http://www.occup-med.com The latest research articles published by Journal of Occupational Medicine and Toxicology 2012-05-03T00:00:00Z IntroductionHealthcare workers (HCW) are exposed to infectious agents. Disease surveillance is therefore needed in order to foster prevention. Methods: The data of the compensation board that covers HCWs of non-governmental healthcare providers was analysed for a five-year period. For hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, the period analysed was extended to the last 15 years. The annual rate of occupational infectious diseases (OIDs) per 100,000 employees was calculated. For NSIs a rate per 1,000 employees was calculated. Results: Within the five years from 2005 to 2009 a total of 384 HCV infections were recognised as OIDs (1.5/100,000 employees). Active TB was the second most frequent cause of an OID. While the numbers of HBV and HCV infections decreased, the numbers for active TB did not follow a clear pattern. Needlestick injuries (NSIs) are still frequent even though their number declined for the first time in 2009 by 3.5%. NSIs were especially often reported at hospitals (29.8/1,000 versus 7.4/1,000 employees for all other HCWs). Conclusion: Although they are declining, HCV infections remain frequent in HCWs, as do NSIs. Whether the reinforcement of the recommendations for the use of safety devices in Germany will prevent NSIs and therefore HCV infections should be closely observed. http://www.occup-med.com/content/7/1/8 Albert Nienhaus Chandrasekharan Kesavachandran Dana Wendeler Frank Haamann Madeleine Dulon Journal of Occupational Medicine and Toxicology 2012, null:8 2012-05-03T00:00:00Z doi:10.1186/1745-6673-7-8 /content/figures/1745-6673-7-8-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 8 2012-05-03T00:00:00Z PDF BackgroundsPrevious studies suggested that endocrine disruptors (ED) are toxic on preimplantation embryos and inhibit development of embryos in vitro culture. However, information about the toxicity of endocrine disruptors on preimplantation development of embryo in human reproductive environment is lacking. Methods: Bisphenol A (BPA) and Aroclor 1254 (polychlorinated biphenyls) were used as endocrine disruptors in this study. Mouse 2-cell embryos were cultured in medium alone or vehicle or co-cultured with human endometrial epithelial layers in increasing ED concentrations. Results: At 72 hours the percentage of normal blastocyst were decreased by ED in a dose-dependent manner while the co-culture system significantly enhanced the rate and reduced the toxicity of endocrine disruptors on the embryonic development in vitro. Conclusions: In conclusion, although EDs have the toxic effect on embryo development, the co-culture with human endometrial cell reduced the preimplantation embryo from it thereby making human reproductive environment protective to preimplantation embryo from the toxicity of endocrine disruptors.Key words: Bisphenol A, Aroclor 1254, Mouse embryo, human endometrial cells, Endocrine disruptors. http://www.occup-med.com/content/7/1/7 Ho-Yeon Song Myeong-Seop Lee Young-Sang Lee Hae-Hyeog Lee Journal of Occupational Medicine and Toxicology 2012, null:7 2012-04-30T00:00:00Z doi:10.1186/1745-6673-7-7 /content/figures/1745-6673-7-7-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 7 2012-04-30T00:00:00Z PDF Background: Interferon-gamma release assays (IGRAs) are increasingly used in the tuberculosis (TB) screening of health care workers (HCWs). However, comparatively high rates of conversions and reversion as well as growing evidence of substantial within-subject variability of interferon-gamma responses complicate their interpretation in the serial testing of HCWs. Methods: We conducted a systematic review on the repeat use of the two commercial IGRAs, the QuantiFERON-TB Gold or In-Tube version (QFT) and the T-SPOT.TB (T-SPOT), in the serial testing and its with-subject variability among HCWs in order to provide guidance on how to interpret serial testing results in the context of the periodic screening of subjects with an increased occupational risk of latent TB infection (LTBI) in countries with low and intermediate TB incidence rates. The Medline, Embase, and Cochrane databases were searched without restrictions. Retrieved articles were complemented by additional hand searched records. Only studies that used commercial IGRAs among HCWs apart from contact and outbreak investigations and those fulfilling further predefined criteria were included. Results: Overall, 20 studies, five using the T-SPOT and 19 using the QFT assay, were included. Fifteen studies met eligibility criteria for serial testing and five studies for within-subject variability. Irrespective of TB incidence rates in the study's country of origin, reversion rates were consistently higher than conversion rates (range 22-71% vs. 1-14%). Subjects with baseline results around the diagnostic threshold were more likely to show inconsistent results on retesting. The within-subject variability of interferon-gamma responses was considerable across all studies systematically assessing