Mutagenicity of Baltic seawater and the relation to certain chemical and microbiological parameters.

The presented work investigates the mutagenicity of seawater with regard to its distribution along the German Baltic Sea coastline. Further on in this paper the relationship between mutagenic activity and certain chemical, microbiological and physical parameters is analysed. Water samples were drawn from eight places between Eckernförde and Ribnitz-Damgarten. Seawater was concentrated using XAD-2/7 resin. Extracts of up to 3-l per plate were tested with the Salmonella mutagenesis assay employing the strains TA 98 and TA 100 with and without addition of S9-mixture for metabolic activation. Samples from Weissenhaus, Travemünde and Wismar demonstrated a mutagenic activity with the strain TA 98. Tested filter sediment was not mutagenic. The sum of six polycyclic aromatic hydrocarbons (PAH) concentrated by XAD resin and obtained by high performance liquid chromatography (HPLC) were between 0.03 and 34.11 ng/l seawater. No correlation of measured mutagenicity and chemical or physical parameters could be established. The sampling place Wismar with one mutagenic sample had the highest number of colony forming units of Escherichia coli.

Sister chromatid exchanges in rotogravure printing plant workers.

OBJECTIVE: The individual burden of inhaled ambient-air toluene and its link to genotoxic phenomena in exposed printing workers. METHOD: The influence of toluene on sister chromatid exchange (SCE) was investigated by monitoring of the individual toluene burden of 42 exposed printing workers. Therefore, the urinary hippuric acid (HA) excretion was measured directly after the work shift. The results were compared with those recorded for a control group consisting of 45 blood donors. SCE frequencies were determined from peripheral lymphocytes for both groups. RESULTS: The median HA excretion of the exposed and nonexposed groups amounted to 1.94 and 0.45 g/g creatinine, respectively. For both groups, different SCE rates were detected: 10.13 and 6.84 counts/lymphocyte for exposed and nonexposed persons, respectively. The independence of the measured values proved to be significant at a high confidence level (P = 0.000) for both groups. The influences of smoking and alcohol consumption on SCE as well as on HA values could be clearly separated from those induced by toluene. CONCLUSIONS: The results of our study indicate a strong relationship between the individual toluene burden and the genotoxic risk of the exposed persons. Since toluene was used for dilution of the letter-press ink, the influence of ink mist on the genotoxic effects could not be completely excluded.

[Detection of an inhibition of benzo(a)pyrene and sodium azide induced mutagenesis by extracts from human feces]. / Nachweis einer Inhibition der mittels Benzo(a)pyren und Natriumazid induzierten Mutagenese durch Extrakte aus menschlichen Fäzes.

Low levels of mutagenic activities were detected in only 5-25% of the feces of people on a normal mixed-western diet, when feces were extracted by solvents and extracts were analyzed for mutagenicity with Ames' standard Salmonella/microsome assay. Since mutagens are know to be present in this type of diet and may be synthesized endogenously by bacteria in the large bowel, the question is if antimutagenic compounds mask the presence of genotoxic substances. We therefore tested the inhibition of known mutagens--benzo(a)-pyrene and sodium azide--by acetone/ethyl-acetate extracts of lyophilized feces in model experiments. These extracts completely suppressed the mutagenicity of benzo(a)pyrene and reduced the mutagenicity of sodium azide by about 60%, but were non-cytotoxic. Using gel filtration over Sephadex LH-20 and subsequent silica gel column chromatography we found that the inhibitors were polar organic compounds with molecular weights about 500 or more. The inhibitory effect could not be changed by esterification or saponification methods but was completely abolished by alkaline potassium permanganate oxidation. We therefore conclude that the antimutagenic activities might be identical with bile pigments.

[Mutagenic activity in the feces of normal people on a mixed diet]. / Mutagene Aktivitäten in Fäzes mischkosternährter Normalpersonen.

Single fecal samples of 25 people, living on a normal mixed Western diet and matched for freedom from any gastrointestinal disorder, were freeze-dried and volatile compounds were collected at -60 degrees C. The residues were extracted with n-hexane-dichloromethane 1:1, and subsequently with acetone-ethylacetate 2:1. The three fractions were assayed for mutagenic activity using the Salmonella typhimurium mammalian microsomal system. Fecal mutagenic activity was observed with the tester strain TA 98 in 28% of the assayed people without microsomal activation, and in 4% of the people with strains TA 98 and TA 100 with microsomal activation.

