Research progress of occupational hazards in plywood manufacturing / 中华劳动卫生职业病杂志

Occupational disease hazards in plywood manufacturing mainly include wood dust, formaldehyde, phenol, ammonia, noise, terpene, microorganisms, etc. The exposure is complex with multiple factors accompanied or coexisted. In the production process, these factors are exceeded, and mass occupational disease hazard events occurred among workers. Exposure to wood dust, formaldehyde, terpene, etc., put workers at increased risk of cancer. This article provides a review of this issue in order to provide a scientific basis for the prevention and control of occupational disease hazards in plywood manufacturing.

Los acúfenos de Miguel Ángel y su relación con la toxicología / Miguel Ángel's tinnitus and its relation to toxicology

Resumen El Plomo ha tenido una estrecha relación con el mundo artístico pictórico a través de los pigmentos utilizados por los artistas durante milenios. El íntimo contacto con sustancias químicas potencialmente peligrosas para la salud, casi siempre sin medidas de higiene y seguridad laboral, ha desarrollado en muchos casos, enfermedades laborales en estos artistas, a veces sospechadas y en otros casos, más que confirmadas. En el presente trabajo se analiza la historia de vida laboral de Miguel Angel Buonarroti, de quien se tiene registro suficiente como para establecer un nexo causal con exposición laboral al Plomo.

Abstract Lead has shown a close relationship with the fine arts'world through the pigments used by artists for thousand of years. Close contact with potentially dangerous chemical substances for health, almost always without occupational hygiene and safety measures, has produced, in many cases, occupational illnesses in these artists, sometimes suspected and in other cases, more than confirmed. In the present work, the history of Miguel Angel Buonarroti's working life is analyzed, since there is sufficient record to establish a causal link with occupational exposure to Lead.

Dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores: um estudo de base populacional / Self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents: a population-based study / Dificultad auditiva autoinformada y exposición ocupacional a agentes otoagresores: un estudio de base poblacional

O objetivo deste estudo foi estimar a associação entre dificuldade auditiva autorreferida e exposição ocupacional a agentes otoagressores em trabalhadores brasileiros. Trata-se de um estudo transversal realizado com dados da Pesquisa Nacional de Saúde (PNS-2013). A variável dependente foi a dificuldade auditiva autorreferida, e foram analisadas três exposições principais: ruído, poeira industrial e substâncias químicas. Realizou-se análise de regressão logística, estimando-se as odds ratio (OR) brutas e ajustadas, com intervalos de 95% de confiança (IC95%). As variáveis principais de exposição foram ajustadas entre si e pelas covariáveis sexo, idade, ambiente de trabalho, tempo de trabalho e hipertensão arterial. Participaram deste estudo 36.442 trabalhadores. Maior prevalência de dificuldade auditiva foi observada em indivíduos expostos à poeira industrial (9,9%) (p < 0,001). Além disso, quanto maior a idade do trabalhador e tempo de trabalho, maior foi a prevalência do desfecho (p < 0,001). Na análise ajustada, trabalhadores expostos a ruído apresentaram 1,65 vez mais chance de referir dificuldade auditiva, quando comparados aos indivíduos não expostos (p < 0,001). O mesmo ocorreu com trabalhadores expostos à poeira industrial (OR = 1,36) (p = 0,012). Não foi observada associação entre o desfecho e a variável exposição a substâncias químicas (p = 0,120). Observou-se associação entre dificuldade auditiva e exposição ocupacional a ruído e à poeira industrial em trabalhadores brasileiros. Reforçam-se a importância do aprimoramento de políticas públicas em saúde auditiva e o desenvolvimento de ações voltadas à prevenção e ao monitoramento auditivo em ambiente ocupacional.

This study's objective was to estimate the association between self-reported hearing impairment and occupational exposure to hazardous noise and ototoxic agents in Brazilian workers. This was a cross-sectional study with data from the Brazilian National Health Survey (PNS-2013). The dependent variable was self-reported hearing impairment, and three principal exposures were analyzed: noise, industrial dust, and chemical substances. Logistic regression was performed, estimating crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI). The principal exposure variables were adjusted for each other and by covariables sex, age, workplace, time on the job, and hypertension. 36,442 workers participated in the study. Higher prevalence of hearing impairment was seen in workers exposed to industrial dust (9.9%) (p < 0.001). The older the worker and the longer the time on the job, the higher the prevalence of hearing impairment (p < 0.001). In the adjusted analysis, workers exposed to noise showed 1.65 higher odds of reporting difficulty hearing, when compared to unexposed individuals (p < 0.001). The same was true for workers exposed to industrial dust (OR = 1.36) (p = 0.012). No association was observed between the outcome and exposure to chemical substances (p = 0.120). There was an association between hearing impairment and occupational exposure to noise and industrial dust in Brazilian workers. This emphasizes the importance of strengthening public policies for hearing health and the development of measures for prevention and auditory monitoring in the workplace.

