Gender Difference in Patients with Recurrent Neurally Mediated Syncope

Purpose

The gender difference of neurally mediated syncope is not well defined in a large patient population. The aim of this study was to evaluate the gender difference of clinical manifestations in patients with neurally mediated syncope who underwent head-up tilt test.

Materials and Methods

The medical records of 1,051 consecutive patients with two or more episodes of syncope, who were diagnosed as having neurally mediated syncope by head-up tilt test, were retrospectively reviewed.

Results

Of 1,051 patients, 497 (47.3%) patients were male and 554 (52.7%) patients were female. Female patients were experiencing syncopal episodes for longer periods of their lives (8.2 ± 9.5 years vs. 6.8 ± 9.2 years, p = 0.002) and more episodes of syncope prior to head-up tilt test (HUT) (7.2 ± 9.4 vs. 5.0 ± 6.4, p = 0.001) than male patients. Micturition syncope (20.0% vs. 5.2%, p < 0.001) was observed more frequently in male patients than in female patients. To the contrary, however, defecation syncope (16.3% vs. 9.3%, p < 0.001) was observed more frequently in female patients than in male patients.

Conclusion

Female patients were experiencing syncopal episodes for longer periods of their lives and more episodes of syncope than male patients. Gender difference was also noted with regard to frequency of situational syncope.     

Standardized Approaches to Syncope Evaluation for Reducing Hospital Admissions and Costs in Overcrowded Emergency Departments

Purpose

The evaluation of syncope is often disorganized and ineffective. The objective of this study was to examine whether implementation of a standardized emergency department (ED) protocol improves the quality of syncope evaluation.

Materials and Methods

This study was a prospective, non-randomized study conducted at a 1900-bed, tertiary teaching hospital in South Korea. We compared two specific periods, including a 12-month observation period (control group, January-December 2009) and a 10-month intervention period after the implementation of standardized approaches, comprising risk stratification, hospital order sets and establishment of a syncope observational unit (intervention group, March-December 2010). Primary end points were hospital admission rates and medical costs related to syncope evaluation.

Results

A total of 244 patients were enrolled in this study (116 patients in the control group and 128 patients in the intervention group). The admission rate decreased by 8.3% in the intervention group (adjusted odds ratio 0.31, 95% confidence interval 0.13-0.70, p=0.005). There was a cost reduction of about 30% during the intervention period [369000 Korean won (KRW), interquartile range (IQR) 240000-602000 KRW], compared with the control period (542000 KRW, IQR 316000-1185000 KRW). The length of stay in the ED was also reduced in the intervention group (median: 4.6 hours vs. 3.4 hours).

Conclusion

Standardized approaches to syncope evaluation reduced hospital admissions, medical costs and length of stay in the overcrowded emergency department of a tertiary teaching hospital in South Korea.     

Arg389Gly β1-adrenergic receptor polymorphism and susceptibility to syncope during tilt test

Introduction

Numerous hormones, neurotransmitters, and other stimuli exert their biological effect on cellular functioning through heptahelical receptors coupled to G proteins (GPCR – G protein-coupled receptors). Adrenergic receptors that belong to this superfamily of receptors are components of the sympathetic nervous system. They play a pivotal role in blood pressure regulation and myocardial contractility. Alterations of the adrenergic receptor pathway have been suggested to be involved in the pathophysiology of vasovagal syncope (VVS). The aim of the present study was to evaluate the distribution of Arg389Gly polymorphism within the ADRB1 gene among patients with recurrent syncope.

Material and methods

Arg389Gly single nucleotide polymorphism was analyzed in 205 patients with recurrent syncope. Ninety-five patients (46%) had a positive head-up tilt test (HUT) result. The control group comprised 143 non-fainting subjects. Genotyping was performed by restriction fragment length polymorphism (RFLP) with BstNI enzyme.

Results

Both analyzed groups had similar distribution of the 389Gly allele. Sixty percent of polymorphic 389Gly carriers belong to the group of syncopal patients, while 40% belong to the control group of healthy subjects.

Conclusions

An association between syncopal incidence and Arg389Gly polymorphism within the ADRB1 gene was not found. The analyzed polymorphism affecting sympathetic activity does not influence vasovagal syncope in Polish patients.     

