Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and prog...Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.展开更多
Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus ...Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus constituting a respiratory threat.Adverse health consequences include respiratory diseases,skin irritation,allergic reactions,and potential long-term health impacts.Data indicates that a broad segment of bakery workers encounters exposure to flour dust,with specific subgroups,such as bakers and dough mixers,being particularly susceptible.Contributing factors to this exposure encompass insufficient ventilation and a lack of awareness.It is vital to assess exposure levels through air quality monitoring and health surveillance.Efficient interventions encompass engineering solutions(e.g.,ventilation systems,dust extraction),administrative measures(including training and the use of personal protective equipment),and the implementation of occupational health and safety programs.Collaborative efforts with healthcare professionals and regulatory authorities are paramount for achieving success.Case studies underscore the effectiveness of such interventions,resulting in improved worker health,thus underscoring the advantages of protective measures.Challenges in this endeavor include industry resistance to change,financial considerations,and issues related to compliance.Future recommendations entail further research,policy enhancements,and the involvement of industry stakeholders and labor unions in advocating for worker safety.展开更多
BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a ...BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.展开更多
<strong>Context:</strong> Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. <strong>Aim:</strong> Th...<strong>Context:</strong> Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. <strong>Aim:</strong> The objective of this study was to understand the perception of the health care workers regarding their occupational exposure to COVID-19, including the safety measures used during field surveillance activities. <strong>Settings and Design:</strong> This cross-sectional study was conducted from June 2020 to July 2020 among the health care workers involved in COVID-19 field containment activities in two south Indian states—Telangana and Tamil Nadu. <strong>Methods and Material:</strong> Respondents were purposively sampled based on their involvement in the COVID-19 field level activities. Sixteen In-Depth Interviewees (IDIs) were conducted telephonically with medical officers, district epidemiologists, community health workers, sanitary workers, emergency medical technicians, and ambulance coordinators.<strong> Statistical Analysis</strong> <strong>Used:</strong> IDIs were analyzed using manual thematic analysis. <strong>Results:</strong> Seven themes and sub-themes emerged: awareness and training, occupational exposure to COVID-19 and duration, safety measures, occupational burnout, social stigma, psychological violence, and facilitating factors. Respondents felt a high level of occupational exposure to COVID-19 in addition to increased workload and stress due to fear of infection, shortage of workforce, denial of week off, psychological violence, and social stigma which affected them deeply. Support from supervisors and family, and measures ensuring the safety of women were facilitating factors to cope with the situation. <strong>Conclusions:</strong> It is important to safeguard the general and mental health of field-level health workers involved in COVID-19 activities, to keep their morale high during the continuing pandemic.展开更多
A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has s...A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.展开更多
Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer estab...Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer established the association of VCM with hepatocellular carcinoma(HCC),though only on the basis of the few cases available.Thereafter,recent reports from the United States cohort and a European sub-cohort of vinyl chloride workers provided compelling evidence of a strong association between cumulative VCM exposure and HCC risk.Further areas of research include the risk of liver cancer at lower levels of exposure and different patterns of risk of ASL and HCC with the time since exposure.The evidence of interaction between VCM exposure and other known liver carcinogens such as alcohol and chronic viral infection provides clues for the health surveillance of exposed workers.Notably,also the risk of VCM-associated chronic liver disease is modulated by alcohol consumption,viral infection,and genetic polymorphism.A counter-intuitive finding from cohort studies of exposed workers is the lower mortality from liver cirrhosis with respect to the general population;this can be attributed to the healthy worker effect and to the selection of liver cancer as the cause of death in the presence of concomitant chronic liver disease.Studies designed to overcome these intricacies confirmed an association between cumulative VCM exposure and the risk of liver cirrhosis.展开更多
