Myocardial involvement in diphtheria patients (a review)

The authors analyze emotional features in workers with occupational exposure to hydrazines, hydrocarbons and nitroglycols. Chronic occupational poisoning with those chemicals induce numerous emotional symptoms that are specific and varying in severity. The materials presented by authors could be interesting for occupational therapist, internist and psychiatrist for early diagnosis of chronic occupational intoxications, treatment of emotional disorders in workers and better occupational safety.     

Clinical course and treatment of acute poisoning caused by some mushrooms

In a longitudinal study, we studied the variability in bronchial responsiveness (BR) to methacholine in aluminum potroom workers suffering from work-related asthma-like symptoms (WASTH) and in symptom-free workers. In the index group, 26 men suffering from WASTH were selected from a cross-sectional survey. The reference group comprised 45 symptom-free men recruited from the enrollment of new employees. Bronchial responsiveness was expressed as the dose-response slope (DRS) of the line through origin and the last data point. The standard deviation of the log-transformed DRS was positively associated with symptom score (P = .012) and the mean BR (P < .001). Our results indicate that the severity of respiratory symptoms in aluminum potroom workers with WASTH reflects the variability in BR.     

Natural history of median nerve sensory conduction in industry: relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years

We evaluated the natural history of median nerve sensory conduction, hand/wrist symptoms, and carpal tunnel syndrome (CTS) in an 11-year longitudinal study of 289 workers from four industries. Twenty hands which had carpal tunnel release surgery were excluded, leaving 558 hands for the primary study group. Overall, the trend was for mean sensory latencies and prevalence of slowing to increase, the prevalence of symptoms to decrease, and the prevalence of CTS to remain unchanged. Among individual hands, nerve conduction abnormalities tended to persist (82% 11-year persistence), while symptoms fluctuated widely (13% 11-year persistence). There was a strong, direct linear correlation between initial severity of slowing and subsequent development of CTS; however, most workers who developed de novo slowing did not develop symptoms or CTS. We conclude that changes in conduction status of the median nerve occur naturally with increasing age and do not necessarily lead to symptoms and CTS.     

Frequency of chronic bronchitis-results of epidemiologic research in the GDR (author's transl)

The frequency of chronic bronchitis among 33000 persons, selected by randomization, between 35 and 64 years of age, living in 4 large cities and 24 selected districts with different air pollution levels in GDR was investigated. A chronic bronchitis questionnaire and measurement of FVC, FEV1, PO2 were used to test each person, partially broncho-provocation-tests with histamin aerosols were performed. According to this investigation 6% of the men and 2.8% of the women suffered from CNSLD. In this group of diseased persons 50% showed obstructive disturbances of ventilation, 20% signs of decreased physical fitness due to respiratory disorders and 10% a manifested respiratory insufficiency.     

Trapezius muscle load as a risk indicator for occupational shoulder-neck complaints

Upper trapezius muscle activity was quantified by electromyographic (EMG) recordings using surface electrodes to study occupational muscle load as a risk indicator for the development of shoulder-neck complaints. Thirty-nine female production workers and thirty-two female office workers showed much larger interindividual differences than the mean difference in muscle activity between the two groups. By comparison with the production workers, the muscle activity patterns of the office workers were characterized by more short pauses and a lower static load. The median load level was similar for the two groups. For the office workers, but not for the production workers, weak correlations were found between symptoms of pain in the shoulder-neck region and some of the EMG parameters (static level and frequency of micropauses > 0.6 s. Current techniques for measuring shoulder muscle load by EMG recordings seem inadequate as screening methods to predict future risk of development of muscle pain symptoms.     

Community violence exposure, adverse childhood experiences, and posttraumatic distress among urban development workers.

The current study examines community violence exposure among 284 urban community development workers located in five U.S. cities. Adulthood exposure to community violence, history of adverse childhood experiences (ACEs), and current symptoms of posttraumatic distress (PTSD) were assessed to test the hypothesis that a personal history of ACEs moderates the relationship between community violence exposure and PTSD symptom severity. Seventy-five percent of urban development workers reported direct community violence victimization, 71% reported a history of at least one ACE, and 14% of the sample met probable diagnostic criteria for PTSD. A multiple regression analysis confirmed that ACEs and indirect adulthood community violence exposure were significantly positively related to the severity of PTSD symptoms. These variables accounted for a small amount of variance in PTSD. Direct exposure to community violence and the interaction between ACEs and community violence did not contribute significant variance to the model. The implications and limitations are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Lysozyme level in blood serum of white Leghorn hens from flocks of different size depending on the egg-laying cycle

