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PubMed1993

n-hexane polyneuropathy in Japan: a review of n-hexane poisoning and its preventive measures.

n-Hexane is used in industry as a solvent for adhesive, dry cleaning, and vegetable oil extraction. In 1963, the first case of severe polyneuropathy suspected to be caused by n-hexane was referred to us. Case studies, animal experiments, and field surveys on n-hexane poisoning were conducted, and preventive measures like threshold limit value revision and biological monitoring were also studied. I review a brief history of our investigations on n-hexane poisoning and its preventive measures in Japan. n-Hexane could cause overt polyneuropathy in workers exposed to more than 100 ppm time-weighted average concentrations [TWA]. The present threshold limit value of 40 ppm in Japan is considered low enough to prevent subclinical impairment of peripheral nerve caused by n-hexane. Urinary 2,5-hexanedione could be a good indicator for biological monitoring of n-hexane exposure. About 2.2 mg/liter of 2,5-hexanedione measured by our improved method corresponds to exposure of 40 ppm (TWA) of n-hexane.

Animals↗

PubMed2001

Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed.

AIMS: Patients without spleens are at increased risk of overwhelming infection. Recently, greater efforts, including the publication of national guidelines, have been made to improve the management of asplenic individuals. In theory, risks of serious sepsis can be reduced by good advice, immunisation, and antibiotic prophylaxis. In practice, such preventive measures might not be followed or may fail. A study of recent cases of overwhelming postsplenectomy infection (OPSI) was undertaken to examine specific associated factors and to determine whether currently recommended preventive measures are being followed. METHODS: Cases of OPSI were identified and reported mainly by microbiologists across the country using a specifically designed proforma. Data including the nature of the infection and vaccination/ antibiotic prophylaxis history since splenectomy were obtained. RESULTS: Seventy seven cases were reported. The age range varied from 3 months (congenital asplenia) to 87 years. In those who had undergone surgical splenectomy, the time interval between surgery and OPSI varied from 24 days to 65 years. Overall mortality reached 50%, with underlying haematological malignancy associated with the highest death rate. Streptococcus pneumoniae caused approximately 90% episodes. Only 31% individuals had received pneumococcal vaccination before OPSI. Seven of 17 pneumococcal infections in immunised cases could be considered vaccine failures. Few patients had been adequately advised on antibiotic prophylaxis or other measures. CONCLUSIONS: Currently accepted best practice for managing asplenic patients is not being followed. Some OPSI cases may still be preventable but many asplenic individuals remain unrecognised. The compilation of asplenic patient registers might help to implement agreed policies with audit necessary to evaluate compliance. More is needed to ensure optimal management for this cohort of the population.

Adolescent↗

PubMed2006

Knowledge and use of preventive measures against malaria in endemic and non-endemic villages in northern Thailand.

The objective of this study was to determine the frequency and determinants of knowledge of malaria in four sites in northern Thailand, and to compare the use of prevention measures between people with and without a knowledge of malaria. An epidemiological survey was conducted in January 2002 among 857 persons living in four sites in northern Thailand. Of the 857 persons, 53% had a knowledge of malaria, ranging from 38% and 51% in non-endemic to 76% and 77% in endemic sites. Headache (89%), shivering (83%) and fever (79%) were the most frequently mentioned symptoms. Younger persons had more knowledge of malaria than older persons; adjusted Odds Ratio (aOR): 3.91 [95% confidence interval (CI): 2.32-6.56] for the 15-29 age group compared to persons 60 years and older. In comparison to men, knowledge of malaria was significantly lower among women (aOR: 2.00, 95%-CI: 1.47-2.70). Persons with knowledge reported a significantly higher use of prevention measures than persons without knowledge of malaria.

Adolescent↗

PubMed1993

General preventive measures against carcinogenic exposure in the external environment.