To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?...To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?o do Jacuipe, Feira de Santana and Salvador in the state of Bahia, Brazil were investigated by experts who correlated protection measures required by law and those applied to the workers. Data collection was performed by help of a questionnaire and non-participant observation record. The age groups of the workers in the three cities surveyed were between 18 to 25 years (30.08%) and 26 to 33 years (34.51%) of the total. The study revealed an association between occupational habits of workers at gas stations and the prevalence of symptoms due to the exposure to the BTEX compounds. Regarding the use of Personal Protective Equipment (PPE) most workers wear boots. The data show that these workers reported symptoms such as headache, rhinitis, leg pain, drowsiness, cough, fatigue, insomnia, tremors and palpitations. These disorders are related back to previous exposure to BTEX compounds which is associated with inadequate occupational habits of the workers which potentiate chemical contamination in their respective environment.展开更多
While precautionary efforts are being made to minimize human health problems associated with agricultural pesticides, the continued occurrence of occupational poisoning from these chemicals raises major concerns among...While precautionary efforts are being made to minimize human health problems associated with agricultural pesticides, the continued occurrence of occupational poisoning from these chemicals raises major concerns among stake- holders. Information gap on human health problems associated with pesticides poses major obstacles to making informed policy decisions, particularly in developing countries where most of the poisonings occurs. In this study, we identified acute human health symptoms associated with pesticide use in cotton zone of C?te d’Ivoire and, documented the response of rural households to the symptoms. The results show that cotton farmers in Cote d’Ivoire suffer from different occupational health hazards from exposure to agricultural pesticides. Key health symptoms reported by pesticide applicators are headache, rheum, cough, skin rash and sneezing. Pesticide applicators reported four times higher symptoms of ill health than other household members who do not normally handle pesticides. Although, households recognized pesticides as an important cause of ill health, some of the symptoms have been accepted as norm by individuals who apply pesticides. Official data on pesticide poisoning in the country is most likely to be seriously under-estimated as applicators visited formal health centers for medical assistance in only 2% of poisoning cases reported. There is a high likelihood that households in the study area under-estimated pesticide-related health costs in making farm production decision-making. Approaches to use economic instruments for reliable monitoring and reporting procedures to formulate appropriate policies and regulations to minimize exposure to pesticides are recommended. Health planners and policy makers should aim at reducing the risks posed by pesticide to farm households by, improving awareness of farmers;promote complementary approach (e.g. Integrated Pest Management) and, use of economic instruments and improved surveillance to bridge the gap in the documentation of pesticide poisoning cases among farmers.展开更多
Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,afla...Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.展开更多
Background: In recent decades, the incidence of children’s hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic...Background: In recent decades, the incidence of children’s hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and methods: Our study was a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012, and which included children with acute leukemia compared to children unharmed by neoplastic disease. Cases and controls were matched by age and gender. Our objective was to describe the socio-occupational characteristics of the parents of children with acute leukemia and to identify potential occupational factors implicated in the genesis of acute leukemia. Results: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0.009, OR = 3.9;CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5, ICa = [1.09 - 11.6]. 25.7% of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006, OR = 1.46, IC = [1.38 - 1.56]). The parental occupational exposures associated to the occurrence of acute leukemia in children were pesticides with a statistically significant difference (p = 0.03, OR = 2.94, IC = [1.06 - 8.13]). This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75;ICa = [1.27 - 11.03]. This difference had become significant after adjustment with the different variables pa = 0.03, ORa = 2.67, ICa = [1.06 - 6.7]. Conclusion: Our results showed some support for a positive association between childhood acute leukemia risk and parental occupational exposure to pesticides and cement. Additionally, acute leukemia risk among children might be increased with parental alcohol consumption.展开更多
Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of ...Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of a hospital accreditation system has put a particular emphasis on staff safety, and on the evaluation of professional practice (EPP) programs. Methods: A cross-sectional survey was conducted amongst 277 HCWs working in 4 general hospitals in South Lebanon. Objective: 1) describe the prevalence and the risk factors for occupational exposure to BBF among HCWs;2) evaluate knowledge, attitude, and practices of HCW concerning blood-borne pathogens and adherence to universal safety precautions. Results: The mean age of the respondents was 32.14 years (SD = 10.33), 57.4% were females. 43.3% of HCWs expressed that they use gloves all the time for every activeity of care. 67.1% were aware that needles should not be recapped after use;registered nurses and nursing students were more aware than physicians and nursing assistants (nurse) in this subject. 30% of HCWs declared having had at least one occupational exposure to BBF;62.7% of all accidental exposure was reported to the department responsible for managing exposures. Percutaneous injuries were the most frequently reported. Vaccination coverage was 88.4% for hepatitis B, and 48.4% against influenza. The source patient was tested in 43.4% of reported BBF exposures. Accidental exposure to BBF was more frequent in older people (OR = 3.42;p = 0.03) and the more experienced. Subjects working in intensive care unit ward reported more exposure to BBF (OR = 3;p = 0.04). Participants incurring exposure to BBF resorted to different measures after the injury suggesting a lack of a uniform policy for post-exposure prophylaxis. Conclusion: Exposure to BBF represents an important and frequently preventable occupational hazard for HCWs in Lebanon that requires continuous EPP of HCWs, and a comprehensive approach for prevention and management.展开更多
The liver is the main organ responsible for the metabolism of drugs and toxic chemicals, and so is the primary target organ for many organic solvents. Work activities with hepatotoxins exposures are numerous and, more...The liver is the main organ responsible for the metabolism of drugs and toxic chemicals, and so is the primary target organ for many organic solvents. Work activities with hepatotoxins exposures are numerous and, moreover, organic solvents are used in various industrial processes. Organic solvents used in different industrial processes may be associated with hepatotoxicity. Several factors contribute to liver toxicity; among these are: species differences, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. This review addresses the mechanisms of hepatotoxicity. The main pathogenic mechanisms responsible for functional and organic damage caused by solvents are: inflammation, dysfunction of cytochrome P450, mitochondrial dysfunction and oxidative stress. The health impact of exposure to solvents in the workplace remains an interesting and worrying question for professional health work.展开更多
Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates ca...Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates call for an explanation. Several environmental and occupational factors have been implicated in the pathogenesis of this disease. Objective: To determine the potential occupational factors correlated in the occurrence of MF. Methods: Case-control study was carried out at the teaching Hospital Farhat Hached of Sousse (Tunisia) to investigate associations of MF and occupational risk factors. A questionnaire on lifetime job history was administered to 24 cases and controls. Cases were patients with MF and whose diagnosis was suspected by a dermatologist and confirmed by pathological examination. Controls were patients consulting in the occupational medicine department and matched to cases by age and gender. Bivariate analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The average age of onset of the disease was 55.41 ± 17.4 years with a sex ratio of 2.42. We found an increased risk of MF associated with tobacco consumption higher than 40 Pack-year (OR = 6.6;95% CI = 1.22 to 35.4), exercise in the textile sector (OR = 9.4;CI = 1.06 to 84.3) and exposure to diesel exhaust (OR = 9.47;95% CI = 1.06 to 84.3). Conclusion: Occupational factors could play a role in the pathogenesis of MF. Regarding our study, smoking, working in the textile industry and exposure to diesel exhaust appear to be involved in the pathogenesis of MF. Further investigation is needed to confirm these findings.展开更多
The study was designed to investigatecytogenotoxic effects of occupationalexposure to N,N’-methylene-bis-(2-amino-1,3,4-thiadiazole) (MATDA) for 11 workers(2 male,9 female) exposed to MATDA for 4-8 years,with the ave...The study was designed to investigatecytogenotoxic effects of occupationalexposure to N,N’-methylene-bis-(2-amino-1,3,4-thiadiazole) (MATDA) for 11 workers(2 male,9 female) exposed to MATDA for 4-8 years,with the average level of 0.展开更多
The prevalence of surface contaminants,such as potentially harmful bacteria,within building environments in the State of Kuwait is not known.To the authors’knowledge,this article is the first of such a report.A total...The prevalence of surface contaminants,such as potentially harmful bacteria,within building environments in the State of Kuwait is not known.To the authors’knowledge,this article is the first of such a report.A total of 342 stool samples were collected from 46 secondary schools to evaluate indoor occurrences of E.coli bacteria within selected lavatory surfaces.After microbiological testing,the results for the spread of the E.coli bacteria were categorized by total count,sampling location dependency,contamination level comparison between genders,and lavatory fixtures(i.e.seat and squat toilets).The results revealed that 7 schools have a bacterial contamination problem,there is cross-contamination between surfaces in the lavatory stalls,the boys’lavatories were less sanitary than the girls’,and that the squat-style toilets are more contaminated than the seat-style.The results suggest that there is significant risk of spread of bacterial infection among students via contaminated hands and surfaces in the lavatory area in some schools.Thus,this study emphasizes the need to improve environmental hygiene and enhanced sanitation in these schools.In addition,conclusions can be drawn as to the effectiveness of the janitorial staff employed by the schools and the efficacy of the cleaning regime used in the lavatories.Furthermore,based on the findings,there are architectural design consequences as squat-style toilets might be excluded in lavatories designed for schools to be constructed in the future.展开更多
