Accident prevention program in a glass factory in Shoubra El Khema district.

BACKGROUND: An accident can be defined as an unplanned event that results in or suggests the possibility of personal injury, property damage production interruption diminished health or environmental damage. The accidents have a cost impact on the employees and the company itself. OBJECTIVE: This intervention study was carried out to decrease the accident rate in a glass factory in Shoubra El-Khema district. METHODS: A glass factory in Shoubra El-Khema was selected to implement an intervention program. The program was done through three phases. 1. A preliminary interview questionnaire. 2. Seminars of health education were done to all workers and managers with availability of health education posters, establishment of accident committee and a new reporting system, contract with a housekeeping company was done and also training of some leaders. 3. Concurrent and final evaluation of the program was done. RESULTS: The incidence rate, frequency and severity rate of accidents were decreased at the end of the year after the intervention program. The differences were statistically significant. The opinions of the workers and managers about the different causes of accidents were changed. The belief of the workers and managers about efficiency of health educatio program was changed. Some leaders were trained on skills of health education. Modification of reporting and notification system was done. CONCLUSION: This intervention study succeeded in decreasing accidents rates and increasing the awareness of the managers to decrease accident rates. The beliefs and thoughts o both workers and managers became near to each other. The production loss due to days lost by accidents was reduced. RECOMMENDATIONS: Upgrading process in the factory are recommended to eliminate the hazards at source. Sustaining and continuation of the established preventive program should be done. Trying to apply the program in similar factories is also recommended.

Effect of occupational lead-exposure on blood pressure, serum aldosterone level and plasma renin activity.

Numerous observations have indicated a relationship between lead exposure and elevated blood pressure. The present study aims to investigate the association between occupational lead-exposure and elevated blood pressure as well as serum aldosterone level and plasma renin activity as parameters affecting blood pressure. Fifty occupationally lead-exposed (16 males and 34 females) and 50 non-exposed (15 males and 34 females) workers were selected after application of certain exclusion criteria. All workers were admitted to complete clinical examination, including standard blood pressure measurement. Also, blood lead level, serum aldosterone concentration and plasma renin activity were estimated. The results of both occupationally lead-exposed males and females demonstrated no significant differences regarding age, work duration, systolic and diastolic blood pressures when compared to occupationally non-exposed males and females; respectively. In addition, occupationally lead-exposed males and females revealed a significant increase in blood lead level and serum aldosterone concentration in comparison to their controls. Moreover, plasma renin activity is significantly decreased among the lead-exposed male workers while it is significantly increased among the lead-exposed female workers in comparison to their controls. It is concluded that serum aldosterone level and plasma renin activity are affected by occupationally low-level of lead exposure, and the present study provide further support for the association between blood lead exposure and blood pressure related hormones.

Chromium induced contact dermatitis and indices for diagnosis.

Chromium exposure plays an important role in development of contact dermatitis. The prevalence of contact dermatitis among tannery workers and cement-exposed workers is high. This study was designed to determine the prevalence of contact dermatitis among some Egyptian workers exposed to chromium and to investigate the role of patch test and IgE immunoassay in diagnosis of contact dermatitis. Eighty-three male workers who were exposed to chromium were selected after application of certain exclusion criteria to be the target population of this study. Forty male workers away from exposure to chromium were taken to be the controls. All the exposed and non exposed workers were investigated through an interview questionnaire, clinical examination, patch test and determination of blood and urine chromium levels, absolute eosinophilic count and total IgE level. The results showed that there was no significant difference between exposed workers with clinically diagnosed contact dermatitis and the clinically free exposed workers regarding age and work duration. 7.7% of exposed workers with positive patch test suffered from contact dermatitis while 31.6% of exposed workers with negative patch test suffered from contact dermatitis. There was no statistically significant difference between clinically diagnosed contact dermatitis workers and clinically free workers regarding blood and urine chromium levels. IgE level and absolute eosinophilic count were statistically higher among exposed workers with contact dermatitis than among clinically free exposed workers. According to the results of this study, it is concluded that the diagnosis of skin hypersensitivity to chromium should depend upon the history of chromium exposure, clinical examination and a battery of investigations including IgE level, eosinophilic count and patch test.

