Biomedical subjects

P Messerer

Publications and source records attributed to P Messerer.

10 recordsLinked to original sources

PubMed2004

[Precautions for intestinal cancer in the workplace. An initiative for secondary prevention in the BASF joint-stock company].

BACKGROUND AND OBJECTIVE: The annual incidence of colorectal cancer in Germany is estimated at 27000 in men and 30000 in women. If the diagnosis is made early the cure rate is over 90%. Against this background the department of occupational medicine and health protection of the BASF Aktiengesellschaft initiated a study on the potential prevention of colorectal cancer among the staff at its Ludwigshafen site. SUBJECTS AND METHODS: The target group included all 13265 actively working employees aged 45 years or above. Those expressing interest were given a standardized questionnaire concerning risk factors for colorectal cancer and a test for occult fecal blood (FOBT). If the test was positive and/or a positive answer was given to the question on blood in the stool or on a positive family history, coloscopy - to be arranged via the general practitioner - was advised, in line with the recommendations of the German Society of Digestive and Metabolic diseases (Deutsche Gesellschaft für Verdauungs- und Stoffwechselerkrankungen). RESULTS: At the end of the study 3732 employees (337 women, 3395 men, mean age 52 years) had completed the questionnaire and the FOBT results were available. Coloscopy was recommended to 688 employees, 323 of whom (47%) underwent the investigation. Nine of the subjects already had manifest cancer, six of them in the early stage T1 or T2. Adenomatous polyps were found in an additional 61 and subsequently excised. Cost-benefit considerations at the company level or in the area of the health system, respectively, gave favourable ratios of 1:10 and 1:14. CONCLUSION: It requires considerable expenditure to increase the number of participants in the cancer prevention programme and obtain a consequent clarification of suspicious findings. Health care within a company is a valuable complementation in Germany of medical care provided by general practitioners or specialist, if close cooperation between practitioners in the given region is assured. Initiatives like the one presented here protect people personally affected against pain and distress and are also of economic value.

Adenomatous Polyps↗

PubMed2000

Specific Helicobacter pylori antigens unable to distinguish nonucler dyspepsia or peptic ulcer cases from asymptomatic seropositive controls: a nested case-control study in employees of a large company.

We investigated in a large industrial population the antibody response to specific H. pylori antigens (CagA and seven others) in relation to peptic ulcer and nonulcer dyspepsia (NUD). The two groups consisted of 37 and 39 employees, respectively, with endoscopically proven peptic ulcer and NUD. Age- and gender-matched controls were H. pylori seropositive employees without abdominal complaints or history of ulcer disease. IgG antibodies against CagA and other antigens were analyzed by western immunoblot. Relative percentages of CagA-positive individuals were 89 and 76% for ulcer cases and their controls (P = 0.22) and 77% and 74% for NUD cases and their controls. The corresponding percentages of VacA-positive individuals were 87 and 76% for ulcer cases and controls and 64% and 77% for NUD cases and controls, respectively. Analysis of other H. pylori-specific antigens was not particularly helpful in discriminating between symptomatic and asymptomatic seropositive individuals for either disease group. In conclusion, assessment of IgG response against specific H. pylori antigens was not predictive of peptic ulcer or NUD case status in this active employee population and would not appear to be useful in routine clinical practice.

Adult↗

PubMed1998

Helicobacter pylori infection: prevalence and clinical relevance in a large company.

Although gastrointestinal (GI) illnesses account for considerable sick absenteeism, there have been few workplace studies of GI disorders. We determined the prevalence of Helicobacter pylori infection by serology and assessed its relation to upper GI tract complaints, personal ulcer history, and family history of stomach cancer in 6,143 employees (mean age, 40.4 years) at BASF's main chemical production facilities in Ludwigshafen, Germany. Employees were recruited during occupational health clinic visits (n = 4,488) and through broad communications efforts (n = 1,655). Participation among clinic attendees was 66%, and this recruitment method was particularly effective in reaching shift employees. Positive immunoglobulin G (IgG) serology (38.2%), ulcers (4.9%), nonulcer dyspepsia (20.4%), and a family history of stomach cancer (6.1%) were common occurrences in this work setting. Further diagnostic evaluation and eradication therapy was recommended for 795 employees (12.9%), based on a combination of positive serology and either upper GI tract complaints or family stomach cancer history, and has been completed for 541 employees. A weak but consistent association was seen between positive serology and cigarette smoking, and shift work was found to be associated with positive serology, but not with ulcer or nonulcer dyspepsia occurrence.

