Antibiotic resistance in porcine pathogenic bacteria and relation to antibiotic usage.

BACKGROUND: Optimal treatment and prudent use of antimicrobials for pigs is imperative to secure animal health and prevent development of critical resistance. An important step in this one-health context is to monitor resistance patterns of important animal pathogens. The aim of this study was to investigate the antimicrobial resistance patterns of five major pathogens in Danish pigs during a period from 2004 to 2017 and elucidate any developments or associations between resistance and usage of antibiotics. RESULTS: The minimum inhibitory concentration (MIC) for Escherichia coli, Actinobacillus pleuropneumoniae, Streptococcus suis, Bordetella bronchiseptica, and Staphylococcus hyicus was determined to representatives of antibiotic classes relevant for treatment or surveillance. Escherichia coli isolates were mostly sensitive to fluoroquinolones and colistin, whereas high levels of resistance were observed to ampicillin, spectinomycin, streptomycin, sulfonamides and tetracycline. While resistance levels to most compounds remained relatively stable during the period, resistance to florfenicol increased from 2.1% in 2004 to 18.1% in 2017, likely in response to a concurrent increase in usage. A temporal association between resistance and usage was also observed for neomycin. E. coli serovars O138 and O149 were generally more resistant than O139. For A. pleuropneumoniae, the resistance pattern was homogenous and predictable throughout the study period, displaying high MIC values only to erythromycin whereas almost all isolates were susceptible to all other compounds. Most S. suis isolates were sensitive to penicillin whereas high resistance levels to erythromycin and tetracycline were recorded, and resistance to erythromycin and trimethoprim increasing over time. For S. hyicus, sensitivity to the majority of the antimicrobials tested was observed. However, penicillin resistance was recorded in 69.4-88.9% of the isolates. All B. bronchiseptica isolates were resistant to ampicillin, whereas all but two isolates were sensitive to florfenicol. The data obtained have served as background for a recent formulation of evidence-based treatment guidelines for pigs. CONCLUSIONS: Antibiotic resistance varied for some pathogens over time and in response to usage. Resistance to critically important compounds was low. The results emphasize the need for continuous surveillance of resistance patterns also in pig pathogenic bacteria.

Personal cooling with phase change materials to improve thermal comfort from a heat wave perspective.

UNLABELLED: The impact of heat waves arising from climate change on human health is predicted to be profound. It is important to be prepared with various preventive measures for such impacts on society. The objective of this study was to investigate whether personal cooling with phase change materials (PCM) could improve thermal comfort in simulated office work at 34°C. Cooling vests with PCM were measured on a thermal manikin before studies on human subjects. Eight male subjects participated in the study in a climatic chamber (T(a) = 34°C, RH = 60%, and ν(a) = 0.4 m/s). Results showed that the cooling effect on the manikin torso was 29.1 W/m(2) in the isothermal condition. The results on the manikin using a constant heating power mode reflect directly the local cooling effect on subjects. The results on the subjects showed that the torso skin temperature decreased by about 2-3°C and remained at 33.3°C. Both whole body and torso thermal sensations were improved. The findings indicate that the personal cooling with PCM can be used as an option to improve thermal comfort for office workers without air conditioning and may be used for vulnerable groups, such as elderly people, when confronted with heat waves. PRACTICAL IMPLICATIONS: Wearable personal cooling integrated with phase change materials has the advantage of cooling human body's micro-environment in contrast to stationary personalized cooling and entire room or building cooling, thus providing greater mobility and helping to save energy. In places where air conditioning is not usually used, this personal cooling method can be used as a preventive measure when confronted with heat waves for office workers, vulnerable populations such as the elderly and disabled people, people with chronic diseases, and for use at home.

Temperature limit values for touching cold surfaces with the fingertip.

