Cardiorespiratory fitness of finnish adolescents.

We evaluated the accuracy of a submaximal cycle ergometer test to assess cardiorespiratory fitness in adolescents and provided population-based reference values. In a health study of the Northern Finland birth cohort born in 1985 - 1986 (NFBC 1986), cardiorespiratory fitness of 5375 males and females aged 15 to 16 years was measured by a submaximal cycle ergometer test by using a two-stage exercise protocol designed for this survey. A total of 4903 subjects performed two work stages. Maximal workload and peak oxygen consumption were calculated on the basis of heart rate responses by the WHO extrapolation method. An additional 472 subjects were able to finish only one work stage. For them, peak oxygen uptake was calculated by the Astrand nomogram. To evaluate the accuracy of submaximal testing, a validation sample of 90 subjects carried out both a submaximal test and a maximal cycle ergometer test with direct measurement of peak oxygen uptake. The WHO method proved to estimate peak oxygen uptake with reasonable accuracy. The Astrand nomogram method overestimated peak oxygen uptake considerably, and therefore a new single-stage regression method was applied to calculate maximal workload and peak oxygen consumption. Reference values of cardiorespiratory fitness were provided for 2690 males and 2685 females aged 15 to 16 years.

Body mass index and weight change from adolescence into adulthood, waist-to-hip ratio and perceived work ability among young adults.

OBJECTIVES: To study how body mass index (BMI, kg/m2) at 14 and 31 years (y) changes in BMI between 14 and 31 y, and waist-to-hip ratio (WHR) at 31 y are associated with poor perceived working ability at 31 y. DESIGN AND SUBJECTS: A population-based cohort, originally 11637 people, born in Northern Finland in 1966 was resurveyed at 14 and 31 y. MEASUREMENTS: Perceived work ability (measured by modified work ability index, WAI), BMI, WHR, alcohol intake, smoking, basic education and work history were recorded at 31 y and BMI also at 14 y. RESULTS: Low WAI (15% of lowest values) at 31 y showed a U-shaped association with BMI at 14 y, and also with BMI at 31 y, except in obese males. Low WAI similarly had a U-shaped association with WHR, but in males only, while in females, the probability of low WAI increased almost linearly with WHR. Low WAI was more common among smokers and people with a low level of education. The pattern for alcohol intake was more equivocal, with a nonsignificant finding in males and an almost linear decrease of low WAI with increasing alcohol intake in females. CONCLUSIONS: Work ability, health habits and anthropometric measures should be evaluated regularly in young workers, and preventive measures against diseases leading to premature retirement should be taken in time, for example by the occupational health-care service.

Extractable latex allergens in airborne glove powder and in cut glove pieces.

BACKGROUND: Quantification of natural rubber latex (NRL) allergens of NRL glove extracts has been reported in several studies. Similarly, immunoassay studies reporting the level of NRL aeroallergens in air samples have been published. When studying the NRL allergens of gloves, however, little attention has been focused on identifying the relationship between extractable NRL allergens of medical gloves and NRL aeroallergens in indoor air. OBJECTIVE: In an experimental study we analysed NRL aeroallergens of medical gloves in joint relation to total airborne dust concentration and NRL allergen concentration in gloves. METHODS: NRL aeroallergen level was measured using a chamber setting with 18 lots of powdered medical gloves. In each setting 10 pairs of powdered NRL gloves were swinging in an unventilated chamber (9 m3). Air samples were collected using airflow through Millipore filters (pore size 0.8 microm). The filters were weighed before and after the experiment, and total airborne dust concentration in the chamber was calculated. The filter samples were then extracted and the NRL allergen level measured by IgE ELISA-inhibition assay. Furthermore, cut NRL gloves were extracted and analysed by the same method. Finally, levels of two major NRL allergens, Hev b1 and Hev b 6.02, were measured in three selected NRL glove brands. RESULTS: The NRL aeroallergen level in the chamber air ranged from < 0.9 to 2.9 allergen units (AU)/m3. The total airborne dust concentration in the chamber air remained low with all lots of gloves measured (range < 20 to 80 microg/m3). The NRL allergen level in cut glove extracts varied over 100-fold (< 10 to 1050 AU/mL). Statistically significant correlation between aeroallergen concentration and airborne dust (r = 0.8, P = 0.0015) concentration was found. Moreover, significant correlation between aeroallergen levels and allergen content of cut glove pieces was observed (r = 0.59, P < 0.05). Hev b 1 levels varied from 9 to 25 ng/mL and the levels of Hev b 6.02 from 1720 to 14460 ng/mL in the glove extracts. In the extracts from airborne dust samples, Hev b 6.02 content varied from 61 to 183 ng/m3, whereas Hev b 1 levels were very low (0.4 to 3 ng/m3). CONCLUSION: An elevated NRL aeroallergen level is rather related to a high level of airborne glove powder than to a high concentration of extractable NRL allergen in medical gloves.