it. Conclusions: On the basis of reviewed studies we advocate using a borderline zone from 0.2-0.7 IU/ml for the interpretation of repeat QFT results in the routine screening of HCWs with an increased LTBI risk. Subjects with QFT results within this borderline zone, with suspected fresh infection, and those who are considered for preventive chemotherapy should be retested with the QFT within a period of about four weeks before preventive chemotherapy is recommended. However, the available data regarding the use of the T-SPOT in the serial testing of HCWs is remarkably limited and warrants further research. http://www.occup-med.com/content/7/1/6 Felix Ringshausen Anja Schablon Albert Nienhaus Journal of Occupational Medicine and Toxicology 2012, null:6 2012-04-26T00:00:00Z doi:10.1186/1745-6673-7-6 /content/figures/1745-6673-7-6-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 6 2012-04-26T00:00:00Z PDF Background: Physical functional limitations (PFL) have mainly been studied in older populations. The aim of this study was to better understand the course of PFL and associations with occupational factors by gender in a middle-aged working population. Methods: The data came from 16,950 workers in the ESTEV (Enquete Sante Travail et Vieillissement) cohort in France. PFL were assessed using the physical abilities section of the Nottingham Health Profile. Occupational conditions were measured with a self-administered questionnaire covering physical and psychosocial factors in 1990 and 1995. Multivariate analyses were used to assess the associations. Results: The PFL appearance rate in 1995 was the same by gender (6.3%); the rate of PFL recovery was higher in men (23.9% versus 20.9%). Age was an independent factor of PFL at age 47 years or older in both genders after adjusting for confounding factors. The PFL appearance rate in 1995 was higher with physical occupational exposure in 1990, such as awkward work with a dose relation in both genders, while the PFL recovery rate decreased significantly only for men. Exposure to psychosocial occupational conditions, such as having the means to produce quality work in 1990, was significantly associated with a decreased PFL appearance rate in 1995 in both genders, and having high decision latitude in 1990 was associated with a decreased PFL appearance rate in 1995 only in men. Changes in exposure to occupational factors between 1990 and 1995 were associated with the PFL appearance and recovery rates in 1995 in both genders. Conclusions: After five years, the course of PFL in this working population changed and was associated with physical and psychosocial occupational factors. Relationships were stronger for the PFL appearance rate in both genders and were weaker for recovery from PFL, mainly among women. http://www.occup-med.com/content/7/1/5 Matthieu de Stampa Aurelien Latouche Francis Derriennic Christine Monfort Annie Touranchet Bernard Cassou Journal of Occupational Medicine and Toxicology 2012, null:5 2012-04-11T00:00:00Z doi:10.1186/1745-6673-7-5 /content/figures/1745-6673-7-5-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 5 2012-04-11T00:00:00Z PDF Marine and freshwater scientists are potentially exposed to a wide variety of occupational hazards. Depending on the focus of their research, risks may include animal attacks, physiological stresses, exposure to toxins and carcinogens, and dangerous environmental conditions. Many of these hazards have been investigated amongst the general population in their recreational use of the environment; however, very few studies have specifically related potential hazards to occupational exposure. For example, while the incidence of shark and crocodile attacks may invoke strong emotions and the occupational risk of working with these animals is certainly real, many more people are stung by jellyfish or bitten by snakes or dogs each year. Furthermore, a large proportion of SCUBA-related injuries and deaths are incurred by novice or uncertified divers, rather than professional divers using aquatic environments. Nonetheless, marine and freshwater research remains a potentially risky occupation, and the likelihood of death, injury and long-term health impacts still needs to be seriously considered. http://www.occup-med.com/content/7/1/4 Glenn Courtenay Derek Smith William Gladstone Journal of Occupational Medicine and Toxicology 2012, null:4 2012-03-19T00:00:00Z doi:10.1186/1745-6673-7-4 /content/figures/1745-6673-7-4-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 4 2012-03-19T00:00:00Z XML Background: In Egypt, many pesticides are used to control pests in agricultural farms. Our study aimed to investigate knowledge and behaviors of farmers related to pesticide use and their relation to educational level and health locus of control. Health locus of control is the degree to which individuals believe that their health is controlled by internal or external factors. Methods: A cross-sectional randomized approach was used to collect data from 335 farmers in Mahmoudiya region, Egypt using an interview questionnaire. Results were analyzed using