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Does exposure to computers affect the routine parameters of semen quality?

AIM: To assess whether exposure to computers harms the semen quality of healthy young men. METHODS: A total of 178 subjects were recruited from two maternity and children healthcare centers in Shanghai, 91 with a history of exposure to computers (i.e., exposure for 20 h or more per week in the last 2 years) and 87 persons to act as control (no or little exposure to computers). Data on the history of exposure to computers and other characteristics were obtained by means of a structured questionnaire interview. Semen samples were collected by masturbation in the place where the semen samples were analyzed. RESULTS: No differences in the distribution of the semen parameters (semen volume, sperm density, percentage of progressive sperm, sperm viability and percentage of normal form sperm) were found between the exposed group and the control group. Exposure to computers was not found to be a risk factor for inferior semen quality after adjusting for potential confounders, including abstinence days, testicle size, occupation, history of exposure to toxic substances. CONCLUSION: The present study did not find that healthy men exposed to computers had inferior semen quality.

Adult↗

Impact of ursolic acid on chronic ethanol-induced oxidative stress in the rat heart.

Oxidative stress plays an important role as a mediator of myocardial damage produced by ethanol. This work was designed to investigate the effect of ursolic acid (UA), a reported radical scavenger and antioxidant, on oxidative stress in the heart of chronically ethanol-administered rats. Chronic ethanol administration (7.9 g/kg/day for 60 days) caused tissue damage that was manifested by the elevation of serum lactate dehydrogenase (LDH) and creatine phosphokinase (CPK). It also induced oxidative stress in the heart by increasing the lipid peroxidation process and by decreasing the antioxidant capacity of the heart. After the induction of toxicity (i.e. initial 30 days), treatment groups received UA (10, 20 and 40 mg/kg/day) along with ethanol for another 30 days. Coadministration of UA effectively (20 mg/kg/day) restored the activities of marker enzymes. It also controlled the oxidative stress by decreasing lipid peroxidation products (manifested by decreased lipid peroxidation products such as thiobarbituric acid reactive substances--TBARS, lipid hydroperoxides--LOOH and conjugated dienes--CD), increasing the activities of free radical scavenging enzymes (superoxide dismutase--SOD, catalase--CAT, glutathione peroxidase--GPx and glutathione S-transferase--GSH) and increasing the levels of non-enzymic antioxidants such as reduced glutathione, ascorbic acid and alpha-tocopherol. These findings demonstrate that UA acts as a protective agent against ethanol-induced abnormalities in the heart by reducing the lipid peroxidation process and by enhancing the antioxidant capacity.

Animals↗

Prevention of work-related cancers.

Work-related cancers are highly preventable. The primary responsibility for prevention rests not with the workers who are affected by cancers, but with the manufacturers and distributors of carcinogenic substances and the companies who use them. U.S. public policies of strict product liability and the Occupational Safety and Health Act of 1970 address the issue of responsibility. Workers, health care providers, and others also have important roles that complement employers' preventive efforts. The range of prevention strategies available includes ones that should be applied to prevent potentially carcinogenic substances from being marketed and distributed; others that apply in the workplace where potential carcinogens are used; and public policy interventions aimed at ensuring universal implementation of pre-market and workplace prevention strategies. Work-related cancer remains a large problem, even though strategies exist to identify carcinogens and prevent and control on-the-job exposures. However, preventive efforts by government and the society have stalled and a continuing lack of toxicity information shows inadequate societal commitment. The principal barriers to prevention of work-related cancers are political and economic rather than scientific and medical.

Journal Article↗

In vitro effects of bryostatin 1 on the metabolism and cytotoxicity of 1-beta-D-arabinofuranosylcytosine in human leukemia cells.

