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[Mucinous adenocarcinoma of the nose and paranasal sinuses, an occupational disease?].

In Great Britain and other countries there have been reports of an increased frequency of adenocarcinoma of the nose and paranasal sinuses, mimicking histologically mucinous colonic carcinoma, among workers exposed to wood dust and workers in the leather industry. No such cases have been reported so far in Switzerland. 31 patients with this type of adenocarcinoma of the nose and paranasal sinuses observed between 1953 and 1984 have been reviewed. In 13 of these patients there was occupational exposure to wood dust, and 4 were shoemakers. The study suggests an association of this type of nasal carcinoma with occupational exposure to wood dust and leatherwork. The nature of the postulated carcinogen is unknown. The authors propose further investigations to define the magnitude of the cancer risk associated with exposure to wood dust and leather.

Adenocarcinoma, Mucinous↗

Biophysical evaluation of footwear for cold-weather climates.

Proper selection of footwear for cold-wet environments is important in determining individual performance and comfort. Testing only total dry insulation (It) is not a wholly adequate basis for boot selection. The present study demonstrates an effective method for evaluating the effects of surface moisture on boot insulation. This method allows a more knowledgeable selection of footwear for cold-wet climates. In this study, regional insulation values were obtained under dry conditions, then during a soak in shallow water, and finally for insulation recovery after removal from water. Results for seven boots show no advantage of presently used synthetic materials during short soak episodes. Insulated leather-synthetic boots, however, recovered to dry insulation levels more rapidly than more traditional insulated leather boots. Rubber waterproof bottoms were the most effective boot construction for retaining insulation levels during water exposure.

Cold Climate↗

Analysis of sexual disparity of violent behavior in PCP intoxication.

We performed a retrospective chart analysis of 33 patients with an Emergency Department discharge diagnosis of phencyclidine (PCP) intoxication. All 33 cases presented to the Emergency Department between November 1986 and April 1987. Thirty of the 33 patients (91%) were classified as mildly intoxicated (per clinical syndrome as described by Aronow and Done) while the remaining 3 patients (9%) were moderately intoxicated. Two of the patients (6%) required benzodiazepine therapy for agitation while an additional 3 patients (9%) required haloperidol for psychotic symptoms. Twenty-three patients (70%) did not require any medication. Of particular interest was our finding that 11 of the 27 males (41%) required leather restraints for agitation or violent behavior while none of the 6 female patients required leather restraints (Fisher's exact test, p = 0.00078). While nursing perception of physical strength may be a confounder, level of agitation and violent behavior is our primary indication for use of restraints. We believe that there is a sexual disparity in level of agitation and violent behavior induced by PCP. We hypothesize that this may be due to pharmacokinetic factors (such as difference in body fat distribution between the sexes) or biological differences in the central nervous system.

Adolescent↗

[Correlation of the actual vitamin B1, B2 and B6 consumption with the biochemical indices of their body allowance].

Correlation of actual consumption of vitamins B1, B2 and B6 with biochemical parameters of their utilization has been studied in two groups of workers (one group was engaged in the synthetic leather industry, the second one in the diamond treatment industry). It is shown that the actual utilization of vitamins B1, B2 and B6 correlated well with the stimulation coefficients (SC) of the basal activity of the corresponding erythrocytic enzymes. This correlation can be expressed in an equation of linear regression with a preset SC. Solution of this equation gives the values that can be used in the diagnosis of changes in the vitamins B1, B2 and B6 requirement in certain population groups. The results of the study evidence that vitamin B1 and B6 are especially necessary for workers whose activity is associated with manifest nervous-emotional stress, while the workers engaged in the synthetic leather industry being exposed to dimethyl formamide are in need of vitamin B2.

Adult↗

[Erysipeloid as an occupational disease of workers in shoe enterprises].

