Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana

Objectives

The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals.

Methods

Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires.

Results

There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4–133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7–30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7–12.3).

Conclusions

The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations.     

An experiment to develop conversion factors to standardise measurements of airborne asbestos

Various researchers and agencies recommend different conversion factors for different asbestos exposures. The aim of this study was to develop conversion factors from particles per cm3 (p cm(-3)) to fibres per cm3 (f cm(-3)) and from mg m(-3) to f cm(-3). More than 1000 exposure measurements were available in the Slovenian asbestos-cement factory Salonit Anhovo. Three types of measurement of asbestos concentrations in the air were used: a konimeter measuring p cm-3, a gravimetric method measuring mg m-3 and a membrane filter method measuring f cm-3. Operation-specific conversion factors among these methods were developed. One conversion factor was obtained for asbestos-pipe-dry jobs (4.7) and one for asbestos-sheet-dry jobs (1.6). Only one conversion factor (0.8) was used for asbestos-cement-pipe-wet and asbestos-cement-pipe-dry jobs. For asbestos cement sheets, two conversion factors were obtained (0.3 and 1.2). The development of five different conversion factors made it possible to calculate cumulative exposure to asbestos from historical data and to decrease exposure misclassification.     

The influence of genetic polymorphisms of GSTP1 on the development of asbestosis

OBJECTIVE: Genetic factors play an important role in the development of asbestosis. The aim of this study was to investigate whether genetic polymorphisms of glutathione S-transferase (GST) P1 represent a risk factor for this disease. METHODS: The study population included 262 workers with asbestosis and 265 matched controls. Information on cumulative asbestos exposure was available. A real-time PCR based on the 5' nuclease assay was designed for the analysis of GSTP1 Ile105Val and Ala114Val polymorphisms. RESULTS: Asbestosis was associated with GSTP1 genotype coding for an enzyme with high conjugation capacity versus genotypes resulting in intermediate and low enzyme activity (odds ratio = 1.49, confidence interval = 1.06-2.10). CONCLUSIONS: The key finding of the study was that GSTP1 genotype coding for an enzyme with high conjugation capacity significantly increases the risk of developing asbestosis.     

The Influence of Workers’ Health Status on Employers’ Decision-Making During Personnel Restructuring in a Typical Public Limited Enterprise in Slovenia

Objectives

Alongside individual indicators of job performance, even workers’ health status could be a criterion for selection. The mechanisms for health selection are a reduction of productivity in relation to illness or certain health behaviour. The aim of the study was to establish how indicators of workers’ health status, which are accessible to the employer, influence the employer’s decision-making on which workers to retain and which to dismiss during personnel restructuring in the enterprise.

Methods

Due to a planned closure of a plant, the observed company began personnel restructuring which included a strategic decrease in the number of employees and the relocation of workers within the company. Two nested case control studies were conducted. The cases were divided into two groups and defined as follows: employees who were relocated and employees whose employment contract was terminated.

Results

The results show that the disability category and long-time sick leave exert the greatest influence on the employer’s decision on the selection of workers. Workers with work-related disability have lower odds to be relocated to a new workplace (OR=0.5; 95% CI 0.2 to 1.1) and higher odds to be dismissed (OR=6.51; 95% CI 3.33 to 12.72). The workers with a history of a long-time sick leave also have lower odds to be relocated (OR=0.31; 95% CI 0.11 to 0.88) and higher odds to be dismissed (OR=4.32; 95% CI 2.08 to 8.96).

Conclusions

Indicators of health which were accessible to the employer actually exerted influence on the employer’s decision-making, which could show a direct form of health selection.     

Soluble mesothelin-related peptides levels in patients with malignant mesothelioma

Soluble mesothelin-related peptides (SMRP) are a potential tumor marker for malignant mesothelioma. The aim of this study was to determine the differences in SMRP levels in patients with malignant mesothelioma before treatment and in various responses to treatment and to investigate whether SMRP level could be useful in evaluating tumor response to treatment. The study included patients with malignant mesothelioma treated at the Institute of Oncology Ljubljana between March 2007 and December 2009. Blood samples were collected before treatment and/or in various responses to treatment. SMRP levels were determined using ELISA assay based upon a combination of two monoclonal antibodies. Mann-Whitney test was used to determine the differences in SMRP levels in various responses to treatment. Median SMRP was 2.80 nmol/L (range 0.00-34.80) before treatment, 0.00 nmol/L (range 0.00-0.00) in complete response, 0.48 nmol/L (range 0.00-4.40) in partial response, 1.65 nmol/L (range 0.00-20.71) in stable disease and 7.15 nmol/L (range 0.44-31.56) in progressive disease. Pre-treatment SMRP levels were significantly higher than in stable disease, partial response and complete response (p=0.006), as were SMRP levels in progressive disease compared to stable disease, partial response and complete response (p< 0.001). Our findings suggest that SMRP may be a useful tumor marker for detecting the progression of malignant mesothelioma and evaluating tumor response to treatment.     

Fibulin-3 as a biomarker of response to treatment in malignant mesothelioma

Background

Fibulin-3 is a new potential biomarker for malignant mesothelioma (MM). This study evaluated the potential applicability of fibulin-3 plasma levels as a biomarker of response to treatment and its prognostic value for progressive disease within 18 months. The potential applicability of fibulin-3 in comparison with or in addition to soluble mesothelin-related peptides (SMRP) was also assessed.

Patients and methods.

The study included 78 MM patients treated at the Institute of Oncology Ljubljana between 2007 and 2011. Fibulin-3 levels in plasma samples obtained before treatment and in various responses to treatment were measured with the enzyme-linked immunosorbent assay.