El objetivo de este estudio fue estimar la asociación entre dificultad auditiva autoinformada y la exposición ocupacional a agentes otoagresores en trabajadores brasileños. Se trata de un estudio transversal, realizado con datos de la Encuesta Nacional de Salud (PNS-2013). La variable dependiente fue la dificultad auditiva autoinformada y se analizaron tres exposiciones principales: ruido, polvo industrial y substancias químicas. Se realizó un análisis de regresión logística, estimándose las odds ratio (OR) brutas y ajustadas, con intervalos de un 95% de confianza (IC95%). Las variables principales de exposición fueron ajustadas entre sí y por las covariables: sexo, edad, ambiente de trabajo, tiempo de trabajo e hipertensión arterial. Participaron en este estudio 36.442 trabajadores. La mayor prevalencia de dificultad auditiva se observó en individuos expuestos al polvo industrial (9,9%) (p < 0,001). Asimismo, cuanto mayor era la edad del trabajador y tiempo de trabajo, mayor fue la prevalencia del desenlace (p < 0,001). En el análisis ajustado, los trabajadores expuestos a ruido presentaron 1,65 veces más oportunidad de informar de dificultad auditiva, cuando se comparan con los individuos no expuestos (p < 0,001). Lo mismo sucedió con trabajadores expuestos a polvo industrial (OR = 1,36) (p = 0,012). No se observó una asociación entre el desenlace y la variable exposición a sustancias químicas (p = 0,120). Se observó una asociación entre dificultad auditiva y exposición ocupacional a ruido y polvo industrial en trabajadores brasileños. Se refuerza la importancia del perfeccionamiento de políticas públicas en salud auditiva y desarrollo de acciones dirigidas a la prevención y monitoreo auditivo en el entorno laboral.

Lung cancer related to occupational exposure: an integrative review / Cáncer de pulmón relacionado con la exposición ocupacional: revisión integrativa / Câncer de pulmão relacionado à exposição ocupacional: revisão integrativa

ABSTRACT Objective: To identify in the literature the carcinogenic agents found in the work environment, the occupations and the risk for lung cancer. Method: A descriptive and analytical study of the Integrative Literature Review type was carried out in national and international databases from the last ten years in the period from 2009 to 2018, concerning 32 studies referring to association between carcinogenic substances to which the worker is exposed and lung cancer. Results: Nine (28.1%) publications originated in China and only one in Brazil. The most exposed workers were from the secondary sector, 50% being from industry and 6.2% from construction, mostly male. Asbestos and silica stood out among the carcinogenic substances most associated with lung cancer risk, accounting for 37.5% and 28.1%, respectively. Conclusions: The association between occupational exposure and the risk for lung cancer was characterized in this research by the substantial scientific evidence from the described studies that confirm this association.

RESUMEN Objetivo: Identificar en la literatura los agentes cancerígenos presentes en el entorno laboral, las ocupaciones y el riesgo de cáncer de pulmón. Método: Estudio descriptivo y analítico de una revisión integradora realizada en una base de datos nacional e internacional de los últimos diez años, entre 2009 y 2018, que comprende 32 estudios referidos a la vinculación entre el cáncer de pulmón y las sustancias cancerígenas de exposición ocupacional. Resultados: Nueve (28,1%) publicaciones tuvieron su origen en China y solo una en Brasil. Los trabajadores más expuestos pertenecían al sector secundario, el 50% a la industria y un 6,2% a la construcción, siendo en su mayoría hombres. El asbesto y la sílice se destacaron entre las sustancias cancerígenas más asociadas con el riesgo de cáncer de pulmón, con índices de 37,5% y el 28,1%, respectivamente. Conclusiones: La vinculación entre la exposición ocupacional y el riesgo de cáncer de pulmón se caracterizó en esta investigación por la evidencia científica sustancial de los estudios descriptos que confirman esta asociación.

RESUMO Objetivo: Identificar na literatura os agentes carcinogênicos presentes no ambiente ocupacional, as ocupações e o risco do câncer de pulmão. Método: Estudo descritivo e analítico de revisão integrativa realizada em base de dados nacionais e internacionais dos últimos dez anos, entre 2009 e 2018, compreendendo 32 estudos referentes à associação entre câncer de pulmão e substâncias carcinogênicas de exposição ocupacional. Resultados: Nove (28,1%) publicações originadas na China e apenas uma brasileira. Os trabalhadores mais expostos foram do setor secundário, sendo 50% da indústria e 6,2% da construção civil, em sua maioria do sexo masculino. O amianto e a sílica sobressaíram-se entre as substâncias carcinogênicas mais associadas ao risco de câncer de pulmão correspondendo a 37,5% e 28,1%, respectivamente. Conclusões: A associação entre a exposição ocupacional e o risco de câncer de pulmão ficou caracterizada nesta pesquisa pelas substanciais evidências científicas dos estudos descritos que confirmam essa associação.