An outbreak of erysipeloid among the workers of a shoe factory is described. The spread of infection occurred due to contact with infected raw materials, which was confirmed by the isolation of Erysipelotrix rhusiopathiae from washings made from chrome and Russia leather supplied by different tanneries, as well as from casein glue. The raw materials could be additionally infected by rodents, in particular by common voles; the above-mentioned infective agent had been repeatedly isolated from these animals on the territory of this region. Leather was also infected in the process of soaking: the infective agent was isolated from the water of soaking baths. For the first time the routes of the spread of erysipeloid infection among shoe factory workers were bacteriologically confirmed. The recommended complex of sanitary, medical and antiepidemic measures led to the liquidation of the outbreak and thus proved to be effective. The authors draw the attention of epidemiologists, sanitary inspectors, occupational pathologists and heads of medical centers at shoe factories to the necessity of preventing the spread of occupational erysipeloid infection among the workers, as well as to the necessity for dermatologists, surgeons and infectionists, most frequently dealing with erysipeloid patients, to be correctly oriented in respect to this infection.

Adult↗

Spontaneous abortions among rubber workers and congenital malformations in their offspring.

Spontaneous abortions of hospitalized women and congenital malformations were analyzed among rubber workers to investigate the possibility of an association between reproductive problems and chemical exposures in the rubber industry. Information on workers was obtained from the membership register of the Union of Rubber and Leather Workers and from the personnel register of a rubber factory. The frequencies of spontaneous abortions did not appreciably differ when the pregnancies occurred during Union membership or during employment in the factory as compared with the pregnancies occurring before or after that time. A case-referent study concerning the association between different exposures and spontaneous abortions showed that the odds ratio for factory workers exposed to rubber chemicals was increased in the footwear department. A corresponding risk was not observed in the tire department. The contradictory observations may be explained by concomitant exposure to solvents in the footwear department or by other nonoccupational factors. The possible association between congenital malformations and exposures in the rubber and leather industries was studied by the case-referent technique. No significant increase in the risk of malformations was observed in any branch of employment. However, the numbers of malformations were rather small.

Abnormalities, Drug-Induced↗

[The risk of the carpal tunnel syndrome in some work activities].

The aim of the study was to generate hypotheses on what could be the ISTAT (National Institute of Statistics) job classes with a major risk of carpal tunnel syndrome in order to plan more specific analytic epidemiology studies and apply more correct ergonomic solutions. A case-control cross-sectional survey without matching was carried out. The source of data were the computerized medical records of a large regional hospital: 833 carpal tunnel syndrome cases (mean age 48, SD 9.33) and 3222 controls (mean age 43.5, SD 13.22) hospitalized for other diseases, were selected. The odds ratio (OR) and 95% confidence limits, controlled for age and gender by a logistic linear regression model, were calculated as measures of association for the comparison between non-exposed managerial/administrative staff and industrial workers. The analysis showed a statistically significant risk for some ISTAT job classes, in particular class 53 (spinners, weavers, dyers and similar jobs) (OR = 2.65; C.L. 1.52-4.62) class 54 (knitters, tailors, hatmakers, upholsterers and similar jobs) (OR = 1.69; C.L. 1.06-2.71), 55 (tanners, shoemakers, leather manufacture workers and similar jobs) (OR = 2.74; C.L. 1.66-4.53) and group 742 (Hotel and restaurant cooks) (OR = 2.99; C.L. 1.45-6.13). Job classes 45 (carpenters, welders and similar jobs). 62 (electricians, electrotechnicians, radio engineers and similar jobs), 63 (gasfitters, plumbers, heating engineers and similar jobs) and 85 (porters and other jobs involving manual handling of loads) showed ORs higher than 2 but without statistical significance. The results are valid for planning further studies, especially in the textile and shoe and leather manufacturing sectors.

Adult↗

A new approach to collagen fiber orientation in cow skin by the microwave method.

