Dairy producer attitudes to pain in cattle in relation to disbudding calves.

Pain is an important indicator of poor welfare of livestock. Despite this, pain has largely gone unrecognized in farm animals due to attitudes of producers and veterinarians, although they play a key role in monitoring and managing the perception of animal pain. Producer attitudes toward animal welfare influence livestock management and production. The aim was to quantify dairy producer attitudes to the painfulness of various cattle diseases and disbudding, a painful routine procedure performed on farm to ensure safer handling of cattle. A questionnaire on disbudding-related opinions and practices was sent to 1,000 Finnish dairy producers (response rate: 45%). Attitudes toward disbudding were gauged using a 5-point Likert scale and attitudes to cattle pain scored on an 11-point numerical rating scale. Principal components analysis was used to assess the loadings, which were further tested for differences between producer gender and housing systems with Mann-Whitney U-tests, and between herd milk yield, herd size, and age and work experience of producers with a Kruskal-Wallis test. Four main factors were identified: factor I ("taking disbudding pain seriously"), factor II ("sensitivity to pain caused by cattle diseases"), factor III ("ready to medicate calves myself"), and factor IV ("pro horns"). Female producers took disbudding pain more seriously, were more sensitive to pain caused to cattle by diseases, and were more ready to medicate disbudded calves than male producers. Producers with tie-stalls favored horns over producers with freestalls. Male producers with tie-stalls were sensitive to cattle pain and preferred horns over male producers with freestalls. Female producers with freestalls were more ready to medicate calves, but did not prefer horns more than female producers with tie-stalls. Taking disbudding seriously correlated with sensitivity to pain caused by cattle diseases. Producers with low-milk-yielding herds were less willing to medicate calves and more willing to keep cattle with horns than producers with higher-yielding herds. Older producers were more sensitive to cattle pain than middle-aged and younger producers. No effect was established for taking disbudding pain seriously: the pro-horn factor was associated with work experience, age, and herd size. Women rated pain higher and were more positive toward pain medication for animals than men. Maintaining horns are more important for producers with tie-stalls than for those with freestalls.

Occupational exposure to particles and incidence of acute myocardial infarction and other ischaemic heart disease.

BACKGROUND: Ambient particulate air pollution has been linked to cardiovascular disease. Occupational particle exposure levels may be several times higher than ambient levels but has been less studied. OBJECTIVES: The authors investigated the association between occupational exposure to particles and the incidence of ischaemic heart disease (IHD). METHODS: The cohort included all manual workers in the Swedish national census of 1980 with information on demographic data and occupation. Information on hospital admissions for acute myocardial infarction or other IHDs and cause of death were obtained from nation-wide registers. A job-exposure matrix for exposure to small (<1 µm) and large (>1 µm) particles was developed. HRs were calculated with Cox regression with adjustment for sex, age, socioeconomic group and urban/rural residential area. RESULTS: Exposure to small particles was associated with an increased HR for acute myocardial infarction of 1.12 (95% CI 1.09 to 1.15), and HR for exposure to large particles was 1.14 (95% CI 1.10 to 1.18). The association was somewhat stronger for workers exposed to small particles for more than 5 years, 1.21 (95% CI 1.11 to 1.31), but no trend with exposure intensity was found. The risk associated with exposure to small particles was higher among women than among men, 1.30 (95% CI 1.12 to 1.51) and 1.10 (95% CI 1.07 to 1.14), respectively. Findings were essentially similar for other IHDs. CONCLUSIONS: This explorative study gives some support to the hypothesis that occupational exposure to particles increases the risk of acute myocardial infarction and other IHD. The findings must be interpreted cautiously due to lack of smoking data.

Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in The Netherlands Cohort Study.

