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Analysis of polar pesticides in rainwater in Denmark by liquid chromatography-tandem mass spectrometry.

A new LC-MS-MS method for analysis of rainwater has been developed and validated for 53 pesticides, degradation products of pesticides and selected nitrophenols. The method was used to monitor the concentration of pesticides in rainwater at one location near Roskilde, Denmark from February 2000 to August 2000. Sampling was done in periods of up to 4 weeks using a cooled wet-only sampler. Water samples were extracted by solid-phase extraction on Oasis HLB columns. The analysis of the extracts was performed by LC-MS-MS with electrospray ionization. All samples were analysed in negative and in positive ionization mode, respectively for acidic and neutral compounds. All analyses were done in the selected reaction monitoring mode in order to obtain a better signal-to-noise ratio. The method has been validated for the following parameters: recovery, detection limit, uncertainty and linearity. Atrazine, terbuthylazine, isoproturon, mechlorprop and (2-methyl-4-chlorophenoxy)acetic acid were measured at concentrations above 0.100 microg/l, mainly during the period of agricultural use. Nitrophenols were measured at high concentrations all year with peaks in the cold season (February-March).

Chromatography, High Pressure Liquid↗

Occurrence of the carcinogenic Bracken constituent ptaquiloside in fronds, topsoils and organic soil layers in Denmark.

Bracken (Pteridium aquilinum (L.) Kuhn) is a common fern found on all continents except Antarctica. It is under suspicion of causing cancer among people who utilizes it as food. The main carcinogenic compound is thought to be the water-soluble compound ptaquiloside. Ptaquiloside-uptake may occur not only through food, but also via drinking water as ptaquiloside might leach from plant material. The purpose of the study was to identify environmental parameters that correlate with the ptaquiloside-content in fronds, and to quantify the amount of ptaquiloside in the soil environment. The ptaquiloside-content in fronds, Oi/Oe-, and Oa/A-horizons was quantified at end of the growth season at 20 sites in Denmark. The fronds had ptaquiloside-contents between 108 and 3795 microgg(-1). The Oi/Oe-horizons had contents between 0.09 and 7.70 microgg(-1), while Oa/A-horizons had contents between 0.01 and 0.09 microgg(-1). The ptaquiloside-content in the standing biomass, which could be transferred to the soil by the end of the growing season, ranged between 10 and 260 mgm(-2), with nine sites having ptaquiloside loads over 100 mgm(-2). The carbon-content in the O-horizon, the precipitation, the amount of Bracken-litter, the turnover rate and the size of Bracken-stands determined the ptaquiloside-content in the soil materials while the content in fronds was found to be a function of the frond-height and the light-exposure in the ecosystem.

Biomass↗

Environmental risk assessment of human pharmaceuticals in Denmark after normal therapeutic use.

An environmental risk assessment is presented for the 25 most used pharmaceuticals in the primary health sector in Denmark. Predicted environmental concentrations (PECs) for the aquatic environment were calculated using conservative assumptions and all PECs exceeded 1 ng/l. Measured concentrations were in general within a factor of 2-5 of PECs and ranged from approximately 0.5 ng/l to 3 micrograms/l for nine of the pharmaceuticals reported in literature. The calculation of predicted no-effect concentration (PNEC) based on aquatic ecotoxicity data was possible for six of the pharmaceuticals. PEC/PNEC ratio exceeded one for ibuprofen, acetylsalicylic acid, and paracetamol. For estrogens the PEC/PNEC ratio approached one when non-standard test was used. The ratio was below one for estrogens (standard test), diazepam and digoxin. For the terrestrial compartment, toxicity data were not available, and no assessment was carried out. Comparisons of predicted concentrations of furosemide, ibuprofen, oxytetracycline and ciprofloxacin in sludge based on either preliminary experimental sludge-water partition coefficients (Kd), octanol-water coefficients (Kow) or acid-base constants (pKa) revealed large variations.

Acetaminophen↗

A survey of the use of dentin-bonding systems in Denmark.

OBJECTIVES: Dentin-bonding systems, which usually involve multistep procedures, are relatively new in dentistry. This study was conducted to survey dental practitioners in Denmark concerning their use of dentin-bonding systems. METHODS: A questionnaire regarding dentin-bonding systems was distributed to dentists at an annual dental conference, and 462 dentists were included in the survey. RESULTS: Dentin-bonding systems were used by 99% of the dentists. Twenty-one different dentin-bonding systems were being used, with six of the systems being used by 78% of the dentists. Of the 456 dentists who used a dentin-bonding system, 77% recalled a clinical procedure for their dentin-bonding system that was in accordance with the written instructions of the manufacturer. The degree to which the dentists complied with the instructions for use, was influenced by the number of operating steps involved for a given dentin-bonding system, by the frequency with which the dentin-bonding system was used, and by the degree to which the dentist was satisfied with the instructions for use provided by the manufacturer. The frequency with which dentin-bonding systems were used, was influenced by year of graduation, place of work, and gender of the dentist. SIGNIFICANCE: Further studies, which focus on the adherence of dental practitioners to instruction manuals are warranted as are investigations of the potential clinical consequences of incorrect use of dentin-bonding systems.