ObjectiveTo evaluate whole-body,extremity and eye-lens occupational dose equivalents of ionizing radiation to Occupationally Exposed Workers(OEWs)in Gabon,monitored by the national Individual Monitoring Service(IMS),i...ObjectiveTo evaluate whole-body,extremity and eye-lens occupational dose equivalents of ionizing radiation to Occupationally Exposed Workers(OEWs)in Gabon,monitored by the national Individual Monitoring Service(IMS),in the medical practice.MethodsA total of 816 dose records for 205 OEWs were evaluated.Doses were collected for an eight-year period,from 2013 to 2020.Twelve public and private hospitals were involved,including a cancer centre where radiotherapy(RT)and nuclear medicine(NM)procedures are regularly performed.OEWs were monitored,on a monthly or quarterly basis,for whole-body dose and extremity dose using an optically stimulated luminescence(OSL)dosimeter worn on the torso or the wrist,as appropriate.Eye-lens dose was estimated from whole-body dose results.ResultsThe whole-body dose distribution was skewed and the zero dose was associated with a probability of 47%.Some recorded doses were associated with estimated X-ray energies above those typically encountered in diagnostic radiology,thus suggesting that some doses attributed to workers and believed to be due to X-rays may in fact be due to background radiation(false positive dose records).For the period 2013–2020,annual doses to OEWs in diagnostic radiology(DR),NM and RT departments were 0.40 mSv,0.38 mSv and 0.09 mSv,respectively.For the same period,the mean annual extremity and eye-lens doses were 0.78 mSv(range:0–5.24mSv)and 0.35 mSv(range:0–3.74mSv),respectively.ConclusionWith little effort by the national IMS and the regulatory body,annual whole-body doses to workers can be kept well below 6mSv,thus efficiently contributing to the optimization of worker's protection.However,extremity doses may in fact be greater than those reported for OEWs in the NM department.Finally,eye-lens doses were well below the new annual dose limit of 20 mSv,thus demonstrating that,in the current situation,OEWs in the NM department do not require routine eye lens dose monitoring.Rather,whole-body dose may be used as an indicator of eye-lens dose.展开更多
Objective To establish occupational exposure limits for glyphosate in workplace air.Methods In November 2014,by searching the documents of the United States Environmental Protection Agency(EPA)on glyphosate toxicity,t...Objective To establish occupational exposure limits for glyphosate in workplace air.Methods In November 2014,by searching the documents of the United States Environmental Protection Agency(EPA)on glyphosate toxicity,the toxicity data and clinical symptoms of glyphosate toxicity were collected through various literature databases。展开更多
BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clini...BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.展开更多
Objective To analyze the level of PCDD/Fs exposure of occupational workers in the waste incineration industry and explore the risk of occupational exposure.Methods In September 2021,literature on environmental PCDD/Fs...Objective To analyze the level of PCDD/Fs exposure of occupational workers in the waste incineration industry and explore the risk of occupational exposure.Methods In September 2021,literature on environmental PCDD/Fs exposure in waste incineration plants published from the establishment of the database to February 10,2021 was retrieved from CNKI database.展开更多
基金funded by the National Institute for Occupational Safety and Health (NIOSH) (75D30119C06390).
文摘Cumulative inhalation of respirable coal mine dust(RCMD)can lead to severe lung diseases,including coal worker's pneu-moconiosis(CWP),silicosis,mixed dust pneumoconiosis,dust-related diffuse fibrosis(DDF),and progressive massive fibrosis(PMF).Statistics from the number of reported cases showed a significant decrease in the progression of respiratory diseases in the 1990s.However,an unexpected increase in the number of CWP cases was reported in the late 1990s.To date,there has been no comprehensive systematic review to assess all contributing factors to the resurgence of CWP cases.This study aims to investigate the effects of various mining parameters on the prevalence of CWP in coal mines.A systematic review using the preferred reporting items for systematic reviews and meta-analysis(PRISMA)method was conducted to investigate the health effects of RCMD exposure and identify the factors that may contribute to the recent resurgence of CWP cases.The systematic review yielded a total of 401 papers,which were added to the database.The total number of 148 and 208 papers were excluded from the database in the process of screening and eligibility,respectively.Then,18 papers were considered for data selection and full-text assessment.The review revealed that factors including geographic location,mine size,mining operation type,coal-seam thickness,coal rank,changes in mining practices,technology advancement,and engi-neering dust control practices are contributing to the recent resurgence of CWP among coal workers.However,the evidence for root causes is limited owing to the methodological constraints of the studies;therefore,further detailed studies are needed.