OBJECTIVES: Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated the reliability of exposure estimates for selected carcinogens obtained through three JEMs by comparing the estimates with case-by-case expert assessment within the Netherlands Cohort Study (NLCS). METHODS: The NLCS includes 58,279 men aged 55-69 years at enrolment in 1986. For a subcohort of these men (n=1630), expert assessment is available for exposure to asbestos, polycyclic aromatic hydrocarbons (PAHs) and welding fumes. Reliability of the different JEMs (DOMJEM (asbestos, PAHs), FINJEM (asbestos, PAHs and welding fumes) and Asbestos JEM (asbestos) was determined by assessing the agreement between these JEMs and the expert assessment. RESULTS: Expert assessment revealed the lowest prevalence of exposure for all three exposures (asbestos 9.3%; PAHs 5.3%; welding fumes 11.7%). The DOMJEM showed the highest level of agreement with the expert assessment for asbestos and PAHs (κs=0.29 and 0.42, respectively), closely followed by the FINJEM. For welding fumes, concordance between the expert assessment and FINJEM was high (κ=0.70). The Asbestos JEM showed poor agreement with the expert asbestos assessment (κ=0.10). CONCLUSIONS: This study shows case-by-case expert assessment to result in the lowest prevalence of occupational exposure in the NLCS. Furthermore, the DOMJEM and FINJEM proved to be rather similar in agreement when compared with the expert assessment. The Asbestos JEM appeared to be less appropriate for use in the NLCS.

Comparison of exposure estimates in the Finnish job-exposure matrix FINJEM with a JEM derived from expert assessments performed in Montreal.

CONTEXT: Retrospective exposure assessment in population-based case-control studies poses a major challenge due to the wide range of occupations and industries involved. The FINJEM is a generic job-exposure matrix (JEM) developed in Finland, which represents a potentially cost-effective exposure assessment tool. While FINJEM has been used in several studies outside Finland, little is known of its applicability in other countries. METHODS: We compared prevalence and intensity of exposure in FINJEM with a JEM developed from expert assessments of occupational histories obtained in a population-based case-control study in Montreal. Agreement for prevalence of exposure was measured by weighted κ coefficients between prevalence categories. Agreement for exposure intensity was measured by Spearman correlation coefficients between cells with non-null exposure. RESULTS: The comparison involved 27 chemicals, the time period 1945-1995 and included 4743 jobs initially assessed by the Montreal experts. 4293 combinations of agent, occupational title and period were available for comparison of prevalence. Agent-specific prevalence was consistently higher in the Montreal JEM (median difference 1.7%). Agent-specific κ values between prevalence categories varied from 0.89 (welding fumes) to 0.07 (flour dust). The comparison of exposure levels involved 14 agents and 198 cells with non-null exposure in both sources. Agent-specific Spearman correlation varied from 0.89 (flour dust) to -0.35 (benzo(a)pyrene). CONCLUSION: Our observations suggest that information concerning several agents (eg, metals, welding fumes) can be successfully transported from Finland to Canada and probably other countries. However, for other agents, there was considerable disagreement, and hence, transportability of FINJEM cannot be assumed by default.

Parathyroid scintigraphy protocols in Finland in 2010. Results of the query and current status.

UNLABELLED: The GOAL of this study was to describe current clinical parathyroid scintigraphy (PS) protocols in Finland. METHODS: all departments of nuclear medicine in Finland were contacted, and instructions regarding PS were requested. RESULTS: instructions regarding PS were received from all of the departments that perform PS (n = 19). Seven hundred and sixty-nine PS studies were performed in 2009 (between 7 and 209 per hospital). Three methods of PS were used. The dual-phase method with (99m)Tc-sestamibi is used in seven hospitals, the dual-tracer method with (123)I/(99m)Tc-sestamibi in eleven, and (99m)TcO4/(99m)Tc-sestamibi in one hospital. The activities of 99mTc-sestamibi, 123I and (99m)TcO4 were 150-800 MBq, 10-30 MBq and 50 MBq, respectively. The anterior image with parallel-hole collimators, the anterior image with pinhole collimator, the oblique angles with pinhole collimator, SPECT and hybrid CT with SPECT were acquired in 84%, 26%, 16%, 63%, and 42% of the hospitals, respectively. Because the imaging techniques were combined, one to four acquisitions were performed per patient. Scatter and attenuation correction were used in five protocols. A correction for crosstalk of (123)I and (99m)Tc gamma energies was not used, but the amount of crosstalk was decreased by using narrow or asymmetric energy windows in all dual isotope protocols. CONCLUSION: 19 hospitals used 18 different study protocols. Thus, significant variability exists in the current practice of PS in Finland. The protocols should be tested with known phantoms to determine any differences in sensitivities for detecting small active structures. Further studies with phantoms are needed to determine the optimal imaging techniques. The results of these phantom studies will provide guidelines for proposing national recommendations for PS.