Urinary excretion of copper and zinc among cigarette smokers.

The urinary levels of cadmium (Cd), zinc (Zn) and copper (Cu) were measured among 11 adult male non-smokers and 38 adult male cigarette smokers to investigate the effect of cigarette smoking on the urinary excretion of Zn and Cu in relation to urinary Cd level. The results indicated that among non-smokers, the urinary levels of Cd, Zn, and Cu were: 1.17-5.24 (3.73 +/- 1.23) microg Cd/gm urinary creatinine, 66.73-156.13 (109.28 +/- 30.27) microg Zn/gm urinary creatinine, 83.17-195.65 (126.72 +/- 41.46) microg Cu/gm urinary creatinine, respectively. The cigarette smokers were classified into two groups according to the level of urinary Cd. The first group contains 13 cases with urinary Cd levels within the normal range of non-smokers, and the urinary levels of both Zn and Cu were observed to be also within the normal range of non-smokers (2.14-4.98 (3.85 +/- 0.97) microg Cd/gm urinary creatinine, 69.40-150.59 (97.61 +/- 21.39) microg Zn/gm urinary creatinine, 85.33-137.42 (96.11 +/- 13.60) microg Cu/gm urinary creatinine, respectively]. The second group contains 25 cases with elevated urinary Cd levels (5.44-40.37 (14.08 +/- 9.69 microg Cd/gm urinary creatinine]. The latter group was further subdivided into two subgroups according to the urinary levels of Zn and Cu. The first subgroup contains 15 cases with urinary levels of both Zn and Cu within the normal range of non-smokers [5.44-13.58 (7.74 +/- 2.11) microg Cd/gm urinary creatinine, 69.54-133.46 (96.95 +/- 22.91) microg Zn/gm urinary creatinine, 93.06-191.90 (133.7 +/- 32.80) microg Cu/gm urinary creatinine, respectively]. The second subgroup contains 10 cases with elevated urinary levels of Zn and/or Cu [13.81-40.37 (23.57 +/- 8.74) microg Cd/gm urinary creatinine, 141.53-511.11 (284.76 +/- 132.45) microg Zn/gm urinary creatinine, 193.06-705.48 (388.49 +/- 158.66) microg Cu/gm urinary creatinine, respectively). In the latter subgroup it was noted that only one case showed elevated levels of urinary Cd and Zn but not Cu, while another case showed increased urinary Cd and Cu levels but not Zn. The results of the present investigation suggest that urinary Cd, at a certain level, may be accompanied by increased urinary excretion of both Zn and Cu among cigarette smokers.

Evaluation of the effectiveness of dipstick haematuria and proteinuria in screening Schistosoma haematobium infection among school children in upper Egypt.

This study aimed at evaluation of validity and reliability of dipstick haematuria and proteinuria in screening school children for Schistosoma haematobium infection. It included a random sample of 400 school children aged 6-15 years in rural area of Fayoum Governorate, upper Egypt. Urine samples of the studied children were tested parasitologically by urine filtration technique as a reference test and semiquantitatively for haematuria and proteinuria using urine reagent strips as screening tests. Results of the study revealed that haematuria was a better indicator for Schistosoma haematobium infection than proteinuria, as it was more sensitive (85.5% 73.4%, respectively), specific (94.4% 82.9%, respectively) and reliable (kappa=92% 80%, respectively). Moreover, it had stronger relationship with intensity of infection (r=0.88 & 0.67, respectively). A combination of different grades of haematuria and proteinuria did not significantly increase either sensitivity or specificity. Dipstick haematuria could be a valuable technique in screening rural Egyptian school children who are at risk of urinary schistosmiasis.

Early detection of nephrotoxic effects due to low-dose exposure of cadmium among cigarette smokers.

