http://www.occup-med.com The most accessed research articles published by Journal of Occupational Medicine and Toxicology 2012-05-03T00:00:00Z 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 It was claimed by the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR)) in a report to the EU-Commission that "....no risks of adverse systemic effects exist and the current use of dental amalgam does not pose a risk of systemic disease..." [1, available from: http://ec.europa.eu/health/ph_risk/committees/04_scenihr/docs/scenihr_o_016.pdf].SCENIHR disregarded the toxicology of mercury and did not include most important scientific studies in their review. But the real scientific data show that:(a) Dental amalgam is by far the main source of human total mercury body burden. This is proven by autopsy studies which found 2-12 times more mercury in body tissues of individuals with dental amalgam. Autopsy studies are the most valuable and most important studies for examining the amalgam-caused mercury body burden.(b) These autopsy studies have shown consistently that many individuals with amalgam have toxic levels of mercury in their brains or kidneys.(c) There is no correlation between mercury levels in blood or urine, and the levels in body tissues or the severity of clinical symptoms. SCENIHR only relied on levels in urine or blood.(d) The half-life of mercury in the brain can last from several years to decades, thus mercury accumulates over time of amalgam exposure in body tissues to toxic levels. However, SCENIHR state that the half-life of mercury in the body is only "20-90 days".(e) Mercury vapor is about ten times more toxic than lead on human neurons and with synergistic toxicity to other metals.(f) Most studies cited by SCENIHR which conclude that amalgam fillings are safe have severe methodical flaws. http://www.occup-med.com/content/6/1/2 Joachim Mutter Journal of Occupational Medicine and Toxicology 2011, null:2 2011-01-13T00:00:00Z doi:10.1186/1745-6673-6-2 /content/figures/1745-6673-6-2-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 2 2011-01-13T00:00:00Z XML Nanoparticles hold tremendous potential as an effective drug delivery system. In this review we discussed recent developments in nanotechnology for drug delivery. To overcome the problems of gene and drug delivery, nanotechnology has gained interest in recent years. Nanosystems with different compositions and biological properties have been extensively investigated for drug and gene delivery applications. To achieve efficient drug delivery it is important to understand the interactions of nanomaterials with the biological environment, targeting cell-surface receptors, drug release, multiple drug administration, stability of therapeutic agents and molecular mechanisms of cell signalling involved in pathobiology of the disease under consideration. Several anti-cancer drugs including paclitaxel, doxorubicin, 5-fluorouracil and dexamethasone have been successfully formulated using nanomaterials. Quantom dots, chitosan, Polylactic/glycolic acid (PLGA) and PLGA-based nanoparticles have also been used for in vitro RNAi delivery. Brain cancer is one of the most difficult malignancies to detect and treat mainly because of the difficulty in getting imaging and therapeutic agents past the blood-brain barrier and into the brain. Anti-cancer drugs such as loperamide and doxorubicin bound to nanomaterials have been shown to cross the intact blood-brain barrier and released at therapeutic concentrations in the brain. The use of nanomaterials including peptide-based nanotubes to target the vascular endothelial growth factor (VEGF) receptor and cell adhesion molecules like integrins, cadherins and selectins, is a new approach to control disease progression. http://www.occup-med.com/content/2/1/16 Sarabjeet Suri Hicham Fenniri Baljit Singh Journal of Occupational Medicine and Toxicology 2007, null:16 2007-12-01T00:00:00Z doi:10.1186/1745-6673-2-16 /content/figures/1745-6673-2-16-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 16 2007-12-01T00:00:00Z XML ObjectiveMany work in injury prone awkward positions that require adequate flexibility and strength in trunk stabilizer muscle groups. Performance on a functional movement screen (FMS) that assessed those factors was conducted and an intervention was designed. Methods: A battery of FMS tests were performed on 433 firefighters. We analyzed the correlation between FMS performance and injuries and other selected parameters. An intervention to improve flexibility and strength in trunk stabilizer or core muscle groups through a training program was evaluated. Results: The intervention reduced lost time due to injuries by 62% and the number of injuries by 42% over a twelve month period as compared to a historical control group. Conclusion: These findings suggest that