[Occupational accidents' insurance is needed after all].
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Accidents, Occupational↗
Biomedical subjects
G Ahlborg
Publications and source records attributed to G Ahlborg.
Assessment of intermittent trichloroethylene exposure in vapor degreasing.
To validate various sampling strategies in assessment of trichloroethylene (TCE) exposure, urine and air samples were obtained from 29 metal workers involved in vapor degreasing. Urinary trichloroacetic acid and trichloroethanol were useful metabolites to estimate TCE exposure on a group basis, but the predictive value of a single urine sample was low when related to the air concentration. With intermittent TCE exposure, the best information is obtained by analyzing both metabolites.
Adult↗
Splanchnic and renal vasoconstriction during neuropeptide Y infusion in healthy humans.
To assess whether neuropeptide Y (NPY) causes vasoconstriction in human splanchnic and renal tissues, six healthy subjects were given NPY intravenously in the basal resting state for 15 min. The NPY dose of 10, 25, and 50 pmol kg-1 min-1 was increased every 5 min. The infusion was accompanied by elevated arterial plasma levels of NPY-like immunoreactivity (Li) which were 15, 40, and 85 times higher than the basal value. After the infusion plasma NPY-Li fell with two half-lives of 5 +/- 0.4 and 29 +/- 1.7 min but was still 4 times the basal values 60 min after the infusion (P less than 0.01). A vasoconstrictor effect was seen at about 500 pM plasma NPY-Li. During the NPY infusion splanchnic and renal blood flows decreased by 26% and 29% respectively. The blood flows in these regions were still below the basal value 40 to 60 min after the NPY infusion. Plasma noradrenaline fell by 20% (P less than 0.02) and arterial glucose by 3% (P less than 0.005) during the NPY infusion. It is concluded that NPY causes a dose-dependent long-lasting vasoconstriction in human renal and splanchnic tissues. The results also suggest that elevated plasma NPY-levels may be associated with changes in the turnover of noradrenaline and glucose.
Adult↗
Is the high lactate release during arm exercise due to a low training status?
To determine whether arm lactate release during arm exercise is related to the training status of the arms, seven arm-trained athletes were studied during 30 min of continuous arm exercise (AE) or leg exercise (LE) of increasing intensities corresponding to 30%, 50%, and 80% of peak VO2 during AE and LE respectively. Blood vessels were catheterized for determination of regional blood flows and substrate exchanges. The respiratory exchange ratio was higher during AE than LE (P less than 0.01). The arteriovenous oxygen difference, [(A-V)O2], for the leg during LE was 11-19% higher than the (A-V)O2 for the arm during AE (P less than 0.01). At the highest intensity the (A-V)O2 was 170 +/- 6 ml O2l-1 during LE, vs. 143 +/- 9 during AE (P less than 0.01). Arm blood flow in relation to limb volume was 56-95% higher during AE (P less than 0.05). Arterial lactate concentrations were 27-60% higher during AE (P less than 0.01) and lactate release from the exercising limb was 2-4 times higher (P less than 0.05) during AE compared to LE. Adrenaline and noradrenaline rose 6- and 21-fold, respectively, during AE and did not differ from corresponding LE values. During AE the (A-V)O2 difference across the arm, arterial lactate concentration, and arm lactate release were of the same magnitude in arm-trained and relatively less arm-trained subjects. Lactate release in relation to O2 uptake by the exercising limb was 7-37% lower during AE in arm-trained subjects compared to AE in arm-untrained subjects but was 3-6 times higher than the corresponding relation during LE (P less than 0.01). We conclude that AE is associated with a larger lactate release compared to LE. This difference is only to a minor extent influenced by intense training of the arms. The high arm vs. leg lactate release appears to be associated with differences in regional circulatory adaptation by the exercising limb.
Adult↗
Splanchnic and renal vasoconstrictor and metabolic responses to neuropeptide Y in resting and exercising man.