Bryostatin 1 is a macrocyclic lactone protein kinase C (PK-C) activator which has demonstrated promising antileukemic activity in preclinical studies. We have examined the effect of this agent on the metabolism and cytotoxicity of 1-beta-D-arabinofuranosylcytosine (ara-C) in both log phase and high-density human promyelocytic leukemia cells (HL-60). Exposure of low-density cells to 12.5 nM bryostatin 1 for 24 hr prior to a 4-hr incubation with 1 or 10 microM ara-C resulted in nearly a 2-fold increase in ara-CTP formation. When cells were maintained under high-cell density conditions (e.g. 5 x 10(6) cells/mL) for 24 hr prior to ara-C exposure, a 90% reduction in ara-CTP formation and ara-C DNA incorporation was observed. However, coincubation of high-density cells with bryostatin 1 for 24 hr increased ara-CTP formation 6- to 8-fold, yielding levels essentially equivalent to those achieved in low-density cells. Smaller (but still significant) increases in ara-C DNA incorporation were also noted. Enhancement of ara-CTP formation by bryostatin 1 occurred over a broad ara-C concentration range (0.1 to 100 microM), involved a temperature-dependent process, could not be mimicked by addition of hematopoietic growth factors, and was not related to neutralization of toxic or inhibitory substances in high-density medium. Exposure of cells to bryostatin 1 did not lead to morphologic or functional evidence of HL-60 cell maturation or an increase in cell viability, but did produce a decline in cellular proliferative activity as determined by thymidine and bromodeoxyuridine incorporation and cytofluorometric analysis. Bryostatin 1 did not exert its effects in high-density cells by inhibiting ara-C deamination or by interfering with ara-CTP dephosphorylation, but instead appeared to act by enhancing ara-C phosphorylation. Although cell-free extracts obtained from high-density cells exposed to bryostatin 1 exhibited levels of deoxycytidine kinase activity compared to controls, treated cells did display a significant decline in intracellular dCTP levels (e.g. 0.7 vs 1.3 pmol/10(6)), and nearly a 2-fold increase in ATP and UTP concentrations. Ara-CTP formation was also increased substantially by other PK-C activators including phorbol dibutyrate and mezerein (10-100 nM); this process was inhibited more than 70% by the PK-C inhibitor H-7 (50 microM), but not by the PK-C inhibitors staurosporine, tamoxifen, and HA1004. Finally, coadministration of ara-C and bryostatin 1 resulted in greater than expected inhibitory effects toward HL-60 cell clonogenic growth.(ABSTRACT TRUNCATED AT 400 WORDS)

Antineoplastic Agents↗

A reallocation of rights in industries with reproductive health hazards.

The U.S. Supreme Court ruling in United Automobile Workers versus Johnson Controls prohibits hiring policies that exclude fertile women from industries posing reproductive health risks to workers and fetuses. Many toxic substances that threaten the developing fetus also pose risks to adult male and female workers. Exclusionary employment policies are socially undesirable for the following reasons: they may lead to worse reproductive outcomes if the indirect effects of lower wages and less adequate health insurance in the alternative available jobs are considered. Second, the effect of such policies could damage the individual woman's overall well-being through its economic impact and her potential loss in autonomy. Third, occupational segregation into less hazardous but lower-paying jobs reinforces gender stereotypes that are restrictive to women. The Supreme Court ruling in the Johnson Controls case reaffirms the importance of the Civil Rights Act as both a shield against unfair treatment for individual women and a commitment to eradicate sexist attitudes and economic inequality throughout society.

Employment↗

The effect of nebulized NaHCO3 treatment on "RADS" due to chlorine gas inhalation.