The relationship between sickness absence caused by chest diseases, smoking habit, and symptoms of chronic bronchitis among the workers of a fertilizer factory in Karaków is examined. The analysis of absence was based on the spells and days of absence registered during a period of six years. The results show that the group of workers with symptoms of chronic bronchitis had many more spells and days of absence caused by chest diseases than persons free from these symptoms. The activity and chronicity of bronchitis symptoms strongly influenced the level of absence, but the role of smoking was not so evident. From the results obtained it appears that analysis of absence can be a valid screening test in the detection of chronic chest diseases, the frequency of which can easily be estimated from absence data.     

A cross-sectional study of prevalence and etiology of signs and symptoms of temporomandibular disorders in high school and university students

The aim of this study was to evaluate the prevalence and need for treatment of temporomandibular disorders (TMD) in students living in Bauru, Brazil. The role of occlusal and emotional factors was also addressed. The presence and severity of TMD was determined by using a self-reported anamnestic questionnaire composed of 10 questions regarding common TMD symptoms. The symptoms were transposed into a severity classification according to the number and frequency of positive responses. Occlusal evaluation included an analysis of retruded contact position, intercuspal position, anterolateral guidance, and nonworking side contacts during mandibular movements. Palpation of the muscles and temporomandibular joints were performed to detect clinical signs of TMD. A chi square test was used to compare clinical and occlusal data with the presence and severity of TMD. A total of 0.65% of the subjects had severe TMD symptoms, 5.81% had moderate symptoms, and 34.84% had mild symptoms. Those with severe and moderate symptom levels were interpreted to be in need of treatment. Symptoms were found significantly more frequently in females than in males (P < .01). Self-reported emotional tension and parafunctional habits demonstrated strong associations with TMD (P < .01). Occlusion did not seem to influence the presence or severity of TMD. Based on these results, the efficacy of some traditional TMD treatments should be reconsidered, and reversible and conservative procedures should be the first choice for managing TMD patients.     

Subserogrouping of 49 Legionella pneumophila serogroup 1 strains with monoclonal antibodies by slide latex agglutination method and its usefulness for epidemiologic study

Pulmonary lung-function testing plays an important role in surveillance programs for occupational respiratory disorders. Spirometry is usually utilized by applying preset cut-off values to discriminate between healthy and unhealthy subjects. This article demonstrates the usefulness of decision analysis techniques to arrive at an optimal diagnosis. The diagnostic performance of FEV1 and FEV1/FVC was evaluated by relative operating characteristics curves (ROCs) applied to data of a cohort gathered in 1965. Both parameters showed quite similar ROCs, with a maximal sensitivity of 40% at a specificity of 95% relative to the physician's diagnosis of respiratory disorder. The area under the curves was. 75 for both FEV1 and FEV1/FVC, illustrating that misclassification of 25% of the subjects is likely to occur. Regarding the consequences of a false-positive and a false-negative decision as of equal importance, the 5%-percentile (FEV1 residual less than -1.2 L) would be the optimal cut-off. An FEV1 residual below the lower 5%-percentile was six times more likely to appear in subjects with chronic nonspecific lung disease (CNSLD) than in subjects without. The post-test probability of CNSLD was three to four times the pre-test probability. In occupational or public health practice, however, false-positive results need to be avoided, even at the expense of a higher false-negative rate. In those situations, a more rigid cut-off between normal and abnormal values may be warranted.     

Observations on midodrine in a case of vasodepressor neurogenic syncope

A 43-year-old man presented with recurrent syncope and dizziness after he had a dual chamber pacemaker fitted for presumed sino-atrial disease. Head-up tilt produced vasodepressor neurocardiogenic syncope, despite appropriate heart rate support during pacing, and reproduced symptoms. Symptoms were not improved by disopyramide. A double-blind cross-over trial of midodrine, an alpha-receptor agonist, was effective in reducing symptoms: it abolished syncope and reduced frequency and severity of dizziness, coupled with improved haemodynamic responses to head-up tilt.     

Psychological distress in workers with traumatic upper or lower limb amputations following industrial injuries.