Occupational exposure to silica and lung cancer risk in the Netherlands.

OBJECTIVES: The lung cancer carcinogenicity of crystalline silica dust remains the subject of discussion. Epidemiological evidence is based on occupational cohort studies and population-based case-control studies. The aim of this study was to assess associations between male lung cancer risk and silica exposure in a population-based cohort study. METHODS: The study was conducted among men aged 55-69 years (n=58 279) from the Netherlands Cohort Study, which included self-reported, life-time job histories. Job titles were linked to the occupational groups of the external Finnish Job Exposure Matrix (FINJEM), including probability and level of silica exposure, each for specific time periods. 1667 incident lung cancer cases with known silica exposure status (210 exposed) were available after 11.3 years of follow-up. Risks were estimated based on a case-cohort design, and using Cox proportional hazards models. RESULTS: Adjusted for smoking and other confounders, elevated risks were observed for exposure duration (RR 1.65, 95% CI 1.14 to 2.41 for 26-51 years vs no exposure) and cumulative exposure (RR 1.47, 95% CI 0.93 to 2.33 for ≥3 vs <3 mg/m(3).year). Associations with average exposure levels were weaker. Associations were stronger for occupations with an exposure probability of ≥90%. Adjustment for asbestos exposure slightly increased the risk. CONCLUSIONS: Results from this prospective population-based cohort study corroborate the classification of crystalline silica as a lung carcinogen. Associations could not be explained by smoking or by asbestos exposure.

Occupational exposures and risk of oesophageal cancer by histological type: a case-control study in eastern Spain.

OBJECTIVE: To explore the relationship between occupations and specific occupational exposures and oesophageal cancer (OC) by histological type. METHODS: A multicentre hospital-based case-control study was conducted in two Mediterranean provinces of Spain. Occupational, sociodemographic and lifestyle information was collected from 185 newly diagnosed male oesophageal cancer patients (147 squamous cell, 38 adenocarcinoma) and 285 frequency matched controls. Occupation was coded according to the Spanish National Classification of Occupations 1994. Occupational exposure to a selection of carcinogenic substances was assessed by the FINJEM job exposure matrix. Odds ratios were calculated by unconditional logistic regression adjusting for age, education, alcohol intake and cigarette smoking. RESULTS: For the squamous cell variety, statistically significant associations were found for waiters and bartenders (OR 8.18, 95% CI 1.98 to 33.75) and miners, shotfirers, stone cutters and carvers (OR 10.78, 95% CI 1.24 to 93.7) in relation to other occupations. For the adenocarcinoma variety, statistically significant associations were observed for carpenters and joiners (OR 9.69), animal producers and related workers (OR 5.61) and building and related electricians (OR 8.26), although these observations were based on a low number of cases. Regarding specific exposures, the study found a statistically significant increased risk of squamous cell carcinoma for ionising radiation, and of adenocarcinoma for high exposure to volatile sulphur compounds (OR 3.12) and lead (OR 5.30). For all histological types of OC combined, a three-fold increase in risk was found with a significant trend for asbestos exposure (OR 3.46, 95% CI 0.99 to 12.10). CONCLUSIONS: The data suggest that some occupational exposures may specifically increase the risk of oesophageal squamous cell carcinoma or adenocarcinoma, while other exposures such as asbestos may increase the overall risk of OC.

Use of p62/SQSTM1 antibodies for neuropathological diagnosis.

