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Refractive Surgery for High Bilateral Myopia in Children with Neurobehavioral Disorders: 2. Laser-Assisted Subepithelial Keratectomy (LASEK).

J AAPOS. 2006 Aug;10(4):364-370

Authors: Tychsen L, Hoekel J

Introduction: A subpopulation of children with high myopia and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated bilaterally using excimer laser technology. Methods: Clinical course and outcome data were collated prospectively in a group of 9 children (mean age, 10.2 years; range, 3-16 years) with neurobehavioral disorders exacerbated by chronic noncompliance with spectacle wear, causing profoundly low functional vision. Myopia in the 18 eyes ranged from -3.75 to -11.5 D (mean -16.6 D) and the desired refraction was approximately +1D. Correction was achieved by bilateral laser-assisted subepithelial keratectomy (ie, LASEK) performed under brief general anesthesia. Mean follow-up was 17 months (range, 6-36 months). Results: Myopia correction averaged 7.9 D. Eighty-nine percent (16/18 eyes) were corrected to within +/-1 D of goal refraction. Uncorrected acuity improved postoperatively in all 18 eyes, with commensurate gains in behavior and environmental visual interaction in 88% (15/17 children). Myopic regression averaged approximately 0.8 D/year. The only complication encountered was mild (1+) corneal haze in 35% of treated eyes. Discussion/Conclusions: Bilateral excimer laser surgery is effective for improving functional vision substantially in highly myopic, neurobehaviorally impaired children who have difficulties wearing glasses. Myopic regression is common. Further study is indicated to determine the long-term safety of these and alternative refractive procedures in similar pediatric populations.

PMID: 16935239 [PubMed - as supplied by publisher]

Posted by blogposter at 10:55 AM | Permalink

Assessment of nutritional status of children under five years of age, pregnant women, and lactating women living in relief camps after the tsunami in Sri Lanka.

Food Nutr Bull. 2006 Jun;27(2):144-52

Authors: Jayatissa R, Bekele A, Piyasena CL, Mahamithawa S

BACKGROUND: A strong earthquake that hit Aceh on December 26, 2004, triggered a powerful tsunami, resulting in an unprecedented catastrophe in Sri Lanka. The initial phase of the disaster was marked by limited access to food coupled with an inadequate supply of safe water and poor environmental hygiene and sanitation, all of which placed children at increased risk for undernutrition. OBJECTIVE: To assess the nutritional status of children under five years of age, pregnant women, and lactating women residing in 40 relief camps after the tsunami. METHODS: A cross-sectional, 30-cluster study was performed. Thirty children under five from each cluster (camp) and all pregnant and lactating women in selected camps were studied. Data were collected by interviews with the primary caregivers of the children, interviews with key informants in the camps, direct observation, and focus group discussions with mothers. Weight, height, or length was measured on children and pregnant women. Mid-upper-arm circumference of lactating women was measured. RESULTS: A total of 878 children were assessed, of whom 16.1%, 20.2%, and 34.7% were wasted, stunted, and underweight, respectively. The prevalence of each indicator was higher in boys than in girls. During the 2 weeks before the survey, 69.5% of the children had acute respiratory tract infections and 17.9% had diarrhea. Although the general food distribution was well in place, the food supply lacked diversity, and 70.9% of the children did not get appropriate supplementary food. The prevalence of undernutrition among pregnant women (n = 168) was 37%. Thirty-one percent of lactating women (n = 97) were underweight, and 20% were overweight. CONCLUSIONS: The prevalence of both acute and chronic undernutrition among children in the camps is significantly higher than the national Sri Lankan average. There is a need to establish nutritional surveillance systems to monitor the nutritional status of displaced and nondisplaced children and mothers.

PMID: 16786980 [PubMed - indexed for MEDLINE]

Posted by blogposter at 02:59 PM | Permalink

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Prioritizing Safe Patient Handling: The American Nurses Association's Handle With Care Campaign.

J Nurs Adm. 2006 July/August;36(78):363-369

Authors: de Castro AB, Hagan P, Nelson A

Nurses continue to suffer debilitating injuries secondary to manual patient handling. Patient care ergonomics has emerged to redesign patient care with reduced exposure to physical hazards. Safe patient handling programs are being increasingly accepted by healthcare organizations to prevent occupational injury and to enhance patient safety. The authors discuss national-level efforts to promote patient care ergonomics principles and safe patient handling programs and their impact on nursing shortages and quality patient care.

PMID: 16902360 [PubMed - as supplied by publisher]

Posted by blogposter at 02:09 PM | Permalink

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Environmental Safety

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PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 12:13 PM | Permalink

Use of Copper Cast Alloys To Control Escherichia coli O157 Cross-Contamination during Food Processing.

Appl Environ Microbiol. 2006 Jun;72(6):4239-44

Authors: Noyce JO, Michels H, Keevil CW

The most notable method of infection from Escherichia coli O157 (E. coli O157) is through contaminated food products, usually ground beef. The objective of this study was to evaluate seven cast copper alloys (61 to 95% Cu) for their ability to reduce the viability of E. coli O157, mixed with or without ground beef juice, and to compare these results to those for stainless steel. E. coli O157 (NCTC 12900) (2 x 10(7) CFU) mixed with extracted beef juice (25%) was inoculated onto coupons of each copper cast alloy or stainless steel and incubated at either 22 degrees C or 4 degrees C for up to 6 h. E. coli O157 viability was determined by plate counts in addition to staining in situ with the respiratory indicator fluorochrome 5-cyano-2,3-ditolyl tetrazolium. Without beef extract, three alloys completely killed the inoculum during the 6-h exposure at 22 degrees C. At 4 degrees C, only the high-copper alloys (>85%) significantly reduced the numbers of O157. With beef juice, only one alloy (95% Cu) completely killed the inoculum at 22 degrees C. For stainless steel, no significant reduction in cell numbers occurred. At 4 degrees C, only alloys C83300 (93% Cu) and C87300 (95% Cu) significantly reduced the numbers of E. coli O157, with 1.5- and 5-log kills, respectively. Reducing the inoculum to 10(3) CFU resulted in a complete kill for all seven cast copper alloys in 20 min or less at 22 degrees C. These results clearly demonstrate the antimicrobial properties of cast copper alloys with regard to E. coli O157, and consequently these alloys have the potential to aid in food safety.