The local clearance of neuropeptide Y (NPY) and whether NPY influences splanchnic and renal metabolism in man have not been investigated previously. The influence of NPY on splanchnic and renal blood flows at physiologically elevated levels has also not been investigated. The effects of a 40-min constant NPY infusion (3 pmol kg-1 min-1) at rest and during 130 min of exercise (50% of VO2max) were studied in six healthy subjects and compared with resting and exercising subjects receiving no NPY. Blood samples were drawn from arterial, hepatic and renal vein catheters for the determination of blood flows (indicators: cardiogreen and para-aminohippuric acid [PAH]), NPY, catecholamines, glucose, lactate and glycerol. NPY infusion was accompanied by: (1) significant fractional extraction of NPY-like immunoreactivity (NPY-Li) by splanchnic tissues at rest (58 +/- 5%) and during exercise (53 +/- 6%), while no arterial-venous differences could be detected across the kidney; (2) a reduction in splanchnic and renal blood flows of up to 18 and 13% respectively (P less than 0.01-0.001) at rest without any additional changes during exercise; and (3) metabolic changes as reflected in: (a) a more marked fall in arterial glucose during exercise compared to the reference group (P less than 0.05); (b) a 35% lower splanchnic glucose release (P less than 0.01) during exercise due to diminished glycogenolysis (P less than 0.01); and (c) a lower arterial lactate level (18% P less than 0.05) together with unchanged splanchnic lactate uptake during exercise, suggesting reduced lactate production by extrahepatic tissues. The disappearance of plasma NPY-Li after the infusions was biphasic with two similar half-lives at rest (4 and 39 min) and during exercise (3 and 43 min).
Adult↗
Psychopharmaceuticals and perinatal deaths.
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Female↗
Long-lasting vasoconstriction and efficient regional extraction of endothelin-1 in human splanchnic and renal tissues.
Six healthy subjects were given endothelin-1, intravenously in a dose of 4 pmol.kg-1.min-1 for 20 min. Blood samples were drawn from arterial, hepatic and renal vein catheters for determinations of splanchnic and renal blood flows and the extraction of endothelin-1 in these vascular beds. Intravenous infusion of endothelin-1 increased the mean arterial blood pressure by 6.8 +/- 2.0 mm Hg (p less than 0.05) and reduced splanchnic and renal blood flows by 34% (p less than 0.005) and 26% (p less than 0.001) respectively. Return to basal flow values occurred after about 1 hr for the splanchnic and 3 hrs for the renal blood flow. The fractional extractions of endothelin-1-like immunoreactivity corresponded to 75 +/- 2% and 60 +/- 2% in the splanchnic and renal vascular beds, respectively. The disappearance curve in plasma and two half-lives of 1.4 +/- 0.1 min and 35 +/- 2.8 min respectively.
Adult↗
Tobacco smoke exposure and pregnancy outcome among working women. A prospective study at prenatal care centers in Orebro County, Sweden.
Among 4,687 women undergoing prenatal care in Orebro County, Sweden, from October 1980 to June 1983, 678 nonsmokers reported passive exposure to tobacco smoke. Of these women, 267 had been passively exposed at work, and the risk ratio (RR) for intrauterine death (spontaneous abortion or stillbirth) among these pregnancies was increased to 1.53 (95% confidence interval (CI) 0.98-2.38) compared with pregnancies of unexposed working women. This could not be explained by age, previous spontaneous abortion, educational level, planning of pregnancy, or alcohol use. The effect was confined to first-trimester fetal loss (adjusted RR = 2.16, 95% CI 1.23-3.81), while active smoking was associated with intrauterine death after the first trimester. Passive exposure in the workplace was weakly associated with preterm birth (less than 37 weeks) but not with low birth weight (less than 2,500 g) among full-term livebirths. Active smoking clearly increased the risk of both of these outcomes. However, passive exposure in the home only did not seem to affect pregnancy outcome. The lack of quantitative exposure data points to the need for more research before passive exposure to tobacco smoke can be regarded as an established hazard to fetal development and survival.
Adult↗
Evidence for release of endothelin-1 in pigs and humans.
The release and pharmacokinetics of endothelin-1 (ET-1) in plasma were studied in pigs and humans in vivo. Between 50-90% of plasma ET-1-like immunoreactivity (LI) was cleared by the pig and human kidney, splanchnic circulation, and skeletal muscle. The precursor big ET-1 was only cleared to a moderate extent (34%) by the kidney with progressive formation of ET-1-LI in the pig. The half-lives of circulating ET-1-LI and big ET-1-LI were about 1 and 10 min, respectively. The threshold vasoconstrictor effects for plasma ET-1-LI in the splanchnic and renal circulation in humans were around 30 pM. ET-1-LI in fetal umbilical arterial plasma was very high (15 pM before and 94 pM after establishment of breathing) compared with about 2 pM in maternal plasma. Bacterial endotoxin or sepsis increased ET-1-LI in plasma more than fivefold in both pigs and humans reaching levels close to threshold vasoconstriction. However, hemorrhagic shock or hypotension did not alter plasma ET-1-LI. It is concluded that ET-1 has a short half-life with very high regional plasma clearance, which limits detection of overflow into the systemic circulation. However, release of ET-1 reaching vasoconstrictor levels seems to occur both upon special physiological circulatory changes in the newborn and in septic shock.