The demonstration of proteinaceous inclusions in the brain is the key step in the pathological diagnosis of degenerative dementias. The diversity of these diseases has necessitated the use of a panel of (immuno)stains to visualize all suspect pathologies, elevating diagnostic costs. Immunodetection of p62 (sequestosome 1), an abundant constituent in diverse pathological inclusions, holds the potential for a broad-specificity, high-contrast inclusion label. In the brain, pathological p62-positive aggregates comprise both cytoplasmic and nuclear types in neurones and glia, with abnormal tau, alpha-synuclein, TAR DNA-binding protein 43 or polyglutamine proteins as primary components. We therefore set out to evaluate the performance of p62 antibodies for diagnostic immunohistochemistry. We optimized the application conditions and compared the staining profiles of eight commercial p62 antibodies with each other and with reference immunostains, using 2-mm tissue multiarrays representing the major tauo- and synucleinopathies and frontotemporal lobar degeneration with ubiquitin-positive inclusions (FTLD-U). The lesions were best visualized using monoclonal antibodies, displaying most types of hallmark inclusions with excellent contrast. Expanding the list of p62-containing aggregates, we demonstrated p62 in tufted astrocytes, coiled bodies, astrocytic plaques, and variform neocortical inclusions and pathological processes in FTLD-U. Polyclonal antibodies exhibited lower sensitivities with variable background levels. We also noted more subtle p62-immunoreactive features lacking overt disease associations. Emphasizing the importance of proper antibody and epitope unmasking methods for maximum sensitivity, we recommend p62 immunodetection as a screening stain for diagnostic practice.

Moulds, bacteria and cancer among Finns: an occupational cohort study.

BACKGROUND: Some environmental moulds and bacteria produce carcinogenic toxins. AIM: To study associations between work-related exposure to moulds and bacteria and cancers in Finland. METHODS: A cohort of all economically active Finns in the population census in 1970 were followed-up for 30 million person-years. Subsequent cancer cases were identified through record linkage with the Finnish Cancer Registry. Observed and expected numbers of cancer cases were calculated by occupation, sex, birth cohort and period of observation. Exposures to moulds of agricultural and industrial origin and to bacteria of non-human origin were estimated with the Finnish Job-Exposure Matrix. RESULTS: Men with the highest mould and bacterial exposure had a reduced relative risk for lung cancer (RR 0.7, 95% CI 0.6 to 0.9 for moulds and RR 0.9, 95% CI 0.8 to 1.0 for bacteria). Women in the highest mould and bacterial exposure category had RRs of 3.1 (95% CI 1.0 to 9.2) and 2.6 (95% CI 1.5 to 4.7) for cervical cancer, respectively. The respective RRs for lip cancer were 2.4 (95% CI 1.2 to 5.1) and 1.6 (95% CI 1.2 to 2.2). CONCLUSIONS: Exposures at the investigated concentrations to either moulds or bacteria are unlikely to be major risk factors of cancer, although suggestions of risk increases were observed for some cancer types. It has been suggested previously that the decreased risk for lung cancer is due to the protective effect of endotoxins.

The role of poly(ADP-ribose) polymerase-1 in CNS disease.

Poly(ADP-ribose) polymerase-1 (PARP-1) is a nuclear enzyme that contributes to both neuronal death and survival under stress conditions. PARP-1 is the most abundant of several PARP family members, accounting for more than 85% of nuclear PARP activity, and is present in all nucleated cells of multicellular animals. When activated by DNA damage, PARP-1 consumes nicotinamide adenine dinucleotide (NAD+) to form branched polymers of ADP-ribose on target proteins. This process can have at least three important consequences in the CNS, depending on the cell type and the extent of DNA damage: 1) Poly(ADP-ribose) formation on histones and on enzymes involved in DNA repair can prevent sister chromatid exchange and facilitate base-excision repair; 2) poly(ADP-ribose) formation can influence the action of transcription factors, notably nuclear factor kappaB, and thereby promote inflammation; and 3) extensive PARP-1 activation can promote neuronal death through mechanisms involving NAD+ depletion and release of apoptosis inducing factor from the mitochondria. PARP-1 activation is thereby a key mediator of neuronal death during excitotoxicity, ischemia, and oxidative stress, and PARP-1 gene deletion or pharmacological inhibition can markedly improve neuronal survival in these settings. PARP-1 activation has also been identified in Alzheimer's disease and in experimental allergic encephalitis, but the role of PARP-1 in these disorders remains to be established.