The effects of low-level exposure to cadmium due to cigarette smoking on renal function were judged by the estimation of urinary levels of total proteins, cadmium, alpha-1-microglobulin (alpha1M) and glutathione S-transferase (GST) activity among 50 males (38 smokers and 12 control non-smokers). Elevated urinary cadmium levels [2.408-28.160; 9.31 +/- 7 .1 microg Cd/gm urine creatinine] were observed among the majority of smokers (24 cases, 63.16%) and these levels showed a positive correlation with age and smoking index. Furthermore, urine total proteins [115.18-652.14; 242.89 +/- 121.88 mg protein/gm urine creatinine) were increased suggesting glomerular involvement among 20 cases (52.63%) of smokers. In addition, urinary alpha1M levels (14.645-86.053; 34.05 +/- 16.83 mg alpha1M/gm urine creatinine) and urinary GST activity [0.0-0.008; 0.00015 +/- 0.0002 micromol/min/100 microl/gm urine creatinine] were elevated among 18 (47.37%) and 20 (52.63%) cases of smokers respectively. Since urinary alpha1M and GST originate from renal proximal tubules, the data of the present investigation could reflect early low-level cadmium exposure nephrotoxic effect on both the glomeruli and tubules.

The impact of health education on the knowledge and attitude of Egyptian nurses towards occupational HIV infection.

There is a phobia about nursing human immunodeficiency virus (HIV) infected patients. This work was carried out to study the impact of health education on the knowledge and attitude of nurses, representing a stratum of health care team, about modes of transmission and prevention of occupational HIV infection. The studied population were students of the High Institute of Nursing, they were subjected to a health education program (HE), and assessment was carried out before and after this intervention. The results revealed that health education is a successful tool in improving the knowledge of the nurses and in minimizing their phobia from occupational HIV infection.

Workers knowledge of accidents' causes.

Accident constitutes a big problem of occupational health. It causes an economic loss to the work and worker. Six hundred workers were investigated by a well standardized questionnaire through interview. Most workers believed that the most important causes of accidents are those belonging to environment and work pattern. They did not know or denied that there are many important personal factors that are considered to be a corner stone in increasing accident rate. Ninety one percent of the investigated workers believed that the improper guarded machines are one of the most important causes of accidents, only 23% of the involved workers considered the psychological and social disturbance to cause accidents. It is concluded that there should be a well prepared program of health education to learn the workers the different causes of accidents and the methods to prevent and decrease the accident rates.

An experimental study on impact of whole body gamma irradiation on liver function and kidney function.

Five groups of rabbits were used to investigate the effect of increasing doses of radiation on liver and kidney function. One group acted as a control group. The other 4 groups were exposed to increasing doses of whole body gamma radiation. 1-5Gy. The kidney and liver function tests were affected one week after exposure, except bilirubin level that was decreased immediately after exposure within 24 hours.

Epidemiological evaluation of oral polio vaccine efficacy in Cairo.

A case-control study was conducted between November 1992 and May, 1993 to assess the effectiveness of routine oral polio vaccine (OPV) immunization against paralytic poliomyelitis among children aged 1-5 years in Cairo city. Cases of paralytic poliomyelitis at Imbaba Institute of poliomyelitis and Ain-Shams Pediatric Hospital fulfilling the study criteria were obtained. The diagnosis of cases was based on clinical grounds. Age and sex-matched controls were recruited concurrently from patients admitted for reasons other than poliomyelitis. There were 55 cases of poliomyelitis. Vaccination status of cases and controls was ascertained by asking the mothers through interviewing using a questionnaire that had been developed for the purpose of the study. Vaccine efficacy (VE) was 86% (95% CI: 39-97%) and 92% (95% CI: 64-98%) for 3 and 4 doses of OPV respectively. For a vaccine like OPV with the potential of near 100% VE after 3 doses, the estimated level of protection (86%) is considered low especially when we realize the enormous efforts carried out by Ministry of Health and UNICEF in Egypt for upgrading the cold-chain. Higher figures of VE are supposed to be achieved if we are going to meet the challenge of poliomyelitis eradication by the year 1994. Potential biases in study design were also discussed.