Attitude of Health Personnel↗

Mortality in parents after death of a child in Denmark: a nationwide follow-up study.

BACKGROUND: Little is known about the effect of parental bereavement on physical health. We investigated whether the death of a child increased mortality in parents. METHODS: We undertook a follow-up study based on national registers. From 1980 to 1996, we enrolled 21062 parents in Denmark who had a child who had died (exposed cohort), and 293745 controls--ie, parents whose children were alive, and whose family structure matched that of the exposed cohort. Natural deaths were defined with ICD8 codes 0000-7969 and ICD10 codes A00-R99, and unnatural deaths with codes 8000-9999 and V01-Y98. We used Cox's proportional-hazards regression models to assess the mortality rate of parents up to 18 years after bereavement. FINDINGS: We observed an increased overall mortality rate in mothers whose child had died (hazards ratio 1.43, 95% CI 1.24-1.64; p<0.0001). An excess mortality from natural causes (1.44, 1.15-1.78; p<0.0001) was noted in mothers only during the 10th-18th year of follow-up. Mothers had increased mortality rates from unnatural causes throughout follow-up, with the highest rate recorded during the first 3 years (3.84, 2.48-5.88; p<0.0001). Bereaved fathers had only an early excess mortality from unnatural causes (1.57, 1.06-2.32; p=0.04). Mothers who lost a child due to an unnatural death or an unexpected death had a hazard ratio of 1.72 (1.38-2.15; p=0.0040) and 1.67 (1.37-2.03; p=0.0037), respectively. INTERPRETATION: The death of a child is associated with an overall increased mortality from both natural and unnatural causes in mothers, and an early increased mortality from unnatural causes in fathers.

Adolescent↗

Group A streptococcal bacteraemias in Denmark 1987-89.

A retrospective study of laboratory-verified cases of Group A Streptococcal bacteraemias in Denmark was conducted for the period 1987-1989 after a sudden increase occurred during the winter 1988-1989. The aim of the study was to describe the epidemiology in the period and to compare cases during the outbreak period with cases in a period with a baseline risk. Based on isolates, a total of 242 cases in 240 patients were included in the study and information on previous health of the patients, source of infection (community-acquired or nosocomial) and outcome were obtained from hospital records. During the epidemic period the total incidence increased three-fold. The frequency of type 1 increased from 1 in 5 to 1 in 2. The number of previously healthy individuals falling ill with type 1 increased 25-fold. The relative increase was higher among patients with community-acquired infection than among patients with nosocomial infection. The lethality rate was 48% during the epidemic in which 38% of the cases occurred. As early diagnosis and treatment are the two most important measures to prevent serious outcome, effectiveness and timeliness of surveillance systems are of extreme importance.

Bacteremia↗

Increasing frequency of vertebral osteomyelitis following Staphylococcus aureus bacteraemia in Denmark 1980-1990.

From 1980 to 1990, 309 cases of haematogenous osteomyelitis were identified in Denmark. Haematogenous osteomyelitis of the vertebral column increased significantly (P < 0.01) from the first to the second half of the period due to an increased number of patients > 50 years of age with community-acquired infection. Vertebral osteomyelitis differed significantly from osteomyelitis of other bones in accordance to age distribution (median 66 vs. 16 years), male/female ratio (75/71 vs. 105/ 58) and patients with diabetes (13% vs. 6%). We found a higher risk of haematogenous osteomyelitis in patients > 50 years of age and among patients with community-acquired infection. The highest incidence (5%) of vertebral osteomyelitis in Staphylococcus aureus bacteraemia in this age group was found in cases without an identified portal of entry. The highest incidence (34%) of osteomyelitis of other bones was found in community-acquired cases in the age group 1-20 years and without an identified portal of entry. The present study discusses reasons for the continued increase of vertebral osteomyelitis among adults and describes incidence rates and major risk factors for developing haematogenous osteomyelitis among patients with S. aureus bacteraemia. We suggest that the localization of haematogenous S. aureus osteomyelitis is connected with the presence of red bone marrow.

