Ethical issues among Finnish occupational physicians and nurses.
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Biomedical subjects
Publications and source records attributed to T Leino.
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Koilonychia is a nail disorder well known to accompany certain systemic diseases, but it can also be caused by external factors. We report two cases of occupational koilonychia in hairdressers caused by the toxic effect of chemicals used in permanent wave. Hairdresser's koilonychia has been seldom reported, but may be common.
We carried out a retrospective cohort study using a self-administered questionnaire to assess the risk of hairdressers to develop asthma and chronic bronchitis. A representative sample of 4433 female hairdressers and an equal number of shop personnel in employment in 1980 was drawn from the Longitudinal Census Data File of Statistics Finland. Physician-diagnosed asthma, chronic bronchitis, and other respiratory diseases in 1980 and 1995 were inquired about in the respiratory part of the questionnaire. The response rate to the questionnaire was 82% for the hairdressers (n = 3484) and 79% for the referents (n = 3357). The prevalence of asthma among the hairdressers was 5.6% in 1980 and 10.1% in 1995, and the prevalence of chronic bronchitis was 3.9% in 1980 and 5.6% in 1995. The relative risk for asthma (odds ratio [OR]: 1.7, 95% confidence interval [CI]: 1.3 to 2.3 in 1980; and OR: 1.7, 95% CI: 1.4 to 2.2 in 1995) and for chronic bronchitis (OR: 2.2, 95% CI: 1.5 to 3.2 in 1980; and OR: 1.9, 95% CI: 1.4 to 2.6 in 1995) among hairdressers was almost twice that in the reference group. The incidence rate of asthma in 1980 through 1995 was 2.2 and of chronic bronchitis was 1.1 cases per 1000 person-years among hairdressers, whereas the rate in the reference group was 1.3 asthma cases and 0.9 chronic bronchitis cases per 1000 person-years. The relative risk for developing asthma during the 15 years observation time was 1.7 (95% CI: 1.1 to 2.5) and for chronic bronchitis was 1.2 (95% CI: 0.7 to 1.9) among hairdressers, compared with referents. Our results indicate that hairdressers are at higher risk for developing asthma.
alpha 2-Adrenergic receptors (alpha 2-ARs) regulate many physiological functions and are targets for clinically important antihypertensive and anesthetic agents. Three human and mouse genes encoding alpha 2-AR subtypes (alpha 2A, alpha 2B, and alpha 2C) have been cloned. We investigated the involvement of the alpha 2C-AR in alpha 2-adrenergic pharmacology by applying molecular genetic techniques to alter the expression of alpha 2C-AR in mice. The effects of dexmedetomidine, a subtype-nonselective alpha 2-AR agonist, on monoamine turnover in brain and on locomotor activity were similar in mice with targeted inactivation of the alpha 2C-AR gene and in their controls, but the hypothermic effect of the alpha 2-AR agonist was significantly attenuated by the receptor gene inactivation. Correspondingly, another strain of transgenic mice with 3-fold overexpression of alpha 2C-AR in striatum and other brain regions expressing alpha 2C-AR showed normal reductions in brain monoamine metabolism and locomotor activity after dexmedetomidine, but their hypothermic response to the alpha 2C-AR agonists was significantly accentuated. The hypothermic effect of alpha 2-AR agonists thus seems to be mediated in part by alpha 2C-AR. Some small but statistically significant differences between the strains were also noted in brain dopamine metabolism. Lack of alpha 2C-AR expression was linked with reduced levels of homovanillic acid in brain, and mice with increased alpha 2C-AR expression had elevated concentrations of the dopamine metabolite compared with their controls.
OBJECTIVES: Hairdressers are exposed to many irritative and allergenic substances capable of causing occupational respiratory symptoms and diseases. The self reported prevalence of respiratory symptoms and diseases was studied, and the risks among hairdressers compared with saleswomen was estimated. METHODS: A cross sectional prevalence study of respiratory symptoms and diseases was carried out among hairdressers and supermarket saleswomen, with a computer assisted telephone interview method (CATI). The study population comprised all the female hairdressers and supermarket saleswomen aged 15-54 years in the Helsinki metropolitan area, Finland. Disproportionate random samples of female hairdressers and sales-women were drawn from the trade union membership registers. The interviews were carried out between February and April 1994. A response rate of 80.5% (355/440) was obtained for hairdressers and 82.2% (583/709) for saleswomen. Atopy, smoking, chronic illnesses, type of work, working hours, working conditions, personal and professional use of hair products, and the use of personal protective devices were assessed. The outcome variables were self reported symptoms of the upper and lower respiratory tract. These were used to define chronic bronchitis, and asthma, laryngitis, and allergic rhinitis diagnosed by a physician. RESULTS: There was a considerable difference in the prevalence of chronic bronchitis; 6.8% in hairdressers versus 1.9% in saleswomen. The odds ratio (OR) adjusted for age, smoking, and atopy for chronic bronchitis indicated an increased risk of chronic bronchitis (OR 4.8, 95% confidence interval (95% CI) 2.2 to 10.1). No association was found between work as a hairdresser and asthma, laryngitis, and allergic rhinitis. Also the prevalence of rhinitis, rhinitis with eye symptoms, cough with phlegm, dyspnoea, and dyspnoea accompanied by cough was increased among hairdressers. The corresponding adjusted risk ORs were 1.7 (95% CI 1.3 to 2.3) for rhinitis, 1.9 (95% CI 1.4 to 2.6) for rhinitis with eye symptoms, 1.4 (CI 1.1 to 1.9) for cough with phlegm, 1.5 (95% CI 1.0 to 2.2) for dyspnoea, and 1.6 (95% CI 1.0 to 2.7) for dyspnoea with cough. CONCLUSIONS: Our results indicate an increased prevalence of upper and lower respiratory symptoms among hairdressers. Allergenic and irritative chemicals in hairdressing are likely candidates explaining the difference found between the hairdressers and controls. Work related reasons should be considered when a hairdresser presents with airway symptoms. Preventive actions are needed to improve the working conditions and personal protection.
