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Biomedical subjects

G Ahlborg

Publications and source records attributed to G Ahlborg.

At least 73 records · Page 4Linked to original sources

Long-term follow up of workers exposed to solvents.

Long term occupational exposure to organic solvents may cause adverse effects to the central nervous system. This collaborative study between six Swedish departments of occupational medicine examines the overall prognosis in terms of working capacity, symptoms, and psychometric test performance for individuals occupationally exposed to organic solvents. After re-analyses of the data from an initial clinical investigation of 111 men, the subjects were divided into two subgroups: one group of 65 with symptoms but no impairment on the tests and one group of 46 with toxic encephalopathy (symptoms and test impairment). At least five years after the initial examination the subjects were asked to attend a re-examination that included a structured medical interview and a psychometric investigation. The results indicate that effects on the central nervous system persist even when exposure has ceased. In the group of 46 more men had stopped working and were receiving sickness or early retirement pensions. This group also had reduced activity levels with regard to everyday life, leisure activities, and education or training and more neuropsychiatric symptoms. There was no support for the view that a solvent induced toxic encephalopathy is a progressive disease comparable with presenile dementia such as Alzheimer's disease or Pick's disease. If a worker was removed from exposure when he presented symptoms without signs of impairment in intellectual function recovery was seen in most cases.

Aged↗

Splanchnic and muscle fructose metabolism during and after exercise.

Regional substrate exchange was studied in 12 healthy males during 90 min of bicycle exercise at 30% of maximal O2 consumption with a 20-min recovery. Six subjects received an intravenous fructose infusion (8.5 mmol/min) from 40 min of exercise to the end of recovery. Splanchnic glucose output, muscle glucose uptake, arterial glucose, and insulin were uninfluenced by the infusion. The respiratory exchange ratio rose to 0.93 +/- 0.04, and arterial free fatty acids fell by 50% (P less than 0.05). Fructose was taken up by splanchnic tissues (45% of administered load), leg muscle (28%), and resting muscle (28%). During infusion, arterial lactate and pyruvate rose two- to threefold, and these substrates were released from splanchnic tissues and taken up by exercising and resting muscle. Splanchnic release of lactate, pyruvate, and glucose accounted for 78% of fructose uptake at 90 min of exercise. Uptake of fructose, lactate, and pyruvate accounted for 55% and together with glucose for 103% of the total oxidative metabolism by exercising muscle. The regional fructose uptakes and lactate exchanges persisted throughout recovery. The present results indicate that fructose infusion during leg exercise 1) results in increased carbohydrate oxidation from fructose, lactate, and pyruvate in exercising muscle, 2) exerts a glycogenic effect in resting muscle and liver during exercise and in liver and muscle recovering from exercise, and 3) does not interfere with glucose metabolism, and that fructose transport into muscle differs from that of glucose.

Adult↗

Low birthweight, congenital malformations, and spontaneous abortions among dry-cleaning workers in Scandinavia.

With a common study protocol, case-referent studies within cohorts were performed in Denmark, Norway, Sweden, and Finland to study reproductive hazards of women doing dry-cleaning work. Due to national differences not all of the studies could follow exactly the same procedures in data collection, but they were all based on the linkage of cohorts of dry-cleaning and laundry workers to national registers of births and reproductive failures. Summary measures from each study were combined without the data being pooled. The most significant finding was an increased risk of spontaneous abortion among the most exposed women in the Finnish data. This finding was only supported by the results of the other studies to a minor degree, and the combined odds ratio had confidence limits which included unity.

Abortion, Spontaneous↗

Pregnancy outcome among working women.