Adolescent↗

Evaluation of a simplified semi-quantitative protocol for the estimation of Vibrio vulnificus in bathing water using cellobiose-colistin agar: a collaborative study with 13 municipal food controlling units in Denmark.

A simplified semi-quantitative method using pre-enrichment in alkaline peptone water supplemented with polymyxin B and plating onto cellobiose-colistin (CC) agar for the estimation of Vibrio vulnificus in bathing water was evaluated. This protocol was tested in a collaborative study with 13 food controlling laboratories in Denmark during the 1999 bathing season in periods when water temperatures exceeded 20 degrees C. The average percentage of yellow colonies larger than 1 mm in diameter on CC agar that could be identified as V. vulnificus by colony hybridization with a species-specific DNA probe was 79%. This high percentage of specificity demonstrated that by using CC agar in estimating the level of V. vulnificus in bathing water, recognition of yellow colonies larger than 1 mm is sufficient for the identification of V. vulnificus with no further characterization needed. The simplified protocol may be included in the routine control of the microbial quality of bathing water done by the local food controlling laboratories, since it involves simple traditional and low-cost microbiological methods with no use of molecular skills or sophisticated equipment.

Baths↗

Natural attenuation of xenobiotic organic compounds in a landfill leachate plume (Vejen, Denmark).

Demonstration of natural attenuation of xenobiotic organic compounds (XOCs) in landfill leachate plumes is a difficult task and still an emerging discipline within groundwater remediation. One of the early studies was made at the Vejen Landfill in Denmark in the late 1980s, which suggested that natural attenuation of XOCs took place under strongly anaerobic conditions within the first 150 m of the leachate plume. This paper reports on a revisit to the same plume 10 years later. Within the strongly anaerobic part of the plume, 49 groundwater samples were characterized with respect to redox-sensitive species and XOCs. The analytical procedures have been developed further and more compounds and lower detection limits were observed this time. In addition, the samples were screened for degradation intermediates and for toxicity. The plume showed fairly stationary features over the 10-year period except that the XOC level as well as the level of chloride and nonvolatile organic carbon (NVOC) in the plume had decreased somewhat. Most of the compounds studied were subject to degradation in addition to dilution. Exceptions were benzene, the herbicide Mecoprop (MCPP), and NVOC. In the early study, NVOC seemed to degrade in the first part of the plume, but this was no longer the case. Benzyl succinic acid (BSA) was for the first time identified in a leachate plume as a direct indicator, and as the only intermediate of toluene degradation. Toxicity measurements on solid phase-extracted (SPE) samples revealed that toxic compounds not analytically identified were still present in the plume, suggesting that toxicity measurements could be helpful in assessing natural attenuation in leachate plumes.

Bacteria↗

Borrelia meningitis in Denmark.

We studied 23 patients with borrelia meningitis, a tick-borne spirochetosis increasingly recognized in Denmark. The disease showed a seasonal incidence from June to December. Twenty one patients experienced a painful sensory radiculitis, in 17 cases followed by a predominantly cranial mononeuritis multiplex mainly affecting the facial nerve (Bannwarth's syndrome). Three patients had focal CNS involvement in the form of a transverse myelitis, a focal encephalitis and a disseminated leucoencephalopathy, respectively. The CSF showed invariably lymphocytic pleocytosis and elevated spinal protein concentration. Measuring borrelia antibodies in the CSF seemed of higher diagnostic sensitivity than in serum. Penicillin therapy was effective even in cases with focal CNS lesions.

Adolescent↗

Incidence of congenital melanocytic nevi in newborn babies in Denmark.

Three hundred fourteen unselected babies were examined within 96 hours of delivery. Three (1%) of the infants had clinically recognizable pigmented lesions. Two of the lesions (mean, 0.6%; range, 0.1%-2.3%; 95% confidence limits) proved histologically to be compound melanocytic nevi. The histology displayed almost identical patterns, with large nests of melanocytes at the dermoepidermal junction and only few nevus cells in the papillary dermis. A 0.6% incidence rate corresponds to 330 congenital melanocytic nevi in Denmark each year (range, 55-1265; 95% confidence limits). Because histology does not seem to be an accurate diagnostic tool to sort out the malignant potential of the small congenital melanocytic nevi, prospective studies are needed to characterize the premalignant melanocytic nevi, whether congenital or acquired.

Denmark↗

A study of hemophilia A in German shepherd dogs in Denmark.