Results

In patients evaluated before the treatment, fibulin-3 levels were not influenced by histopathological sub-types, tumour stages or the presence of metastatic disease. Significantly higher fibulin-3 levels were found in progressive disease as compared to the levels before treatment (Mann-Whitney [U] test = 472.50, p = 0.003), in complete response to treatment (U = 42.00, p = 0.010), and in stable disease (U = 542.00, p = 0.001). Patients with fibulin-3 levels exceeding 34.25 ng/ml before treatment had more than four times higher probability for developing progressive disease within 18 months (odds ratio [OR] = 4.35, 95% confidence interval [CI] 1.56–12.13). Additionally, patients with fibulin-3 levels above 34.25 ng/ml after treatment with complete response or stable disease had increased odds for progressive disease within 18 months (OR = 6.94, 95% CI 0.99–48.55 and OR = 4.39, 95% CI 1.63–11.81, respectively).

Conclusions

Our findings suggest that in addition to SMRP fibulin-3 could also be helpful in detecting the progression of MM.     

The Role of Polymorphisms in Glutathione-related Genes in Asbestos-related Diseases

BackgroundThe study investigated the influence of GCLC, GCLM, GSTM1, GSTT1 and GSTP1 polymorphisms, as well as the influence of interactions between polymorphism and interactions between polymorphisms and asbestos exposure, on the risk of developing pleural plaques, asbestosis and malignant mesothelioma (MM).Subjects and methodsThe cross sectional study included 940 asbestos-exposed subjects, among them 390 subjects with pleural plaques, 147 subjects with asbestosis, 225 subjects with MM and 178 subjects with no asbestos-related disease. GCLC rs17883901, GCLM rs41303970, GSTM1 null, GSTT1 null, GSTP1 rs1695 and GSTP1 rs1138272 genotypes were determined using PCR based methods. In statistical analysis, logistic regression was used.ResultsGSTT1 null genotype was associated with the decreased risk for pleural plaques (OR = 0.63; 95% CI = 0.40–0.98; p = 0.026) and asbestosis (OR = 0.51; 95% CI = 0.28–0.93; p = 0.028), but not for MM. A positive association was found between GSTP1 rs1695 AG + GG vs. AA genotypes for MM when compared to pleural plaques (OR = 1.39; 95% CI = 1.00–1.94; p = 0.049). The interactions between different polymorphisms showed no significant influence on the risk of investigated asbestos-related diseases. The interaction between GSTT1 null polymorphism and asbestos exposure decreased the MM risk (OR = 0.17; 95% CI = 0.03–0.85; p = 0.031).ConclusionsOur findings suggest that GSTT1 null genotype may be associated with a decreased risk for pleural plaques and asbestosis, may modify the association between asbestos exposure and MM and may consequently act protectively on MM risk. This study also revealed a protective effect of the interaction between GSTP1 rs1695 polymorphism and asbestos exposure on MM risk.Key words: polymorphisms, glutathione-related genes, asbestos, asbestosis, pleural plaques, malignant mesothelioma     

Staurosporine induces apoptosis and necroptosis in cultured rat astrocytes

Apoptosis and necroptosis are highly regulated, interconnected forms of a cell death. The distinction between them is critical, because necroptosis may cause significant cell loss and local inflammation, whereas apoptosis is essential for tissue homeostasis. The same stimulus can induce both apoptosis and necroptosis. Both forms of a cell death were detected in various pathologies, including pathologies in the central nervous system. Astrocytes are a large, heterogeneous cell population in the central nervous system, with many supportive, developmental functions. Although their demise may seriously impair normal functions of the central nervous system, it is still poorly understood. In this study, apoptosis and necroptosis were induced in cultured rat astrocytes by staurosporine. When a low concentration (10(-7) M) of staurosporine was applied, a significantly increased proportion of early apoptotic cells was detected after regeneration in a staurosporine free medium. The proportion of necroptotic cells was already increased without regeneration after 3 hours of exposure to staurosporine. When a higher (10(-6) M) concentration of staurosporine was applied, further significantly increased necroptosis was detected after regeneration in a staurosporine free medium. Necroptosis was significantly reduced when RIP1 kinase was inhibited by necrostatin-1, whereas inhibition of caspases with z-vad-fmk, an irreversible pan-caspase inhibitor, did not prevent necroptosis. This report of necroptosis induced by staurosporine represents a simple approach for the in vitro induction and detection of apoptosis and necroptosis.     

Multiple role of histamine H1-receptor-PKC-MAPK signalling pathway in histamine-stimulated nerve growth factor synthesis and secretion

Histamine is a potent stimulator of nerve growth factor (NGF) production in the central nerve system and in the periphery as well. In this review, the biochemical mechanisms of histamine-stimulated NGF synthesis and secretion, and interactions between histamine, interleukin-1beta, and interleukin-6 are discussed. The main signalling pathway, involved in the stimulation of NGF production by histamine, includes activation of histamine H(1)-receptor, stimulation of Ca(2+)-dependent protein kinase C and mitogen-activated protein kinase. The same signalling pathway is involved in the interactions between histamine, interleukin-1beta, and interleukin-6, where NGF secretion is amplified. Whereas histamine and interleukin-1beta cause additive stimulatory effect on NGF secretion, interaction between histamine and interleukin-6 causes a long-term synergism. Thus, activation of histamine H(1)-receptor-protein kinase C-mitogen-activated protein kinase signalling pathway plays a crucial role not only in the direct stimulation of NGF secretion by histamine, but also in the indirect stimulation via different types of interactions between histamine, interleukin-1beta, and interleukin-6, which may have important therapeutic implications in modulation of NGF production.