Effect of Parachlamydia acanthamoebae on pulmonary function parameters in a bovine respiratory model.

The aim of this study was to evaluate pulmonary dysfunction induced by experimental infection with Parachlamydia acanthamoebae in calves. Intrabronchial inoculation with P. acanthamoebae was performed in 31 calves aged 2-3 months old at two different challenge doses of 10(8) and 10(10) inclusion-forming units (IFU) per animal. Control animals received heat inactivated bacteria. The effects on pulmonary gas exchange were determined by arterial blood gas analysis and haemoximetry during the 7 days post inoculation (DPI). For pulmonary function testing (PFT), impulse oscillometry, capnography, and measurement of O2 uptake were undertaken in spontaneously breathing animals 7 and 3 days before inoculation and were repeated until 10 DPI. In the early phase after challenge (1-3 DPI), mild hypoxaemia occurred, which was accompanied by a significant reduction in both tidal and alveolar volumes (each related to bodyweight, BW). In parallel, expiratory flow rate and specific ventilation (i.e. minute ventilation related to O2 uptake) were significantly increased. Minute and alveolar ventilations (each related to metabolic BW) increased significantly due to higher respiratory rates, lasting until 4 and 5 DPI, respectively. Oxygen uptake was slightly reduced during the first 2 days after challenge, but increased significantly during the recovery phase, from 4 to 8 DPI. No deterioration in respiratory mechanics or acid-base balance was observed. Respiratory infection with 10(10) IFU P. acanthamoebae per calf induced mild respiratory dysfunction, mainly characterised by hypoxaemia. The study's findings do not indicate severe pathophysiological consequences of P. acanthamoebae infection on pulmonary function in the bovine host.

Activities of an Environmental Analysis Van in the German Federal State Schleswig-Holstein.

A cooperation was started between the Union of Physicians of Schleswig-Holstein (Bad Segeberg, Germany) and an environmental engineer in 1992. A mobile unit for environmental analysis was set up, the Environmental analysis Van (EAV) or mobile umweltambulanz. Inspection of sites and collection of air and dust/material samples for analysis of xenobiotics were performed on request. The results of this cooperation were evaluated to show which sources of indoor pollutants could be particularly relevant to human health impairment. During a 30-month period form July 1993 to December 1995, 1793 site inspections wer conducted. Xenobiotic analysis and subsequent advising was performed in 1318 cases; enhanced concentrations of one or more toxic substances (mainly biocides such a pentachlorophenol, permethrin, and/or hexachlorocyclohexane) were found in 71% of the sites analyzed. Formaldehyde, volatile organic compounds, and contamination by molds were also documented. A follow-up was done on 80 clients of the Environmental Analysis Van, which had detected elevated concentrations of permethrin because of pyrethroid-treated carpeting. The effect of removing all contaminated carpeting on health improvement in comparison with nonremoval was statistically significant (p<0.0001). Pyrethroid-treated carpeting, which was already 5, 7 and 10 years old, revealed permethrin concentrations of 115, 100, and 150 mg/kg dust. This result indicates that indoor contamination of permethrin is highly persistent and may be the cause of adverse health effects.

[Effects of renovation measures on the health status of persons, exposed to pyrethroids through carpets and flooring]. / Auswirkungen von Sanierungs-massnahmen auf den Gesundheitszustand von Personen, die über Teppiche bzw. Auslegeware gegenüber Pyrethroiden exponiert waren.

80 clients of a mobile unit for environmental quality testing were contacted after monitoring for potential toxic substances in their homes or places of work. Elevated concentrations of pyrethroids (in all cases at least permethrin) were found in these 80 cases in dust or materials, mainly because of pyrethroid treated carpetings. The clients were questioned whether they removed one or all of the contaminated carpets. Furthermore, they were questioned as to their state of health and the period of time which had passed since the carpets were removed. 75 of the 80 contacted clients had initially called the mobile unit for environmental quality testing because of health impairments, whereas 5 clients had done this only for preventive reasons. 47 (59%) of the contacted clients had removed all carpetings which were contaminated with permethrin. 8 (10%) clients had got rid of a part of the contaminated carpets and 25 (31%) clients did not remove any carpet. 39 (83%) of the clients who had removed all contaminated carpetings, described a complete or at least partial improvement of their complaints. The complaints of 6 (13%) clients did not improve despite removal of their carpets. The lowest concentration of permethrin that was assessed at the homes of clients, who, after removing all contaminated carpet floorings, described complete recovery, were 10-15 mg/kg dust and 15 mg/kg carpet, respectively. The effect of removing all contaminated carpetings on health improvement in comparison with the results of not removing any carpet was statistically significant (test: chi 2, p < 0.0001). The corrected contingency coefficient amounted to 0.71. In 3 cases, where the contaminated carpets had already existed for 5, 7 and 10 years in the homes of clients, there were still permethrin-concentrations of 115, 100 and 150 mg per kg dust. This result indicates that indoor contamination of permethrin is highly persistent.