PMID: 16751537 [PubMed - in process]

Posted by blogposter at 02:29 PM | Permalink

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Keeping yourself safe: ask the right questions--right from the start.

Am J Nurs. 2006 May;106(5):88

Authors: Condon M, Hughes N

PMID: 16639264 [PubMed - indexed for MEDLINE]

Posted by blogposter at 03:07 PM | Permalink

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Persistence of caliciviruses on environmental surfaces and their transfer to food.

Int J Food Microbiol. 2006 Apr 15;108(1):84-91

Authors: D'Souza DH, Sair A, Williams K, Papafragkou E, Jean J, Moore C, Jaykus L

The noroviruses (NoV) are a common cause of human gastroenteritis whose transmission by foodborne routes is well documented. Fecally contaminated surfaces are likely to contribute to this foodborne transmission and to the propagation of viral disease outbreaks. The purpose of this study was to (i) investigate the stability of NoV on various food preparation surfaces; and (ii) evaluate the degree of virus transfer from these surfaces to a model-ready-to-eat (RTE) food. For the virus persistence experiments, stainless steel, formica and ceramic coupons were artificially contaminated with Norwalk virus (NV), the prototype genogroup I NoV; NV RNA; or feline calicivirus (FCV) F9 (a NoV surrogate), stored at ambient temperature for up to 7 d, and periodically assayed for detection. In the transfer experiments, stainless steel coupons were inoculated with NV or FCV F9 and allowed to dry for 10, 30 and 60 min, after which lettuce leaves were exposed to the surface of the coupons at various contact pressures (10, 100, and 1000 g/9 cm2). Virus recovery was evaluated by RT-PCR (for NV and NV RNA) or by plaque assay (for FCV F9) using Crandell Reese Feline Kidney (CRFK) cells. NV and FCV were detected on all three surfaces for up to 7 d post-inoculation; for FCV, there was an approximate 6 to 7-log10 drop in virus titer over the 7 d evaluation period. By contrast, when stainless steel was inoculated with purified NV RNA, RT-PCR detection was not possible beyond 24 h. Transfer of both NV and FCV from stainless steel surfaces to lettuce occurred with relative ease. This study confirms lengthy NoV persistence on common food preparation surfaces and their ease of transfer, confirming a potential role for environmental contamination in the propagation of viral gastroenteritis.

PMID: 16473426 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:12 AM | Permalink

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Ergonomic design interventions--a case study involving portable ladders.

Ergonomics. 2006 Feb 22;49(3):221-34

Authors: Shepherd GW, Kahler RJ, Cross J

Portable ladders are one of the most ancient tools conceived by man. They remain ubiquitous and indispensable even today. It is interesting to note that there is little difference between the makeshift portable ladders used throughout history and some still used today. The design of portable ladders seems to have simply evolved, rather than been subject to formal design process, including ergonomic criteria. An analysis of 277 fatalities associated with ladders was conducted to describe the pattern of ladder fatalities and identify and assess ergonomic design controls. All ladder fatalities analysed were found to contain multiple human, equipment (ladder) and environmental causative factors. It is hypothesized that significant gains with regard to reducing future fatalities can be achieved by applying ergonomic design principles to ladders to accommodate predictable and undesirable human behaviour. Without effective future change, the only prediction that can be made is that the pattern of ladder fatalities will simply continue.

PMID: 16540436 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:38 AM | Permalink

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Development of a statewide hospital plan for radiologic emergencies.

Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):16-24

Authors: Dainiak N, Delli Carpini D, Bohan M, Werdmann M, Wilds E, Barlow A, Beck C, Cheng D, Daly N, Glazer P, Mas P, Nath R, Piontek G, Price K, Albanese J, Roberts K, Salner AL, Rockwell S

Although general guidelines have been developed for triage of victims in the field and for hospitals to plan for a radiologic event, specific information for clinicians and administrators is not available for guidance in efficient management of radiation victims during their early encounter in the hospital. A consensus document was developed by staff members of four Connecticut hospitals, two institutions of higher learning, and the State of Connecticut Department of Environmental Protection and Office of Emergency Preparedness, with assistance of the American Society for Therapeutic Radiology and Oncology. The objective was to write a practical manual for clinicians (including radiation oncologists, emergency room physicians, and nursing staff), hospital administrators, radiation safety officers, and other individuals knowledgeable in radiation monitoring that would be useful for evaluation and management of radiation injury. The rationale for and process by which the radiation response plan was developed and implemented in the State of Connecticut are reviewed. Hospital admission pathways are described, based on classification of victims as exposed, contaminated, and/or physically injured. This manual will be of value to those involved in planning the health care response to a radiologic event.

PMID: 16618574 [PubMed - in process]

Posted by blogposter at 11:47 AM | Permalink

Too much of a good thing? Update on fish consumption and mercury exposure.