Animals↗
Splanchnic release of neuropeptide Y during prolonged exercise with and without beta-adrenoceptor blockade in healthy man.
Plasma levels of neuropeptide Y- (NPY-) like immunoreactivity (Li) and catecholamines in the brachial artery, femoral vein and hepatic vein were monitored during physical exercise in a total of 19 healthy men to detect any local release from the leg and splanchnic region. In addition, propranolol (0.15 mg kg-1 i.v.) was given during exercise to determine whether beta-adrenoceptor blockade influenced the increase in plasma NPY-Li and catecholamines. Leg and splanchnic blood flows were measured using indicator dilution techniques and indocyanine green dye. Graded arm exercise was associated with elevations of arterial plasma NPY-Li (two-fold) and noradrenaline (12-fold) comparable to those previously found during leg exercise. During prolonged leg exercise a significant vasoconstriction and release of NPY-Li and noradrenaline was observed in the splanchnic region while no net exchange was found in the exercising leg where marked vasodilatation occurred. Administration of propranolol during exercise produced a clear-cut additional increase in plasma NPY-Li as well as in noradrenaline and adrenaline. It is concluded that splanchnic vasoconstriction during exercise is associated with a local release of both NPY-Li and noradrenaline. The additional elevation in plasma NPY-Li and catecholamines after propranolol during exercise is probably due to increased nerve activity and/or decreased disposal.
Adrenergic beta-Antagonists↗
Metabolism in exercising arm vs. leg muscle.
Arm and leg metabolism were compared by arterial and venous catheterization and blood flow measurements (by dye dilution techniques) in two groups of subjects performing 30-min continuous arm or leg exercise of increasing intensity corresponding to approximately 30, 50 and 80% of max oxygen uptake for arm or leg exercise. The absolute work-loads were 2.5-3 times higher during leg compared to arm exercise. Heart rates were the same in both types of exercise. r-Values were 0.97-1.07 during arm exercise. Arterial noradrenaline and adrenaline levels became higher during leg compared to arm exercise (P less than 0.05-0.01). Arterial lactate concentration was 50% higher for arm exercise at the two lower intensities (P less than 0.001) and the same at the highest intensity compared to leg exercise. Arm lactate release was three times higher (P less than 0.01) or the same as leg lactate output at corresponding exercise intensities. Arm and leg glucose uptake during exercise were of the same magnitude at the lower intensities. In contrast to the leg substrate exchange, arm lactate output was higher than the simultaneous glucose uptake (P less than 0.05-0.001), indicating a relatively higher rate of glycogen degradation. In conclusion, exercising arm compared to leg muscles working at the same relative intensities utilize more carbohydrate, mainly muscle glycogen resulting in higher lactate release by the exercising extremity. This cannot solely be explained on the basis of differences in the degree of training and occurs with lower catecholamine levels compared to leg exercise.
Adult↗
Arm blood flow at rest and during arm exercise.
To test the applicability of a dye-dilution method to quantitate total arm blood flow at rest and during arm exercise, indocyanine green was infused at a constant rate into the brachial artery. Eight subjects performed continuous 30-min arm exercises with an increase in intensity every 10 min (30, 60, and 90 W). The loads corresponded to 29 +/- 1, 48 +/- 2, and 78 +/- 4% (means +/- SE) of the maximal O2 uptake (VO2max 2.13 +/- 0.08 l/min) during arm exercise. VO2max during arm exercise was 61 +/- 1.7% of that during leg exercise. The dye concentration was analyzed in blood samples from three arm veins, two ipsi- and one contralateral, at shoulder level. Corresponding dye concentrations in both ipsilateral veins and a stable concentration difference between ipsi- and contralateral veins were achieved. Total arm blood flow was calculated to be 0.21 +/- 0.04 l/min at rest and 2.43 +/- 0.14 l/min at 90 W. Arm O2 uptake rose from 9 +/- 2 to 323 +/- 21 ml/min. Arm blood flow and O2 uptake each correlated linearly with both work load (r = 0.98) and pulmonary O2 uptake (r greater than or equal to 0.98). Mechanical efficiency for the arm and body was 34-44 and 16-19%, respectively. We conclude that arm blood flow can be determined by continuous infusion of indocyanine green.
Adult↗
[Working environment and pregnancy].
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Female↗
Mortality and cancer morbidity after exposure to military aircraft fuel.
