Endotoxin exposure and changes in short-term pulmonary function among sewage workers

Objectives: The inhaled endotoxin is considered as a causative factor in the process of acute bronchial obstruction, which can be measured by a decrease in forced expiratory volume in 1 s (FEV1). The aim of this study was to assess endotoxin exposure among sewage treatment plant workers (STPW) and its effect on across-shift changes in respiratory airflow. Material and Methods: A group of 78 STPW from a large sewage treatment plant was studied. Inhalable dust for endotoxin assessment was collected using personal aerosol samplers. Endotoxin was assayed with the kinetic, chromogenic Limulus amebocyte lysate test. Across-shift spirometric measurements were performed on Mondays, after 2-days absence from work, with the use of portable spirometer. The forced vital capacity (FVC), and FEV1 parameters were analyzed. Multifactor regression modeling was performed to determine parameters significantly associated with endotoxin exposure. Results: The concentration of inhalable dust and endotoxin ranged from 0.01–1.38 mg/m3 and 0.68–214 endotoxin units per cubic meter of air (EU/m3), respectively. Endotoxins were characterized with the skewed distribution (arithmetic mean (AM) = 38.8 EU/m3, geometric mean (GM) = 15.4 EU/m3, geometric standard deviation (GSD) = 4.21). Through the use of multifactor analysis, which excluded the main confounders (inhalable dust and smoking habit) it was found that, despite low levels of endotoxin, it had significant impact on the observed across-shift decline in FEV1 (p = 0.044). For this parameter, the regression slope was additionally calculated (r = –0.017, p = 0.071). Conclusions: Relatively low levels of endotoxin among sewage treatment plant workers may cause small, but significant across-shift declines in FEV1. The observed relationship was independent of organic dust concentrations and smoking habit. The respiratory protection should be provided for STPW

Effect of environmental phthalate exposure on pregnancy duration and birth outcomes

Objectives: The objective of this study was to evaluate the impact of phthalate exposure on pregnancy duration and birth outcomes based on the Polish Mother and Child Cohort (REPRO_PL). Material and Methods: Phthalate exposure was determined by measuring 11 phthalate metabolites (mono-ethyl phthalate (MEP), mono-iso-butyl phthalate (MiBP), mono-n-butyl phthalate (MnBP), 3OH-mono-n-butyl phthalate (OH-MnBP), mono-benzyl phthalate (MBzP), mono‑ (2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-hydroxy-iso-nonyl phthalate (MHiNP), mono-oxo-iso-nonyl phthalate (MOiNP), and mono-n-octyl phthalate (MOP)) in the urine collected from 165 mothers during the third trimester of pregnancy by high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). The following measures at birth were considered: gestational age, birth weight, length as well as head and chest circumference. Results: Pregnancy duration was inversely associated with natural log concentrations (μg/g creatinine) of MEP (standardized regression coefficient (β) = –0.2, p = 0.04) after adjustment for a variety of confounders. Significant impact of MOiNP on head circumference (β = –0.1, p = 0.05) was also observed. Conclusions: The study findings add further support to the hypothesis that phthalate exposure may be associated with shorter pregnancy duration and a decreased head circumference, and underscore importance of public health interventions to reduce that exposure

