Women in dental surgeries: reproductive hazards in occupational exposure to metallic mercury

Summary Eighty-one women (45 dentists and 36 dental assistants) occupationally exposed to metallic mercury underwent a toxicoclinical examination. Total mercury lebels (TMLs) were determined in scalp and pubic hair by cold vapour AAS. Furthermore a detailed questionnaire study was made concerning adverse reproductive events. TMLs in the hair of the exposed women examined exceeded significantly those determined in the hair of 34 controls not exposed to mercury. All exposed women had continued working during pregnancy. There was a significant, positive association between TMLs in the hair of exposed women and the occurrence of reproductive failures in their history. The relation between TMLs in the scalp hair and the prevalence of menstrual cycle disorders was statistically significant. These findings indicate that dental work could be another occupational hazard with respect to reproductive processes.     

The effect of occupational exposure to mercury vapour on the fertility of female dental assistants.

Exposure to mercury vapour or inorganic mercury compounds can impair fertility in laboratory animals. To study the effects of mercury vapour on fertility in women, eligibility questionnaires were sent to 7000 registered dental assistants in California. The final eligible sample of 418 women, who had become pregnant during the previous four years, were interviewed by telephone. Detailed information was collected on mercury handling practices and the number of menstrual cycles without contraception it had taken them to become pregnant. Dental assistants not working with amalgam served as unexposed controls. Women with high occupational exposure to mercury were less fertile than unexposed controls. The fecundability (probability of conception each menstrual cycle) of women who prepared 30 or more amalgams per week and who had five or more poor mercury hygiene factors was only 63% of that for unexposed women (95% CI 42%-96%) after controlling for covariates. Women with low exposure were more fertile, however, than unexposed controls. Possible explanations for the U shaped dose response and limitations of the exposure measure are discussed. Further investigation is needed that uses biological measures of mercury exposure.     

Perceptions of dental fluorosis and evaluation of agreement between parents and children: validation of a questionnaire

This study aimed to validate the Child's and Parent's Questionnaire about Teeth Appearance and to evaluate concerns relative to fluorosis among 213 pairs of parents and 12-year-old children from two regions of Brazil. Reliability was assessed by Cronbach's alpha and intraclass correlation coefficient, and construct and criterion validity by Spearman's correlations. Student t-test was used to compare the two regions and to assess parent/child agreement. Internal consistency was acceptable, and test-retest reliability was moderate to excellent. Perception of moderate to severe fluorosis and clinical data were significantly correlated, as were perception of fluorosis and subjects' concerns. Although parents from Rafael Arruda, Ceará State, showed a higher perception of fluorosis, parental concern was greater in Piracicaba, S?o Paulo State. Parents were more worried and dissatisfied with their children's dental appearance than the children themselves. This version of the questionnaire proved to be valid and reliable for assessing children's and parents' perceptions of dental fluorosis.     

Cancer deaths and occupational exposure in a group of plutonium workers

An exploratory epidemiological study was conducted for 319 deceased nuclear workers who had intakes of transuranic radionuclides and histories of employment during the time period from 1943 to 1995. The workers were employed at various facilities throughout the United States, including the Department of Energy defense facilities and uranium mining and milling sites. The majority of individuals were involved in documented radiological incidents during their careers. All had voluntarily agreed to donate their organs or whole body to the United States Transuranium and Uranium Registries. External and internal dose assessments were performed using occupational exposure histories and postmortem concentrations of transuranic radionuclides in critical organs. Statistical data analyses were performed to investigate the potential relationship between radiation exposure and causes of death within this population due to cancers of the lungs, liver, and all sites combined while controlling for the effects of other confounders. No association was found between radiation exposure and death due to cancer (α = 0.05). However, statistically significant associations were found between death due to any type of cancer and smoking (yes or no) (odds ratio = 5.41; 95% CI: 1.42 to 20.67) and rate of cigarette smoking (packs per day) (odds ratio = 2.70; 95% CI: 1.37 to 5.30).     