Nutr Rev. 2006 Mar;64(3):139-45

Authors: Levenson CW, Axelrad DM

While there is a significant amount of data showing health benefits of increased fish consumption, there are conflicting reports about the cardiovascular risks of mercury in seafood. A recent long-term study attempted to resolve this controversy, providing an opportunity to balance recommendations from the US Environmental Protection Agency for mercury with those from the American Heart Association for fish consumption.

PMID: 16572601 [PubMed - indexed for MEDLINE]

Posted by blogposter at 11:28 AM | Permalink

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Possible impact of phthalates on infant reproductive health.

Int J Androl. 2006 Feb;29(1):172-80; discussion 181-5

Authors: Lottrup G, Andersson AM, Leffers H, Mortensen GK, Toppari J, Skakkebaek NE, Main KM

Phthalates adversely affect the male reproductive system in animals, inducing hypospadias, cryptorchidism, reduced testosterone production and decreased sperm counts. Phthalate effects are much more severe after in utero than adult exposure. Little is known about human health effects. This study discusses two recent studies on perinatal phthalate exposure, which indicated that human testicular development might be susceptible to phthalates. One study analysed phthalate monoesters in breast milk and reproductive hormone levels in infants. Five of six phthalates [monoethyl-(MEP), monobutyl- (MBP), monomethyl- (MMP), mono-2-ethylhexyl- (MEHP) and mono-isononyl phthalate (MiNP)] showed correlation with hormone levels in healthy boys, which were indicative of lower androgen activity and reduced Leydig cell function. MEP and MBP were positively correlated with serum sex hormone-binding globulin (SHBG) levels. MMP, MEP, MBP, MEHP and MiNP were positively correlated with the LH/testosterone ratio. Another study found a reduction of the anogenital index (AGI) in infant boys with increasing levels of MBP, MEP, monobenzyl- and mono-isobutyl phthalate in maternal urine samples during late-pregnancy. Boys with small AGI showed a high prevalence of cryptorchidism and small genital size. Taken together these studies suggest an antivirilizing effect of phthalates in infants. Most of these findings are in line with animal observations. However, the possible effects of MEP appear to be limited to humans. This may be due to differences in exposure routes (inhalation and dermal absorption which circumvents liver detoxification in addition to oral) and metabolism, or this association could be spurious. As phthalates are produced as bulk chemicals worldwide, these new findings raise concern about the safety of phthalate exposure for pregnant women and infants.

PMID: 16466537 [PubMed - indexed for MEDLINE]

Posted by blogposter at 06:24 PM | Permalink

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Hypersensitivity pneumonitis due to metal working fluids: Sporadic or under reported?

Am J Ind Med. 2006 Apr 3;

Authors: Gupta A, Rosenman KD

BACKGROUND: Occupational exposure to metal working fluids (MWF) is common with over 1.2 million workers in the United States involved in machine finishing, machine tooling, and other metalworking operations. MWF is a known cause of hypersensitivity pneumonitis (HP). Recent reports of outbreaks of hypersensitivity HP secondary to exposure to MWF are reported. DESIGN: Cases were identified through the Occupational Disease surveillance system in the State of Michigan and from referrals for evaluation to the Division of Occupational and Environmental Medicine at Michigan State University (MSU). Each patient underwent a clinical examination including an occupational history, lung function studies, radiographic imaging, and in some cases lung biopsies. Following the diagnosis of definite HP, an industrial hygiene investigation was carried out, which included a plant walk-through, and review of the "Injury and Illness" log. Air monitoring and microbial sampling results were reviewed. RESULTS: As part of Michigan's mandatory surveillance system for occupational illnesses, seven cases of suspected HP were identified in 2003-2004 from three facilities manufacturing automobile parts in Michigan. Each plant used semi-synthetic MWFs, and conducted a MWF management program including biocide additions. Two facilities had recently changed the MWF before the cases arose. Growth of mycobacteria was found in these two MWFs. Breathing zone samples for particulates of two employees in plant A (two cases) ranged from 0.48 to 0.56 mg/m(3). In plant B (four cases), two employees' sampling results ranged from 0.10 to 0.14 mg/m(3). No air sampling data were available from plant C. CONCLUSION: Hypersensitivity pneumonitis due to exposure to MWFs is under-recognized by health care providers, and current surveillance systems are inadequate to provide a true estimate of its occurrence. HP arose from environments with exposures well below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for MWF, and in one case from exposures well below the National Institute of Occupational Safety and Health (NIOSH) recommended exposure limit (REL). The sporadic nature of reports of HP in relationship to MWF probably represents a combination of workplace changes that cause the disease and inadequate recognition and reporting of the disease when it does occur. Physician awareness of HP secondary to MWF and an effective medical surveillance program are necessary to better understanding the epidemiology and prevention of this disease. Am. J. Ind. Med. 2006. (c) 2006 Wiley-Liss, Inc.

PMID: 16586404 [PubMed - as supplied by publisher]

Posted by blogposter at 06:09 PM | Permalink

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Printed circuit board industry.

Int J Hyg Environ Health. 2006 Mar 30;

Authors: Ladou J

The printed circuit board is the platform upon which microelectronic components such as semiconductor chips and capacitors are mounted. It provides the electrical interconnections between components and is found in virtually all electronics products. Once considered low technology, the printed circuit board is evolving into a high-technology product. Printed circuit board manufacturing is highly complicated, requiring large equipment investments and over 50 process steps. Many of the high-speed, miniaturized printed circuit boards are now manufactured in cleanrooms with the same health and safety problems posed by other microelectronics manufacturing. Asia produces three-fourths of the world's printed circuit boards. In Asian countries, glycol ethers are the major solvents used in the printed circuit board industry. Large quantities of hazardous chemicals such as formaldehyde, dimethylformamide, and lead are used by the printed circuit board industry. For decades, chemically intensive and often sloppy manufacturing processes exposed tens of thousands of workers to a large number of chemicals that are now known to be reproductive toxicants and carcinogens. The printed circuit board industry has exposed workers to high doses of toxic metals, solvents, acids, and photolithographic chemicals. Only recently has there been any serious effort to diminish the quantity of lead distributed worldwide by the printed circuit board industry. Billions of electronics products have been discarded in every region of the world. This paper summarizes recent regulatory and enforcement efforts.