文摘Occupational exposure to flour dust within bakery environments presents significant health hazards to bakery personnel.Flour dust,generated as a byproduct during baking,becomes airborne during the baking process,thus constituting a respiratory threat.Adverse health consequences include respiratory diseases,skin irritation,allergic reactions,and potential long-term health impacts.Data indicates that a broad segment of bakery workers encounters exposure to flour dust,with specific subgroups,such as bakers and dough mixers,being particularly susceptible.Contributing factors to this exposure encompass insufficient ventilation and a lack of awareness.It is vital to assess exposure levels through air quality monitoring and health surveillance.Efficient interventions encompass engineering solutions(e.g.,ventilation systems,dust extraction),administrative measures(including training and the use of personal protective equipment),and the implementation of occupational health and safety programs.Collaborative efforts with healthcare professionals and regulatory authorities are paramount for achieving success.Case studies underscore the effectiveness of such interventions,resulting in improved worker health,thus underscoring the advantages of protective measures.Challenges in this endeavor include industry resistance to change,financial considerations,and issues related to compliance.Future recommendations entail further research,policy enhancements,and the involvement of industry stakeholders and labor unions in advocating for worker safety.
文摘BACKGROUND Although minimal change disease(MCD)and focal segmental glomerulosclerosis(FSGS)have been described as two separate forms of nephrotic syndrome(NS),they are not completely independent.We report a case of a patient transitioning from MCD to FSGS,review the literature,and explore the relationship between the two diseases.CASE SUMMARY A 42-year-old male welder,presenting with lower extremity edema and elevated serum creatinine,was diagnosed with NS and end-stage kidney disease(ESKD)based on laboratory test results.The patient had undergone a kidney biopsy for NS 20 years previously,which indicated MCD,and a second recent kidney biopsy suggested FSGS.The patient was an electric welder with excessive levels of cadmium and lead in his blood.Consequently,we suspect that his aggravated pathology and occurrence of ESKD were related to metal nephrotoxicity.The patient eventually received kidney replacement therapy and quit his job which involved long-term exposure to metals.During the 1-year follow-up period,the patient was negative for metal elements in the blood and urine and recovered partial kidney function.CONCLUSION MCD and FSGS may be different stages of the same disease.The transition from MCD to FSGS in this case indicates disease progression,which may be related to excessive metal contaminants caused by the patient’s occupation.
文摘<strong>Context:</strong> Health Care Workers (HCWs) involved in field-level activities are exposed to COVID-19 which puts them under physical and psychological stress. <strong>Aim:</strong> The objective of this study was to understand the perception of the health care workers regarding their occupational exposure to COVID-19, including the safety measures used during field surveillance activities. <strong>Settings and Design:</strong> This cross-sectional study was conducted from June 2020 to July 2020 among the health care workers involved in COVID-19 field containment activities in two south Indian states—Telangana and Tamil Nadu. <strong>Methods and Material:</strong> Respondents were purposively sampled based on their involvement in the COVID-19 field level activities. Sixteen In-Depth Interviewees (IDIs) were conducted telephonically with medical officers, district epidemiologists, community health workers, sanitary workers, emergency medical technicians, and ambulance coordinators.<strong> Statistical Analysis</strong> <strong>Used:</strong> IDIs were analyzed using manual thematic analysis. <strong>Results:</strong> Seven themes and sub-themes emerged: awareness and training, occupational exposure to COVID-19 and duration, safety measures, occupational burnout, social stigma, psychological violence, and facilitating factors. Respondents felt a high level of occupational exposure to COVID-19 in addition to increased workload and stress due to fear of infection, shortage of workforce, denial of week off, psychological violence, and social stigma which affected them deeply. Support from supervisors and family, and measures ensuring the safety of women were facilitating factors to cope with the situation. <strong>Conclusions:</strong> It is important to safeguard the general and mental health of field-level health workers involved in COVID-19 activities, to keep their morale high during the continuing pandemic.
文摘A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer.In more recent times,however,a growing evidence has shown that other determinants can be very important in increasing(or reducing) incidence of this malignancy.The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground,and high risks of colorectal cancer have been reported among workers in some industrial branches.The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities,by means of a scientific literature review and meta-analysis.This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds,such as leather(RR = 1.70,95%CI:1.24-2.34),basic metals(RR = 1.32,95%CI:1.07-1.65),plastic and rubber manufacturing(RR = 1.30,95%CI:0.98-1.71 and RR = 1.27,95%CI:0.92-1.76,respectively),besides workers in the sector of repair and installation of machinery exposed to asbestos(RR = 1.40,95%CI:1.07-1.84).Based on our results,the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%.However,homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.
