Exposure to hazardous substances and male reproductive health: a research framework

The discovery in the mid-1970s that occupational exposures to pesticides could diminish or destroy the fertility of workers sparked concern about the effects of hazardous substances on male reproductive health. More recently, there is evidence that sperm quantity and quality may have declined worldwide, that the incidence of testicular cancer has progressively increased in many countries, and that other disorders of the male reproductive tract such as hypospadias and cryptorchidism may have also increased. There is growing concern that occupational factors and environmental chemical exposures, including in utero and childhood exposures to compounds with estrogenic activity, may be correlated with these observed changes in male reproductive health and fertility. We review the evidence and methodologies that have contributed to our current understanding of environmental effects on male reproductive health and fertility and discuss the methodologic issues which confront investigators in this area. One of the greatest challenges confronting researchers in this area is assessing and comparing results from existing studies. We elaborate recommendations for future research. Researchers in the field of male reproductive health should continue working to prioritize hazardous substances; elucidate the magnitude of male reproductive health effects, particularly in the areas of testicular cancer, hypospadias, and cryptorchidism; develop biomarkers of exposure to reproductive toxins and of reproductive health effects for research and clinical use; foster collaborative interdisciplinary research; and recognize the importance of standardized laboratory methods and sample archiving.     

Eliminating health disparities among minority women: a report on conference workshop process and outcomes

A national conference convened in May 2001 explored health disparities among minority women. It included 5 one-hour workshops that randomly assigned each participant to 1 of 4 groups. Groups generated recommendations on conference topics and from these identified priority recommendations. Trained facilitators guided groups through brainstorming and weighted voting processes; individual recommendations were submitted in writing. Participants generated 598 recommendations, 71 of them voted as priorities; these were analyzed to capture participants' "messages." Central themes focused on access issues and cultural incompetence as deterrents to the elimination of health disparities and on education, funding, and community-based, community-driven research as mechanisms for change. Strategies for change included reinventing or expanding the role of minority communities and changing health care itself and "how" it does its work. The essential element in all recommendations was community leadership and control.     

Eliminating tobacco-related health disparities: directions for future research

Certain groups in the United States remain at high risk and suffer disproportionately from tobacco-related illness and death despite progress made in reducing tobacco use. To address gaps in research on tobacco-related disparities and develop a comprehensive agenda aimed at reducing such disparities, representatives from funding agencies, community-based organizations, and academic institutions convened at the National Conference on Tobacco and Health Disparities in 2002. Conference participants reviewed the current research, identified existing gaps, and prioritized scientific recommendations. Panel discussions were organized to address research areas affecting underserved and understudied populations. We report major research recommendations made by the conference participants in several scientific domains. These recommendations will ultimately help guide the field in reducing and eliminating tobacco-related disparities in the United States.     

Australian occupational therapy research: A review of publications 1987–91

The aim of this study was to describe the characteristics of Australian occupational therapy research published during the period 1987–91. A literature review of the Australian Occupational Therapy Journal for the years 1987–91, and the Australian Association of Occupational Therapists' conference proceedings for the years 1988 and 1991 was conducted. A number of trends were identified. The proportion of research journal articles and conference papers over the 5 year period remained stable. Most journal research articles were written by academics, while clinicians were the most frequent authors of conference research papers. The majority of the research articles reviewed were the result of collaboration between authors; however, this collaboration was not usually between occupational therapy academics and clinicians. Research was predominantly on topics related to practice in clinical specialty areas; however, academics focused more on education and professional issues. The main method for data collection used in the research articles was by surveys. These findings provide valuable information about the nature of Australian occupational therapy research.     

Role of environmental chemicals in diabetes and obesity: a National Toxicology Program workshop review

