Trends and determinants among cardiac disabled workers in Alexandria

The present study was designed to investigate the trend and determinant factors among cardiac disabled workers presented in the years 2003-2005 at Health Insurance Committee for disability rating in Alexandria and to compare the currently used system with others. A retrospective study was conducted to review complete records for those below the age 65 years. The available data were coded to include age, gender, job title, disabling symptoms, presence or absence of abnormal findings in resting electrocardiogram and chest X-ray. Extra-investigations were considered by the committee in some cases including echocardiography, cardiac stress test and coronary angiography. Therapeutic interventions were coded and etiological diagnosis was classified into ischemic heart disease [IHD], rheumatic heart disease [RHD], hypertension [HT] and cardiomyopathies [CM]. The functional diagnosis was reported as presence or absence of heart failure and disability was rated as partial or total. Results revealed that rates of disabling dyspnoea, CM and heart failure were significantly increasing from year to year [p=0.038, 0.039 and 0.023 respectively]. The most common etiological diagnosis for the presented cases was IHD with high rates ranging from 69.7% to 73.6% across the 3 years. Logistic regression with total disability as the dependent variable showed that heart failure and additional information by echocardiography were the independent determinants [p= 0.020 and 0.004 respectively]. Simplified comparison between current cardiac disability rating system and American medical Association impairment classification was given. The present disability rating system lack standardization and quantification. It is recommended to integrate the metabolic equivalent [METs] measurement with the current system. Also to emphasize cardiovascular preventive programs to control cardiac disability

VOCs-enrichment factor as an indicator of IAQ and health problems in economic residences in Alexandria

Indoor air quality of 5 blocks in Alexandria was investigated. VOCs-enrichment factor [VEF], that is potentially useful in lAQ investigations was evaluated in this study. Concentrations of VOCs and CO 2 were determined for 26 units and VEF was calculated. 100 housewives were selected randomly for the study [20 from each block]. For each subject, an interview, general and systemic examination, pulmonary function tests, and radiological examination were carried out. The most frequent complaint among the study population was the nonspecific complaints [51%] followed by respiratory system complaints [34%], while 28% of the studied sample reported mental complaints. There have been many studies in residences, but few include both VOCs and CO 2 concentrations. Although VOCs concentrations vary over a large range of concentrations for indoor [0.150-2.989 mg/m 3] and for outdoor [0.123-2.975 mg/m 3], the presence of elevated VOCs indicates strong contaminating source in the building. Outdoor VOCs concentration can be quite variable reflecting vehicular, commercial, and industrial emissions. CO 2 is a crude indicator of ventilation efficiency. 65% of units had VEF of about 1 indicating that bioeffluent emissions prevail, 23% of units had VEF>5 which indicates existence of strong abiotic VOCs sources, and 12% of units had VEF < 0.3 which indicates existence of large combustion source of CO 2 Adverse health responses potentially caused by VOCs in non-industrial indoor environment are irritant, systemic, and toxic effect. In addition, symptoms such as headache, fatigue, and mental confusion are indicators of the presence of combustion products such as CO 2. The VEF is applicable to residences and the present study suggests that people suspecting a connection between their health impairment and housing conditions should be taken seriously