The fiber orientation of cow leather sheets corresponding to the corium of the middle layer in the cow skin was studied by measuring the angular dependence of transmitted microwave intensity and the complex dielectric constant at a microwave frequency of 3.9 GHz. The direction of the minimum transmitted microwave intensity and the maximum dielectric loss agrees with that of the maximum mechanical breaking strength, suggesting that the collagen fibers constituting the cow leather should be preferably oriented in the direction of minimum transmitted microwaves and the maximum dielectric loss. The electron microphotograph supported this suggestion. The main chain direction of collagen fibers and the degree of orientation varied from position to position in the sheet. The present microwave method is convenient for quick determination of the orientation of collagen fibers in the cow skin. It can be applied non-destructively and contact-freely.

Animals↗

[Work and mental health: risk groups].

Analysis of the Quebec Health survey identified those Quebec industrial sectors and professions in which workers are at risk of higher psychological distress and lower psychological well-being. Risk levels were measured by odds ratio, controlling for: health status, sex, social support and stressful life events. Results show that those at risk are blue collar workers and less qualified workers of traditional sectors. Lower job latitude could explain those results. Results show that risk of mental health problems is significantly higher in the following industrial sectors: leather, chemicals, paint and varnish industries; urban bus transport and taxi; shoe, clothing and textile retail stores; department stores; restaurant services; insurance and public administration (excluding defence). Risk of mental health problems is higher in the following professions road transport (excluding truck drivers); textile, leather, fur manufacturing and repairing; housekeeping and maintenance; painters, tapestry-workers, insulation and waterproofing, food and beverages sector; data processors; editors and university professors.

Adolescent↗

In situ femoropopliteal and infrapopliteal bypass. Two-year experience.

We describe 83 in situ femoropopliteal and infrapopliteal artery bypass grafts. The in situ technique involved the valve incision method using scissors, the valvulotome (Leather), and a modified valve cutter (Hall). Arteriovenous fistulae were detected intraoperatively by angiography and/or the Doppler method and ligated. The operative indications were rest pain, ulcer, and gangrene in 88% of cases, and claudication in 7.2%. The mean preoperative ankle pressure was 61.3 mm Hg and the ankle-brachial index was 0.43. The mean postoperative ankle pressure was 125.3 mm Hg and the ankle-brachial index was 0.97. The vein utilization rate was 96%. One-year patency for popliteal anastomoses was 85.7%, for peroneal anastomoses it was 100%, and for infrapopliteal anastomoses it was 89.6%. The data suggest that the practicing vascular surgeon can adopt the in situ technique and can expect high graft patency rates even in limb salvage situations with poor distal outflow.

Aged↗

In situ grafting made easy. Modification of a technique.

In situ bypass grafting has come of age following a period of disenchantment. It has become, in some centers, the operation of choice for bypasses to the tibial and peroneal vessels. Two fundamentally different techniques for this procedure have evolved. The first, following the method of Hall, uses a retrograde valvulotome passed from the distal saphenous vein to the proximal vein; on withdrawal, it severs the valves. A second approach, that of Leather, uses microscissors and a right-angle valvulotome, along with a disposable valve stripper, to disrupt the valves. Proponents exist for both approaches. In 1983 we reported our protocol for in situ grafting using the Hall technique. A number of modifications have since been made to expedite the technique. We describe and provide illustrations of these modifications.

Femoral Vein↗

Running shoes for relief of plantar pressure in diabetic patients.

There is a causal relationship between diabetic foot ulceration, elevated plantar pressure, and severe sensory neuropathy. Cushioned footwear intended to relieve plantar pressure is well established for prevention and healing of plantar ulcers. The aim of the present study was to investigate whether pressure relief by means of a running shoe with optimized forefoot pressure damping is comparable to that of a custom-made soft insole placed into an in-depth shoe. The in-shoe pressures were compared to an in-depth shoe with the original cork insole and with a leather-soled Oxford shoe. The maximum reduction of plantar pressure in the running shoe was 47% under the 2nd and 3rd metatarsal heads, 29% at the first metatarsal head, and 32% at the great toe in comparison to the Oxford shoe. This was surpassed only by the custom-made insole, which reduced pressures at the metatarsal heads by 50%. The specially designed running shoe yielded the same pressure relief at the central metatarsal heads as the custom-made insole. Such shoes are likely to be very useful in preventing diabetic foot ulceration in high-risk patients as a comparatively affordable and immediately available device.