Glucose levels and hemodynamic changes in patients submitted to routine dental treatment with and without local anesthesia

OBJECTIVE:

The aim of this study was to (1) observe the extent to which hemodynamic and glucose measurements change in patients submitted to a dental procedure with and without a local anesthetic and a vasoconstrictor (LAVA; 2% mepivacaine with adrenaline 1∶100,000) and (2) correlate those parameters with the patients'' anxiety levels.

METHOD:

This was an unblinded, random, prospective, and observational study with paired groups. Patients were evaluated during two different consultations during which they either did or did not receive a local anesthetic/vasoconstrictor.

RESULTS:

Thirty‐seven patients ranging in age from 18 to 45 years (mean 30.4 ± 5.5 years) were evaluated. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, heart rate, and glucose levels, did not change significantly in healthy patients, regardless of whether a LAVA was administered during the dental treatment.

CONCLUSION:

The patients'' anxiety statuses neither varied significantly nor showed any correlation with the studied hemodynamic parameters and glucose levels, regardless of whether local anesthetics were used.     

Diagnostic patterns in the evaluation of patients presenting with syncope at the emergency or outpatient department

Purpose

Patterns of syncope evaluation vary widely among physicians and hospitals. The aim of this study was to assess current diagnostic patterns and medical costs in the evaluation of patients presenting with syncope at the emergency department (ED) or the outpatient department (OPD) of a referral hospital.

Materials and Methods

This study included 171 consecutive patients with syncope, who visited the ED or OPD between January 2009 and July 2009.

Results

The ED group had fewer episodes of syncope [2 (1-2) vs. 2 (1-5), p=0.014] and fewer prodromal symptoms (81.5% vs. 93.3%, p=0.018) than the OPD group. Diagnostic tests were more frequently performed in the ED group than in the OPD group (6.2±1.7 vs. 5.3±2.0; p=0.012). In addition, tests with low diagnostic yields were more frequently used in the ED group than in the OPD group. The total cost of syncope evaluation per patient was higher in the ED group than in the OPD group [823000 (440000-1408000) won vs. 420000 (186000-766000) won, p<0.001].

Conclusion

There were some differences in the clinical characteristics of patients and diagnostic patterns in the evaluation of syncope between the ED and the OPD groups. Therefore, a selective diagnostic approach according to the presentation site is needed to improve diagnostic yields and to reduce the time and costs of evaluation of syncope.     

Characteristics of Glottic Closure Reflex in a Canine Model

Purpose

The most important function of the larynx is airway protection which is provided through a polysynaptic reflex closure triggered by the receptors in the glottic and supraglottic mucosa, evoking the reflex contraction of the laryngeal muscles especially by strong adduction of vocal cords. Based on the hypotheses that central facilitation is essential for this bilateral adductor reflex and that its disturbance can result in weakened laryngeal closure, we designed this study to elucidate the effect of central facilitation on this protective reflex.

Materials and Methods

Seven adult, 20 kg mongrel dogs underwent evoked response laryngeal electromyography under 0.5 to 1.0 MAC (minimum alveolar concentration) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles.

Results

Ipsilateral reflex closure was consistantly recorded regardless of anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels were deepened. Additionally, late responses (R2) were detected in one animal at lower level of anesthesia.

Conclusions

Deepened level of anesthesia affects central facilitation and results in the loss of the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may possibly provide a way to prevent aspiration in unconscious patients.     

Total Oxidant Status, Total Antioxidant Status, and Paraoxonase and Arylesterase Activities during Laparoscopic Cholecystectomy

INTRODUCTION:

Laparoscopic cholecystectomy is the gold standard for the treatment of gallstone disease; however, adverse hemodynamic changes induced by increased intraabdominal pressure due to pneumoperitoneum are known to occur. Herein, we investigated the effects of pneumoperitoneum on oxidative stress markers, including paraoxonase, arylesterase, total oxidant status, and total antioxidant status, during laparoscopic cholecystectomy.

PATIENTS AND METHODS:

Patients that underwent a laparoscopic cholecystectomy were classified as Group I, whereas patients that underwent surgical procedures for an abdominal wall hernia under general anesthesia were classified as Group II. Blood samples were obtained during the preoperative period, the perioperative period, and 24 hours after surgery (postoperative day 1). Leukocyte counts, neutrophil rates, paraoxonase activities, arylesterase activities, and total oxidant and antioxidant status levels were measured.