PMID: 16580876 [PubMed - as supplied by publisher]

Posted by blogposter at 03:35 PM | Permalink

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Mercury elimination update.

Am J Nurs. 2006 Mar;106(3):88

Authors: Condon M, Brannen L

PMID: 16534403 [PubMed - indexed for MEDLINE]

Posted by blogposter at 08:24 AM | Permalink

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Mercury elimination update.

Am J Nurs. 2006 Mar;106(3):88

Authors: Condon M, Brannen L

PMID: 16534403 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:41 PM | Permalink

Have you been sexually harassed in school? What female high school students regard as harassment.

Int J Adolesc Med Health. 2005 Oct-Dec;17(4):391-406

Authors: Witkowska E, Gillander G din K

The aim of the study was to explore what behaviors experienced from peers and school staff at school are acknowledged as sexual harassment, and perceived as problematic, by female high school students, and what other factors may be relevant. Analyses were performed of responses (to 540 questionnaires) in an anonymous self-report mail survey from a random sample of female Swedish high-school students (59% response rate). Exposure to relevant behaviors, of varying levels of severity, alone, does not explain the acknowledgment of harassment. Many students were subjected to many of the potentially offensive behaviors without labeling them as sexual harassment, despite the fact that they saw many of them as problematic. Further, viewing the relevant behaviors as problems in one's school did not necessarily lead to acknowledging that sexual harassment in general was a problem. However, the behaviors seen as problems were less likely to be dismissed as sexual harassment than personal experiences. This was especially true of the most common behaviors, namely verbal ones. The results demonstrate female students' reluctance to label incidents as sexual harassment, despite the fact that actual behaviors are perceived as environmental problems. Potentially offensive sex-related behaviors become normalized in the school environment and are difficult to address, when little support is provided by schools.

PMID: 16445077 [PubMed - indexed for MEDLINE]

Posted by blogposter at 05:04 PM | Permalink

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Selected science: an industry campaign to undermine an OSHA hexavalent chromium standard.

Environ Health. 2006;5:5

Authors: Michaels D, Monforton C, Lurie P

While exposure to hexavalent chromium (Cr(VI)) has been associated with increased lung cancer risk for more than 50 years, the chemical is not currently regulated by the U.S. Occupational Safety and Health Administration (OSHA) on the basis of its carcinogenicity. The agency was petitioned in 1993 and sued in 1997 and 2002 to lower the workplace Cr(VI) exposure limit, resulting in a court order to issue a final standard by February 2006. Faced with the threat of stronger regulation, the chromium industry initiated an effort to challenge the scientific evidence supporting a more protective standard. This effort included the use of "product defense" consultants to conduct post hoc analyses of a publicly-funded study to challenge results viewed unfavorably by the industry. The industry also commissioned a study of the mortality experience of workers at four low-exposure chromium plants, but did not make the results available to OSHA in a timely manner, despite multiple agency requests for precisely these sorts of data. The commissioned study found a statistically significant elevation in lung cancer risk among Cr(VI)-exposed workers at levels far below the current standard. This finding changed when the multi-plant cohort was divided into two statistically underpowered components and then published separately. The findings of the first paper published have been used by the chromium industry to attempt to slow OSHA's standard setting process. The second paper was withheld from OSHA until it was accepted for publication in a scientific journal, after the rulemaking record had closed. Studies funded by private sponsors that seek to influence public regulatory proceedings should be subject to the same access and reporting provisions as those applied to publicly funded science. Parties in regulatory proceedings should be required to disclose whether the studies were performed by researchers who had the right to present their findings without the sponsor's consent or influence, and to certify that all relevant data have been submitted to the public record, whether published or not.

PMID: 16504102 [PubMed - indexed for MEDLINE]

Posted by blogposter at 04:33 PM | Permalink

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Low-density Lipoprotein Apheresis Therapy With a Direct Hemoperfusion Column: A Japanese Multicenter Clinical Trial.

Ther Apher Dial. 2006 Feb;10(1):32-41

Authors: Tasaki H, Yamashita K, Saito Y, Bujo H, Daida H, Mabuchi H, Tominaga Y, Matsuzaki M, Fukunari K, Nakazawa R, Tsuji M, Kawade Y, Yamamoto S, Ueda Y, Takayama K

Low-density lipoprotein (LDL) apheresis has been applied to patients with familial hypercholesterolemia (FH) with coronary artery disease (CAD). To examine the efficacy and safety of a new type of LDL adsorption column (KLD01, Kaneka, Osaka, Japan), which deals with whole blood without separating plasma, the new system was evaluated in a multicenter trial. The present study included 33 FH patients with CAD (24 males, 9 females, 57 +/- 13 years) who were treated five times with a mean interval of 2.12 +/- 0.60 weeks between treatments. We studied the removal efficacies for serum LDL cholesterol, Lipoprotein(a) (Lp(a)) and triglyceride, the times for the preparation of the system and for treatment, symptoms, and the biochemical data. The scheduled treatments were completed by 31 patients. Serum levels of LDL cholesterol, Lp(a) and triglycerides were all significantly reduced with KLD01; 61.5 +/- 6.2%, 72.4 +/- 5.9% and 69.5 +/- 9.7%, respectively. The times for both setting up the column system (26 +/- 7 min) and treatment (138 +/- 20 min) were shorter with KLD01 than conventional methods. Adverse reactions occurred in eight cases (17 episodes), but the patients fully recovered immediately after each apheresis therapy session. We conclude that the new type of LDL adsorption column, one that deals with whole blood, is a promising apheresis therapy for FH patients in view of its efficacy, reduced time for treatment, and safety.

