Immune cell counts and risks of respiratory infections among infants exposed pre- and postnatally to organochlorine compounds: a prospective study

<p>Abstract</p> <p>Background</p> <p>Early-life chemical exposure may influence immune system development, subsequently affecting child health. We investigated immunomodulatory potentials of polychlorinated biphenyls (PCBs) and <it>p,p'</it>-DDE in infants.</p> <p>Methods</p> <p>Prenatal exposure to PCBs and <it>p,p'</it>-DDE was estimated from maternal serum concentrations during pregnancy. Postnatal exposure was calculated from concentrations of the compounds in mother's milk, total number of nursing days, and percentage of full nursing each week during the 3 month nursing period. Number and types of infections among infants were registered by the mothers (N = 190). White blood cell counts (N = 86) and lymphocyte subsets (N = 52) were analyzed in a subgroup of infants at 3 months of age.</p> <p>Results</p> <p>Infants with the highest prenatal exposure to PCB congeners CB-28, CB-52 and CB-101 had an increased risk of respiratory infection during the study period. In contrast, the infection odds ratios (ORs) were highest among infants with the lowest prenatal mono-<it>ortho </it>PCB (CB-105, CB-118, CB-156, CB-167) and di-<it>ortho </it>PCB (CB-138, CB-153, CB-180) exposure, and postnatal mono- and di-<it>ortho </it>PCB, and <it>p,p'</it>-DDE exposure. Similar results were found for pre- and postnatal CB-153 exposure, a good marker for total PCB exposure. Altogether, a negative relationship was indicated between infections and total organochlorine compound exposure during the whole pre- and postnatal period. Prenatal exposure to CB-28, CB-52 and CB-101 was positively associated with numbers of lymphocytes and monocytes in infants 3 months after delivery. Prenatal exposure to <it>p,p'</it>-DDE was negatively associated with the percentage of eosinophils. No significant associations were found between PCB and <it>p,p'</it>-DDE exposure and numbers/percentages of lymphocyte subsets, after adjustment for potential confounders.</p> <p>Conclusion</p> <p>This hypothesis generating study suggests that background exposure to PCBs and <it>p,p'</it>-DDE early in life modulate immune system development. Strong correlations between mono- and di-<it>ortho </it>PCBs, and <it>p,p'</it>-DDE exposures make it difficult to identify the most important contributor to the suggested immunomodulation, and to separate effects due to pre- and postnatal exposure. The suggested PCB and <it>p,p'</it>-DDE modulation of infection risks may have consequences for the health development during childhood, since respiratory infections early in life may be risk factors for asthma and middle ear infections.</p

Occurrence and impact of back pain on the quality of life of healthcare workers

Introduction and Objective. Back pain affects specific occupational groups, among which healthcare workers are the most predisposed. Therefore, the aim of this study was to determine the interdependences between subjective disability and their correlation with pain intensity and quality of life assessment among professionally active medical workers, taking into account working, socio-demographic and health conditions. Materials and Method. The cross-sectional study enrolled 110 professionally active medical workers (nurses, midwives, paramedics and physiotherapists). The study was conducted by a diagnostic survey method using 4 questionnaires: Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), World Health Organization Quality of Life BREF (WHOQoL-BREF), and the authors’ questionnaire. Results. Back pain was reported by 103 respondents (94%) with the lumbar area indicated the most frequently (72.81%). Severe pain every day was reported by 49.51% of respondents and was associated with longer working time. ODI questionnaire confirmed III and IV degrees of disability in paramedics and nurses, who additionally obtained the lowest results in the quality of life assessment. Correlations between age and VAS were demonstrated (p=0.002), and between VAS and ODI pain (p<0.0001) and ODI disability (p<0.0001). Conclusions. Back pain associated with professional activities is the consequence of overload. Health care workers should be included in a preventive programme and attend systematic ergonomics courses. Health care facilities should be retrofitted with equipment enabling work in accordance with the principles of ergonomics. The ODI questionnaire, together with the VAS method and scales for testing the quality of life, are useful tools in the clinical assessment of individuals with back pain