The role of occupational and environmental exposures in the aetiology of acquired severe aplastic anaemia: a case control investigation

Aplastic anaemia is a rare but serious disorder with a high morbidity and mortality rate. The causes of aplastic anaemia are, for the most part, unknown. We report on the hypothesis that aplastic anaemia may be caused by occupational and/or environmental exposures to certain chemicals. The UK Aplastic Anaemia Study was an interview-based case-control study covering the whole of Great Britain. Those patients diagnosed between 1 July 1993 and 20 October 1997, aged < or =75 years and born and diagnosed in the UK were eligible for the study. Two hundred eligible cases of aplastic anaemia were compared with 387 age- and sex-matched controls. A number of occupational exposures showed increases in risk. In a multivariate model of these exposures the odds ratios (ORs) for solvents/degreasing agents, pesticides and radiation were >2 and statistically significant. Reported chemical treatment of houses within 5 years of diagnosis had a significantly raised risk for adults [OR = 2.51, 95% confidence interval (CI) 1.02-12.01], particularly for woodworm treatment (OR = 5.1, 95% CI 1.5-17.4). This study identified significant risks associated with self-reported exposure to solvents, radiation and pesticides in the workplace. Self-reported chemical treatment of houses was also associated with an increased risk of developing aplastic anaemia, in keeping with previous literature.     

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。     

Mentoring at Men's Sheds: an international survey about a community approach to health and well‐being

Men's Sheds are named within the Australian and Irish National Male Health Policies as an exemplar of male health and well‐being and offer a range of formal and informal mentoring to counter the known consequences of social exclusion. The study aimed to report on whether Men's Sheds undertake mentoring programmes, and if so, who is being mentored; are mentors being trained, and if so by whom; and the perceived effectiveness of the mentoring programme. Furthermore, the study aimed to explore associations between sheds with a mentoring programme and factors that reflect an inclusive and a health‐focused environment. All known Men's Sheds were invited to participate in the survey; of those, 324 (42.8%) Men's Sheds in Australia and 59 (48.0%) International sheds participated in the study between April and August 2012. Overall, 39.2% (n = 127) of Australian sheds and 23.7% (n = 14) of International sheds undertook formal mentoring. Youth was the most common group being mentored in both Australia (60.6%; n = 77) and Internationally (71.4%; n = 10). Over half of Australian shed co‐ordinators rated their mentoring programme as moderately effective (52.8%; n = 67) and over a third as highly effective (36.2%; n = 46), while half of International shed co‐ordinators rated theirs as highly effective (50.0%; n = 7). The findings from this paper support the notion that a large number of Men's Sheds offer formal mentoring programmes targeting a range of disadvantaged sub‐populations, thus supporting social inclusion. Inter‐generational mentoring is the most frequently occurring type of mentoring programme. While training mentors occurs at some sheds, the efficacy of this training and programme outcomes are unknown. A typology of shed types appears to be emerging based on a divergence of sheds with a more utilitarian focus and sheds that appear to embrace a health and well‐being focus.     

Male reproductive organs are at risk from environmental hazards

Male reproductive disorders that are of interest from an environmental point of view include sexual dysfunction,infertility,cryptorchidism,hypospadias and testicular cancer. Several reports suggest declining sperm counts and increase of these reproductive disorders in some areas during some time periods past 50 years. Except for testicular cancer this evidence is circumstantial and needs cautious interpretation. However,the male germ line is one of the most sensitive tissues to the damaging effects of ionizing radiation,radiant heat and a number of known toxicants. So far occupational hazards are the best documented risk factors for impaired male reproductive function and include physical exposures （radiant heat,ionizing radiation,high frequency electromagnetic radiation）,chemical exposures （some solvents as carbon disulfide and ethylene glycol ethers,some pesticides as dibromochloropropane,ethylendibromide and DDT/DDE,some heavy metals as inorganic lead and mercury） and work processes such as metal welding. Improved working conditions in affluent countries have dramatically decreased known hazardous workplace exposures,but millions of workers in less affluent countries are at risk from reproductive toxicants.New data show that environmental low-level exposure to biopersistent pollutants in the diet may pose a risk to people in all parts of the world. For other toxicants the evidence is only suggestive and further evaluation is needed before conclusions can be drawn. Whether compounds as phthalates,bisphenol A and boron that are present in a large number of industrial and consumer products entails a risk remains to be established. The same applies to psychosocial stressors and use of mobile phones. Finally,there are data indicating a particular vulnerability of the fetal testis to toxicants-for instance maternal tobacco smoking. Time has come where male reproductive toxicity should be addressed form entirely new angles including exposures very early in life.     