OBJECTIVES: At the request of the European Commission and in the framework of the European Machinery Directive, research was performed in five different laboratories to develop specifications for surface temperature limit values for the short-term accidental touching of the fingertip with cold surfaces. METHODS: Data were collected in four laboratories with a total of 20 males and 20 females performing a grand total of 1655 exposures. Each touched polished blocks of aluminium, stainless steel, nylon-6 and wood using the distal phalanx of the index finger with a contact force of 1.0, 2.9 and 9.8 N, at surface temperatures from +2 to -40 degrees C for a maximum duration of 120 s. Conditions were selected in order to elicit varying rates of skin cooling upon contact. Contact temperature (TC) of the fingertip was measured over time using a T-type thermocouple. RESULTS: A database obtained from the experiments was collated and analysed to characterize fingertip contact cooling across a range of materials and surface temperatures. The database was subsequently used to develop a predictive model to describe the contact duration required for skin contact temperature to reach the physiological criteria of onset of pain (15 degrees C), onset of numbness (7 degrees C) and onset of frostbite risk (0 degrees C). CONCLUSIONS: The data reflect the strong link between the risk of skin damage and the thermal properties of the material touched. For aluminium and steel, skin temperatures of 0 degrees C occurs within 2-6 s at surface temperatures of -15 degrees C. For non-metallic surfaces, onset of numbness occurs within 15-65 s of contact at -35 degrees C and onset of cold pain occurs within 5 s of contact at -20 degrees C. The predictive model subsequently developed was a non-linear exponential expression also reflecting the effects of material thermal properties and initial temperature. This model provides information for the protection of workers against the risk of cold injury by establishing the temperature limits of cold touchable surfaces for a broad range of materials, and it is now proposed as guidance values in a new international standard.

Cold but comfortable? Application of comfort criteria to cold environments.

UNLABELLED: Fanger defined two physiological criteria that are basic requirements for people's perception of thermal neutrality and, eventually, thermal comfort. Mean skin temperature and evaporative heat loss are defined as functions of metabolic rate. The equations are derived from experiments in light clothing at or close to normal indoor climate. Relations between skin temperature and sweating on the one hand and thermal sensation and comfort on the other are well recognized; the precise description of the relationships vary and may differ from normal indoor environments to more extreme thermal stress. In moderately cold environments (around +10 degrees C) ISO/DIS 7730 and ISO/DIS 11079 prescribe significantly different responses. Evaluation of the rationale behind the comfort criteria and the basic heat transfer equations in the two models reveals some clear differences. By modification of the sweating criteria and some of the heat transfer equations, predictions become much more similar. It is concluded that the basic comfort criteria may apply also to moderately cold and cold environments, but must consider the complex heat transfer through multilayer clothing in a more adequate way. PRACTICAL IMPLICATIONS: The suggested, modified comfort criteria incorporated either in the PMV-index or in the IREQ-index, provide more realistic and reliable prediction of heat balance and conditions for comfort in cool and cold environments.

Comfort climate evaluation with thermal manikin methods and computer simulation models.

With increasing demand for acceptable environment in the modern workplace is it necessary, already in the construction phase, to estimate what effect different environmental factors have on the occupants. Thermal sensation is affected by many factors in the work place environment, especially thermal factors and effects from air movement caused by different ventilation principles. A series of full scale measurements as well as numerical calculations have been carried out in order to investigate whether Computational Fluid Dynamics (CFD) calculations and measurements with a thermal manikin are able to predict the perceived thermal climate. When human thermal sensation is linked together in measurements and calculations, the thermal situation in the work place environment is visualized. The results show relatively good agreement with the measurements made in the real environment. However, numerical and experimental methods need to be further developed. Evaluation methods of this type, will enable engineers to make better predictions and early decisions in the design and construction process. This also opens possibilities to use results from a number of full scale tests providing means to improve the comfort, health and productivity in working life.

Temperature limit values for gripping cold surfaces.