Chlorine is one of the most common substances involved in toxic inhalation. As with all irritant gases, the airway injuries caused by chlorine gas may result in clinical manifestations similar to those of asthma. In this study, we investigated the effect of nebulized sodium bicarbonate (NSB) on the treatment and quality of life (QoL) of victims exposed to chlorine gas. Forty-four consecutive patients with reactive airways dysfunction syndrome (RADS) due to chlorine inhalation (40 females and 4 males, age range 17-56 yr) were included in this study. Patients were placed in control and treatment groups in a sequential odd-even fashion based on their order of presentation. Treatment of all patients included corticosteroids and nebulized short-acting beta2-agonists. Then the control group (n = 22) received nebulized placebo (NP), and the NSB group (n = 22) received NSB treatment (4 cm3 of 4.20% sodium bicarbonate solution). A quality of life (QoL) questionnaire and pulmonary function tests (PFTs) were performed before and after treatments in both groups. The most common symptoms were dyspnea (82%) and chest tightness (82%). Baseline characteristics of both groups were similar. Compared to the placebo group, the NSB group had significantly higher FEV1 values at 120 and 240 min (p < .05). Significantly more improvement in QoL questionnaire scores occurred in the NSB group compared to the NP group (p < .001). Thus, NSB is a clinically useful treatment, as tested by PFTs and QoL questionnaire, for patients with RADS caused by exposure to chlorine gas.

Adolescent↗

Strategies for inhibiting multistage carcinogenesis based on signal transduction pathways.

It is obvious that the simplest approach to cancer prevention is to avoid exposure to causative agents, whether they be tumor initiators, promoters, or agents that enhance the progression of cells to increasing degrees of malignancy. On the other hand, this simple approach will not always be feasible, either because the causative agent cannot be readily removed from the environment, the precise agent is not known with certainty, or individuals have already suffered significant exposure. It is necessary, therefore, to develop new strategies that can arrest or even reverse tumor development at various stages in the carcinogenic process. The long latency in tumor development, the multistage nature of the process, and the potential reversibility of some of these stages, offer reasons for optimism that this can be achieved. Advances in our understanding of the fundamental mechanisms by which environmental agents produce disturbances in growth control suggest very specific strategies. This paper provides examples of how recent knowledge in the areas of growth factors, growth factor receptors, protein kinases, signal transduction pathways, oncogenes and growth suppressor genes might lead to the development of such strategies. Major problems will include the development of agents which will specifically act on the target cells of interest without producing toxicity to other tissues, as well as better methods for identifying those individuals who are at risk of developing cancer and, therefore, warrant such therapy.

Animals↗

Toxicological studies of chemical mixtures of environmental concern at the National Toxicology Program: health effects of groundwater contaminants.

In cooperation with the Agency for Toxic Substances and Disease Registry, the National Toxicology Program is participating in a Public Health Service activity related to the Comprehensive Environmental Response, Compensation and Liability Act (Superfund Act) by conducting toxicology studies on chemicals found in high-priority hazardous waste sites and for which adequate toxicological data are not available. As part of this effort, a project on the toxicology of chemical mixtures of groundwater contaminants was initiated. The first study, centered on the health effects of groundwater contaminants, is at the contractual stage. Nineteen organic and six inorganic chemicals, selected from more than 1000 known groundwater contaminants, will be given in drinking water to Fischer 344 rats and B6C3F1 mice for 3 or 6 months. Controls and five dose levels, based on average concentrations (i.e., baseline level) of individual component chemicals, or 0.1-, 10-, or 1000-fold of the baseline level, will be used. Toxicological end points include mortality, clinical signs, water and food consumption, body and organ weights, clinical pathology analytes (e.g., hematology, clinical chemistry, and urinalysis), gross and histopathology, neurobehavioral tests, sperm morphology and vaginal cytology evaluations (SMVCE), and cytogenetics. This paper summarizes the rationale behind our experimental design and the factors one must consider when designing studies of complex chemical mixtures.

Animals↗

Final report of the safety assessment of L-Ascorbic Acid, Calcium Ascorbate, Magnesium Ascorbate, Magnesium Ascorbyl Phosphate, Sodium Ascorbate, and Sodium Ascorbyl Phosphate as used in cosmetics.