Classical hemophilia, hemophilia A, is the most common coagulation disorder in dogs. This article presents a comprehensive study of this disease in German Shepherd dogs in Denmark. Emphasis is placed on pathophysiology, diagnosis, genetics, therapy, and prophylaxis. Furthermore, a scheme for a rational elimination of the causative gene from the population is presented.

Animals↗

A multicenter questionnaire investigation of attitudes toward hand hygiene, assessed by the staff in fifteen hospitals in Denmark and Norway.

A questionnaire survey was carried out anonymously among 2557 health care workers in Denmark and Norway to identify and quantify factors that affect the handwashing behavior of physicians, nurses, and other staff groups who perform direct patient care. For number of daily patient contacts physicians reported significantly fewer instances of hand hygiene (HH) per day than did those in other medical professions. Male physicians reported significantly fewer HH per day than did their female colleagues. Significant differences were found among staff groups in emphasis on factors motivating and discouraging HH. The main motivating factor for all groups, however, was an awareness that HH is important for the prevention of infection. Skin problems from frequent handwashing and the use of agents that irritate and dry the skin were the main reasons for disinclination toward HH. The number of points given to these statements correlated well with the stated frequency of HH in staff groups with relatively many (9 to 24) patient contacts per day. Many studies have revealed low standards of HH in health care settings. Whenever HH is taught, the significance of HH for the prevention of infection is always stressed. The participants in this survey were well aware of this significance, but there is still a discrepancy between theory and practice. Goal-specific strategies to improve HH practices would probably be more effective if more were done to minimize the factors that health care workers find detrimental to HH. Continual evaluation of the possibly detrimental effects of current hand washing agents should also be carried out.

Attitude of Health Personnel↗

Butyltin compounds in sediment and molluscs from the shipping strait between Denmark and Sweden.

The distribution of tributyltin (TBT) contamination in the subtidal zone of the waters between Denmark and Sweden was investigated in relation to major international shipping lanes. Sediment and different benthic molluscs were sampled in transects along and perpendicularly to the shipping lanes in the Sound (Øresund) and the Kattegat/Skagerrak region. The samples were analysed for TBT and its degradation products, dibutyltin (DBT) and monobutyltin (MBT), using GC-PFPD. In sediments, the TBT concentration ranged from <1 to 19 ng g(-1) dry weight (dw) with a strong correlation between the TBT concentration and the organic fraction in sediment (r(2)=0.90) in the samples collected in the Sound, where the highest concentrations were found. This relationship was not observed in the samples from the Kattegat because the TBT concentration in most sediment samples was below the limit of detection. In the molluscs, TBT and its degradation products were detected in all samples from the entire area with concentrations ranging from 8.1 ng g(-1) dw in Buccinum undatum to 1316 ng g(-1) dw in Nuculana pernula. The deposit-feeding bivalve N. pernula was found to have a particularly high accumulation potential for TBT. In addition, a strong correlation between TBT concentrations in sediment and N. pernula was found. Therefore this species seems to be an ideal organism for monitoring sediment contamination. The TBT concentration in N. pernula was found to decrease gradually along the shipping lanes from the Sound, through the Kattegat and into the Skagerrak.

Animals↗

Epidemiology of chronic non-malignant pain in Denmark.

A series of health surveys are conducted every sixth to seventh year in Denmark. In the most recent survey of 2000, a national random sample (>16 years) was drawn from the Danish Central Personal Register. Out of the original sample 12,333 (74%) were interviewed and of these 10,066 returned a completed questionnaire (SF-36). The present study includes only those who both took part in the interview and the postal questionnaire. Cancer patients were excluded. Persons suffering from chronic pain (PG) were identified through the question 'Do you have chronic/long lasting pain lasting 6 months or more'? An overall chronic pain prevalence of 19% was found -16% for men and 21% for women. Prevalence of chronic pain increased with increasing age. Persons >/=67 years had 3.9 higher odds of suffering from chronic pain than persons in the age group 16-24 years. Compared with married persons, divorced or separated persons had 1.5 higher odds of chronic pain. Odds for chronic pain were 1.9 higher among those with an education of less than 10 years compared with individuals with an education of 13 years or more. During a 14-day period reporters of chronic pain had an average of 0.8 days (range 0-10) lost due to illness compared with an average of 0.4 days (range 0-10) for the control group (CG) (Odds Ratio (OR)) 2.0). Persons with a job which required high physical strain were more likely to report chronic pain compared with those with a sedentary job (OR 2.2). The odds of quitting one's job because of ill health were seven times higher among people belonging to the PG. A strong association between chronic pain and poor self-rated health was also demonstrated. The PG had twice as many contacts with various health professionals compared with the CG, and the health care system was, on average, utilised 25% more (overall contacts) by the PG than by the general population. Among the persons in the PG, 33% were not satisfied with the examinations carried out in connection with their pain condition and 40% were not satisfied with the treatment offered. Nearly 130,000 adults, corresponding to 3% of the Danish population, use opioids on a regular basis. Opioids are used by 12% of the PG.