The influence of occupational factors on the outcome of pregnancy was investigated in a prospective study of 3901 women who worked during their pregnancy and received prenatal care in Orebro County from October 1980 to June 1983. Data on occupational factors, social circumstances, and life-style factors were obtained from questionnaires. There were no significant differences in the incidence of adverse pregnancy outcome (spontaneous abortion, perinatal death, birth defects, or low birthweight) between the nine occupational categories used when nonoccupational factors were accounted for. No increased risk was found for exposure to organic solvents, but the adjusted risk ratio of adverse outcome was 1.28 (95% CI 0.91-1.80) for "other chemical exposures." The work conditions in this county have been generally favorable in recent years, and the results therefore cannot be generalized to conditions with higher exposures. Methodological problems such as misclassification of exposure and the possible bias resulting from different rates of legal abortions among occupational groups are discussed.

Abortion, Spontaneous↗

Diazo-positive metabolites in urine from workers exposed to aromatic nitro-amino compounds.

The amount of diazo-positive compounds in urine from workers at a chemical plant producing pharmaceuticals and explosives was determined in samples collected after work and after a holiday. Forty-five persons working with aromatic nitro-amino compounds (ANA) showed a statistically significant (p less than 0.01) increase in the exposed samples (1.21 +/- 1.40 mmol/mol creatinine) compared to the unexposed samples (0.56 +/- 0.31 mmol/mol creatinine). No increase in the level of diazo-positive metabolites was found in the 25 workers not exposed to ANA compounds. In a follow-up study, 32 trinitrotoluene (TNT) workers were divided into three exposure categories and seemed to show a dose-dependent increase in the level of urinary diazo-positive metabolites. However, there was a considerable interindividual variation. The method seems suitable for the biological assessment of exposure to ANA compounds--at least on a group level. This may be valuable, especially in situations where significant dermal uptake is expected.

Amines↗

Mutagenic activity and metabolites in the urine of workers exposed to trinitrotoluene (TNT).

Urine samples taken after work and after a free weekend from 50 workers employed in various activities in a chemical plant manufacturing explosives were analysed. On the basis of hygienic surveys, the subjects were divided into three categories of exposure to trinitrotoluene (TNT). The urine analyses consisted of gas chromatographic identification of TNT and its two metabolites, 4-ADNT and 2-ADNT, and a determination of the mutagenic activity. Two frame shift detector strains of Salmonella typhimurium were used, TA 98 and TA 98 NR, the latter being deficient in endogenous nitroreductase activity. On the basis of previous results on TNT mutagenicity, no exogeneous metabolic system was used to test the urine concentrates. Both tester strains showed that the mean urinary mutagenic activity was higher in the after work samples than in post weekend samples from the same subjects, showing that bacterial nitroreductase activity was not significantly responsible for the mutagenicity, although the response was higher with strain TA 98 than with TA 98 NR. The interindividual variation in urine mutagenicity was high, however, and the difference between the two sampling times was statistically significant (p less than 0.05) only for the high exposed group (workers in trotyl foundry and sieve house). Correlation between urinary mutagenicity and concentration of TNT in urine was poor; correlation was significant only with the urinary concentration of 4-ADNT. The correlation between urinary TNT and both metabolites was good (p less than 0.001). These results suggest that analysis of 4-ADNT in urine would be a sufficient biological measure for controlling exposure to TNT.

Aniline Compounds↗

Delivery outcome among women employed in the plastics industry in Sweden and Norway.

In Sweden and Norway separate case-control studies of pregnancy outcome for the period 1973-1981 among female workers in the plastics industry were carried out with similar design. Employment records were obtained from companies producing and/or processing plastics and these were matched with the national medical birth and malformation registers. Within the cohorts of pregnancies during which the mother held employment in a plastics industry (1.397 in the Swedish and 288 in the Norwegian study), cases of stillbirths or infant deaths, selected malformations, or low birthweight (less than 2,000 g) were identified. For each case two controls from the same source were individually matched with regard to date of birth, age of mother, and parity. Exposure data concerning the 44 Swedish and ten Norwegian triplets were obtained from the employers. An increased odds ratio was found for processing of polyvinylchloride (PVC) plastics (95% CI Sweden 1.0-5.1; total material 1.1-4.5). However, processing of cold plastics yielded a higher odds ratio than processing of heated plastics. No increased odds ratio was found for processing of styrene or polyurethane plastics. Since not all of the plastics industries in the two countries participated in the studies and the number of cases was small, the result must be interpreted with caution.