OBJECTIVES: At the request of the European Commission and in the framework of the European Machinery Directive, research was conducted jointly in five different laboratories to develop specifications for surface temperature limit values for the gripping and handling of cold items. METHODS: Four hundred and fourteen experiments were run where male and female subjects were invited to grip for up to 20 min cold bars of different contact coefficients, i.e. polished wood, nylon, stone, steel and aluminium. The air temperature and the bars' initial surface temperatures ranged between 0 and -30 degrees C for the various experiments. While gripping the bars, either only the hand or the whole body was exposed to cold. RESULTS: The data were used to develop a prediction formula and a graph of the surface temperature limit values in order for the skin contact temperature not to reach <15 degrees C. This duration is shown to offer a significant degree of safety with respect to the minimal surface temperature spontaneously tolerated by the subjects. CONCLUSIONS: Experiments and modelling must be pursued to extend these data to other conditions of exposure.

Assessment of the risk of heat disorders encountered during work in hot conditions.

OBJECTIVE: To co-ordinate the work of the main European research teams in the field of thermal factors in order to develop and improve significantly the methods presently available for assessing the risks of heat disorders encountered during work in hot conditions. METHOD: Each item from the required sweat rate model was reviewed on the basis of the most recent literature. A database with 1,113 laboratory and field experiments, covering the whole range of hot working conditions, was assembled and used for the validation. RESULTS: Influence of clothing ensemble on heat exchange: methods and formulas were developed that take into account the dynamic effects associated with forced convection and the pumping effect associated with body movements and exercise. Prediction of the average skin temperature: the model used in the required sweat rate standard ISO 7933 was extended to cover more severe conditions with high radiation and high humidity and different clothing and take into account the rectal temperature for the prediction of the skin temperature. Criteria for estimating acceptable exposure times in hot work environments: criteria were reviewed and updated concerning the maximum increase in core temperature and the acceptable water loss, for acclimatised and nonacclimatised subjects. These limits are intended to protect 95% of the population. Measuring strategy: a strategy was developed to assess the risks in any working situation with varying conditions of climate, metabolic rate or clothing. A detailed methodology was developed in three stages: an "observation" method for the recognition of the conditions that might lead to thermal stress; an "analysis" method for evaluating the problem and optimising the solutions; and an "expert" method for in-depth analysis of the working situation when needed. VALIDATION: the different results were used to prepare a revision of the interpretation procedure proposed in the ISO standard 7933. We validated the modified approaches using the database. This involved the whole range of conditions for which the model was extended, namely conditions with high and low radiation, humidity and air velocity as well as fluctuating conditions. Based on these results, the predicted heat strain model was developed: it is presently proposed as an ISO and CEN standard.

Validation of methods for determination of metabolic rate in the Edholm scale and ISO 8996.

The aim of this study was to validate the Edholm scale (Edholm, 1966) and the ISO 8996 standard (International Organization for Standardization [ISO], 1990) by comparing the metabolic rates estimated for both methods with the actual measured metabolic rate (MMeas) in 6 manual material handling tasks simulated under laboratory conditions. The metabolic rate was calculated from oxygen consumption VO2 (19 participants) according to Standard No. ISO 8996 (ISO, 1990). Additionally, the participants estimated perceived exertion using the Borg scale. The metabolic rates derived from the Edholm scale (MEdh) overestimated 5 of 6 activities by 34-50% (alpha = .05). The metabolic rates derived from ISO 8996 (MISO) overestimated all activities by 7-38% (alpha = .05).

[Functionality of inhalation aerosols is inadequate or lost at low temperature]. / Inhalationsaerosolers funktion försämras eller uteblir i kyla.

Correct and safe performance of metered-dose inhalers are necessary for efficient treatment of asthma under all climatic conditions. The spray mechanism malfunctioned when canister temperature was below -15 degrees C. The range and propagation of the spray plume at canister temperatures below 10 degrees C deviated clearly from those at 20 degrees C. Also the composition and particle concentration of the spray plume at low temperatures differed from those at more normal temperatures. Information must be provided to the effect that a canister must not be cold when used.

Effects of metabolic rate on thermal responses at different air velocities in -10 degrees C.

