Ointment is evenly spread on the skin, in contrast to creams and solutions.

BACKGROUND: The efficacy of topical therapy depends on the patient spreading the topical drug in an even layer to give a standard dose. Ointments are believed to be more effective than creams and solutions. OBJECTIVES: To compare the application and spreading of four different pharmaceutical vehicles. METHODS: Twenty-nine healthy volunteers applied a fixed amount (0.1 g) of solution (S), ointment (O), cream (C) and low-viscosity cream (LVC) to the abdominal skin. Area of spread, skin surface lipids (dependent on formulation) and changes in skin surface temperature (cooling due to evaporation of formulation water/alcohol) were measured. RESULTS: Area of spread: O = C = LVC = S. Skin surface lipids: O > C > LVC > S. Difference in skin surface lipids between centre and periphery: O < C = LVC = S. Cooling: O < C = LVC < S. CONCLUSIONS: The four formulations were spread to similar areas. The ointment was spread evenly in the treated area while the other formulations were unevenly spread, with a lower dose in the periphery. Creams and solutions have disadvantages as vehicles, as rapid evaporation of formulation water/alcohol, measured as cooling, influences spread, resulting in an uneven topical dose within the treated area. In contrast, ointment is evenly spread and is thus a more appropriate formulation. Patients should be instructed to apply creams and solutions to multiple sites and to spread them quickly.

Comparison of two pH meters used for skin surface pH measurement: the pH meter 'pH900' from Courage & Khazaka versus the pH meter '1140' from Mettler Toledo.

BACKGROUND/AIMS: Measurement of skin surface pH is used in clinical research to evaluate hazardous shifts in pH following external exposures and to evaluate the state of diseased skin with acute or chronic changes. It is therefore important to measure skin surface pH as precisely as possible. The aim of this study was to compare two commercially available pH meters used for skin surface pH measurement, to reveal differences between them in measured skin pH on the forearm. METHODS: The first pH meter (pH900) had a pointed electrode and a stabilisation period of 3 s. The second pH meter (pH meter 1140) had a circular electrode and no fixed stabilisation period. Twelve healthy subjects (6 male and 6 female Caucasians) entered the study. The pH measurements were performed once an hour from 8 a.m. to 3 p.m. on both forearms in five areas from the elbow to the "wristwatch" zone. In each area, three measurements were performed next to each other with both pH meters (15 measurements per arm per hour per pH meter). RESULTS: The pH900 has a higher measuring level and a higher variation than the pH meter 1140. CONCLUSION: A skin surface pH meter with a circular electrode and with no fixed stabilisation period is preferable. It is recommended that the pH meter be allowed to stabilise for at least 7 s before the result is read.

Females have lower skin surface pH than men. A study on the surface of gender, forearm site variation, right/left difference and time of the day on the skin surface pH.

BACKGROUND/AIMS: It is of great interest to describe the many functions and properties of the skin in order to better understand reactions that result in different skin abnormalities, as a prerequisite in the development of skin products and topical medicines. Skin surface pH is considered a critical parameter of skin wellbeing and is typically studied on the forearm skin. Despite many previous investigations, this is an extensive field that still needs a great deal of research. The aim of our study was to investigate gender related differences, differences between right and left arms, anatomical variation and daytime variation in skin surface pH. METHODS: Skin surface pH was measured on the flexor surface of the forearm on eleven healthy volunteers (6 men and 5 women). A Mettler Toledo pH meter (pH meter 1140) was used. The subjects were measured once every hour from 8 a.m. to 3 p.m. in five areas from the elbow to the wrist. In each of the five areas, three measurements were performed next to each other, and the mean of these was used in subsequent calculations. RESULTS: A statistically significant difference in skin pH between men (mean pH=5.80) and women (mean pH=5.54) was found, with women being more acidic than men (P<0.01). No difference between right and left arm was found. In men, the area closest to the wrist had significantly lower pH values compared with the proximal sites. This was not the case in women. Skin surface pH decreased during normal working hours in both genders. CONCLUSION: Spontaneous skin surface pH was found to be significantly lower in women, as compared to men--albeit, the difference was small and of unknown relevance. Nevertheless, comparative studies on skin surface pH should be balanced with respect to gender. There appeared to be no right/left difference and no systematic change during the working day. Also, measurements should not be conducted close to the wrist.

Exposure-response relationship between gastrointestinal problems among waste collectors and bioaerosol exposure.

