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PubMedDate not supplied

Rapid detection of Salmonella from poultry by real-time polymerase chain reaction with fluorescent hybridization probes.

Detection of Salmonella by bacteriologic methods is known to be time consuming. Therefore, we have developed a real-time probe-specific polymerase chain reaction (PCR) to rapidly detect Salmonella invA gene-based PCR products from chicken feces and carcasses by a fluorescence resonance energy transfer assay. The sensitivity and the specificity of this system were determined as 3 colony-forming units ml(-1) and 100%, respectively. Overnight tetrathionate broth enrichment cultures of chicken feces and carcass samples were used in template preparation for PCR. Also, a standard bacteriology was performed (National Poultry Improvement Plan-U.S. Department of Agriculture, Bacteriological Analytical Manual-Food and Drug Administration Center for Food Safety and Applied Nutrition) for confirmation. Seventy-two cloacal swab, 147 intestine, and 50 carcass (neck) samples were examined. Thirteen (8.8%) and 25 (17%) of the intestinal samples were found to harbor Salmonella by bacteriology and PCR, respectively. Forty-five of 50 (90%) carcass samples were Salmonella positive by both methods. Salmonella was not detected from cloacal swab samples. Results indicate that this assay has the potential for use in routine monitoring and detection of Salmonella in infected flocks and carcasses.

Animals↗
PubMedDate not supplied

Diesel particulate matter exposure to railroad train crews.

Exposure assessments were conducted aboard diesel locomotives. Results were evaluated to determine variables that affect exposure to DPM (diesel particulate matter) and to assess use of EC (elemental carbon) and OC (organic carbon) as surrogates for DPM. National Institute for Occupational Safety and Health Method 5040 was used for collection and analysis of samples in locomotives and in nonrailroad settings. The level of EC, but not OC, in locomotives was found to be significantly affected by position of exhaust stacks and windows. EC ranged from < 1 to 45 micrograms/m3 with a geometric mean (GM) of 3.7 micrograms/m3 and OC ranged from 4 to 4570 micrograms/m3 with a GM of 36.3 micrograms/m3. Background measurements of EC ranged from < 1 to 8 micrograms/m3 and OC levels were 4 to 84 micrograms/m3. This study confirms that train crew exposure to DPM is much lower than exposures for miners, is comparable to background urban exposures, and is lower than but comparable to exposures for truck drivers. It also indicates that EC levels are highly predictive of diesel exhaust exposure whereas OC levels are not, and that open windows and exhaust stack(s) in front of the locomotive cab have a significant effect on EC.

Air Pollutants, Occupational↗
PubMed2002

Failure after 5 years of self-regulation: a health and safety audit of New Zealand engineering companies carrying out welding.

The aim of this study was to audit the degree of compliance with new health and safety legislation 5 years after enactment in a typical cross-section of New Zealand manufacturing industries. To this end, 299 randomly selected enterprises using a welding process were visited by Occupational Safety and Health Officers of the Department of Labour. An interviewer-administered questionnaire concerning the nature of the hazards encountered in that enterprise and the chosen control measures employed to protect the health of their employees was undertaken and analysed. Only 40% of New Zealand businesses in this sample undertaking welding had adopted the most basic of regulatory requirements to control health and safety risks. This percentage seemed independent of employer size. Fundamental safety issues (e.g. welding in confined spaces) were ignored by >50% of enterprises. In conclusion, self-management of health and safety risks had not occurred in over half the enterprises surveyed.

Cross-Sectional Studies↗
PubMed2005

Quantification of 2,4-D on solid-phase exposure sampling media by LC-MS-MS.

