PubMed Health⌕ Search

Biomedical subjects

Y Lerman

Publications and source records attributed to Y Lerman.

At least 19 recordsLinked to original sources
PubMed2006

The risk of hepatitis A infection among healthcare workers: a review of reported outbreaks and sero-epidemiologic studies.

All reports of hepatitis A (HA) outbreaks in healthcare settings published between 1975 and 2003 were studied to determine the background immunity or susceptibility of healthcare workers (HCWs) to HA. Twenty-six reports were found. The number of infected personnel ranged from one to 66 and, in most outbreaks, nurses accounted for the majority of personnel infected, reflecting high attack rates reaching 15-41%. In addition, we found 23 sero-epidemiological studies for HA among HCWs that had been performed in 13 different countries. Seroprevalence rates of HCWs with anti-HA antibody ranged between 4% among paramedical workers in Germany to 88% among hospital maintenance workers in Portugal. Effective infection control of HA outbreaks in hospitals demands early recognition, including awareness of atypical presentations of the infection, and strict adherence to universal infection control measures. Education programmes are of special importance for HCWs in neonatal, paediatric and intensive care units. The findings of the current study suggest that a pre-employment screening policy and administration of active vaccination to susceptible HCWs, particularly nurses, should be seriously considered in high-risk settings.

Adolescent↗
PubMed2004

Seroepidemiology of varicella-zoster virus antibodies among health-care workers and day-care-centre workers.

Inclusion of live varicella vaccine in the routine occupational health vaccination schedule requires knowledge of the natural immunity to varicella zoster virus (VZV) among high-risk occupations. This study aims were to evaluate VZV antibody positivity among health-care workers (HCWs) and day-care-centre workers (DCWs) and to assess its association with potential risk factors. Three groups of workers were tested for VZV antibody positivity: hospitals and community clinic HCWs (n = 335), DCWs (n = 117) and blue-collar workers as controls (n = 121). The total VZV antibody positivity was 94.4%. There was no significant difference in VZV antibody positivity among study groups. DCWs had the lowest VZV seroprevalence (90.9%, 95% CI 85.7-96.1) and controls the highest (96.6%, 95% CI 93.2-99.9). This high VZV antibody positivity suggests that no special occupational measures are indicated in health-care or day-care occupational settings in Israel. On-going monitoring of the natural immunity to VZV is necessary to detect trends over time.

Adult↗
PubMed2003

Modulation of polymorphonuclear leukocytes function by incubation with human serum from oxidant-challenged individuals.

Polymorphonuclear leukocytes (PMN) from healthy donors were tested for stimulated release of superoxide anions after being incubated with serum of welders and of a group of unexposed individuals. These two groups were further subdivided either according to age or to smoking habits. The experiments showed that stimulated superoxide production from PMN was inhibited (P < 0.05) by serum from young smokers as compared to that of young nonsmokers, both from the unexposed group. Incubation of PMN with serum from elderly nonsmoking individuals decreased superoxide production as compared to incubation with serum from young nonsmoking individuals, both from the unexposed group. A decrease in superoxide production by incubation with serum of welders as compared to that of unexposed individuals was significant only when the comparison was carried out between the young, non-smoking subgroups. These findings suggest that age, smoking, and exposure to oxidants induce appearance in serum of factors that affect the PMN function

Adult↗
PubMed2003

Hepatitis A virus seropositivity among hospital and community healthcare workers in Israel-the role of occupation, demography and socioeconomic background.

Hospital and community-clinic workers were tested for hepatitis A virus antibodies (HAV)-IgG to identify variables associated with presence of (HAV-IgG) and to determine whether sociodemographic background may explain all differences in HAV seropositivty among healthcare workers. Logistic regression analysis was used to identify variable associated with HAV-immunity. Multivariate logistic regression analysis revealed that HAV-seroprevalence correlated significantly (P<0.01) with age, siblings, residence in rural areas and origin. Nurse aides had an increased risk for HAV seropositivity (OR=5.04; 95% CI: 1.49-17.08) whereas physicians had a lower risk (OR=0.54: 95% CI: 0.30-0.98). Age and socioeconomic background were independently correlated with HAV immunity but did not explain all difference in HAV-seroprevalence. The higher susceptibility and elevated incidence of hepatitis A amongst physicians, prioritize primary prevention in this group.

Academic Medical Centers↗
PubMed2001

Pregnancy outcome following exposure to shortwaves among female physiotherapists in Israel.