2014-2020年某三甲医院医务人员血源性职业暴露特点及防控费用

目的 探讨医务人员血源性职业暴露发生特点,分析相关影响因素及防控费用,探讨防控措施,为医务人员职业防护提供科学有效的依据。方法 采用回顾性研究方法调查某三甲综合性教学医院2014年-2020年发生血源性职业暴露的医务人员114例,收集上报随访数据。结果 工龄<5年的医务人员最易发生职业暴露(45.61%)。暴露人员以手术科室为主(73.69%),前3位的分别是手术室、关节外科、产科;暴露源以乙型肝炎病毒为主(75.44%);锐器伤是主要暴露环节(88.60%)。护士暴露最多的地点为病房,主要时机是注射及拔针操作时;医生暴露最多的地点为手术室,主要时机是器械使用中,暴露场所及时机差异有统计学意义(P<0.05)。2014-2020年血源性职业暴露发生率呈下降趋势(P<0.05);暴露发生月份中,7、8月高发,其次是3、4月。血源性职业暴露防控费用平均每例392.22元,HCV、HBV、梅毒职业暴露平均费用分别为684.43元、388.09元、335.57元,其中HBV暴露者抗体滴度≥10 mIU/ml,平均每例95.70元,与无表面抗体或抗体滴度不足时(平均每例502.51元),同比降低80.95%。结论 应重点加强对职业暴露高危人群、高危科室、高危环节和高危时刻的防控,践行长效防控机制,有效预防血源性职业暴露的发生,降低其卫生经济负担。     

Nephropathy in cadmium workers: assessment of risk from airborne occupational exposure to cadmium

To assess the quantitative relation between exposure to airborne cadmium and various markers of renal tubular and glomerular function, 45 male workers employed at a plant that recovers cadmium from industrial waste and 32 male hospital workers of similar age and geographical location were examined. Cumulative external exposure to airborne cadmium (dose) was estimated from historical air sampling data, adjusted for respirator use. Increasing cadmium dose was associated with multiple renal tubular functional abnormalities, including reduced reabsorption of beta-2-microglobulin (beta-2), retinol binding protein (RBP), calcium, and phosphate. Serum creatinine concentration also increased with cadmium dose, suggesting impaired glomerular function. Mean systolic and diastolic blood pressures were higher in the cadmium workers than in the unexposed (134 v 120 mm Hg and 80 v 73 mm Hg respectively), but only systolic blood pressure was significantly associated with cadmium dose in multivariate analyses. Cadmium dose remained the most important predictor of serum creatinine concentration after controlling for age, blood pressure, body size, and other extraneous factors. Logistic regression to model the probability (prevalence) of various renal abnormalities with increasing dose of cadmium was used. The probability of multiple tubular abnormalities and raised serum creatinine concentration increased sharply at cumulative cadmium exposures exceeding 300 mg/m3 days, corresponding to working for 4.3 years at the current permissible United States exposure limit for cadmium dust.     

Doses from occupational exposure: a study of radiation doses to workers in Kuwait over a four-year period

The personal monitoring facility in the Ministry of Public Health's Radiation Protection Department has provided service to all users of ionizing radiation in medicine, research and industry in Kuwait. Exposure results during 1980-1983 were compared and analysed to examine the efficiency of protection measures adopted by each occupation. The results indicate that annual doses received by workers in different occupations in recent years tend to be generally low, but remain higher than those received by similar workers in other countries. Several overexposures to radiologists, radiology nurses, medical radiographers, and industrial radiographers increased the overall annual collective doses. As a result, protective measures designed for radiologists and nurses involved with special radiographical procedures should be improved. The recent use of the after-loading technique in intra-cavitary therapy was responsible for a significant reduction in the overall average doses received by workers involved in radiotherapy.     