PMID: 16556134 [PubMed - in process]

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Evaluation for safety of antioxidant chemopreventive agents.

Antioxid Redox Signal. 2005 Nov-Dec;7(11-12):1728-39

Authors: Kawanishi S, Oikawa S, Murata M

Antioxidants are considered as the most promising chemopreventive agents against various human cancers. However, some antioxidants play paradoxical roles, acting as "double-edged sword." A primary property of effective and acceptable chemopreventive agents should be freedom from toxic effects in healthy population. Miscarriage of the intervention by beta-carotene made us realize the necessity for evaluation of safety before recommending use of antioxidant supplements for chemoprevention. We have evaluated the safety of antioxidants on the basis of reactivity with DNA. Our results revealed that phytic acid, luteolin, and retinoic acid did not cause DNA damage under the experimental condition. Furthermore, phytic acid inhibited the formation of 8-oxo-7,8-dihydro-2'-deoxyguanosine, an indicator of oxidative DNA damage, in cultured cells treated with a H(2)O(2)-generating system. Thus, it is expected that these chemopreventive agents can safely protect humans against cancer. On the other hand, some chemopreventive agents with prooxidant properties (alpha-tocopherol, quercetin, catechins, isothiocyanates, N-acetylcysteine) caused DNA damage via generation of reactive oxygen species in the presence of metal ions and endogenous reductants under some circumstances. Furthermore, other chemopreventive agents (beta-carotene, genistein, daidzein, propyl gallate, curcumin) exerted prooxidant properties after metabolic activation. Therefore, further studies on safety should be required when antioxidants are used for cancer prevention. Antioxid. Redox Signal. 7, 1728-1739.

PMID: 16356133 [PubMed - in process]

Posted by blogposter at 05:02 PM | Permalink

Evaluation for safety of antioxidant chemopreventive agents.

Antioxid Redox Signal. 2005 Nov-Dec;7(11-12):1728-39

Authors: Kawanishi S, Oikawa S, Murata M

Antioxidants are considered as the most promising chemopreventive agents against various human cancers. However, some antioxidants play paradoxical roles, acting as "double-edged sword." A primary property of effective and acceptable chemopreventive agents should be freedom from toxic effects in healthy population. Miscarriage of the intervention by beta-carotene made us realize the necessity for evaluation of safety before recommending use of antioxidant supplements for chemoprevention. We have evaluated the safety of antioxidants on the basis of reactivity with DNA. Our results revealed that phytic acid, luteolin, and retinoic acid did not cause DNA damage under the experimental condition. Furthermore, phytic acid inhibited the formation of 8-oxo-7,8-dihydro-2'-deoxyguanosine, an indicator of oxidative DNA damage, in cultured cells treated with a H(2)O(2)-generating system. Thus, it is expected that these chemopreventive agents can safely protect humans against cancer. On the other hand, some chemopreventive agents with prooxidant properties (alpha-tocopherol, quercetin, catechins, isothiocyanates, N-acetylcysteine) caused DNA damage via generation of reactive oxygen species in the presence of metal ions and endogenous reductants under some circumstances. Furthermore, other chemopreventive agents (beta-carotene, genistein, daidzein, propyl gallate, curcumin) exerted prooxidant properties after metabolic activation. Therefore, further studies on safety should be required when antioxidants are used for cancer prevention. Antioxid. Redox Signal. 7, 1728-1739.

PMID: 16356133 [PubMed - in process]

Posted by blogposter at 06:36 PM | Permalink

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A proposed methodology for setting occupational exposure limits for hydrocarbon solvents.

J Occup Environ Hyg. 2005 Oct;2(10):524-42

Authors: McKee RH, Medeiros AM, Daughtrey WC

Occupational exposure limit (OEL) development for hydrocarbon solvents is complicated because most of these solvents have complex compositions and only a few representative constituents have been studied in detail. A proposed solution to this problem is to group constituents with similar physical, chemical, and toxicological properties and to assign "guidance values" to each group. A unique OEL can then be calculated for each solvent, using a reciprocal calculation procedure (RCP) based on the liquid composition. This procedure follows the American Conference of Governmental Industrial Hygienists' (ACGIH) generic advice for complex mixtures and is recommended by the U.K. Health and Safety Executive for OEL calculations by hydrocarbon solvent manufacturers. The RCP is justified, as the toxicological properties of the constituents are additive and the differences between the vapor and liquid compositions do not substantially affect the calculated exposure limits. The guidance values are based principally on acute central nervous system depression and eye and respiratory tract irritation, effects that are the most sensitive indicators of hydrocarbon solvent exposure. One benefit of this procedure is that it is a relatively simple but practical procedure that requires limited compositional information. Further, it provides OEL recommendations that are consistent with occupational experience and current regulatory advice. Groupings and guidance values are proposed, and sample calculations are provided.

PMID: 16174635 [PubMed - indexed for MEDLINE]

Posted by blogposter at 01:00 PM | Permalink

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Evaluation of lead hazard control treatments in four Massachusetts communities through analysis of blood-lead surveillance data.