BACKGROUND: The findings of the few epidemiological studies on the possible association between shortwave diathermy use by pregnant physiotherapists and adverse pregnancy outcome are inconsistent. We investigated such an association among physiotherapists in Israel. METHODS: Individualized data on exposure to shortwaves, ultrasound, and heavy lifting were collected by questionnaires and telephone interviews. RESULTS: The 434 studied women included 930 pregnancies: 175 ended in spontaneous abortions, 45 had fetal malformations, 47 were delivered prematurely, and 33 infants had low birth weight. The remaining 630 normal pregnancies comprised the control group. Univariate analysis showed that exposure to shortwaves was associated with a significantly increased odds ratio (O.R.) for congenital malformations (O.R. 2.24, CI 1.27-4.83, P =.006) and low birth weight (O.R. 2.99, CI 1.32-6,79, P =.006). This effect increased in a dose-related manner. After controlling for potential confounding variables, only low birth weight reached statistical significance (O.R. 2.75, CI 1.07-7.04, P =.03). From the potentially confounding variables tested, febrile disease during pregnancy was found to be significantly associated with low birth weight (O.R. 3.37, CI 1.38-8.25, P =.01). CONCLUSIONS: The findings of our study suggest that shortwaves have potentially harmful effects on pregnancy outcome, specifically low birth weight.

Case-Control Studies↗
PubMed2001

Epidemiology of bronchial asthma and chronic rhinitis in schoolchildren of different ethnic origins from two neighboring towns in Israel.

Allergic diseases have increased significantly in developed countries for reasons yet to be determined. We studied the epidemiology of bronchial asthma (B.A.) and chronic rhinitis (Ch.R.) among Israeli school children from two neighboring towns, one Jewish (Zichron Yaakov, school population = 585) and the other Arab (Paradis, school population = 658). The children (age range 8-17 years, 567 males, 676 females) shared the same climate and had similar demographic characteristics. They received similar medical care and had the same rates of hospitalization and emergency room visits. The Jewish children had a higher prevalence of B.A. (13.7% vs. 9.4%), Ch.R. (19.7% vs. 9.7%), and stuffy nose (31% vs. 14%) than their Arab counterparts. In addition to ethnicity, parental smoking habits were the major differentiating factor between the two groups: 20% of the mothers and 29% of the fathers from Zichron Yaakov and 2% of the mothers and 60% of the fathers from Paradis were smokers. Smoking fathers increased the rate of B.A. in both towns as well as emergency room visits, but not the rate of Ch.R. or stuffy nose. A familial history of B.A. was the main determinant for having childhood asthma or chronic rhinitis. We conclude that in addition to family history and ethnicity, smoking among mothers was the major contributing factor for the higher prevalence of atopic diseases among Jewish schoolchildren compared to their Arab counterparts.

Adolescent↗
PubMed2001

Superoxide anion release by peripheral polymorphonuclear leukocytes in welders.

OBJECTIVES: To investigate peripheral blood neutrophil [polymorphonuclear leukocyte (PMN)] function in a group of 23 welders compared with that in an age- and smoking habit-matched non-exposed control group. METHODS: Stimulated release of superoxide anions from PMN isolated from peripheral blood of welders and of a matched group was carried out. RESULTS: The stimulated release of superoxide anions in PMNs from welders was significantly lower (P = 0.021) than that of a control group. Smokers and older workers had a lower function of PMNs than non-smokers and younger workers. CONCLUSIONS: PMN function of welders is lower than that of controls. This effect might indicate reduced immunological defences in oxidant-exposed individuals. It is possible that PMN function might serve as a biological marker of exposure in the periodic health surveillance of welders.

Adult↗
PubMed2001

West Nile Virus Myelitis.

STUDY DESIGN: A case report. SETTING: Department of Rehabilitation Medicine, Reuth Medical Center, Tel Aviv, Israel. METHOD: Summary of the clinical course during in-patient and out-patient treatment of a patient with West Nile Virus Myelitis. RESULTS AND CONCLUSION: A healthy young woman, whose medical history revealed only a benign Duane syndrome and a few months' duration of bipolar disorder, contracted encephalo-myelitis due to a West Nile Virus infection. Although she recovered remarkably after long-term rehabilitation treatments, some weakness and pain remained.

Activities of Daily Living↗
PubMed2001

The presence of hepatitis A antibodies in dental workers. A seroepidemiologic study.