Background: There has been increasing interest in the concept that exposures to environmental chemicals may be contributing factors to the epidemics of diabetes and obesity. On 11–13 January 2011, the National Institute of Environmental Health Sciences (NIEHS) Division of the National Toxicology Program (NTP) organized a workshop to evaluate the current state of the science on these topics of increasing public health concern.Objective: The main objective of the workshop was to develop recommendations for a research agenda after completing a critical analysis of the literature for humans and experimental animals exposed to certain environmental chemicals. The environmental exposures considered at the workshop were arsenic, persistent organic pollutants, maternal smoking/nicotine, organotins, phthalates, bisphenol A, and pesticides. High-throughput screening data from Toxicology in the 21st Century (Tox21) were also considered as a way to evaluate potential cellular pathways and generate -hypotheses for testing which and how certain chemicals might perturb biological processes related to diabetes and obesity.Conclusions: Overall, the review of the existing literature identified linkages between several of the environmental exposures and type 2 diabetes. There was also support for the “developmental obesogen” hypothesis, which suggests that chemical exposures may increase the risk of obesity by altering the differentiation of adipocytes or the development of neural circuits that regulate feeding behavior. The effects may be most apparent when the developmental exposure is combined with consumption of a high-calorie, high-carbohydrate, or high-fat diet later in life. Research on environmental chemical exposures and type 1 diabetes was very limited. This lack of research was considered a critical data gap. In this workshop review, we outline the major themes that emerged from the workshop and discuss activities that NIEHS/NTP is undertaking to address research recommendations. This review also serves as an introduction to an upcoming series of articles that review the literature regarding specific exposures and outcomes in more detail.     

As the ship sails forth

This concluding article comments on what we learned from the conference, what we still need to know, and what we need to do now. It describes what participants said about the impact of the conference and the follow-up steps that have been taken so far. In terms of what we learned, there was agreement on the importance of culture in understanding literacy and health literacy; the importance of context; the integral relationship between literacy and health literacy and the concept of "empowerment;" the value of efforts to improve health through literacy and health literacy; and the need for collaboration. We need more and better information on how our various efforts are working; the cost of low literacy; the links between health, education, and lifelong learning; the needs and strengths of Aboriginal people, and the perspectives of Francophone and ethnocultural groups. Specific topics worthy of pursuit are suggested. They are followed by a list of recommendations from the conference related to focussing on language and culture, and to building best practices, knowledge, and healthy public policy. The paper presents some findings from the conference evaluation, which suggests that the conference met its goals. It concludes by reporting on actions that have been taken to implement the conference recommendations, including the establishment of a Health Literacy Expert Committee and the submission of several funding proposals.     

Women's health and the environment: innovations in science and policy

Current scientific findings indicate that environmental factors affect women's health. Specifically, evidence has accumulated on the effects of the environment on reproductive health, cancer, injury, respiratory problems, autoimmune diseases, and other health problems. To review the current state of the science and policies related to women's health and the environment, the Federal Interagency Working Group on Women's Health and the Environment of the Department of Health and Human Services and the Society for Women's Health Research jointly sponsored a conference in 1998 entitled Women's Health and the Environment: Innovations in Science and Policy. The aim of the conference was to provide a forum for scientists to share recent findings, promising avenues of research, methodological barriers, and data gaps about women's susceptibility to environmental agents. The conference generated 22 recommendations for policy, 17 recommendations for communication and training, and 48 recommendations for research to be considered by the federal government. The purpose of this review is to bring to the attention of the scientific community and policymakers the breadth of the women's health implications associated with environmental factors by highlighting key research findings presented at the conference. This review summarizes the current status of science in women's health, it describes relevant activities by the federal government, and it suggests recommendations for future research and policy initiatives in the context of women's health and the environment.     

Report of a joint National Institutes of Health (NIH)/ Agency for International Development (AID)/ Program for Applied Research in Fertility Regulation (PARFR) Workshop on Research and Development of Immunological Methods of Fertility Regulation

Reproductive immunology has been identified as a topic of interest by several national and international agencies supporting contraceptive development. Owing to these interests, a joint NIH/AID/PARFR Workshop on Research and Development of Immunological Methods of Fertility Regulation was convened at NIH. The purpose of the Workshop was to review current research in reproductive immunology with specific reference to research on sources of antigens that have the potential for eliciting an immune response and which can interfere with reproductive processes in both the male and the female. The Workshop resulted in recommendations to investigators and funding agencies interested in conducting and supporting research and development activities in this field, respectively. It was the consensus that immunological approaches offer some unique advantages in fertility regulation, however, a considerable research effort must be mounted to recognize their full potential.     

Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative Study

Background

Little research documents the self-identified reproductive health priorities and health care experiences of lesbian, gay, bisexual, transgender, queer (LGBTQ)-identified individuals who may be in need of services.

