Development of Liquid-Chromatography Tandem-Mass-Spectrometry Method for Determining Environmental Contamination by Powdered Medicinal Drugs in Pharmacies.

The environment and personnel are both exposed to powdered pharmaceuticals inside pharmacies. This makes developing new methods for rapidly determining such contaminants an important objective. In this study, we developed a liquid-chromatography tandem-mass-spectrometry (LC-MS/MS) method for the simultaneous qualitative and quantitative determination of powdered medicinal drugs, such as famotidine, risperidone, lansoprazole, olanzapine, haloperidol, clarithromycin, promethazine, levomepromazine, and chlorpromazine. The method involves the use of acetaminophen as the internal standard, an LC-MS/MS method with a core-shell column, and a 10 mM ammonium formate/acetonitrile gradient mobile phase. The analytes were separated within 14 min, and MS with an electrospray ionization source in positive-ion mode was used. The limits of detection for the 9 drugs were .1-8.4 ng/mL. Linear calibration curves in the 10-50 000 ng/mL range were constructed, and inter-day accuracies of 92.6-113.8% were determined for the 9 drugs. The coefficients of variation were less than 14.6%. These data suggest that the proposed method is applicable for the routine assaying of powdered-medicine contamination in pharmacies.

Occupational Fatalities Due to Mammal-Related Accidents in Japan, 2000-2019.

INTRODUCTION: Animal-related fatal accidents occur annually while individuals are outside working. This study intended to evaluate the trends of occupational fatal accidents related to mammals and compare them with nonoccupational accidents. METHODS: We collected occupational and nonoccupational fatalities related to mammals between 2000 and 2019 from data on fatal occupational accident cases certified by the Ministry of Health, Labor and Welfare, Japan, in addition to other statistics from relevant ministries, media reports such as newspapers, and academic case reports. RESULTS: A total of 109 fatal accidents related to mammals were confirmed as occurring during work, and 129 were confirmed as taking place outside of work. Of the former, accidents among livestock farmers and horse racing-related workers accounted for about half. Among the accidents not related to work, dog attacks, infectious diseases from cats or dogs, traffic accidents with wild animals, and bear attacks during wild vegetable picking were common. Deaths from infectious diseases caused by dogs and cats have rarely been reported in the mass media. CONCLUSIONS: Although the number of fatal occupational accidents related to mammals is not large, we concluded that it is necessary to continue preventive measures centered on accidents at livestock farms and in horse racing-related workplaces. It is also necessary to inform people about the risks of infectious diseases mediated by dogs and cats.

Suspended particle and drug ingredient concentrations in hospital dispensaries and implications for pharmacists' working environments.

OBJECTIVES: The aim of this study was to assess the present status of working environments for pharmacists, including the concentrations of suspended particles and suspended drug ingredients in dispensaries. METHODS: We conducted a survey on the work processes and working environment in 15 hospital dispensaries, and measured the concentrations of suspended particles and suspended drug ingredients using digital dust counter and high-performance liquid chromatography tandem mass spectrometry (LC-MS/MS), respectively. Of 25 types of powdered drugs that were frequently handled in the 15 dispensaries surveyed, 11 could be quantitatively determined. RESULTS: The amounts of suspended particles were relatively high, but below the reference value, in three dispensaries without dust collectors. The sedative-hypnotic drug zopiclone was detected in the suspended particles at one dispensary that was not equipped with dust collectors, and the antipyretic and analgesic drug acetaminophen was detected in two dispensaries equipped with dust collectors. There was no correlation between the daily number of prescriptions containing powdered drugs and the concentration of suspended particles in dispensaries. CONCLUSION: On the basis of the suspended particle concentrations measured, we concluded that dust collectors were effective in these dispensaries. However, suspended drug ingredients were detected also in dispensaries with dust collectors. These results suggest that the drug dust control systems of individual dispensaries should be properly installed and managed.

Prevalence of subjective symptoms among hospital pharmacists and association with drug compounding practices.

In Japan, the principal role of hospital pharmacists has changed from that of dispensing medicines for outpatients to provision of clinical pharmacy services for inpatients. A self-administered questionnaire about subjective symptoms, working patterns, work environments and job satisfaction was administered to 495 hospital pharmacists and 84 prefectural office-based pharmacists (control group). The response rates were 63.4% and 90.5%, respectively. Hospital pharmacists showed a higher prevalence of nasal symptoms than that shown by the control office-based pharmacist group. The prevalence rate of nasal symptoms was lower only in male pharmacists who worked in a dispensary equipped with dust collector. The prevalence of symptoms noticed by hospital pharmacists and community pharmacists after starting drug compounding practices was also compared. The prevalence of subjective symptoms that pharmacists noticed after starting drug compounding was lower in hospital pharmacists than in community pharmacists. Job satisfaction was lower in hospital pharmacists than in office-based pharmacists; however, there was no clear association between the subjective symptoms reported and job satisfaction. Further studies on removal effect of drug dust in a dispensary and symptoms in individual pharmacy facilities are needed.

Views of old age and death held by working-age men and women and their relationship to health-related behavior.

BACKGROUND: Many working-age people have poor health habits. The aim of this study was to investigate their views of old age and death and the relationship of those views to their health habits. METHODS: A structured interview about views on old age and death, self-rated health, satisfaction with life (life satisfaction) and health habits was conducted on a random sample of 1,200 men and women aged 30-59 years in the southern part of Gifu Prefecture, Japan. The response rate was 78%. RESULTS: Less than half as many respondents expected to live past 80 years than expected to live past 70 years. A greater percentage of men than women had no plan for old age, while the percentage of women who expected to live with friends and family was higher than that for men. For men, fewer symptoms, life satisfaction, valuing health, and anxiety about health status during solitary old age, and for women, occupation, fewer symptoms, life satisfaction, valuing health, expecting social participation during old age, expecting to live with her spouse during old age and considering one's own death were positively associated with health habits. Experience of presence at a deathbed was not related to health habits. CONCLUSIONS: Results of our survey suggest that men have a poor outlook toward old age and death and suggest the possibility that helping men prepare for an inevitable death may help them live fuller lives.

Relationship of health services to medical expenses for the national health insurance and certification rate for long-term care insurance services in municipalities.

In many municipalities, implementation rates of health services mandated by the Health and Medical Service Law for the Elderly have not reached the national goal that was set at the start. This study aimed to evaluate the effects of health services using medical expenses for the National Health Insurance (NHI) and certification rate for long-term care insurance services in 99 municipalities in Gifu Prefecture as indices. Both indices were standardized by the age composition of the population. Among the health services, visit rates for health examinations or implementation rates for health education or health counseling correlated negatively with medical expenses for each insured person. The visit rate for gastric cancer screening correlated negatively with medical expenses for malignant neoplasms of the stomach. Implementation rates of health education or health counseling, or ratios of public health nurses correlated positively with certification rates for long-term support need and care need grade 1, and negatively with those for long-term care need grades 2, 3, and 4. The author concluded that medical expenses are reduced by the implementation of available health services, that early detection and prevention of aggravation of disease is essential for those who need long-term care services, and that health services must be reinforced with primary prevention.