A health promotion programme for oil refinery employees: changes of health promotion needs observed at three years.

The main aim of this three-year follow-up study was to evaluate the long-term effects of a workplace health promotion intervention programme offered by the Neste Oyj corporation's occupational health service. Another aim was to study factors associated with changes in health promotion needs. These were assessed using information obtained by means of questionnaires and laboratory measurements. The target areas assessed were physical activity, musculoskeletal problems, dietary habits, obesity, blood pressure, serum lipids, smoking, quality of sleep and mental well-being. Participants from one oil refinery were offered special health promotion counselling, while those from the other oil refinery studied received only their personal results, written information and instructions. Evaluation of the changes in needs was mainly based on comparison of the results of two examinations performed with an interval of three years. Effects of special health promotion counselling were observed in the target area of physical activity. Elimination of certain health promotion needs was seen in both groups in all of the target areas. The most extensive changes were seen in the target areas of musculoskeletal symptoms, dietary habits, blood pressure and mental well-being. Basic education, occupational status and age-group, as well as the value of tending health were frequent variables explaining the reduction in the need for health promotion activities. Worker participation in health promotion counselling activities provided by occupational health services can be high, as in this study in which the participation rate was 90% and the drop-out rate during the three years only 10%.

Life-style related health promotion needs in oil refinery employees.

This report describes the screening procedure used in the assessment of health promotion needs in a group of oil refinery employees (n = 885). The aim of the study was to assess the life-style related health promotion needs before initiating an intervention programme study. The frequency of different health promotion needs and their distribution according to age, gender and employee group were examined, as well as the factors explaining different health promotion needs. The assessment was based on laboratory tests and questionnaires covering the target areas of physical activity and fitness, dietary habits, overweight, blood pressure, serum lipids, smoking, alcohol consumption, sleep, mental health, and musculoskeletal symptoms. Life-style related health promotion needs were frequent. Self-assessed health was strongly associated with health promotion needs in most of the ten target areas and also with the total number per person of areas with health promotion needs. Health promotion needs were also associated with such demographic variables as age, gender, basic education, and vocational training. If health promotion activities are provided to employees in a company, assessment of individual needs is necessary to find the employees with the greatest need of health promotion actions. This study presents one method of screening, although certain simplification is needed to make it fit into the daily routines. The contents of health promotion activities could also vary according to the differences related to age and gender observed in health promotion needs of the target population.

The role of occupational and non-occupational factors in workers ill-health.

In most European countries occupational health and public health have developed separately, the reasons behind this are mainly historical and political. Although this may be understandable, even today, due to the political factors involved, it is amazing that the research on the morbidity and mortality of people of working age does not aim at comprehensive analyses of etiological factors behind these types of health outcomes. Our knowledge on the health needs of workers is limited, in most countries we even lack any information on distribution of the major illnesses amongst the various occupational categories. Some information, however, is currently being gathered, based on the need to make operational the concept of work-related diseases which has been put forward by WHO. The US NIOSH programme on work-related diseases, or the Danish TOP-11-Programme, serve as examples for these types of developments. Additional need to study the causes of ill-health, and ways to counteract them amongst the working population, results from the health promotion action that has also been developed as a part of the HFA 2000. The aim of this overview is to study the importance of occupational and non-occupational factors in the etiology of the ill-health of workers. Evidently, such analyses are premature today. However, some anecdotal examples will be mentioned. The major emphasis of the paper is, however, laid on the needs for the coordination and evaluation of occupational health and other health programmes concerning those of working age. Some assumptions will also be made on the development of occupational health and the consequences of this development for those who are occupational health practitioners.

Cytotoxic effects of four types of welding fumes on macrophages in vitro: a comparative study.

The effects of fume particles given off by the manual metal arc (MMA) and metal inert gas (MIG) welding of stainless steel (SS) and mild steel (MS) were studied on rat alveolar macrophage cultures in vitro. The fumes were generated by welding, and particulate material obtained was collected on membrane filters. The macrophage cultures were exposed to the total dust and to its water-insoluble fractions. Cell variability and the release of both lactate dehydrogenase and one lysosomal enzyme from the cells to the medium were measured after an exposure period of 24 h. The cytotoxic control dust was DQ 12 quartz, and the inert control dust was pure titanium dioxide. According to the parameters studied, SS/MMA and MS/MMA welding fumes were cytotoxic to rat alveolar macrophages. The cytotoxic effect of SS/MMA welding fumes decreased after the samples had been washed with phosphate-buffered salt solution. The MIG welding fumes of SS and MS had markedly smaller effects on the cells. Diluted solutions of potassium chromate were also tested in order to investigate its role in the cytotoxicity of SS/MMA welding fumes. The results suggest that hexavalent chromium may be responsible for the cytotoxicity of SS/MMA.