BACKGROUND: The licensing of hepatitis A vaccine in the United States and other countries in the 1990s raised the question of vaccine candidates. The authors undertook a study to evaluate the presence of antibodies against hepatitis A virus, or HAV, in dental workers. METHODS: The authors recruited 115 members of the dental staff of Tel Aviv University: 82 dentists, 21 dental assistants, eight dental hygienists and four laboratory technicians. The subjects completed a structured questionnaire regarding demographic information (such as age, sex, number of siblings, number of children) and occupational characteristics. Venous blood was obtained and examined for presence of immunoglobulin G antibodies to HAV by microparticle enzyme immunoassay. RESULTS: Univariant analysis (chi 2 and Student t test) and multivariate stepwise logistic regression analysis were used to identify variables that were associated with seropositivity. Greater number of years of occupation in dentistry were independently and significantly (P = .0004) associated with seropositivity to HAV. The calculated odds ratio showed that each year of work increased the likelihood of being seropositive by 1.06 (6 percent). Subjects tended to have higher seropositive rates if they were older, had a greater number of children, had a greater number of siblings, had worked in hospitals and worked with children (pediatric dentists and orthodontists). CONCLUSIONS: This study suggests that HAV can be considered a hazard to dental workers, with risk increasing as the number of years in dentistry increases. More studies with larger sample sizes are needed. CLINICAL IMPLICATIONS: As HAV infection is associated with morbidity and mortality, dentists--especially those working in areas of endemic HAV (such as Africa, Asia and Latin America)--are encouraged to consider receiving the active vaccine to prevent HAV infection.

Adult↗
PubMed2001

Cost-benefit analysis of active vaccination campaigns against hepatitis A among daycare centre personnel in Israel.

OBJECTIVE: To evaluate, in economic terms, active vaccination campaigns against hepatitis A in comparison with the use of nonspecific immune globulin for the prevention of the disease among daycare centre employees in Israel. SETTING: Hypothetical analysis of the costs and benefits related to vaccination campaigns of workers currently employed in daycare centres in Israel. METHODS: A cost-benefit analysis was performed, comparing mass and selective active vaccination strategies for the daycare centre working force. Direct and indirect costs of diagnosis, treatment and immunisation as well as productivity loss were considered. A Markov-based model was developed using data from previous epidemiological studies and literature. RESULTS: The benefit-to-cost ratios of selective and mass active vaccination strategies were 1.50 [net present value (NPV) $US606 396] and 0.04 (NPV-$US2.36 million), respectively (2000 values). CONCLUSION: Under these study assumptions, the practice of administering hepatitis A active vaccine to serologically proven non-immune daycare centre workers has a cost-benefit justification, and should be widely considered in countries with a similar hepatitis A epidemiology to that in this study.

Adolescent↗
PubMed2000

A graded work site intervention program to improve sun protection and skin cancer awareness in outdoor workers in Israel.

OBJECTIVES: A graded worksite intervention program to improve sun protection and skin cancer awareness of outdoor workers was implemented and evaluated longitudinally over a period of 20 months. METHODS: Outdoor male workers (144/213 recruits) from geographically separated units of the Israel National Water Company were allocated to complete (n = 37), partial (n = 72) or minimal (n = 35) intervention groups. Subsequent to the assignment and training of local safety officers, an educational and medical screening package was provided to the corresponding groups either once, or repeatedly a year later. Personal sun protective gear was provided upon repeated intervention. Outcome measures were evaluated through self-response questionnaires administered prior to the first intervention pulse, and 8 months after the first and second interventions. RESULTS: A 15-61% improvement in sun-protection habits was noted in the entire study population 8 months after initialization, compared to no sunscreen use, 20% sun-exposed skin area and highest mean occupational exposure dose of 1.68 MED/day at pre-test. An even greater use of sunscreen was evident 1 year later in the complete and partial intervention groups, + 80% and + 52%, respectively. The baseline rate of self-examination of the skin in the same two groups (49%) increased significantly at post-test (+ 71% and + 53%, respectively). CONCLUSIONS: This integrated intervention program led to significantly improved sun protection and skin cancer awareness. Repeated intervention combined with the supply of sun-protective gear contributed to an even greater impact.

Adult↗
PubMed2000

Circulating natural killer cells in retired asbestos cement workers.