Occupational skin disorders in a subset of Nigerian hairdressers

Introduction: hairdressing is associated with a wide range of disorders. This is particularly true in the African hairdresser, who is saddled with the responsibility of 'taming' the rather difficult-to-manage African hair, and is thus exposed to a wide range of chemical, biological and physical materials in the hair grooming process. We therefore sought to determine the prevalence and pattern of occupational skin disorders among hairdressers in Ibadan, one of the oldest and largest cities in Nigeria.Methods: this was a cross sectional study of hairdressers conducted in 2013 in Ibadan, Nigeria. Hairdressers and their apprentices were interviewed using a structured questionnaire, following which a thorough physical examination was performed to identify any skin disorder.Results: a total of 226 hairstylists were recruited. The prevalence of occupational skin disorders in the study was 68.13%. The prevalence of specific skin disorders was 32.74% for nail disorders; 28.75% for traumatic skin disorders; and 2.64% for hand dermatitis.Conclusion: there is a high prevalence of occupational skin disorders among hairdressers, and this may have personal and public health implications

Intoxicación ocupacional por metales pesados / Occupational poisoning due to heavy metals

Se efectuó una revisión bibliográfica exhaustiva con vistas a demostrar la relación existente entre ciertas profesiones y las intoxicaciones por metales pesados. A tales efectos, en el presente artículo se describen las fuentes de emisión y las aplicaciones de dichos metales, así como las afecciones que provocan a la salud. Se constató que las intoxicaciones diagnosticadas en trabajadores de la provincia, en el período 2000-2016, estuvieron asociadas a diferentes empleos, tales como reparación de baterías, plomería, soldadura y odontología. A partir de lo anterior se exponen algunas recomendaciones a considerar en los campos salud ocupacional-metales pesados

An exhaustive literature review aimed at demonstrating the existent relationship between certain professions and poisonings due to heavy metals was carried out. To such effects, the emission sources and uses of these metals are described in this work, as well as the disorders that cause to health. It was verified that the poisonings diagnosed in workers of the province, during 2000-2016, were associated with different jobs, such as batteries repair, plumbing, welding and dentistry. From the above-mentioned, some recommendations to consider everything regarding occupational health-heavy metals are exposed

Irregularidad menstrual y exposición a mercurio en la minería artesanal del oro en Colombia / Human mercury exposure and irregular menstrual cycles in relation to artisanal gold mining in Colombia

Introducción. El proceso de extracción del oro por amalgamación con mercurio es común en la minería artesanal. Los efectos sobre la reproducción de la exposición al mercurio elemental en el contexto de la minería del oro, no han sido suficientemente estudiados. Objetivo. Evaluar el efecto de la exposición al mercurio elemental durante la minería del oro, sobre la regularidad del ciclo menstrual y la presentación de abortos en Colombia. Materiales y métodos. Se hizo un estudio analítico de corte transversal. Las participantes residían en distritos de minería de oro con historia de exposición al mercurio elemental y se las comparó con un grupo de mujeres no expuestas, en cuanto a la regularidad del ciclo menstrual y la ocurrencia de abortos. Para el registro de las variables de exposición y resultado, se usó un cuestionario cuya reproducibilidad prueba-reprueba fue evaluada. Se calcularon las razones de prevalencia mediante un modelo binomial y se evaluó la bondad de ajuste. Resultados. Participaron 72 mujeres expuestas y 121 mujeres no expuestas al mercurio. Entre las mujeres expuestas, el tiempo promedio de exposición al mercurio fue de 19,58 ± 9,53 años. La prevalencia ajustada de menstruación irregular en los últimos seis meses, fue mayor en el grupo de mujeres expuestas crónicamente a vapores de mercurio (razón de prevalencia, RP=1,59, IC 95% 0,93-2,73), pero la proporción de mujeres con historia de abortos no fue diferente. Conclusiones. La exposición al mercurio elemental durante el proceso artesanal de la minería del oro podría estar asociada con una mayor prevalencia de irregularidad del ciclo menstrual, pero no con la presentación de abortos.

Introduction: Artisanal mining commonly extracts gold with an amalgamation process that uses mercury. The reproductive effects from exposure to elemental mercury used in gold mining have not been sufficiently studied. Objective: To evaluate the effect of the exposure to elemental mercury used in gold mining on menstrual cycle regularity and the occurrence of miscarriages in Colombia. Materials and methods: An analytical cross-sectional study was conducted. The participants were female residents of gold mining districts, with a history of exposure to elemental mercury. Menstrual regularity and the occurrence of miscarriages were compared between these women and an unexposed group. Exposure and outcome variables were registered based on a questionnaire which was evaluated for its test-retest reproducibility. Prevalence rates were calculated using a binomial model and goodness-of-fit was evaluated. Results: A total of 72 women exposed to mercury and 121 unexposed women participated. The average time of exposure to mercury among exposed women was 19.58 ± 9.53 years. The adjusted prevalence of irregular menstruation over the last six months was higher in the group of women chronically exposed to mercury vapors (PR=1.59, 95% CI 0.93-2.73), while there was no difference in the proportion of women with a history of miscarriages. Conclusions: Exposure to elemental mercury used in artisanal gold mining may be associated with a higher prevalence of irregular menstrual cycles but not with the occurrence of miscarriage.