Different measures are used to prevent unacceptable carcinogenic exposure from different sources in the external environment, be it accumulated carcinogens from previous pollution, exposure related to life-style, and exposure related to living standards and the organization of the community as a whole. A precondition for goal-directed prevention is knowledge of exposures to carcinogens and measures to minimize or substitute carcinogens in products and in emissions. One of the most significant sources of carcinogens in the outdoor air in many Western countries is the traffic, especially diesel-powered vehicles. Necessary preventive measures include restriction of carcinogenic exhaust from the individual vehicle, plans for the community to diminish transportation needs, as well as to changing the usual behaviour of the individual. Unlike exposure to carcinogens in the surrounding air, exposure to accumulated carcinogens in ground-water and in soil at polluted sites may be diminished by the pattern of use. International aspects are involved in for instance minimizing the risk of getting skin cancer from sunlight. Besides protecting vulnerable individuals there should be a global preservation of the ozone layer. Lowering the risk of long transported air pollution, like radioactivity from accidents at nuclear power stations, demands international efforts to increase safety measures and information about accidents.

Animals↗

PubMedDate not supplied

Buses as fire hazards: a Swedish problem only? Suggestions for fire-prevention measures.

In Sweden, approximately 6% of all human transportation is made via buses. The Swedish Board of Accident Investigation and the Swedish Rescue Services Agency have pointed out repeatedly that buses are potential fire and burn hazards, not only when involved in collisions but also in other circumstances. The number of fire incidents is increasing, especially in newer buses. In conjunction with the Swedish Rescue Services Agency, we examined some of the recent bus fires in Sweden. We did not find any casualties, but the results of our study suggest that casualties as a result of bus fires are imminent unless preventive measures are taken. We also studied experiences from previous bus fires and suggest preventive measures.

Burns↗

PubMed1998

Occurrence of occupational asthma in aluminum potroom workers in relation to preventive measures.

The purpose of this study was to investigate whether preventive measures such as reduction of exposure and the introduction of the histamine provocation test (HPT) as a selection instrument resulted in a lower incidence of potroom asthma (PA) and a longer time lag between the commencement of employment and the occurrence of PA. Between 1970 and 1990, 179 cases of PA were diagnosed. This period was divided into three periods. During period 1 (1970-1975), no exposure data were available. Period 2 (1976-1981) is characterized by known exposure data obtained by means of fluoride determinations in urine. At the beginning of period 3 (1982-1990) the HPT was incorporated into the preemployment medical examination. We computed the incidence density (ID) in the three periods and analyzed the timelag in relation to the year of employment and confounding factors such as age, atopic history, blood eosinophil counts, lung function, smoking habits at preemployment, and exposure level. After introduction of the preemployment HPT the ID decreased, but cases continued to occur (ID 11.6 in period 2 versus 2.5 in period 3). The time lag was did not differ when subjects with bronchial hyperresponsiveness were screened out. The exposure level and an atopic history were factors associated with the period of employment and, therefore, confounded the results. The results of this study support the role of an atopic history as a risk factor for development of PA at lower exposure levels and suggest that potroom exposure not only incites asthmatic symptoms but also acts as an inducer of respiratory disease.

Aluminum↗

PubMed1996

Respiratory morbidity in relationship to farm characteristics in swine confinement work: possible preventive measures.

Swine confinement farming is associated with an increased risk of respiratory morbidity. Adverse health effects have been shown in association with levels of dust, endotoxins, and ammonia. This study was conducted to evaluate characteristics of confinement farms associated with respiratory morbidity in order to establish priorities for preventive measures. A questionnaire on symptoms and farm characteristics was completed by 1,432 male swine confinement farmers. Of these, 200 with and 200 without chronic respiratory symptoms were randomly selected for lung function testing. A significantly increased risk for chronic respiratory symptoms was shown if farmers used wood-shavings as bedding (prevalent odds ratio [POR]2.2), used disinfectants (POR 1.7), used natural ventilation (POR 2.6), had floor types other than slatted or half-slatted (POR 2.1), or used a mechanical feeding system (POR 1.4). Lung function (FEV1) was significantly lower with increasing numbers of years worked (51 ml/10 years), with smaller numbers of pigs (8.5 ml/100 pigs), and when the air outlet of the ventilation system was via the pit (248 ml). To decrease the risk of respiratory morbidity the following preventive measures are proposed: discouragement of the use of disinfectants and of wood-shavings as bedding, and promotion of the use of mechanical ventilation systems.

