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A death-certificate-based case-control study was undertaken covering 249 patients with multiple myeloma diagnosed in Western Australia from 1975 to 1984 whose deaths were registered in Western Australia in the same period (73.4% of the total diagnosed) and 996 control decedents who were matched to the cases by age, sex and death registration district. Death from multiple myeloma was associated with both farming [odds ratio (OR) 1.44 with 95% confidence interval (CI) 0.81-2.55] and woodworking (OR 1.70 with 95% CI 0.67-4.31) but not with farming as the father's occupation (OR 0.96 with 95% CI 0.66-1.41). It was also more frequent in migrants to Australia than in native-born Australians (OR 1.31 with 95% CI 0.99-1.74) particularly those born in England (OR 1.57 with 95% CI 1.11-2.42) and Italy (OR 2.02 with 95% CI 1.09-3.74). An apparent excess of multiple myeloma in all rural residents appeared to be due to bias introduced by matching for death registration district, as rural residents dying from multiple myeloma were more likely to die and have their deaths registered in the city than other rural residents. A conditional logistic regression analysis showed the above associations to be substantially independent of one another.
PURPOSE: To determine the role of occupational and personal risk factors of carpal tunnel syndrome (CTS) separately in men and women.METHODS: Men (n = 404) and women (n = 404) younger than 65 years with first surgery for CTS in 1995/96 were sampled at random from the Bremen population (0.65 million) and matched to controls by age and gender sampled from the population registry. A self-administered questionnaire with 77 questions inquired about personal factors and activities during work and private environment (response: 60% of eligible cases and 52% in controls, respectively).RESULTS: CTS risk increased with body mass index (BMI): odds ratio for each unit of BMI [kg/m(2)] OR(men) = 1.13; (95%-confidence-limits CL(men) 1.06, 1.20), OR(women) = 1.09 (CL(women) 1.04, 1.14). Multivariate analysis adjusting for BMI showed more pronounced risks in men compared with women for repetitive movements of the hand: OR(m) = 2.89 (CL 1.82, 4.58); OR(w) = 2.10 (CL 1.37, 3.22), for forceful grip: OR(m) = 2.69 (CL 1.70, 4.27); OR(w) = 2.29 (CL 1.43, 3.66), but not for household chores: OR(m) = 0.64 (CL 0.40, 1.03); OR(w) = 0.88 (CL 0.34, 2.29). Women worked less hours per week than men but manual exposures remained more relevant in men after adjustment. Exposure-response-relationships could be demonstrated for all work related exposures. Women were at higher risk for CTS if they had had more than two births or a history of hysterectomy. Adding these factors to the logistic model still showed an association between manual work and CTS. Blinded expert rating (manual vs. non-manual) of jobs held by respondents and non-respondents and by cases and controls did not reveal relevant selection effects or recall-bias.CONCLUSIONS: CTS is a work related disease in both men and women, the fraction attributable to work in the Bremen population under age 65 is estimated to be 33% in men and 15% in women. Funding: German Federal Ministry for Education & Research: 01 EG 9512.
We have recently demonstrated that adenosine, acting via adenosine A2 receptors, inhibits generation of superoxide anions (O2-) by stimulated neutrophils. To determine the mechanism(s) by which adenosine inhibits O2- generation stimulated by the chemoattractant N-formylmethionylleucylphenylalanine (FMLP), we examined cyclic AMP (cAMP) concentrations, stimulated membrane depolarization and Ca2+ movements. Neither adenosine nor 5'-N-ethylcarboxamidoadenosine (NECA), the most potent agonist at adenosine A2 receptors, increases neutrophil cAMP content. However in the presence of the non-methylxanthine phosphodiesterase inhibitor, Ro-20-1724, both adenosine and NECA elicit a reversible increase in intracellular cAMP concentration. The chemoattractant FMLP also elicits an increment in the neutrophil cAMP content. NECA, in the presence of Ro-20-1724, synergistically enhances the increment in cAMP following stimulation by FMLP. However Ro-20-1724 does not potentiate the inhibition of O2- generation by NECA. Unlike other agents which increase neutrophil cAMP concentrations, NECA, even in the presence of a phosphodiesterase inhibitor, only trivially inhibits degranulation. We also found that adenosine markedly inhibits stimulated membrane depolarization but does not affect the stimulated increment in free ionized intracellular calcium. Moreover, inhibition by adenosine of O2- generation does not vary with the concentration of extracellular calcium. These results fulfil the last criterion for the demonstration of an A2 receptor on human neutrophils, and indicate that adenosine occupies an A2 receptor on neutrophils to raise intracellular cAMP in synergy with occupancy of the FMLP receptor. The results reported here also indicate that cAMP is not the second messenger for inhibition of O2- generation by adenosine and its analogues.