Body fluid proteins and peptides as tumour markers in clinical cancer research and in monitoring exposure to carcinogens.

A brief review is given of the various groups of peptides and proteins that have been applied as tumour markers in human studies. Special attention is given to markers used for detection of bronchogenic lung tumours. In addition, a review is made of the few published studies on the levels of certain tumour markers in working populations that have been exposed to carcinogens. There is a considerable lack of present knowledge on the applicability of tumour marker assays to monitoring of human exposure to carcinogens. When such studies are planned, it is valuable to combine these analyses with other types of indicators of carcinogen exposure and effects.

Effects of ionophores and metabolic inhibitors on the mitochondrial membrane potential within isolated hepatocytes as measured with the safranine method.

A difference spectrum with a peak of absorbance at 526nm appears slowly upon addition of valinomycin or KCN in combination with oligomycin to a hepatocyte suspension in the presence of safranine. When the cells are incubated at 37 degrees C in a medium containing safranine, a slow decrease in the absorbance occurs at the wavelength pair 524-484 nm. The change in absorbance is completed within 20-30 min after additions of cells to a medium containing safranine. At this time the safranine concentration of the outer medium is considerably decreased. The safranine signal is completely reversed by valinomycin, carbonyl cyanide p-trifluoromethoxyphenyl-hydrazone or KCN in combination with oligomycin. None of these treatments have any immediate effect on cellular ATP concentrations or the 36Cl- equilibrium potential across the plasma membrane. In the presence of iodoacetate a slow reversal of the trace can be induced upon addition of KCN, but not of oligomycin alone. Rotenone, in combination with oligomycin, does not reverse the safranine signal except when both KF and iodoacetate are present, in which case a slow reversal is seen. A subsequent addition of duroquinone brings back the signal to the same level as in the presence of rotenone alone. The results indicate that the spectral response of safranine in the presence of isolated hepatocytes is a result of a slow penetration of safranine into intracellular mitochondria, where aggregation of safranine molecules occurs as a response to the mitochondrial membrane potential.

Effect of propranolol and related drugs on transmembraneous pH differences in liposomes.

Propranolol (1-isopropylamino-3-(1-naphtoloxy)-propan-2-ol) a beta-adrenergic receptor blocking agent was found to cause changes of transmembraneous pH in liposomes prepared from Soy-lecithin and cardiolipin. When the external pH was neutral and the internum of the liposomes acidic, the drug decreased the pH gradient. When the externum was acidic and the internum neutral, the gradient was increased by the drug. The effect of butacaine was similar to that of propranolol, while procaine, timolol and practolol were ineffective. It is suggested that the charged form of propranolol is bound to the membrane and dislocates protons from binding sites in the membrane and that the uncharged form of propranolol penetrates the membrane. After penetration it could associate with protons in the intraliposomal compartment and hence increase the pH of the interior. Depending on the direction of the pre-existing proton gradient propranolol would thus be able to increase or decrease the pH difference across the liposomal membrane.

Change of mitochondrial buffering capacity induced by propranolol.

Propranolol is able to increase the amount of the titratable groups of mitochondrial membranes. This effect occurs with sonicated particles and with liposomes, too. The phenomenon is only seen in the presence of salt solutions, not in sucrose. Propranolol increases the fluorescence of anilino-naphthalene sulphonate (ANS) in mitochondrial suspensions. The increase is counteracted by increasing concentrations of potassium chloride. It is suggested that the increase of the titratable groups results from a decrease of the aggregation of the phospholipids of the membranes. At the same time the environment of the bound ANS molecules is more hydrophobic in sucrose than in potassium chloride. The amount of the buffering groups and the hydrophilicity are in direct and the amount of the buffering groups and the fluorescence of ANS in inverse correlation.

Action of propranolol on mitochondrial proton fluxes.

The action of propranolol, a Beta-blocking adrenergic agent, on mitochondrial proton fluxes in nonenergized and energized conditions has been studied. 1. The drug inhibited the actions of valinomycin, higericin and FCCP on the inner mitochondrial membrane. 2. It decreased the rate and extent of active energized proton expulsion and passive collapse of the proton gradient so formed. 3. Propranolol was able to increase the permeation of chloride ion through the inner mitochondrial membrane in nonenergized and energized conditions. 4. The drug inhibited mitochondrial contraction but stimulated swelling in various conditions. It is suggested that propranolol is is able to change the proton and chloride permeabilities of mitochondria by perturbing the structure of inner membrane phospholipids, thus enlarging the water-lipid interface.