Objective: To determine whether individuals with traumatic upper limb amputations would report more symptoms of posttraumatic stress disorder (PTSD) and depression than individuals with traumatic lower limb amputations. Study Design: Retrospective file review. Setting: CARF-accredited outpatient rehabilitation center. Participants: Thirty workers with unilateral upper limb amputations and 25 workers with unilateral lower limb amputations. Main Outcome Measures: Presence or absence of depression, symptoms of PTSD, and pain. Results: The upper limb group had a higher frequency of depression and symptoms of PTSD than the lower limb group. The 2 groups did not differ with respect to pain complaints. Conclusion: More so than injuries to the lower limbs, upper limb injuries may render individuals vulnerable to PTSD and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Job Stress Survey: Assessing perceived severity and frequency of occurrence of generic sources of stress in the workplace.

In this article, the authors respond to comments in the October 1998 issue of the Journal of Occupational Health Psychology (Vol. 3, No. 4) in regard to measuring occupational stress with the Job Stress Survey (JSS). The authors are pleased that (a) the need to assess the perceived severity and frequency of occurrence of specific sources of occupational stress was acknowledged and (b) job pressure and lack of organizational support were recognized as key dimensions of stress in the workplace. In addressing concerns about the independence of JSS severity and frequency ratings and the utility of the JSS for assessing jobs with extensive person-machine interactions, the authors noted that correlations among JSS severity and frequency scores were relatively low, and that person-focused stressor items were relevant for employees with person-machine jobs because most workers are required to deal with supervisors and fellow employees. It was concluded that the JSS provides important information about sources of occupational stress that can adversely affect the health and productivity of men and women employed in a wide variety of work settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Respiratory findings in workers employed in the brick-manufacturing industry

We studied 233 male workers employed in two brick-manufacturing plants and 149 matched control workers. The mean age of the brick workers was 35 years, with a mean duration of employment in this industry of 16 years. The prevalence of chronic respiratory symptoms as well as acute symptoms during the work shift were recorded. Lung function was measured on Monday during the work shift by recording maximum expiratory flow-volume (MEFV) curves, from which the forced vital capacity (FVC), the one-second forced expiratory volume (FEV1) and flow rates at 50% and the last 75% of the FVC (FEF50, FEF75) were measured. The results of periodic chest roentgenograms were reviewed. There was a significantly higher prevalence of chronic cough (31.8%), chronic phlegm (26.2%), and chest tightness (24.0%) in exposed workers, compared with control workers (20.1%; 18.1%; 0%) (P < 0.05). This increased symptom frequency was also documented among nonsmokers studied by age and by length of employment, suggesting a work-related effect. Among work shift-related symptoms, high prevalences were noted for upper respiratory tract symptoms (e.g., dry throat, eye irritation, throat irritation). The measured FVC and FEV1 were significantly lower than predicted for brick workers and suggested a restrictive pattern. The mean FVC (as a percent of predicted) was 78.1% and FEV1 was 88.1%. The FEF50 and FEF25 were not significantly decreased. A multiple regression analysis with age, exposure, and smoking as predictors and lung function parameters as response variables showed a significant effect between exposure and FVC. Significant chest roentgenographic abnormalities were not documented. These findings of a restrictive lung function pattern in brick workers with normal chest roentgenograms may suggest early interstitial disease. Additionally, a bronchitic component, as suggested by the respiratory symptoms, may also be present.     

Homeless youth and their exposure to and involvement in violence while living on the streets

Sick building syndrome is the term given to a heterogeneous constellation of symptoms that affects workers in modern mechanically ventilated office buildings. Although the cause is unknown, there is evidence that the local environment of the work station is an important determinant of symptoms. In this study, investigators examined the effect of a new, individually controlled ventilation system on workers' symptoms. Investigators studied two groups of workers in one mechanically ventilated office building: (1) a control group at whose worksite no intervention was made and (2) an intervention group. The intervention consisted of installation of a device that allowed each worker control over the ventilation supplied to his or her worksite. Just before, and 4 and 16 mo after installation of this device, workers completed self-administered questionnaires regarding occurrence of symptoms. The new ventilation system resulted in higher air velocities, more variable temperatures, and higher concentrations of airborne dust and fungal spores. Four months after installation, workers with the new ventilation system reported fewer symptoms that were (a) work-related (p < .05) and that were work-related and frequent (p < .05); in addition, they reported fewer symptoms that reduced their capacity to work (p < .01). Sixteen months after installation, workers with the new device reported fewer symptoms than at baseline (although not as significantly), and they indicated that the indoor air quality improved their productivity by 11%, compared with a 4% reduction of productivity among the control group of workers (p < .001). Investigators concluded that the new ventilation system, which provided the workers with individual control over ventilation, was associated with important and sustained reduction in symptoms.     

