Розвиток поглядів про взаємозв'язок війни і миру, про «право народів» у елліністично-римській соціально-філософській думці

Античные мыслители лишь затронули вопрос об общем и вечном мире (в форме мечты, философского идеала идеального и гармонического государства), не находя способов примирения противоборствующих сторон, средств решения внутренних и внешних конфликтов.Античні мислителі лише порушили питання про загальний і вічний мир (у формі мрії, філософського ідеалу ідеальної і гармонічної держави), не знаходячи способів примирення протиборчих сторін, засобів вирішення внутрішніх і зовнішніх конфліктів

'Relieved working' study: systematic development and design of an intervention to decrease occupational quartz exposure at construction worksites

Occupational quartz exposure continues to be a serious hazard in the construction industry. Until now, evidence-based interventions aimed at reducing quartz exposure are scarce. The aim of this study was to systematically develop an intervention and to describe the study to evaluate its effectiveness. Methods/Design. The intervention was developed according to the principles of the Intervention Mapping protocol, meaning that evidence from the literature was combined with information collected from stakeholders (e.g., construction workers, managers and researchers). The intervention aimed to integrate technical, behavioural and organizational factors. The intervention consists of two plenary meetings for all employers within the company, and individual visits at construction worksites, including specific intervention materials. Additionally, a demonstration session regarding control measures was organized for all managers. The effectiveness of the intervention will be evaluated in a cluster randomized controlled trial among eight construction companies, with measurements at baseline and follow-up. Outcome measures are personal respirable dust and quartz exposure by means of exposure assessment, and behavioural and organizational determinants which will be assessed by means of questionnaires. Additionally, a process evaluation will shed light on whether the intervention (does not) works, and, if so, the reasons for this. Discussion. Applying Intervention Mapping in the development of an intervention to reduce occupational quartz exposure was useful, as different stakeholders provided input for the intervention as well as the implementation strategy. Therefore, the feasibility of the intervention has been enhanced, as it appeals to construction workers and managers and will not unduly interfere with the ongoing construction work. Trial registration number. NTR4586 (May 7th 2014)

Leukemia from dermal exposure to cyclophosphamide among nurses in the Netherlands : Quantitative assessment of the risk

Several studies showed that oncology nurses are exposed to antineoplastic drugs via the skin during daily activities. Several antineoplastic drugs (including cyclophosphamide) have been classified as carcinogenic to humans. This study aims to assess the leukemia risk of occupational exposure to cyclophosphamide. Average task frequencies from the population of oncology nurses in the Netherlands and task-based dermal exposure intensities were used to calculate oncology nurses' dermal exposure levels. A dermal absorption model in combination with a physiologically based pharmacokinetic model was used to assess the delivered dose of cyclophosphamide and its active metabolites in the bone marrow. This delivered dose was subsequently related to pharmacodynamic and epidemiological information from a longitudinal study with cyclophosphamide- treated patients to estimate the excess lifetime leukemia risk at age 80 for Dutch oncology nurses after 40 years of exposure to cyclophosphamide. The excess lifetime leukemia risk at age 80 of an exposed oncology nurse after 40 years of dermal exposure to cyclophosphamide was estimated to be 1.04 per million oncology nurses. This risk could potentially increase to a maximum of 154 per million if a nurse performs all cyclophosphamide-related tasks with the maximum frequency (as observed in this population) and is exposed to maximum exposure intensities for each task without using protective gloves for 40 years. This study indicates that the risk of an oncology nurse in a Dutch hospital with an average dermal exposure to cyclophosphamide is well below the maximum tolerable risk of one extra death from cancer per 250 deaths after 40 years of occupational exposure, and that this level is not exceeded in a worst-case scenario

Quartz and respirable dust in the Dutch construction industry : A baseline exposure assessment as part of a multidimensional intervention approach

Quartz exposure can cause several respiratory health effects. Although quartz exposure has been described in several observational workplace studies, well-designed intervention studies that investigate the effect of control strategies are lacking. Tis article describes a baseline exposure study that is part of a multidimensional intervention program aiming to reduce quartz exposure among construction workers. In this study, personal respirable dust and quartz exposure was assessed among 116 construction workers (bricklayers, carpenters, concrete drillers, demolishers, and tuck pointers). Possible determinants of exposure, like job, tasks, and work practices, use of control measures, and organizational and psychosocial factors, were explored using exposure models for respirable dust and quartz separately. Stratified analyses by job title were performed to evaluate the effect of control measures on exposure and to explore the association between control measures and psychosocial factors. Overall, 62% of all measurements exceeded the Dutch occupational exposure limit for quartz and 11% for respirable dust. Concrete drillers and tuck pointers had the highest exposures for quartz and respirable dust (0.20 and 3.43 mg m-3, respectively). Significant predictors of elevated quartz exposure were abrasive tasks and type of material worked on. Surprisingly, in a univariate model, an increased knowledge level was associated with an increase in exposure. Although control measures were used infrequently, if used they resulted in approximately 40% reduction in quartz exposure among concrete drillers and tuck pointers. Only among concrete drillers, the use of control measures was associated with a higher score for social influence (factor 1.6); knowledge showed an inverse association with use of control measures for concrete drillers, demolishers, and tuck pointers. In conclusion, the detailed information on determinants of exposure, use of control measures, and constraints to use these control measures can be used for the determination and systematic prioritization of intervention measures used to design and implement our intervention strategy. Tis study underlines the need for multidisciplinary workplace exposure control strategies although larger study populations are necessary to determine a possible causal association between organizational and psychosocial factors and psychosocial factors and control measures