OBJECTIVES: A high frequency of gastrointestinal problems has previously been reported for waste collectors. The present study relates the gastrointestinal problems to measurements of the bioaerosols that waste collectors are exposed to during work. METHODS: A job-exposure matrix was constructed from a combination of questionnaire data and field measurements. The questionnaire data were collected from 1747 male waste collectors and a comparison group of 1111 male municipal workers. Moreover a total of 189 full-shift personal samples was collected. The samples were used for characterizing the bioaerosol exposure described by viable fungi, total count of fungal spores, microorganisms, and endotoxins. RESULTS: In a multivariate analysis, high exposure to endotoxins was associated with nausea [prevalence proportion ratio (PPR) 1.60], and the risk of reporting nausea decreased with decreasing exposure so that workers with low exposure had the fewest reports (PPR 1.39) in the comparison with the unexposed group. High exposure to endotoxins was also associated with reports of diarrhea (PPR 5.60), and the risk of reporting diarrhea decreased with decreasing exposure so that the workers with low exposure had the fewest reports (PPR 3.02). The same pattern existed for exposure to fungi, for which high exposure resulted in the most reports (PPR = 4.59), and for diarrhea, for which low exposure resulted in the fewest reports (PPR = 3.15). CONCLUSIONS: An exposure-response relationship was found between nausea and endotoxin exposure and between diarrhea and exposure to both endotoxins and viable fungi.

Injuries among domestic waste collectors.

Detailed information on occupational injuries and the precise number of injuries among waste collectors is missing. In this study, risk circumstances associated with injuries among waste collectors were analyzed and described. The study was carried out in a single company with 667 employees in 1993. For each injury, information was collected on date, time, type, and severity of the injury, injury circumstances, department of employment, external or internal registration, sex, year of birth and employment, type of employment, and a registration of where the injury happened. A total of 17% of the employees experienced injury. The number of injuries decreased with increasing seniority and age. Most injuries occurred outside the company area. More injuries occurred on Mondays and Thursdays, and there were peaks in the injury rate in May and September. Most often injured was the back, followed by the knees, hands, and feet. The job as a waste collector was associated with a high risk of experiencing an occupational injury and the number of injuries decreased with increasing seniority and nonsignificantly with increasing age. Moreover, a seasonal and weekly variation was observed.

Comparison of a self-administered questionnaire and a telephone interview of 146 Danish waste collectors.

Methods to collect epidemiologic data include, among other means, self-administered questionnaires and personal and telephone interviews. In some studies, these data collection methods are used simultaneously. However, little is known about the comparability of the data obtained, thus, the validity of pooling data. A self-administered questionnaire was completed by 146 waste collectors, who participated in a telephone interview 3 months later. The responses to health questions were compared. Agreement percentages and kappa values were calculated. An answer pattern shift was detected in a subgroup of questions with five answer options. Grouping the answer options diminished the shift in the answer pattern. The questions in a yes/no format generally showed no shift in the answer pattern. The study indicates that caution should be exercised when pooling data collected by self-administered questionnaire and telephone interview in epidemiological research. Some types of questions seem to be sensitive to the data collection method.

Season, equipment, and job function related to gastrointestinal problems in waste collectors.

OBJECTIVES: Informal reports have suggested that work as a waste collector entails exposures that cause gastrointestinal symptoms--such as nausea and diarrhoea. This study explores this hypothesis by correlating data on the type of waste collected, the persons' job function, the equipment used, and the times of the week and the year of reported nausea and diarrhoea. METHODS: 1747 male waste collectors and a control group for comparison of 1111 male municipality workers answered a questionnaire on work environment, work related exposure, and health status. RESULTS: In a multivariate analysis collection of organic and residual waste (prevalence proportion ratio (PPR) 1.45) and mixed household waste (PPR 1.43) were associated with reported nausea and so was the job loader (PPR 1.51). More symptoms were reported in the summer. Multivariate analysis of diarrhoea showed that the job front runner was associated with reported diarrhoea (PPR 1.22) and so was the job loader (PPR 1.26). More symptoms occurred in the summer. The workers stated that the gastrointestinal symptoms were related to the smell of rotten waste. This may support the hypothesis that microbial compounds were the causal agents. CONCLUSION: The gastrointestinal symptoms were associated with the job of waste collector and moreover the symptoms predominantly occurred in the summer.

Collection of domestic waste. Review of occupational health problems and their possible causes.