core strength and functional movement enhancement programs to prevent injuries in workers whose work involves awkward positions is warranted. http://www.occup-med.com/content/2/1/3 W Peate Gerry Bates Karen Lunda Smitha Francis Kristen Bellamy Journal of Occupational Medicine and Toxicology 2007, null:3 2007-04-11T00:00:00Z doi:10.1186/1745-6673-2-3 /content/figures/1745-6673-2-3-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 3 2007-04-11T00:00:00Z XML Psychotrauma occurs as a result to a traumatic event, which may involve witnessing someone's actual death or personally experiencing serious physical injury, assault, rape and sexual abuse, being held as a hostage, or a threat to physical or psychological integrity. Post-traumatic stress disorder (PTSD) is an anxiety disorder and was defined in the past as railway spine, traumatic war neurosis, stress syndrome, shell shock, battle fatigue, combat fatigue, or post-traumatic stress syndrome (PTSS). If untreated, post-traumatic stress disorder can impair relationships of those affected and strain their families and society. Deployed soldiers are especially at a high risk to be affected by PTSD but often receive inadequate treatment. Reviews to date have focused only on a single type of treatment or groups of soldiers from only one country. The aim of the current review was to evaluate characteristics of therapeutic methods used internationally to treat male soldiers' PTSD after peacekeeping operations in South Eastern Europe and the Gulf wars.This systematic literature review returned results pertaining to the symptoms, diagnosis, timing and effectiveness of treatment. Sample groups and controls were relatively small and, therefore, the results lack generalizability. Further research is needed to understand the influence and unique psychological requirements of each specific military operation on the internationally deployed soldiers. http://www.occup-med.com/content/4/1/21 Karin Vitzthum Stefanie Mache Ricarda Joachim David Quarcoo David Groneberg Journal of Occupational Medicine and Toxicology 2009, null:21 2009-07-30T00:00:00Z doi:10.1186/1745-6673-4-21 /content/figures/1745-6673-4-21-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 21 2009-07-30T00:00:00Z XML Ethanol is widely used in all kinds of products with direct exposure to the human skin (e.g. medicinal products like hand disinfectants in occupational settings, cosmetics like hairsprays or mouthwashes, pharmaceutical preparations, and many household products). Contradictory evidence about the safety of such topical applications of the alcohol can be found in the scientific literature, yet an up-to-date risk assessment of ethanol application on the skin and inside the oral cavity is currently lacking.The first and foremost concerns of topical ethanol applications for public health are its carcinogenic effects, as there is unambiguous evidence for the carcinogenicity of ethanol orally consumed in the form of alcoholic beverages. So far there is a lack of evidence to associate topical ethanol use with an increased risk of skin cancer. Limited and conflicting epidemiological evidence is available on the link between the use of ethanol in the oral cavity in the form of mouthwashes or mouthrinses and oral cancer. Some studies pointed to an increased risk of oral cancer due to locally produced acetaldehyde, operating via a similar mechanism to that found after alcoholic beverage ingestion.In addition, topically applied ethanol acts as a skin penetration enhancer and may facilitate the transdermal absorption of xenobiotics (e.g. carcinogenic contaminants in cosmetic formulations). Ethanol use is associated with skin irritation or contact dermatitis, especially in humans with an aldehyde dehydrogenase (ALDH) deficiency.After regular application of ethanol on the skin (e.g. in the form of hand disinfectants) relatively low but measurable blood concentrations of ethanol and its metabolite acetaldehyde may occur, which are, however, below acute toxic levels. Only in children, especially through lacerated skin, can percutaneous toxicity occur.As there might be industry bias in many studies about the safety of topical ethanol applications, as well as a general lack of scientific research on the long-term effects, there is a requirement for independent studies on this topic. The research focus should be set on the chronic toxic effects of ethanol and acetaldehyde at the point of impact, with special regard to children and individuals with genetic deficiencies in ethanol metabolism. http://www.occup-med.com/content/3/1/26 Dirk Lachenmeier Journal of Occupational Medicine and Toxicology 2008, null:26 2008-11-13T00:00:00Z doi:10.1186/1745-6673-3-26 /content/figures/1745-6673-3-26-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 26 2008-11-13T00:00:00Z XML