Computer keyboard force and upper extremity symptoms

This case-control study assessed whether office workers who report more severe levels of musculoskeletal symptoms of the upper extremities demonstrate higher levels of keyforce in comparison to controls with less severe symptoms. Office workers reporting working on computer keyboards for four hours per day were classified as cases or controls based upon a median split on a Composite Symptom Severity score (cases = 23, controls = 25). Keyboard force and keying rate were measured during a 15-minute keyboarding task. Measures of task-related discomfort, muscular fatigue, pain, upper extremity symptoms, psychological distress and force were collected at baseline, post-keyboard task, and recovery. Ratings of perceived effort and task credibility were also obtained. Measures of work demands, perceived job stress, and upper extremity strength and flexibility were also collected. The results indicated group equivalence on reported work demands and upper extremity strength. Cases were more likely to receive a medical diagnosis of upper extremity cumulative trauma disorder, awaken from sleep due to symptoms, report higher levels of pain during work, experience greater impact of pain on function, and report higher workload pressure and lower support. Cases generated significantly higher keyboarding forces than controls, although both groups produced forces well above that required to operate the keyboard (4-5 times activation force). Cases reported higher levels of upper extremity symptoms and discomfort than controls, and these measures were highest after the keyboarding task for both groups. No significant correlation between keyforce and key rate was observed in either group. Results suggest that generation of excessive force while working on a computer keyboard may contribute to the severity of upper extremity symptoms. Clinically, the findings suggest that evaluating how an individual worker performs keyboarding tasks, or his or her workstyle, may be helpful in the management of these symptoms and disorders.     

A comparison between the effects of medial septal lesions and entorhinal cortex lesions on performance of nonspatial working memory tasks and reversal learning

Two studies explored the relationship between cognitions and long-term symptoms in adult child sexual abuse (CSA) survivors. In Study 1, an American sample of 43 survivors completed questionnaires assessing attributional style and dysfunctional beliefs in cognitive themes affected by victimization, as well as measures of posttraumatic symptoms. Survivors' attributions of negative events were more internal, stable, and global than those of 29 comparison subjects without a history of CSA. However, only the globality scale was significantly related with severity of long-term symptoms. High correlations between dysfunctional beliefs concerning safety, trust, esteem, or intimacy, and posttrauma symptoms were found. The latter finding was replicated in Study 2 with a German sample of 35 CSA survivors, even when controlling for frequency of abuse.     

Personal and environmental predictors of posttraumatic stress in emergency management professionals.

Among first responders and other emergency workers in the disaster ecology, an understudied group is that of emergency management professionals (EMP). These individuals share many of the same role conflicts and ambiguities as do health care workers and as a group have been part of national discussions about their role in post-Katrina recovery. Though they have frequent exposures to professional stressors, little is known about the personality traits, cultural issues, and role conflicts that might contribute to their ability to withstand posttraumatic stress symptoms or to grow from their work roles. This research explored 3 models that attempt to explain how previously identified personality traits and role issues such as trauma exposure, burnout, and compassion satisfaction among similar helpers and first responders might predict posttraumatic stress symptoms in EMPs. A sample of 197 participants was recruited using an online methodology, and data were analyzed using hierarchical regression. The results supported a model containing neuroticism and extraversion, trauma exposure frequency, burnout, and compassion satisfaction, accounting for the most variance in predicting PTSD symptoms. Neuroticism, burnout, and compassion satisfaction were found to be significant individual positive predictors, whereas ethnic identity did not significantly contribute to variance or serve as a moderator with trauma exposure. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Factors related to delayed treatment and posttreatment symptom severity in Taiwanese patients with benign prostatic hyperplasia