A review of current literature on epidemiology of immediate glove irritation and latex allergy.

Natural rubber latex (NRL) allergy has attained world-wide importance with the diagnosis of glove hypersensitivity, contact urticaria, rhinitis, conjunctivitis, asthma and anaphylaxis. In the present report, the latest literature of the epidemiology of NRL allergy is reviewed, an account on the incidence of NRL allergy (19 new cases of contact urticaria/100,000 workers per year) among health care workers is given and the prevention of NRL allergy is discussed. Among health care workers, NRL allergy has gained prominence particularly with the spread of AIDS and an increase in the use of rubber gloves for barrier protection. For screening NRL allergy, a simple and quick test based on a self-administered questionnaire has been presented, but it needs further evaluation before routine use can commence. Further analytic studies will show if the use of low allergen gloves reduces the incidence of NRL allergy.

Occupational induction of hypersensitivity after an accidental exposure to chloromethylisothiazolinone and methylisothiazolinone (CMI/MI) in an industrial worker.

A process worker in a paper chemical plant developed an immediate local dermal irritation and delayed bullous dermatitis due to induction of hypersensitivity following an accidental exposure to chloromethylisothiazolinone and methylisothiazolinone (CMI/MI) biocide. Contact allergy to the isothiazolinone mixture was confirmed by skin patch testing. The dermatitis healed in four weeks, and the worker was advised to avoid all CMI/MI containing products. In a one-year follow-up he did not present with any further skin symptoms. Preventive measures are important for avoiding induction of hypersensitivity to concentrated CMI/MI solutions in industrial workers.

Postal questionnaire study of disability associated with latex allergy among health care workers in Finland.

In this study, the association between natural rubber latex (NRL) sensitization and work ability index (WAI) among health care workers was investigated. Furthermore, the diagnostic sensitivity and specificity of a postal questionnaire as a screening device of NRL allergy was evaluated. The study population consisted of 32 female health care workers with an occupational latex allergy, and 51 control subjects who were individually matched for age and occupation. A self-administered two-part questionnaire, including seven items of a work ability index (WAI), as well as questions on glove-related symptoms, was mailed to the subjects. The median age for NRL allergic subjects was 40 years (range 23-62), and the diagnosis of occupational latex allergy had been made six years (range 2-16) before the present study. The WAI scores were on average lower among the sensitized subjects as compared with their nonsensitized controls. Even after removing the contribution of the presence of allergic eczema, diagnosed by a physician, from the original WAI score, the proportion of NRL allergic subjects and the control subjects in the good work ability category were 34% and 53%, respectively. Ten health care workers (31%) had changed occupation and one early retirement had occurred after sensitization to NRL. The sensitivity and specificity of the present self-administered questionnaire as an indicator for latex allergy was 84% and 98%, respectively. In conclusion, there is a clear association between NRL allergy and a decrease in the WAI among health care workers, which cannot be explained by age, gender, profession, or history of atopy.

Evaluation of occupational health service in the wood processing industry--determination of employee satisfaction.

In order to define priorities for improvement of the occupational health service (OHS) in one primary health care unit, employees' satisfaction was evaluated with a postal questionnaire. The questionnaire covered items on service reservation, personal health education received, quality of the OHS, and use of the OHS within six months by the employees. This evaluation was one step of the quality system that was planned in accordance with the ISO 9004-2 standard for continuous quality improvement of OHS. The study population was all of 1,050 employees working for five employers; 546 (52%) employees responded to the inquiry. However, only 377 of them had made use of the OHS within the last six months before the inquiry. The mean age of the responders was 42 years (SD = 9 years) and 76% of the respondents were men. The percentages of employees with a high degree of satisfaction with the quality of the OHS and personal health education in the OHS were 76% and 69%, respectively. However, concerning the quality of the OHS, the proportion of highly satisfied employees was 27% higher (95% CI = 19-35%) among those who had used OHS within six months compared to the others. Furthermore, when the oldest (> 48 years) and the youngest (< 35 years) age groups were compared, the difference between the proportions of highly satisfied employees was 21% (95% CI = 31%). In conclusion, the high differences suggest a close linkage between the employee's satisfaction with the OHS, the use of the OHS and ageing.