Three types of solid-phase chemical exposure sampling media: cellulose, polyurethane foam, and XAD-2, were analyzed for 2,4-dichlorophenoxyacetic acid (2,4-D) and the amine salts of 2,4-D. Individual samples were extracted into acidified methanol, and the extracts were analyzed via liquid chromatography-tandem mass spectrometry using electrospray ionization and a C(8) reversed-phase LC column. (13)C 2,4-D and a labeled benzoic acid (13)C or d5) were employed as the surrogate and internal standard, respectively. Over a three-year study of pesticide exposure among agricultural workers involving a high volume of analyses, values of average % recovery for (13)C 2,4-D on personal exposure samples ranged from 87 to 98 with a % relative standard deviation ranging from 7 to 12. The performance of the method compares favorably with that of the current National Institute for Occupational Safety and Health-recommended approach for the analysis of 2,4-D on these types of exposure sampling matrices.

2,4-Dichlorophenoxyacetic Acid↗
PubMed1994

Neutron activation analysis for the determination of trace elements in biological materials.

Neutron activation analysis, in both its radiochemical and instrumental forms, is a precious technique for the determination of trace elements in biological materials. Probably its most important advantage is its relative freedom from errors resulting from contamination of the samples. Invaluable characteristics are also its excellent sensitivity, outstanding selectivity, and remarkable multielement capability. It is, however, necessary to warn against uncritical expectations. This is best illustrated by the seriously inconsistent results obtained in several laboratories. Because of the necessity to have access to a nuclear research reactor, the stringent safety rules to be observed, the rather high costs of the analyses, the relatively low sample throughput, and the sometimes long delay between the taking of a sample and the obtaining the final result, the use of neutron activation analysis remained restricted to a few--essentially research--laboratories. It found its main application in solving arduous problems and in paving the way for other analytical techniques better suited to routine applications.

Animals↗
PubMed2004

Risk factors for work-related low back pain in registered nurses, and potential obstacles in using mechanical lifting devices.

Back pain disability is a serious and costly problem affecting the nursing profession. The purposes of this study were to determine risk factors for work-related low back pain (WRLBP) in registered nurses and to record the reported use or reasons for nonuse of mechanical lifts. Our hypothesis was that workers who attributed the cause of WRLBP to their own actions would be knowledgeable about back safety, would be more likely to use lifts, and would report less WRLBP. A random sample of 270 registered nurses was selected from two acute care hospitals in central Illinois to identify WRLBP risk factors. This cross-sectional study gathered information on individual, physical workload, psychological, and organizational factors that may present a risk for WRLBP. Information was also collected on the use of safety devices and back pain symptoms. The response rate was 50.4%. Nearly 84% of respondents had WRLBP in the past, and 36.2% had WRLBP in the past year that limited movement or interfered with routine activities. Among the risk factors significantly associated with WRLBP were more years worked in nursing, frequent lifting, and low social support. Only 11% reported that they routinely used mechanical lifting devices, and the primary reason given for failure to use lifting equipment was unavailability of equipment. The reasons for the lack of use of mechanical lifts should be investigated and addressed.

Adult↗
PubMed2006

Association between health care providers' influence on parents who have concerns about vaccine safety and vaccination coverage.

OBJECTIVES: Parents who have concerns about vaccine safety may be reluctant to have their children vaccinated. The purpose of this study was to explore how vaccination coverage among children 19 to 35 months of age is associated with health care providers' influence on parents' decision to vaccinate their children, and with parents' beliefs about vaccine safety. METHODS: Parents of 7695 children 19 to 35 months of age sampled by the National Immunization Survey were administered the National Immunization Survey Parental Knowledge Module between the third quarter of 2001 and the fourth quarter of 2002. Health care providers were defined as a physician, nurse, or any other type of health care professional. Parents provided responses that summarized the degree to which they believed vaccines were safe, and the influence providers had on their decisions to vaccinate their children. Children were determined to be up-to-date if their vaccination providers reported administering > or = 4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine, > or = 3 doses of polio vaccine, > or = 1 dose of measles-mumps-rubella vaccine, > or = 3 doses of Haemophilus influenzae type b vaccine, and > or = 3 doses of hepatitis B vaccine. RESULTS: Of all of the parents, 5.7% thought that vaccines were not safe, and 21.5% said that their decision to vaccinate their children was not influenced by a health care provider. Compared with parents who responded that providers were not influential in their decision to vaccinate their children, parents who responded that providers were influential were twice as likely to respond that vaccines were safe for children. Among children whose parents believed that vaccines were not safe, those whose parents' decision to vaccinate was influenced by a health care provider had an estimated vaccination coverage rate that was significantly higher than the estimated coverage rate among children whose parents' decision was not influenced by a health care provider (74.4% vs 50.3%; estimated difference: 24.1%). CONCLUSIONS: Health care providers have a positive influence on parents to vaccinate their children, including parents who believe that vaccinations are unsafe. Physicians, nurses, and other health care professionals should increase their efforts to build honest and respectful relationships with parents, especially when parents express concerns about vaccine safety or have misconceptions about the benefits and risks of vaccinations.