某八溴联苯醚生产企业工人职业性有害因素接触与职业健康体检资料分析

某企业八溴联苯醚生产过程中的职业性有害因素氯仿和八溴联苯醚粉尘的不合格率分别为5.6%和15.6%,体检资料显示氯丙烯/氯仿接触组的肝肾功能检查异常率较高,而八溴联苯醚接触组的肝脏毒性、肺功能及心血管指标异常率较高。     

Statistical study of the correlation between mercury exposure (TWA) and urinary mercury concentrations in chloralkali workers

The present report completes a previous study made on three chloralkali plants that was presented at the 8th International Conference on Occupational Health in the Chemical Industry, Tokyo, 1980, with the final results from five plants located in various regions of Italy. A total of 14,339 measurements of mercury in air and 8,042 determinations of mercury in urine were considered. The total number of workers involved was 275. On the basis of these data, we believe it can be concluded that, as previously reported, a correlation exists between mercury concentrations in the air and in the urine of exposed workers. This correlation is such that for exposures in the order of the present TLV (0.05 mg/m³), the value of the Z ratio (ratio between mean urinary mercury values expressed in mg/l and mean airborne mercury concentrations expressed in mg/m³) is 1.3, while the urinary mercury values vary from 0.051 mg/l to 0.078 mg/l with a mean value of 0.065 mg/l.     

Relation between exposure related indices and neurological and neurophysiological effects in workers previously exposed to mercury vapour.

A cross sectional study of aspects of their neurology was carried out on 77 chloralkali workers previously exposed to mercury (Hg) vapour and compared with 53 age matched referents. The chloralkali workers had been exposed for an average of 7.9 years at a concentration of 59 micrograms Hg/m3 in the working atmosphere. The individual mean urinary concentration of Hg for each year of exposure was 531 nmol Hg/1. On average the exposure had ceased 12.3 years before the examinations. Both the median sensory nerve conduction velocity and the amplitude of the sural nerve were associated with measures of cumulative exposure to Hg. An association was also found between years since first exposure to Hg and aspects of the visual evoked response. Previously exposed subjects with postural tremor or impaired coordination also had alterations in visual evoked response. These results may indicate an effect of previous exposure to mercury vapour on the nervous system, possibly in the visual pathway, cerebellum, and the peripheral sensory nerves.     

三氯乙烯作业人群外周血淋巴细胞染色体损伤研究

目的探讨三氯乙烯(TCE)致作业人群外周血淋巴细胞染色体损伤的作用。方法以91名TCE暴露工人和59名对照作为研究对象,调查职业史、年龄、性别、吸烟和饮酒等信息。收集班后尿,测定尿中三氯乙酸(TCA)水平反映TCE暴露内剂量。抽取肘静脉血,胞质分裂阻滞微核法制备外周血淋巴细胞涂片,计数微核、核质桥和核芽发生率,评价染色体损伤水平。结果两组研究对象在年龄、性别、吸烟、饮酒状况等方面均无显著性差异。暴露组平均TCE作业工龄为1.8年。暴露组尿中TCA水平为57.5mg/L,远远高于对照组0.9mg/L。两组研究对象的微核率及核质桥率无显著差异,但暴露组核芽率[(1.6±1.0)‰]显著高于对照组[(1.2±0.8)‰,P=0.05]。核芽率的升高在尿TCA≥50.0 mg/L组和TCE作业工龄≥1.8年组中表现更为明显。同时,尿TCA≥50.0 mg/L的工人,其微核率[(1.8±0.9)‰]也显著高于对照组[(1.4±0.7)‰,P=0.05]。未发现年龄、性别、吸烟、饮酒对微核率、核质桥率、核芽率的显著影响。结论 TCE暴露可致作业工人染色体损伤增加,核芽可以较为敏感的检出由TCE职业暴露所引发的基因组不稳定性。     

