Detecting cumulative trauma disorders in workers performing repetitive tasks

On-site testing of 157 poultry processors disclosed that 50% had three or more abnormal upper extremity findings out of a total of 22 possibles. The average worker had five to six abnormal findings. Impaired pinch strength, decreased vibration sensitivity in the fingertips, and reports of current numbness were the most prevalent. Of workers with signs, 25% reported no symptoms, whereas only 8% of workers reported symptoms but had no signs. The investigators concluded that this measurement method has utility for assessments of worker populations to determine prevalence of CTDs and, potentially, for preclinical detection of these disorders to permit early intervention, reduce medical costs, and minimize disability. The need for accurate measurement to enhance early detection and prevention is discussed.     

强氧酸性离子水毒性试验研究

目的 了解新型消毒剂强氧酸性离子水的毒性。方法 采用一次性限量灌胃法测定急性经口ＬＤ５０;采用剂量递增蓄积系数法测定蓄积毒性;采用取样前３０小时、６小时两次给予受试物法测定其对小鼠骨髓嗜多染红细胞微核形成的影响;用斑贴法测定其对动物的皮肤刺激强度;用棉条浸入法测定其对大鼠阴道粘膜的刺激强度。结果急性经口ＬＤ５０大于２１５００ｍｇ／ｋｇ·ｂｗ,属实际无毒物,蓄积试验属弱蓄积性,对小鼠骨髓微核细胞未见损伤作用,对家兔皮肤和大鼠阴道粘膜无刺激。结论 强氧酸性离子水是一种安全的消毒剂。     

Comparison of serum fluoride levels after administration of monofluorophosphate-calcium carbonate or sodium fluoride: differences in peak serum concentrations

Fluoride salts are widely used in Europe in the treatment of established osteoporosis with crush fractures for their ability to increase trabecular bone mass. However, in the United States fluorides are still regarded as an experimental drug. In a prospective, randomized study we compared the fluoride pharmacokinetics of enteric-coated sodium fluoride and disodium monofluorophosphate calcium carbonate (MFP-Ca) over the period of 76 h. Twenty subjects (12 females, 8 males), aged 35–80 years, free of gastrointestinal disorders, renal impairment, and liver disease and without prior fluoride intake entered the study. Ten subjects received NaF (11.3 mg fluoride) twice a day and the other ten MFP-Ca (13.2 mg fluoride) twice a day. During the study period of 76 h the patient's usual food intake was not changed. Serum fluoride levels were determined using an ion sensitive electrode. After intake of a single drug preparation of MFPCa or NaF, MFP-Ca showed a significantly shorter lag time of absorption and a significantly higher maximal serum fluoride concentration than NaF (P<0.01). A comparison of fluoride cumulative characteristics of both drugs showed virtually identical serum fluoride levels before intake of the morning dose on all 4 study days, whereas serum fluoride concentrations measured 4 h afterwards were significantly higher for MFP-Ca than for NaF. These data provide evidence of high peak serum fluoride levels for MFP-Ca, whereas only small peak-to-trough fluctuations are seen for NaF.Abbreviations MFP-Ca disodium monofluorophosphate-calcium carbonate - C _max maximum drug concentration - T _max lag time of maximum drug concentration - AUC area under the serum concentration versus time curve Correspondence to: L. Erlacher     

Cumulative biochemical effects of repeated subclinical hydrogen sulfide intoxication in mouse brain

Summary Adult female NMRI mice exposed four times to 100 ppm hydrogen sulfide vapour for 2 h at 4-day intervals showed increasing inhibition of the cerebral cytochrome oxidase activity. Cerebral RNA decreased significantly after the fourth exposure. This change was accompanied by the reduced orotic acid uptake in the RNA fraction. At the same time, 2,3-cyclic nucleotide 3-phosphohydrolase activity used as a marker for glia increased. Acetylcholine esterase activity remained unchanged. The initial exposures also caused an increase in the superoxide dismutase activity and an increase in the glutathione concentration. The latter effects were abolished in the third and fourth exposures. The present data seem to indicate that the biochemical effects of repeated subclinical hydrogen sulfide intoxications are cumulative.     

镉污染对育龄妇女生殖健康的影响

目的 探讨福建省政和县环境镉污染对女性生殖健康的影响。方法 根据环境镉污染检测结果,对镉污染较严重的2个自然村育龄妇女的生殖健康状况作调查,并与非污染区育龄妇女的生殖健康状况作对比。结果 污染区育龄妇女中,未婚女性的月经周期异常率、痛经发生率(分别为19.1％和42.6％)均高于非污染区(分别为5.7％和18.9％);污染区已婚妇女不孕症发生率(6.3％)高于非污染区已婚妇女(1.1％);已婚妇女前两胎妊娠时频发恶心、频发呕吐的发生率,前两胎早产发生率及前两胎死胎死产发生率(分别为44.7％、31.7％、10.27％和4.23％)高于非污染区已婚妇女(分别为26.5％、17.8％、2.85％和1.05％),差异均有统计学意义(P<0.05);累积比数模型分析表明:在控制其他因素的影响后,居住在污染区的育龄妇女,其生殖功能受到损害的可能性更大,其相对危险度是居住在非污染区育龄妇女的2.072倍(95％CI:1.526～2.813)。结论 污染区育龄妇女生殖健康的各个方面已受到不同程度的影响。     

Functional outcomes and complications after treatment of distal radius fracture in patients sixty years and over: A systematic review and network meta-analysis