文摘Portal hypertension,liver fibrosis,and angiosarcoma of the liver(ASL)have been reported among workers exposed to vinyl chloride monomer(VCM)since the 1970s.In 2007,the International Agency for Research on Cancer established the association of VCM with hepatocellular carcinoma(HCC),though only on the basis of the few cases available.Thereafter,recent reports from the United States cohort and a European sub-cohort of vinyl chloride workers provided compelling evidence of a strong association between cumulative VCM exposure and HCC risk.Further areas of research include the risk of liver cancer at lower levels of exposure and different patterns of risk of ASL and HCC with the time since exposure.The evidence of interaction between VCM exposure and other known liver carcinogens such as alcohol and chronic viral infection provides clues for the health surveillance of exposed workers.Notably,also the risk of VCM-associated chronic liver disease is modulated by alcohol consumption,viral infection,and genetic polymorphism.A counter-intuitive finding from cohort studies of exposed workers is the lower mortality from liver cirrhosis with respect to the general population;this can be attributed to the healthy worker effect and to the selection of liver cancer as the cause of death in the presence of concomitant chronic liver disease.Studies designed to overcome these intricacies confirmed an association between cumulative VCM exposure and the risk of liver cirrhosis.
文摘To show the risks and harm caused by the occupational exposure to the benzene, toluene, ethylbenzene and xylenes compounds (BTEX), the working conditions of 113 persons employed at gas stations in the cities of Riach?o do Jacuipe, Feira de Santana and Salvador in the state of Bahia, Brazil were investigated by experts who correlated protection measures required by law and those applied to the workers. Data collection was performed by help of a questionnaire and non-participant observation record. The age groups of the workers in the three cities surveyed were between 18 to 25 years (30.08%) and 26 to 33 years (34.51%) of the total. The study revealed an association between occupational habits of workers at gas stations and the prevalence of symptoms due to the exposure to the BTEX compounds. Regarding the use of Personal Protective Equipment (PPE) most workers wear boots. The data show that these workers reported symptoms such as headache, rhinitis, leg pain, drowsiness, cough, fatigue, insomnia, tremors and palpitations. These disorders are related back to previous exposure to BTEX compounds which is associated with inadequate occupational habits of the workers which potentiate chemical contamination in their respective environment.
文摘While precautionary efforts are being made to minimize human health problems associated with agricultural pesticides, the continued occurrence of occupational poisoning from these chemicals raises major concerns among stake- holders. Information gap on human health problems associated with pesticides poses major obstacles to making informed policy decisions, particularly in developing countries where most of the poisonings occurs. In this study, we identified acute human health symptoms associated with pesticide use in cotton zone of C?te d’Ivoire and, documented the response of rural households to the symptoms. The results show that cotton farmers in Cote d’Ivoire suffer from different occupational health hazards from exposure to agricultural pesticides. Key health symptoms reported by pesticide applicators are headache, rheum, cough, skin rash and sneezing. Pesticide applicators reported four times higher symptoms of ill health than other household members who do not normally handle pesticides. Although, households recognized pesticides as an important cause of ill health, some of the symptoms have been accepted as norm by individuals who apply pesticides. Official data on pesticide poisoning in the country is most likely to be seriously under-estimated as applicators visited formal health centers for medical assistance in only 2% of poisoning cases reported. There is a high likelihood that households in the study area under-estimated pesticide-related health costs in making farm production decision-making. Approaches to use economic instruments for reliable monitoring and reporting procedures to formulate appropriate policies and regulations to minimize exposure to pesticides are recommended. Health planners and policy makers should aim at reducing the risks posed by pesticide to farm households by, improving awareness of farmers;promote complementary approach (e.g. Integrated Pest Management) and, use of economic instruments and improved surveillance to bridge the gap in the documentation of pesticide poisoning cases among farmers.
文摘Hepatocellular carcinoma(HCC)is the most common type of liver cancer.The main risk factors for HCC are alcoholism,hepatitis B virus,hepatitis C virus,nonalcoholic steatohepatitis,obesity,type 2 diabetes,cirrhosis,aflatoxin,hemochromatosis,Wilson’s disease and hemophilia.Occupational exposure to chemicals is another risk factor for HCC.Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent.This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem.