Current activities of the international commission on radiological protection

The advice of the International Commission on Radiological Protection (ICRP) is aimed principally at the regulators and operators that have responsibility for establishing protection standards. ICRP's present recommendations were published in 1991. Since then, the Commission has published additional recommendations, and the system of protection has become increasingly complex. The Commission has decided to simplify its system and make it more coherent. In 2005, the Commission plans to adopt a new set of recommendations that should be seen as a consolidation of earlier recommendations. In the review of the current system of protection, many topics are being looked at and all committees are currently addressing issues of relevance for the revision. A proposal for the new recommendations on radiological protection will be discussed at the 11th International Radiation Protection Association conference in Madrid in 2004. When the Commission adopts the new recommendations in 2005, 15 y will have passed since the 1990 recommendations were adopted.     

Employer Policies and Practices to Manage and Prevent Disability: Conclusion to the Special Issue

Purpose Research of employer policies and practices to manage and prevent disability spans many disciplines and perspectives, and there are many challenges related to stakeholder collaboration, data access, and interventions. The purpose of this article is to synthesize the findings from a conference and year-long collaboration among a group of invited researchers intended to spur new research innovations in this field. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The conference goals were to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. In this paper, we summarize key points from the 6 resulting papers, compare them with an earlier 2005 conference on improving return-to-work research, and conclude with recommendations for further overarching research directions. Results/Conclusion In comparison with the 2005 conference, a greater emphasis was placed on organizational and social factors, employer roles and responsibilities, methods of implementation, non-clinical approaches, and facilitating stay-at-work as well as return-to-work. A special panel of employer consultants and representatives who were featured at the 2015 conference reinforced the importance of organizational culture, leadership style, and financial decision-making strategies at the employer level. Based on the conference proceedings, we recommend that future research in this area should strive for: (a) broader inclusion of workers and workplaces; (b) attention to multilevel influences in the workplace; (c) a focus on social as well as physical aspects of work; (d) earlier employer collaboration efforts; (e) more attention to implementation factors; and (f) a broader assessment of possible outcome domains.     

The future of intervention research at NIOSH

The National Institute for Occupational Safety and Health (NIOSH) has recently made a commitment to increase both extramural and intramural support of control technology and intervention research. It is important for NIOSH to use intervention research more aggressively because it provides a mechanism to go beyond investigation, identification, and recommendations to actually determine if prevention has occurred. Intervention research can assess the effectiveness of the hierarchy of controls, workplace standards, and health and medical care, as well as provide important information on occupational disease and injury surveillance and health communication efforts. In pursuing intervention research, NIOSH will focus on enhancing its existing control technology and surveillance programs, seeking input from partners in industry and labor, pursuing interdisciplinary approaches, considering the cost and feasibility of controls, considering and integrating behavioral procedures, and widely disseminating the results. (This article is a US Government work and, as such, is in the public domain in the United States of America.) © 1996 Wiley-Liss, Inc.     

Investigations on the use of testosterone oenanthate as a male contraceptive agent

The effect of exogenous testosterone on male gonadal function was in vestigated by applying a practical dose schedule of weekly injections of testosterone enanthate. 7 healthy young males received 22 intramuscular injections of 250 mg testosterone enanthate once a week for a period of 21 weeks. Mean sperm counts were reduced from a pretreatment value of 73 million sperm/ml to below 3 million sperm/ml within 9 weeks of testosterone administration and remained so during the whole treatment period. A marked recovery of spermatogenesis did not occur before 13 weeks after testosterone withdrawal, when the mean sperm count rose to 63 million sperm/ml. Changes of the mean sperm motility and percentage of normal sperm morphology generally paralleled those of the mean sperm concentration, whereas the mean semen volume, libido, potency, and secondary sex characteristics remained unaffected. A consistently azoospermic semen was not developed by any individual. This and the fact that sperm counts in 3 out of 7 males still showed some depression of spermatogenesis at the end of the observation period of 28 weeks after testosterone withdrawal indicate that testosterone enanthate admin istered in the described dose schedule is not a safe male contraceptive agent. However, further research on the use of hormones for the control of fertility in men seems warranted.     

Patient-physician communication barriers regarding fertility preservation among newly diagnosed cancer patients

With cancer survival rates increasing, new directions have focused on issues of survivorship, with an intense focus on quality of life. One area gaining increased attention is fertility preservation and future parenthood among cancer survivors. Although medical options for fertility preservation exist, most are not well understood by physicians, patients and family members, and are not readily accessible to patients and their health care providers. This paper discusses the current difficulties in communicating information about fertility preservation in the United States. Physician level of knowledge about fertility preservation, attitudes and comfort level with the topics, patient preferences, and financial and practice barriers may serve as obstacles in the communication process. Social, interaction and behavioral research studies are well poised to address the communication barriers and provide possible solutions to problems in understanding fertility preservation, for patients, family members and health care providers alike.     