[Multiple chemical sensitivity disorder in patients with neurotoxic illnesses]. / Vielfache Chemikalienunverträglichkeit (Multiple Chemical Sensitivity Disorder) bei Patienten mit neurotoxischen Gesundheitsstörungen.

The data of 466 subjects suffering from neurologic disorders which are suggested to be caused by neurotoxic agents in their environment retrospectively was evaluated and documented. Among these cases there were 151 subjects with symptoms of Multiple Chemical Sensitivity Disorder (MCSD). The relationship between the neurological health impairments and neurotoxic agents in the environment of these patients was characterised using five different categories (probable = A, possible = B, uncertain = C, unclarified = D, not probable = E). From the 466 patients 320 subjects (69%) could be assigned to the categories A and B, respectively. Within theses 320 cases with chronic neurotoxic health impairments 136 subjects (79 females and 57 males) showed signs of MCSD. Age and gender of cases as well as duration and character of exposure to neurotoxic substances retrospectively were assessed from the explicit files of the patients, which had been made anonymous for this purpose. Frequency of characteristic symptoms of neurotoxicity were analysed. Results are given for patients with neurotoxic health impairments with MCSD (n = 136) and without MCSD (n = 184). Neurotoxic substances which were used as indoor wood preservatives (mainly Pentachlorophenol and/or Lindane) were found to be the causative agents in 63% of the cases with neurotoxic health impairments and MCSD. Other important neurotoxic substances to which the patients were mainly exposed were organic solvents (25%), formaldehyde (15%), dental materials (15%), pyrethroides (13%), and other biocides (19%) (multiple exposures were possible). The time of exposure was calculated as being > or = 10 years for 55% of the patients with MCSD and for 50% of the group with neurotoxic health impairments but without MCSD. Out of the 184 cases with neurotoxic health impairments but without MCSD there were 22%, and out of the 136 cases with MCSD there were 39% who showed all symptoms of chronic fatigue syndrome. 53% of the cases with MCSD had an allergic disposition compared to only 20% of the cases without MCSD. This work is not a controlled epidemiological study but a retrospective documentation and evaluation of data related to environmental medicine. With the present documentation in this purely descriptive manner the proof of a causal relationship was not possible or intended. But because corresponding epidemiological studies are lacking, this documentation can give important information on characteristic features of Multiple Chemical Sensitivity Disorder and chronic neurotoxic health impairments. Such information is essential for planning and carrying out epidemiological studies urgently needed in this field.

[Regional distribution of stomach and colon cancer mortality in the Dithmarschen and Nordfriesland districts--cartographic presentation]. / Regionale Verteilung der Magen- und Kolonkrebsmortalität in den Kreisen Dithmarschen und Nordfriesland--kartographische Darstellung.

In two counties (Dithmarschen and Nordfriesland) of the Federal State of Schleswig-Holstein (in the northern part of Germany) the cancer mortality rates, especially those of stomach and colon cancer, were evaluated for the time period 1980-1991. For this purpose the corresponding death certificates collected in these counties were analysed. The counties were subdivided into 16 and 17 smaller areas, respectively. The age-adjusted mortality rates were calculated and the obtained data scaled into eight sections, which were graphically mapped over the smaller areas of the two counties. The frequency of these cancer mortality rates reflects a wide range of distribution pattern in the smaller areas of the two counties, which greatly differ from the cancer mortality values calculated for the two counties as a whole. In comparison with the frequency of stomach cancer mortality for men published in the German Cancer Atlas in 1984 it could be demonstrated that this cancer mortality further decreased in these counties. However, in some smaller areas of these counties, especially in rural areas, the mortality rates of stomach cancer in men were still rather high. The opposite seems to be reflected regarding the frequency of colon cancer mortality. Here higher frequencies of mortality were seen in the small cities of these counties. We suggest that a more subtile cancer mortality mapping can be performed easily without any risk of hurting the requirements of personal data securities, because cancer mortality data are already continuously evaluated by a trained staff at the offices of statistical affairs. These data may be transferred and used for cancer mortality mapping as described in the present paper. In order to guarantee that there will be no violation of personal data secrecy the cancer mortality mapping must be restricted to cancer sites with high frequencies of mortality. All published data should be supervised by an official with special knowledge of the requirements of personal data protection. This study underlines the necessity for higher resolution (smaller areas) in cancer registries as essential prerequisite for systematical exploration of the origins of cancer mortality and as a basis for preventive measures.