The effectiveness of human impact assessment in the Finnish Healthy Cities Network

OBJECTIVES: To develop a framework for analysing the effectiveness of prospective assessment and to apply the framework to human impact assessments (HuIA) carried out in the Finnish Healthy Cities Network. METHODS: The framework was formed by synthesizing and developing the themes that emerged from the published literature on effectiveness. The research material consists of interviews with people who participated in the assessment process in the municipalities (19 interviews). The research material also included assessment documents, proceedings of working meetings, municipal policy documents, background material and project reports produced in the municipalities studied. The research datasets were examined by content analysis. RESULTS: HuIA increased the decision-makers' awareness of effects and functioned as a tool for empowerment. The latter was apparent, for instance, in the social welfare and healthcare sector, finding a role for itself in decisively co-ordinating interdisciplinary work and actively seeking to alleviate identified negative effects. The assessment process also opened up the planning process, committed various actors to the decision, helped select the right alternative and promoted social learning. CONCLUSIONS: From the viewpoint of preparation and decision-making, the effectiveness of a HuIA increases when assessment becomes a recurring process and an integral part of an organization's activities. Integration of an assessment into permanent structures or activities, such as drawing up programmes or preparing strategies, helps the results of the assessment to be seen more clearly. From the viewpoint of decision-making, it is also important to strengthen the decision-makers' expertise in prospective assessment. When the effectiveness of HuIA is looked at in a new way (i.e. from the viewpoint of goal achievement, decision-making or learning), a more comprehensive interpretation can be given. (AU)

The effectiveness of human impact assessment in the Finnish Healthy Cities Network.

OBJECTIVES: To develop a framework for analysing the effectiveness of prospective assessment and to apply the framework to human impact assessments (HuIA) carried out in the Finnish Healthy Cities Network. METHODS: The framework was formed by synthesizing and developing the themes that emerged from the published literature on effectiveness. The research material consists of interviews with people who participated in the assessment process in the municipalities (19 interviews). The research material also included assessment documents, proceedings of working meetings, municipal policy documents, background material and project reports produced in the municipalities studied. The research datasets were examined by content analysis. RESULTS: HuIA increased the decision-makers' awareness of effects and functioned as a tool for empowerment. The latter was apparent, for instance, in the social welfare and healthcare sector, finding a role for itself in decisively co-ordinating interdisciplinary work and actively seeking to alleviate identified negative effects. The assessment process also opened up the planning process, committed various actors to the decision, helped select the right alternative and promoted social learning. CONCLUSIONS: From the viewpoint of preparation and decision-making, the effectiveness of a HuIA increases when assessment becomes a recurring process and an integral part of an organization's activities. Integration of an assessment into permanent structures or activities, such as drawing up programmes or preparing strategies, helps the results of the assessment to be seen more clearly. From the viewpoint of decision-making, it is also important to strengthen the decision-makers' expertise in prospective assessment. When the effectiveness of HuIA is looked at in a new way (i.e. from the viewpoint of goal achievement, decision-making or learning), a more comprehensive interpretation can be given.

The triad of shift work, occupational noise, and physical workload and risk of coronary heart disease.

BACKGROUND: Shift work, noise, and physical workload are very common occupational exposures and they tend to cluster in the same groups of workers. OBJECTIVES: To study the short and long term effects of these exposures on risk of coronary heart disease (CHD) and to estimate the joint effects of these factors. METHODS: The study population in this prospective 13 year follow up study of 1804 middle aged industrially employed men was collected at the first screening for the Helsinki Heart Study. The CHD end points (ICD-9 codes 410-414 and ICD-10 codes I20-I25) were obtained from official Finnish registers. The Finnish job-exposure matrix FINJEM provided information on occupational exposures. Relative risks (RR) of CHD for the exposures were estimated using Cox's proportional hazard models adjusting for classical risk factors of CHD. RESULTS: The RR in the five year follow up for continuous noise combined with impulse noise was 1.28; for shift work it was 1.59, and for physical workload 1.18, while in the 13 year follow up the RRs were 1.58, 1.34, and 1.31, respectively. When adjusted for white-collar/blue-collar status the RRs decreased markedly. The RR in the 13 year follow up for those exposed to two risk factors was close to 1.7 and for those exposed to all three, 1.87. CONCLUSION: Shift work and continuous noise entailed an excess risk for CHD in the shortest follow up with only a few retired workers but a decreasing risk during the longer follow up. For physical workload and impulse noise the trend was opposite: the CHD risk was increasing with increasing follow up time despite increasing numbers of retired workers.