Environ Res. 2005 Oct;99(2):214-23

Authors: Strauss W, Pivetz T, Ashley P, Menkedick J, Slone E, Cameron S

This study utilized existing blood-lead surveillance data and records of housing properties treated for lead hazard control (LHC) in order to investigate the effectiveness of LHC treatments performed in four Massachusetts communities (Boston, Cambridge, Malden, and Springfield). This research is part of the US Department of Housing and Urban Development's (HUD) overall program evaluation strategy for assessing the effectiveness of their LHC Grant Program. Childhood blood-lead levels (BLLs) in housing units that were treated through HUD's LHC Grant Program were compared to BLLs in untreated matched control housing units. Data from multiple sources-local housing departments, local tax assessor departments, and the Massachusetts Department of Public Health-were linked to identify similar sets of treated and untreated dwellings. Geometric mean BLLs from before and after treatment were compared for the two sets of housing. Ten years of blood-lead surveillance data for children living in the selected dwellings were analyzed using log-linear mixed models and logistic regression models. Results indicate a 50% decline in BLLs in treated homes, a significantly larger decline than in untreated homes after adjusting for the general downward trend in BLLs observed in the general population for the last several years. Data show that homes that received HUD LHC treatments had children with blood-lead levels that declined twice as fast as in similar untreated homes. These findings show that LHC efforts are successful in reducing children's blood-lead levels.

PMID: 16194671 [PubMed - indexed for MEDLINE]

Posted by blogposter at 06:13 PM | Permalink

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Di(2-ethylhexyl)phthalate (DEHP) exposure of voluntary plasma and platelet donors.

Int J Hyg Environ Health. 2005 Nov 18;208(6):489-498

Authors: Koch HM, Angerer J, Drexler H, Eckstein R, Weisbach V

Each year thousands of healthy volunteers undergo apheresis procedures to donate blood components and safe lives. However, many disposables used in apheresis contain di(2-ethylhexyl)phthalate (DEHP). This way, donors are exposed to DEHP, which is a reproductive and developmental toxicant in animals and a suspected endocrine modulator in humans. We quantified the DEHP exposure of six plasma donors, six discontinuous-flow platelet donors and six continuous-flow platelet donors by determining three specific metabolites in urine (5OH-MEHP: mono(2-ethyl-5-hydroxyhexyl)phthalate; 5oxo-MEHP: mono(2-ethyl-5-oxo-hexyl)phthalate and MEHP: mono(2-ethylhexyl)phthalate). We found maximum concentrations in urine samples after the discontinuous-flow plateletpheresis procedure with 826mug/l for 5OH-MEHP, 774mug/l for 5oxo-MEHP and 266mug/l for MEHP (mean of the six volunteers). Metabolite excretions were found to be significantly (p<0.0001) higher for both plateletpheresis techniques compared to plasmapheresis and controls. Continuous-flow plateletpheresis led to significantly higher (p<0.0001) excretions than discontinuous-flow plateletpheresis. Mean absolute DEHP exposures were 1.2mg for discontinuous- and 2.1mg for continuous-flow plateletpheresis. Exposure for plasmapheresis (0.37mg) was in the range of the controls (0.41mg). Mean DEHP doses for both plateletpheresis techniques (18.1 and 32.3mug/kg/day) were close to or exceeded the reference dose (RfD) of the US EPA and tolerable daily intake (TDI) value of the EU on the day of the apheresis. Therefore, margins of safety might be insufficient to protect especially young men and women in their reproductive age from effects on reproductivity. At present, discontinuous-flow devices should be preferred to avert conceivable health risks from plateletpheresis donors. Strategies to avoid DEHP exposure of donors during apheresis need to be developed.

PMID: 16325559 [PubMed - as supplied by publisher]

Posted by blogposter at 04:53 PM | Permalink

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Understanding parental motivators and barriers to uptake of child poison safety strategies: a qualitative study.

Inj Prev. 2005 Dec;11(6):373-7

Authors: Gibbs L, Waters E, Sherrard J, Ozanne-Smith J, Robinson J, Young S, Hutchinson A

OBJECTIVES: To develop an understanding of factors acting as barriers and motivators to parental uptake of child poison safety strategies. DESIGN: A qualitative study involving semistructured interviews and focus groups. A grounded theory approach was used for the collection and analysis of data. PARTICIPANTS: Sixty five parents of children under 5 years of age, some of whom had experienced an unintentional child poisoning incident. RESULTS: A range of knowledge based, environmental, and behavioral barriers to comprehensive parental uptake of poison safety practices were identified. As a result there tended to be only partial implementation of safety initiatives in the home. Selection of safety practices was often guided by the interests and behaviors of the child. This made the child vulnerable to changes in the home environment, inadequate supervision, and/or shifts in their own behavior and developmental ability. Personal or vicarious exposure of a parent to a child poisoning incident was a significant motivator for parental review of safety practices. CONCLUSION: Environmental measures targeting child resistant containers, warning labels, and lockable poisons cupboards will support parents' efforts to maintain poison safety. Additional education campaigns using stories of actual poisoning incidents may help to increase awareness of risk and encourage increased uptake.

PMID: 16326774 [PubMed - in process]

Posted by blogposter at 11:56 AM | Permalink

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Enterococcal resistance - An overview.

Indian J Med Microbiol. 2005 Oct-Dec;23(4):214-9

Authors: Marothi YA, Agnihotri H, Dubey D

Nosocomial acquisition of microorganisms resistant to multiple antibiotics represents a threat to patient safety. Here, we review the antimicrobial resistance in Enterococcus, which makes it important nosocomial pathogen. The emergence of enterococci with acquired resistance to vancomycin has been particularly problematic as it often occurs in enterococci that are also highly resistant to ampicillin and aminoglycoside thereby associated with devastating therapeutic consequences. Multiple factors contribute to colonization and infection with vancomycin resistant enterococci ultimately leading to environmental contamination and cross infection. Decreasing the prevalence of these resistant strains by multiple control efforts therefore, is of paramount importance.