Diabetic Foot↗

Sinonasal cancer and occupation. Results from the reanalysis of twelve case-control studies.

A pooled reanalysis of twelve case-control studies on sinonasal cancer and occupation from seven countries was conducted in order to study associations with occupations other than wood- and leather-related occupations. The pooled data set included a total of 930 cases (680 men and 250 women) and 3,136 controls (2,349 men and 787 women). All the studies included a detailed occupational history for cases and controls. Each job was coded using the same classifications for occupation and industry. Two approaches were used in the analysis: systematic analysis of occupations; a priori analysis using a preestablished list of occupations and industries. The results confirmed associations observed in several studies not included in this analysis. For agricultural workers, significant excesses were observed for squamous cell carcinoma among women (OR = 1.69) and men (OR = 3.72 for ten years or more of employment as an orchard worker), and adenocarcinomas among men (OR = 2.98 for ten years or more of employment). Associations with textile occupations were observed for adenocarcinoma among women (OR = 2.60) and squamous cell carcinoma among men (OR = 5.09 for fiber preparers, 3.01 for bleachers). Elevated risks for both histologic types were observed among men employed in food manufacturing (OR = 3.25, adenocarcinoma), or as food preservers (OR = 13.9, squamous cell carcinoma), and among men employed as cooks (OR = 1.99, squamous cell carcinoma). A positive association with squamous cell carcinoma was observed for male transport equipment operators (OR = 1.21), and also with adenocarcinoma for male motor-vehicle drivers (OR = 2.50). A number of other associations were observed in the systematic analysis.

Adenocarcinoma↗

Maternal occupational exposure to chemical substances and the risk of infants small-for-gestational-age.

BACKGROUND: The association between maternal occupational exposure to specific chemical substances (organic solvents, carbon tetrachloride, herbicides, chlorophenols, polychlorinated biphenyls, aromatic amines, lead and lead compounds, mercury and mercury compounds) and birth of small-for-gestational-age (SGA) infants was evaluated using data from a prospective cohort study of 3,946 pregnant women in West Germany from 1987 to 1988. METHODS: Occupational, medical, and psychosocial information was gathered through a questionnaire from pregnant women who were recruited between 15 and 28 gestational weeks. Exposure to chemical substances at the current workplace was assessed by a job-exposure matrix constructed by Pannett in 1985 and weighted for the number of working hours per week. Women not working at the time of the interview, women with multiple births, and women with stillbirths were excluded from analysis. Data were analyzed using dichotomous and polytomous logistic regression to control for age, smoking status, alcohol consumption, body mass index, and number of former births. RESULTS: The results of the dichotomous logistic regression analysis suggest that leather work might be associated with the birth of infants small-for-gestational-age through exposure to chlorophenols (P = 0.02) and aromatic amines (P = 0.05). In the polytomous logistic regression analysis, only the association between exposure to mercury and growth retardation reached statistical significance (P = 0.02); however, the power of the study is limited. Further adjustment for income, shift work, and heavy physical work had no substantial effect on the results. CONCLUSIONS: These findings suggest that maternal exposure to specific chemicals at work may be a risk factor for the birth of SGA infants.

Adolescent↗

Ovarian cancer and occupational exposures in Finland.

