: 20 May 1999 https://doi.org/10.1002/(SICI)1099-1301(199901/03)1:1<57::AID-JEM2>3.0.CO;2-LAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume1, Issue1January/March 1999Pages 57-57 RelatedInformation
Time-series analyses and cohort studies provide different methods of looking at the health effects of air pollution. With respect to mortality, the relative risk associated with a defined increase in the concentration of particulate matter is numerically much higher if derived from cohort studies than if based on time-series analyses. This discrepancy is often explained by arguing that chronic effects of air pollutants can only be assessed in cohort studies. However, with respect to changes in life expectancy, the results of the two study types can be shown to be consistent. In calculations of pollution-related health costs, mortality plays a dominant role. Applying the relative risk derived from cohort studies directly as a multiplier on daily or annual mortality leads to a considerable overestimation of effects. Copyright © 1999 John Wiley & Sons, Ltd.
We investigated effects of summer air pollution exposure on outdoor workers in the Fraser Valley, Canada. Fifty farm workers performed spirometry daily before and after each 12–16 h workday from 1 July to 18 August 1994. The mean daily maximum (1 h) ambient ozone concentration was 39 ppb (range 10–89 ppb) and the mean daily maximum 8 h average ozone concentration was 31 ppb (range 5–66 ppb). PM10 concentrations were low (mean 24 h average 16 μg m−3, range 6–30 μg m−3) and highly correlated with ozone. Due to the high level of correlation between ozone, temperature and PM10 it was not possible to separately analyse the effect of each of these variables on lung function. In regression models including daily maximum ozone (an indicator of photochemical smog), an individual's mean lung function level and the Julian date, decreased afternoon FEV1 and FVC, and the daily change (afternoon–morning) corrected for the morning measurement, were associated with ozone. These associations were still apparent the following morning, suggesting a persistent air pollution effect. These results reproduce our earlier finding of persistent lung function decrements in farm workers in the Fraser Valley associated with relatively low concentrations of ambient air pollution. In the subset of 12 individuals who participated in both studies, there was no correlation in individual responses to ozone between the two study periods. During both summer studies we observed a marked seasonal decline in lung function, although lung function levels improved to initial values between the two studies, suggesting a reversible seasonal effect of ozone on lung function. Copyright © 1999 John Wiley & Sons, Ltd.
Building dampness in the floor construction is known to cause chemical degradation of polyvinyl chloride floor coatings, but few epidemiological studies on this topic have been published. Another topic of interest is the different symptoms in different buildings constructed with different building materials and with different architectural designs. The term Sick Building Syndrome (SBS) is sometimes used to describe irritation to the eyes, skin, and upper airways, headache and fatigue in relation to the indoor environment. The aim of our investigation was to study symptoms in relation to building dampness and type of building in geriatric hospitals. Four hospitals for geriatrics were selected to represent buildings with different ages and design, irrespectively of symptom prevalence. All staff (n = 95) were requested to answer a medical questionnaire, 88 (93%) participated. Measurements of room temperature, relative air humidity, air flow rate, illumination, moulds, bacteria, formaldehyde and other volatile compounds, respirable dust, carbon monoxide, carbon dioxide, nitrogen dioxide and ozone were carried out in all buildings. Statistical analyses were performed by bivariate analysis, and multiple logistic regression, adjusting for possible influence of building age, age of the subjects, gender, tobacco smoke, atopy and the perceived psychosocial work environment. Dampness in the upper concrete floor surface (75–84%), ammonia under the floor [3 parts per million (3 ppm)], and 2-ethyl-1-hexanol in the air were detected in two buildings built in 1985 and 1993. Increased occurrence of ocular, nasal and throat symptoms, and dry facial skin were found in the damp buildings. Those in the specially designed building had fewer of these symptoms. In conclusion, the study provides new evidence on possible health effects of dampness-related alkaline degradation of di(2-ethyl-hexyl) phthalate (DEPH) in PVC-building material. Emissions related to degradation of DEPH due to dampness in the floor construction, detected by an increase of 2-ethyl-1-hexanol in the air, seems to increase the occurrence of ocular, nasal, throat and facial skin symptoms. The indoor environment of one specially designed building with a high ceiling and avoidance of fluorescent lighting and interior plastic materials, seemed to have a positive influence on well-being. Our results support the view that building dampness should be avoided, and shows that it is possible to construct a new building where the inhabitants have few symptoms. Copyright © 1999 John Wiley & Sons, Ltd.