Adolescent↗

PubMed1998

Blood lipid concentrations of dioxins and furans in a sample of BASF employees included in the IARC registry of workers exposed to phenoxy acid herbicides and/or chlorophenols.

Depending on process conditions, polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) may be generated as low-level byproducts of chlorophenol and chlorophenoxy herbicides manufacture. A stratified random sample of 20 active employees from a cohort of phenoxy herbicide workers was selected in 1995 for determining PCDD and PCDF congeners in blood lipids to assess the extent of past PCDD and PCDF exposure in this cohort and whether that exposure might explain site-specific cancer findings in the total cohort. This cohort is included in the IARC International Registry of Persons Exposed to Phenoxyacid Herbicides and Their Contaminants. For the 19 persons who participated, median PCDD and PCDF concentrations were comparable to background concentrations in the general population. Median levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin, the sum of hexachlorodibenzo-p-dioxin, pentachlorodibenzofurans, and two dioxin toxicity equivalents values were statistically higher in 7 employees assigned to synthesis operations than for 12 employees assigned to other operations. However, the PCDD and PCDF concentrations were low relative to those seen in other dioxin-exposed cohorts. We conclude that PCDD and PCDF exposures of cohort members are unlikely to explain the elevated standardized mortality ratios observed in this cohort for several cancer sites.

Adult↗

PubMed1994

Morbidity follow up study of BASF employees exposed to 2,3,7, 8-tetrachlorodibenzo-p-dioxin (TCDD) after a 1953 chemical reactor incident.

OBJECTIVE: The aim was to examine the long term morbidity experience of men exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). METHODS: A retrospective cohort morbidity study of 158 men first exposed to TCDD between 17 November 1953 and 16 November 1954 subdivided by chloracne state and back calculated TCDD blood lipid concentration, and 161 referents. Cause specific illness absence and admissions to hospital were examined between 1953 and 1989. RESULTS: On an ever or never basis, thyroid disease and appendicitis were diagnosed more often in the study group; these diseases were not differentially distributed by chloracne state, but were increased in the high TCDD subgroup. An 18% increase in total illness episodes was also seen (p = 0.002); illness rates increased with severity of chloracne and higher TCDD concentration within the chloracne subgroup. There were increases in infectious and parasitic diseases (primarily ill defined intestinal infections), disorders of the peripheral nervous system and sense organs, upper respiratory tract infections, and other skin diseases. Several of these increases correlated with chloracne state and infections disease episodes increased with higher TCDD concentration as well. Occurrences of mental disorders correlated with severity of chloracne, but not TCDD concentration. Benign and unspecified neoplasms were marginally increased in the severe chloracne and high TCDD subgroups. Chronic liver disease was marginally increased in the high TCDD subgroup. Findings relative to occurrence of ulcers, chronic lung disease, and kidney and metabolic disorders were unremarkable. DISCUSSION: For various conditions, increased illness episodes were seen among TCDD exposed employees compared with referents and were associated with either or both chloracne severity and back calculated TCDD concentration. The results are derived from insurance data; hence, it is possible that heightened awareness and personal health concerns led to greater utilisation of medical services in the exposed group. The findings based on TCDD concentration should be less subject to this potential bias.

Absenteeism↗

PubMed1993

Assessment of past occupational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin using blood lipid analyses.

Current 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) concentrations were determined in blood samples for 138 persons who had been involved in assessment, clean-up and demolition activities after the 1953 BASF trichlorophenol reactor accident. From these data and detailed descriptions of the circumstances and duration of individual exposure, a regression model was developed for describing the relationships between various exposure situations and TCDD concentration. The model explained 65% of the variability in log (TCDD) concentration. Using half-life assumptions and the regression model parameters we estimated cumulative TCDD concentrations back-calculated to the time of exposure for all 254 members of the accident cohort. The geometric mean cumulative TCDD concentration for all cohort members averaged 137.7 ppt. Estimated cumulative TCDD concentrations correlated well with chloracne severity. The mean TCDD concentrations were 38.4 ppt for the no chloracne subgroup (n = 139), 420.8 ppt for the moderate chloracne subgroup (n = 59) and 1008 ppt for the severe chloracne subgroup (n = 56). The estimation procedure should be helpful in assessing the relationships between various health outcomes and TCDD exposure in this cohort.

