Auditory and Respiratory Health Disorders Among Workers in an Iron and Steel Factory

Background: Iron is the world's most commonly used metal and can usually be found with other elements in the form of steel. The frequently recorded health disorders between iron and steel industry workers includes: respiratory and skin problems as well as noise-related hearing impairment. Objectives: Study auditory and respiratory health disorders among exposed workers in an iron and steel factory in Sadat city, Menoufiya governorate and assess workplace environment in the same factory. Participants and Methods: One hundred and six occupationally exposed male workers in an iron and steel factory was chosen and matched for age, sex, residence, education, income and smoking habit with a control (non exposed) group. A predesigned questionnaire including personal and occupational data and some respiratory and auditory manifestations was filled. All participants were subjected to spirometric measurements and audiometry. Environmental study for noise, dust and fumes measurements was also done. Results: Environmental study revealed higher mean value of noise and lower mean values of dust and fumes than the standard levels. Exposed workers showed significant higher prevalence of respiratory and auditory manifestations, spirometric and auditory findings than controls. With increasing years of employment, deterioration of spirometric measurements and audiometric changes increase. Conclusion: From environmental measures, although dust and fume levels were lower than the PEL; there were early changes in the spirometric measurements in exposed workers. Working in iron and steel industry may be associated with higher prevalence of chest manifestations, hearing impairment, changes in the mean values of different spirometric measurements and noise induced hearing loss. Recommendations: Exclusion of individuals having any respiratory or auditory manifestations during pre-employment medical examination. For early detection of respiratory and auditory disorders, spirometry and audiometry should be included in the periodic medical examination. Accurate health records of workers, so, those at risk can be monitored, and/or pre-placed. Using personal protective equipments especially masks and ear muffles as well as prohibit smoking in the workplace. Keywords: iron and steel Workers, hearing loss, respiratory disorder

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease