Employment security and health

OBJECTIVE: To study the relation of contractual and perceived employment security to employee health. DESIGN: Cross sectional survey. SETTING: Municipal sector employees in eight Finnish towns. PARTICIPANTS: 5981 employees with a permanent contract and 2786 employees with a non-permanent contract (2194 fixed term contract, 682 government subsidised contract). OUTCOME MEASURES: Poor self rated health, chronic disease, and psychological distress. RESULTS: Compared with permanent employees, fixed term men and women had better self rated health (men odds ratio 0.70; 95% confidence intervals 0.50 to 0.98, women 0.70 (0.60 to 0.82) and less chronic disease (men 0.69; 0.52 to 0.91; women 0.89; 0.79 to 1.02), but women had more psychological distress (1.26; 1.09 to 1.45). The only difference between subsidised employees and permanent employees was the high level of psychological distress in women (1.35; 1.09 to 1.68). Low perceived employment security was associated with poor health across all three indicators. The association of low perceived security with psychological distress was significantly stronger in permanent employees than among fixed term and subsidised employees, indicating that perceived security is more important for mental health among employees with a permanent contract. CONCLUSIONS: Contractual security and perceived security of employment are differently associated with health. It is therefore important to distinguish between these aspects of employment security in studies of labour market status and health. Such studies will also need to control for health selection, which is unlikely to operate in the same way among permanent and non-permanent employees.     

Toenail selenium concentration and lung cancer in male smokers (Finland)

Background: The objective of this investigation was to evaluate the association between toenail selenium concentration and lung cancer risk in male smokers. Methods: We conducted a nested case–control study within the Alpha–Tocopherol Beta–Carotene Cancer Prevention Study cohort. This substudy included 250 randomly selected incident lung cancer cases and 250 controls matched on age (up to ± 5 years), intervention group assignment, and date or randomization (±15 days). Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using conditional logistic regression methods. Finland began fortification of argricultural fertilizers in the fall of 1984, increasing the dietary intake, plasma, and toenail selenium concentrations for the population. The present analyses were based on the calculated residual of toenail selenium after regressing it on date of randomization. The selenium residual and the interaction of the residual with date of randomization were included in models with smoking status and body mass index as covariates. Results: We observed a suggestion of a protective association for higher selenium status among men who entered the trial early (when the range of selenium values included very low levels). The OR for men with adjusted toenail selenium concentrations at the 75th percentile compared to those with the lowest selenium concentrations ranged between 0.20 (0.09–0.44) for men randomized earliest in the trail and 0.61 (0.27–1.41) for men randomized in the fifth year. Conclusions: These results suggest that low selenium status may be associated with increased risk for lung cancer.     

Cancer incidence in a cohort of Finnish male smokers.

A total of 29,133 male smokers, aged 50-69 years, were recruited into the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study in 1984-1988. The nationwide Finnish Cancer Registry (FCR) recorded 5944 incident cases of cancer in this cohort through the end of 1999. Compared with the FCR data of the entire Finnish male population of same age the standardized incidence ratio (SIR) of total cancer in the ATBC cohort was 1.55 [95% confidence interval (CI) 1.51-1.59]. There was a significant excess of established smoking-related malignancies, such as lung cancer (SIR 2.45, 95% CI 2.35-2.56), and cancers of the tongue, mouth, pharynx, larynx, oesophagus, pancreas, stomach, liver, urinary bladder and kidney. In addition to these sites, cancers of the prostate and colon were slightly more common in the ATBC cohort than in the total Finnish male population (SIR 1.10, 95% CI 1.04-1.18 and SIR 1.14, 95% CI 1.00-1.30, respectively). In conclusion, the risk of many cancers was significantly higher in the ATBC Study cohort compared with the total Finnish male population of same age. In addition to the well known smoking-related cancers, cigarette smoking may increase slightly the risk of colon and prostate cancer, too.     

No lymphokines in T-cells around loosened hip prostheses

Research results have been contradictory about the role of lymphocytes and immune response in aseptic loosening of total hip replacement (THR). Conclusive evidence is still lacking in spite of extensive in vivo and in vitro studies. Our study was designed to check whether T-cells were activated and if they produced lymphokines in synovial membrane-like interface tissue around loosened THRs. Tissue sections were stabilized and permeabilized to allow the cytokine-specific antibodies to penetrate through the cell membrane and the membranes of intracellular organelles. This technique, combined with computer-assisted image analysis, permits the detection and quantitation of lymphokine-producing cells. We found that the number of T-cells was low, and none of the T-cells was activated, as shown by the absence of interleukin-2 receptor (IL-2R) immunoreactivity. There was no cell producing lymphokines, such as interleukin-2 (IL-2), interferon-gamma (IFN-gamma), and tumor necrosis factor-beta (TNF-beta). Our results suggest that T-cell-mediated immune response is not actively involved in aseptic loosening of THR.     