Pearson Chi-square test, Fisher's exact test, Student t-test and ANOVA. Results: The average age of farmers was 34 years and 61% of them didn't receive school education. School education was related to higher levels of knowledge and behaviors. Farmers who received school education had more knowledge about the negative effects of pesticides on health and routes of contamination with pesticides. They also had higher scores on reading labels of pesticides containers and taking precautions after coming in contact with pesticides. Regarding health locus of control, higher internal beliefs were significantly related to higher knowledge and behaviors scores, while there was no significant relation between chance and powerful others beliefs with knowledge or behaviors. Conclusion: In the present study, higher level of education and lower level of internal beliefs were related to better knowledge and safer use of pesticides among Egyptian farmers. We recommend that strategies for raising internal beliefs must be included in health education programs that aim to ameliorate pesticides use among farmers. http://www.occup-med.com/content/7/1/3 Sherine Gaber Soha Abdel-Latif Journal of Occupational Medicine and Toxicology 2012, null:3 2012-02-25T00:00:00Z doi:10.1186/1745-6673-7-3 /content/figures/1745-6673-7-3-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 3 2012-02-25T00:00:00Z XML Background: Chlorine dioxide (CD) gas has a potent antimicrobial activity at extremely low concentration and may serve as a new tool for infection control occupationally as well as publicly. However, it remains unknown whether the chronic exposure of CD gas concentration effective against microbes is safe. Therefore, long-term, low concentration CD gas inhalation toxicity was studied in rats as a six-month continuous whole-body exposure followed by a two-week recovery period, so as to prove that the CD gas exposed up to 0.1 ppm (volume ratio) is judged as safe on the basis of a battery of toxicological examinations. Methods: CD gas at 0.05 ppm or 0.1 ppm for 24 hours/day and 7 days/week was exposed to rats for 6 months under an unrestrained condition with free access to chow and water in a chamber so as to simulate the ordinary lifestyle in human. The control animals were exposed to air only. During the study period, the body weight as well as the food and water consumptions were recorded. After the 6-month exposure and the 2-week recovery period, animals were sacrificed and a battery of toxicological examinations, including biochemistry, hematology, necropsy, organ weights and histopathology, were performed. Results: Well regulated levels of CD gas were exposed throughout the chamber over the entire study period. No CD gas-related toxicity sign was observed during the whole study period. No significant difference was observed in body weight gain, food and water consumptions, and relative organ weight. In biochemistry and hematology examinations, changes did not appear to be related to CD gas toxicity. In necropsy and histopathology, no CD gas-related toxicity was observed even in expected target respiratory organs. Conclusions: CD gas up to 0.1 ppm, exceeding the level effective against microbes, exposed to whole body in rats continuously for six months was not toxic, under a condition simulating the conventional lifestyle in human. http://www.occup-med.com/content/7/1/2 Akinori Akamatsu Cheolsung Lee Hirofumi Morino Takanori Miura Norio Ogata Takashi Shibata Journal of Occupational Medicine and Toxicology 2012, null:2 2012-02-21T00:00:00Z doi:10.1186/1745-6673-7-2 /content/figures/1745-6673-7-2-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 2 2012-02-21T00:00:00Z XML Background: A major cause of the hearing loss following exposure to intense noise involves release of free radicals resulting from the elevated metabolism. The free radicals induce damage to several of the components of the cochlear amplifier including the outer hair cells and indirectly to the transduction currents. Salicylic acid induces a reversible hearing loss since it binds to the motor protein prestin in the outer hair cells, reducing electromotility. Furosemide also induces a reversible hearing loss since it reduces the endocochlear potential which is a major component of the cochlear transduction currents. On the other hand, each of these drugs also provides protection from a noise induced hearing loss if they are injected just before a noise exposure, probably as a result of the decreased metabolism induced in their presence, with release of lower levels of free radicals. In this study, both drugs were administered in order to assess whether their protective effects would be additive. Methods: The study was conducted on normal hearing albino mice of the Sabra strain. They were injected with either salicylic acid alone (N = 11), or furosemide alone (N = 14), or both together (N = 14), or with saline control (N = 11) and exposed to broad band noise for 3.5 hours. An additional group of 9 mice was injected with both salicylic acid and furosemide, but not exposed to noise. The degree