Occupational eye dose to medical staff in various interventional cardiologic procedures: is the need for lead goggles the same in all groups of radiation workers?

Considering the increased use of interventional cardiologic procedures and concern about irradiation to the eyes, it is necessary to measure eye dose in radiation workers. The assessment of eye dose using collar dose is a routine but inaccurate method. Therefore this study was designed to measure eye dose in the radiation workers of various interventional cardiologic procedures. In this study eye dose was measured for left and right eyes in three groups of radiation workers in angiography ward of Afshar hospital in various procedures using TLD. Measurements were done separately for cardiologists, nurses and radio-technologists in 100 procedures. The nurses functioned as surgical assistants and were usually close to the table. The correlation of staff dose to exposure parameters was also investigated. Eye dose in physicians were higher than other staff in all procedures. Also the left eye dose was considerably higher than right one, especially for physicians. The median equivalent dose per procedure of left eye for physicians, nurses and radio-technologists were 7.4, 3.6, 1.4 µSv (PCI) and 3.2, 3.1, 1.3 µSv (Adhoc) and 3.2, 1.7, 1.1 µSv (CA), respectively. The annual left eye equivalent dose with (without) using lead goggles were 2.4 (15.3), 1.4 (2.2), 1.0 (1.1) mSv for physicians, nurses and radio-technologists, respectively. There were also a positive correlation between eye dose and KAP for procedures without lead goggles. The lead goggles showed lower protection effects for radio-technologists than other staff. Only 30% of physicians received a dose higher than 1/3 of the ICRP annual dose limit, therefor only physician eye dose should be monitored in catheterization labs.

Concurrent effect of noise exposure and smoking on extended high-frequency pure-tone thresholds.

OBJECTIVE: Concurrent effect of noise and smoking on hearing loss is a recent concern. In this study, the concurrent effect of noise and smoking on hearing loss in conventional frequencies and frequencies higher than 8 kHz was assessed. DESIGN: This was a cross-sectional study on workers exposed to noise who were divided into two groups: smokers and non-smokers. Hearing thresholds were assessed by conventional audiometry, and HFA. Data were analysed using non-parametric tests and Student's t-test. STUDY SAMPLE: There were 212 workers. RESULTS: Ninety-seven subjects were smokers and 115 individuals were non-smokers. All subjects were exposed to 92.1 ± 2.4 dBA (Leq8h). The highest threshold in conventional and high-frequency audiometry was observed at 6 kHz and 16 kHz, respectively. Hearing threshold at frequencies above 1 kHz was significantly higher in the smokers than non-smokers. There was no correlation between hearing thresholds and pack-years of smoking. CONCLUSIONS: Concurrent exposure to noise and smoking may be associated with more hearing loss than exposure to noise alone in the conventional and high frequencies. However, other differences between smokers and non-smokers may explain these differences as well.

Bronchodilator Response of FEV6 and FEV3 as Surrogates of Forced Vital Capacity.

BACKGROUND: Spirometry as a non-invasive and inexpensive test is widely used for occupational health evaluations. Bronchodilator test is used for the assessment of airflow limitation and increase in forced expiratory volume in 1 second (FEV1) or forced vital capacity (FVC) is considered as a positive response. This study was performed to assess the response of forced expiratory volume in 6 seconds (FEV6), forced expiratory volume in 3 seconds (FEV3), and forced expiratory time (FET) to bronchodilator administration. MATERIALS AND METHODS: In this cross-sectional study, the response of FEV3, FEV6, FEV1/FEV3, FEV1/FEV6 and FET to bronchodilator administration was assessed in subjects referred to Yazd occupational medicine clinic regardless of their diagnosis. The average increase in spirometric parameters (i.e. FVC, FEV1, FEV1/FVC, FEV3, FEV6, FEV1/FEV3, FEV1/FEV6 and FET) was measured. The difference between baseline and post-bronchodilator spirometries was assessed by calculating absolute change and change from baseline as well. Data analysis was done by Student's t test, chi square test and Pearson's correlation test. RESULTS: Totally 104 subjects were entered in the study. FEV1 showed the highest response to bronchodilator. FVC response to bronchodilator was correlated with FET, but such correlation was not observed for FEV6 and FEV3. The mean increase in FEV6, FEV3, and FET after bronchodilator administration was 50.90 ml (2.23%), 110.51 ml (3.08%) and -1.85 s, respectively. CONCLUSION: FVE6 can be used as a substitute for FVC for the assessment of bronchodilator response without the need for FET adjustment.

Across-shift changes of exhaled nitric oxide and spirometric indices among cotton textile workers.

OBJECTIVES: For the purpose of evaluation of exhaled NO as an index of airway inflammation, we assessed changes in fractional exhaled NO (FeNO) across a work shift and its relationship with respiratory complaints. MATERIAL AND METHODS: Chronic and work-aggravated respiratory complaints were assessed using a questionnaire in 89 male textile workers. FeNO and spirometry were performed before and after a work shift and all the changes were registered. RESULTS: A significant increase in FeNO after a work shift was observed. Post-shift FeNO was significantly higher among the subjects with chronic respiratory complaints. There was an obvious decrease in FVC, and FEV1 after a work shift; however, we couldn't find a significant relationship between changes in respiratory parameters and concentration of inhalable dusts. CONCLUSIONS: FeNO increase after a work shift along with pulmonary function decrement and higher post-shift FeNO among subjects with respiratory complaints makes across-shift FeNO a non-invasive test for assessment of airway hyper-responsiveness in textile workers.

Assessment of bronchodilator response in various spirometric patterns.

BACKGROUND: Spirometry is a physiologic test that measures the volume of air an individual inhales or exhales and the rate at which the volume is changed as a function of time. Bronchodilator response, as a beneficial test for diagnosis of bronchial responsiveness is measured using the percent change from baseline and absolute changes in forced expiratory volume in 1 second and/or forced vital capacity. In this study we aimed to assess the increase in spirometric parameters in patients with symptoms of asthma regardless of spirometric pattern. MATERIALS AND METHODS: In this cross-sectional study bronchodilator test was performed in individuals with dyspnea, cough or wheezing and the mean increase in various spirometric parameters was measured and compared among individuals with different spirometric patterns. RESULTS: Among all individuals 24.5% responded to bronchodilator. Forced expiratory volume in 1 second was the parameter with the most frequent response to bronchodilator. Patients with mixed pattern had the highest frequency of response to bronchodilator. Response to bronchodilator was more than 50% in most mid flow volumes. CONCLUSION: Some patients with symptoms of asthma may show restrictive or mixed pattern in spirometry which may respond to bronchodilator administration.

Effects of training intervention on non-ergonomic positions among video display terminals (VDT) users.

OBJECTIVE: Substantial evidence shows an association between musculoskeletal disorders (MSDs) and certain work-related physical factors. One of the jobs with known ergonomic hazards is working with video display terminals (VDTs). Redesign, ergonomic improvements, and education have generally been recommended as solutions for the prevention of musculoskeletal disorders. We designed this study to assess the effects of ergonomic training on the working postures of VDT users. METHODS: In an intervention study, we assessed the impact of ergonomic training on the ergonomic hazards and work postures in employees working with VDTs. Participants and their workstations were assessed by Rapid Upper Limb Assessment (RULA) method before and after training. PARTICIPANTS: 70 employees of an office, working with a VDT more than four hours per day entered the study. RESULTS: The greatest compliance with OSHA workstation recommendations was seen with the monitor (21.4% of cases) and the least compliance with the one was the chair (10.0%). Mean RULA score before and after intervention were 5.90, and 5.07, respectively, and the difference was statistically significant (p < 0.001). CONCLUSIONS: It can be concluded from this study that training office ergonomics to the VDT users, even without changing work place components can significantly improve VDT users' behavior and ability to properly fit a workstation to him/herself.

An epidemiologic survey on burns in Yazd from 2008 till 2009.

Burns are injuries which may require long hospitalization and may result in important impairment and disability. Burn injuries are still common especially in developing countries. Assessment of the epidemiology of burns is very important for introduction of preventive methods. This study was conducted in Yazd to assess and describe the epidemiology of burns including its main causes, and its demographics. In a prospective study during a 1 year period, we assessed the epidemiology of burns in Shahid Sadoughi Burns hospital in Yazd. During this period, 1947 injured patients referred to this hospital. Data were gathered using a questionnaire about demographics and the properties of the burn injury. Burns were more frequent among men than women. A significant number of patients were children. 8.8% of patients needed hospitalization. Thermal burns were much more common than other types. Scalds were the most common cause of burn, and hands were the body region most commonly affected. Mean total body surface area burned (TBSA) was 6.16% (±9.93). This study showed a high incidence of burn injuries at home and in the workplace. The burns were mostly preventive and many of them can be prevented by education.

Prevalence of Overweight and Obesity among Iranian School Children in Different Ethnicities.

OBJECTIVE: Malnutrition, overweight and obesity are major health concerns in modern societies and especially among children. Overweight and obesity affect children's current and future health. It is known that the prevalence of overweight differs by race, sex, and geographic location. METHODS: In a cross-sectional study 30092 Iranian children aged 7-18 years in six ethnic groups were selected by a cluster sampling. Prevalence of obesity and overweight and distribution of body mass index (BMI) by gender, age, and ethnicity were measured. Cutoff points of BMI for defining obesity and overweight were based on the Iranian, and IOTF standard values. FINDINGS: This study showed a significant ethnic difference in BMI. Prevalence of overweight and obesity among Iranian children was 9.27% and 3.22% respectively comparing international standards. The frequency of overweight and obesity was higher in boys. CONCLUSION: This study showed a significant difference in BMI among different ethnic groups.

Spirometric indices after bronchodilator test in obstructive lung disease.

Bronchial responsiveness to bronchodilator medications is usually tested to establish reversibility of airflow obstruction. Among the various tests to establish bronchodilator response, FEV1, FEF(25-75%) or FEF50%, and FVC are the most widely used. In a cross-sectional study, we assessed spirometric responses after administration of bronchodilator in 187 workers with obstructive pattern in spirometry. Considering responsiveness to bronchodilator (200 cc and 12% increase in FEV1 or FVC), the study cases were divided into responsive or non-responsive groups, and the average increase in spirometric indices were measured and compared between two groups. 35.8% of cases were responsive to bronchodilator. Among responsive cases, FEV1 was the most frequent index increased significantly; And PEF and FVC were the least frequent ones. The highest mean increase from baseline after administration of bronchodilator was observed in FEF75%. Increases in all indices were significantly higher in responsive group. The increase in FEV1% predicted was inversely correlated with baseline FEV1. In conclusion, we consider that FEV1 is the most reliable spirometric index for assessing bronchodilator response. And Bronchial reversibility has an inverse relationship with baseline measures.

The relation between shift work, sleepiness, fatigue and accidents in Iranian Industrial Mining Group workers.

The aim of this study was to examine the rate of fatigue and sleepiness around the shift and non-shift workers and its relation to occupational accidents. This was a cross-sectional study on the workers of Iranian Industrial Mining Group. They included 137 shift workers as the case and 130 non-shift workers as the control. A multi-part questionnaire including demographic characteristics, Piper Fatigue Scale and Epworth Sleepiness Scale were applied. The chi(2) test and t-test were used to measure differences between variables. The mean of PFS scores in the two groups was significantly different (p=0.045), but the difference in the mean of ESS scores was not significant. Shift workers with the reported accident had a higher score on fatigue than shift workers with no accident (p<0.001) whereas the difference in the number of accidents in the two groups was not related significantly to the rate of sleepiness. The rate of fatigue and the number of the work accidents was more in the shift workers. Also, fatigue had a stronger relationship with the occupational accidents as compared to sleepiness. It seems that evaluation of fatigue as compared to sleepiness is a more accurate factor for preventing work accidents.