Is occupational exposure to solvents associated with an increased risk for developing systemic scleroderma?

BACKGROUND: Our study was aimed to investigate in a German collective if there are any hints for an increased occupational or environmental risk to develop systemic sclerosis, especially, focussing on work-related exposure to solvents. Moreover, we tried to evaluate the feasibility of a sampling method addressing support groups. METHODS: A standardised questionnaire was published in two journals subscribed by members of two different support groups and all members were asked to complete the questionnaire and to return it anonymously. The subjects were not informed on the scientific hypotheses, nor did they know who of them belonged to the case group (scleroderma) or to the control group (multiple sclerosis). RESULTS: 175 questionnaires could be included in the statistical analysis. As expected, a female predominance was in our collective. In the male subpopulation, the occupational exposure to solvents was higher in the case group than in the control-group (70% versus 45.8%). Based only on the male subgroup, a tendency for an association between occupational exposure to solvents and the risk to develop systemic sclerosis was found. CONCLUSION: According to our experience in this case-control-study exposure misclassification, qualitative or quantitative, was an eminent problem. Within such a setting, it is generally very difficult to establish an exact dose-response relationship due to incomplete, imprecise or missing data concerning duration of exposure, frequency of use and kind of solvent. Additionally, a well-known problem in studies based on self-reported questionnaires is the so-called volunteer bias. Unfortunately, but similar to other studies assessing epidemiologic factors in such a rare disease, our study was of limited power, especially in the subgroups defined by gender

Mobile Air Quality Studies (MAQS) - an international project

Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"- exposure in relation to non-"traffic zone"-exposure. Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including including NO2, SO2, nanoparticles, and ozone

Evaluation of a Dipstick Test (Allergodip ® -Latex) for in vitro Diagnosis of Natural Rubber Latex Allergy

Abstract Background: IgE-mediated hypersensitivity to latex has been recognized as an increasing health problem with far-reaching consequences for patients, regarding both their occupational situation and safety in medical care. Therefore, a correct diagnosis of natural rubber latex (NRL) allergy is essential. The purpose of the study was to evaluate sensitivity and specificity of several established diagnostic methods for NRL allergy (in vitro assays and skin prick test) in relation to a new semiquantitative dipstick test (Allergodip ® -Latex, Allergopharma) as a screening test for NRL allergy. Methods: Data obtained with quantitative assays including Pharmacia CAP System ® (FEIA), DPC-AlaSTAT ® and Magic Lite ® were compared with the dipstick test results in latex-sensitized (n = 151) and nonsensitized persons (n = 232). In addition these in vitro findings were related to clinical symptoms after exposure to latex and skin prick test results with a panel of different latex allergen extracts. Results: When comparing sensitivity and specificity of all in vitro assays relative to skin prick test results the Pharmacia CAP System ® (FEIA) had the highest sensitivity in the range of 90%. Sensitivity of the other in vitro assays was in the range of 73.7-74.9%, specificity varied from 85.3 to 89.8%. A diagnostic standard was defined in terms of at least three corresponding test results out of all diagnostic methods (in vitro assays and skin prick test). The sensitivity and specificity of each diagnostic test were determined relative to this diagnostic standard. Hereby the Allergodip test results showed a sensitivity of 91% and a specificity of 93%

Does Smoking Have a Significant Impact on Early Irritant Hand Dermatitis in Metal Workers?

Background: Although they know the long-term complications of smoking, many smokers require additional motivation for entering a smoking cessation programme. At the same time, smoking is considered a possible promoting factor for various skin diseases. Objective: The present study assesses the impact of smoking on occupational hand dermatitis in a high-risk population. Material and Methods: 1,355 metal workers, 97.3% of them shift workers, took part in a standardized interview and a dermatological examination of their hands. A subgroup of 1,020 males was willing to be followed-up for 1 year. Of those, 78.3% could be included in the final assessment. Results: Compared to the general German adult population the percentage of smokers was increased (41.7% at baseline). Probably due to self-selection bias and to a higher drop-out rate, the proportion of smokers was significantly lower at follow-up. Compared to nonsmokers, smokers had significantly higher score values for both erythematous lesions and vesicles. Conclusion: The present data might give additional support for occupational physicians or dermatologists to convince workers to quit smoking

Influence of Diet on Exposure to Acrylamide – Reflections on the Validity of a Questionnaire

Aim: This pilot study attempts to assess how far the standardized questionnaires are a valid tool to detect the food-related burden of acrylamide. Acrylamide is a toxic substance classifi ed by the International Agency of Research on Cancer, as well as the Deutsche Forschungsgemeinschaft, as a probable human carcinogen. Methods: A venous blood sample was taken in order to determine the smoking-specifi c acrylnitrile adduct N-cyanoethylvaline and the acrylamide adduct N-2-carbamoylethylvaline in a female study population expecting delivery soon. A standardized questionnaire was used to determine the consumption of acrylamide-contaminated food. The results of our questionnaire were transferred to a linear evaluation system. Finally, anamnestic data of the questionnaire were correlated to objective parameters such as blood levels of hemoglobin adducts of acrylamide and acrylonitrile. Results: A positive correlation between the acrylamide intake and the levels of hemoglobin adducts in our study population was not proven. Conclusions: Evaluation of food-related exposure to acrylamide is diffi cult due to several reasons. Firstly, the validity of anamnestic data strongly depends on the patient’s ability to remember precisely all consumed food (quality as well as quantity) over a 3-month period. In addition, the contamination of acrylamide in food varies from one product to another; even the contamination of the same product is variable. Therefore, the missing correlation between the questionnaire and hemoglobin adduct rates is rather due to restricted validity of anamnestic data