There is increasing recognition in comparative risk assessment of the intrinsic subjectivity of fundamental framing assumptions and the consequent necessity for active participation in analysis by all interested and affected parties. Despite this, there remains considerable inertia in the implementation of these insights in formal policy making and regulatory procedures on risk. Here, the issue seems as often to be seen as a need for better ‘communication’ and ‘management’ as for better analysis, with attention devoted as much to the classification of divergent public perspectives as to techniques for direct stakeholder participation. Pointing to the fundamental methodological problems posed in risk assessment by the conditions of ignorance and Arrow's impossibility, the present paper contends that public participation is as much a matter of analytical rigour as it is of political legitimacy. It is argued that straightforward techniques such as multi-criteria and sensitivity analysis, along with a formal approach to diversification across portfolios of ‘less risky’ options, may go some way toward addressing these apparently intractable problems. Copyright © 1999 John Wiley & Sons, Ltd.
Nephropathy has been reported in children with overt lead intoxication. Only recently low-level lead exposure has been associated with renal effects, especially with regard to tubular function. The objective of the present study was to investigate the relation between lead exposure and renal function in children in the Katowice region, an industrial area in Poland. This cross-sectional study involved 157 children, aged 4–14 years. Blood lead concentration was used as an index of lead exposure. Glomerular filtration rate was estimated using the height adjusted serum creatinine calculation (crea-GFR) and measurement of cystatin C in serum. The renal tubular function was evaluated by measuring the urinary concentration of protein HC. The median blood lead concentration was 0.35 μmol/L (72 μg/L) with a range of 0.09–1.36 μmol/L. Crea-GFR (n = 143) decreased significantly (p = 0.002) with increasing concentrations of lead in the blood. Serum cystatin C (n = 84) increased with blood lead (p = 0.004). There was an association (p = 0.002) between blood lead and urinary concentration of protein HC (n = 49). In summary, the present findings indicate that the association between blood lead and the markers of renal function on both a glomerular and a tubular level may be caused by environmental lead exposure. Copyright © 1999 John Wiley & Sons, Ltd.
Recent epidemiological data have indicated that the ambient concentration of the inhalable fraction of atmospheric particles (PM10) is associated with respiratory and cardiovascular morbidity and mortality. These effects may be related to particle induced inflammatory reactions in the airways, but little actual information is available about the deposition and retention of ambient particles in human airways, particularly in the very small airways. To examine this question, we isolated portions of large airways, large airway carinas, and small airways between the mainstem bronchus and the respiratory bronchioles (RB) from the autopsy lungs of seven never-smokers from the general population, and determined mineral content by analytical electron microscopy. Overall, RB at generations 11,12, and 13 showed consistently high particle concentrations, averaging 25 to 100 times the particle concentration in the mainstem bronchus, but roughly similar elevated concentrations were also seen in the carinas of airway generations 4 and 5. Mean aerodynamic particle sizes by site ranged between 0.30 and 0.60μoxm, with slightly larger particles in the RB. Crystalline silica was the predominant mineral species in all sites. Ultrafine particles were present in all sites but constituted less than 15% of the total number of particles in any location. Ultrafine particles were largely individual particles of metals and crystalline silica, and no aggregated carbonaceous or noncarbonaceous ultrafine particles were identified. More than 90% of the particles in every site had aerodynamic diameters less than 2.5μoxm. We conclude that the RB and the carinas of generations 4 and 5 in the normal human lung show very high and roughly equal concentrations of inhaled ambient particles, suggesting that these two anatomic compartments are potential sites of particle toxicity. All portions of the airways effectively retain PM2.5. Ultrafine particles are retained throughout the airways and also show concentration peaks in the large airway carinas and RB. Copyright © 1999 John Wiley & Sons, Ltd.