Hairdressers are exposed daily at their work to many different hair chemicals and dandruff. The work-related nasal symptoms are common, especially with hair bleaching and striping. There are some reports on hairdressers asthma, but publications concerning occupational rhinitis among hairdressers are very few. The purpose of this study is to investigate the work-related rhinitis symptoms of hairdressers, and to study whether nasal provocation tests (NPTs) can be applied in diagnostics. The study subjects were 40 hairdressers having work-related rhinitis symptoms. Detailed work and exposure histories and work-related symptoms were inquired of using a questionnaire. Prick tests were done. Altogether 142 NPTs were done: 40 placebo, 36 dandruff, 35 ammonium persulphate (APS), and 31 ammonium thioglycolate (ATG). To register the nasal response rhinorrhea and nasal blockage were scored. In 3 allergen NPTs there was an essential change in the nasal status: in 2 APS and in 1 dandruff tests. Three patients were diagnosed as having an occupational rhinitis. The low number of positive reactions in NPTs and few positive reactions in skin prick tests verified that immediate allergy caused by hairdressers' work substances is uncommon. However, in cases of clear work-related rhinitis, there is a need to perform examinations to find the probable allergy.
This article describes a widespread outbreak of hepatitis A virus (HAV) infection amongst drug abusers in Finland. Although attempts to demonstrate the virus in amphetamines failed, the infection was assumed to be linked to intravenous use of the drug. The unusual mode of transmission prompted us to analyse possible atypical clinical features as well as the spread of the virus to the general population, nowadays practically without protective immunity. Serologically verified cases that occurred in Helsinki were interviewed, their hospital records were analysed and their contacts were serology tested. Amphetamine lots, as well as faecal samples from patients, were examined with RT-PCR. Detailed information was obtained from 238 subjects, among whom 131 admitted drug abuse and 67 cases were classified as secondary cases. Phylogenetic analysis of virus strains from HAV-infected cases suggested a common origin, and epidemiological observations linked it with particular lots of amphetamine. Three cases died, and 3 presented with severe clinical disease. Icterus was more common among i.v. drug abusers than others. Infection with hepatitis A virus was probably related to the faecal contamination of amphetamine associated with the transportation of the drugs in the gastrointestinal tract.
BACKGROUND: The effects of psychological workload on inflight heart rate were studied in five experienced (flight instructors) and five less experienced (cadets) military pilots of the Finnish Air Force (FAF). METHOD: The subjects performed the same flight mission twice; first with the BA Hawk MK 51 simulator with minimal G-forces and after that with the BA Hawk MK 51 jet trainer with Gz-forces below +2. The mission included: a) 2 min rest after seating; b) take-off; c) ILS approach in the minimum weather conditions (initial, intermediate and final approach); d) landing tour (visual approach); and e) landing. The heart rates were continuously measured using a small portable recorder developed at the University of Jyväskylä, Finland. The R-R intervals were stored and analyzed with an accuracy of 1 ms. The different phases of each flight were marked in the data by using codes given beforehand for each critical event. RESULTS: The take-off resulted in a significant increase in the heart rate from the resting levels both in the cadets and the flight instructors in both planes. In the simulator the heart rate decreased during the initial approach and slightly increased after it during the intermediate approach. Thereafter the heart rate decreased during the landing tour which seemed to be the least psychologically demanding phase of the simulated flight. The heart rate increased again during the landing but did not exceed the heart rates measured during the take-off and the ILS-approach. There were no statistical differences between the groups. In the jet trainer no decrease in the heart rate could be observed immediately after the take-off, unlike in the case of the simulated flight. The inflight heart rate increased during the final approach, decreased during the landing tour and finally increased during the landing. According to the heart rate analysis the final approach was the most loaded phase of the real flight. The changes towards the phases of final approach and landing were greater among the flight instructors. CONCLUSION: There were no statistically significant differences between the mean heart rates during the real and the simulated flight. It is suggested that the heart rate changes for most reflected the changes in cognitive workload.
