Non-cancer diseases requiring admission to hospital among German seafarers

Background: This study estimated the discharge diagnosis due to non-cancer diseases of German seamen employed on German vessels in comparison to the general German male population. Materials and methods: In a database, the German health insurance company for seafarers determined the discharge diagnoses from hospital for all German seafarers. In the time period from January 1997 to December 2007, this database encompassed on average more than 21,000 German seamen per year. It served as a source for comparison with the official national database on discharge diagnoses from the general German population. Thus, the standardised hospitalisation ratio (SHR) could be calculated. Results: During the above mentioned time period, the most prominent non-cancer diagnoses among seafarers were diseases of the circulatory system, diseases of the digestive system, diseases of the musculoskeletal system, as well as injury and poisoning. Compared to the reference population, decreased SHRs were observed for almost all examined diseases with the exception of asbestosis (SHR: 1.79; 95% CI 0.65–3.90). In contrast to the deck and engine room crew, the galley staff demonstrated an increased SHR for almost all examined diseases, particularly for lifestyle-related diseases. Conclusions: Although the presented data are likely biased by the healthy worker effect and by underreporting due to treatment on board or abroad, an elevated SHR for (lifestyle-related) diseases was observed in the galley staff. Therefore, especially this occupational group seems to need specific advice on healthy behaviours both on board and ashore

Overview and prospect: food and nutrition of seafarers on merchant ships

During stay on board, seafarers have limited influence on quality and quantity of food over several months. Furthermore, the nutrition on board is characterised by different dietary habits in the multi-ethnic crews, differential food supply in crew’s and officers’ mess room and irregular mealtimes due to the shifts on board. Internationally, nutritional situation on board is not standardised, but reflects the flag-state standard. Up to date, there is only little comprehensive research published concerning food patterns of seafarers; these studies often lack in objective examination methods to estimate the actual food intake and activity-related energy requirements. Therefore, to examine the food and nutrition of seafarers, shipping companies should be interviewed about food provisions on board, and seafarers about eating habits in consideration of possible socio-cultural and psychological backgrounds for malnutrition. These studies should also encompass seafarers’ health parameters related to nutrition on board (energy consumption, bioelectrical impedance analysis, ergospirometry and blood analysis). In total, further research directly on board is needed to know more about seafarers’ food and nutrition situation at sea

Fitness to work: a comparison of European guidelines in the offshore wind industry

Occupational medicine must be able to meet the challenges of rapidly changing technologies and innovations, including the implementation of health and safety standards for physically and psychologically demanding work environments. One such challenge is presented by the offshore wind industry. Here, the demand for “Fitness to Work” regulations for potential employees is justified. An appropriate evaluation has to consider the two aspects “fit for task” and “fit for location and conditions”. Guidelines for the fitness testing of offshore employees have been created by various national organisations. The guidelines of the industry organisations of the United Kingdom (Oil & Gas UK) and the Netherlands (NOGEPA), as well as the Norwegian Directorate of Health, were developed for employees of offshore oil and gas platforms. In Germany, however, a medical guideline for fitness testing specific to workers in the offshore wind industry has recently been created. Such recommendations should be made on the basis of accident statistics and rescue reports, but there are only limited data available. In this paper, we present, compare and discuss the content and features of the various guidelines, as well as their recommendations for medical assessment

possible lead and/ or mercury intoxication from imported natural health products and a need for scientifically evaluated poisoning monitoring from environmental exposures

Background With increases in globalization, cultural remedies from Chinese, Ayurvedic, Arab and other traditions have become more available to international consumers, offering unfamiliar “Natural Health Products” (NHP), used as alternative medicine or supplementary medicine. Contamination with toxic ingredients including lead, mercury, arsenic, and other toxic elements has been documented in several of these products from various parts of the globe, particularly from some parts of Asia and the Orient. Findings We have been following this development in the last 6 years and have analyzed n = 20 such products (60 analyses) from patients with intoxication symptoms in a pilot study, showing alarming high concentrations of mercury and/or lead (the first one in “therapeutic” doses). 82 % of the studied NHP contained lead concentrations above the EU limit for dietary supplements. 62 % of the samples exceeded the limit values for mercury. Elevated blood lead and mercury levels in patients along with clinical intoxication symptoms corroborate the causal assumption of intoxication (s). We present one detailed clinical case report of severe lead and mercury intoxications and give an overview about blood concentration related symptoms and signs of n = 41 case reports of mercury intoxications of the German monitoring BfR-DocCenter. Conclusions For NHP there is evidence on a distinct toxicological risk with alarming low awareness for a possible intoxication which prevents potentially life-saving diagnostic steps in affected cases. In many cases patients do not communicate the events to their physicians or the local health authority so that case reports (e.g. the BfR-DocCentre) are missing. Thus, there is an urgent need to raise awareness and to initiate more suitable monitory systems (e.g. National Monitoring of Poisonings) and control practice protecting the public