The effects of exercise intensity on thermoregulatory responses in cold (-10 degrees C) in a 0.2 (still air, NoWi), 1.0 (Wi1), and 5.0 (Wi5) m x s(-1) wind were studied. Eight young and healthy men, preconditioned in thermoneutral (+20 degrees C) environment for 60 min, walked for 60 min on the treadmill at 2.8 km/h with different combinations of wind and exercise intensity. Exercise level was adjusted by changing the inclination of the treadmill between 0 degrees (lower exercise intensity, metabolic rate 124 W x m(-2), LE) and 6 degrees (higher exercise intensity, metabolic rate 195 W x m(-2), HE). Due to exercise increased heat production and circulatory adjustments, the rectal temperature (T(re)), mean skin temperature (Tsk) and mean body temperature (Tb) were significantly higher at the end of HE in comparison to LE in NoWi and Wi1, and T(re) and Tb also in Wi5. Tsk and Tb were significantly decreased by 5.0 m x s(-1) wind in comparison to NoWi and Wi1. The higher exercise intensity was intense enough to diminish peripheral vasoconstriction and consequently the finger skin temperature was significantly higher at the end of HE in comparison to LE in NoWi and Wi1. Mean heat flux from the skin was unaffected by the exercise intensity. At LE oxygen consumption (VO2) was significantly higher in Wi5 than NoWi and Wi1. Heart rate was unaffected by the wind speed. The results suggest that, with studied exercise intensities, produced without changes in walking speed, the metabolic rate is not so important that it should be taken into consideration in the calculation of wind chill index.

Development and validation of the predicted heat strain model.

Eight laboratories participated in a concerted research project on the assessment of hot working conditions. The objectives were, among others, to co-ordinate the work of the main European research teams in the field of thermal factors and to improve the methods available to assess the risks of heat disorders at the workplace, and in particular the "Required Sweat Rate" model as presented in International Standard ISO 7933 Standard (1989). The scientific bases of this standard were thoroughly reviewed and a revised model, called "Predicted Heat Strain" (PHS), was developed. This model was then used to predict the minute by minute sweat rates and rectal temperatures during 909 laboratory and field experiments collected from the partners. The Pearson correlation coefficients between observed and predicted values were equal to 0.76 and 0.66 for laboratory experiments and 0.74 and 0.59 for field experiments, respectively, for the sweat rates and the rectal temperatures. The change in sweat rate with time was predicted more accurately by the PHS model than by the required sweat rate model. This suggests that the PHS model would provide an improved basis upon which to determine allowable exposure times from the predicted heat strain in terms of dehydration and increased core temperature.

Validation of a model for prediction of skin temperatures in footwear.

A model for foot skin temperature prediction was evaluated on the basis of 2 experiments on subjects at various environmental temperatures (light seated manual work at -10.7 degrees C (Study 1), and a short walking period in combination with standing and sitting at +2.8 degrees C, -11.8 degrees C and -24.6 degrees C (Study 2), with boots of 3 insulation levels. Insulation of the footwear was measured on a thermal foot model. Predicted and measured data showed a relatively good correlation (r = 0.87) at the 2 colder conditions in Study 2. The environmental temperature of 2.8 degrees C was not low enough at the chosen activity for a considerable foot skin temperature drop. In Study 1 the predicted temperature stayed higher for the whole exposure period and the difference between the predicted and the measured foot skin temperatures grew proportionally with time, while subsequent warm-up curves at room temperature were almost parallel. In Study 1 the correlation was 0.95. However, the paired t-test showed usually significant differences between measured and predicted foot skin temperatures. The insulation values from thermal foot measurements can be used in the model calculations. Lotens' foot model is lacking activity as direct input parameter, however, the blood flow is used instead (effect through Tcore). The Lotens foot model can give reasonable foot skin temperature values if the model limitations are considered. Due to the lack of activity level input, it will be difficult to make any good estimation of foot skin temperature during intermittent exercise. The rate of the foot temperature recovery after cold exposure was somewhat overestimated in the model--the warm-up of the feet of the subjects started later and was slower in the beginning of the warm-up than in the prediction. It could be useful to develop the model further by taking into consideration various wetness and activity levels.

Thermal responses to cold wind of thermoneutral and cooled subjects.