Occupational exposure to eight organic dusts and respiratory cancer among Finns.

BACKGROUND: There is inconclusive evidence concerning cancer risks of organic dusts. AIM: The carcinogenic exposures are mainly inhalatory and the authors therefore studied associations between occupational exposure to eight different organic dusts and respiratory cancers in Finland. METHODS: The authors followed up a cohort of all economically active Finns born between 1906 and 1945 for 30 million person-years during 1971-95. Incident cases of nasal, laryngeal, and lung cancer and mesotheliomas were identified through a record linkage with the Finnish Cancer Registry. Occupations from the population census in 1970 were converted to exposures to eight organic dusts with a job-exposure matrix (FINJEM). Cumulative exposure (CE) was calculated as a product of prevalence, level, and estimated duration of exposure. Standardised incidence ratios (SIR) and 95% confidence intervals (CI) adjusted for age, period, and social class were calculated for each organic dust using the economically active population as the reference. RESULTS: A total of 20 426 incident cases of respiratory cancer were observed. Slightly increased risk was observed among men exposed to wood dust for nasal cancer (SIR 1.42, 95% CI 0.79 to 2.44). For laryngeal cancer, men exposed to plant dust (mainly grain millers) had a raised SIR in the high exposure class (SIR 3.55, 95% CI 1.30 to 7.72). Men exposed to wood dust had a raised SIR for lung cancer, but only in the low exposure class (SIR 1.11, 95% CI 1.04 to 1.18). Women exposed to wood dust showed an increased SIR for mesotheliomas in the low exposure class (SIR 4.57, 95% CI 1.25 to 11.7) and some excess in the medium exposure category. CONCLUSIONS: Exposure to organic dusts is unlikely to be a major risk factor of respiratory cancer. Even exposure to wood dust which is a major exposure in Finland seems to have minor effect for nasal cancer. The authors found suggestive evidence that exposure to grain dust may increase the risk of laryngeal cancer, and some support to the hypothesis that exposure to textile dust, and to plant and animal dust (agricultural dusts) may decrease the risk of lung cancer.

TICAREX: Exposiciones laborales a agentes cancerígenos y plaguicidas en Costa Rica / TICAREX: occupational exposure to carcinogens and pesticides in Costa Rica

El sistema europeo de datos CAREX (CARcinogen Exposure) considera la fuerza laboral de un país agrupada en 55 sectores económicos según la Clasificación Internacional de Actividades Económicas de las Naciones Unidas, segunda revisión de 1968, y mediante la aplicación de proporciones de trabajadores expuestos a partir de datos generados en estudios de higiene industrial para 139 agentes carcinógenos, los convierte en fuerza laboral expuesta y número de trabajadores expuestos a agentes carcinogénicos, según rama de actividad. En este artículo se describe una modificación y extensión del sistema CAREX para calcular los números de trabajadores expuestos a agentes cancerígenos y plaguicidas en Costa Rica. Esta primera aplicación de CAREX fuera de Europa (TICAREX) fue realizada en Costa Rica, Centroamérica, para 27 agentes cancerígenos y 7 grupos de plaguicidas, considerados de interés para el país, realizando estimaciones por separado para mujeres y hombres. Los agentes cancerígenos más frecuentes a los que se expone la fuerza laboral de Costa Rica de 1.3 millones fueron la radiación solar (333,000 trabajadores), las emisiones de diesel (278,000), paraquat y diquat (175,000), el humo de tabaco ambiental (71,000), los compuestos de cromo hexavalente (55,000), el benceno (52,000), mancozeb, maneb y zineb (49,000), clorotalonil (38,000), el polvo de madera (32,000), el cuarzo (27,000), benomil (19,000), el plomo y sus compuestos inorgánicos (19,000), tetracloroetileno (18,000), y los compuestos aromáticos policíclicos (17,000). En los hombres, la distribución se mantuvo muy ajustada a los anteriores rangos, sin embargo en las mujeres, debido a su diferente distribución en los sectores, el formaldehído, el radón y el cloruro de metileno superaron a los plaguicidas, el cromo (VI), el polvo de madera y el cuarzo. La agricultura, la construcción, los servicios personales y domésticos, el transporte terrestre y acuático y los servicios asociados al transporte, la fabricación de productos cerámicos y similares, la manufactura de productos de madera, la minería, la silvicultura, la pesca, la fabricación de maquinaria y aparatos eléctricos, bares y restaurantes fueron sectores de donde las exposiciones son frecuentes. Una reducción drástica de exposiciones laborales y ambientales a estos agentes daría por resultado mejoras sustanciales en los niveles de salud pública y ocupacional. La vigilancia de las exposiciones laborales y de la salud en el trabajo son esenciales para el control de la contaminación y de las exposiciones a los agentes cancerígenos