文摘Background: In recent decades, the incidence of children’s hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and methods: Our study was a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012, and which included children with acute leukemia compared to children unharmed by neoplastic disease. Cases and controls were matched by age and gender. Our objective was to describe the socio-occupational characteristics of the parents of children with acute leukemia and to identify potential occupational factors implicated in the genesis of acute leukemia. Results: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0.009, OR = 3.9;CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5, ICa = [1.09 - 11.6]. 25.7% of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006, OR = 1.46, IC = [1.38 - 1.56]). The parental occupational exposures associated to the occurrence of acute leukemia in children were pesticides with a statistically significant difference (p = 0.03, OR = 2.94, IC = [1.06 - 8.13]). This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75;ICa = [1.27 - 11.03]. This difference had become significant after adjustment with the different variables pa = 0.03, ORa = 2.67, ICa = [1.06 - 6.7]. Conclusion: Our results showed some support for a positive association between childhood acute leukemia risk and parental occupational exposure to pesticides and cement. Additionally, acute leukemia risk among children might be increased with parental alcohol consumption.
文摘Healthcare workers (HCWs) who are employed in traditional health care workplaces face a serious danger that may threaten their life;it is their exposure to blood and body fluids (BBF). In Lebanon, the introduction of a hospital accreditation system has put a particular emphasis on staff safety, and on the evaluation of professional practice (EPP) programs. Methods: A cross-sectional survey was conducted amongst 277 HCWs working in 4 general hospitals in South Lebanon. Objective: 1) describe the prevalence and the risk factors for occupational exposure to BBF among HCWs;2) evaluate knowledge, attitude, and practices of HCW concerning blood-borne pathogens and adherence to universal safety precautions. Results: The mean age of the respondents was 32.14 years (SD = 10.33), 57.4% were females. 43.3% of HCWs expressed that they use gloves all the time for every activeity of care. 67.1% were aware that needles should not be recapped after use;registered nurses and nursing students were more aware than physicians and nursing assistants (nurse) in this subject. 30% of HCWs declared having had at least one occupational exposure to BBF;62.7% of all accidental exposure was reported to the department responsible for managing exposures. Percutaneous injuries were the most frequently reported. Vaccination coverage was 88.4% for hepatitis B, and 48.4% against influenza. The source patient was tested in 43.4% of reported BBF exposures. Accidental exposure to BBF was more frequent in older people (OR = 3.42;p = 0.03) and the more experienced. Subjects working in intensive care unit ward reported more exposure to BBF (OR = 3;p = 0.04). Participants incurring exposure to BBF resorted to different measures after the injury suggesting a lack of a uniform policy for post-exposure prophylaxis. Conclusion: Exposure to BBF represents an important and frequently preventable occupational hazard for HCWs in Lebanon that requires continuous EPP of HCWs, and a comprehensive approach for prevention and management.
文摘The liver is the main organ responsible for the metabolism of drugs and toxic chemicals, and so is the primary target organ for many organic solvents. Work activities with hepatotoxins exposures are numerous and, moreover, organic solvents are used in various industrial processes. Organic solvents used in different industrial processes may be associated with hepatotoxicity. Several factors contribute to liver toxicity; among these are: species differences, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. This review addresses the mechanisms of hepatotoxicity. The main pathogenic mechanisms responsible for functional and organic damage caused by solvents are: inflammation, dysfunction of cytochrome P450, mitochondrial dysfunction and oxidative stress. The health impact of exposure to solvents in the workplace remains an interesting and worrying question for professional health work.
文摘Introduction: The mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas representing about 50% of all cutaneous lymphomas. Its pathogenesis remains poorly understood. Thus, its rising incidence rates call for an explanation. Several environmental and occupational factors have been implicated in the pathogenesis of this disease. Objective: To determine the potential occupational factors correlated in the occurrence of MF. Methods: Case-control study was carried out at the teaching Hospital Farhat Hached of Sousse (Tunisia) to investigate associations of MF and occupational risk factors. A questionnaire on lifetime job history was administered to 24 cases and controls. Cases were patients with MF and whose diagnosis was suspected by a dermatologist and confirmed by pathological examination. Controls were patients consulting in the occupational medicine department and matched to cases by age and gender. Bivariate analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The average age of onset of the disease was 55.41 ± 17.4 years with a sex ratio of 2.42. We found an increased risk of MF associated with tobacco consumption higher than 40 Pack-year (OR = 6.6;95% CI = 1.22 to 35.4), exercise in the textile sector (OR = 9.4;CI = 1.06 to 84.3) and exposure to diesel exhaust (OR = 9.47;95% CI = 1.06 to 84.3). Conclusion: Occupational factors could play a role in the pathogenesis of MF. Regarding our study, smoking, working in the textile industry and exposure to diesel exhaust appear to be involved in the pathogenesis of MF. Further investigation is needed to confirm these findings.