PMID: 16327115 [PubMed - in process]

Posted by blogposter at 09:20 PM | Permalink

Standing still: why North American workers are not insisting on seats despite known health benefits.

Int J Health Serv. 2005;35(4):745-63

Authors: Messing K, Fortin S, Rail G, Randoin M

Prolonged standing is associated with health problems. Despite regulations providing for access to seats, most Qu bec (Canada) workers usually stand. Only one in six can sit at will. Standing service workers such as cashiers and sales personnel are often confined to a small area where sitting is theoretically feasible. In many other countries, such workers have access to seats. This study asks why North American workers do not press for seats. In a qualitative, exploratory approach, 30 young workers who usually work standing were interviewed about their perceptions and experiences of prolonged standing at work. All but one experienced discomfort associated with this posture, and two-thirds reported that they had changed their lifestyle in some way as a result of their symptoms. However, their accounts of relationships with employers, health care personnel, and the health and safety system suggest that many environmental factors as well as attitudes toward work, employers, health, and the body contribute to maintaining the status quo. Workers describe problems with the image of a seated worker and thought that asking for a seat would threaten their relationship with the employer. Personal comfort was considered an insufficient reason to challenge worksite design, attitudes, and organization.

PMID: 16320901 [PubMed - in process]

Posted by blogposter at 10:16 AM | Permalink

Several-fold increase in risk of overanticoagulation by CYP2C9 mutations.

Clin Pharmacol Ther. 2005 Nov;78(5):540-50

Authors: Lindh JD, Lundgren S, Holm L, Alfredsson L, Rane A

OBJECTIVE: Our objective was to prospectively study the impact of CYP2C9 polymorphism (*2 and *3) on the risk of overanticoagulation during the induction phase of warfarin therapy. METHODS: Blood samples for genotyping were collected from 219 patients requiring warfarin therapy, and clinical data were prospectively collected during the first 3 weeks of medication. Patients were divided into 3 groups according to CYP2C9 genotype, as follows: *1 (homozygous), *2 (*1/*2 and *2/*2), and *3 (any genotype containing the *3 allele). RESULTS: During the first week of treatment, the relative risk of achieving at least 1 international normalized ratio (INR) value above the therapeutic interval (2-3) was 2.8 (95% confidence interval, 1.2-6.7) and 6.1 (2.7-13.6) in the *2 and *3 groups, respectively (with *1 used as control). During the second week, the corresponding values were 2.1 (1.2-3.7) and 3.5 (2.1-5.8), respectively. By the third week, the genetic impact was no longer evident, presumably as a result of successful dose individualization. Increased INR levels (compared with the *1 group) were already demonstrated in the *2 group on the fourth treatment day. CONCLUSIONS: The CYP2C9*2 and *3 single-nucleotide polymorphisms significantly increase the risk of overanticoagulation during the first 2 weeks of warfarin treatment, with increased INR levels evident after only 4 days' treatment in *2 carriers. Our prospective data are consistent with results from previous retrospective studies and indicate that CYP2C9 genotyping may be a means of improving safety during warfarin induction.

PMID: 16321620 [PubMed - in process]

Posted by blogposter at 09:34 PM | Permalink

Several-fold increase in risk of overanticoagulation by CYP2C9 mutations.

Clin Pharmacol Ther. 2005 Nov;78(5):540-50

Authors: Lindh JD, Lundgren S, Holm L, Alfredsson L, Rane A

OBJECTIVE: Our objective was to prospectively study the impact of CYP2C9 polymorphism (*2 and *3) on the risk of overanticoagulation during the induction phase of warfarin therapy. METHODS: Blood samples for genotyping were collected from 219 patients requiring warfarin therapy, and clinical data were prospectively collected during the first 3 weeks of medication. Patients were divided into 3 groups according to CYP2C9 genotype, as follows: *1 (homozygous), *2 (*1/*2 and *2/*2), and *3 (any genotype containing the *3 allele). RESULTS: During the first week of treatment, the relative risk of achieving at least 1 international normalized ratio (INR) value above the therapeutic interval (2-3) was 2.8 (95% confidence interval, 1.2-6.7) and 6.1 (2.7-13.6) in the *2 and *3 groups, respectively (with *1 used as control). During the second week, the corresponding values were 2.1 (1.2-3.7) and 3.5 (2.1-5.8), respectively. By the third week, the genetic impact was no longer evident, presumably as a result of successful dose individualization. Increased INR levels (compared with the *1 group) were already demonstrated in the *2 group on the fourth treatment day. CONCLUSIONS: The CYP2C9*2 and *3 single-nucleotide polymorphisms significantly increase the risk of overanticoagulation during the first 2 weeks of warfarin treatment, with increased INR levels evident after only 4 days' treatment in *2 carriers. Our prospective data are consistent with results from previous retrospective studies and indicate that CYP2C9 genotyping may be a means of improving safety during warfarin induction.

PMID: 16321620 [PubMed - in process]

Posted by blogposter at 06:37 PM | Permalink

Standing still: why North American workers are not insisting on seats despite known health benefits.

Int J Health Serv. 2005;35(4):745-63

Authors: Messing K, Fortin S, Rail G, Randoin M

Prolonged standing is associated with health problems. Despite regulations providing for access to seats, most Qu bec (Canada) workers usually stand. Only one in six can sit at will. Standing service workers such as cashiers and sales personnel are often confined to a small area where sitting is theoretically feasible. In many other countries, such workers have access to seats. This study asks why North American workers do not press for seats. In a qualitative, exploratory approach, 30 young workers who usually work standing were interviewed about their perceptions and experiences of prolonged standing at work. All but one experienced discomfort associated with this posture, and two-thirds reported that they had changed their lifestyle in some way as a result of their symptoms. However, their accounts of relationships with employers, health care personnel, and the health and safety system suggest that many environmental factors as well as attitudes toward work, employers, health, and the body contribute to maintaining the status quo. Workers describe problems with the image of a seated worker and thought that asking for a seat would threaten their relationship with the employer. Personal comfort was considered an insufficient reason to challenge worksite design, attitudes, and organization.