The effects of initial thermal state on thermoregulatory responses to cold (-10 degrees C) in a 0.2 (still air), 1.0, and 5.0 m. S(-1) wind speed were studied. Eight young male subjects were first preconditioned in thermoneutral (+20 degrees C, TN) or cool (-5 degrees C, CO) environment for 60 min. After preconditioning the subjects were exposed to wind at -10 degrees C in a standing position, facing the wind, for 30 min. Precooling decreased mean skin temperature (Tsk) by 4.0 (SEM 0.1) degrees C (P < 0.001) and increased heat flux by 57 (SEM 2) W x m(-2) (P < 0.001) in comparison to TN. Cooling rate of Tsk was faster (P < 0.001) in TN than in CO at every wind speed. Even so, Tsk ended up at a lower level in CO (P < 0.001-0.01) than in TN at every wind speed. Local skin temperatures of hand, finger, foot and toe were significantly lower in CO than in TN at the end of all exposures to wind. Heat flux from the skin was 8% higher (NS) in TN at 5.0 m x s(-1) wind speed in comparison to CO. A 5.0 m x s(-1) wind speed increased oxygen consumption significantly (P < 0.001) in both CO and TN in comparison to still air. At 5.0 m x s(-1) wind speed the general thermal sensation was the same (cold) in both TN and CO, despite the higher Tsk in TN. In conclusion, Tsk decreased more rapidly in TN, probably due to rapid skin vasoconstriction and redistribution of circulation to the central body. Probably for the same reason, dry heat loss from the skin was at nearly the same level in both TN and CO. Although the initial thermal state did not affect the amount of heat loss, it significantly affected the peripheral temperatures and thermal sensations and should therefore be taken into consideration in the prediction of thermophysiological responses to wind.

Strategies for prevention of cold stress in the elderly.

Human health and wellbeing require simple and effective strategies for prevention and alleviation of harmful effects of cold exposure. Adoption of a strategy should consider the type of cold stress; (1) whole body cooling, (2) extremity cooling, (3) convective cooling (wind chill), (4) conductive cooling (contact), and (5) airway cooling. The prime goal is to prevent tissue cooling. The risk, nature and magnitude of strain depend largely on the cooling effect, which results from the interaction of climate factors (mainly air temperature and wind), protection (clothing) and metabolic heat production (activity, "behaviour"). The effects (strain) of tissue cooling are acute, progressive or chronic. Acute effects are primarily thermoregulatory reflexes mediated by the sympathetic system and comprise immediate cardiovascular and respiratory reactions. Progressive effects are characterized by gradual temperature drop in peripheral or core tissues. This results in pain, neuro-muscular insufficiency, sensory loss and, eventually, cold injury. Chronic effects are likely to affect peripheral nerves and vessels, as well as cardio-respiratory function. The progressive degradation of physiological functions in the elderly increases the risk of harmful effects with cold exposure. This requires careful examination of relevant assessment criteria, as well as the development of simple and efficient strategies for prevention of cold stress.

Prediction of duration limited exposure for participants wearing chemical protective clothing in the cold.

The suitability of the IREQ (insulation required) index for predicting the thermal responses of 6 participants wearing chemical protective clothing was tested during exercise at -20 and -25 degrees C. IREQ was used to calculate duration limited exposure (DLE). Measured DLE correlated (r =0.899, p <0.001) with the predicted DLE. In exposures exceeding 40 min, however, the predicted DLE tended to be 10-20 min too short compared to the measured one. During short exposures the prediction was 5-20 min too long. The results show that IREQ overestimated the cold strain in participants wearing chemical protective clothing during cold exposures longer than 40 min. Nevertheless, predicted DLE never exceeded measured times and thus the prediction was always safe from the occupational point of view.

Face temperature and cardiorespiratory responses to wind in thermoneutral and cool subjects exposed to -10 degrees C.