Steuerung nichtvisueller Lichtwirkungen mit Einbindung arbeitsplatzbezogener Beleuchtung

Durch Variation von Lichtstrom, Lichtfarbe und Abstrahlcharakteristik der Beleuchtung lassen sich die spektrale Verteilung und die Beleuchtungsstärke in der Augenebene verändern und nichtvisuelle Lichtwirkungen bewusst steuern. Der Dynamikbereich wird maßgeblich über den Variationsbereich der ähnlichsten Farbtemperatur bestimmt. Um unterschiedlichen Lichtbedürfnissen, Vorlieben und Sehanforderungen gerecht zu werden, sind Arbeitsbereiche zusätzlich zur Allgemeinbeleuchtung mit einer arbeitsplatzbezogenen Beleuchtung (APL) ausgestattet, die individuell bei Bedarf zugeschaltet werden kann. Anhand von Messungen an Industriearbeitsplätzen kann gezeigt werden, dass durch eine statische Lichtfarbe der Arbeitsplatzbeleuchtung der Dynamikbereich der Lichtfarbe einer dynamischen Allgemeinbeleuchtung auf 1/3 reduziert wird und mit deren Wirksamkeit der Unterstützung nichtvisueller Lichtwirkungen konfligiert. Nur wenn die arbeitsplatzbezogene Beleuchtung in die Steuerung der Beleuchtungsanlage integriert ist, ist eine gezielte Unterstützung nichtvisueller Lichtwirkungen sinnvoll möglich. Um die Wirksamkeit der Steuerung einer dynamischen Allgemeinbeleuchtung möglichst wenig zu stören, ist es notwendig, die Abstrahlung der arbeitsplatzbezogenen Beleuchtung in Richtung der vertikalen Augenebene zu kontrollieren

Evaluation verhaltenspräventiver Gesundheitsförderungsmaßnahmen in Inklusionsbetrieben

Hintergrund: Inklusionsbetriebe nach §§ 215-218 SGB IX bieten schwerbehinderten Menschen eine Beschäftigung auf dem allgemeinen Arbeitsmarkt. Seit 2018 sind Inklusionsbetriebe verpflichtet, Maßnahmen der betrieblichen Gesundheitsförderung (BGF) anzubieten. Ziel der Arbeit: Das Ziel der vorliegenden Studie ist es, verhaltenspräventive BGF-Angebote in Form von Seminaren für schwerbehinderte Beschäftigte und deren Leitungskräfte in Inklusionsbetrieben zu evaluieren. Material und Methoden: Anhand eines multimethodischen Studiendesigns erfolgte im Zeitraum von Juni bis November 2021 eine Evaluation der 12 Beschäftigtenseminare (3 Seminarkonzepte, z. B. Selbstfürsorge im Arbeitsalltag) mittels Fokusgruppen (n = 44) und eine Evaluation der 3 Leitungskräfteseminare zur gesunden Führung mittels eines standardisierten Fragebogens (n = 10). Die erhobenen quantitativen Daten wurden deskriptiv ausgewertet und die qualitativen Daten mithilfe der qualitativen Inhaltsanalyse nach Mayring induktiv analysiert. Ergebnisse: Die Ergebnisse zeigten, dass die durchgeführten Maßnahmen zur BGF von Beschäftigten hinsichtlich der Zufriedenheit, der Seminarlänge, der Verständlichkeit und des erwarteten Nutzens mehrheitlich positiv bewertet wurden. Die Leitungskräfte bewerteten die Seminarinhalte, die Didaktik, die Seminarleitung und den Beitrag der Teilnehmenden mehrheitlich positiv. Diskussion: Die Studie lieferte erste empirische Erkenntnisse zur Evaluation von BGF-Maßnahmen in Inklusionsbetrieben. Vor allem die auf die Inklusionsbetriebe angepassten Seminarinhalte konnten die Zufriedenheit der Teilnehmenden mit der Gesundheitsförderungsmaßnahme positiv beeinflussen. Insgesamt bedarf es weiterer Studien zur Entwicklung und Evaluation von verhältnis- und verhaltensbezogenen BGF-Maßnahmen in Inklusionsbetrieben.Background: Social firms according to §§ 215-218 SGB IX offer employment to severely disabled people on the general labour market. Since 2018, social firms are obliged to offer workplace health promotion (WHP) measures. Objectives: This study aims to evaluate behavioural-related offers implemented as seminars for WHP for severely disabled employees and their supervisors in social firms. Materials and methods: Using a multimethod study design, from June to November 2021, 12 seminars for employees (3 seminar concepts, e.g. on self-care in everyday work) were evaluated by means of focus groups (n = 44) and 3 seminars for supervisors on healthy leadership by means of a standardized questionnaire (n = 10). The collected quantitative data were analysed descriptively and the qualitative data were analysed inductively according to Mayring’s qualitative content analysis. Results: The results indicated that the implemented WHP measures for employees were rated positively by the majority in terms of satisfaction, seminar length, comprehensibility and usefulness. Similarly, supervisors evaluated the seminar content, didactics, instructor as well as the contribution of other participants mostly positively. Conclusion: The study provided initial empirical findings on the evaluation of WHP measures in social firms. In particular, seminar content adapted to the setting of social firms had a positive influence on participants’ satisfaction with health promotion measures. Overall, further studies are needed to develop and evaluate structural and behavioural-related WHP offers in social firms