RESULTS:

The differences in leukocyte counts and neutrophil rates were not significant between the two groups. In Group I, no significant differences in the total oxidant and antioxidant status levels were identified; however, paraoxonase and arylesterase levels were lower on postoperative day 1. No significant changes were observed in the total oxidant status, total antioxidant status, and paraoxonase or arylesterase activities in Group II. The perioperative total antioxidant status and arylesterase level were higher in Group I in comparison to Group II.

CONCLUSION:

Paraoxonase and arylesterase levels are useful markers in the evaluation of oxidative stress caused by intraabdominal pressure due to pneumoperitoneum.     

H wave and spinal root potentials in neuromonitoring of S1 root function during evacuation of herniated disc: preliminary results

Aim

To determine the changes in the tibial H reflex and spinal nerve root potentials (SRPs) of the S1 root during posterior discectomy and the effects of surgical manipulation.

Methods

Tibial H reflex responses (M and H waves) were intermittently recorded from the soleus muscle by surface electrodes during different stages of surgery in 5 patients with S₁ radiculopathy. All patients had Achilles reflex preserved bilateraly and no paresis on manual strength testing preoperatively. SRPs were additionally obtained by direct epidural recordings from the surgically exposed S₁ root in 2 of them.

Results

The variations in the amplitude of H wave were minor and reversible upon the cessation of surgical manipulation of the root, but the H reflex was not lost either temporarily or permanently in any of the patients. Prolongation of H wave latency by up to 18% at the end of surgery in comparison with preoperative value was noticed in 4 patients. However, there was increased degree of desynchronization of the SRP in some phases of the spinal root manipulation, such as root mobilization before the disc incision and retraction during the disc evacuation. H waves and SRPs were continuously present during the surgery. Ankle jerks were preserved postoperatively in all 5 patients.

Conclusion

Unremarkable variations in H wave latency may be followed by increased SRP desynchronization. Monitoring of the epidurally recorded SRPs seems to be more sensitive to surgical manipulations of the spinal nerve root than the tibial H reflex recordings from the soleus muscle.Surgical manipulation of the lumbosacral nerve root is an inevitable step in posterior discectomy. Monosynaptic H reflex can be used in neuromonitoring of the S1 root function during evacuation of the herniated disc at the level L5-S1 to assess the extent of surgical manipulation. A subpopulation of patients with S1-root compression by herniated disc has a preserved ankle jerk at the time of surgery. The effect of surgical manipulations on the H wave amplitude and latency can be monitored during the surgery for herniated disc removal in such patients.The H reflex plays an important role in the electrodiagnostic work-up of compressive lumbosacral radiculopathies, but it does not always give specific information even in clinical S₁-radiculopathy. Needle recording electrodes may be placed percutaneously under a fluoroscopic view as close as possible to each of the L₄-S₁ roots to identify exactly the abnormal spinal nerve root potential (SRP) of the compressed root upon tibial H reflex (1,2).The H reflex has already been used intraoperatively as a neurophysiological test for the identification of certain roots or rootlets to increase the selectivity of partial dorsal rhyzotomy in spastic patients (3-5). However, continuous assessment of the S₁ spinal nerve root function by H reflex during discectomy has not yet been studied. In the present study, the H reflex and spinal root potentials (SRP) were during posterior discectomy to assess the effects of surgical manipulation.     

Screening older people with musculoskeletal pain for depressive symptoms in primary care

Background

Older patients presenting to GPs with musculoskeletal pain are at high risk of having concurrent depression.

Aim

To investigate the performance of ultra-short (1–4 items tools) screening questions used during the consultation, and through a patient questionnaire to detect depressive symptoms among older adults presenting with musculoskeletal pain to general practice.

Design of study

Cross-sectional survey, linked GP consultation data.

Setting

General practices in central Cheshire, UK.

Method

Consecutive patients aged ≥50 years presenting with non-inflammatory musculoskeletal pain were eligible to participate. GPs screened all patients in the consultation for the presence of depressive symptoms using two questions. All patients were sent a postal questionnaire within 1 week of consultation containing the Hospital Anxiety and Depression Scale and the written version of the depression screening questions.

Results

The total number of patients included in the study was 428. In total, 35.5% of consulters had comorbid depressive symptoms, with 13.5% experiencing moderate or severe symptoms. Just over half of participants (n = 218/242; 51.4%) screened positive on self-administered screening at home compared with only 78 (20.8%) on GP-administered screening in the consultation. There was little difference between GPadministered and self-administered screening in the probability of depressive symptoms among those who screened positive with regard to exhibiting signs of having depressive symptoms.