OCCUPATIONAL DISEASES IN POLAND IN 2013 AND THEIR CAUSATIVE AGENTS

Background: The paper presents the incidence of occupational diseases in Poland (2013). Material and Methods: Occupational disease reporting forms, supplied to the Central Register of Occupational Diseases, were used as the study material. The incidence was specified in terms of rates per 100 000 employed people. Results: The number of new cases was 2214 with the incidence rate of 15.6. The downward trend recorded over several years continues; compared to 2012, the number of new cases decreased by 7.8%. Exposure to dusts (35% cases), mostly inorganic (carbon, asbestos, and industrial dusts containing free crystalline silica) was the most common cause of occupational diseases. Among the organic dusts allergenic effects of flour and vegetable dusts predominated. Every 3rd case of occupational disease was attributable to physical agents, mainly the way the work is done, excessive vocal effort and noise. The sections of national economy with the highest incidence comprised mining and quarrying (271.1), manufacturing (24.3), education (22.4), agriculture, forestry, hunting and fishing (21.0), human health and social assistance (20.5). Conclusions: The decreased incidence of ‘traditional’ diseases observed over the recent 15 years and the analysis of the 2013 incidence indicate a need to revise the Polish list of occupational diseases by exposures found in the modern work environment. Particular attention should be paid to conditions prevailing in workplaces with high exposures to industrial dusts containing free crystalline silica. A considerable variation in the incidence of voice disorders in teachers between individual voivodeships (provinces) points to the need for harmonization of the standards of preventive, diagnostic and certification procedures. Med Pr 2014;65(4):463–47

Ocena wrażliwości na wybrane leki przeciwgrzybicze szczepów grzybów wyizolowanych od kobiet ciężarnych z cukrzycą oraz zdrowych

Abstract Objectives: An increase in the frequency of fungal infections is related with progress in mycology and decreased susceptibility of fungal strains to commonly used antifungal agents. Diabetes and pregnancy are two independent factors believed to be responsible for an increased risk of mycoses. The aim: The aim of the study was to assess the susceptibility of fungal strains isolated from pregnant women with diabetes as well as healthy pregnant women to ten antifungal agents. Material and methods: In the study 106 diabetic pregnant women and 102 healthy pregnant women were included. Susceptibility of the fungal strains was assessed in vitro by disk diffusion test. Results: Fungal strains were detected in 190 (30.4%) out of 624 samples obtained from vagina, rectum and oral cavity of 208 women. Fungi were found in 42.1% of pregnant women with diabetes and in 41.5% of health pregnant patients. Strains isolated from the diabetic women showed the highest susceptibility to pimaricin (34.4%), nystatin (31.3%) and tioconazole (31.3%) while those from healthy pregnant women were mostly susceptible to itraconazole (59.6%) and miconazole (53.2%). The comparison of the susceptibility of fungi to antifungal agents revealed that the strains isolated form healthy women were significantly more susceptible to clotrimazole (p=0.003), itraconazole (pStreszczenie Wstęp: Obserwowany wzrost częstości zarażeń grzybami jest związany z postępem diagnostyki mikologicznej oraz ze zmniejszona wrażliwością szczepów grzybów na powszechnie używane leki przeciwgrzybicze. Cukrzyca i ciąża są rozpatrywane jako niezależne czynniki zwiększające ryzyko zarażeń grzybami. Cel pracy: Celem pracy była ocena wrażliwości szczepów grzybów, wyizolowanych od kobiet ciężarnych z cukrzycą i zdrowych, na dziesięć leków przeciwgrzybiczych. Materiały i metody: Badania przeprowadzono wśród 102 ciężarnych z cukrzycą oraz 106 losowo wybranych zdrowych ciężarnych. Oznaczenia wrażliwości grzybów na leki dokonano metodą dyfuzyjno-krążkową. Wyniki: Spośród 624 próbek pobranych z pochwy, odbytu i jamy ustnej od 208 kobiet, grzyby wykryto łącznie w 190 (30,4%) próbkach, w tym u 42,1% ciężarnych z cukrzycą oraz u 41,5% zdrowych ciężarnych. Szczepy wyizolowane od ciężarnych z cukrzycą wykazywały największą wrażliwość na pimarycynę (34,4%), nystatynę (31,3%) oraz tiokonazol (31,3%), natomiast szczepy izolowane od zdrowych ciężarnych były najbardziej wrażliwe na itrakonazol (59,6%) i mikonazol (53,2%). Porównanie stopnia wrażliwości szczepów na poszczególne leki w obu badanych grupach wykazało, że grzyby izolowane od zdrowych ciężarnych wykazywały większą wrażliwość na działanie klotrimazolu (p=0,003), itrakonazolu (