We evaluated the sociodemographic and clinical factors of delayed treatment and posttreatment symptom severity in outpatients with benign prostatic hyperplasia (BPH). The study included 146 BPH patients treated at the National Taiwan University Hospital in early 1997. All patients were treated with alpha-adrenergic antagonists or finasteride for at least 2 weeks. A questionnaire based on Andersen's Health Behavior Model was used to assess various sociodemographic features, while the pre- and posttreatment symptoms severity was rated according to the International Prostate Symptom Score (IPSS). Multiple logistic regression was used to assess the associations of these factors with delayed treatment and posttreatment symptom severity. Subjects who had recently quit smoking or were blue-collar workers tended to delay treatment, while those who chose a medical center as the care provider for chronic diseases tended to be less likely to delay treatment. However, none of these associations were statistically significant. No enabling factors (income, insurance) or need factors (symptom scores) evaluated were associated with delayed treatment. Predisposing factors associated with higher posttreatment symptom severity were delayed treatment (over 12 months) (adjusted odds ratio [OR]: 2.67, 95% confidence interval [CI]: 1.16-6.16), quitting smoking (adjusted OR: 4.47, 95% CI: 1.34-14.94), and having never smoked (adjusted OR: 3.73, 95% CI: 1.15-12.11). Subjects with severe pretreatment symptoms were far more likely than subjects with mild pretreatment symptoms to have severe symptoms after treatment (adjusted OR: 52.69, 95% CI: 54.46-621.90). Our findings, though based on a limited number of subjects, suggest sociodemographic factors rather than objective clinical attributes (prostate specific antigen level, prostate volume, and urodynamic results) are associated with delayed treatment in Taiwanese men with BPH. Both pretreatment symptom severity and sociodemographic factors are related to posttreatment symptom severity.     

Respiratory disease in workers exposed to colophony solder flux fumes: continuing health concerns

The objectives of this study were to establish the prevalence of respiratory, eye, nose and throat symptoms of likely work-relation in workers exposed to colophony solder flux fumes and to assess their lung function. A cross-sectional study was conducted in four medium-sized electronics firms in which control measures to capture solder flux fume were absent or visibly ineffective. All female solders and women working adjacent to soldering stations completed an administered questionnaire concerning symptoms, work history and current soldering frequency. Measurements were made of their forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) during the course of a working shift, using a Vitallograph-Compact portable spirometer. Using weekly hours of soldering as a crude index of current exposure, workers were classified into high (> or = 37 h/wk) and low (< or = 20 h/wk) exposure groups, and their health responses were compared in the analysis. Individuals with symptoms suggestive of work-related asthma were also asked to provide serial peak flow measurements over a further 2-week period, and adequate returns were charted and read by two physicians experienced in the diagnosis of occupational asthma. Data were collected on 152 female workers (overall participation rate = 97%). Symptoms of recurrent, persistent wheeze and/or chest tightness were reported by 75 (49%) of interviewees; 36 (24%) gave a history typical of occupational asthma and six more (4%) a history of pre-existing asthma worsened at work. Twenty-one (14%) of the workforce complained of recurrent breathlessness on moderate exertion; 41 workers (27%) had work-related symptoms of the nose or throat and 25 (16%) had work-related eye symptoms. The odds ratios for 'all wheeze', shortness of breath, and work-related eye, nose and chest symptoms were all significantly greater (raised about 4-5 fold) in women who soldered > or = 37 h/wk when compared with those soldering < or = 20 h/wk. After adjustment by logistic regression for atopy, age and smoking status even higher risk estimates were generally obtained. The odds ratios (OR) and 95% confidence intervals (CI) for high vs. low were: for 'all wheeze', OR = 7.2, CI = 2.5-20.7; for work-related eye symptoms, OR = 5.2, CI = 1.4-19.8; for work-related nasal symptoms, OR = 4.0, CI = 1.4-11.1 and for occupational asthma symptoms, OR = 5.2, CI = 1.4-14.2. Mean FEV1 and FVC percentage difference from expected were slightly lower in full-time solderers than in part-time solderers, but the differences were not significant. Thirty-seven of the 51 workers (73%) who were asked to carry out serial peak flow measurements completed an adequate return: 27 of these records confirmed the presence of asthma, and in all of the cases the history suggested onset post-dating employment in soldering. Eleven peak flow records were indicative of occupational asthma. The health problems associated with colophony solder flux were documented over 18 years ago, but are still clearly apparent in situations where adequate control has not been achieved.     

Psychiatric correlates of MR deep white matter lesions in probable Alzheimer's disease

The authors examined the relationship between psychiatric symptoms and the presence of of MR deep white matter lesions (DWMLs) in 28 probable Alzheimer's disease (AD) patients with mild to moderate dementia. The difference in frequency of psychiatric symptoms between patients with and without DWMLs was not statistically significant. However, MR global scores of severity correlated with the presence of ideational disturbances (such as low self-esteem and suicidal ideation). Analysis of specific cerebral regions indicated that the highest correlation occurred in the frontal white matter. Thus, DWMLs are correlated with specific symptoms of depression in AD. Whether DWMLs are etiologically related to these symptoms remains to be determined.