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Biomedical subjects

M A Boillat

Publications and source records attributed to M A Boillat.

At least 19 recordsLinked to original sources

Neurobehavioral test performance among apprentice painters: baseline data.

In the debate on chronic effects of solvent use, it is often difficult to find information on the cerebral health status of subjects before any exposure has occurred. The objective of this study was to obtain baseline data by examination of workers at the beginning of their occupational lives. This study compares the performance of 57 apprentice painters, mean age 16.6 +/- 1.2 years, with that of 62 apprentices, mean age 16.2 +/- years, drawn from other manual trades involving no significant exposure to solvents. Their performances were compared twice over a period of 3 years using a series of behavioral tests chosen from a translated version of the Neurobehavioral Evaluation System (NES). There were no major differences in performance between the apprentices, except for the verbal ability test, which showed lower results for painters. This can be explained by factors such as socioeconomic background, previous schooling, or mother tongue, and raises the question of whether it is appropriate to use such a test to adjust for the influence of premorbid ability in elderly exposed workers.

Adolescent

[Reasons for consultation in occupational medicine].

The inability to characterize more precisely the extent of occupational diseases limits the implementation of an effective preventive policy. Furthermore, not all work-related conditions are reported by the Swiss workers' compensation system. A seven-year (1986 to 1992) retrospective study of medical visits in an Institute of Occupational Health Sciences is presented. The objective of this study is to expand data on occupational diseases for clinical and public health intervention. 298 patients have been examined for a possible work-related condition. In 140 cases (47%), an occupational disease according to the Swiss Law was found. Respiratory tract was the main target of industrial pollutants. Respiratory irritations, solvent intoxications, contact dermatitis and asthma were the most frequent conditions seen. 97 workplace visits (32% of all medical visits) were necessary for diagnostic purposes. Painters (construction, cars) and other solvent exposed workers were at particular risk. Rare alpha-1-antitrypsin phenotypes were found several times in workers with respiratory diseases confirming the value of this test in occupational medicine. Despite many referral biases, direct clinical and public health applications of the data are possible. This study confirms the hypothesis that occupational respiratory diseases and intoxications are probably underreported in the workers' compensation statistics. Activities with an increased risk of work-related diseases have been identified so workplace intervention could be highly targeted. This study shows also that a more intense collaboration between primary care physicians, hospital services and occupational medical specialists is necessary to improve clinical and epidemiological surveillance of work-related health conditions.

Adolescent

[Health problems related to occupational activities].

Statistical data obtained from insurance companies give certainly a good picture of work effects on health in the field of accidents. This is different for occupational diseases, which are more difficult to diagnose and which are recognized on the basis of medicolegal criteria. Statistics do not involve other aspects than diseases, such as discomfort, ergonomical questions, psychophysiological consequences and situations where there is a limited role of occupation. Prevention of work related health problems has to consider these characteristics and needs to be based on risk analysis, a prospective procedure. The advantage of such an approach is the possibility of adjustment to a changing work environment and to new technologies.

Accidents, Occupational

Smell or taste disturbances, neurological symptoms, and hydrocarbon exposure.

A total of 264 workers participated in a cross-sectional study concerning the toxicity of hydrocarbons. The clinical examination shows an increased prevalence of smell and/or taste disturbances in the heavily exposed group. These symptoms appear to be generally transitory and reversible. They seem to be due to concentration peaks rather than to a long exposure duration. They are associated with acute depressor effects and not with symptoms which could belong to a hydrocarbon-induced chronic toxic encephalopathy.

Adult

Carpal tunnel syndrome: role of occupation.

A total of 21 consecutive patients who underwent surgery for carpal tunnel syndrome in a regional hospital were analysed for their trade and serum alpha 1-antitrypsin phenotypes. The majority of these cases were women and mostly manual trades and professions were involved. Furthermore, heterozygous antitrypsin phenotypes were more frequent among the surgical cases than among the general Swiss population. In a second stage, the incidence of carpal tunnel syndrome in Switzerland was studied for 1 year from June 1988 through May 1989 using the sentinel system developed by the Federal Office of Public Health Administration. In all, 188 cases were found, most of whom were women, which was compatible with the frequency in other countries. A complementary questionnaire that was filled out by 65 cases and their matched controls showed that housewives and shop clerks were overrepresented among the patients. Likewise, exposure to vibrating tools and frequent extensions and/or flexions of the wrist were mentioned more often by the cases than by the controls. The present study confirms previous findings that women are at greater risk of developing carpal tunnel syndrome especially in jobs requiring repetitive movements or operation of vibrating tools. A constitutional element in pathogenesis was suggested by observations that the mothers of the cases had often also been afflicted with carpal tunnel syndrome and that the frequency of distribution of antitrypsin phenotypes in patients differed from that in the general population.

Adult

Musculoskeletal and skin disorders in a population of floor-layers.

In the frame of a study on hydrocarbon-induced toxic effects, the knee morbidity and the prevalence of work-related arthralgias, gonalgias, myalgias and skin anomalies were investigated in a group a floor-layers. The results show that a previous history of knee morbidity is distinctly higher in floor-layers and that these workers have a higher prevalence of musculoskeletal and cutaneous disturbances than the comparison group. Owing to the fairly high prevalence of these troubles, it seems that this pathology deserves more attention and that more efficient preventive measures are indicated.

Adolescent

Health and health-related problems in a cohort of apprentices in Switzerland.