PMID: 16320901 [PubMed - in process]

Posted by blogposter at 02:07 PM | Permalink

Excess propagation and biological control of zooplanktonic Cyclops in drinking water sources.

Water Sci Technol. 2005;52(8):151-9

Authors: Cui FY, Lin T, Liu DM, Zhang LQ

Starting with the occurrence of Cyclops in drinking water sources and its danger to drinking water safety, we extensively investigated the nature of its excess propagation by analyzing the effect of living space and predator pressure in the food chain on its survival. Then we developed an ecological project using fish biomanipulation, different to the conventional fishery culture technique, to control excess propagation of Cyclops. The control effects on Cyclops of four species of fish were investigated experimentally at a stocking density of 30 g/m3 of water. Results showed that the food habit of the fish had a significant influence on the biological control of Cyclops. The propagation of Cyclops could be controlled effectively and also the water quality improved simultaneously by stocking filter-feeding fish, such as silver carp (Hypophthalmichthys molitrix) and bighead carp (Aristichthys nobilis). However, herbivorous Ctenopharyngodon idellus and omnivorous Cyprinus carpio had no obvious biological effects on controlling the growth of Cyclops and restoring water quality. The results further proved that under conditions of proper poly-culture densities of silver carp and bighead carp, the number of Cyclops might be controlled at very low levels and eutrophication might be abated by removing nutrients from the water body.

PMID: 16312962 [PubMed - in process]

Posted by blogposter at 08:01 PM | Permalink

In situ sample cleanup during immunoassay: a simple method for rapid detection of aflatoxin B, in food samples.

J Food Prot. 2005 Oct;68(10):2169-77

Authors: Pal A, Acharya D, Saha D, Roy D, Dhar TK

A strategy for rapid in situ elimination of interfering substances that are present in extracts of food samples during assay is described in this article. The novel feature of this method is that the sample purification is carried out as a part of the assay, and a separate sample cleanup step is not required. The assay procedure involves the sequential addition of standard or sample, cleaning solutions, and aflatoxin B1-horseradish peroxidase conjugate (AFB1-HRP) over antibody-spotted zones of a membrane, and 3,3'-diaminobenzidine was used as the substrate for visualization. We have determined that trifluoroacetic acid and propionic acids at concentrations of 100 mM are highly effective for cleaning groundnut, wheat, corn, and poultry feed samples and that NaHCO3 (100 mM) is successful in cleaning processed soybean. In all cases, subsequent washing was performed with phosphate-buffered saline solution to facilitate the removal of traces of adhering interfering substances. A batch of 12 samples can be analyzed within 8 min either by visual comparison of the color intensity (inversely related to the analyte concentration) of a sample spot with those of reference standards or, more precisely, by densitometry. The method was tested for the analysis of AFB1 in groundnut, wheat, corn, processed soybean, chili, and poultry feed. The detection limit obtained was 5 microg/kg, except for chili, where it was 10 microg/kg. The average recoveries from different noninfected food samples spiked with AFB1 at concentrations of 5 to 100 microg/kg were between 99 and 105%. The values obtained for infected corn and groundnut samples correlated well with the estimates obtained by high-pressure liquid chromatography. The absence of a sample extraction step reduces the cost and labor involved in the assay. The method may be potentially applicable to the assay of other mycotoxins and environmental pollutants.

PMID: 16245725 [PubMed - indexed for MEDLINE]

Posted by blogposter at 10:03 PM | Permalink

Multidrug-resistant Klebsiella pneumoniae isolated from farm environments and retail products in Oklahoma.

J Food Prot. 2005 Oct;68(10):2022-9

Authors: Kim SH, Wei CI, Tzou YM, An H

Multidrug-resistant enteric bacteria were isolated from turkey, cattle, and chicken farms and retail meat products in Oklahoma. Among the isolated species, multidrug-resistant Klebsiella pneumoniae was prevalently isolated from most of the collected samples. Therefore, a total of 132 isolates of K. pneumoniae were characterized to understand their potential roles in the dissemination of antibiotic-resistance genes in the food chains. Multidrug-resistant K. pneumoniae was most frequently recovered from a turkey farm and ground turkey products among the tested samples. All isolates were resistant to ampicillin, tetracycline, streptomycin, gentamycin, and kanamycin. Class 1 integrons located in plasmids were identified as a common carrier of the aadA1 gene, encoding resistance to streptomycin and spectinomycin. Production of beta-lactamase in the K. pneumoniae isolates played a major role in the resistance to beta-lactam agents. Most isolates (96%) possessed bla(SHV1). Five strains were able to express both SHV-11 (pI 6.2) and TEM-1 (pI 5.2) beta-lactamase. Transfer of these antibiotic-resistance genes to Escherichia coli was demonstrated by transconjugation. The bacterial genomic DNA restriction patterns by pulsed-field gel electrophoresis showed that the same clones of multidrug-resistant K. pneumoniae remained in feathers, feed, feces, and drinking water in turkey environments, indicating the possible dissemination of antibiotic-resistance genes in the ecosystem and cross-contamination of antibiotic-resistant bacteria during processing and distribution of products.

PMID: 16245702 [PubMed - indexed for MEDLINE]

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