In order to elucidate a possible excess risk of lymphatic malignancies due to aircraft fuel exposure in the Swedish Armed Forces (SAF), a historical prospective cohort study was conducted. During a 9-year follow-up period, 3 cases of malignant lymphoma were detected versus 3.21 expected tumors of the lymphatic system (standardized incidence ratio (SIR) 93; 95% confidence interval (CI) 19-273) among 2,176 men. The overall SIR was 91 (CI 66-120), whereas the corresponding mortality ratio was only 54 (CI 42-68; p less than 0.001). In conclusion, no evidence was found for an association between military aircraft fuel and the occurrence of malignant lymphomas or other malignancies among exposed men in the SAF. For a definite risk assessment, further follow-up is necessary.
Adult↗
Pregnancy outcome among women working in laundries and dry-cleaning shops using tetrachloroethylene.
Case-referent studies were performed within two cohorts of women engaged in laundry or dry-cleaning work. The aim was to elucidate if tetrachloroethylene (perchloroethylene) exposure increased the risk of adverse pregnancy outcome (spontaneous abortion, perinatal death, congenital malformations or birth weight less than 1,500 g). Pregnancies and outcomes were identified in national registers and exposure data were obtained from the women by postal questionnaires. Response rates were 75-88%. Conditional logistic regression analysis of the total material yielded an adjusted odds ratio for tetrachloroethylene exposure during the first trimester of 1.1 (95% confidence interval 0.6-2.0) when several potential confounding factors were accounted for. The total material included few highly exposed pregnancies and a limited number of cases of specific adverse outcomes. Consequently, the results do not invalidate the recommendation that tetrachloroethylene should be handled with caution by women in childbearing ages.
Abortion, Spontaneous↗
Function of the masticatory system in 20 patients with mandibular hypo- or hyperplasia after correction by a sagittal split osteotomy.
Twenty patients with malocclusions were examined for signs and symptoms of craniomandibular disorders (CMD) before surgical correction of their anomalies. Such signs and symptoms were very common and were in many patients the main reason for requesting treatment. Eight patients had rigid and 12 non-rigid fixation. All patients were re-examined 1 year after surgery. This examination showed a statistically significant improvement of signs and symptoms of CMD but those who had had non-rigid fixation showed a statistically significant impairment in maximal mouth opening while no such change was noted in those treated with rigid fixation. Eight patients reported significant reduction of their recurrent headaches. It is concluded that surgical correction of malocclusion has a beneficial effect not only on the aesthetic appearance and dental occlusion but also on signs and symptoms of CMD.
Adolescent↗
Heavy lifting during pregnancy--a hazard to the fetus? A prospective study.
The influence of heavy lifting during pregnancy on gestational age, birthweight and the risk of fetal death (spontaneous abortion or stillbirth) was investigated in a prospective study of 3906 occupationally active women. Information on exposure was collected at the women's first contact with the antenatal care centres in Orebro County from October 1980 to June 1983. Logistic and linear regression were used to analyse the data, allowing for several non-occupational factors in the models. Women who reported heavy lifting did not have in general more unfavourable outcomes than other women, although the risk estimates varied between different occupational categories. Lifting of weights greater than or equal to 12 kg more than 50 times per week increased the risk of pre-term birth (less than 37 weeks of gestation--odds ratio 1.7), but only among women who stopped working before the 32nd week of pregnancy. Unfavourable outcomes were more common among those who reported chemical exposure during pregnancy. The preventive routines and regulations in Sweden may have helped to reduce possible risks from heavy lifting during pregnancy.
Abortion, Spontaneous↗
Long-term follow up of workers exposed to solvents.
Long term occupational exposure to organic solvents may cause adverse effects to the central nervous system. This collaborative study between six Swedish departments of occupational medicine examines the overall prognosis in terms of working capacity, symptoms, and psychometric test performance for individuals occupationally exposed to organic solvents. After re-analyses of the data from an initial clinical investigation of 111 men, the subjects were divided into two subgroups: one group of 65 with symptoms but no impairment on the tests and one group of 46 with toxic encephalopathy (symptoms and test impairment). At least five years after the initial examination the subjects were asked to attend a re-examination that included a structured medical interview and a psychometric investigation. The results indicate that effects on the central nervous system persist even when exposure has ceased. In the group of 46 more men had stopped working and were receiving sickness or early retirement pensions. This group also had reduced activity levels with regard to everyday life, leisure activities, and education or training and more neuropsychiatric symptoms. There was no support for the view that a solvent induced toxic encephalopathy is a progressive disease comparable with presenile dementia such as Alzheimer's disease or Pick's disease. If a worker was removed from exposure when he presented symptoms without signs of impairment in intellectual function recovery was seen in most cases.
Aged↗