L-Ascorbic Acid, Calcium Ascorbate, Magnesium Ascorbate, Magnesium Ascorbyl Phosphate, Sodium Ascorbate, and Sodium Ascorbyl Phosphate function in cosmetic formulations primarily as antioxidants. Ascorbic Acid is commonly called Vitamin C. Ascorbic Acid is used as an antioxidant and pH adjuster in a large variety of cosmetic formulations, over 3/4 of which were hair dyes and colors at concentrations between 0.3% and 0.6%. For other uses, the reported concentrations were either very low (<0.01%) or in the 5% to 10% range. Calcium Ascorbate and Magnesium Ascorbate are described as antioxidants and skin conditioning agents--miscellaneous for use in cosmetics, but are not currently used. Sodium Ascorbyl Phosphate functions as an antioxidant in cosmetic products and is used at concentrations ranging from 0.01% to 3%. Magnesium Ascorbyl Phosphate functions as an antioxidant in cosmetics and was reported being used at concentrations from 0.001% to 3%. Sodium Ascorbate also functions as an antioxidant in cosmetics at concentrations from 0.0003% to 0.3%. Related ingredients (Ascorbyl Palmitate, Ascorbyl Dipalmitate, Ascorbyl Stearate, Erythorbic Acid, and Sodium Erythorbate) have been previously reviewed by the Cosmetic Ingredient Review (CIR) Expert Panel and found "to be safe for use as cosmetic ingredients in the present practices of good use." Ascorbic Acid is a generally recognized as safe (GRAS) substance for use as a chemical preservative in foods and as a nutrient and/or dietary supplement. Calcium Ascorbate and Sodium Ascorbate are listed as GRAS substances for use as chemical preservatives. L-Ascorbic Acid is readily and reversibly oxidized to L-dehydroascorbic acid and both forms exist in equilibrium in the body. Permeation rates of Ascorbic Acid through whole and stripped mouse skin were 3.43 +/- 0.74 microg/cm(2)/h and 33.2 +/- 5.2 microg/cm(2)/h. Acute oral and parenteral studies in mice, rats, rabbits, guinea pigs, dogs, and cats demonstrated little toxicity. Ascorbic Acid and Sodium Ascorbate acted as a nitrosation inhibitor in several food and cosmetic product studies. No compound-related clinical signs or gross or microscopic pathological effects were observed in either mice, rats, or guinea pigs in short-term studies. Male guinea pigs fed a control basal diet and given up to 250 mg Ascorbic Acid orally for 20 weeks had similar hemoglobin, blood glucose, serum iron, liver iron, and liver glycogen levels compared to control values. Male and female F344/N rats and B6C3F(1) mice were fed diets containing up to 100,000 ppm Ascorbic Acid for 13 weeks with little toxicity. Chronic Ascorbic Acid feeding studies showed toxic effects at dosages above 25 mg/kg body weight (bw) in rats and guinea pigs. Groups of male and female rats given daily doses up to 2000 mg/kg bw Ascorbic Acid for 2 years had no macro- or microscopically detectable toxic lesions. Mice given Ascorbic Acid subcutaneous and intravenous daily doses (500 to 1000 mg/kg bw) for 7 days had no changes in appetite, weight gain, and general behavior; and histological examination of various organs showed no changes. Ascorbic Acid was a photoprotectant when applied to mice and pig skin before exposure to ultraviolet (UV) radiation. The inhibition of UV-induced suppression of contact hypersensitivity was also noted. Magnesium Ascorbyl Phosphate administration immediately after exposure in hairless mice significantly delayed skin tumor formation and hyperplasia induced by chronic exposure to UV radiation. Pregnant mice and rats were given daily oral doses of Ascorbic Acid up to 1000 mg/kg bw with no indications of adult-toxic, teratogenic, or fetotoxic effects. Ascorbic Acid and Sodium Ascorbate were not genotoxic in several bacterial and mammalian test systems, consistent with the antioxidant properties of these chemicals. In the presence of certain enzyme systems or metal ions, evidence of genotoxicity was seen. The National Toxicology Program (NTP) conducted a 2-year oral carcinogenesis bioassay of Ascorbic Acid (25,000 and 50,000 ppm) in F344/N rats and B6C3F(1) mice. Ascorbic Acid was not carcinogenic in either sex of both rats and mice. Inhibition of carcinogenesis and tumor growth related to Ascorbic Acid's antioxidant properties has been reported. Sodium Ascorbate has been shown to promote the development of urinary carcinomas in two-stage carcinogenesis studies. Dermal application of Ascorbic Acid to patients with radiation dermatitis and burn victims had no adverse effects. Ascorbic Acid was a photoprotectant in clinical human UV studies at doses well above the minimal erythema dose (MED). An opaque cream containing 5% Ascorbic Acid did not induce dermal sensitization in 103 human subjects. A product containing 10% Ascorbic Acid was nonirritant in a 4-day minicumulative patch assay on human skin and a facial treatment containing 10% Ascorbic Acid was not a contact sensitizer in a maximization assay on 26 humans. Because of the structural and functional similarities of these ingredients, the Panel believes that the data on one ingredient can be extrapolated to all of them. The Expert Panel attributed the finding that Ascorbic Acid was genotoxic in these few assay systems due to the presence of other chemicals, e.g., metals, or certain enzyme systems, which effectively convert Ascorbic Acid's antioxidant action to that of a pro-oxidant. When Ascorbic Acid acts as an antioxidant, the Panel concluded that Ascorbic Acid is not genotoxic. Supporting this view were the carcinogenicity studies conducted by the NTP, which demonstrated no evidence of carcinogenicity. Ascorbic Acid was found to effectively inhibit nitrosamine yield in several test systems. The Panel did review studies in which Sodium Ascorbate acted as a tumor promoter in animals. These results were considered to be related to the concentration of sodium ions and the pH of urine in the test animals. Similar effects were seen with sodium bicarbonate. Because of the concern that certain metal ions may combine with these ingredients to produce pro-oxidant activity, the Panel cautioned formulators to be certain that these ingredients are acting as antioxidants in cosmetic formulations. The Panel believed that the clinical experience in which Ascorbic Acid was used on damaged skin with no adverse effects and the repeat-insult patch test (RIPT) using 5% Ascorbic Acid with negative results supports the finding that this group of ingredients does not present a risk of skin sensitization. These data coupled with an absence of reports in the clinical literature of Ascorbic Acid sensitization strongly support the safety of these ingredients.