Agricultural Workers' Diseases↗

PubMedDate not supplied

[Pressure ulcers in intensive care: assessment of risk and prevention measures].

UNLABELLED: Pressure ulcers (PU) are associated to greater patient morbidity and mortality. Thus, all prevention measures are very important. In order to establish the appropriate care early, the first measure is the identification of patients at risk of developing PU, using specific scales. OBJECTIVES: 1) to assess the risk of developing PU in the patients admitted in an Intensive Care Unit (ICU), using the Waterlow scale; 2) to identify patients with PU and to analyse the possible relationship between them and the measured risk; 3) to analyse the preventive care received by patients for its prevention. METHOD: This descriptive study analysed the risk of developing PU in 91 critical patients with a stay greater than 3 days. To measure the risk the Waterlow scale (modified by Weststrate in 1998), that included 14 risk factors, was used. Sociodemographic data, cause of admission, patients with PU, its location and grade and care applied were also collected. RESULTS: Risk grade obtained on the Waterlow scale was: without risk (< 10 points) in 8 patients, 23 with risk (10-14 points), 29 with high risk (15-19 points) and 31 had very high risk (20 points). Thirteen patients had ulcer, in 10 of them it was present on admission. Their score obtained on the scale was risk in 2 patients, high risk in 5 and very high risk in the remaining 6. A statistically significant difference was found between the mean score of risk of the 13 patients who had ulcer and the remaining sample (21.85-16.83; p = 0.005). When the risk factors included in the scale and its relationship with the presence of ulcer were analysed, statistically significant difference was only found in the "heart failure" factor (vasoconstrictor treatment), p = 0.045. No association was found between age, gender, diagnosis and presence of ulcer. Regarding the daily care applied to patients, the following results were obtained: skin hydration and hygiene were done in 100% of the patients, patient repositioning were done every 2 hours or more frequently in 80% of the patients, every 3 hours in 10% and in the remaining 10%, with a frequency greater than 4 hours. Heel protection was applied in 57% of the patients and special mattress was used in 54%. CONCLUSIONS: Most of the studied patients had high risk of developing PU. The patients who had an ulcer were at risk of developing it. The low incidence of ulcers obtained in this study allows us to consider appropriate the protocol of care.

Adult↗

PubMed2004

Cardiology management improves secondary prevention measures among patients with coronary artery disease.

OBJECTIVES: The goal of this study was to determine if cardiology subspecialty involvement improves the attainment of recommended low-density lipoprotein (LDL) cholesterol and blood pressure (BP) targets in coronary artery disease (CAD) patients. BACKGROUND: The impact of physician specialty on secondary prevention measures for CAD in ambulatory care is unknown. METHODS: This was a retrospective cohort study of 13,995 patients with CAD seen at eight ambulatory care Veteran Affairs facilities from 1998 to 2000. Patients with cardiology involvement were defined as those seen in cardiology clinic in addition to primary care. The main outcomes of interest were LDL cholesterol < or =100 mg/dl and BP < or =130/85 mm Hg. Multivariable hierarchical regression analyses were used to determine the independent association of cardiology involvement with improved LDL cholesterol and BP control. RESULTS: Overall, 3,771 (27.0%) patients had cardiology involvement. A higher proportion of patients with cardiology involvement achieved LDL cholesterol (55.6% vs. 45.6%; p < 0.01) and BP (45.3% vs. 35.9%; p < 0.01) goals. In multivariable hierarchical regression analysis, cardiology involvement was independently associated with better LDL cholesterol (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.40 to 1.82) and BP (OR, 1.52; 95% CI, 1.32 to 1.77) control. The benefit of cardiology involvement was consistent across a range of LDL and BP targets, in analysis of LDL and BP as continuous outcomes, and among subgroups of high-risk patients, including diabetic patients, the elderly, and those with prior revascularization. CONCLUSIONS: Cardiology involvement is associated with better LDL cholesterol and BP control among CAD patients. However, significant room for improvement in secondary prevention measures remains, irrespective of physician specialty.