The European data system CAREX takes the workforce of a country grouped into 55 economic sectors according to the International Economic Activity Classification of the United Nations, the second 1968 revision and through the application of proportions of workers exposed to 139 carcinogenic agents based on data from industrial hygiene studies, converting it into the total workforce exposed to carcinogens by sector. . In this article we describe a modification and extension of of the CAREX system in order to calculate the number of workers exposed to carcinogens in Costa Rica. It is the first use of CAREX outside Europe (TICAREX) in Costa Rica, Central America, for 27carcinogens and 7 groups of pesticides thought to be of interest for the country, with separate estimations for men and women. The most frequent agents of exposure for the 1.3 million workers of Costa Rica were solar radiation (333,000 workers); diesel exhaust (278,000); paraquat and diquat (175,000); environmental tobacco smoke (71,000); hexavalent chromium compounds (55,000); benzene (52,000); mancozeb, maneb and zineb (49,000); chlorothalonil (38,000); wood dust (32,000); quartz (27,000); benomyl (19,000); lead and its inorganic compounds (19,000); tetrachloroethylene (18,000); and polycyclic aromatic hydrocarbons (17,000). Owing to the different occupational distribution between the genders, exposures to formaldehyde, radon and methylene chloride were more frequent than pesticides, hexavalent chromium, wood dust, and quartz in women. Agriculture, construction, personal and domestic services, manufacture of wood products, mining, forestry, fishing, manufacture of electrical products, and bars and restaurants were sectors with frequent exposures. Substantial reduction of occupational and environmental exposures to these agents would significantly improve public and occupational health. Reduction of occupational exposures is usually also followed by improvement of environmental quality. Monitoring of exposures and health of workers and the general public is an essential element in the control of environmental contamination and human exposures

Neighbourhood unemployment and all cause mortality: a comparison of six countries.

STUDY OBJECTIVE: Studies have shown that living in more deprived neighbourhoods is related to higher mortality rates, independent of individual socioeconomic characteristics. One approach that contributes to understanding the processes underlying this association is to examine whether the relation is modified by the country context. In this study, the size of the association between neighbourhood unemployment rates and all cause mortality was compared across samples from six countries (United States, Netherlands, England, Finland, Italy, and Spain). DESIGN: Data from three prospective cohort studies (ARIC (US), GLOBE (Netherlands), and Whitehall II (England)) and three population based register studies (Helsinki, Turin, Madrid) were analysed. In each study, neighbourhood unemployment rates were derived from census, register based data. Cox proportional hazard models, taking into account the possible correlation of outcomes among people of the same neighbourhood, were used to assess the associations between neighbourhood unemployment and all cause mortality, adjusted for education and occupation at the individual level. RESULTS: In men, after adjustment for age, education, and occupation, living in the quartile of neighbourhoods with the highest compared with the lowest unemployment rates was associated with increased hazards of mortality (14%-46%), although for the Whitehall II study associations were not statistically significant. Similar patterns were found in women, but associations were not statistically significant in two of the five studies that included women. CONCLUSIONS: Living in more deprived neighbourhoods is associated with increased all cause mortality in the US and five European countries, independent of individual socioeconomic characteristics. There is no evidence that country substantially modified this association.

Comparison of manual and automated quantification methods of 123I-ADAM.

