[Occupational protection in biological waste treatment plants from the occupational medicine viewpoint]. / Arbeitsschutz in biologischen Abfallbehandlungsanlagen aus arbeitsmedizinischer Sicht.

Composting of biogenous waste matter constitutes an important segment in the Federal Republic of Germany's developing waste and recycling management. The processes used in compost production entail exposure to bio-aerosols, gases, dust, microorganisms and their toxins, additionally noise, fluctuating climatic conditions and various accident dangers. A study carried out was task with elaborating a specific profile of strains on compost workers in comparison with a control group. 42 composting plants were visited in 1996 and 1997. In the plants, spread out over seven federal states, 184 compost workers participated in 1996 and 178 in 1997. The control group comprised 66 (1996) and 63 (1997) employees of a senior state authority with office and laboratory jobs. About 400 mainly humanly relevant air measurements for meso-phile/thermo-phile actinomycetins or mould fungi provided emissions data for the purpose of estimating biological risks. Jeopardy analysis of jobs for chemical and physical jeopardy factors was based on the checklist method supported by GC-MS screening as well as measurements of noise level, light density and dust concentrations. On-site medical examination of all 491 employees comprised detailed industrial-medical anamnesis, internistic-clinical physical examination, recording of static-dynamic pulmonary function parameters as well as haematological-immuno-serological screening. From the results, it can be concluded that ailments of the respiratory tract and the lungs as well as chronic bronchitis, bronchial asthma and exogenous allergic alveolitis are not found with significantly greater frequency in compost workers than they were in the control group. The same is likewise true for allergies, diseases of the locomotor system and the skin. ODTS did not occur. During the study period, there was one case of occupational disease in a compost worker with an hypersensitivity pneumonitis caused by Aspergillus fumigatus. Efforts are necessary for a better filter technique and the reduction of noise and carbon dioxide hazards.

[Report of 2 cases of irreversible Horner syndrome after puncture of the internal jugular vein]. / Berich über 2 Fälle eines irreversiblen Horner-Syndroms nach Punktion der Vena jugularis interna.

Two cases are presented with irreversible Horner's syndrome after cannulation of the internal jugular vein during the intraoperative period. In the first case the cannulation succeeded only after several attempts. In the second case the cannulation succeeded the first time. All cannulations were performed by experienced anaesthesiologists. This means, that a strict indication for the cannulation of the internal jugular vein must be considered, because of the possibility of irreversible damage, even if the cannulation is performed by an experienced physician.

[Epidural morphine analgesia (PMA). III. Cancer pain (author's transl)]. / Peridurale Morphin-Analgesie. III. Karzinomschmerzen.

The effect of PMA in pain therapy was investigated over a period of one year on 52 patients suffering from terminal cancer. These patients, 22 being outpatients, received a total number of 85 peridural catheters. 75 of these catheters were evaluated according to morphine dosage and effect. The onset of PMA resulted in a drastic reduction in the need for high dose systemically applied analgesics. PMA was also successfully applied in cases with rapidly spreading metastases. Our catheters have remained in place up to 170 days. Side effects were rarely observed. Tachyphylaxis did not develop and almost all patients were satisfied with the therapy. Due to special care of the catheter we observed only 7 cases of infected puncture sites. Our clinical studies have proven that peridural morphine analgesia can be successfully applied as pain therapy in patients suffering from terminal cancer.