Abnormalities, Drug-Induced↗

Carbohydrate utilization by exercising muscle following pre-exercise glucose ingestion.

The effect on exercising muscle metabolism of prior ingestion of 200 g glucose was examined in six healthy subjects during 40 min leg exercise at 30% of maximal oxygen uptake. Leg glucose uptake during exercise was on average two- to three-fold higher after glucose (E + G) compared to exercise without glucose (E) and could account for 44-48% of the oxidative leg metabolism (control value: 19%, P less than 0.05-0.01). In contrast to E, which was associated with a significant release of leg lactate, pyruvate and alanine, E + G gave no leg production of lactate or alanine and an uptake of pyruvate. The respiratory exchange ratios (R) were higher during G + E and corresponded to a carbohydrate oxidation of 54-69% as against 46-49% (P less than 0.05-0.01) during E. Estimated from R-values and leg oxygen and glucose uptakes, carbohydrate oxidation during G less than E was almost completely accounted for by blood glucose. During E, on the other hand, carbohydrate oxidation exceeded leg glucose uptake, indicating a small but significant muscle glycogen breakdown (P less than 0.01). The rate of glycogen utilization during E or G + E was too small to be detected by direct measurements of muscle glycogen content. The results demonstrate that glucose ingestion prior to light exercise is followed by increased uptake and more efficient oxidation of glucose, as well as by insignificant muscle glycogen degradation by exercising muscle. Although the present findings suggest a glycogen-conserving effect of glucose ingestion under these conditions, the main fuel shift is from fat to glucose oxidation.

Adult↗

Changes in temporomandibular joint pain-dysfunction after surgical correction of dentofacial anomalies.

20 patients with dentofacial anomalies were investigated with respect to signs and symptoms of temporomandibular joint pain-dysfunction, which was a common reason for requesting treatment. After surgical correction of the malocclusions, the patients were re-examined 1 week after removal of intermaxillary fixation (IMF), 6 months after surgery and, finally, after 1 to 2 1/2 years. Several of the patients complained of recurrent headaches before surgery and also reported several other subjective symptoms of temporomandibular joint pain-dysfunction. At final control, a statistically significant reduction in headache frequency, as well as for the anamnestic dysfunction index as a whole, was noted. An impairment of clinical signs of temporomandibular joint pain-dysfunction was noted 1 week after removal of IMF, but the situation then returned to that found preoperatively. At final control, a statistically significant reduction of the clinical dysfunction index used was noted. In line with other previous investigations, the patients were satisfied with the aesthetic result of the treatment. A statistically significant increase in number of occluding pairs of teeth was recorded postoperatively and the patients reported an improvement of chewing ability. It is concluded that surgical correction of dentofacial anomalies has a beneficial effect not only on aesthetic and dental occlusion but also upon signs and symptoms of temporomandibular joint pain-dysfunction.

Adolescent↗

Splanchnic and peripheral glucose and lactate metabolism during and after prolonged arm exercise.

Splanchnic and peripheral exchange of glucose and gluconeogenic substrates was examined in 12 healthy subjects during 2 h of arm or leg exercise on a bicycle ergometer and during a 40-min postexercise recovery period. The work intensity corresponded to 30% of the maximal pulmonary oxygen uptake. The regional exchange of substrates was evaluated using catheter technique and indicator dilution methods for blood flow measurements. Our findings indicate that prolonged arm exercise as compared with exercise with the legs results in a greater increase in heart rate (25-40%) and a more marked reduction in splanchnic blood flow (10-30%) as well as higher arterial concentrations of lactate, free fatty acids, and catecholamines. The respiratory exchange ratio was consistently higher with arm exercise. In addition, arm exercise results in a greater fractional extraction and utilization of glucose by exercising muscle as well as a greater hepatic gluconeogenesis from lactate and glycerol. During recovery from prolonged arm exercise, leg muscle becomes an important site of lactate release to the splanchnic bed, despite a lack of net glucose uptake by the leg. Simultaneously, arm muscle shows an increase in glucose uptake in the absence of a net release of lactate. These coincident but discordant processes in the leg and arm during recovery suggest the occurrence of a redistribution of muscle glycogen from previously resting (leg) muscle to previously exercising (arm) muscle.