UNLABELLED: 123I-ADAM is a novel radioligand for imaging of the brain serotonin transporters (SERTs). Traditionally, the analysis of brain receptor studies has been based on observer-dependent manual region of interest definitions and visual interpretation. Our aim was to create a template for automated image registrations and volume of interest (VOI) quantifications and to show that an automated quantification method of 123I-ADAM is more repeatable than the manual method. PATIENTS, METHODS: A template and a predefined VOI map was created from 123I-ADAM scans done for healthy volunteers (n = 15). Scans of another group of healthy persons (HS, n = 12) and patients with bulimia nervosa (BN, n = 10) were automatically fitted to the template and specific binding ratios (SBRs) were calculated by using the VOI map. Manual VOI definitions were done for the HS and BN groups by both one and two observers. The repeatability of the automated method was evaluated by using the BN group. RESULTS: For the manual method, the interobserver coefficient of repeatability was 0.61 for the HS group and 1.00 for the BN group. The introobserver coefficient of repeatability for the BN group was 0.70. For the automated method, the coefficient of repeatability was 0.13 for SBRs in midbrain. CONCLUSION: An automated quantification gives valuable information in addition to visual interpretation decreasing also the total image handling time and giving clear advantages for research work. An automated method for analysing 123I-ADAM binding to the brain SERT gives repeatable results for fitting the studies to the template and for calculating SBRs, and could therefore replace manual methods.

Psychosocial work factors and dementia.

AIMS: To evaluate the association between psychosocial workplace factors and dementia in a case-control study. METHODS: Patients with dementia (aged 55-99 years) were recruited from 23 general practices in the city of Frankfurt-on-Main and surrounding area in 1998-2000. Of these, 108 were suffering from possible Alzheimer's disease, 59 from possible vascular dementia, and 28 from secondary or unclassified dementia. A total of 229 control subjects (aged 60-94 years) was recruited from the same study region: 122 population controls and 107 dementia-free ambulatory patients. A detailed job history was elicited in a structured personal interview (next-of-kin interviews of cases). Psychosocial work exposure was assigned to cases and control subjects by linking lifetime job histories with a Finnish job-exposure matrix. Data were analysed using logistic regression, to control for age, region, sex, dementia in parents, education, smoking, and the psychosocial network at age 30. RESULTS: There were decreased odds ratios for high challenge at work, high control possibilities at work, and high social demands at work. High risks for error at work revealed a significant positive association with the diagnosis of dementia. Restriction of the analysis to cases with possible Alzheimer's disease or to cases with possible vascular dementia led to similar results. CONCLUSIONS: These results support a role for psychosocial work factors in the aetiology of dementia. As an alternative explanation, people might have chosen jobs with poor work factors due to preclinical dementia, which becomes clinically manifest decades later.

Occupational exposure to chemical agents in the paper industry.

As part of an International Agency for Research on Cancer (IARC) international epidemiological study of workers in the pulp and paper industry, previously unpublished exposure measurements were assembled in a database. This article summarizes the results of 3,873 measurements carried out in the production departments of paper and paperboard mills and recycling plants in 12 countries. In the paper and paperboard mills, most of the agents were measured in the pulping and refining departments and in on-machine coating and winding of paper/paperboard. Exposures to asbestos, carbon monoxide, formaldehyde, fungal spores, bacteria, nitrogen dioxide, minerals dusts, paper dust, sulphuric acid and different solvents sometimes exceeded exposure limit values. In the re-pulping and de-inking departments of recycling plants high exposures to formaldehyde, fungal spores, bacteria and paper dust were observed. High exposures to asbestos, bioaerosols, carbon monoxide and paper dust were found in many departments; ammonia, formaldehyde, mineral and paper dust and solvents were found in coating machines; and diphenyl and polychlorobiphenyls (PCBs) were found in some special circumstances. Measurements in the newsprint and uncoated paper machine departments revealed only a few elevated exposures. In nearly all departments, measurements of epichlorohydrin, PCBs, sulphur dioxide, hydrogen sulphide and mercaptans tended to be low, often even below their detection limits. In spite of some uncertainties in the measurement data, the study provides new insights into the level and variation of occupational exposures of production workers in the paper and paperboard industry.