Biomonitoring of polycyclic aromatic hydrocarbons in firefighters at fire training facilities and in employees at respiratory protection and hose workshops

IntroductionPolycyclic aromatic hydrocarbons (PAHs) are carcinogenic to humans and are formed by incomplete combustion. PAHs are always present during firefighting operations, and fire department members can be exposed to them in the workplace.MethodsIn this study, we analyzed 1-hydroxypyrene (1-OHP) in 36 urine samples from nine firefighters, collected before and after fire training sessions, and 32 urine samples from eight employees at respiratory protection and hose workshops. To assess breakthrough PAH exposure through personal protective equipment and potential dermal uptake, some of the workshop employees wore cotton garments under their regular workwear. Cotton samples were then examined for the presence of 17 semi-volatile and low-volatility PAHs.ResultsAfter firefighting exercises, we observed approximately a fivefold increase in mean 1-OHP concentrations in samples from firefighters, from 0.24 μg/L to 1.17 μg/L (maximum: 5.31 μg/L). In contrast, 1-OHP levels in workshop employees were found to be low, with the majority of urine samples yielding concentrations below the limit of quantification (LOQ: 0.05 μg/L, maximum: 0.11 μg/L). Similarly, low PAH levels were found on the workshop employees' cotton undergarments, with maximum concentrations of 250 and 205 ng/g for pyrene and benzo[a]pyrene, respectively.DiscussionIn conclusion, significant increases in 1-OHP in urine were observed in firefighters after training sessions, whereas work-related exposure remained low among workshop employees

Comparative analysis of selected exhaled breath biomarkers obtained with two different temperature-controlled devices

<p>Abstract</p> <p>Background</p> <p>The collection of exhaled breath condensate (EBC) is a suitable and non-invasive method for evaluation of airway inflammation. Several studies indicate that the composition of the condensate and the recovery of biomarkers are affected by physical characteristics of the condensing device and collecting circumstances. Additionally, there is an apparent influence of the condensing temperature, and often the level of detection of the assay is a limiting factor. The ECoScreen2 device is a new, partly single-use disposable system designed for studying different lung compartments.</p> <p>Methods</p> <p>EBC samples were collected from 16 healthy non-smokers by using the two commercially available devices ECoScreen2 and ECoScreen at a controlled temperature of -20°C. EBC volume, pH, NOx, LTB₄, PGE₂, 8-isoprostane and cys-LTs were determined.</p> <p>Results</p> <p>EBC collected with ECoScreen2 was less acidic compared to ECoScreen. ECoScreen2 was superior concerning condensate volume and detection of biomarkers, as more samples were above the detection limit (LTB₄and PGE₂) or showed higher concentrations (8-isoprostane). However, NOx was detected only in EBC sampled by ECoScreen.</p> <p>Conclusion</p> <p>ECoScreen2 in combination with mediator specific enzyme immunoassays may be suitable for measurement of different biomarkers. Using this equipment, patterns of markers can be assessed that are likely to reflect the complex pathophysiological processes in inflammatory respiratory disease.</p

Night Shift Work Affects Urine Metabolite Profiles of Nurses with Early Chronotype

Night shift work can have a serious impact on health. Here, we assess whether and how night shift work influences the metabolite profiles, specifically with respect to different chronotype classes. We have recruited 100 women including 68 nurses working both, day shift and night shifts for up to 5 consecutive days and collected 3640 spontaneous urine samples. About 424 waking-up urine samples were measured using a targeted metabolomics approach. To account for urine dilution, we applied three methods to normalize the metabolite values: creatinine-, osmolality- and regression-based normalization. Based on linear mixed effect models, we found 31 metabolites significantly (false discovery rate <0.05) affected in nurses working in night shifts. One metabolite, acylcarnitine C10:2, was consistently identified with all three normalization methods. We further observed 11 and 4 metabolites significantly associated with night shift in early and late chronotype classes, respectively. Increased levels of medium- and long chain acylcarnitines indicate a strong impairment of the fatty acid oxidation. Our results show that night shift work influences acylcarnitines and BCAAs, particularly in nurses in the early chronotype class. Women with intermediate and late chronotypes appear to be less affected by night shift work