BACKGROUND: No single occupational or environmental agent has been established as causing ovarian cancer, existing studies often being based on ecologic or proportional mortality data in which potential confounders related to reproductive history have not been taken into account. METHODS: This study linked 324 job titles of occupationally active Finnish women (n = 892,591) at 1970 census with incidence of ovarian cancer (Finnish Cancer Registry, 5,072 cases) during 1971-1995 (over 15 million person-years). The job titles were converted into indicators of exposure to 33 agents, using a national job-exposure matrix based on measurements and surveys (FINJEM). Poisson regression analyses were performed with stratification by birth cohort, follow-up period, and socioeconomic status, and adjusted for mean number of children, mean age at first delivery, and turnover rate for each job title. RESULTS: We found indications of elevated risks for aromatic hydrocarbon solvents (standardized incidence ratio 1.3 (95% CI 1.0-1.7), leather dust (1.4; 0.7-2.7), man-made vitreous fibers (1.3; 0.9-1.8), and high levels of asbestos (1.3; 0.9-1.8), and diesel (1.7; 0.7-4.1), and gasoline (1.5; 1.0-2.0) engine exhausts). Previously reported findings for hairdressers and women in the printing industry were supported in our data, but not for women in dry cleaning jobs. CONCLUSIONS: Given the various drawbacks in linkage studies and job-exposure matrices, the excesses found in this study need confirmation in individual-level studies.

Adult↗

Biodegradation of pentachlorophenol (PCP) by white rot fungal strains screened from local sources and its estimation by high-performance liquid chromatography.

White rot fungal strains screened from local sources (wood trunks and from effluents of pulp and paper industry) were tested for their ability to biodegrade polymeric compounds, viz. polymeric dyes (crystal violet and brilliant green) and chlorinated phenol (pentachlorophenol). Two of the most promising strains showing maximum degradation of polymeric dyes were selected to study the biodegradation potential and pattern of biodegradation of pentachlorophenol (PCP), a commonly used leather preservative and a potential carcinogen. PCP was quantitatively estimated and analysed by high-performance liquid chromatography (HPLC). Conditions were optimized for the measurement of PCP on HPLC, which were: mobile phase, 60% acetonitrile and 40% water; flow rate, 1 mL/ min; column, mu Bondapack C18 RP and UV detector at 238 nm. One of the white rot fungal strains isolated from wood trunk showed a maximum 68% biodegradation of PCP in liquid-buffered medium in 16 days. The biodegradation pattern of PCP followed a pseudo-first-order kinetics. Studies on enhancement of biodegradation of polymeric dyes and PCP showed that the kinetics of biodegradation is greatly improved by the presence of manganese ions, H2O2 and glucose in the medium. This strongly suggests the involvement of peroxidase enzyme machinery of white rot fungus in the biodegradation process of PCP.

Biodegradation, Environmental↗

Effect of oral and parenteral administration of metanil yellow on some hepatic and intestinal biochemical parameters.

Metanil yellow, a non-permitted colour for food commodities, is used in the leather, paper and textile industries. In this paper the effect of oral and parenteral administration of Metanil yellow on hepatic and intestinal biochemical parameters was investigated. Oral administration of Metanil yellow (430 mg kg-1 body wt.) for 7 days caused significant depletion of hepatic and intestinal glutathione levels (33-52%) with a concomitant increase in lipid peroxidation (49-121%). Metanil yellow treatment for 7 days also led to a significant increase in cytochrome P-450 (P-450)-dependent aryl hydrocarbon hydroxylase (AHH) activity (99-223%) in the liver and intestine. Cytosolic glutathione-S-transferase (GST) (32-136%) and quinone reductase (QR) (20-92%) activities were also found to be substantially induced in hepatic and intestinal tissues following oral treatment of Metanil yellow. It is interesting to note that oral treatment of Metanil yellow showed a greater response in cytosolic enzymes of hepatic tissue as compared to intestine. Single parenteral administration of Metanil yellow (80 mg kg-1 body wt.) caused significant induction of P-450 and its dependent monooxygenases. Even after 5 days of single parenteral administration of Metanil yellow, hepatic AHH activity showed an elevation of 48% while other monooxygenases were marginally increased. Cytosolic GST and QR showed respective peak inductions of 92% and 60% after 2 and 3 days of parenteral administration of Metanil yellow, which levels off after the 5th day. It can be concluded that Metanil yellow acts as an inducer of a specific form of microsomal P-450 and cytosolic GST and QR, which may involve a cytosolic Ah receptor.

Administration, Oral↗