The correlation between blood and urine level of cadmium and nasal and paranasal sinuses disorders.

Over exposure to cadmium may produce numerous adverse health effects, including changes in the nasal mucosa. Cadmium levels were measured in blood and urine samples taken from 106 workers who were exposed to high levels of cadmium and nickel in a cadmium nickel battery plant. Pathological results were observed in 46% and 51% of the blood and urine samples respectively. A positive association was found between clinical nasal complaints and pathological levels of cadmium in blood (P = 0.006) and urine (P = 0.045) samples. All the workers underwent sinus X-rays and 63% of them were abnormal. No correlation was found between pathological sinus X-rays and pathological cadmium level in blood and urine samples. A positive correlation was found between clinical nasal complaints and abnormal sinus X-rays. The prevalence of sinus X-ray abnormalities in an asymptomatic general population is 33% as compared to 63% in our study. This difference is highly significant statistically (P < 0.0001). Our result shows a possible harmful effect of cadmium on the paranasal sinuses.

Worksite screening for high blood cholesterol: implications for detection, evaluation and treatment--the Israel CORDIS Study.

Current recommendations for optimal blood cholesterol levels could have major implications for the detection, evaluation and treatment of high blood cholesterol in Israel. During 1985-87, in the framework of the CORDIS Study, a sample of 3,556 males and 1,558 females, aged 20-64, employed in Israeli industry were screened at the worksite for lipids, lipoproteins and other cardiovascular risk factors. From the age-group 20-24 to 60-64 years, the prevalence of high blood cholesterol (greater than 239 mg/dl) increased from 1.6% to 34.3% for males and from 5.4% to 36.7% for females. Ethnic differences were present, with those from Western countries generally having the highest prevalence. When examined in two age-groups, 20-44 and 45-64 years respectively, 28.6% and 54% of males and 8.8% and 37.5% of females had a combination of cholesterol levels and coronary heart disease (CHD) risk factors for which lipoprotein analysis is currently recommended. There was an increase in the prevalence of high blood cholesterol with increased number of non-lipid CHD risk factors (for 0 to greater than or equal to 3 risk factors, age-adjusted prevalence ranged from 18.2 to 37.5% for males and 9.6% to 41.4% for females). Less than 5% of those with high blood cholesterol were aware of their condition, and less than 1% were under treatment. The prevalence of high blood cholesterol in the working population is Israel appears to be similar to that of the United States. Age-related changes in low density and high density lipoprotein cholesterol levels are such that monitoring of cholesterol in most people need not be more frequent than every 3-5 years. Any cholesterol screening program should be designed to allow for varying schedules according to age, sex and the presence of other risk factors for cardiovascular disease.

Blood pressure and serum cholesterol among male Ethiopian immigrants compared to other Israelis.

STUDY OBJECTIVE: The aim was to determine the effect of migration from a non-industrialised to an industrialised society on age related changes in blood pressure and serum cholesterol. DESIGN: The study was a comparison of major risk factors for cardiovascular disease in cross sectional surveys in two groups: Ethiopian immigrants and Israeli industrial employees. SETTING: Ethiopian immigrants were examined at Army induction centres in Israel; industrial employees were examined in the course of a national Israeli study on occupational risk factors for cardiovascular disease. PARTICIPANTS: Participants were a sample of 387 male Ethiopians, aged 20-49 years, examined in 1987, who had immigrated to Israel three to four years previously, and a sample of 2747 male Israeli industrial employees in the same age group examined in 1985-7. MEASUREMENTS AND MAIN RESULTS: Among the Ethiopians there were no cases of overweight (Quetelet's index above 2.8) and only 6.7% were smokers, as compared with 20.7% overweight and 47.1% smokers among the other Israelis (p less than 0.001 for both variables). There were no significant differences in the prevalence of hypertension (11.6% and 13.0% for Ethiopians and other Israelis respectively). Hypercholesterolaemia (greater than 5.2 mmol/litre, 200 mg/dl) was much more prevalent among the other Israelis (42.0% v 9.6%, p less than 0.001). Blood pressures were similar and increased with age in both groups. However, in contrast to the other Israelis, average serum cholesterol among the Ethiopians was low and increased minimally with age. After regression adjustment for age and body mass index, blood pressures were higher among the Ethiopians, whereas serum cholesterol remained considerably higher among the other Israelis. Serum cholesterol was correlated with blood pressure in both groups. CONCLUSIONS: Since Ethiopian immigrants have been found to have uniformly low blood pressures on arrival in Israel, these findings suggest that there is an age dependent effect on blood pressure resulting from migration which is not reflected in the serum cholesterol values.

Ergonomic stress levels, personal characteristics, accident occurrence and sickness absence among factory workers.

This study was designed to evaluate the association of a single, integrated measure of simultaneous exposure to a number of adverse work and environmental conditions, termed the Ergonomic Stress Level (E-S-L), on workers' accident and sickness absence rates. The factors determining the E-S-L were body motion and posture, physical effort, active hazards and environmental stressors. E-S-L evaluation was based on 'walk-through' hazard inventories, direct observations, measurements and interviews. Workers were assigned to one of four stress levels ranging from low (A) to high (D). Subjects were 729 males, aged 20-67 years, employed in five factories in Israel. A linear relationship between E-S-L AND accident incidence was found, increasing from the lowest to the highest E-S-L. Moreover, workers more sensitive to environmental stressors, as indicated by their reported subjective annoyance, showed higher accident rates across all the ergonomic stress levels, a tendency which was statistically significant at levels C and D. On the other hand, sickness absence was significantly related to the overall subjective stress experienced, as manifested by reported job dissatisfaction and somatic complaints, and not directly to E-S-L. These findings highlight the role of aggregate work stress, coupled with individual sensitivity to environmental stressors, in increasing the risk of accidents.