文摘The study was designed to investigatecytogenotoxic effects of occupationalexposure to N,N’-methylene-bis-(2-amino-1,3,4-thiadiazole) (MATDA) for 11 workers(2 male,9 female) exposed to MATDA for 4-8 years,with the average level of 0.
文摘The prevalence of surface contaminants,such as potentially harmful bacteria,within building environments in the State of Kuwait is not known.To the authors’knowledge,this article is the first of such a report.A total of 342 stool samples were collected from 46 secondary schools to evaluate indoor occurrences of E.coli bacteria within selected lavatory surfaces.After microbiological testing,the results for the spread of the E.coli bacteria were categorized by total count,sampling location dependency,contamination level comparison between genders,and lavatory fixtures(i.e.seat and squat toilets).The results revealed that 7 schools have a bacterial contamination problem,there is cross-contamination between surfaces in the lavatory stalls,the boys’lavatories were less sanitary than the girls’,and that the squat-style toilets are more contaminated than the seat-style.The results suggest that there is significant risk of spread of bacterial infection among students via contaminated hands and surfaces in the lavatory area in some schools.Thus,this study emphasizes the need to improve environmental hygiene and enhanced sanitation in these schools.In addition,conclusions can be drawn as to the effectiveness of the janitorial staff employed by the schools and the efficacy of the cleaning regime used in the lavatories.Furthermore,based on the findings,there are architectural design consequences as squat-style toilets might be excluded in lavatories designed for schools to be constructed in the future.
基金This work has received operational support from the National Regulatory Authority of Gabon.
文摘ObjectiveTo evaluate whole-body,extremity and eye-lens occupational dose equivalents of ionizing radiation to Occupationally Exposed Workers(OEWs)in Gabon,monitored by the national Individual Monitoring Service(IMS),in the medical practice.MethodsA total of 816 dose records for 205 OEWs were evaluated.Doses were collected for an eight-year period,from 2013 to 2020.Twelve public and private hospitals were involved,including a cancer centre where radiotherapy(RT)and nuclear medicine(NM)procedures are regularly performed.OEWs were monitored,on a monthly or quarterly basis,for whole-body dose and extremity dose using an optically stimulated luminescence(OSL)dosimeter worn on the torso or the wrist,as appropriate.Eye-lens dose was estimated from whole-body dose results.ResultsThe whole-body dose distribution was skewed and the zero dose was associated with a probability of 47%.Some recorded doses were associated with estimated X-ray energies above those typically encountered in diagnostic radiology,thus suggesting that some doses attributed to workers and believed to be due to X-rays may in fact be due to background radiation(false positive dose records).For the period 2013–2020,annual doses to OEWs in diagnostic radiology(DR),NM and RT departments were 0.40 mSv,0.38 mSv and 0.09 mSv,respectively.For the same period,the mean annual extremity and eye-lens doses were 0.78 mSv(range:0–5.24mSv)and 0.35 mSv(range:0–3.74mSv),respectively.ConclusionWith little effort by the national IMS and the regulatory body,annual whole-body doses to workers can be kept well below 6mSv,thus efficiently contributing to the optimization of worker's protection.However,extremity doses may in fact be greater than those reported for OEWs in the NM department.Finally,eye-lens doses were well below the new annual dose limit of 20 mSv,thus demonstrating that,in the current situation,OEWs in the NM department do not require routine eye lens dose monitoring.Rather,whole-body dose may be used as an indicator of eye-lens dose.
文摘Objective To establish occupational exposure limits for glyphosate in workplace air.Methods In November 2014,by searching the documents of the United States Environmental Protection Agency(EPA)on glyphosate toxicity,the toxicity data and clinical symptoms of glyphosate toxicity were collected through various literature databases。
基金supported by National Natural Science Foundation of China(82172184)。
文摘BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.
文摘Objective To analyze the level of PCDD/Fs exposure of occupational workers in the waste incineration industry and explore the risk of occupational exposure.Methods In September 2021,literature on environmental PCDD/Fs exposure in waste incineration plants published from the establishment of the database to February 10,2021 was retrieved from CNKI database.