Glove-related rhinopathy among hospital personnel.

Hypersensitivity to natural rubber latex (NRL) in health care personnel exposed to powdered latex gloves appears as conjunctivitis, rhinitis, nasal congestion, cough, dyspnea, or bronchial asthma in approximately 30% of all cases with latex allergy while most of the patients have contact urticaria. The purpose of the present study was to determine the prevalence of latex-induced allergic rhinitis in health care workers using NRL gloves on a daily basis. Clinical examination accompanied by skin prick test (SPT) with latex glove extracts and common aeroallergens, measurements of specific IgE to NRL, and lung function tests were performed in 25 symptomatic workers and 11 latex-exposed asymptomatic controls. Sensitization to NRL was detected using SPT in one (4%) of 25 symptomatic workers but not in any of the asymptomatic controls. Positive SPT to aeroallergens was demonstrated in 8/25 symptomatic workers and 6/11 controls. Measurements of forced vital capacity, forced expiratory volume in I sec, and bronchial methacholine challenge did not show any significant differences between the study groups. In conclusion, NRL-aeroallergen-induced occupational rhinitis may occur among physicians and nurses who have a frequent use of latex gloves on a daily basis at hospital work. However, a relatively low prevalence of NRL-induced occupational rhinitis is associated with profuse consumption of no-powder sterile gloves.

Latex-induced allergic rhinitis in a laboratory nurse.

A case of occupational rhinitis in association with natural rubber latex hypersensitivity is presented. In the nasal provocation test for natural rubber latex glove powder the nurse experienced rhinorrhoea. A significant increase in the amount of nasal secretion and mucosal oedema could be detected. The patient also showed a positive skin prick test to natural rubber latex allergens, and an elevated natural rubber specific IgE level in her serum. This, to our knowledge, has not been previously reported in the literature.

Glove-induced dermal and respiratory symptoms among health care workers in one Finnish hospital.

To evaluate the prevalence of skin and respiratory symptoms associated with the use of protective gloves in health care workers, an inquiry study was carried out on 534 hospital employees who used protective latex or vinyl gloves on a daily basis at work. The prevalence of skin disorders related to the usage of gloves was 56%. Rhinorrhea or nasal congestion was present in 13% of the workers who used powdered disposable gloves. The prevalence of both skin and respiratory symptoms was significantly higher among the workers who used gloves > 2 hours a day (p < 0.001). The skin disorders were more common in young employees. The findings indicate that most of the symptoms were caused by irritation or an immediate, IgE-mediated allergy. We conclude that there is a positive correlation between the duration of daily glove usage at work and the skin and respiratory symptoms. In order to reduce skin disorders associated with the daily use of gloves, it is necessary to develop safer materials in the glove manufacturing process.

Detection of airborne natural rubber latex by immunoelectrophoresis, RAST inhibition, and immunospot method.

Occupational dermal and respiratory allergies caused by natural rubber latex (NRL) have been encountered with increasing frequency in health care workers. In order to measure the amount of airborne NRL, area and personal air sampling was performed in three hospital laboratories where workers used latex gloves. The total dust levels in laboratory air samples were lower than 0.17 mg/m3. RAST inhibition suggested that NRL antigens may exist both in the area and personal samples. Immunospot measurements, rocket immunoelectroporesis, and rocket radioimmunoelectrophoresis did not show any NRL activities in laboratory airsamples, although they were able to detect immunoactive material in positive control filter specimens. We conclude that the airborne NRL concentration was undetectable in daily hospital laboratory environment where workers used disposable NRL gloves. Airborne NRL, however, can be measured by using immunological assays.

Sauna builder's asthma caused by obeche (Triplochiton scleroxylon) dust.

Two carpenters developed rhinitis, conjunctivitis, bronchial wheezing, and dyspnoea while using obeche (Triplochiton scleroxylon, African maple) at their work while they built saunas. Skin prick tests showed an immediate reaction, specific IgE to obeche was detected in their serum, and bronchial provocation test with obeche gave an immediate reaction with decrease of FEV1 and PEF values. The symptoms disappeared after avoiding the use of obeche. Obeche may cause a health hazard to carpenters who are exposed to this dust and who may develop allergic symptoms after the exposure.