The purpose of the present paper is to examine the complex set of questions about the PM-mortality exposure–response (E-R) relationship by looking at the practical and demonstrable consequences of time series model building and by considering alternate modelling methods. Two questions are posed. The first is how to demonstrate goodness-of-fit for an exposure–response model and the effectiveness of a particular term in the model. The second is how to detect poor model fit associated with unusual relationships in the data, such as thresholds or other non-linear patterns. Suggested solutions are demonstrated using the Philadelphia data set used by Kelsall. These solutions are potentially applicable to other time series data analyses. Examination of the example data indicate several findings. First, the addition of the pollution terms to a model which contains temporal and weather variables has a negligible change on the predictive ability of the model. While the statistical criteria are slightly improved the practical improvement in mortality prediction is minimal. Second, for these data, there is demonstrable evidence that there is a threshold effect for total suspended particulate (TSP) on predicted mortality. The threshold is also seen in the gaseous pollutants. Lastly, the inclusion of terms representing the day of the week statistically improves model fit to a greater extent than the pollution terms. The results from this exercise suggest that several steps should be added to the traditional analysis and presentation of time-series data. These include visual and tabular presentation of results from each major model and analysis for a threshold at least for the criteria pollutant terms. The presentation elements allow the reader to independently assess model fit and the predictive capabilities of the model. Determination of a threshold allows objective determination of a no adverse effect level. Overall, application of these methods to time-series analyses provides more specificity for testing the predictive power of the model and for protecting health.Copyright © 1999 John Wiley & Sons, Ltd.
The aim of the study was to determine the prevalence of sensitization and contact dermatitis in a population of Italian farmers and the importance of pesticides as skin sensitizers. Sixty-four female worker (mean age 35) employed in the harvesting of cherries, peaches, olives and grapes were studied. Skin diseases were assessed with a questionnaire and physical examination. The farm workers were patch tested with the GIRDCA standard series containing 30 allergens and six pesticides currently used on the farm. 18 workers (28%) were sensitized to one or more allergens. 36 subjects (52%) were found to be atopic and three (4.7%) had dermatitis of the hands with positive reactions to the GIRDCA standard series. Differences in contact sensitization betweeen atopic and non atopic patients were not statistically significant (χ2 test). One worker had contact urticaria to peaches and 36 farmers (52%) referred to itching and skin rashes in summer, during the harvesting of peaches. Only 18 workers reported that they almost always wore protective clothing. Despite the high frequency of positive patch tests, contact sensitization to pesticides was unusual in our group. No cases of allergic contact dermatitis to pesticides were found and only one patient who was symptomless (1.5%) had an allergic reaction to pesticides (azinphos-methyl). Copyright © 1999 John Wiley & Sons, Ltd.
The concept of biomonitoring comprises the one-off or repeated systemic measurement of concentrations of hazardous substances and their metabolites in biological materials. If the materials are from a human biological source, the concept of human-biomonitoring is usual. In contrast to determining exposure to the human environment (e.g. air quality, food contamination), biomonitoring has the advantage of reflecting the actual, individual exposure of a human organism (e.g. in the form of biomarker). This enables an individual health risk concerning systemic effects to be better described than by solely measuring exposure. Benzene and toluene are volatile organic compounds (VOC). Their ubiquity means they are found in all indoor air. Due to their toxic potential (benzene—carcinogenic, toluene—neurotoxic) and the quantities in which toluene is found, sometimes actual exposure to toluene must be measured. One way is to test urine for specific metabolites to monitor the internal burden and dosage. S-phenyl- and S-benzylmercapturic acid (SPMA and SBMA) were selected and their concentrations determined in urine samples from Leipzig children. The results were correlated with the benzene and toluene concentrations of indoor air. Whereas a correlation was found between benzene and SPMA, no connection was established between toluene and SBMA. One of the next targets is to find a correlation between the measuring results and information concerning ailments given in response to questionnaires on the children’s health.<<< WCODE [203] >>>Copyright © 1999 John Wiley & Sons, Ltd.