[The behavior of polycyclic aromatic hydrocarbons in soil fertilized with sewage sludge-garbage compost. I. Field studies]. / Das Verhalten von polyzyklischen, aromatischen Kohlenwasserstoffen (PAK) in mit Müll-Klärschlamm-Kompost gedüngten Böden. I. Freilanduntersuchungen.

Sewage sludge-garbage composts which are used as soil conditioners usually contain high concentrations of PAH. A risk for human health could arise if the use of such composts leads to high concentrations of PAH in the soil and these are taken up by plants for human consumption. We investigated the fate of PAH introduced into the soil with sewage sludge-garbage compost and the possible association with the microbial flora. Field investigations in wineyards during more than 18 months showed no reduction of PAH in the soil. There was no seasonal variation and no correlation between microbial data and PAH concentrations in the wineyards treated with compost or untreated. From these findings it must be concluded that under natural conditions PAH persist in the soil for a long time and are not taken up by plants to an appreciable extent.

[The behavior of polycyclic aromatic hydrocarbons in soil fertilized with sewage sludge-garbage compost. II. Laboratory studies]. / Das Verhalten von polyzyklischen, aromatischen Kohlenwasserstoffen (PAK) in mit Müll-Klärschlamm-Kompost gedüngten Böden. II. Laborversuche.

The possible destruction in the soil of PAH present in sewage sludge-garbage composts in considerable amounts has been studied under various conditions. Sandy and loamy soil were mixed with the compost and kept in a climate chamber at 20 degrees C, 25 degrees C and 28 degrees C with 30% and 80% relative moisture. One part of the samples was illuminated the other kept in the dark. Control samples with and without compost were sterilized. PAH determinations, bacterial counts on Moutonagar and counts of the actinomycetes were carried out in regular intervals. No influence of temperature, moisture or light could be demonstrated under the experimental conditions. No difference in the behaviour of PAH concentrations in sterilized and nonsterilized soil samples during the periods of experiment, no increase or decrease of PAH were found. There was no correlation between bacterial counts and PAH concentrations. The laboratory experiments confirmed the results of the field investigations.

[Hygienic and bacteriological comparative studies in 50 hospitals. V. Bacterial contamination of hospital surfaces (author's transl)]. / Hygienisch-bakteriologische Vergleichsuntersuchungen an 50 Krankenhäusern. V. Keimzahlen auf Flächen in Krankenhäusern.

Environmental examination were carried out in 50 hospitals using "rodac-plates" (size: 21 cm2) for 7971 samples, to acquire a semiquantitative assessment of microbial contamination of surfaces. Up to 20 percent of the impression cultures showed uncountable numbers of colonies (more than 300/21 cm2). Therefore statements on the microbial content were not to be based on mean values alone. The actual state of surface contamination was assessed by the mean value of all plates with colony counts below 300 and by the median value. Additionally numbers of samples with colony counts below 10 and more than 300 were recorded. The mean value of all samples with less than 300 colonies/21 cm2 was 58. 21% had less than 10, 23% more than 300 colonies. In operating suites, delivery rooms, and premature wards the mean value was 30 colonies/21 cm2. Surfaces with less than 10 colonies amounted to 30 percent, with more than 300 to 5 percent. Samples from intensive-care units, from new-born-, and childrens wards had mean values of 50 colonies/21 cm2. Percentages of plates below 10 and above 300 colonies differed too much to be grouped. Surgical, internal, and gynaecological wards showed mean values of more than 60 colonies/21 cm2. 15 percent of plates had less than 10 colonies, 10 percent more than 300. Differentiations as to specifications of rooms and surfaces in regard to bacterial contamination have been made.

[Hygienic and bacteriological comparative studies in 50 hospitals. VI. The efficacy of a hospital-hygienic instruction regarding 6 hospitals]. / Hygienisch-bakteriologische Vergleichsuntersuchungen an 50 Krankenhäusern. VI. Zur Effektivität krankenhaushygienischer Beratung am Beispiel von 6 Krankenhäusern.

The efficacy of hospital hygienic measures was checked in six hospitals. The programme was started by determining the effective state. Subsequently a two-day extension course for the training and instruction of the responsible personnel in charge (physicians, nurses and administrative staff) in the essential problems of hospital hygiene was held. The next measure consisted in giving advice in the preparation of hygiene plans which had to make allowance for the prevailing personal and constructional situation as well as for the hospital equipment. The hygiene plans represented the written concept of the measures to be implemented. Then enquiries, local inspections as well as hygienic-bacteriological ambient analyses were carried out to determine the hygienic situation in the hospital after adoption of the measures and the findings were compared with the situation preceding the initiation of the hygienic programme. The results show that the proposed improvements were mostly realised as far as such administrative measures as the procurement of disinfectant dispensers, throwaway towels and suitable disinfectants were concerned. The instructions given for the implementation of suitable methods of application were complied with to a lesser extent. Moreover, considerable improvements were achieved with regard to the operation and efficiency of the sterilizers. On the whole, the present study demonstrates that suitable measures largely reduce the extensive gaps in information on the part of the staff on hospital hygiene and that the resulting intensification of efforts can greatly contribute towards an improvement of the overall hygiene in hospitals.