Administration, Oral↗

Effects of ethanol dose and ethanol withdrawal on rat liver mitochondrial glutathione: implication of potentiated acetaminophen toxicity in alcoholics.

Chronic ethanol consumption potentiates acetaminophen (APAP) hepatotoxicity through enhanced NAPQI formation via CYP2E1 induction and selective depletion of mitochondrial glutathione. Because the prevalence of the interaction is extremely low given the use of APAP and the incidence of alcohol abuse, we studied the effects of ethanol dose and ethanol withdrawal on selective mitochondrial glutathione (GSH) depletion and APAP toxicity in liver slices. Rats were fed the Lieber-DeCarli diet containing ethanol (0, 7, 18, 27, and 36% total energy) for 6 weeks. The highest ethanol-containing diet (36% energy as ethanol) was replaced by control diet for 2, 5, 12, and 17 h. Maximal CYP2E1 induction was caused by 36% energy as ethanol diet (2.2-fold, p < 0.05 versus control). The activity and liver protein content returned to the control level 17 h after ethanol withdrawal. The 36% energy as ethanol diet caused maximal mitochondrial GSH depletion (51%, p < 0.05 versus control), which was restored 17 h after ethanol withdrawal (22.0 +/- 4.9 versus 11.7 +/- 1.7 nmol/mg protein of 0 h, p < 0.01). Elevated glutathione S-transferase-alpha release in liver slices (a measure of toxicity) was observed in rats fed 36% energy as ethanol diet (1 mM APAP: 69 +/- 10 versus 3 +/- 1% of control, p < 0.01). Enhanced toxicity disappeared when ethanol dose decreased and when ethanol was removed (7.2% ethanol: 3 +/- 1% and 17 h: 2 +/- 1%, p < 0.01 versus 0 h 36% energy as ethanol). In conclusion, high-dose ethanol potentiated APAP hepatotoxicity via CYP2E1 induction and selective mitochondrial GSH depletion. Mitochondrial GSH depletion quickly reversed when ethanol was withdrawn. The time window for both mechanisms to act in concert is narrow.