Occupational diseases due to allergic and toxic chemicals in health care workers: fitness for work

The purpose of this review is to suggest job fitness criteria for health care workers exposed to sensitizing or chemical agents. These recommendations are derived from a comparison between previous documents on prevention and management of allergic and chemical risks in health care settings and updated evidence; the job fitness criteria and the main documents on these topics are summarized in tables. Glove allergy, in particular latex allergy, is still a significant problem but we should remember that a wide choice of alternative materials is now easily available; many different alternative health products are also currently available when an allergy to disinfectants or detergents is diagnosed. Hence the prevention of allergic diseases is mostly based on an appropriate choice and use of the gloves and health products according to the specific tasks and possible individual susceptibility; this meets the requirements of the "good health care organization", which translates into lower costs, if possible, as well as the best protection of worker's health. Concerning chemical risk, it should be remembered that during the last 20 years the improvements made in work environments have profoundly changed the mode and the levels of exposure to chemical substances and the current recommendations concerning the management of workers exposed to anesthetic gases, antineoplastic agents and sterilizers/disinfectants significantly differ from those of early 1990s. However, the past prudential guidelines are still valid for formaldehyde.     

Research Priorities for Fertility and Conception Research as Identified by Multidisciplinary Health Care Practitioners and Researchers

The Robinson Research Institute of the University of Adelaide convened a multidisciplinary group of n = 33 clinicians, researchers and representatives of government organisations on the 2 October 2014 for a workshop entitled “Promoting fertility and healthy conception. How do we generate greater reproductive health awareness?” The key aim of the workshop was to assess the body of knowledge that informs clinical practice and government policy, and to identify questions and additional information needed by health practitioners and government representatives working in the field of reproductive health and to frame future research and policy. The workshop identified topics that fell mostly into three categories: lifestyle-related, societal and biological factors. The lifestyle topics included nutrition and diet, exercise, obesity, shift work and other factors deemed to be modifiable at the level of the individual. The societal topics included discussions of matters that are structural, and resistant to change by individuals, including specific ethical issues, social disadvantage, government and educational policies. The biological factors are intrinsic physical states of the individual, and included many factors where there is a dense body of scientific knowledge which may not be readily accessible in less academic language. This workshop thus provided an opportunity to identify further actions that could be undertaken to meet the needs of diverse organisations and groups of professionals with an interest in human fertility. Since so many factors in our social and biological environment can impact fertility and preconception health, it is imperative to involve many disciplines or levels of government or societal organisations that have not traditionally been involved in this area.     

Pigments in your food

Twelve years ago the first Pigments in Food conference was organized to bring together scientists specialized in the research of pigments to share their results and problems with each other. The most important aim of the congress was to offer a possibility for scientists such as pigment chemists, food chemists, food technologists, agriculturists, nutritionists, and also industry people from all over the world to meet and discuss the different aspects of food pigments. The content of the conference primarily, but not exclusively, addresses anthocyanins, carotenoids and chlorophylls. This special issue allows the reader to take a look at the versatility of topics that were presented on the most recent congress in the series, namely, the 6th International Congress on Pigments in Food entitled “Chemical, Biological and Technological Aspects” held in Budapest, Hungary, from 20 to 24 June, 2010.     

New Technologies and Worker Safety in Western Agriculture

ABSTRACT

The New Paths: Health and Safety in Western Agriculture conference, November 11–13, 2008, highlighted the role of technological innovation in agricultural production. The tree fruit industry in the Pacific Northwest has adopted a “technology road map” to reduce production costs and improve efficiency. An agricultural tour provided field demonstrations and discussions on such topics as mobile work platforms in orchards, traumatic and musculoskeletal injuries, and new pest control technologies. Occupational safety and health research will need to adapt to and keep pace with rapid changes in agricultural production processes.     

Zur Fortentwicklung der Arbeiten bei den Empfehlungen der Kommission für Krankenhaushygiene und Infektionspr?vention (KRINKO)

The Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute developed evidence-based recommendations for the prevention and control of nosocomial infections in Germany. Considering the growing impact of multiresistant pathogens (MRE) on morbidity and mortality related to nosocomial infections, the prevention and control of MRE is one of the most important topics on the current agenda. Currently, the German recommendations on methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) are being re-evaluated and a recommendation discussing options for the prevention and control of MR Gram-negative pathogens is awaited and will be published in the next months.