Oncogenic interaction of carcinogenic and non-carcinogenic polycyclic aromatic hydrocarbons in mice.

To evaluate possible interactions between PAH occurring in automobile exhaust condensates with regard to their tumour forming potency, the following experiments were performed. Six different doses of benzo[a]pyrene (3-100 microgram) and of dibenzo]a,h]anthracene (2-75 microgram) and mixtures thereof were tested subcutaneously on female NMRI mice. In addition, mixtures of 10 non-carcinogenic hydrocarbons were applied: benzo[e]pyrene, benzo[a]anthracene, phenanthrene, anthracene, pyrene, fluoranthene, chrysene, perylene, benzo[ghi]perylene and coronene. Mixtures of all 12 PAH were also applied. The proportion of PAH in all mixtures used was the same as in automobile exhaust condensates; benzo[a]pyrene was used as reference substance. The most important results were as follows: 1. Small doses of dibenzo[a,h]anthracene have a greater tumour promoting effect than do comparable doses of benzo[a]pyrene. Increased doses increase the effect of benzo[a]pyrene more than that of dibenzo[a,h]anthracene. 2. The mixture of benzo[a]pyrene and dibenzo[a,h]anthracene is 1.4 time more active than dibenzo[a,h]anthracene alone. 3. The mixture of all PAH has a lower efficacy than dibenzo[a,h]anthracene alone, amounting to only 0.03 that of dibenzanthracene; however, the activity of dibenzo[a,h]anthracene within the mixture of the 12 PAH increases by a factor of 3.1. 4. The activity of a mixture of dibenzo[a,h]anthracene and benzo[a]pyrene depends to about 40% on dibenzo[a,h]anthracene; and that of 12 PAH to 30% on dibenzo[a,h]anthracene alone or to 80% on a mixture of dibenzo[a,h]anthracene and benzo[a]pyrene.

[Effects of longterm HCG administration on testicular function in hemodialysis patients (author's transl)]. / Auswirkungen einer langdauernden exogenen Gonadotropinzufuhr auf die testikuläre Insuffizienz bei Dauerdialysepatienten

Thirtheen male patients with chronic renal failure undergoing regular dialysis treatment (2 X 8-10 hours/week) were treated with gonadotropins (HCG, Primogonyl) primarily 2 X 2,000 IU/week and later 2,000 IU/week. Before HCG administration and during 4-months HCG-therapy testosterone, dihydrotestosterone, Androstandiol, LH and FSH levels were determined by RIA-methods in 7-14 days intervals. Before HCG-application plasma testosterone levels were low and did not increase in the course of regular dialysis treatment. Derivates from testosterone like dihydrotestosterone and Androstandiol were elevated in plasma, presumbably because of accumulation in renal failure. LH-levels were slightly elevated on the average. FSH-levels showed a high individual variation but also seemed to be elevated on the average. HCG stimulation by exogenous HCG administration for short time resulted in a insufficient rise of testosterone levels as compared to normals. During prolonged HCG administration plasma testosterone levels increased to normal but dropped immediatly after cessation of therapy or reduction to less than 2,000 IU HCG twice/week. Body weight, plasma proteins, haematocrite and fertility did not improve significantly. These results indicate that in chronic renal failure androgen synthesis by testicular tissue is seriously impaired and does not improve under usual dialysis treatment. Feedback regulation of testosterone levels by increase of LH levels seems not to be sufficient although pituitary response is found to be normal. This may be explained by elevated levels of testosterone derivates which exert negative feedback effects.