Solvent transfer - efficiency of risk management measures

A series of laboratory simulations were conducted in order to determine the airborne protection that might be afforded by different combinations of workplace exposure controls typically encountered when handling volatile solvents (e.g. solvent transfer). These conditions, referred to as risk management measures (RMMs) under the Registration, Evaluation and Authorisation of Chemicals Regulation (REACH), are typically described using standard phrases in safety data sheets [and specifically those of the European Phrase Catalogue (EUPhraC)]. Ethanol was used as a model compound and its emissions were monitored continuously with a portable IR spectrometer at 3000 cm−1. Theaverage emission reduction performance of the investigated RMMs (e.g. containment, extract ventilation, drum pump) exceeded 90%. They present suitable ways to reduce airborne solvent exposure in a workplace and confirmed the initial expectations derived at by the European Solvents Industry Group (ESIG) and the European Centre For Ecotoxicology and toxicology of Chemicals (ECETOC) Targeted Risk Assessment (TRA) model

Process evaluation of an intervention program to reduce occupational quartz exposure among Dutch construction workers

OBJECTIVES: Evaluate the process of an intervention in the construction industry to reduce quartz exposure. METHODS: In a cluster randomized controlled trial, data on seven process aspects (ie, recruitment, reach, dose delivered, dose received, fidelity, satisfaction, and context) were quantitatively collected on manager and worker levels. RESULTS: Dose delivered was 95% for the plenary sessions and 20% for the worksite visit. Although the protocol was mostly implemented as intended, dose received was lower than expected. Both managers and workers appreciated the intervention and recommended the intervention for future implementation. Workers attending all intervention sessions were most satisfied about the intervention. CONCLUSIONS: High rates for dose delivered and fidelity for the plenary sessions and relatively high satisfaction rates were achieved. Furthermore, continuous monitoring of contextual factors beforehand and alongside the implementation of interventions is recommended

Effectiveness of a Multidimensional Randomized Control Intervention to Reduce Quartz Exposure Among Construction Workers

There is little evidence with respect to the effectiveness of intervention programs that focus on the reduction of occupational quartz exposure in the construction industry. This article evaluates the effectiveness of a multidimensional intervention which was aimed at reducing occupational quartz exposure among construction workers by increasing the use of technical control measures. Eight companies participating in the cluster randomized controlled trial were randomly allocated to the intervention (four companies) or control condition (four companies). The multidimensional intervention included engineering, organizational, and behavioural elements at both organizational and individual level. Full-shift personal quartz exposure measurements and detailed observations were conducted before and after the intervention among bricklayers, carpenters, concrete drillers, demolishers, and tuck pointers (n = 282). About 59% of these workers measured at baseline were reassessed during follow-up. Bayesian hierarchical models were used to evaluate the intervention effect on exposure levels. Concrete drillers in the intervention group used technical control measures, particularly water suppression, for a significantly greater proportion of the time spent on abrasive tasks during follow-up compared to baseline (93 versus 62%; P < 0.05). A similar effect, although not statistically significant, was observed among demolishers. A substantial overall reduction in quartz exposure (73 versus 40% in the intervention and control group respectively; P < 0.001) was observed for concrete drillers, demolishers, and tuck pointers. The decrease in exposure in the intervention group compared to controls was significantly larger for demolishers and tuck pointers, but not for concrete drillers. The observed effect could at least partly be explained by the introduced interventions; the statistically significant increased use of control measures among concrete drillers explains the observed effect to some extent in this job category only. Sensitivity analyses indicated that the observed decrease in exposure may also partly be attributable to changes in work location and abrasiveness of the tasks performed. Despite the difficulties in assessing the exact magnitude of the intervention, this study showed that the structured intervention approach at least partly contributed to a substantial reduction in quartz exposure among high exposed construction workers

Application of a dynamic population-based model to assess the effect of silica exposure interventions on COPD in Dutch construction workers : results from the 'Relieved Working Study'

OBJECTIVES: A multidimensional intervention aimed at reducing silica exposure in the Dutch construction industry was performed. The objective of this study was to assess the effect of the achieved reduction in exposure on the burden of chronic obstructive pulmonary disease (COPD) in construction workers. METHOD: The intervention aimed at technical, organisational and psycho-social factors and was performed in four construction companies. Pre and post intervention respirable quartz exposure measurements were taken in these and four additional control companies. A mathematical simulation model was used to generate COPD prevalences (GOLD stage ≥1) in response to silica exposure, population characteristics and Dutch trends in smoking behaviour for a population of 20-65 year old construction workers with lifetime silica exposure. RESULTS: Pre-intervention exposure assessment demonstrated highest respirable quartz levels (mg/m(3)) for concrete drillers (GM: 0.20, GSD: 2.75), tuck pointers (GM: 0.18, GSD (2.18) and demolishers (GM: 0.12, GSD: 2.86), exceeding the Dutch occupational exposure limit (OEL) in 71, 92 and 97% of cases, respectively. Preliminary simulations estimated COPD prevalence at 21, 20 and 17% for these groups respectively, as compared to 14% when quartz exposure is reduced to the Dutch OEL and 8% with no exposure. CONCLUSIONS: For several job categories high exposure levels exceeding the Dutch OEL were observed. Reducing these levels to below the OEL would lead to a substantial reduction in the burden of disease. The post intervention exposure levels will become available early 2014. The effect on the burden of disease and economic impact will be assessed with an refined model incorporating population dynamics