Conclusion

Older patients consulting their GP with musculoskeletal pain frequently have comorbid mental ill health. Ultrashort depression screening questions administered during the consultation miss a large number of those with depressive symptoms, including six out of eight patients with severe symptoms. An improvement in the performance of screening questions in this patient group or narrowing the definition of ‘high risk’ from all patients aged ≥50 years presenting with musculoskeletal pain could help to improve detection.     

Serum adenosine deaminase,catalase and carbonic anhydrase activities in patients with bladder cancer

OBJECTIVES:

The relationship between adenosine deaminase and various cancers has been investigated in several studies. However, serum adenosine deaminase activity and carbonic anhydrase and catalase activities in patients with bladder cancer have not previously been reported. Therefore, the aim of this study was to measure serum adenosine deaminase, carbonic anhydrase and catalase activities in patients with bladder cancer.

MATERIALS AND METHODS:

Forty patients with bladder cancer and 30 healthy controls were enrolled in the study. Serum adenosine deaminase, carbonic anhydrase and catalase activities were measured spectrophotometrically.

RESULTS:

Serum adenosine deaminase, carbonic anhydrase and catalase activities were significantly higher in patients with bladder cancer than controls (all significant, p<0.001).

CONCLUSIONS:

These markers might be a potentially important finding as an additional diagnostic biochemical tool for bladder cancer.     

Induction of anesthesia in coronary artery bypass graft surgery: the hemodynamic and analgesic effects of ketamine

OBJECTIVE

The aim of this prospective, randomized study was to evaluate the hemodynamic and analgesic effects of ketamine by comparing it with propofol starting at the induction of anesthesia until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery.

INTRODUCTION

Anesthetic induction and maintenance may induce myocardial ischemia in patients with coronary artery disease. A primary goal in the anesthesia of patients undergoing coronary artery bypass grafting surgery is both the attenuation of sympathetic responses to noxious stimuli and the prevention of hypotension.

METHODS

Thirty patients undergoing coronary artery bypass grafting surgery were randomized to receive either ketamine 2 mg.kg⁻¹ (Group K) or propofol 0.5 mg.kg⁻¹ (Group P) during induction of anesthesia. Patients also received standardized doses of midazolam, fentanyl, and rocuronium in the induction sequence. The duration of anesthesia from induction to skin incision and sternotomy, as well as the supplemental doses of fentanyl and sevoflurane, were recorded. Heart rate, mean arterial pressure, central venous pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, cardiac index, systemic and pulmonary vascular resistance indices, stroke work index, and left and right ventricular stroke work indices were obtained before induction of anesthesia; one minute after induction; one, three, five, and ten minutes after intubation; one minute after skin incision; and at one minute after sternotomy.

RESULTS

There were significant changes in the measured and calculated hemodynamic variables when compared to their values before induction. One minute after induction, mean arterial pressure and the systemic vascular resistance index decreased significantly in group P (p<0.01).

CONCLUSION

There were no differences between groups in the consumption of sevoflurane or in the use of additional fentanyl. The combination of ketamine, midazolam, and fentanyl for the induction of anesthesia provided better hemodynamic stability during induction and until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery.     

Epsilon sarcoglycan mutations and phenotype in French patients with myoclonic syndromes

Background

Myoclonus dystonia syndrome (MDS) is an autosomal dominant movement disorder caused by mutations in the epsilon‐sarcoglycan gene (SGCE) on chromosome 7q21.

Methods

We have screened for SGCE mutations in index cases from 76 French patients with myoclonic syndromes, including myoclonus dystonia (M‐D), essential myoclonus (E‐M), primary myoclonic dystonia, generalised dystonia, dystonia with tremor, and benign hereditary chorea. All coding exons of the SGCE gene were analysed. The DYT1 mutation was also tested.

Results

Sixteen index cases had SGCE mutations while one case with primary myoclonic dystonia carried the DYT1 mutation. Thirteen different mutations were found: three nonsense mutations, three missense mutations, three splice site mutations, three deletions, and one insertion. Eleven of the SGCE index cases had M‐D and five E‐M. No SGCE mutations were detected in patients with other phenotypes. The total number of mutation carriers in the families was 38, six of whom were asymptomatic. Penetrance was complete in paternal transmissions and null in maternal transmissions. MDS patients with SGCE mutation had a significantly earlier onset than the non‐carriers. None of the patients had severe psychiatric disorders.