[Hygienic and bacteriological comparative studies in 50 hospitals. II. The role of staff in the distribution of pathogenic organisms in surgical wards (author's transl)]. / Hygienisch-bakteriologische Vergleichsuntersuchungen an 50 Krankenhäusern. II. Zur Bedeutung des Personals für die Ausbreitung von Krankheitserregern auf chirurgischen Stationen

Before hygienic measures are recommended to a hospital it is absolutely necessary for the source of infection and the paths of infection - both possible and to be expected - to be clearly established. In order to be able to evaluate the paths of spread, one of the basic prerequisites would be to carry out examinations with a view to determining the number of persons who are carriers of pathogenic germs. To this effect, bacteriological samples of the right hand, the skin at the forehead/hairline, the coat in the area of the navel and the throat were taken from the nursing staff in surgical wards in 50 different hospitals. At the same time details of hand disinfection and hand drying were collected by questioning and local inspection. In at least one of the 4 swabs from 72 persons (= 38%) and in two or more swabs from 26 persons (= 14%). Staph. aureus was detected. The hair was the most contaminated area, followed by the coat and hands, while the throat was the least contaminated zone. To prevent pathogenic germs being spread by hand, alcohol-containing preparations were prevalently used (in 79% of the wards inspected). The hygienic hand disinfection was inadequate in 53% of the surgical wards. In four wards the hands were washed with soap exclusively. 35% of the surgical wards used common towels and disposable towels were used almost as frequently. In the remaining cases common and disposable towels were employed simultaneously. Storage of the used and unused disposable towels was in the main unsatisfactory. In view of the conditions met with in the various hospitals, proper hand disinfection must be insisted on, i.e. the hands must first be disinfected with a tested preparation and then washed, as may be required. If time plays a major role, alcohol-containing preparations should be used. Towels for common use must no longer be available in hospitals because they are important carriers of pathogenic germs.

[Hygienic and bacteriological comparative studies in 50 hospitals. III. The efficacy of sterilization (author's transl)]. / Hygienisch-bakteriologische Vergleichsuntersuchungen an 50 Krankenhäusern. III. Die Effektivität der Sterilisation

As part of an investigation carried out in 50 hospitals we particularly checked the sterilisers available for proper functioning and correct operation. The work group examined 461 sterilisation programmes in 338 sterilisation units (176 autoclaves, 153 hot-air apparatus and 9 ethylene oxide units) during the daily routine operation. The group carried out biological and physical inspections and carefully recorded the faults and deficiencies detected during the sterilisation procedure. It was found that only in 22% of the hospitals was a proper functioning and correct operation of all the sterilising units in use ensured. Technical faults and errors in operating the equipment and especially in the loading in 23% of the programmes prevented sterility. Almost 50% of the hot-air sterilisers and about a quarter of the autoclaves fail to produce a consistent satisfactory effect. The incidence of errors which occurred with ethylene oxide sterilisation cannot be generalised, since only a limited number of units were checked. A breakdown by functional areas and wards indicates that serious errors occur not only in the centralised large units but also in little-used small autoclaves in peripheral areas. A comparison with the literature shows that our results do not differ to any appreciable extent from those obtained by other workers, over the last twenty years. Here systematic inspections by external control authorities could improve the situation within a few years. Regular inspections to be carried out by the hospitals themselves using modern test methods are necessary, and need internal record-keeping. In spite of this, we cannot at present do without external inspections. We pin our hopes mainly in regular and thorough expert training of the staff and on much closer cooperation between hospital and hygienist.

[Hygienic and bacteriological comparative studies in 50 hospitals. I. Methods and aim of microbiological monitoring (author's transl)]. / Hygienisch-bakteriologische Vergleichsuntersuchungen an 50 Krankenhäusern. I. Methoden und Ziele der Kontrolluntersuchungen

Within a period of a year, environmental examinations were carried out in 50 hospitals selected at random in Rheinland-Pfalz with a view to determining the effective conditions, mainly in such risky areas as operating theatres, delivery rooms, intensive-care units and neonatal wards. In this first report the method is described. Such investigations are based on a detailed interrogation of the staff, and local inspection. As is evident from the extract from the questionnaire, the investigation was mainly concerned with details of the functional procedure and the implementation of measures of hospital hygiene. During the subsequent inspection of the rooms, we had the various procedures demonstrated to us. The testing of the sterilisation effect of all 461 programmes of the sterilisers was carried out with spore earth in accordance with DIN 58947. Staph. aureus and Bac. mesentericus spore preparations in accordance with DIN 58949 were used to check the thermal bed-disinfection apparatus. For the determination of the qualitative and quantitative contamination of persons, we employed 2321 sponge-type impression preparations and 8790 "Rodac plates" for the surfaces of floors and furniture. Throat swabs were taken from each of the 831 persons examined, and checked for the presence of pathogens. 2848 blood agar plates were exposed for one hour to ascertain the sedimenting air germs. Although this method is not suitable for determining the germ content per cubic metre of air, it nevertheless furnishes a good idea of the prevailing conditions without involving much work. As part of such environmental examinations, it is very important to determine the contamination of liquids from buckets, disinfecting solutions, bottles from oxygenators, air humidifiers etc. When the samples contained growth-inhibiting additives, we immediately mixed them with an inactivation medium. In the laboratory, blood and endo-agar plates were inoculated with the concentrate and dilutions. In addition we enriched the sediment in 2% sugar bouillon. All culture media were incubated for 48 hours at 37 degrees C. Subsequently we counted the colonies and differentiated in accordance with the usual biochemical or, if required, serological methods. Further reports will discuss the results of this investigation.