Acne Vulgaris↗

PubMed1990

Thirty-four-year mortality follow-up of BASF employees exposed to 2,3,7,8-TCDD after the 1953 accident.

2,3,7,8-Tetrachlorodibenzodioxin (TCDD) was formed in an uncontrolled decomposition reaction at BASF Aktiengesellschaft on 17 November 1953. This report presents the findings of a 34-year mortality follow-up study of 247 workers who were partly heavily exposed; 78 thereof had died. We divided these employees into three cohorts based on the amount and reliability of the exposure information. The mortality was compared with the national mortality rates in the Federal Republic of Germany (FRG) and is presented in terms of standardized mortality ratios (SMRs) together with 90% confidence intervals (CI) for different periods of time since the first exposure. In general, the overall mortality of these workers was similar to the rates of the national population. The SMR for all malignant neoplasms based on 23 deaths was 117 (90% CI: 80, 166), suggesting no overall increase in cancer among those employees. When workers with chloracne were examined separately, the SMR for all malignant neoplasms was not significantly elevated overall (SMR 139; 87, 211), but it was for the time period 20 or more years after the first exposure (SMR 201; 122, 315). Results for 22 causes of death as well as additional information on the type of exposure and skin findings are presented and discussed in relation to the current literature. In general, our results do not appear to support a strong association between cancer mortality and TCDD, but they do suggest that some hazard may have been produced.

Accidents, Occupational↗

PubMed1989

EPAC--a database system for epicrises of occupational examinations in the chemical industry.

The Medical Service at BASF Aktiengesellschaft in Ludwigshafen began work on introducing an occupational medical information system in 1980. Having developed software for recording acute cases and laboratory results. EPAC was finally introduced in 1989 and integrated into the rest of the system. The aim of the system is to maintain a record of all medical examinations, along with all important personal details and the type of work in which the employee is engaged, the reason for the examination, the diagnosis (and all the factors taken into account in reaching it), and the interpretation of the results from the point of view of occupational medical practice. The details stored in the database provide information on the following: How often is the same diagnosis made for employees in the same type of employment? How does the incidence of diagnoses differ between different groups of employees with different places of work? What is the frequency with which a diagnosis gives rise to a restrictive medical judgement with regard to the employee's work? The opportunities offered by this system for statistical evaluation are discussed with the aid of a few practical examples from the first half of 1989.

Chemical Industry↗

PubMed1985

[So-called preventive ovarectomy].

Carcinoma of the ovaries can be prevented by performing the operation known as prophylactic oophorectomy, i.e. the simultaneous removal of macroscopically non-pathological ovaries in laparotomy because of a benign disease (for example, in uterus myomatosus). Hence, this operation is advocated on the basis of numerous clinical studies, using in most cases derived epidemiological arguments. However, model calculations with population-based data from the Federal Republic of Germany show that, firstly, the so-called prophylactic oophorectomy cannot be justified by means of epidemiological arguments, and, secondly, that no epidemiological effect can be expected to materialise from prophylactic oophorectomy, since unrealistically high prevalences of oophorectomy or hysterectomy must be assumed as essential prerequisites of such an effect. These considerations result in the following assessment: In women who are still menstruating or who are in their menopausal stage, prophylactic oophorectomy cannot be regarded as a generally recommended procedure. This operation is of individual significance, but by no means of epidemiological importance, even in post-menopausal women.

Adolescent↗

PubMedDate not supplied

BASF studies: epidemiological and clinical investigations on dioxin-exposed chemical workers.

First in 1953 and again later in 1988, BASF Aktiengesellschaft, Ludwigshafen, Germany, faced production-related dioxin contamination problems. In both situations, the immediate actions were efforts to limit the potential for employee exposure. In 1953, after a reactor accident, the production of trichlorophenol was stopped and extensive clean-up and demolition work was undertaken. In 1988, major technical improvements were made to an extrusion blending process and the flame retardants were changed to substances that chemically should not be dioxin precursors. The health experience of the potentially exposed populations has been followed extensively in both situations. Five recent epidemiological investigations: a long-term mortality follow-up, a morbidity study, a clinical laboratory study, and a chromosome study of persons from the 1953 accident cohort, as well as immunological studies of employees assigned to the extrusion operations, are discussed. In addition, considerable dioxin biomonitoring data from blood lipids for both populations are summarized.

Chromosome Aberrations↗