Interaction of Smoking and Lead Exposure among Carriers of Genetic Variants Associated with a Higher Level of Oxidative Stress Indicators.

Smoking and lead (Pb) exposure increased oxidative stress in human body, and people with some gene variants may be susceptible to Pb and smoking via oxidative stress. The aim of this study is to evaluate oxidative stress by measuring thiobarbituric acid reactive substances (TBARS) and the relationship of lipid peroxidation markers in Pb workers with different gene polymorphisms (rs4673 and rs1050450) in both smokers and nonsmokers. Blood samples were collected from 267 Pb workers who received their annual health examination in the Kaohsiung Medical University Hospital. Glutathione peroxidase 1 (GPx-1) rs1050450 and cytochrome B-245 Alpha Chain (CYBA) rs4673 single-nucleotide polymorphisms (SNP) were analyzed by specific primer-probes using Real-Time PCR methods. The interaction between blood Pb and smoking increased serum levels of TBARS and the ratio of oxidative low-density lipoprotein and low-density lipoprotein (oxLDL/LDL). Analysis of workers with rs1050450 SNPs showed higher blood Pb levels in the workers with CC genotype than those with CT genotype. Smokers had significantly higher blood Pb, alanine transaminase (ALT), TBARS, and OxLDL levels than nonsmokers. TBARS increased 0.009 nmol/mL when blood Pb increased one µg/dL in smokers compared to nonsmokers. The ratio of OxLDL/LDL increased 0.223 when blood Pb increased one µg/dL in smokers compared to nonsmokers. TBARS levels and the ratio of OxLDL/LDL were positively correlated and interacted between blood Pb and smoking after the adjustment of confounders, suggesting that smoking cessation is an important issue in the Pb-exposed working environment.

Night-shift work and risk of compromised visual acuity among the workers in an electronics manufacturing company.

OBJECTIVES: To evaluate the association between night-shift work exposure and visual health, this cross-sectional study utilized visual acuity, a surrogate measure for visual function, as a parameter, and performed an analysis comparing visual acuity between daytime and nighttime employees in an electronics manufacturing company. MATERIAL AND METHODS: Data of personal histories, occupational records, physical examinations and blood tests was obtained from the electronic health records of workers. The total of 8280 workers including 3098 women and 5182 men, wearing their own daily used eyeglasses, were included in the final analysis. The mean age of the sample population was 34.7 years old (standard deviation = 5.4 years). All workers were divided into 3 work categories - consistent daytime worker (CDW), day-shift worker (DSW) and night-shift worker (NSW). The check-up results of glasses-corrected visual acuity (c-VA) were utilized to classify individuals as good (≥ 1.2, both eyes) and inadequate (< 0.8, the better eye) c-VA. RESULTS: Consistent daytime workers had the highest rate of good c-VA (42.5% vs. 25.1% DSW and 21.1% NSW, p = 0.047). Night-shift workers had the highest rate of inadequate c-VA (CDW, DSW and NSW: 2.6%, 6.2%, and 7.6%, p = 0.03) among all employees. After controlling for covariates, NSW were found at an increased risk for inadequate c-VA (adjusted odds ratio (ORa) = 2.7, 95% confidence interval (CI): 2.0-3.6, vs. CDW), and less likely to have good c-VA (ORa = 0.4, 95% CI: 0.4-0.5, vs. CDW). CONCLUSIONS: Night-shift work is moderately associated with compromised visual acuity of employees in this electronics manufacturing company. Int J Occup Med Environ Health 2018;31(1):71-79.

Acute aortic dissection type A with acute coronary involvement: a novel classification.

BACKGROUND: Acute coronary involvement (ACI) due to acute aortic dissection (AAD) type A is potentially fatal. We examined selected patients with AAD type A, which had evolved over 14 years, and acute coronary involvement. The purpose of this study was to determine the characteristics of patients with ACI due to AAD type A. METHODS: Between 1997 and 2011, we recruited 20 patients (14.1%) with ACI (14 men, 6 women; mean age: 51.8 ± 11.8 years; age range: 35-79 years) from 142 patients who had undergone surgical repair of AAD type A. RESULTS: We propose a novel 4-category classification scheme based on the surgical pathological findings. The right coronary artery was involved in 15 patients, and the left was involved in 5 patients. Fourteen patients had preoperative myocardial ischemia. In the other 6 patients, acute coronary involvement was found intraoperatively. Patients with ACI were significantly younger than those without ACI (51.8 ± 11.8 vs. 61.0 ± 11.8; p = 0.001), a lower prevalence of intramural hematoma (5.0% vs. 32.8%; p = 0.011), a higher aortic regurgitation rate (95.0% vs. 53.5%; p = 0.001). Patients presenting with ACI had an in-hospital mortality rate of 20.0% (4/20), while those without ACI had an in-hospital mortality rate of 19.7% (24/122). CONCLUSIONS: Acute coronary involvement due to AAD type A is not always associated with coronary malperfusion. Patients with ACI were much younger, had a higher aortic regurgitation rate, and, less commonly, had intramural hematoma. This new classification scheme would make it more convenient for surgeons to decide on treatment options for this special cohort.