Conclusion

This large cohort of index patients shows that SGCE mutations are primarily found in patients with M‐D and to a lesser extent E‐M, but are present in only 30% of these patients combined (M‐D and E‐M).     

Locomotor differences in Mongolian gerbils with the effects of midazolam administration in the form of eye drops

Background

Midazolam is a sedative-hypnotic agent with amnestic and anticonvulsant properties that can be administrated to mammals through various routes, such as intravenous, intramuscular, oral, intrathecal, rectal, and buccal. Midazolam administration in the form of eye drops through the conjunctiva is not reported in the literature.

Aim

This study aims to demonstrate the possible central nervous system effects of midazolam administration as eyes drops in Mongolian gerbils.

Materials and Methods

Fourteen gerbils were randomly assigned to one of two equal sized groups. The active arm received 2 ml of 10 mg midazolam as eye drops in both eyes. Control group received a total of 2 ml of physiological saline (0.9% NaCl). We subjected the gerbils to an adapted “Open Field” to determine the possible effects on central nervous system of midazolam. Gerbils were allowed to move freely in the open field. Before and after the drug administration, locomotor activities of each gerbil have been recorded. Frequency of loss of righting reflex was quantified.

Results

Conjunctival midazolam administration resulted with the transient loss of righting reflex (p=0.017) and suppressed exploration motion (p=0.018) in the open field test compared to control subjects.

Conclusions

In the present study, administration of conjunctival midazolam as an eye drop may affect gerbil''s locomotor activities and open field behaviors. We argue that, using a sedative and anticonvulsive drug such as midazolam via conjunctival route may be useful in some clinical situations. Therefore, it could be beneficial to develop a new conjunctival formulation of midazolam. Also, there is a need for trials in humans with pharmacokinetic studies.     

Does the professional and working context of United Kingdom clinicians predict if they use practices to support patients with long term conditions to self manage?

Introduction

Our study examines how the professional and employment context may influence clinicians’ practice self management support for patients with long term conditions (LTC).

Material and methods

We surveyed clinicians working with patients with depression, chronic obstructive pulmonary disorder (COPD), chronic musculo skeletal pain and diabetes.

Results

Clinicians most frequently endorsed items on a scale concerned with patient centeredness, and less frequently endorsed items concerned with clinical and organizational self management support. The most important factors predicting these latter activities were the intensity of working experience with patients with LTC and attending professional training addressing the principles and practice of self management support. Practicing patient centeredness was endorsed by nearly all respondents, and so was not sensitive to variation on work variables.

Conclusions

The interaction of training and intensity of work with patients with LTC seems to have the most powerful effect on undertaking clinical and organizational self management support practices. To facilitate clinicians’ practice of self management support for patients with LTC it is very important to provide relevant professional training and to build specialized patient care teams with professionals having complimentary skills.     

The Effect of Posture on Cheyne-Stokes Respirations and Hemodynamics in Patients with Heart Failure

Study Objectives:

Cheyne-Stokes respirations occur in 40% of patients with heart failure. Orthopnea is a cardinal symptom of heart failure and may affect the patient''s sleeping angle. The objective of this study was to assess the respiratory and hemodynamic response to sleeping angle in a group of subjects with stable heart failure.

Design:

Twenty-five patients underwent overnight polysomnography with simultaneous and continuous impedance cardiographic monitoring. Sleeping polysomnographic and impedance cardiographic data were recorded.

Setting:

The study was conducted in a sleep center.

Patients:

All 25 patients had clinically stable heart failure and left ventricular ejection fractions < 40%.

Interventions:

The patients slept at 0°, 15°, 30°, and 45° in random order.

Measurements and Results:

Seventeen patients had Cheyne-Stokes apneas (index > 5/h) and 23 patients had hypopneas (index > 5/h). The hypopnea index showed no response to sleeping angle. The Cheyne-Stokes apnea index decreased with increasing sleeping angle (P < 0.001). This effect was seen only during supine sleep and non-rapid eye movement sleep and was absent in non-supine sleep, rapid eye movement sleep, and during periods of wakefulness. Thoracic fluid content index and left ventricular hemodynamics measured by impedance cardiography showed no response to sleeping angle.