Acetaminophen↗

NTP technical report on the toxicity studies of of n-Hexane in B6C3F1 Mice (Inhalation Studies) (CAS No. 110-54-3).

Thirteen-week inhalation toxicity studies of n-hexane were conducted with B6C3F1 mice of each sex exposed to 0, 500, 1,000, 4,000, or 10,000 ppm, 6 hours per day, 5 days per week or to 1,000 ppm, 22 hours per day (referred to as 1,000c), 5 days per week. All mice lived to the end of the studies. The final mean body weights of mice exposed to 1,000c ppm or 10,000 ppm were 10% or 17% lower than that of the controls for males and 0% or 6% lower for females. Hematologic analyses were performed on whole blood samples collected at the end of the 13-week exposure. Segmented neutrophils were significantly increased in male mice exposed to 10,000 ppm. A battery of behavioral measurements was conducted on mice, and the only parameter affected was locomotor activity, which was decreased in female mice at 1,000c ppm and 10,000 ppm. The test battery performed included forelimb and hind limb grip strength, motor activity and exploratory behavior, acoustic startle response, foot splay, and analgesia response. Compound-related lesions of the nasal turbinates were seen in all groups of exposed mice except males exposed to 500 or 4,000 ppm. At the 10,000-ppm concentration, nasal lesions included inflammatory, erosive, and regenerative lesions of the olfactory and respiratory epithelium; luminal exudation and metaplastic lesions of the olfactory epithelium; and fibrosis of the submucosa. Lymphoid hyperplasia of the mandibular lymph nodes and neutrophilic hyperplasia of the bone marrow were also seen. At lower concentrations, lesions were not present in all mice and were limited to minimal regeneration or metaplasia of the olfactory epithelium. A few paranodal swellings in the teased fibers of the tibial nerve were observed in 3/4 males and 3/4 females exposed to 10,000 ppm, 3/4 males and 3/4 females exposed to 1,000c ppm, and 0/4 male and 0/4 female controls; the severity of the lesions was minimal. Neither segmental demyelination nor distal axonal degeneration was seen. Exposure of mice to n-hexane at concentrations up to 10,000 ppm resulted in only minimal toxicity. Paranodal swellings seen in nerves at 1,000c ppm and at 10,000 ppm were considered to be minimal nerve damage that would not result in paralysis. Exposure- related lesions of the nasal cavity occurred after n-hexane exposure, but minimal or no effects were seen at 1,000 ppm or below. Synonyms: Hexyl hydride. (NOTE: These studies were supported in part by funds from the Comprehensive Environmental Response, Compensation, and Liability Act trust fund (Superfund) by an interagency agreement with the Agency for Toxic Substances and Disease Registry, U.S. Public Health Service.)

Journal Article↗

TCDD increases inhibin A production by human luteinized granulosa cells in vitro.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is the most toxic of the halogenated dioxins and one of the most poisonous substances known to man. The major toxic effects of TCDD on reproduction are decreased fertility and diminished ability to maintain a pregnancy. Granulosa cells obtained from hormonally stimulated women participating in an in-vitro fertilization program were cultured with 3.1 femtomolar, 3.1 picomolar and 3.1 nanomolar TCDD. While inhibin B production was not altered, inhibin A production increased significantly after 4 hours of exposure to both nanomolar and micromolar TCDD concentrations. By 8 hours of exposure to these concentrations of dioxin, human luteinizing granulosa cells exhibited a pronounced increase in inhibin A, nearly quadrupling secretion from unexposed control cells. TCDD continued to increase inhibin A secretion at the picomolar concentration at 24 and 36 hours. It is conceivable that TCDD may act at the ovary to augment inhibin A secretion, thereby reducing FSH-stimulable estrogen secretion by granulosa cells.

