Live-cell fluorescence imaging of echinoderm embryos.

The rapid development, simplicity and optical clarity of the sea urchin embryo make it an excellent model system for studying the dynamic events of early development. An ever-growing palette of fluorescent proteins and biosensors can now be applied to studying sea urchin development, and there are now a wide variety of imaging modes that can be employed to image sea urchin embryogenesis. However, when performing live-cell imaging, one must take into consideration the sensitivity of embryos (and fluorescent probes) to the intense light associated with confocal microscopes. Here, we discuss general considerations for keeping embryos viable on the microscope stage, as well as probes for imaging cellular membranes and the cytoskeleton. We compare the relative merits of different confocal microscopes for live imaging of embryos and describe the potential for live-cell super-resolution microscopy.

Ultrafine particle exposure during fire suppression--is it an important contributory factor for coronary heart disease in firefighters?

OBJECTIVE: Coronary heart disease (CHD) is the primary cause of death among US firefighters during fire suppression. In other populations, exposure to respirable particles, including ultrafine particles, has been widely implicated as a risk factor for CHD. This study is the first to report detailed characterization of respirable particles released by combustion of an automobile and model residential structures under firefighter exposure conditions. METHODS: Characterization was performed when feasible during knockdown and routinely during overhaul. RESULTS: Ultrafines accounted for >70% of particles in all fire suppression stages, occurring in concentrations exceeding background by factors between 2 (automobile) and 400 (bedroom), consistent among all structures. CONCLUSIONS: Exposure to ultrafine particles during fire suppression should be considered a potential contributing factor for CHD in firefighters. Of major significance is their predominance during overhaul, where firefighters frequently remove respiratory protection.

Violence against emergency department workers.

The purpose of this study was to describe the violence experienced by Emergency Department (ED) workers from patients and visitors during the 6 months before the survey. Two hundred forty-two employees at five hospitals who came in direct contact with patients or visitors completed a survey. The study found that most workers had been verbally harassed by patients or visitors at least once. There were at least 319 assaults by patients and 10 assaults by visitors. Sixty-five percent of subjects assaulted stated that they did not report the assault to hospital authorities. Sixty-four percent of subjects had not had any violence prevention training during the previous 12 months. There were significant relationships among violent experiences, feelings of safety, and job satisfaction. ED workers are at high risk for violence, and efforts are needed to decrease the incidence of violence. Such efforts are likely to have a positive impact on job satisfaction and retention of ED workers.

Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis.

This report updates U.S. Public Health Service recommendations for the management of health-care personnel (HCP) who have occupational exposure to blood and other body fluids that might contain human immunodeficiency virus (HIV). Although the principles of exposure management remain unchanged, recommended HIV postexposure prophylaxis (PEP) regimens have been changed. This report emphasizes adherence to HIV PEP when it is indicated for an exposure, expert consultation in management of exposures, follow-up of exposed workers to improve adherence to PEP, and monitoring for adverse events, including seroconversion. To ensure timely postexposure management and administration of HIV PEP, clinicians should consider occupational exposures as urgent medical concerns.

Blood-borne pathogens among firefighters and emergency medical technicians.

OBJECTIVE: Firefighters and emergency medical services (EMS) personnel have the potential for occupational exposures to blood, which increases their risk for occupational blood-borne infection. To address this concern, the authors conducted a literature review of occupational blood exposures, the seroprevalence of blood-borne pathogens among these workers, and the seroprevalence of blood-borne pathogens among the patients they serve. METHODS: A MEDLINE search was conducted, and all identified articles that described surveys of exposures to blood or surveillance of blood-borne infections among firefighters and/or emergency medical technicians (EMTs) in the United States were reviewed. For hepatitis B, only seroprevalence surveys conducted after the 1992 requirement by the Bloodborne Pathogens Standard to offer vaccination to potentially exposed employees were included. RESULTS: From these data, the expected number of annual occupational hapatitis C virus seroconversions was estimated to be between 5.8 and 118.9 per 100,000 employee-years for EMT-paramedics, between 3.4 and 33.7 per 100,000 for firefighter-EMTs, and up to 3.6 per 100,000 for firefighters (non-EMT). CONCLUSIONS: This review suggests there are a limited number of studies addressing this issue, and these studies have numerous limitations. Despite the expected occupational seroconversions and recognizing the limitations in drawing conclusions from these studies, it appears that firefighters and EMS personnel do not have an elevated seroprevalence of hepatitis C virus compared with the general population. Improved exposure surveillance programs would clarify exposure risks and identify potential interventions for firefighters and EMS personnel.