Child, Preschool↗
PubMedDate not supplied

[An intervention on the coke-oven at the siderurgical plant in Genoa].

OBJECTIVE: To assess the personal exposure of workers employed at the coke-oven in a steel plant in Genoa. DESIGN: Definition and implementation of a set of measurements for the environmental quality for the determination of PAH and benzene by means of personal sampling. Urinary determination of the metabolic substances given by benzo(a)pyrene and benzene was implemented for workers in different areas. Air pollution control was implemented by the firm during the years 1997, 1998, 1999 and 2001. Operative ways and sampling methods were previously discussed by our Operational Unit of Occupational Health and Safety Control (UO PSAL) together with the steel plant and its consultant Clinica del lavoro Luigi Devoto. MAIN OUTCOME MEASURES: First environmental pre-screening of personal exposure to the pollutant, March to April 1997; first campaign of environmental and biological measurements, March 1998; second campaign of measurements, February to October 1999 and March 2001. RESULTS: The findings showed that among all workers, some groups were more exposed to PAH or benzene: "covers" employees, "change" employees, "loading" employees, "refrigeration and condensation" employees. REMARKS: Relative shortage of scientific data, particularly with regards to the correlation risk/damage; our office operators were unable to collect parallel samples in order to validate results of environmental and biological analysis because of some local problems; problems in maintaining effectively the corrective actions taken; omissions and lack of standards in the process used for recording exposures. Lack of awareness, on the workers side, on their "right to know" about personal risk. Importance of a technical discussion, promoted by the Genoa Province Administration, intended for the exchange of information, for providing support to decisions, for comparing opinions about the effectiveness of the implemented precautionary measures and for interpreting results. The following interventions were carried out: revision of job procedures, job methods and Risk Assessment Document; training and information about the employees' risk, edited by the firm's Service for Prevention and Protection (SPP) and by a physician indicated by the firm; PPE (Personal Protective Equipment), revision by the SPP.

Benzene↗
PubMed1992

Morbidity among municipal waste incinerator workers.

Incinerator workers are exposed to many toxic compounds, most notably heavy metals. We evaluated medical and exposure monitoring data of an actively employed cohort of Philadelphia incinerator workers following an Agency for Toxic Substances and Disease Registry site survey and National Institute for Occupational Safety and Health (NIOSH) health hazard evaluation (HHE). Of the many airborne samples taken by NIOSH, only four of the personal breathing zone samples were above OSHA or ACGIH standards: one for lead, one for phosphorous, and two for total particulates. Because samples were taken during limited operations (only one of the two incinerators were operating), the results may underestimate historical exposures at this site. We limited our medical analysis to the 86 male workers who participated in the HHE out of the 105 active employees. The 86 employees were divided into potential high and low exposure groups based on a work site analysis done by an independent industrial hygienist. Eight individuals had at least one elevated biological index indicating exposure to a heavy metal. These elevations, however, were unrelated to the workers' exposure categories. Furthermore, no clinically significant mean blood or serum measurements were noted. Thirty-four percent of the workers had evidence of hypertension which increased the risk of significant proteinuria. Neither hypertension nor proteinuria were related to exposure group. Changes in pulmonary function related only to smoking status. Although there was some evidence of an increased risk of exposure to products of incinerator waste, we could not relate the few elevated biological tests to exposure classification. Additional studies are needed to assess the potential health effects of municipal waste incinerator by-products.