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The environmental mercury contamination at the Tucuruí water reservoir was studied by measuring the amount of mercury in human hair samples collected from fishermen and their families. Samples were also collected from the Parakanã Indian reservation in the vicinity to give information about the background levels in the area. The mercury concentrations in hair samples ranged from 0.9 to 240 mg/kg. The mean value in the main reservoir was 65 mg/kg. Seven values exceeded 100 mg/kg and 31 values exceeded 50 mg/kg. The hair Hg concentrations amongst the fishermen in Tucuruí reservoir are high enough to cause health effects. The fetal exposure is especially alarming. Changes in gold mining practises and in the human diet are recommended.
Acrylates have a broad area of application in various products including glues, sealants and adhesives. Whereas anaerobic acrylic sealants are well-known sensitizers, acrylate glues that cure in air have only seldom been reported as allergens. Here a patient sensitized to such a glue, and developing hand dermatitis that spread to the lower arms, chest, neck and face, is presented. Her glue was analyzed by gas chromatography/mass spectrometry (GC/MS) and contained 24.6% 2-hydroxyethyl methacrylate (2-HEMA) and 0.4% ethylene glycol dimethacrylate (EGDMA). These 2 acrylate compounds, as well as her glue, provoked an allergic patch test reaction. Also many other acrylate compounds, e.g., tetrahydrofurfuryl methacrylate, gave an allergic reaction indicating cross-allergy. The patient could not continue in her previous workplace because of severely relapsing skin symptoms.
The effects of psychological workload on the plasma levels of eight neuroendocrine hormones were studied in 5 undergraduate and 5 senior military pilots of the Finnish Air Force (FAF). All subjects performed the same short-term basic flight mission, which included the following: 1) start; 2) ILS-approach in minimum weather conditions; 3) visual approach; and 4) landing. The mission was performed twice: first with the BA Hawk MK 51 simulator with minimal G-forces and after that with a BA Hawk MK 51 jet trainer with Gz-forces below +2. Blood samples were collected 30 min before and 10 min after the mission and were measured for adrenaline, noradrenaline, ACTH, beta-endorphin, prolactin, vasopressin (AVP), atrial natriuretic peptide (ANP), and cortisol. The plasma levels of adrenaline, noradrenaline, ACTH, beta-endorphin, and cortisol did not change significantly in response to simulated or real flight. Plasma prolactin levels increased significantly (p = 0.037) in all subjects after the mission performed with jet trainer, and the increase was especially great in cadets. However, the same mission performed with the simulator did not raise plasma prolactin levels. This finding suggests that the psychological workload in a flight simulator does not correspond to the psychological workload in a real jet trainer, at least not in basic flying. Plasma AVP increased significantly (p = 0.032) after the mission performed with the simulator in cadets; this increase can be described as a "first-time effect." Plasma ANP also increased significantly (p < 0.05) after a real jet trainer flight.(ABSTRACT TRUNCATED AT 250 WORDS)
Occupational respiratory symptoms caused by decorative flowers are seldom reported in the literature. In the years 1985-1993 four such cases of occupational asthma were diagnosed at the Institute of Occupational Health of Finland. Occupational asthma was caused by freesias (n = 1), chrysanthemums (n = 1), and tulips (n = 2). The diagnoses were based on work-related respiratory symptoms during flower handling in the patients' histories, specific challenge tests, and allergologic examinations. Flower allergy is rare but can even develop into occupational asthma. It usually leads to a change of profession.
It is known from experimental studies that antigenic potency and the concentration of antigen determine whether exposure to an antigen will result in sensitization. A single accidental exposure to concentrated antigen may therefore induce primary sensitization. The purpose of this report was to collect clinical cases in which a single exposure had resulted in contact dermatitis suspected to be allergic. Only patients without previous relevant skin symptoms were included. Patch testing was used to demonstrate sensitization. 6 patients developed occupational allergic contact dermatitis from accidental exposure. Patch testing revealed allergy to diglycidylether of bisphenol A epoxy resin, polyfunctional aziridine hardener, methyl acrylate, phenol-formaldehyde resin, and methylchloroisothiazolinone/methylisothiazolinone (Kathon LX), respectively. Furthermore, 2 patients developed allergic contact dermatitis from their first exposure to tear gas chemicals, namely omega-chloroacetophenone and ortho-chlorobenzylidene malonitrile. A single exposure can therefore induce both sensitization and subsequent allergic contact dermatitis without further exposure. The allergens described must be considered strong allergens. The skin should immediately be cleaned if an accidental splash with such an allergen has taken place.
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