Out of a cohort of 1200 apprentices in Switzerland, 781 boys and 417 girls completed a questionnaire on their perceived health and health problems in their selected apprenticeship. Each participant was interviewed afterwards by the school nurses in three state-owned professional schools where the apprentices attended their classes. Ninety-five per cent of the respondents enjoyed excellent health, 28 cases had nervous system or psychological problems, 17 cases had problems of a locomotor nature, 12 subjects had gastrointestinal or endocrinological symptoms, and there was one with a past history of a malignant disease. Twelve cases also had respiratory symptoms or diagnoses. One hundred and nineteen apprentices reported that they had been troubled by the workplace. Exposure to solvents, chemicals in general, dust, smoke and noise were often mentioned as causes. Thirty-eight of them had contacted their family physician in connection with these problems. The cohort had experienced, mostly during their first year, 191 cases of accident necessitating medical care. Cuts, shocks and falls were the most common occurrences. Meat cutters and butchers had the highest frequency of accidents. Near-accidents had been experienced so far by 46 per cent of the respondents. At the interviews, school nurses provided counsel and intervened in flagrant cases of occupational risks. It seems that an ordinary medical certificate does not predict accident-proneness or possible medical problems, while in-school health programmes could provide rapid intervention and support.

Accidents, Occupational

Glycosaminoglycans, albuminuria and hydrocarbon exposure.

The value of the glycosaminoglycans (GAG) determination in urine was examined in a population of hydrocarbon-exposed workers and compared to the usefulness of the fractional albumin clearance (FAC). Blood pressure and hydrocarbon exposure interact to increase the FAC but the GAG concentration seems less useful because too many other variables influence it as well.

Adolescent

[Glomerular erythrocytes, albuminuria, glycosaminoglycans and exposure to hydrocarbons].

As part of a study on the possible nephrotoxicity of hydrocarbons, the urinary erythrocyte concentration and the percentage of glomerular erythrocytes were assessed. Albumin excretion rate, glycosaminoglycan and retinol-binding protein concentration, and N-acetyl-beta-glucosaminidase activity were measured simultaneously. The results show that the erythrocyte concentration and the percentage of glomerular erythrocytes tend to increase with hydrocarbon exposure, and that a nephrotoxic effect of occupational hydrocarbon exposure deserves consideration.

Acetylglucosaminidase

Hydrocarbon exposure, hypertension and kidney function tests.

Control and hydrocarbon exposed workers participated in a cross-sectional study about the nephrotoxicity of chronic hydrocarbon exposure. Different markers of glomerular and tubular function as well as the celluria were examined and compared. The results show that the interaction between hypertension and hydrocarbon exposure has an influence on the kidney function. For the clearance the interaction age-exposure seems to play a more important role than age or exposure alone. The most useful markers appear to be the albuminuria, the N-acetyl-beta-D-glucosaminidase activity, the retinol-binding-protein concentration and the creatinine clearance.

Adult

Demethylation pathways in caffeine metabolism as indicators of variability in 1,1,1-trichloroethane oxidation in man.

Twenty volunteers were exposed to 191 +/- 7 p.p.m. 1,1,1-trichloroethane or 50 +/- 2 p.p.m. perchloroethylene vapour for 6 hr. They were then evaluated for their rate of caffeine metabolism, mephenytoin hydroxylation and debrisoquine hydroxylation. Seven subjects were identified as 'fast acetylators' of caffeine and one person as a slow metabolizer of debrisoquine. The "slow acetylators" exposed to perchloroethylene excreted an average of 3.83 +/- 0.35 mg trichloroacetic acid within 24 hr (N = 13, +/- S.E.) and the 'fast acetylators' 3.58 +/- 0.48 mg (N = 7, +/- S.E.). The excretion of trichloroethanol by the same persons after 1,1,1-trichloroethane exposure was 14.1 +/- 1.12 mg and 16.7 +/- 1.48 mg, respectively. The excretion of trichloroacetic acid in the latter exposure varied significantly between the seven 'fast' and 13 'slow acetylators' (0.43 +/- 0.08 mg versus 1.03 +/- 0.19 mg; +/- S.E.; P = 0.037). A multiple linear regression analysis confirmed this association when other factors, such as body weight, creatinine clearance, smoking habit and alcohol consumption, were taken into account. One volunteer proved to be a poor hydroxylator of debrisoquine and excreted half the amount of trichloroacetic acid in the perchloroethylene exposure and half the amount of trichloroethanol in the 1,1,1-trichloroethane exposure compared to the others. A reduction in the solvent metabolism could thus be predicted by the debrisoquine test. On the other hand, the caffeine test predicted faster oxidation of trichloroethanol which could be of toxicological and pharmacological importance e.g. in the clinical use of chloral.

Adult

Hydrocarbon exposure, pancreatitis, and bile acids.

The data on hydrocarbon induced pancreatitis are conflicting. This question was therefore studied in a non-selected population exposed to hydrocarbons and in "formerly" exposed workers. Neither the past clinical history nor the pancreatic tests provided any evidence for a causal relation between exposure and pancreatitis. No signs of hydrocarbon induced liver damage were seen either. As a healthy worker effect cannot be totally excluded, however, a case-control study in a group of patients suffering from non-alcohol induced pancreatitis could give useful indications for finally excluding the possibility of pancreatitis being induced by hydrocarbons.

Alcohol Drinking