Adult↗
PubMed1995

Salivary sampling for hepatitis B surface antigen carriage: a sensitive technique suitable for epidemiological studies.

Vertical transmission from mothers to infants of hepatitis B infection result in a high incidence of carriage in children with long-term consequences, and is the focus of current immunization strategies. The use of saliva for hepatitis B surface antigen (HBsAg) screening in a country with an intermediate to high prevalence of chronic carriage was investigated. We recruited 88 Thai women with known HBsAg status (44 positive, 44 negative) who were attending an antenatal clinic. The collection of saliva was acceptable to all patients. Aspects of technique regarding collection and handling in a tropical setting are discussed. Comparing the detection of HBsAg in saliva to serum using a commercially available serological test kit without modification, the sensitivity was 92.0% (95% CI 84.8-99.5) and the specificity was 86.8% (95% CI 76.0-97.6). Population acceptability and safety advantages along with a high sensitivity strongly support the use of salivary sampling for epidemiological surveillance of hepatitis B virus.

Adolescent↗
PubMedDate not supplied

Analyzing planned maintenance (PM) inspection data by failure mode and effect analysis methodology.

There is no question that medical devices are becoming more reliable. However, we have had some difficulty finding a satisfactory method for providing persuasive documentary evidence that this improved reliability will allow us to relax our traditional planned maintenance (PM) practices without compromising patient safety. The acceptance and increasing use of Failure Mode and Effect Analysis (FMEA) by several of the oversight agencies, including the Joint Commission on Accreditation of Healthcare Organizations, provides us with an important opportunity to take another shot at this vexing problem. Using this proven FMEA methodology and some relatively simple rules to quantify the results of the routine PM inspections that all healthcare providers are still performing in considerable abundance, we have developed a method that allows us to reduce the test results to a simple, single measure (the Risk Score) that can be used to characterize the effectiveness and levels of safety of our current PM regimens. When tested on theoretical data and a sample of real PM inspection results, the method provides answers that seem reasonable. Although it will probably require some modification as we begin the standardized data gathering and gain working experience, it is our hope that this new approach will become generally accepted within the industry. This kind of positive response should enable us to persuade the various accrediting and licensing agencies to similarly accept the concept.

Documentation↗
PubMed2000

Evaluation of worker safety and health training.

BACKGROUND: Few studies of worker training have addressed the impact on participant's health and safety behaviors and efforts to change health and safety conditions at the workplace. The present study is an evaluation of these impacts as reported by workers and managers. METHODS: The UAB/CLEAR program has trained over 1,000 participants since 1992. A survey was mailed to a sample of workers and all participating managers. RESULTS: The results revealed that both groups reported increasing personal safety and health behavior, both contributed to emergency preparedness, and both influenced the elimination of hazardous chemicals. Managers reported greater influence on health and safety which may be explained by their relatively more powerful position. However, an impressive percentage of workers reported influencing changes. CONCLUSIONS: This pattern indicates that when the environment supports joint decision making by workers and management, initiating changes becomes easier.

Evaluation Studies as Topic↗
PubMed2000

The safety and efficacy of laparoscopic live donor nephrectomy: a systematic review.