The effect of past exposure to asbestos on natural killer (NK) cell number and activity is uncertain. We measured NK cell number and activity in 1052 retired asbestos workers without symptomatic lung disease, lung cancer, or mesothelioma and with a long latency period from exposure; results were compared with those for 100 healthy age-matched controls. The exposed workers showed a decreased NK cell activity and increased NK cell number, yielding a 10.8 higher odds ratio for low NK activity per cell compared with controls (95% confidence interval 6.4 to 18.4), which was due to both a decrease in NK cell activity and an increase in NK cell number. Asbestos exposure of 10 years or more increased the risk of low NK activity per cell. We conclude that exposure to asbestos is associated with diminished effectiveness of NK cells and a concomitant increase in the number of NK circulating cells.

Aged↗
PubMed1999

Occupations at increased risk of hepatitis A: a 2-year nationwide historical prospective study.

The recent licensing of active hepatitis A vaccines raises the question of vaccine candidates. Although various groups of workers are at theoretical occupational risk of hepatitis A infection, no comprehensive quantitative data exist to determine which occupational groups should receive active vaccination. Therefore, the aims of this study were to identify occupations at risk for hepatitis A infection and to determine their relative risk. In this nationwide historical prospective study, the relative risk of hepatitis A among different occupations in Israel was determined according to the incidence of hepatitis A in different occupations during 1993 and 1994 compared with the incidence of hepatitis A in two standard populations. After age, gender, ethnicity, and time of immigration to Israel were controlled for, certain occupations showed a significant increased risk of hepatitis A: yeshiva students (standardized incidence ratio (SIR) = 9.98, 99% confidence interval: 7.55, 13.18), day care center and kindergarten staff (SIR = 5.47, 99% confidence interval: 3.50, 8.57), food industry workers (SIR = 5.41, 99% confidence interval: 1.92, 15.25), teachers (SIR = 4.02, 99% confidence interval: 2.92, 5.48), physicians and dentists (SIR = 3.77, 99% confidence interval: 1.78, 8.14), and therapists and medical technicians (SIR = 3.75, 99% confidence interval: 1.75, 8.14). Sewage workers and nurses did not show any significantly increased risk. The results were validated by comparison with an additional standard population. This first nationwide study identified occupations at risk of hepatitis A infection. It emerged that the authors' approach can provide a yardstick for measuring samples in both large and small countries that have a socioeconomic background similar to that of Israel.

Adolescent↗
PubMed1999

[How valid is the official data from the Health Department on reported morbidity in Israel? Hepatitis A as an example].

Hepatitis A is one of the most frequently reported notifiable infectious diseases in Israel. The annual incidence as reported is around 70/100,000. The physician or the diagnostic laboratory notifies the district health office of the Ministry of Health. The purpose of this research was to evaluate the sensitivity of passive surveillance of hepatitis A morbidity among adults, 18 years and over. Methods included study of notifications to the Ministry of Health or hospitalizations of cases of hepatitis A and of positive laboratory tests results (IgM) for hepatitis A. We estimated the extent of under-reporting by 2 different methods of extrapolation. Data based on passive surveillance among the adult population, between 1.1.1993-31.12.1994, comprised less than 1/5 of the actual number of cases. Physicians notified about 6.2% of their hepatitis A patients. 5.1% of the notifications to the district health office were sent twice or more, usually both by the physicians and labs. The official data on hepatitis A morbidity, based on passive surveillance, are considerably underestimated. Physicians and public health officials should be aware that such data may not accurately reflect the magnitude of the risk or the amount of disease that can be prevented. Efforts should be made to improve this situation.

Adult↗
PubMed1999

Chronic burnout, somatic arousal and elevated salivary cortisol levels.

Burnout syndrome, comprised of the symptoms of emotional exhaustion, physical fatigue, and cognitive weariness, is believed to be a result of ineffective coping with enduring stress. This study of 111 nonshift blue-collar workers free of cardiovascular disease (CVD) examined whether chronic burnout is associated with a state of somatic and physiological hyperarousal. Results showed that 37 workers exhibited symptoms of chronic burnout, with symptoms lasting at least 6 months. These workers, compared to those with no burnout symptoms (n = 52) or nonchronic burnout symptoms (n = 22), had higher levels of tension at work, postwork irritability, more sleep disturbances and complaints of waking up exhausted, and higher cortisol levels during the work day. These results suggest that chronic burnout is associated with heightened somatic arousal and elevated salivary cortisol levels. This may be part of the mechanism underlying the emerging association between burnout and risk of CVD.

Adaptation, Psychological↗