Oral iron is sufficient for erythropoietin treatment of very low birth-weight infants

The aim of this study was to compare two different doses and means of administration of iron in recombinant human erythropoietin (rHuEPO)-treated very low birth-weight (VLBW) infants. VLBW infants (n = 41) were randomized to one of three groups. Fourteen infants were treated with rHuEPO (300 IU/kg three times a week s.c.) and oral iron (ferrofumarate, 6 mg of iron/kg per day). Another 14 infants received the same erythropoietin dose and intramuscular iron (ferroxypolymaltose, once 12 mg of iron/kg weekly). Thirteen infants were treated with the same dose of intramuscular iron but did not receive rHuEPO. After the 3-week study period, haemoglobin concentrations and reticulocyte counts were similar in the rHuEPO-treated groups and both were higher than in the group not receiving rHuEPO (P < 0.001). In both rHuEPO-treated groups the transferrin receptor concentration increased from 6.8–7.2 mg/l to 10.5–11.3 mg/l. Conclusion In erythropoietin-treated very low birth weight infants the iron need for erythropoiesis can be met by oral administration of iron. Received: 17 November 1997 and in revised form: 6 March 1998 / Accepted: 30 April 1998     

Lack of effect of hormonal treatment and smoking on cytokeratin expression in buccal mucosa

Differences in cytokeratin expression of clinically normal buccal mucosa were studied in 50 healthy women by indirect immunofluorescence staining with monoclonal antibodies. The subjects were divided into four groups: control group (N= 18), smokers (N=8), oral contraceptive users (N=8) and smokers receiving oral contraceptives (N=16). Our findings indicate that cytokeratin expression in non-cornified stratified epithelium is not influenced by smoking or oestradiol/progesterone treatment. Only cytokeratin No. 19 showed variable patterns of expression but the differences could not be ascribed to smoking or contraceptives. Cytokeratin No. 19 gave a positive reaction in the basal and suprabasal layers in 34 subjects (68%). In 9 (18%) specimens, the staining was positive in the basal cells and showed a positive heterogeneous cytoplasmic reaction in the suprabasal cells. Interestingly, cytokeratin No. 7 was recognized in all epithelial cells except the basal cells. Our results suggest that changes in the serum oestradiol levels do not affect the cytokeratin pattern in buccal mucosa.     

Saccharide residues in human gingiva as revealed with fluorochrome-coupled lectins

The histochemical binding of 16 fluorochrome-conjugated lectins to human marginal gingiva was investigated. Of a total of 14 galactose/N-acetylgalactosamine (Gal/GalNAc)-specific lectins, Dolichos biflorus (DBA), Helix pomatia (HPA), and Helix aspersa agglutinins (HAA) were blood group A-reactive whereas Griffonia simplicifolia I-B4 (GSA-I-B4) and Sophora japonica (SJA) agglutinins were blood group B-reactive. HPA, HAA and GSA-I-B4 bound to all suprabasal epithelial cells and to vascular endothelia in tissues with compatible blood groups and detected only upper epithelial cells in tissues lacking the respective blood group antigens. SJA, on the other hand, bound to suprabasal epithelial cells and to endothelial cells in specimens from blood group B, AB and A individuals. DBA gave a heterogeneous labeling of upper epithelial cells in blood group A, AB and B specimens but not in O specimens and did not react with endothelia in any of the tissue samples. DBA bound, instead, consistently to mast cells in gingival lamina propria. Of the other Gal/GalNAc-reactive lectins, 2 bound to suprabasal epithelial cells and 7 to all viable cell layers in gingival epithelium. The binding of these lectins was blood group-independent. Of the fucose-specific lectins, Ulex europaeus agglutinin I (UEA-I) gave an intense suprabasal cell membrane-type of epithelial fluorescence in blood group O specimens and a more diffuse staining in other specimens and recognized endothelial cells in a blood group-independent way. Anguilla anguilla agglutinin (AAA) gave a blood group-independent epithelial staining and bound heterogeneously to endothelial cells only in blood group O samples.(ABSTRACT TRUNCATED AT 250 WORDS)     

Radioimmunoassay for Doxepin and Desmethyldoxepin

Abstract: A simple and sensitive radioimmunoassay (RIA) for the determination of doxepin and desmethyldoxepin in plasma or serum has been developed using a previously reported antiserum to the tricyclic anti-depressants. Before assay, doxepin is separated from desmethyldoxepin with selective extraction at different pH values enabling each to be measured specifically. ³H-imipramine is used as tracer. By using the extraction procedure doxepin and desmethyldoxepin concentrations can be measured down to 9 nmol/l from a 0.1 ml sample. If necessary, sensitivity can be doubled by taking a 0.2 ml sample to the extraction. Recoveries of doxepin and desmethyldoxepin were quantitative when the drugs were added at different concentrations to normal, pooled human plasma and the inter- and intra-assay coefficients of variation did not exceed 9%. The concentrations obtained from patient samples by the present RIA correlated well with those by high-pressure liquid chromatography. The RIA was also shown to be useful in pharmacokinetic single dose studies with doxepin.     

Prevention of Hemophilus influenzae type b bacteremic infections with the capsular polysaccharide vaccine

A long-term follow-up of approximately 50,000 children who received the Hemophilus influenzae type b capsular polysaccharide vaccine in 1974 at three months to five years of age has shown good protective efficacy in those who received the vaccine at 18 months or older. No adverse effects were observed. Analysis of paired serum samples from 514 vaccinated children showed that effective immunization with this vaccine could be performed after but not before the age of 16 to 20 months. An analysis of 956 bacteremic H. influenzae infections occurring in Finland over a period of five years showed that 94 per cent of all cases were in children under 10 years of age. Of these, 40 per cent occurred in children under 18 months, and 60 per cent in children between the ages of 1 1/2 and 9 years. These 60 per cent are potentially preventable with the capsular polysaccharide vaccine.