BACKGROUND: The aim of this systematic review was to compare the safety and efficacy of laparoscopic live donor nephrectomy with the "gold" standard of open live donor nephrectomy. METHODS SEARCH STRATEGY: Three search strategies were devised to enable literature retrieval from the Medline, Current Contents, Embase, and Cochrane Library databases up until, and including, February 2000. STUDY SELECTION: Inclusion of a report was determined on the basis of a predetermined protocol, independent assessment by two reviewers, and a final consensus decision. English language reports were selected and acceptable study designs included randomized-controlled trials, controlled clinical trials, case series, or case reports. Each report was required to provide information on at least one of several safety and efficacy outcomes as detailed in the protocol. DATA COLLECTION AND ANALYSIS: Twenty-five reports met the inclusion criteria. They were tabulated and critically appraised in terms of the methodology and design, sample size, outcomes, and the possible influence of bias, confounding, and chance. RESULTS: High level evidence comparing the safety and efficacy of laparoscopic live donor nephrectomy with open donor nephrectomy was not available at the time of this review. Limited low level evidence suggested that the laparoscopic approach might be advantageous regarding the donor's hospital stay, convalescence, pain, and resumption of employment. CONCLUSIONS: The ASERNIP-S Review Group concluded that the evidence-base for laparoscopic live donor nephrectomy was inadequate to make a safety and efficacy recommendation. Clinical and research recommendations were developed regarding the introduction and current practice of this procedure in Australia.

Australia↗
PubMedDate not supplied

A pilot study of the safety and efficacy of supplemental arginine to enhance immune function in persons with HIV/AIDS.

OBJECTIVE: We collected preliminary data on the safety and efficacy of supplemental arginine to improve natural killer cell cytotoxicity in a sample of persons with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). METHODS: In a randomized, double-blind, placebo-controlled pilot study in an academic medical center-based infectious disease clinic, 11 clinically stable, HIV-infected adults had been treated with highly active, antiretroviral therapy and had HIV plasma RNA levels of less than 10 000 copies/mL. Participants were randomly assigned to receive 19.6 g of arginine/d (n = 6) or placebo (n = 5) for 14 d. Plasma HIV RNA levels, neuropsychologic functioning, and self-reported adverse events were analyzed for safety of treatment. Efficacy was measured by natural killer cell cytotoxicity. RESULTS: None of the participants experienced any adverse clinical, virologic, or neuropsychologic events that necessitated withdrawal from the study. The arginine-supplemented group showed a mean natural killer cell cytotoxicity increase of 18.9 lytic units, whereas the placebo group showed an increase of 0.3 lytic units. This difference was not statistically significant (P = 0.79). CONCLUSIONS: Short-term arginine supplementation is safe for persons with HIV/AIDS. Additional studies with larger samples and longer periods are warranted to determine the effects of arginine supplementation on other indices of immune function and on clinical outcomes such as intercurrent illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Fear of crime and health in residential tower blocks. A case study in Liverpool, UK.

BACKGROUND: Though it is often assumed that fear of crime erodes mental health, research evidence is limited. Our study seeks to assess the relationship between these attributes in residents of the city of Liverpool. METHOD: Evidence is drawn from a sample survey of 407 adults living in 21 tower blocks. A number of social and psychosocial attributes linked with feelings of safety are compared with self-reported health status using logistic and multiple regression techniques. Possible reciprocal relationships were investigated using two-stage least squares. RESULTS: Fear of crime in this sample is generally much lower in the home than in Britain as a whole and much higher out on the neighbouring streets at night, but there are sub-group variations. We find significant associations between fear of crime and health status. Feelings of safety when out alone after dark is the most consistent predictor of health status. Those feeling safe score significantly higher on all five dimensions of the SF-36 measure which cover mental and social well-being. Mental health is the strongest correlate and is probably a consequence rather than cause of feelings of safety. CONCLUSION: The evidence suggests elderly residents believe tower blocks provide safe accommodation. However, feelings of safety in these 'fortresses' do not generally extend to walking in neighbouring streets. Fear of crime erodes quality of life and is associated with poorer health.

Adult↗
PubMed1990

An evaluation of the chorionic villus sampling learning curve.