The effects of the thermal state of the body (slightly cool and neutral) and moderate wind speeds on face temperature, blood pressure, respiratory function and pain sensation during cold exposure were studied on eight healthy male subjects. They were dressed in cold-protective clothing and preconditioned at + 20 degrees C (TN) and -5 degrees C (CO) for 60 min, then exposed to -10 degrees C and 0 m x s(-1) (NoW), 1 (W1) and 5 (W5) m x s(-1) wind for 30 min. Thus, each individual was exposed six times. The exposure to wind entailed a combination of strong cooling of the bare face and mild body cooling. The forehead, cheek and nose temperatures decreased during cold exposure, and the decrease was greater at higher air velocities (P < 0.0001). All subjects reported pain sensations at 5 m x s(-1). At the end of exposure only the nose temperature was significantly lower in CO than in TN subjects; it was about 2 degrees C and reached 0 degrees C in two experiments. The systolic and diastolic blood pressure (SBP and DBP, respectively) increased significantly by 7.7 and 5.9 mmHg, respectively, during preconditioning at -5 degrees C, but did not change at + 20 degrees C. SBP and DBP increased during exposure to -10 degrees C in TN by approximately 9 mmHg. However, the total average increase of blood pressure (1-90 min) was similar in TN and CO (SBP 15 mmHg and DBP 13 mmHg). SBP and DBP increased more during exposure to 5 m x s(-1) at -10 degrees C than NoW. Blood pressure responses as observed in this study (SBP and DBP up to 51 and 45 mmHg, respectively) are potential health risks for hypertensive individuals and angina patients. Respiratory functions (FVC, FEV1) were reduced by about 3% by the cold (-5 and -10 degrees C) compared to pre-experiment values. Furthermore, the Wind Chill Index seems to underestimate the cooling power of 5 m x s(-1) at -10 degrees C of bare skin (e.g. face). Therefore it needs to be revised and we suggest that it is expanded to include risk levels for pain sensation.

Change of footwear insulation at various sweating rates.

Moisture inside the footwear can considerably affect the thermal insulation. In this study with a thermal foot model there was simulated three sweat rates (3, 5 and 10 g/h). Five types of footwear with various insulation levels (dry insulation from 0.19 to 0.50 m2. K/W) were tested. The footwear insulation reduction was calculated for 1.5 hour period. The reduction in insulation was related to sweating rate and initial insulation. The footwear with high insulation lost even in percentile more insulation than thin boots under the same conditions (9-19% at 3 g/h, 13-27% at 5 g/h and 19-36% at 10 g/h). A relationship between insulation decrease and sweating rate was established. An 8-hour sweating test (5 g/h) and a test for determining evaporative heat, losses were carried out in addition. The insulation reduction during the first 1.5 hours of the 8-hour test answered for more than half of the total reduction.

Evaluation of hand and finger heat loss with a heated hand model.

A heated full-scale hand model has been used to determine indirectly hand and finger heat losses of human subjects exposed to four ambient cold conditions (0, 4, 10 and 16 degrees C, air velocity approximately 0.3 m/s). Heat transfer coefficients determined with the hand model, were used to calculate heat flux based on measured skin to ambient temperature gradients. The responses of eight subjects from a previous study were used for the analysis. The measurements were carried out in a small climate chamber which was cooled by evaporating liquid carbon dioxide. The thermal hand was put into the chamber in a vertical position with the thumb up. The surface temperature of the thermal hand was controlled at 21, 25, 28, 31 and 34 degrees C under each of the four ambient cold conditions, in order to investigate possible temperature dependence of the calculated combined convective and radiate heat transfer coefficient (hCR). The value of hCR varied between approximately 9-13 W/m2 degree C for fingers and palm and back of hand, respectively. Calculated heat losses showed significant individual variation, corresponding to the maintained skin to ambient temperature gradient. Individual values from about 50 to more than 300 W/m2 were calculated. Several subjects showed CIVD and heat fluxes associated with this phenomenon were sometimes doubled. The measurement results showed realistic and comparable with literature date. The advantages of the thermal hand model can be counted as easy to use; directly measures the heat loss; highly reproducible and no interruption. It appears that a heated hand model provides a useful methods for analysis and quantification of hand heat loss.