PPARγ induces growth inhibition and apoptosis through upregulation of insulin-like growth factor-binding protein-3 in gastric cancer cells

Peroxisome proliferator activator receptor-gamma (PPARγ) is a ligand-activated transcriptional factor involved in the carcinogenesis of various cancers. Insulin-like growth factor-binding protein-3 (IGFBP-3) is a tumor suppressor gene that has anti-apoptotic activity. The purpose of this study was to investigate the anticancer mechanism of PPARγ with respect to IGFBP-3. PPARγ was overexpressed in SNU-668 gastric cancer cells using an adenovirus gene transfer system. The cells in which PPARγ was overexpressed exhibited growth inhibition, induction of apoptosis, and a significant increase in IGFBP-3 expression. We investigated the underlying molecular mechanisms of PPARγ in SNU-668 cells using an IGFBP-3 promoter/luciferase reporter system. Luciferase activity was increased up to 15-fold in PPARγ transfected cells, suggesting that PPARγ may directly interact with IGFBP-3 promoter to induce its expression. Deletion analysis of the IGFBP-3 promoter showed that luciferase activity was markedly reduced in cells without putative p53-binding sites (-Δ1755, -Δ1795). This suggests that the critical PPARγ-response region is located within the p53-binding region of the IGFBP-3 promoter. We further demonstrated an increase in PPARγ-induced luciferase activity even in cells treated with siRNA to silence p53 expression. Taken together, these data suggest that PPARγ exhibits its anticancer effect by increasing IGFBP-3 expression, and that IGFBP-3 is a significant tumor suppressor.

Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma

18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the predictive ability of different FDG standardized uptake values (SUVs) in 74 patients with newly diagnosed NSCLC. 18F-FDG PET/CT scans were performed and different SUV parameters (SUVmax, SUVavg, SUVT/L, and SUVT/A) obtained, and their relationship with clinical characteristics were investigated. Meanwhile, correlation and multiple stepwise regression analyses were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and tumor size significantly affected SUV parameters. The mean SUVs of squamous cell carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors exhibited higher SUVs than well-differentiated ones. Further analyses based on the pathologic type revealed that the SUVmax, SUVavg, and SUVT/L of poorly differentiated adenocarcinoma tumors were higher than those of moderately or well-differentiated tumors. Among these four SUV parameters, SUVT/L was the primary predictor for tumor differentiation. However, in adenocarcinoma, SUVmax was the determining factor for tumor differentiation. Our results showed that these four SUV parameters had predictive significance related to NSCLC tumor differentiation; SUVT/L appeared to be most useful overall, but SUVmax was the best index for adenocarcinoma tumor differentiation.

Inhalación masiva de amoniaco: reporte de dos casos / Massive ammonia inhalation: report of two cases

Ammonia (NH3) is an irritant and corrosive gas whose inhalation at high concentrations mainly occurs during agricultural and industrial activities, as occupational accidents. The extent and severity of the damage depends on the concentration and time of exposure to the toxic, which can cause skin, eye, respiratory and life-threatening injuries. We present two cases of patients acutely exposed to high concentrations of NH3. Both patients survived to the acute phase of the respiratory injury, but developed chronic lung derangements.

El amoniaco (NH3) es un gas irritante y corrosivo cuya inhalación aguda en altas concentraciones se produce principalmente durante accidentes laborales en el sector agrícola e industrial. La extensión y severidad del daño depende de la concentración y tiempo de exposición al tóxico, el cual puede causar lesiones a nivel cutáneo, ocular, respiratorio y riesgo vital. Presentamos dos casos de pacientes expuestos en forma aguda a NH3 en altas concentraciones. Ambos pacientes sobrevivieron a la fase aguda y evolucionaron con lesiones respiratorias crónicas.

Compensation for Occupational Diseases by Chemical Agents in Korea

Investigation into the frequency of compensation for occupational diseases (ODs) caused by hazardous chemicals revealed an important opportunity for the improvement and further development of occupational health and safety systems in Korea. In response to concerns after outbreaks of disease due to chemical exposure, specific criteria for recognition of ODs were established and included in the Enforcement Decree of the Labor Standard Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) on June 28, 2013. However, the original versions of the LSA and IACIA contain several limitations. First, the criteria was listed inconsistently according to the symptoms or signs of acute poisoning. Second, all newly recognized hazardous chemicals and chemicals recognized as hazardous by the International Labor Organization (ILO) were not included in the LSA and IACIA. Although recent amendments have addressed these shortcomings, future amendments should strive to include all chemicals listed by the ILO and continuously add newly discovered hazardous chemicals as they are introduced into the workplace.