Cadmium (Cd) has been in industrial use for a long period of time. Its serious toxicity moved into scientific focus during the middle of the last century. In this review, we discuss historic and recent developments of toxicological and epidemiological questions, including exposition sources, resorption pathways and organ damage processes. http://www.occup-med.com/content/1/1/22 Johannes Godt Christian Grosse-Siestrup Franziska Scheidig Vera Esche Paul Brandenburg Andrea Reich David Groneberg Journal of Occupational Medicine and Toxicology 2006, null:22 2006-09-10T00:00:00Z doi:10.1186/1745-6673-1-22 /content/figures/1745-6673-1-22-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 22 2006-09-10T00:00:00Z XML Nanotechnology presents the possibility of revolutionizing many aspects of our lives. People in many settings (academic, small and large industrial, and the general public in industrialized nations) are either developing or using engineered nanomaterials (ENMs) or ENM-containing products. However, our understanding of the occupational, health and safety aspects of ENMs is still in its formative stage. A survey of the literature indicates the available information is incomplete, many of the early findings have not been independently verified, and some may have been over-interpreted. This review describes ENMs briefly, their application, the ENM workforce, the major routes of human exposure, some examples of uptake and adverse effects, what little has been reported on occupational exposure assessment, and approaches to minimize exposure and health hazards. These latter approaches include engineering controls such as fume hoods and personal protective equipment. Results showing the effectiveness - or lack thereof - of some of these controls are also included. This review is presented in the context of the Risk Assessment/Risk Management framework, as a paradigm to systematically work through issues regarding human health hazards of ENMs. Examples are discussed of current knowledge of nanoscale materials for each component of the Risk Assessment/Risk Management framework. Given the notable lack of information, current recommendations to minimize exposure and hazards are largely based on common sense, knowledge by analogy to ultrafine material toxicity, and general health and safety recommendations. This review may serve as an overview for health and safety personnel, management, and ENM workers to establish and maintain a safe work environment. Small start-up companies and research institutions with limited personnel or expertise in nanotechnology health and safety issues may find this review particularly useful. http://www.occup-med.com/content/6/1/7 Robert Yokel Robert MacPhail Journal of Occupational Medicine and Toxicology 2011, null:7 2011-03-21T00:00:00Z doi:10.1186/1745-6673-6-7 /content/figures/1745-6673-6-7-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 7 2011-03-21T00:00:00Z XML 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 Background: The ability of drugs to reduce noise induced hearing loss (NIHL) has been evaluated in diverse experimental conditions (animal species, noise intensities, durations, assessment techniques, etc), making it difficult to assess their relative efficacy. The present study was designed to provide more uniform comparisons and to allow to a better understanding of the mechanism of the NIHL. Methods: The drugs studied included furosemide (loop diuretic) and the antioxidants N Acetyl-L-Cysteine, vitamins A, C, E with the vasodilator magnesium. Mice were exposed to a continuous broadband noise (113 dB SPL for 3.5 hours) and the NIHL was assessed in all animals before noise exposure and 1 week after with auditory nerve brainstem evoked responses (ABR) to broadband clicks and to 8 kHz tone bursts. Results: Each of the drugs alone and in combination led to similar reductions in NIHL. Conclusions: The loop diuretic furosemide, by reducing the magnitude of the endocochlear potential in scala media, probably depressed active vibrations of the outer hair cells and basilar membrane, resulting in reduction of free radical formation during the noise exposure. The antioxidants N Acetyl-L-Cysteine and vitamins A, C, E with the vasodilator magnesium presumably counteract the free radicals. Thus, the administration of the antioxidants to animals in which free radical formation had already been reduced by previous injection of furosemide did not have an additional protective effect on the NIHL. http://www.occup-med.com/content/5/1/26 Sharon Tamir Cahtia Adelman Jeffrey Weinberger Haim Sohmer Journal of Occupational Medicine and Toxicology 2010, null:26 2010-09-01T00:00:00Z doi:10.1186/1745-6673-5-26 /content/figures/1745-6673-5-26-toc.gif Journal of Occupational Medicine and Toxicology 1745-6673 ${item.volume} 26 2010-09-01T00:00:00Z XML