Prior studies have identified a correlation between the rate of fetal loss (subsequent to chorionic villus sampling) and the operator's level of experience. However, centers performing only modest numbers of procedures during the initial phase of their programs have reported loss rates similar to those of the more active diagnostic units. Our personal experience would suggest that a "learning curve" for chorionic villus sampling does exist but that fetal loss may be an insensitive end point with which to evaluate the impact of cumulative performance. In an attempt to quantify the learning curve that we have appreciated subjectively, a detailed analysis of our initial experience with chorionic villus sampling was undertaken. Between May 1988 and August 1989, a total of 185 procedures were accomplished consecutively by one operator and form the basis for this analysis. Transcervical (n = 82) and transabdominal (n = 103) techniques were used for posterior and anterior-fundal placental locations, respectively. Three pregnancy losses occurred and insufficient material for analysis was retrieved in five patients. We observed a significant reduction in the required number of placental aspirations during the study interval (p less than 0.001). When analyzed separately, consecutive performances of the transabdominal technique demonstrated a significant reduction in the mean number of placental passes (p less than 0.00001) along with more efficient sampling (increased sample weight/aspiration attempt; p less than 0.01). Although the fetal loss rate is a critical measure of safety and may directly be related to operator experience, other measures of expertise (e.g., single-pass success rate) may be more appropriate indicators of competence and may be useful to centers wishing to initiate their own chorionic villus sampling programs.

Abortion, Spontaneous↗
PubMed2006

Potential sources of microbial contamination in unpasteurized apple cider.

A study was conducted to identify possible sources of microbial contamination and to assess the effect of good cleaning and sanitation practices on the microbial quality and safety of unpasteurized apple cider. Raw unwashed apples, washed apples, cleaning water, fresh cider, and finished cider samples were collected from five Ontario producers over 4 months and microbiologically tested. Total coliforms were found in 31, 71 and 38% of the unwashed apple, water, and washed apple samples, respectively. Escherichia coli was found in 40% of the water samples from one producer alone. The washing step was identified as a potential source of contamination, possibly due to water in the dump tanks seldom being refreshed, and because scrubbers, spray nozzles, and conveyors were not properly cleaned and sanitized. Higher total coliform counts (P < 0.0001) and prevalence (P < 0.0001) in fresh cider compared with those in unwashed apples and washed apples indicated considerable microbial buildup along the process, possibly explained by the lack of appropriate equipment sanitation procedures. Results showed that producers who had better sanitary practices in place had lower (P < 0.001) total coliform prevalence than the rest of the producers. Overall results show that good sanitation procedures are associated with improved microbial quality of fresh cider in terms of total coliforms and that operators who pasteurize and/or UV treat their product should still be required to have a sound good manufacturing practices program in place to prevent recontamination. Cryptosporidium parvum, an important pathogen for this industry, was found in different sample types, including washed apples, water, and fresh and finished cider.

Animals↗
PubMed1994

Knowledge and practice of sexual safety in Melbourne gay men in the nineties.

Despite the impact of education programs, the ability of gay men to sustain sexual safety still comes under public scrutiny. A self-administered questionnaire was distributed in 1990 to a convenience sample of 284 gay-identified Melbourne men recruited from gay groups, health clinics, gay pubs and nightclubs, sex-on-premises venues, and the social networks of these men. The questionnaire measured the perceived safety of various sexual practices and the practice of unprotected anal intercourse over the previous three months. These results were compared with results from other Australian studies. Whereas nearly all the men were sexually active, only a small proportion considered activities such as oral sex without ejaculation and anal sex with condoms to be 'totally safe'. The majority considered these activities to be 'more safe than unsafe', suggesting a risk-reduction rather than a 'no-risk' approach to sex. Comparisons with other Australian studies suggest that gay men are becoming more confident in the safety of sexual activities labelled as 'safe' by the AIDS Council. There was no elevated practice of unprotected anal sex at 'sex-on-premises' venues. Most men who had anal sex used condoms all of the time, whether sexual partnerships were 'once only' or were 'ongoing', suggesting that 'condoms always' is still a viable option in various partnerships. There was some evidence that a minority of men abandoned condoms in ongoing partnerships. If specific education campaigns are developed to promote 'negotiated safety' in partnerships, then such campaigns should not contradict the 'condoms always' strategy.

Adult↗