Adrenergic beta-Antagonists↗

PubMed2003

[Prevention measures against Legionella infection in a circulating hot water bath].

For the sake of water conservation, a system for circulating hot water is widely used at public baths in Japan. Recently, large outbreaks of Legionella infection have occurred in public baths in Miyazaki and Kagoshima prefectures. More than three hundred persons were infected with Legionella pneumophila, and eight died. These outbreaks revealed that the Manual of Prevention Measures against Legionella Infection in a Circulating Hot Water Bath, which was published by the Ministry of Health, Labour and Welfare in Japan in 2001, was not fully understood or conformed to by managers of the baths. Microbiological features about legionellae should be fully understood for prevention of Legionella infection in a circulating hot water or spring bath. This review describes the microbiological characteristics of legionellae, their habits in the environment, pathogenesis, symptoms of Legionella infection, and disease outbreaks in Japan. I also describe practical prevention measures to deal with this organism in a circulating hot water or spring bath.

Baths↗

PubMed2002

[The risk of variant Creutzfeldt-Jakob disease in the Netherlands and the effect of preventive measures].

Variant Creutzfeldt-Jakob disease (vCJD) is a fatal and untreatable neurological disease, in which pathogenic prions (PrPSc) are involved. There is convincing epidemiological and experimental evidence that vCJD is a human expression of bovine spongiform encephalopathy (BSE). The risk of transmission of pathogenic prions which cause vCJD to humans is influenced by the species barrier, genetic susceptibility of the host, dose of infection and route of exposure. Transmission of pathogenic prions from bovines to humans is possible through meat products containing nerve and lymphatic tissue, and through medical products derived from bovine material. Human to human transmission is, in principle, also possible via blood and blood-derived products, human organs and tissues for transplantation, and through surgical instruments. Preventive measures to reduce transmission from bovines to humans have been introduced step by step in the Netherlands since 1989. With proper implementation, the current risk of becoming infected by Dutch meat products is small. It is very likely, however, that in the past decade BSE-infected bovines have entered the food chain. The Dutch population has also been exposed to foreign infected meat products. Measures to prevent human to human transmission are currently being improved in the Netherlands. It is expected that cases of vCJD will occur in the Netherlands in the future, but the number cannot be estimated accurately. The presence of PrPSc in both the livestock and in the human population in the Netherlands constitutes a permanent public health threat and is a reason for continued vigilance and active prevention.

Animals↗

PubMed1995

Caries incidence, effect of preventive measures, and caries prediction in Uruguayan children.

In 1988, 100 12- to 13-year-old children from two neighborhoods in Montevideo with different standards of living were examined. Twenty-three children with large numbers of mutans streptococci, lactobacilli, or decayed surfaces or a combination of these factors were considered to be at high risk of developing caries. Twelve of these 23 children were selected for special preventive measures. A second examination was made 18 months later, at which 81 of the originally 100 children were studied. The clinical and microbiologic variables were tested for their ability to predict caries by calculating their sensitivity, specificity, the positive and negative predictive values. The incidence of new DMFS was significantly higher in the children from the low than in those from the high socioeconomic area. It was also significantly higher in the children considered being at high risk than in those at low risk at the start of the study. Preventive measures reduced the caries risk. The highest sensitivity was obtained with the clinical test, whereas the highest specificity was obtained with the combined clinical and microbiologic tests. The findings indicate that methods for identifying children at risk which started to be used in Scandinavia 20 years ago could be applied in the Uruguayan population of today. It is valuable to know this, as the resources for both treatment and prevention are very limited.