Exposición a la contaminación con plomo en taller de ensamble de baterías / Exposure to lead contamination in battery assembly workshop

Introducción: Las consecuencias perjudiciales del plomo (Pb) en la salud de las personas, y los trabajadores en particular, han sido suficientemente demostradas desde hace mucho tiempo. No obstante ser un problema de tan larga data, llega hasta la actualidad; y los talleres de baterías constituyen una de las fuentes de contaminación. Objetivo General: Conocer el nivel de exposición al Pb de la totalidad de trabajadores directos de un taller de ensamble de baterías de la localidad de Boulogne, Buenos Aires. Objetivos Específicos: -Evaluar los registros sobre el nivel de Pb en sangre de los trabajadores entre 2007 y 2013. -Describir las condiciones de trabajo y las prácticas higiénicas de los empleados. -Medir la cantidad de Pb existente en el aire del establecimiento. Material y métodos: Es un estudio observacional descriptivo. El relevamiento general de riesgos se realizó mediante observación directa. Se analizaron las plombemias de los trabajadores. Las prácticas higiénico-laborales se estudiaron mediante un cuestionario semi-estructurado. Se llevó a cabo un estudio del aire. Resultados: El cumplimiento de las normas de seguridad e higiene laboral es parcial. Es una planta pequeña y mal ventilada, sin un adecuado sistema de extracción ni ventilación. No utiliza proceso húmedo o con aspiradores para la limpieza. No es sistemático el recambio de filtros de la campana de extracción ni de los respiradores personales. Las plombemias realizadas entre diciembre de 2007 y marzo de 2013 muestran valores superiores a los límites aceptables, alcanzando el promedio 19,23 ug/100ml (rango: 3 ug/100ml - 48,8 ug/100ml). Existen debilidades en cuanto a la utilización de la máscara de protección con filtros, a su higienización y a la forma en que esto se realiza. Resultados de las muestras del aire: en crisol: concentración de plomo (resultado analítico): 0,06 mg/m³; en intercelda: 0,92 mg/m3; en el sector de etiquetado: 0,03 mg/m³. Conclusiones principales: Se requiere el mejoramiento de las normas de seguridad e higiene laborales.

Introduction: The harmful effects of lead (Pb) on the health of people and workers in particular have long been sufficiently demonstrated. However being a problem as longstanding, arrives to present workshops and batteries are one of the sources of pollution. General Objective: To determine the level of exposure to Pb of all direct workers of a battery assembly workshop in the town of Boulogne, Buenos Aires. Specific Objectives: -Evaluate the records on the level of Pb in blood of workers between 2007 and 2013. -Describe the working conditions and hygiene practices of employees. -Measure the amount of Pb in the air existing in the establishment. Material and Methods: It is an observational descriptive study. The general risk survey-stage was conducted by direct observation. The lead levels of workers were analyzed. Hygiene and work practices were studied using a semi-structured questionnaire. It was made an air study. Results: Compliance with safety and hygiene is partial. It is a small and stuffy plant without adequate ventilation or exhaust system. It does not use wet or vacuum for cleaning process. No systematic replacement filters range hood or personal respirators. The lead levels between December 2007 and March 2013 show above acceptable limits values, reaching 19,23 ug/100ml average (range: 3 ug/100ml - 48,8 ug/100ml). There are weaknesses with regard to the use of the protective mask filters, to sanitize and the way this is done. Results of air samples: in pot: lead concentration (analytical result): 0,06 mg/ m3, in intercell 0,92 mg/m3; labeling sector: 0,03 mg/m3. Main conclusions: improving the safety and health at work is required.

Saúde auditiva e qualidade de vida em trabalhadores expostos a agrotóxicos / Hearing care and quality of life among workers exposed to pesticides

O objetivo deste estudo foi determinar a relação entre a exposição ao agrotóxico e a ocorrência de perda auditiva nos trabalhadores rurais do Povoado Colônia Treze, Lagarto (SE). Foram selecionados 351 trabalhadores adultos na faixa etária de 18 a 59 anos, com atividade laboral atual ou pregressa na área rural, com ou sem uso de agrotóxico. A avaliação audiológica foi composta de ficha para registro dos limiares tonais aéreos pelo critério de normalidade preconizado por Merluzzi 1979. O instrumento usado para a avaliação da qualidade de vida foi a versão brasileira do Short Form 36 (SF-36). Foi realizada análise estatística (testes qui-quadrado χ², não paramétrico de Kruskal-Wallis, V de Cramer e d de Cohen) com nível de significância de 95% (p < 0,05). Os resultados relacionaram o uso de agrotóxico com o grau de toxicidade, com a presença de perda auditiva e com os índices de qualidade de vida (p < 0,001). Este estudo pode comprovar que os agricultores, usuários de agrotóxicos apresentaram piores níveis de qualidade de vida quando comparados com aqueles que não os utilizaram. O uso de agrotóxico e sua classe toxicológica interferiram de maneira mais impactante na classificação de perda auditiva apresentada nos mesmos e novos estudos são recomendados para avaliar outros impactos nesta população.

The objective of this study was to determine the relationship between exposure to pesticides and the occurrence of hearing loss among rural workers of Povoado Colônia Treze, Lagarto, State of Sergipe, Brazil. A total of 351 adult workers aged 18 to 59 years were selected, with current or past work activity in rural areas, with or without use of pesticides. The hearing evaluation included a form to record air-borne tonal thresholds using normality criteria recommended by Merluzzi 1979. The instrument used for assessing the quality of life was the Brazilian version of Short Form 36 (SF-36). Statistical analysis was performed (chi-square c², nonparametric Kruskal-Wallis test, Cramer's V and Cohen's d) with a significance level of 95% (p <0.05). The results related the use of pesticide with the degree of toxicity in the presence of hearing loss and indices of quality of life (p <0.001). This study proved that agricultural workers, users of pesticides showed the worst levels of quality of life when compared with those who have not handled them. The use of pesticides and their toxicity class interfered in a most striking way in the classification of hearing loss presented in this group and further studies are recommended to assess other impacts on this population.