Cancer in veterinarians

OBJECTIVES—Veterinarians come into contact with several potentially carcinogenic exposures in the course of their occupation. These exposures include radiation, anaesthetic gases, pesticides (particularly insecticides), and zoonotic organisms. This review aims to summarise what is known about the carcinogenic risks in this profession.
METHODS—The levels of exposure to potential carcinogens in the veterinary profession are examined and evidence is reviewed for carcinogenesis of these substances in humans at doses similar to those experienced by veterinarians. The few published studies of cancer in veterinarians are also summarised.
RESULTS—Veterinarians have considerable potential for exposure to several known and potential carcinogens. Risks may be posed by work in clinics with poorly maintained x ray equipment, by use of insecticides, and from contact with carcinogenic zoonotic organisms. The few studies available suggest that veterinarians have increased mortality from lymphohaematopoietic cancers, melanoma, and possibly colon cancer.
CONCLUSIONS—The exposures examined in this review are not unique to the veterinary profession, and, as a consequence, information gathered on the carcinogenic risks of these exposures has implications for many other occupations such as veterinary nurses, animal handlers, and some farmers, as well as dentists, radiographers, and anaesthetists.


Keywords: cancer; veterinarians; occupation     

A case-control study of lung cancer in Casablanca,Morocco

Objective: To evaluate etiologic risk factors for lung cancer in Casablanca, Morocco. Methods: We conducted a hospital-based case–control study that included 118 incident lung cancer cases and 235 age-, sex- and residence-matched controls. We analyzed the data using matched univariate and matched and unmatched multivariate logistic regression analyses. Results: Active tobacco smoking and history of chronic bronchitis were the strongest risk factors for lung cancer in the matched logistic regression model. Multivariate odds ratio (OR) and 95% confidence intervals varied from 1.79 (0.47–6.79) for former light smokers to 26.07 (6.58–103.27) for current heavy tobacco smokers at the time of disease occurrence. Combined use of hashish/kiff and snuff had an OR of 6.67 (1.65–26.90), whereas the OR for hashish/kiff (without snuff) was 1.93 (0.57–6.58). History of chronic bronchitis had an OR of 4.16 (1.76–9.85). Other slightly increased risks of lung cancer were found for exposure to passive smoking (1.36; 0.71–2.62), occupational exposures (1.75; 0.84–3.63), use of candles for lighting (1.44; 0.42–5.01), and poor ventilation of the kitchen (1.22; 0.57–2.58). Conclusions: This study confirms known risk factors for lung cancer and uncovers potential new etiologic ones such as the role of hashish/kiff.     

Demographic, family, and occupational characteristics associated with major depression: the Harvard study of moods and cycles

OBJECTIVE: This study assesses the extent to which women with and without major depression differ by demographic, familial, and occupational characteristics. METHOD: From a community-based sample, the authors identified 332 women with and 644 women without current or past major depression based on Structured Clinical Interviews for DSM-IV. Demographic and background interviews were conducted in-person. RESULTS: Depressed women were more likely to have gained >or =35 lbs between age 18 and study enrollment (OR=1.6, 95% CI 1.1-2.5), experienced divorce (OR=2.0, 95% CI 1.4-2.8), or changed occupations (OR=1.5, 95% CI 1.1-2.1) compared with non-depressed women. Compared with women with no brothers, those with > or =1 brothers were less likely to have a history of depression (OR=0.8, 95% CI 0.6-1.1), whereas compared with women with no sisters, those with > or =1 sisters were more likely to have current or past depression (OR=1.4, 95% CI 1.0-1.9). These findings were not influenced by family sibship size. CONCLUSION: These results illustrate demographic differences between women with and without major depression and that sibship gender rather than size may also influence risk.