Adolescent↗

PubMed1983

Incidence of ischaemic heart disease in relation to blood cholesterol level, and the influence of non-medicamentous preventive measures on the cholesterol level in an open population.

Results are presented of a prospective study of the male population of Kaunas, aged 45-59 years, who were examined in 1972-1974 within the framework of the Kaunas-Rotterdam Study. Among 2,034 men, who at the first examination were without signs of ischaemic heart disease (IHD), there appeared after 7.4 years 75 cases of IHD. The age-adjusted IHD incidence per 1,000 inhabitants amounted in the 1st quartile of blood cholesterol (CS) distribution to 12.1, in the IInd quartile to 23.8, in the IIIrd quartile to 40.3 and in the IVth quartile to 69.6. Analysis of the findings carried out by using the multiple logistic function showed that the Cs level ranked first among all investigated IHD risk factors. The influence of nonmedicamentous preventive measures on the CS level was studied within the framework of the programme of assessing the effectiveness of multifactorial IHD prevention in subjects with a CS level of 6.72 mM/l and more, who at the initial examination were without signs of IHD. After two years of the operation of preventive measures, the CS level decreased by 11.6% vs. the initial value.

Cholesterol↗

PubMed2004

Irritant hand dermatitis: severity of disease, occupational exposure to skin irritants and preventive measures 5 years after initial diagnosis.

Irritant contact dermatitis (ICD) is often chronic; its aetiology frequently being related to occupational exposure. Management of ICD involves persistent reduction in exposure to skin irritants such as water, detergents and prolonged occlusion by gloves. The aim of this study was to determine the severity of hand dermatitis 5 years after initial diagnosis and to find out what factors were related to this outcome. A questionnaire survey was carried out on severity of hand dermatitis, exposure to skin irritants and preventive measures, 5 years after initial ICD diagnosis. Of a cohort of 201 patients with ICD, 172 received the questionnaire and 124 (72%) responded. 5 years after initial diagnosis, 50% still had medium and 32% severe hand dermatitis. Patients with severe ICD and high exposure showed low levels of prevention and difficulty in changing their occupational exposure. Use of emollients was predominantly therapeutic rather than preventive. Occupation was changed in 57% of cases, of which 46% was permanent. In this population, ICD is a chronic disease; implementation of secondary preventive measures appears to fail. In occupations with high exposure to skin irritants, implementation of permanent exposure reduction is more difficult, compared to occupations with a medium level of exposure. High exposures might have led to change of occupation; medium exposures could have been reduced to low levels. In occupations with high exposure, women were overrepresented.

Dermatitis, Allergic Contact↗

PubMed1994

Influence of caries-preventive measures in mothers on cariogenic bacteria and caries experience in their children.

Preventive measures, which reduced the salivary level of mutans streptococci in mothers, delayed colonization by these organisms in their children. The preventive programme was discontinued when the children were 3 years old. These children, at the age of 7 years, and their mothers were now examined to determine the effect of the earlier caries-preventive approach. The control mothers had significantly higher levels of salivary mutans streptococci and lactobacilli than the test mothers (p < 0.05). The median level of salivary mutans streptococci was 0.6 x 10(6) c.f.u. (colony-forming units) per ml in the test mothers and 1.3 x 10(6) c.f.u. in the control mothers. The median level of salivary lactobacilli was 10 times higher in control than test mothers (80 x 10(3) and 7 x 10(3) c.f.u. per ml, respectively). Significantly more children of control than test mothers carried mutans streptococci (95 versus 46%) (z-test; p < 0.01). Children of test mothers had lower salivary levels of mutants streptococci and lactobacilli (p < 0.05). Twenty three % of the test children were caries-free, compared with 9% of the control children (z-test; p < 0.01). The mean caries experience of the test children was also significantly lower than that of the control children (defstot 5.2 and 8.6, respectively; p < 0.05). The results show that reduction of the mutans streptococci in the mother during the emergence of the primary teeth in her child has a long-term influence on colonization by these bacteria and the caries experience in the child.