During the last decade, a growing interest in recycling of domestic waste has emerged, and action plans to increase the recycling of domestic waste have been agreed by many governments. A common feature of these plans is the implementation of new systems and equipment for the collection of domestic waste which has been separated at source. However, only limited information exists on possible occupational health problems related to such new systems. Occupational accidents are very frequent among waste collectors. Based on current knowledge, it appears that the risk factors should be considered as an integrated entity, i.e. technical factors (poor accessibility to the waste, design of equipment) may act in concert with high working rate, visual fatigue due to poor illumination and perhaps muscle fatigue due to high work load. Musculoskeletal problems are also common among waste collectors. A good deal of knowledge has accumulated on mechanical load on the spine and energetic load on the cardio-pulmonary system in relation to the handling of waste bags, bins, domestic containers and large containers. However, epidemiologic studies with exposure classification based on field measurement are needed, both to further identify high risk work conditions and to provide a detailed basis for the establishment of occupational exposure limits for mechanical and energetic load particularly in relation to pulling, pushing and tilting of containers. In 1975, an excess risk for chronic bronchitis was reported for waste collectors in Geneva (Rufèner-Press et al., 1975) and data from the Danish Registry of Occupational Accidents and Diseases also indicate an excess risk for pulmonary problems among waste collectors compared with the total work force. Surprisingly few measurements of potentially hazardous airborne exposures have been performed, and the causality of work-related pulmonary problems among waste collectors is unknown. Recent studies have indicated that implementation of some new waste collection systems may result in an increased risk of occupational health problems. High incidence rates of gastrointestinal problems, irritation of the eye and skin, and perhaps symptoms of organic dust toxic syndrome (influenza-like symptoms, cough, muscle pains, fever, fatigue, headache) have been reported among workers collecting the biodegradable fraction of domestic waste. The few data available on exposure to bio-aerosols and volatile compounds have indicated that these waste collectors may be simultaneously exposed to multiple agents such as dust containing bacteria, endotoxin, mould spores, glucans, volatile organic compounds, and diesel exhaust. Several studies have reported similar health problems as well as high incidence rates of pulmonary disease among workers at plants recycling domestic waste.(ABSTRACT TRUNCATED AT 400 WORDS)

Sorting and recycling of domestic waste. Review of occupational health problems and their possible causes.

In order to reduce the strain on the environment from the deposition of waste in landfills and combustion at incineration plants, several governments throughout the industrialized world have planned greatly increased recycling of domestic waste by the turn of the millennium. To implement the plans, new waste recycling facilities are to be built and the number of workers involved in waste sorting and recycling will increase steadily during the next decade. Several studies have reinforced the hypothesis that exposure to airborne microorganisms and the toxic products thereof are important factors causing a multitude of health problems among workers at waste sorting and recycling plants. Workers at transfer stations, landfills and incineration plants may experience an increased risk of pulmonary disorders and gastrointestinal problems. High concentrations of total airborne dust, bacteria, faecal coliform bacteria and fungal spores have been reported. The concentrations are considered to be sufficiently high to cause adverse health effects. In addition, a high incidence of lower back injuries, probably due to heavy lifting during work, has been reported among workers at landfills and incineration plants. Workers involved in manual sorting of unseparated domestic waste, as well as workers at compost plants experience more or less frequent symptoms of organic dust toxic syndrome (ODTS) (cough, chest-tightness, dyspnoea, influenza-like symptoms such as chills, fever, muscle ache, joint pain, fatigue and headache), gastrointestinal problems such as nausea and diarrhoea, irritation of the skin, eye and mucous membranes of the nose and upper airways, etc. In addition cases of severe occupational pulmonary diseases (asthma, alveolitis, bronchitis) have been reported. Manual sorting of unseparated domestic waste may be associated with exposures to large quantities of airborne bacteria and endotoxin. Several work functions in compost plants can result in very high exposure to airborne fungal spores and thermophilic actinomycetes. At plants sorting separated domestic waste, e.g. the combustible fraction of waste composed of paper, cardboard and plastics, the workers may have an increased risk of gastrointestinal symptoms and irritation of the eyes and skin. At such plants the bioaerosol exposure levels are in general low, but at some work tasks, e.g. manual sorting and work near the balers, exposure levels may occasionally be high enough to be potentially harmful. Workers handling the source-sorted paper or cardboard fraction do not appear to have an elevated risk of occupational health problems related to bioaerosol exposure, and the bioaerosol exposure is generally low.(ABSTRACT TRUNCATED AT 400 WORDS)