Fatores associados às alterações da função pulmonar em trabalhadores de indústria de cerâmica / Factors associated with alterations in lung function among workers in the ceramics industry

O objetivo deste artigo é analisar a função pulmonar em trabalhadores de indústrias de cerâmica no município de Várzea Grande, Mato Grosso. Estudo transversal realizado com 183 trabalhadores de indústrias de cerâmica desse município. Para identificação dos fatores sociodemográficos, fatores ambientais e do tabagismo foi utilizado um questionário estruturado e para avaliação da função pulmonar foi realizada a espirometria. Foram realizadas análises descritiva, bivariada e regressão múltipla de Poisson. Os trabalhadores em sua maioria são do sexo masculino (94%) predominando indivíduos com idade até 39 anos (74,9%). A prevalência de sintomáticos respiratórios foi de 44,9%, sendo 14,8% portadores de sintomas considerados como graves e 30,1% sintomas não graves. Foram encontradas associações de função pulmonar alterada com as variáveis tempo de exposição e substância inalada. Os trabalhadores com 4 ou mais anos de exposição apresentaram 1,99 vezes mais função pulmonar alterada que os indivíduos com tempo de exposição de até 3 anos ; os indivíduos que inalaram poeira e desmoldante apresentaram 2,97 vezes mais alteração da função pulmonar. Esta, nos trabalhadores avaliados, está relacionada ao maior tempo de exposição e à inalação de poeira e desmoldante.

This article seeks to assess lung function in workers of ceramic industries in the municipality of Várzea Grande - Mato Grosso. A cross-sectional study of 183 workers was conducted in the ceramics town of Várzea Grande (MT). A structured questionnaire was used to identify socio-demographic factors, environmental factors and smoking. and spirometry was performed to evaluatie the pulmonary function. Descriptive analysis and bivariate and multiple Poisson regression were performed. The workers are mostly male (94%) with a predominance of individuals aged 39 years (74.9%). The prevalence of respiratory symptoms was 44.9%, 14.8 patients with symptoms considered serious and 30.1% with non-serious symptoms. Associations were found of abnormal pulmonary function with the variables of exposure time and substance inhaled. Employees with four or more years of exposure had 1.99 times more lung function alterations than individuals with exposure time of up to 3 years; individuals who had inhaled dust and mold release had 2.97 times higher alteration in lung function. The change in lung function in workers assessed is related to longer exposure and inhalation of dust and mold release.

Self-reported hearing performance in workers exposed to solvents / Autoavaliação de funções auditivas em trabalhadores expostos a solventes / Autoevaluación de funciones auditivas en trabajadores expuestos a solventes

OBJECTIVE: To compare hearing performance relating to the peripheral and central auditory system between solvent-exposed and non-exposed workers. METHODS: Forty-eight workers exposed to a mixture of solvents and 48 non-exposed control subjects of matched age, gender and educational level were selected to participate in the study. The evaluation procedures included: pure-tone audiometry (500 - 8,000 Hz), to investigate the peripheral auditory system; the Random Gap Detection test, to assess the central auditory system; and the Amsterdam Inventory for Auditory Disability and Handicap, to investigate subjects' self-reported hearing performance in daily-life activities. A Student t test and analyses of covariance (ANCOVA) were computed to determine possible significant differences between solvent-exposed and non-exposed subjects for the hearing level, Random Gap Detection test and Amsterdam Inventory for Auditory Disability and Handicap. Pearson correlations among the three measures were also calculated. RESULTS: Solvent-exposed subjects exhibited significantly poorer hearing thresholds for the right ear than non-exposed subjects. Also, solvent-exposed subjects exhibited poorer results for the Random Gap Detection test and self-reported poorer listening performance than non-exposed subjects. Results of the Amsterdam Inventory for Auditory Disability and Handicap were significantly correlated with the binaural average of subject pure-tone thresholds and Random Gap Detection test performance. CONCLUSIONS: Solvent exposure is associated with poorer hearing performance in daily life activities that relate to the function of the peripheral and central auditory system.

OBJETIVO: Comparar o desempenho das atividades diárias relacionadas a funções do sistema auditivo periférico e central entre trabalhadores expostos e não expostos a solventes. MÉTODOS: Participaram do estudo 96 trabalhadores, sendo 48 expostos a solventes e 48 não expostos, pareados por escolaridade, idade e sexo. Os procedimentos de avaliação incluíram: audiometria de tons puros (500 a 8.000 Hz), para avaliar o sistema auditivo periférico; teste de Random Gap Detection, para avaliar o sistema auditivo central; e o Amsterdam Inventory for Auditory Disability and Handicap, para estudar a performance em atividades da vida diária que envolvem a audição, por meio de autoavaliação. Teste t de student e a análise de covariância (ANCOVA) foram utilizados. Foram calculadas as correlações de Pearson entre os resultados dos três testes. RESULTADOS: Sujeitos expostos a solventes tiveram limiares auditivos significativamente piores na orelha direita que os sujeitos não expostos. Apresentaram também resultados significativamente piores no teste de Random Gap Detection e funcionamento autorreportado significativamente mais alterado que os sujeitos não expostos. Foi observada correlação significativa entre os resultados do Amsterdam Inventory for Auditory Disability and Handicap e a média binaural dos limiares auditivos e com os resultados do teste de Random Gap Detection. CONCLUSÕES: A exposição a solventes está associada com as dificuldades da vida diária relacionadas com as funções do sistema auditivo periférico e central.