Case-Control Studies↗

PubMed1982

Preventive measures in house-dust allergy.

To evaluate the effect of preventive measures on the concentration of house-dust mites (Pyroglyphidae), the homes of 23 consecutive patients allergic to house-dust mites and the homes of 75 randomly selected control subjects were studied. Although the patients' homes were cleaned more frequently (p less than 0.0007 for 4 cleaning qualities), greater concentrations of house-dust mites (p = 0.0073) were found in dust from bedroom carpets in the patients' homes than in the homes of the control subjects. A tendency (p less than 0.15) in the same direction was found for mattress surfaces and living room carpets. High absolute humidity of indoor air was related to greater concentrations of house-dust mites. There was a tendency (p less than 0.10) towards higher humidity in the patients' homes than in those of the control subjects. It was concluded that high humidity improves the survival of house-dust mites in homes. Energy saving measures such as installing insulation raises indoor humidity and can lead to an increased incidence and severity of house-dust mite allergy.

Animals↗

PubMed2000

Types of corrosion in removable appliances: annotated cases and preventative measures.

Three different types of electrochemical corrosion cells are discussed - composition, concentration, and stress cells. Annotated cases are presented for each type of corrosion cell in removable appliances using conventional photography, scanning electron microscopy, and X-ray elemental analyses. The complexity that corrosion can attain is illustrated via the case of a palatal expansion device. Specific examples of galvanic cells, which are possible in orthodontic practice, are summarized in terms of the anodic and cathodic half-cells. These include material differences, oxygen gradients, presence of debris, changes in pH, induced stress levels, changes in stress states, and variations in as-received history. A galvanic series is constructed from the orthodontist's perspective that includes titanium, nickel-titanium, cobalt-chromium, and stainless steel alloys, as well as glass-fiber-reinforced polymer-matrix composites. Preventative measures are presented from the perspectives of the raw material manufacturers, the dental laboratories, the chair-side practitioner, and the patient. A list of materials is provided, which are known to promote corrosion in the event that stainless steels are sensitized as a consequence of improper handling. In the final analysis, however, retainers and removable appliances are reliable if corrosion cells are conscientiously averted and preventative measures are routinely employed.

Journal Article↗

PubMed1997

[Coagulase typing of Staphylococcus aureus in the geriatric wards after introduction of preventive measures of hospital infection].

In the early 1980's methicillin-resistant Staphylococcus aureus (MRSA) was reported as a major pathogenic organism of geriatric hospital infection in Japan. At the same time in our geriatric wards, including 190 beds, MRSA infection was prevalent. In the early 1980's in our geriatric wards minocycline was one of the most sensitive antibiotics to MRSA isolated in our wards and used frequently against MRSA pneumonias and bacteremia. In the late 1980's resistant strains of MRSA to minocycline rapidly increased because vancomycin was not allowed to introduced for treatment of MRSA before 1991 in Japan. At the same period the predominant coagulase type changed from type II to type VII. To decrease minocycline-resistant strains to MRSA after 1987, use of minocycline was limited. Moreover since Oct. 1991 to decrease nosocomial infections some active preventive measures against hospital infection, including limited use of 2nd and 3rd cephems, were taken. In this study changing patterns of coagulase type of Staphylococcus aureus were discussed. At least 4 years was needed to find out that the predominant coagulase type changed from type VII to type II again in 1991. In this study about 22 antimicrobial agents MICs of 313 strains of Staphylococcus aureus isolated between March 1992 and June 1993 were determined and compared with the data of MICs before introduction of preventive measures. The pattern of susceptibility to MINO was in part improved. Thus the some sensitive strains of S. aureus were observed again in our geriatric wards. Interestingly indeed it took approximately 5 years to find out the emergence of sensitive strains to MINO since limitation of use of MINO in 1987.

Bacterial Typing Techniques↗