The possibility that an endogenous ligand for the digitalis receptor might exist has been a source of speculation resulting in efforts over the past decades to identify such a hormone. In the current context it is of interest that prolonged wash of myocardial and skeletal muscular samples from subjects who were not in digoxin treatment generally resulted in small tendencies to increase 3H-ouabain binding ranging from 2 to 9% and from -2 to 7%, respectively. It may be appreciated that neither wet weight nor water content of left ventricular or skeletal muscular samples have been found to change as a result of the prolonged wash. Although these tendencies most likely are a mere play of chance, it may be argued that the studies did not entirely rule out the possibility of the existence of a quantitatively small amount of endogenous digitalislike factor. However, based on the evaluations of receptor occupancy with digoxin during treatment of 24-34% in the left ventricle and 9-13% in skeletal muscle, it would seem reasonable to expect that a comparatively larger fraction of digitalis receptors should be occupied by a putative endogenous digitalislike factor, if such a factor were to be of any physiological significance.
After primary treatment due to genital and breast cancer we judged with a total of three hundred and sixty three (363) working women the reintegration into their former jobs. The rate of rehabilitation amounted to 37.2 per cent. The temporary prescription of sheltered jobs--i.e. of work which corresponds with the needs of rehabilitation--was for 56.1 per cent of the women, whereas 23 per cent of the women had to take up a job other that before. In the first place the after-care covers general and gynaecological examination aiming at uncovering recurrence and second tumours and the earliest possible phase, and in the second place special attention is given to the therapy of hormonal deficiency, post treatment effects and incidental cases. The results which the team of specialists from many fields had got from group as well as individual talks are the basis for a follow-up care, mainly done by the psychologists. As a result of this a classification into some possible intervention groups. Special attention has to be given to women where there has been a family history with oncological diseases. A thoroughly coordinated and well-balanced approach to the gynaecological tumour--after-care is indispensable, i.e. it has to integrate firmly the occupational rehabilitation and to bear in mind never to ask too much of the patient.
In Norway the Directorate of Labour Inspection's pneumoconiosis panel consists of two radiologists. Pneumoconioses are notifiable diseases, and doctors are required by law to notify suspected and confirmed cases to the Directorate of Labour Inspection. Chest films are sent to the Directorate. The pneumoconiosis panel reads and classifies the cases according to ILO-standards. During a 9 months' period, 177 chest films were examined, 162 of which were from persons exposed mainly to asbestos. In this group of 162, 96 persons had parietal pleural plaques only, and 21 or 17% had pleuropulmonary asbestosis with visceral pleural thickening from which fibrous streaks radiated into the lung. Ten persons had pulmonary asbestosis alone or combined with pleural plaques. This group included one mesothelioma. The notification form used by the doctors demands adequate information on occupational history and exposures. More specific information would facilitate the work of the panel.
Numerous issues concerning occupational dermatitis are covered, including age and gender of workers it affects, its anatomic location, and length of time a single eruption lasts. Extensive tables show the results of patch testing in various populations.
263 patients with coniotuberculosis of the intrathoracic lymph nodes were compared clinically according to whether they were or not at 0ccupational risk of silicosis. Patients exposed to quartz dust had some special morphological picture of affected lymph nodes: periadenitis, dust caseosis and tubercula in the presence anthracosilicosis sclerosis. Silicotuberculous broncho-adenitis in silicosis patients is characterized by solitary lesions of the lymph nodes, bronchi, rare dissemination to the lungs. Coniotuberculous broncho-adenitis in elderly subjects arises in the result of occupation-unrelated accumulation in the lymph nodes of coal and quartz dust and runs chronically. Unless the disease is controlled early and actively, it may generalize and aggravate with perforation in the bronchi, vessels and esophagus. Profuse hemorrhage, caverns, atelectasis are also possible.
In this paper we have discussed the method of the "pure" detoxification (without the use of any psychotropics) of patients addicted to drugs, narcotics and chemicals treated at the Occupational Diseases & Toxicology Ward of the WCMP in Poznań. The material includes 152 cases of addicted patients who were treated in the Ward in the period from 1986 till 1996. Our research proved that the applied method is safe for the patients. We also found that addicts sharing hospital room with general medicine, not addicted patients, experience a positive effects in the process of treatment and resocialization.
A factory survey was conducted in a plant where N,N-dimethylformamide (DMF) was in use during the production of polyurethane plastics and related materials. In all, 318 DMF-exposed workers (195 men and 123 women) and 143 non-exposed controls (67 men and 76 women) were examined for time-weighted average exposure (to DMF and other solvents by diffusive sampling), hematology, serum biochemistry, subjective symptoms, and clinical signs. Most of the exposed workers were exposed only to DMF, whereas others were exposed to a combination of DMF and toluene. DMF exposure in the former group was up to 7.0 ppm (geometric mean on a workshop basis), whereas it was up to 2.1 ppm in combination with 4.2 ppm toluene. Both hematology and serum biochemistry, results (including aspartate and alanine aminotransferases, gamma-glutamyl transpeptidase and amylase) were essentially comparable among the 3 groups. There was, however, a dose-dependent increase in subjective symptoms, especially during work, and in digestive system-related symptoms such as nausea and abdominal pain in the past 3-month period. The prevalence rate of alcohol intolerance complaints among male (assumedly) social drinkers was also elevated in relation to DMF dose.