AimThis network meta-analysis aims to compare functional outcomes and complications between conservative treatment and surgery for distal radius fractures in patients aged 60 years and over.MethodsWe searched the PubMed, EMBASE, and Web of Science databases for randomized controlled trials (RCTs) assessing the effect of conservative treatment and surgery for distal radius fractures in patients aged 60 years and over. Primary outcomes included grip strength and overall complications. Secondary outcomes included Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Patient-Rated Wrist Evaluation (PRWE) scores, wrist range of motion and forearm rotation, and radiographic assessment. All continuous outcomes were assessed using standardized mean differences (SMDs) with 95% confidence intervals (CIs), and binary outcomes were assessed using odds ratio (OR) with 95% CIs. The surface under the cumulative ranking curve (SUCRA) was used to determine a hierarchy of treatments. Cluster analysis was performed for grouping treatments based on the SUCRA values of primary outcomes.ResultsFourteen RCTs were included to compare conservative treatment, volar lockedplate (VLP), K-wires fixation, and external-fixation. VLP outperformed conservative treatment for 1-year and minimum 2-year grip strength (SMD; 0.28 [0.07 to 0.48] and 0.27 [0.02 to 0.53], respectively). VLP yielded the optimal grip strength at 1-year and minimum 2-year follow-up (SUCRA; 89.8% and 86.7%, respectively). In a subgroup analysis of patients aged 60 to 80 years old, VLP outperformed conservative treatment in DASH and PRWE scores (SMD, 0.33 [0.10, 0.56] and 0.23 [0.01, 0.45], respectively). In addition, VLP had the fewest complications (SUCRA = 84.3%). Cluster analysis suggested that VLP and K-wire fixation were more effective treatment groups.ConclusionEvidence to date demonstrates that VLP provides measurable benefits in grip strength and fewer complications to those 60 years of age and over, and that benefit is not reflected in current practice guidelines. There is a subgroup of patients where K-wire fixation outcomes are similar to those of VLP; defining this subgroup may yield substantial societal benefits.     

Statistics for Risk Assessment of Chemical Carcinogens∗

Risk assessment is a scientific process of evaluation of potential health risks of chemical exposures to humans from available information. It involves analysis of the relationship between exposure and health related outcomes to derive an allowable exposure level. Because of lack of human exposure data, the major source of information for studying potential health effects of chemicals on humans is generally obtained from animal dose response experiments. Animal data are often evaluated in two aspects via statistical analysis: qualitative testing and quantitative estimation. The qualitative testing is to determine if the chemical causes an adverse health effect, i.e., if there is a statistically significant difference between treated and control animals. Quantitative estimation involves fitting a dose-response model to derive an allowable exposure level for humans. This paper reviews statistical principles and procedures for qualitative and quantitative approaches to human risk assessment.     

Cumulative Marijuana Use and Carotid Intima-Media Thickness at Middle Age: The CARDIA Study

BackgroundLong-term cardiovascular health effects of marijuana are understudied. Future cardiovascular disease is often indicated by subclinical atherosclerosis for which carotid intima-media thickness is an established parameter.MethodsUsing the data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 Black and white women and men at Year 20 visit, we studied the association between carotid intima-media thickness in midlife and lifetime exposure to marijuana (1 marijuana year = 365 days of use) and tobacco smoking (1 pack-year = 20 cigarettes/day for 365 days). We measured carotid intima-media thickness by ultrasound and defined high carotid intima-media thickness at the threshold of the 75th percentile of all examined participants. We fit logistic regression models stratified by tobacco smoking exposure, adjusting for demographics, cardiovascular risk factors, and other drug exposures.ResultsData was complete for 3257 participants; 2722 (84%) reported ever marijuana use; 374 (11%) were current users; 1539 (47%) reported ever tobacco smoking; 610 (19%) were current smokers. Multivariable adjusted models showed no association between cumulative marijuana exposure and high carotid intima-media thickness in never or ever tobacco smokers, odds ratio (OR) 0.87 (95% confidence interval [CI]: 0.63-1.21) at 1 marijuana-year among never smokers and OR 1.11 (95% CI: 0.85-1.45) among ever tobacco smokers. Cumulative exposure to tobacco was strongly associated with high carotid intima-media thickness, OR 1.88 (95%CI: 1.20-2.94) for 20 pack-years of exposure.ConclusionsThis study adds to the growing body of evidence that there might be no association between the average population level of marijuana use and subclinical atherosclerosis.     

成都市两城区部分成年男性吸烟者吸烟行为调查

目的 分析成都市成年男性吸烟者吸烟行为、吸烟量及其变化的影响因素。方法对成都市两城区320名成年男性吸烟者面对面问卷调查。采用描述性分析、t检验、χ²检验、单因素方差分析、Kruskal-Wails H秩和检验、累积比数logistic回归方法分析数据。结果 分析显示吸烟者更换卷烟后, 吸烟量增加(t=2.327, P=0.021), 焦油量降低(t=-11.251, P<0.001);累积比数logistic回归分析显示, 学历较低(OR=1.968, P=0.040)、收入较高(OR=2.053, P=0.043)、烟蒂较短(OR=2.366, P=0.010)、尼古丁高依赖(OR=7.143, P<0.001)者吸烟量更大。结论 更换卷烟的吸烟者更倾向选择低焦油卷烟;学历低、收入高、尼古丁高依赖的吸烟者是控烟健康教育、行为干预的重点人群。