Cell Line↗

Human pharmacology and abuse potential of the analgesic buprenorphine: a potential agent for treating narcotic addiction.

Buprenorphine was evaluated for its abuse potential and utility in treating narcotic addiction. The drug was morphine-like but was 25 to 50 times more potent than morphine and was longer-acting. Little if any physical dependence of clinical significance was produced by buprenorphine. The effects of morphine to 120-mg doses were blocked by buprenorphine, a blockade that persisted for 29 1/2 hours. In man, buprenorphine has less intrinsic activity than morphine, and as such, as a low abuse potential. Moreover, the drug has potential for treating narcotic addiction since it is acceptable to addicts, is long-acting, produces a low level of physical dependence such that patients may be easily detoxified, is less toxic than drugs used for maintenance therapy, and blocks the effects of narcotics.

Adult↗

Environmental pollutants and allergy diseases.

A rapid increase in the prevalence of allergic diseases of our times as well as a significant increase in the IgE production in our population cannot be explained only by the genetic influence. Allergy is a growing, special problem of the industrial regions and well developed countries. The environmental factors and style of life seem to be the most important reasons of this phenomenon. The environment in which we live is full of natural and manmade substances capable of causing reactions in susceptible individuals. Xenobiotic--unnatural substances which appeared in polluted environment and act on our immunity may induce the suppression of it and in this way provoke the infection or neoplastic diseases. They may also induce the hyper-reactivity reaction and then become the reason of allergic or autoagression diseases. We distinquish two types of environmental pollution. Type I--with a high level of SO2 which induce infections and the chronic inflammation as a consequence of their irritants and a toxic action and type II pollutants (NOx, O3, VOC--volatile organic chemicals) which promote allergic diseases. The allergy in polluted areas additionally is accompanied very often by pseudo-allergy and toxic reactions. In order to stop the present increasing trend of allergic diseases we must increase our attempts to control allergens and irritants. There is no doubt today that the development of allergic diseases is related to the genetic predisposition and environmental factors.

Air Pollution, Indoor↗

New trends in the development of occupational exposure limits for airborne chemicals in China.

Occupational exposure limits (OELs) are well established in many countries, which serve occupational professionals as benchmarks of industrial hygiene practice at workplaces worldwide. Starting in the mid-1950s, the central government of China began promulgating OELs for hazardous substances at workplaces. This paper discusses the historical basis, philosophical principles and schematic protocols of developing and setting OELs in China. The underlying principles include: (1) protection of human health being the first and the most important criterion; (2) the use of quantitative epidemiological studies in humans being given top priority; (3) integration and full use of all information sources, including animal experimental data for new chemicals or chemicals with new toxicity concerns; (4) considerations of socioeconomic and technological feasibilities in the country; and (5) amending existing standards based on new evidence. The strategy of the World Health Organization's "Two-step Procedure" is applied to convert health-based recommendations to law-based operational OELs, with considerations for national technological and socioeconomic conditions and priorities. As a result of the recent passage of the new law Occupational Diseases Prevention and Control Act of the People's Republic of China (ODPCAct), an official document Occupational Exposure Limits for Hazardous Agents in the Workplace containing a comprehensive list of new and amended OELs has been issued, which has now become one of the most essential regulations affiliated with the ODPCAct. This paper provides a brief summary of the salient features of the new law ODPCAct and the principles and processes of developing or amending OELs. This paper also discusses the challenges that lie ahead in enforcing the new regulations in China.

Air Pollutants, Occupational↗

Synthetic retinoids in dermatology.