Corrosive compounds and burns destroy the skin barrier function. Little is known about the dynamics of repair of this function during the healing process. The passive sustainable hydration test was performed as a non-invasive approach to measure water loss through the skin using electrometric evaluations under continuous occlusion by the sensor probe. Evaluations were made in 10 patients suffering from recent second- and third-degree contact burns. Skin sites corresponding to burned and unburned areas, and to healing sites following grafts or not were compared. The data show that the skin barrier function improves progressively and often irregularly after contact burn, and may remain altered for more than 2 months after epithelialisation. Therefore, maturation of the stratum corneum appears to be a slow process. The consequences of this during the healing phase following contact burns are twofold: the resistance of the water barrier remains impaired and the risk of transcutaneous penetration of various xenobiotics including toxic products is increased. Copyright © 1999 John Wiley & Sons, Ltd.
Rapid industrialization usually brings both economic development and environmental pollution, which often produces occupational diseases in the workplace and environmental diseases in the nearby community. From experience of documenting 17 occupational diseases, we found that they resulted from a lack of a comprehensive hazard communication system. The spillage of such unknown chemical hazards also produced environmental diseases for the neighbouring factories and community. Because the general treatment of occupational and environmental diseases must include the identification of hazard and taking preventive procedures to avoid further exposure, it is essential to recognize and control the hazard at the start of an industry. Thus, implementation of the life cycle assessment in ISO (International Organization of Standardization) 14000 series will guide an industry to identify and minimize the use of hazardous chemicals. A similar practice of risk assessment and reduction for every unit operation in the production process proposed by BS (British Standard) 8800 will also help to improve occupational health. Although implementation of such systems is a voluntary compliance, actual practice demands the same systems in related or satellite factories and has a strong market implication. Copyright © 1999 John Wiley & Sons, Ltd.
Comparisons of red blood cell cholinesterase values (AChE, EC 3.1.1.7) from different laboratories can be difficult. This study evaluated different methods of interlaboratory comparison. Eleven subjects gave triplicate samples for analysis by three commercial laboratories. Comparisons were made relative to the mid-point of each laboratory’s reference range (mid-range), and by transformation to Ellman assay activity in U/mL using published/derived conversion factors. To observe each laboratory’s reliability, four subjects submitted two additional duplicate samples to each laboratory. The mean intraspecimen variabilities were 3%, range 1%–8%; 4%, range 0–9%; and 13%, range 2%–24% for laboratories 1–3, respectively. The mean mid-range percent for laboratory 3 was substantially lower than the means for laboratories 1 and 2. Therefore, laboratory 3 values were adjusted based on the means for laboratories 1 and 2 and the mid-point suggested by laboratory 3’s assay kit. The mean AChE relative to these mid-points were 109%, 107%, and 107% for laboratories 1–3, respectively. Ellman activities were 19.0, 19.9 and 20.8 U/mL for laboratories 1–3, respectively. Intrasubject differences for both comparison methods showed agreement that approximated intraspecimen variabilities for each laboratory. Comparisons involving laboratory 3 showed the poorest agreement consistent with laboratory 3’s greater intraspecimen variation. AChE from different laboratories can be compared by both methods evaluated in this study. All comparisons are limited by the precision and reliability of the laboratories involved. Copyright © 1999 John Wiley & Sons, Ltd.