Prevalence and correlates of ventricular premature beats detected by ambulatory electrocardiography in working populations.

The associations of ventricular premature beats detected on a one-hour ambulatory electrocardiogram with demographic, behavioral, physiologic, and anthropometric variables were examined in 2,331 factory workers aged 20-69 years. Ventricular premature beats were more prevalent with increasing age and with abnormal resting electrocardiograms. From the age of 40, they were more common among males than among females. An association with ethnicity was observed, ventricular premature beats being most common among Israelis of European origin. In univariate analysis, resting heart rate was inversely associated with the presence of ventricular premature beats for females only. Ambulatory heart rate was positively associated with ventricular premature beats only among males. No associations with smoking habits or relative weight were found. Among males and females with normal electrocardiograms, systolic and diastolic blood pressures were significant correlates of ventricular premature beats in univariate analysis and after controlling for age, resting and ambulatory heart rates, and ethnic origin.

Interrelationships between blood pressure, serum calcium and other biochemical variables.

The association of serum calcium with blood pressure (BP), was examined in a group of 727 male industrial workers aged 20-69 in Israel, who underwent screening for risk factors for cardiovascular disease. Serum calcium was found to be significantly correlated with systolic BP (r = 0.18, p less than 0.001) only among those under the age of 40. This association persisted after adjustment for age and serum albumin levels but was not statistically significant after further adjustment for serum cholesterol. These findings contribute to the evidence implicating calcium as a key factor in the control of blood pressure. However, the fact that adjustment for serum cholesterol levels eliminated the significance of the association between BP and serum calcium suggests that this association may not be direct.

Association of serum lipids with coffee, tea, and egg consumption in free-living subjects.

The associations of serum lipids with coffee, tea, and egg consumption were examined in a survey of 658 men in Israel. A significant, positive association was found between coffee consumption and serum total cholesterol (TC), mainly reflecting a difference in the low density lipoprotein cholesterol (LDL-C). Among the subjects aged 20-39, the difference in TC between the lowest and highest consumption categories was 13.2 mg/dl, and among those aged 40-69 the difference was 7.4 mg/dl. An even stronger, negative association between tea intake and TC was present; the difference between the lowest and highest consumption categories was 28.7 mg/dl for the younger subjects and 18.4 mg/dl for the older group. On the other hand, serum TC levels were not elevated at higher levels of whole egg consumption. Thus, allowing for the bias inherent in dietary recall, coffee and tea consumption appear to be associated more strongly with serum lipid and lipoprotein levels than egg consumption.

Blood pressure in smokers and nonsmokers: epidemiologic findings.

Although cigarette smoking produces an acute rise in blood pressure (BP), results from epidemiologic studies have generally shown smokers to have lower BP than nonsmokers. This phenomenon has frequently been ascribed to a failure to account for other BP-associated differences between smokers and nonsmokers. Consequently, the role of cigarette smoking as a risk factor for hypertension remains unclear. In this article the results of a large epidemiologic study of smoking and BP in a working population are presented. The results show a pattern of higher BP among nonsmokers and ex-smokers than among smokers. These differences could not be explained by various potentially confounding factors, such as relative weight, ethnic origin, alcohol and coffee intake, and participation in leisure time sports. While the considerable adverse effects of smoking on health are well established, the role of smoking as a risk factor for hypertension is not supported by the epidemiologic evidence. Furthermore, the data are highly suggestive of lower BP among smokers compared with nonsmokers, whereas ex-smokers have BPs similar to those of nonsmokers.

Inconsistencies in the correlates of blood pressure and heart rate.

Various correlates of blood pressure (BP) and resting heart rate (HR) were compared in a study population of 1667 male and 520 female factory employees in Israel. The strong positive association between HR and both diastolic and systolic BP described in other epidemiologic studies was again evident. However, the correlates of HR and BP did not coincide. In multiple regression analyses age was found to be positively associated with BP in both sexes, whereas it was only moderately associated with HR in males and inversely associated with HR in females. Relative weight was positively associated with BP in both sexes but its association with HR was linear in young males and older females and U- or J-shaped in the other sub-groups. Cigarette smoking was inversely associated with diastolic BP in several subgroups but was positively associated with HR in most sub-groups. Ethnic-related variations in blood pressure, where found, did not parallel any differences in HR and in one group they were contradictory. The inconsistencies in the correlates of HR and blood pressure may reflect different mechanisms by which certain factors influence BP with varying effects on the HR.

Ethnic differences in selected cardiovascular disease risk factors in Israeli workers.

Ethnic differences in the distribution of risk factors for coronary heart disease were investigated between 1979 and 1982 in 2,355 Jewish and Arab factory employees in Israel. Among both sexes, blood pressure (BP) was found to be significantly higher in those of European origin than in those of Asian or North African origin, mainly in the 20- to 39-year age-group. Ethnic differences in height and weight were generally more marked than those in Quetelet's index. Among older men, Western Europeans smoked the least. They had the highest prevalence of ECG abnormalities and of cardiovascular disease. Arab workers from the Gaza Strip had the highest smoking rates and the lowest prevalence of ECG abnormalities and awareness of cardiovascular disease. After adjusting for age, Quetelet's index, smoking and place of employment, ethnic differences in BP and heart rate were apparent in both sexes, but were more significant among men. The findings indicate that ethnic differences in BP noted in earlier studies are evident in the younger age-group, whereas smoking behavior and relative weight differ mainly at an older age.