of the resulting hearing loss was assessed by recording thresholds of the auditory nerve brainstem evoked responses to broad band clicks before the injections and noise, and 7, 14 and 21 days after. Results: The noise induced hearing loss in the mice injected with salicylic acid alone or furosemide alone was smaller than in those injected with saline, i.e. these drugs provided protection, as in previous studies in this laboratory. There was no threshold elevation after two weeks in the mice injected with both drugs without noise exposure, i.e. the effects of the two drugs given together was reversible. On the other hand, there was a significant hearing loss (i.e. threshold elevation) in the group which received both drugs and was also exposed to noise, with mean threshold elevations of 38.8 ± 19.0 dB and 28.3 ± 11.7 dB 7 days after noise exposure. Conclusions: This result is very surprising, if not paradoxical. Drugs which provide protection from a noise induced hearing loss when administered alone, not only do not provide protection when given together, but also induce a greater hearing loss when accompanied by noise. This observation may be related to the finding that the depression of the endocochlear potential normally caused by furosemide is reduced in the presence of salicylic acid, so that the protection usually provided by furosemide is not present when it is administered together with salicylic acid. Thus it seems that each drug may interfere with the protective action of the other when coupled with noise. http://www.occup-med.com/content/7/1/1 Marrigje de Jong Cahtia Adelman Melissa Rubin Haim Sohmer Journal of Occupational Medicine and Toxicology 2012, null:1 2012-01-22T00:00:00Z doi:10.1186/1745-6673-7-1 /content/figures/1745-6673-7-1-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 1 2012-01-22T00:00:00Z XML Background: Exposure to continuous and impulse noise can induce a hearing loss. Leupeptin is an inhibitor of the calpains, a family of calcium-activated proteases which promote cell death. The objective of this study is to assess whether Leupeptin could reduce the hearing loss resulting from rifle impulse noise. Methods: A polyethelene tube was implanted into middle ear cavities of eight fat sand rats (16 ears). Following determination of auditory nerve brainstem evoked response (ABR) threshold in each ear, the animals were exposed to the noise of 10 M16 rifle shots. Immediately after the exposure, saline was then applied to one (control) ear and non-toxic concentrations of leupeptin determined in the first phase of the study were applied to the other ear, for four consecutive days. Results: Eight days after the exposure, the threshold shift (ABR) in the control ears was significantly greater (44 dB) than in the leupeptin ears (27 dB). Conclusion: Leupeptin applied to the middle ear cavity can reduce the hearing loss resulting from exposure to impulse noise. http://www.occup-med.com/content/6/1/38 Haim Gavriel Abraham Shulman Alfred Stracher Haim Sohmer Journal of Occupational Medicine and Toxicology 2011, null:38 2011-12-29T00:00:00Z doi:10.1186/1745-6673-6-38 /content/figures/1745-6673-6-38-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 38 2011-12-29T00:00:00Z XML Background: The study investigates whether established in-patient therapy for teachers with burnout results in long-acting success and whether gender gaps and differences between teachers of different school levels exist. According to our knowledge, our study is the most extensive inpatient intervention study on the burnout of a defined occupational group, i.e., teachers. Methods: 200 teachers participated, 150 took part in a later performed katamnestic survey.The Maslach Burnout Inventory (MBI) was used and work-related data were recorded. The days of incapacity for work and the percentage of teachers endangered by burnout decreased, which supports the long-term success of the treatment. Results: Significant differences between males and females and between teacher levels were found. However, the differences between teacher levels only showed up before treatment. Because males only underwent treatment at a more severe stage, further efforts in persuading males to start therapy earlier are needed. Conclusions: The proven and long-term success of the performed intervention could have greater effects if people, especially males, undergo treatment more frequently. Our results are based on selectively high proposition of teachers of advanced age. Thus it is possible that the long term effect of the intervention, particularly on retirement age, is greater when the intervention is started earlier. Regular burnout tests could help to identify risk cases among teachers at an early stage and to offer a therapeutic intervention. http://www.occup-med.com/content/6/1/37 Ralf Wegner Peter Berger Bernd Poschadel Ulf Manuwald Xaver Baur Journal of Occupational Medicine and Toxicology 2011, null:37 2011-12-22T00:00:00Z doi:10.1186/1745-6673-6-37 /content/figures/1745-6673-6-37-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 37 2011-12-22T00:00:00Z XML