The potential of vitamin A, or retinol, in the treatment of a variety of skin diseases has long been recognized, but because of serious toxic effects this substance generally could not be used. The recent development and marketing of two relatively non-toxic synthetic analogues, which are known as retinoids, has made it possible to treat some of the diseases that are resistant to standard forms of therapy. Isotretinoin is very effective in cystic and conglobate acne, while etretinate is especially useful in the more severe forms of psoriasis. Good results have also been obtained in other disorders of keratinization. Vitamin A and its derivatives apparently have an antineoplastic effect as well and may come to be used in both the prevention and the treatment of epithelial cancer. In many of these diseases the retinoids act by enhancing the normal differentiation and proliferation of epidermal tissues, but the exact mechanisms are not well understood. Their influence on the intracellular polyamines that control the synthesis of nucleic acids and proteins may be an important factor. Although the retinoids have few serious systemic effects, they are teratogenic, and because they persist in the body their use in women of childbearing potential is limited.

Acne Vulgaris↗

Oxidative burst of neutrophils in patients with rheumatoid arthritis: influence of various cytokines and medication.

OBJECTIVE: Toxic oxygen products are believed to be implicated in tissue damage in some complex-mediated diseases such as rheumatoid arthritis. In the present study we compared the superoxide (O2) production of polymorphonuclear leukocytes (PMNs) in 21 patients with rheumatoid arthritis (RA) with that of 9 healthy controls, examining the effect of different stimulants and cytokines on the oxidative burst (OB). Since many drugs used in the treatment of RA may alter O2 metabolism, the effects of antirheumatic medication were also studied. METHODS: Generation of superoxide anions was analysed by a flow cytometric method, using the fluorochrome dihydro-rhodamine. As stimulants for OB, we used N-formyl-methionyl-leucyl-phenylalanine (fMLP), which acts via a membrane receptor, and phorbol-myristate acetate (PMA), which acts in a membrane receptor-independent manner. As preactivating substances, TNF-alpha, G-CSF and GM-CSF were applied. RESULTS: In RA patients under treatment with antirheumatic medication, fMLP-induced OB (+/- cytokines) was significantly reduced, while O2 production after stimulation with PMA was similar compared to controls. GM-CSF showed the highest level of preactivation in controls, whereas in RA patients TNF-alpha proved to be most potent. In both controls and RA patients, a combination of GM-CSF or G-CSF with TNF-alpha further enhanced OB. No correlation between OB and clinical data or treatment could be established in RA patients. CONCLUSIONS: There is a reduced cytokine priming capacity for OB in RA patients under antirheumatic medication in spite of the presence of an intact enzyme system of OB. Antirheumatic medication combining multiple drugs capable of decreasing OB might effectively modulate oxidative metabolism.

Adult↗

Clinical assessment and pharmacotherapy of the alcohol withdrawal syndrome.

All patients in alcohol withdrawal should have a full assessment for detecting medical complications. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A) scale permits a quantitative assessment for following the clinical course and therapeutic response in patients in withdrawal. Most patients with mild withdrawal symptoms do not require hospitalization and respond to non-pharmacologic supportive care. Early initiation of treatment with supportive nursing care and, if necessary, benzodiazepines usually will prevent progression to serious withdrawal reactions and provide the patient with sufficient symptomatic relief. Pharmacotherapy can be considerably simplified by using the loading dose technique, i.e., giving diazepam every 1-2 hr initially until the patient shows signs of clinical improvement and/or mild sedation. If long half-life drugs (e.g., diazepam) are used, further therapy is rarely needed and complications are prevented. Short-acting benzodiazepines can also be given in a similar fashion in the milder clinical syndrome. Phenytoin should only be given to patients with a preexisting seizure disorder. Phenothiazines, barbiturates, paraldehyde, and antihistamines have no role in the treatment of withdrawal because of their toxicity or lack of efficacy. Haloperidol is effective in the control of hallucinations in patients also treated with a benzodiazepine. The treatment of alcoholic intoxication and withdrawal is only the first step toward full rehabilitation.

Adrenergic beta-Antagonists↗