OBJETIVO: Comparar el desempeño de las actividades diarias relacionadas a funciones del sistema auditivo periférico y central entre trabajadores expuestos y no expuestos a solventes. MÉTODOS: Participaron del estudio, 96 trabajadores, siendo 48 expuestos a solventes y no expuestos, pareados por escolaridad, edad y sexo. Los procedimientos de evaluación incluyeron: audiometría de sonidos puros (500 a 8.000 Hz), para evaluar el sistema auditivo periférico; prueba de Random Gap Detection, para evaluar el sistema auditivo central; y el Amsterdam Inventory for Auditory Disability and Handicap, para estudiar la performance en actividades de la vida diaria que envuelven la audición, por medio de auto-evaluación. Prueba t de Student y el análisis de covarianza (ANCOVA) fueron utilizados. Se calcularon las correlaciones de Pearson entre los resultados de las tres pruebas. RESULTADOS: Sujetos expuestos a solventes tuvieron umbrales auditivos significativamente peores en el oído derecho que los sujetos no expuestos. Se presentaron también resultados significativamente peores en la prueba de Random Gap Detection y funcionamiento auto-reportado significativamente más alterado que los sujetos no expuestos. Se observó correlación significativa entre los resultados del Amsterdam Inventory for Auditory Disability and Handicap y el promedio binaural de los umbrales auditivos y con los resultados de la prueba de Random Gap Detection. CONCLUSIONES: La exposición a solventes está asociada con las dificultades de la vida diaria relacionadas con las funciones del sistema auditivo periférico y central.

Linfoma no Hodgkin gástrico asociado a intoxicación por metales pesados / Gastric non-Hodgkin lymphoma associated with heavy metal exposures

El Linfoma no Hodgkin (LNH) extraganglionar es una neoplasia maligna que corresponde al 40% de los casos de LNH, siendo el tracto gastrointestintal (TGI) la localización más común. Dentro del TGI es el estómago el órgano más afectado (60%). Presentamos el caso de un hombre de 52 años trabajador en empresa minera por más de 10 años, el cual es derivado al Servicio de Gastroenterología por presentar un cuadro de epigastralgia, náuseas y baja de peso. La endoscopía digestiva mostró una lesión ulcerada en cuerpo gástrico a la cual se le tomaron múltiples biopsias. El estudio histológico y el posterior análisis inmunohistoquímico permitieron realizar el diagnóstico de LNH B difuso de células grandes. Asimismo, el paciente presentó compromiso de múltiples órganos en relación a exposición crónica de metales pesados, lo cual fue comprobado en el mineralograma, siendo las de mayor concentración el uranio, talio, arsénico, plomo y mercurio. En la literatura se ha descrito la asociación de exposición laboral crónica a Uranio y Arsénico con la presentación de LNH de compromiso gastrointestinal. Por tal motivo, el compromiso gástrico no se puede considerar como un daño aislado, sino más bien parte del compromiso sistémico asociado a concentraciones elevadas de metales. La minería constituye el principal motor de ingresos económicos para el Perú, sin embargo, no existen reportes hasta la fecha de la asociación de LNH de compromiso gastrointestinal en relación a exposición laboral a metales pesados.

Primary extranodal Non-Hodgkin lymphoma (NHL) is a non epithelial tumours that accounts for 40% of cases of NHL. Spread of nodal lymphomas to the gastrointestinal tract (GIT) is the most common location. Within the GIT is the stomach the most affected organ (60%). We report the case of 52-year- old man, mining company worker for over 10 years, which is derived to the Service of Gastroenterology with history of epigastric pain, nausea, vomiting and weight loss. Upper gastrointestinal endoscopic examination revealed an ulcerated lesion on greater curve of stomach and histopathological examination and subsequent immunohistochemical analysis showed diffuse large B cell gastric NHL. Also, the patient had multiple organ involvement in relation to chronic exposure to heavy metals, which was found in the mineralograma, with the highest concentration of uranium, thallium, arsenic, lead and mercury. The literature has described the association of chronic occupational exposure to uranium and arsenic with NHL presenting gastrointestinal involvement. Therefore, gastric commitment can not be considered as an isolated injury, but rather part of systemic involvement associated with elevated concentrations of metals. Mining is a key driver of income for Peru; however, there are no reports to date of the association of gastrointestinal NHL commitment regarding occupational exposure to heavy metals.

