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Hedelin, Anna S; Sundblad, Britt-Marie; Sahlander, Karin; Wilkinson, Kai; Seisenbaeva, Gulaim; Kessler, Vadim; Larsson, Kjell; Palmberg, Lena
doi: 10.1136/oemed-2015-103522pmid: 27378812
ObjectivesTo evaluate innate immunity responses, lung function and symptoms in volunteers acutely exposed to organic dust in swine buildings after installing particle separators aimed to reduce particulate matter exposure.Methods11 healthy participants were exposed in 2 different facilities, with and without installed particle separators, in a cross-over design including 2–3 weeks wash-out between the 2 exposures. Size, distribution and composition of particulate matter and endotoxins in the air were measured. Lung function (spirometry), bronchial responsiveness, symptoms questionnaire and markers of innate immunity in blood and nasal lavage were measured before and after the 3-hour exposures.ResultsThe number of particles, in particular fine particles sized 0.3–0.5 µm, was reduced in the particle-separated swine building environment (PSE) compared with that in the conventional building (CE). In the PSE, headache (p=0.03) and increased body temperature (p=0.016) were less pronounced than in the CE. The expression of toll-like receptors (TLR)2 and TLR4 on blood monocytes significantly increased (p=0.016 and 0.017, respectively) while cluster of differentiation (CD)14 on neutrophils decreased (p=0.05) after exposure in the CE, yet with no difference between the 2 exposures. Compared with the conventional environment, exposure to the PSE yielded lower interleukin (IL)-6 (p=0.02) and IL-8 (p=0.04) levels in the upper respiratory tract, as assessed by nasal lavage.ConclusionsParticulate matter and organic dust in the swine building were reduced after installing particle separators, which, in naïve never exposed volunteers, in turn reduced adverse health effects caused by acute exposure in swine buildings compared with exposure to the conventional swine building environment.
Friedman, Stephen M; Farfel, Mark R; Maslow, Carey; Jordan, Hannah T; Li, Jiehui; Alper, Howard; Cone, James E; Stellman, Steven D; Brackbill, Robert M
doi: 10.1136/oemed-2015-103512pmid: 27449135
Jang, Seongjae; Lee, Jin Kyung; Cho, Minsu; Yang, Su San; Kim, Seung Hyun; Kim, Wan Tae
doi: 10.1136/oemed-2016-103775pmid: 27466611
BackgroundIndustrial radiography is known to be one of the most vulnerable lines of work among the range of different radiation work. According to the relevant law in Korea, every worker registered in this work should check their blood cell counts every year in addition to their thermoluminescent dosimeter (TLD) doses. Since the law was enacted, however, few follow-up studies have been carried out based on the obtained results.ObjectivesTo ascertain the clinical usefulness of complete blood cell count (CBC) results and suggest a proper protocol of health protection for radiation workers.MethodsAfter reviewing all the consecutive results of CBC and TLD doses from radiation workers registered nationwide, we selected two groups of high-risk radiation workers, CBC-high risk (CBC-HR) and TLD-high risk (TLD-HR) groups. A control group of unexposed healthy adults was also included. We compared the absorbed doses calculated by cytogenetic biodosimetry among those three groups, and examined possible confounding factors for each group.ResultsBoth groups of high-risk radiation workers, CBC-HR and TLD-HR, showed higher chromosome aberrations than the control group. In the control group, previous medical history of a CT scan increased the frequency of chromosome aberrations. In contrast, the frequency of chromosome aberrations in the high-risk radiation workers was affected not by the previous CT history but only by the duration of their work.ConclusionsWe ascertain that reviewing consecutive results of blood cell counts and cytogenetic biodosimetry are useful complementary tools to TLD doses for health protection regulation. Several confounding factors including work duration and previous medical history need to be considered for the interpretation of biodosimetry results.
doi: 10.1136/oemed-2016-103688pmid: 27535036
BackgroundVibration-induced white finger (VWF) is the vascular component of the hand–arm vibration syndrome (HAVS). Two tests have been standardised so as to assist the diagnosis of VWF: the measurement of finger rewarming times and the measurement of finger systolic blood pressures (FSBPs).ObjectivesThis study investigates whether the two tests distinguish between fingers with and without symptoms of whiteness and compares individual results between the two test methods.MethodsIn 60 men reporting symptoms of the HAVS, the times for their fingers to rewarm by 4°C (after immersion in 15°C water for 5 min) and FSBPs at 30°C, 15°C and 10°C were measured on the same day.ResultsThere were significant increases in finger rewarming times and significant reductions in FSBPs at both 15°C and 10°C in fingers reported to suffer blanching. The FSBPs had sensitivities and specificities >90%, whereas the finger rewarming test had a sensitivity of 77% and a specificity of 79%. Fingers having longer rewarming times had lower FSBPs at both temperatures.ConclusionsThe findings suggest that, when the test conditions are controlled according to the relevant standard, finger rewarming times and FSBPs can provide useful information for the diagnosis of VWF, although FSBPs are more sensitive and more specific.
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ObjectivesThe prevalence of persistent lower respiratory symptoms (LRS) among rescue/recovery workers, local area workers, residents and passers-by in the World Trade Center Health Registry (WTCHR) was analysed to identify associated factors and to measure its effect on quality of life (QoL) 10 years after 9/11/2001.MethodsThis cross-sectional study included 18 913 adults who completed 3 WTCHR surveys (2003–2004 (Wave 1 (W1)), 2006–2007 (Wave 2 (W2)) and 2011–2012 (Wave 3 (W3)). LRS were defined as self-reported cough, wheeze, dyspnoea or inhaler use in the 30 days before survey. The prevalence of three LRS outcomes: LRS at W1; LRS at W1 and W2; and LRS at W1, W2 and W3 (persistent LRS) was compared with no LRS on WTC exposure and probable mental health conditions determined by standard screening tests. Diminished physical and mental health QoL measures were examined as potential LRS outcomes, using multivariable logistic and Poisson regression.ResultsOf the 4 outcomes, persistent LRS was reported by 14.7%. Adjusted ORs for disaster exposure, probable post-traumatic stress disorder (PTSD) at W2, lacking college education and obesity were incrementally higher moving from LRS at W1, LRS at W1 and W2 to persistent LRS. Half of those with persistent LRS were comorbid for probable PTSD, depression or generalised anxiety disorder. Enrollees with persistent LRS were 3 times more likely to report poor physical health and ∼ 50% more likely to report poor mental health than the no LRS group.ConclusionsLRS, accompanied by mental health conditions and decreased QoL, have persisted for at least 10 years after 9/11/2001. Affected adults require continuing surveillance and treatment.