[Hygienic and bacteriological comparative studies in 50 hospitals. IV. The bacterial contamination of fluids of intensiv care units, wards for premature children and new-born wards (author's transl)]. / Hygienisch-bakteriologische Vergleichsuntersuchungen an 50 Krankenhäusern. IV. Die bakterielle Kontamination von Flüssigkeiten aus Intensiv- pflege-, Frühgeborenen- und Neugeborenenstationen

In intensive-care units and wards for prematures frequent use is made of medical apparatuses (such as oxygenators, nebulizers, respirators and incubators). These units are provided with a water reservoir which is utilized for the humidifications of the inspiratory air. They have become indispensable tools, especially in the treatment of seriously-ill patients. However, the water reservoirs of these devices have also frequently been found to harbour sometimes high concentrations of pathogens. With a view to clarifying the question as to the extent that liquids of different origin in the hospital area are contaminated with bacteria, 323 liquid samples were collected from intensive-care units, wards for premature and for newborn babies, and submitted for analysis. The senior nurse was questioned to obtain information about the measures of disinfection adopted in the respective wards. It was possible to cultivate pathogens from 22 per cent of the samples. P. aeruginosa accounted for 46 per cent, Enterobacter for 17.6% and E. coli for 12 per cent. A breakdown of the liquids by origin gives the following picture: 30 per cent of the liquids used for humidification of the inspiratory air (from respirators, inhalers etc.) were contaminated with pathogens. The analysis yielded a similar result in about 47 per cent of the cleaning water samples, in 10 per cent of the solutions in which clinical thermometers are kept and in 0 per cent of liquids from containers in which dressing forceps are kept. It emerged from inquiries that the lack of knowledge about the proper implementation of disinfection measures on the part of the nursing staff is still considerable. As a result, disinfectants of the quarternary ammonium compounds were used for the disinfection of medical apparatus in 37 per cent of all applications although their bactericidal action on gram-negative bacteria is limited. As regards the antimicrobial treatment of such parts as nebulizer chambers, connecting tubes, reservoirs of ultrasonic nebulizers, oxygen bottles and respiratory, parts with which the patient does not come into direct contact - the possibility of sterilizing them by autoclaving should be examined first. Not until this procedure has been ruled out on account of the thermolability of the materials used should another procedure such as keeping the materials in a disinfecting solution be adopted.

Investigations on the carcinogenic burden by air pollution in man. XI. About the effect of aluminiumhydroxid upon the benzo(a)pyrene carcinogenesis.

Recent publications point towards a probable influence of trace elements on the cancerogenicity of chemical substances. On the basis of these reports we chose Al(OH)3 as trace element in our experiments, trying to clarify the influence of some adjuvants of vaccines on oncogenesis as described by several authors. To female NMRI-mice we applied subcutaneously 10 mug, 50 mug, 100 mug benzo(a)pyrene respectively in 0,5 ml tricaprylin-Al(OH)3-gel mixture and compared it with similar doses of benzo(a)pyrene in 0,5 ml tricaprylin-NaCl solutions. Results of experiments: 1. Al(OH)3 considerably reduced the tumor formation in the groups, treated with 10 and 50 mug benzo(a)pyrene; even tumor rates in the 100 mug benzo(a)pyrene group were diminished but much less than by the lower doses. 2. After ninety weeks the amount of tumors in the groups treated with 10 or 50 mug benzo(a)pyrene + Al(OH)3 was significantly lower than that of their control groups. At the highest doses (100 mug) a significant difference could not be noted. 3. Mean periods of tumor induction within all groups treated with benzo(a)pyrene-Al(OH)3 were significantly prolonged in comparison to controls. 4. In experiments with subcutaneously treated mice the doses-effect-relationship is changed when Al(OH)3 corresponds to the results of experiment with atmospheric dusts or exhaustion condensates. It is still pending whether adsorbtive or other processes make this effect.