Analiza przebiegu ciąży i porodu u nastolatek w latach 2000-2006

Abstract Objectives: The aim of our analysis was to retrospectively analyze the course of pregnancy and delivery in the group of Polish women, aged from 15 to 25. Material and methods: We analyzed 345 woman, aged 15-25, treated in the KMMPiG ICZMP in Lodz between the years 2000 and 2006. The investigated patients were divided into two groups: 15-18-year-olds constituted the research group and 19-25-year-olds, that is the control group. Factors which have been taken into consideration included: pregnancy history, ultrasound examinations, delivery mode, birth weight and the APGAR score. Results: 62.7% (n=69) delivered naturally, 30.9% (n=34) by caesarean section and 6.36% (n=7) by forceps in the group of adolescents and 67.6% (n=159), 32.4% (n=71) and 2% (n=5) (p=0.379; OR 1.27) in the control group. 25.5% (n=26) of the adolescent women (Streszczenie Cel pracy: Celem pracy była analiza retrospektywna przebiegu ciąży i porodu u młodych Polek w wieku 15-25 lat. Materiał i metody: Analizie poddano 345 kobiet w wieku 15-25 lat leczonych w KMMPiG ICZMP w Łodzi w latach 2000-2006. Badane pacjentki podzielono na dwie grupy. Kobiety w wieku od 15 do 18 lat stanowiły grupę badaną, natomiast w wieku 19-25 lat zakwalifikowano do grupy kontrolnej. W badaniu pod uwagę wzięto przebieg ciąży, przeprowadzone badania ultrasonograficzne, sposób porodu, masę urodzeniową dziecka oraz ocen´ dobrostanu w skali Apgar. Wyniki: Wśród młodocianych 62,7% (n=69) kobiet urodziło drogami i siłami natury, 30,9% (n=34) droga cięcia cesarskiego oraz 6,36% (n=7) droga porodu kleszczowego; w grupie kontrolnej odpowiednio 67,6% (n=159), 32,4% (n=71) i 2% (n=5) (p=0,379; OR 1,27). Spośród badanych nastoletnich kobiet 25,5% (n=26) urodziło przedwcześnie

A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

Funding: The study was supported by the European Cooperation in Science and Technology, who provided funds for publication. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Programme (FP7/2007-2013), projects Early Nutrition and ODIN under grant agreement numbers 289346 and 613977.Peer reviewedPublisher PD

A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

Background Maternal smoking during pregnancy is linked to reduced birth weight but the gestation at onset of this relationship is not certain. We present a systematic review of the literature describing associations between maternal smoking during pregnancy and ultrasound measurements of fetal size, together with an accompanying meta-analysis. Methods Studies were selected from electronic databases (OVID, EMBASE and Google Scholar) that examined associations between maternal smoking or smoke exposure and antenatal fetal ultrasound measurements. Outcome measures were first, second or third trimester fetal measurements. Results There were 284 abstracts identified, 16 papers were included in the review and the metaanalysis included data from eight populations. Maternal smoking was associated with reduced second trimester head size (mean reduction 0.09 standard deviation (SD) [95% CI 0.01, 0.16]) and femur length (0.06 [0.01, 0.10]) and reduced third trimester head size (0.18SD [0.13, 0.23]), femur length (0.27 SD [0.21, 0.32]) and estimated fetal weight (0.18 SD [0.11, 0.24]). Higher maternal cigarette consumption was associated with a lower z score for head size in the second (mean difference 0.09 SD [0, 0.19]) and third (0.15 SD [0.03, 0.26]) trimesters compared to lower consumption. Fetal measurements were not reduced for those whose mothers quit before or after becoming pregnant compared to mothers who had never smoked. Conclusions Maternal smoking during pregnancy is associated with reduced fetal measurements after the first trimester, particularly reduced head size and femur length. These effects may be attenuated if mothers quit or reduce cigarette consumption during pregnancy