Alteraciones hematológicas en trabajadores expuestos ocupacionalmente a mezcla de benceno- tolueno-xileno (BTX) en una fábrica de pinturas / Blood disorders among workers exposed to a mixture of benzene-toluene-xylene (BTX) in a paint factory

Objetivos. Evaluar las tres series celulares sanguíneas e identificar la presencia de hipocromía, macrocitosis, leucopenia, linfocitopenia y trombocitopenia en un grupo de trabajadores expuestos a la mezcla de benceno-tolueno-xileno (BTX). Materiales y métodos. Estudio transversal donde se incluyó a 97 trabajadores de una empresa de pinturas de México a los que se les realizó una biometría hemática convencional y les fue estimada la exposición a través de la dosis diaria potencial acumulada para vapores de BTX. Resultados. Del total de trabajadores, 19,6%, mostró macrocitosis, 18,6%, linfocitopenia, 10,3% hipocromía, 7,2% trombocitopenia y 5,2% leucopenia. La asociación cruda de macrocitosis con exposición a dosis alta de mezcla de BTX fue la única significativa (OR:3,6; IC95%: 1,08 - 13,9; p=0,02) y en la que se estructuró un modelo de regresión logística (OR:6,7; IC95%: 1,33 - 13,55; p:0,02) ajustada por edad, consumo de alcohol y tabaquismo. Conclusiones. Todos los componentes citohemáticos analizados mostraron cambios leves; que podrían estar asociados con la exposición a la mezcla de BTX. De ellos, la macrocitosis podría constituirse en una manifestación precoz que merece ser vigilada.

Objectives. Evaluate the three blood cell series and identify the presence of hypochromia, macrocytosis, leucopenia, lymphopenia, and thrombocytopenia in a group of workers exposed to the mixture of benzene-toluene-xylene (BTX). Materials and methods. A cross-sectional study which included 97 workers from a paint factory in Mexico. The participants underwent conventional blood count and tests for potential cumulative daily dose of BTX fumes, to estimate exposure. Results. From the total of workers, 19.6% showed macrocytosis, 18.6%, lymphopenia, hypochromia 10.3%, 7.2% and 5.2% thrombocytopenia leukopenia. The crude association of macrocytosis with exposure to high doses of BTX mixture was the only with statistical significance (OR: 3.6, 95% CI 1.08 to 13.9, P = 0.02), and the base for a logistic regression model (OR: 6.7, 95% CI 1.33 to 13.55, P = 0.02) adjusted for age, alcohol consumption, and smoking. Conclusions. All blood cytological components analyzed demonstrated mild changes, potentially associated with exposure to the mixture of BTX. Macrocytosis could constitute an early manifestation worthy for surveillance.

Identifying Genetic Susceptibility to Sensitization to Cephalosporins in Health Care Workers

Exposure to cephalosporins could cause occupational allergic diseases in health care workers (HCWs). We evaluated the prevalence of serum specific IgE and IgG antibodies to cephalosporin-human serum albumin (HSA) conjugate and to identify potential genetic risk factors associated with sensitization to cephalosporins in exposed HCWs. The study population consisted of 153 HCWs who had been exposed to antibiotics in a single university hospital and 86 unexposed healthy controls. A questionnaire survey of work-related symptoms (WRS) was administered. A skin-prick test (SPT) was performed, and serum-specific IgE and IgG antibodies to 3 commonly prescribed cephalosporins were measured by ELISA. Four single-nucleotide polymorphisms of the candidate genes related to IgE sensitization were genotyped. The prevalence of WRS to cephalosporins was 2.6%. The prevalence rates of serum-specific IgE and IgG antibodies to cephalosporins were 20.3% and 14.7%, respectively. The FcepsilonR1beta-109T > C polymorphism was significantly associated with IgE sensitization to cephalosporins in HCWs (P = 0.036, OR = 3.553; CI, 1.324-9.532). The in vitro functional assay demonstrated that the T allele of FcepsilonR1beta-109T had greater promoter activity than did the C allele (P C polymorphism may be a potential genetic risk factor for increased IgE sensitization to cephalosporins.

A Case of Piperacillin-induced Occupational Anaphylaxis: Detection of Serum IgE to Piperacillin-HSA Conjugate

This is the first reported detection of serum IgE antibody to piperacillin-human serum albumin (HSA) conjugate in a patient presenting with anaphylaxis that developed after occupational exposure. A 24-yr-old nurse, who had worked at a University Hospital for 2 yr, experienced chest tightness, dizziness, generalized urticaria, abdominal pain, and diarrhea 10 min after administering a piperacillin injection. She had previously suffered from atopic dermatitis. A skin prick test for common inhalant allergens was entirely negative; in contrast, her serum total IgE was elevated (283 IU/mL). A high level of piperacillin-specific serum IgE was detected by ELISA using piperacillin-HSA conjugate. Significant inhibition upon addition of both free piperacillin and piperacillin-HSA conjugate was detected by inhibition ELISA. These data suggest that piperacillin exposure in the workplace can induce occupational anaphylaxis and urticaria mediated by an interaction of IgE with the hapten of piperacillin.