Adolescent↗

Worm control practices on sheep farms in Denmark and implications for the development of anthelmintic resistance.

A questionnaire survey was undertaken on sheep farms in Denmark to obtain information on sheep management and worm control practices. The questionnaires were inserted in the June and July, 1993 issue of the Danish Sheep Breeders Journal, circulated monthly to approximately 1200 sheep breeders nationwide. A total of 183 (11%) questionnaires were returned. A second questionnaire was posted to 50 of the 183 responding farmers to examine the repeatability of responses to the first questionnaire. The majority (97%) of the 183 farmers used anthelmintics. The mean number of doses per year for lambs (< 12 months old) and adult sheep (> 12 months old) were 1.9 and 2.3, respectively. Only 42% of the farms followed predetermined drenching programmes. Live weights were determined by visual appraisal on 45% and 84% of the farms for lambs and adult sheep, respectively. In calculating anthelmintic doses for groups of lambs and adult sheep, the recommended weights of the heaviest animals were only used on only 18% and 27% of the farms respectively. Benzimidazoles were the most commonly used anthelmintics from 1986 to 1993. Eighty one percent of 94 responding farmers had been using the same class of anthelmintic for 3 or more consecutive years. Information from this study indicated lack of knowledge about worm control strategies, anthelmintic use and the problem of anthelmintic resistance among the majority of Danish sheep farmers. The majority of responses to the questionnaire were repeatable at least to a fair degree except when farmers were asked to recall anthelmintics used in past years.

Administration, Oral↗

A survey of anthelmintic resistance in nematode parasites of goats in Denmark.

The occurrence of anthelmintic resistance in 15 goat herds in Denmark was investigated using the faecal egg count reduction test (FECRT), egg hatch assay (EHA) for thiabendazole (TBZ) and a microlarval development assay (LDA) for TBZ, levamisole (LEV) and ivermectin (IVM). Resistance to both benzimidazole (BZ) and levamisole (LEV) anthelmintics was detected on six farms, and to both BZs and IVM on one farm. Resistance to BZs was also detected on two farms and to LEV on two farms. Ivermectin resistance was present on one farm. Trichostrongylus and Ostertagia spp. were the predominant nematode species in both pre-treatment and post-treatment faecal cultures. In all nine instances where BZ resistance was detected in the FECRT, the LD50 values for TBZ in the EHA were higher than 0.5 microM TBZ (0.1 microgram TBZ/ml), indicating resistance. LD50 values for TBZ in the LDA were also higher than 0.5 microM where resistance to BZs was detected in the FECRT, except two farms where LD50 values of 0.21 and 0.29 microM TBZ were recorded. LD50 values in the LDA for isolates declared resistant to LEV ranged from 0.78 to 5.62 microM LEV. For IVM, the two resistant isolates had LD50 values of 25 and 68 nM IVM. There were disagreements in the declaration of resistance between methods of calculating faecal egg count reduction percentage (FECR%) based on the arithmetic mean and those where geometric mean EPG is used. Similarly, inclusion of pre-treatment EPG or control group EPG in the calculation of FECR% influenced declaration of resistance.

Animal Husbandry↗

Phylogenetic characterisation of the G(L) sequences of equine arteritis virus isolated from semen of asymptomatic stallions and fatal cases of equine viral arteritis in Denmark.

The study describes for the first time the phylogenetic relationship between equine arteritis virus (EAV) isolated from asymptomatic virus-shedding stallions and fatal cases of equine viral arteritis (EVA) in an European country. EAV was isolated from three dead foals and an aborted foetus during three different outbreaks of EVA. From these fatalities, the complete open reading frame 5, encoding the EAV G(L) protein, was amplified by reverse transcription-polymerase chain reaction and subjected to nucleotide sequence analysis. Furthermore, DNA sequences were obtained from virus isolated from semen samples of seven virus-shedding, but clinically healthy, Danish stallions. DNA sequence alignment revealed an overall divergence of 0-14 and 0-10% at the nucleotide and amino acid levels, respectively. Phylogenetic analysis including 24 previously published sequences revealed that European as well as North American "types" of EAV were present in the semen of asymptomatic carrier stallions and in fatal cases of EVA. Our results reveal that the presence of EAV-shedding stallions in Denmark represents a potential source of severe EVA.

Amino Acid Sequence↗