Adult↗

Urinary screening for potentially genotoxic exposures in a chemical industry.

Mutagenic activity, measured by the bacterial fluctuation assay and thioether concentration in urine from workers at a chemical plant producing pharmaceuticals and explosives, was determined before and after exposure. Of 12 groups only those exposed to trinitrotoluene (n = 14) showed a significant increase in mutagenic activity using Salmonella typhimurium TA 98 without any exogenous metabolic system. The same strain responded only weakly when the S-9 mix was used; with Escherichia coli WP2 uvrA no effect of exposure was observed. Urinary thioether concentration was higher among smokers than among non-smokers, but occupational exposure had no effect. Urinary mutagenicity testing may be a useful tool for screening potentially genotoxic exposures in complex chemical environments.

Chemical Industry↗

Mechanism for glycogenolysis in nonexercising human muscle during and after exercise.

Arterial-deep venous differences for glucose and lactate across the nonexercising forearm were determined in healthy subjects during 3 h of leg exercise at 50% of maximum oxygen uptake and during 20-min recovery. At 160 min of exercise 0.5 mg propranolol was infused into the brachial artery. The results were compared with a control group that did not receive propranolol during exercise. Exercise stimulated to increased forearm lactate release which was higher than that which could be accounted for by the simultaneous blood glucose uptake. After propranolol forearm lactate production decreased during and after exercise while the controls still showed increasing lactate release. In contrast to the control values the lactate production by the blocked forearm could be accounted for by the glucose uptake. It is concluded that the stimulating effect of prolonged exercise on nonexercising muscle that persists during recovery is characterized by increased lactate release derived from beta-adrenergically stimulated glycogenolysis.

Adult↗

Gamma camera detection of 99mTC-plasmin in the diagnosis of deep-vein thrombosis.

99mTc-Plasmin scintigraphy of suspected vein thrombosis registered by a gamma camera was compared with phlebography. The results indicate that the plasmin test can be an alternative method to phlebography. The plasmin test registered by a gamma camera has a high sensitivity but relatively low specificity; this agrees with the results of previous investigations regarding registration with a single detector.

Adult↗

Assessment of methods and results of reproductive occupational epidemiology: spontaneous abortions and malformations in the offspring of working women.

Epidemiological studies relating occupational exposures of working women to spontaneous abortions and malformation are reviewed and some methodological considerations are presented. The reproductive epidemiology is less developed than epidemiology in general and seems to involve some specific problems. The ascertainment of exposure and of outcome may be problematic. The exposures may be reported differently by the women depending on the outcome of the pregnancy; thus confirmation of exposure from an independent data source would be an asset. The recognition of spontaneous abortions by women is variable and this should be considered in the study design. An access to medical records could provide objective data on the outcome, but it may introduce other types of asymmetries. The types of occupational exposures of the women, suggested to carry a risk of spontaneous abortions, include anesthetic agents, laboratory work, copper smelting, soldering, and chemical sterilization using ethylene oxide and glutaraldehyde. Maternal employment in laboratories and exposure to solvents has been linked to a risk of congenital malformations in the offspring in five studies. Data on the teratogenic effects of anesthetic gases has been conflicting. In one study, employment in copper smelting was associated with malformations in the offspring.

Abnormalities, Drug-Induced↗