2019-2020年某市30所医院医护人员血源性职业暴露调查

目的 了解医务人员血源性职业暴露与防护现状,为控制职业暴露提出可行性建议。方法 整群抽取2019-2020年某市30所医院,回顾性收集医务人员职业暴露监测资料,包括职业暴露管理情况、职业暴露现状等进行描述性分析。结果 共报告职业暴露1 263例次(2.45%),2019、2020年暴露例次率差异具有统计学意义(2.72%vs. 2.20%,χ²=14.557,P<0.001)。实习/进修人员暴露例次率最高(3.80%)。护士占48.22%,工龄≤5年占63.18%,针刺伤是主要的暴露方式(75.77%),暴露源以乙型肝炎病毒阳性为主(19.48%),暴露高危科室为门急诊,个人不慎/操作不熟练是暴露的主要原因(65.56%)。无暴露后感染病例发生。结论 提高防护意识,规范诊疗行为,可有效防控职业暴露发生。     

钢铁冶金工厂职业性噪声与高血压的流行病学研究

目的 探讨冶金工人噪声暴露与高血压发病的关系。方法 对某钢铁冶金企业1694名男性工人（噪声暴露1225例,对照469例）,采用问卷、现场环境噪声测试等方法进行调查研究。结果 高血压的患病率在噪声暴露组为13．31％,明显高于对照组（7．8％）,两组比较,差异有显著性（P＜0．01）。随累积噪声暴露量水平的增高,高血压患病率有增高的趋势。Logistic回归分析结果表明,在控制了年龄、父母高血压史和体重指数等混杂因素后,累积噪声暴露量是高血压发病的危险因素,文化程度高是高血压的保护因素。结论 噪声暴露可能是高血压发病的危险因素,降低作业现场噪声,可能是降低冶金企业工人高血压发病的有效措施。     

某院医务人员血源性职业暴露的流行病学研究

目的掌握某院医务人员血源性职业暴露的流行病学特征。方法采用随机偶遇的方法对该院374名临床医务人员进行回顾性问卷调查。结果医务人员职业暴露后处理内容和处理流程正确率分别为54.81%（205/374）、89.84%（336/374）。 共发生血源性职业暴露174例、533例次,暴露率为46.52%(174/374)。不同科室、岗位医务人员职业暴露率比较,差异有统计学意义(P＜0.05);外科、儿科和内科的医务人员暴露率较高,分别为64.46%（78/121）、60.00%（18/30）和40.00%（50/125）;护士和医生暴露率较高,分别为51.52%（102/198）、47.27%（52/110）。医务人员血源性暴露时间主要集中在上午和晚上,穿刺、采血或处理物品为主要的暴露环节,暴露地点主要是病房和手术或换药室。结论该院医务人员血源性职业暴露率较高,应加强医院高危科室、人员和操作的血源性职业暴露防控措施的落实。     

一起医务人员HIV职业暴露的追踪调查与反思

目的了解某院医务人员人免疫缺陷病毒（HIV）职业暴露情况,发现存在的问题,进行针对性管理,以提高职业防护能力。方法对2007年3月发生的一起医务人员HIV职业暴露事件进行回顾性调查和血清学追踪监测。结果此次事件中共36名医务人员发生HIV职业暴露,经完整皮肤暴露率为72.22%（26人）, 损伤性暴露率25.00%（9人）,黏膜暴露率2.78%（1人）。发生职业暴露后,严格按规范要求实施急救处理者仅1人（2.78%）。所有职业暴露人员经临床追踪12个月,全部HIV血清学监测阴性。结论医务人员是HIV职业暴露的高危人群,该院职业防护管理工作存在重大隐患,必须加强培训和教育。     

The health of the workers in a rapidly developing country: effects of occupational exposure to noise and heat

