[Hepatitis B is an occupational risk for health personnel. Preventive vaccination is recommended].
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Biomedical subjects
Publications and source records attributed to B Frenning.
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The prevalence of hepatitis C virus (HCV) markers was investigated among health care staff with a high rate of exposure to blood or needle-stick injuries. After screening sera in pools of 10 at a time and individual testing of all reactive pools, totally 6 of 880 (0.7%; 95% confidence interval, 0.25-14.8%) were positive for anti-HCV, a figure of the same order as that found among Swedish first-time blood donors. Among the seropositives, all of five evaluable had been exposed to blood and four of five to needle-stick injuries. Our data suggest that HCV, in addition to hepatitis B virus, may constitute an occupational hazard for health care workers in Stockholm, even though the risk appears to be low, and personal risk factors such as intravenous drug abuse or blood transfusion could not be ruled out as sources of the infection.
Hospital staff members who failed to respond (anti-HBs < 10 IU/l) after 3 doses of a recombinant hepatitis B (HBV) vaccine (given either as 20 micrograms intramuscularly (n = 8) or 2 micrograms intradermally (n = 15)) received 1 or 2 additional doses by the same route as the initial vaccination. After the first additional dose, 12/23 responded with anti-HBs levels > or = 10 IU/l and after the second, another 2/5 responded, corresponding to a total response rate of 61%. No significant difference was seen in the response rate according to vaccination route, gender, age, or whether the vaccinee was a smoker or not. In this limited study some 50% of non-responders to 3 intradermal or intramuscular doses of recombinant HBV vaccine seroconverted after an additional 1-2 doses given by the same route as the initial vaccination, suggesting that additional doses can be administered by the same route as the initial one.
The prevalence of hepatitis B virus (HBV) markers and exposure to risks possibly associated with HBV transmission were investigated in 797 health care workers (HCW) from Stockholm. Altogether, 31/797 (3.9%) persons were positive for at least one HBV marker, 8.0, 7.9 and 6.4% respectively of children's nurses, laboratory assistants and psychiatric assistant nurses. A history of exposure to needle-stick injuries from any patient, was more often obtained from HCW with HBV markers than from HCW without such markers. The prevalence of HBV markers increased with age and duration of occupation in health care. Most HCW had been exposed to at least one occupational risk for HBV transmission early in their professional careers. Although the risk of acquiring HBV at present is low, the virus constitutes a potential occupational hazard for non-vaccinated HCW in Stockholm, a risk which may increase in the future since the number of chronic HBsAg carriers is increasing in Sweden.
In an open controlled study 286 health care workers in Stockholm, Sweden, received 20 micrograms of a recombinant hepatitis B vaccine (Engerix B) by the intramuscular route, and 383 2 micrograms by the intradermal route. Seroconversion to protective anti-HBs levels (anti-HBs titre greater than or equal to 10 IU/l) was achieved in 94% of the i.m. and 89% of the i.d. vaccinees. Female sex, intramuscular vaccination, young age, and being a non-smoker were associated with a higher response rate and a higher geometric mean anti-HBs titre than male sex, intradermal vaccination, old age and being a smoker. If an acceptable response rate to protective anti-HBs levels of 85% is chosen, intradermal vaccination can be used as a cost reducing strategy for all women and for non-smoking men less than 30 years of age, as estimated in a logistic regression model. Due to the variable antibody response in different individuals, post vaccination testing for anti-HBs titres is recommended in health care workers, regardless of vaccination route.
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The exposure to vapors from jet fuel under different work conditions was examined in three aircraft squadrons. Exposure measurements were made by charcoal sampling in the breathing zones of 23 randomly selected employees belonging to three different personnel groups. Each person was followed during two consecutive days by long-time sampling and, furthermore, by 15-minute sampling during work operations with possible high exposure. The charcoal tubes were eluted with carbon disulfide, and the hydrocarbons were analyzed with gas chromatography. The geometric mean of both the long- and the short-time exposure was only 1-2% of the corresponding occupational exposure limits. The highest long-time exposure observed was about 25% of the occupational exposure limit, while the highest short-time exposure was about 130% of the corresponding limit. Thus the present long-term exposure to solvent vapor in Swedish aircraft units is low, but infrequent short-time exposure above the present limit may occur in some work operations.
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A cohort study on mortality among all members of the Swedish Chimney Sweeps Union who were active in 1950 or later and have been members for at least 10 a has been performed; 2,071 chimney sweeps fulfilled the criteria and the loss in the follow-up was less than 1 %. The observed numbers of death before the age of 80 were compared with sex-, calendar year-, and age class specific expectancy values from the national statistics of 1951-1979. Two hundred and thirty deaths were observed versus 197.6 expected. This result was due to a significant excess of deaths from tumors, particularly lung and esophageal cancer, and from nonmalignant chronic respiratory diseases. The multifold increased risk from these diseases could hardly be explained by extreme smoking or alcohol habits but rather by exposure to polycyclic aromatic hydrocarbons, nitrogen compounds, arsenic, and asbestos in combination with exposure to sulfur dioxide. The excess mortality had occurred in spite of favorable selection factors as demonstrated in different subcohorts. Preventive actions to diminish inhalation of soot and combustion gases should be taken.
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The possible influence of moderate amounts of acetylsalicyclic acid (ASA) on gastric emptying, duodeno-gastric reflux and small bowel propulsion was studied in rats with permanent gastric and duodenal tubes. The ASA-containing or the control solution was introduced intra-gastrically half an hour before the simultaneous administration of differently labeled radioactive test meals into the stomach and the duodenum. ASA was given as 7.5 or 15.0 mM solution in 100 mM hydrochloric acid or in 100 mM sodium chloride. After 15 minutes the gastrointestinal propulsion was examined. No effect of the ASA treatment was noted. No increase in duodeno-gastric reflux was found in the ASA-treated animals.
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Sodium carboxyl-14C acetylsalicylate was injected intravenously into fasted rats in which gastric secretion was either inhibited by atropine or stimulated by histamine. After one hour blood samples and specimens from the glandular portion of the gastric mucosa, muscle, liver, and kidney were taken. The 14C activity in the blood and specimens was determined by liquid scintillation counting after combustion. The drug concentration was lowest in muscle and gastric mucosa, intermediate in the liver, and highest in the kidney, where it equalled that in the blood. The concentrations were proportional to the amount of drug injected in all the examined tissues. There was no difference between rats given histamine and those given atropine. The secretory state of the gastric mucosa thus did not affect the concentration of the drug in this tissue when acetylsalicylate was given intravenously.
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