Conclusions:

Changing the heart failure patient''s sleeping angle from 0° to 45° results in a significant decrease in Cheyne-Stokes apneas. This decrease occurs on a constant base of hypopneas. The changes in Cheyne-Stokes apneas are not related to changes in lung congestion and left ventricular hemodynamics.

Citation:

Soll BAG; Yeo KK; Davis JW; Seto TB; Schatz IJ; Shen EN. The effect of posture on Cheyne-Stokes respirations and hemodynamics in patients with heart failure. SLEEP 2009;32(11):1499-1506.     

Outcome of knee injuries in general practice: 1-year follow-up

Background

Knee injuries may lead to pain and to functional limitations in the activities of daily living. Patients with knee injuries are frequently seen in general practice; however, the outcome and management in these patients is not known.

Aim

To assess the outcome and management of knee injuries at 12 months'' follow-up in general practice.

Design of study

A prospective observational cohort study with a 1-year follow-up.

Setting

Primary health care.

Method

Adult patients consulting their GP after knee injury (n = 134) participated in the cohort. A magnetic resonance imaging scan was carried out and patients were diagnosed as either no lesion or an isolated meniscal tear, an isolated collateral or cruciate ligament lesion, or a combination. Follow-up questionnaires were filled in up to 12 months'' follow-up.

Results

At 12 months'' follow-up, 34 patients reported full recovery and 67 patients reported major improvement. At baseline, 37 patients (28%) were referred to physical therapy and 17 patients (13%) were referred to secondary care. During 1 year of follow-up, another 21 referrals to physical therapy and 11 referrals to secondary care took place. The pain severity decreased the most, and the Lysholm knee score increased in the majority of patients during the first 3 months after injury. In total, 18 arthroscopies were performed in 15 patients. One patient underwent an anterior cruciate ligament reconstruction.

Conclusion

The vast majority of patients report clinically relevant recovery. There is no clear difference in outcomes between patients with meniscal tears or ligament lesions and patients without these diagnoses.     

A comparison of three different target-controlled remifentanil infusion rates during target-controlled propofol infusion for oocyte retrieval

OBJECTIVE:

To evaluate the effects of three different target-controlled remifentanil infusion rates during target-controlled propofol infusion on hemodynamic parameters, pain, sedation, and recovery score during oocyte retrieval.

METHODS:

Sixty-nine women were scheduled for oocyte retrieval. Target-controlled propofol infusion at an effect-site concentration of 1.5 µg/mL was instituted. The patients were randomly allocated to receive remifentanil at an effect-site concentration of either 1.5 (group I, n = 23), 2 (group II, n = 23) or 2.5 ng/mL (group III, n = 23). Hemodynamic variables, sedation, pain, the Aldrete recovery score, and side effects were recorded.

RESULTS:

Hemodynamic variables, sedation and pain scores and the number of patients with the maximum Aldrete recovery score 10 min after the procedure were comparable among the groups. The number of patients in group III with the maximum Aldrete recovery score 5 min after the procedure was significantly lower than that in groups I and II. One patient in group II and one patient in group III suffered from nausea.

CONCLUSION:

Similar pain-free conscious sedation conditions without significant changes in hemodynamic parameters were provided by all three protocols. However, target controlled infusion of remifentanil at 1.5 or 2 ng/mL proved superior at providing early recovery compared to 2.5 ng/mL.     

Health status within the precincts of a nickel-copper mining and smelting environment

Background

Mining and smelting activities affect the biophysical environment and human health.

Objective

This paper elucidates on the human health status of residents close to a nickel-copper mine and concentrator/smelter plant.

Method

600 questionnaires were administered and data generated was processed.

Results

Health complaints of respondents included palpitations, lower abdominal pain, shortness of breath, constant chest pains, unusual spitting, coughing regularly, frequent headaches, loss of body weight, regular constipation, diarrhoea, nausea, vomiting, urinary pain, and unusual genital discharge. Many respondents suffered from headaches frequently with >50% from five sites. The majority of respondents having frequent influenza/common colds were from three sites. Pracetamol, aspirin and ibuprofen were taken for headache, period, back and abdominal pain. Fumes, vibrations, noise and constant movement of heavy equipment were considered as disturbing factors affecting health.

Conclusion

Fumes of SO₂ emanating from mining and smelting were the most suspected causative agent affecting health. Control site values for fumes, dust, vibrations and noise were very low. A link between health status and environmental pollution due to mining activities was thus inferred.