Occupational hygiene and safety have not been high on the agenda of industrial management in developing countries for a variety of reasons. This cross-sectional study was undertaken to assess the exposure to noise and heat, and to study the level of occupational hygiene practiced, at a foundry in a rapidly developing country (Dubai, United Arab Emirates). Audiometry, muscle cramps and visual acuity were measured in workers at a foundry and compared with the results from workers at a soft-drink bottling plant. Thermal stress, relative humidity, ventilation, illumination and noise levels were measured at different work units at the foundry and at the soft-drink bottling factory. Thermal stress index was high while relative humidity and ventilation were low at the foundry compared with the bottling plant. Noise levels were also high at the foundry, exceeding 90 dB at almost all work units except the fabrication workshop. Mild or moderate visual defects were observed among 31% of foundry workers, compared with 19% of the bottling plant workers.Muscle cramps were reported by 30% of all workers at the foundry, compared with 5% at the bottling plant. Visual disability was the highest among furnace operators and fabricators. Mean hearing disability was 8.69 +/- 1.08% among foundry workers, compared with 4.56 +/- 0.82% among bottling plant workers. The high thermal stress, noise levels and exposure to non-ionizing radiations at the foundry might have contributed to the higher frequency of muscle cramps and the greater hearing and visual disabilities, respectively, among these workers. Non-use of personal protective equipment and poor occupational hygiene and safety measures were also seen to affect eye and ear health adversely among the workers at the foundry.     

High exposure of Chinese mercury mine workers to elemental mercury vapor and increased methylmercury levels in their hair

Objective The aim of this study was to determine the level of exposure of mercury (Hg) miners and smelter workers to elemental mercury (Hg⁰) vapor in China, who work in Hg mines without using protective equipment against Hg⁰ vapor. In addition, the level of methylmercury (MeHg) intake by the workers was estimated from the MeHg concentration in their hair. Methods Urinary total mercury (THg) and hair THg and MeHg concentrations were measured in 26 Hg miners and smelter workers (i.e., exposed group), and 48 unexposed people (unexposed group). Results The exposed group showed high geometric mean THg concentrations in urine (258 ng/ml, 226 μg/g creatinine) and hair (20.0 μg/g). The urinary THg concentration of the smelter workers in particular was extremely high (338 μg/g creatinine in urine). The highest urine THg concentration reached 4577 μg/g creatinine. THg concentrations in urine and hair showed a significant correlation in the exposed group (r=0.62), indicating the adhesion of Hg⁰ vapor to hair. However, no such significant correlation was found in the unexposed group. Hair MeHg concentration in the exposed group (1.97 μg/g) was about threefold higher than that in the unexposed group (0.60 μg/g). Conclusions This study shows that smelter workers in a Chinese Hg mine are exposed to extremely high levels of Hg⁰ vapor, and that Hg miners are exposed to higher levels of MeHg than the unexposed subjects. Further study is needed to determine the cause of the higher hair MeHg concentration in the exposed group.     

我国职业性铅接触对作业女工生殖健康影响的Meta分析

目的 综合分析职业性铅接触对作业女工生殖功能的影响,取得敏感性生殖效应指标.方法 检索和收集1979-2008年国内发表的关于职业性铅接触对作业女工生殖功能影响的文献,经严格的筛选后,应用Bev man软件对入选文献进行一致性检验并采用相应的数学模型进行数据合并,采用Meta分析合并相对危险度(RR)值作为各项目的 总效应指标.结果 共纳入16篇文献.与对照组比较,职业性铅接触与女性月经周期异常(RR=1.78,95%CI:1.51～2.09)、经量过少(RR=1.46,95%CI:1.20～1.78)、经前期综合征(RR=1.71,95%CI:1.19～2.45)、痛经(RR=1.42,95%CI:1.09～2.23)、妊娠高血压(RR=4.47,95%CI:1.50～13.32)、妊娠合并贫血(RR=3.23,95%CI:1.07～9.78)、早产(RR=3.39,95%CI:2.22～5.19)、自然流产(RR=3.51,95%CI:2.38～5.19)、死胎死产(Rr=5.25,95%CI:3.38～8.14)及女工子代低体质量出生(RR=2.80,95%CI:1.19～6.61)和出生缺陷(RR=4.72,95%CI:3.11～7.16)的正相关有显著性(P<0.05).结论 职业性铅接触可以引起女工月经周期异常和经量减少,增加痛经和经前期综合征的发生,同时还会影响妊娠及其子代发育,表现为增加妊娠合并高血压、妊娠合并贫血、早产、自然流产和死胎死产的发生,并导致其子代出生低体质量和出生缺陷.