Immunity against vaccine-preventable diseases among pregnant employees in Germany. A situation analysis before the introduction of the Measles Protection Act.

BACKGROUND: Immunization against vaccine-preventable diseases prior to pregnancy is an important measure of primary prevention both for the mother and the unborn child. We analyzed immunity rates against measles, mumps, rubella, varicella, and pertussis in pregnant employees in Germany prior to significant changes in legal conditions in 2020, to provide a basis of comparison for future research. METHODS: We analyzed occupational-medical routine data in three collectives of pregnant women with an occupational risk of infection in the years 2018 and 2019: 1: hospital staff with regular access to an in-house company physician (n = 148); 2: employees in childcare with regular access to external occupational-health services (n = 139); 3: teachers with no regular access to occupational healthcare (n = 285). Immune status was assessed by a physician based on vaccination certificates, laboratory results, and medical documentation on prior infections. We compared immunity rates against measles, rubella, varicella, and pertussis as well as full immunity against all targeted vaccine-preventable diseases. RESULTS: Altogether, n = 572 pregnant women were included in our study. Of these women, 96.5 % were immune to rubella, 95.8 % to varicella, 88.3 % to measles, 82.7 % to mumps, and 67.8 % to pertussis. Only 56.2 % of the women had full immunity against all targeted vaccine-preventable diseases. Collective 1 showed the highest immunity rates against measles and pertussis as well as the highest rate of full immunity against all targeted vaccine-preventable diseases. The immunity rates against rubella and varicella did not differ significantly between the collectives. With the exception of rubella, the lowest immunity rates during pregnancy were found in Collective 3. CONCLUSION: We found pregnancy-relevant immunity gaps in all our study groups with significant differences between the collectives. Considering the potentially devastating consequences of infections during pregnancy, all medical professionals and health-policy makers should be involved in an increased effort to improve vaccination rates prior to pregnancy.

Microemulsion and microsuspension polymerization of methyl methacrylate in surfactant-free microemulsions (SFME).

HYPOTHESIS: This article presents a free-radical polymerization method in a mesostructured system - free of any surfactants, protective colloids, or other auxiliary agents. It is applicable for a large variety of industrially relevant vinylic monomers. The aim of this work is to study the impact of surfactant-free mesostructuring on the polymerization kinetics and the polymer derived. EXPERIMENTS: So-called surfactant-free microemulsions (SFME) were investigated as reaction media with a simple composition comprising water, a hydrotrope (ethanol, n-propanol, isopropanol, tert-butyl alcohol), and the monomer as the reactive oil phase (methyl methacrylate). Polymerization reactions were performed using oil-soluble, thermal- and UV-active initiators (surfactant-free microsuspension polymerization) and water-soluble, redox-active initiators (surfactant-free microemulsion polymerization). Structural analysis of the SFMEs used and the polymerization kinetics were followed by dynamic light scattering (DLS). Dried polymers were analyzed with regard to their conversion yield by mass balance, the corresponding molar masses were determined using gel permeation chromatography (GPC), and the morphology was investigated by light microscopy. FINDINGS: All alcohols are suitable hydrotropes to form SFMEs, except for ethanol, which forms a molecularly disperse system. We observe significant differences in the polymerization kinetics and the molar masses of the polymers obtained. Ethanol leads to significantly higher molar masses. Within a system, higher concentrations of the other alcohols investigated give rise to less pronounced mesostructuring, lower conversions, and lower average molar masses. It could be demonstrated that the effective concentration of alcohol in the oil-rich pseudophases as well as the repulsive effect of the surfactant-free, alcohol-rich interphases constitute the relevant factors influencing polymerization. Concerning the morphology, the polymers derived range from powder-like polymers in the so-called "pre-Ouzo region" over porous-solid polymers in the bicontinuous region to dense, almost compacted, transparent polymers in unstructured regions, comparable to the findings for surfactant-based systems reported in the literature. Polymerizations in SFME comprise a new intermediate between well-known solution (i.e., molecularly dispersed) and microemulsion respectively microsuspension polymerization processes.

Improving Rheological and Mechanical Properties of Various Virgin and Recycled Polypropylenes by Blending with Long-Chain Branched Polypropylene.

Blends of two long-chain branched polypropylenes (LCB-PP) and five linear polypropylenes (L-PP) were prepared in a single screw extruder at 240 °C. The two LCB-PPs were self-created via reactive extrusion at 180 °C by using dimyristyl peroxydicarbonate (PODIC C126) and dilauroyl peroxide (LP) as peroxides. For blending two virgin and three recycled PPs like coffee caps, yoghurt cups and buckets with different melt flow rate (MFR) values were used. The influence of using blends was assessed by investigating the rheological (dynamic and extensional rheology) and mechanical properties (tensile test and impact tensile test). The dynamic rheology indicated that the molecular weight as well as the molecular weight distribution could be increased or broadened. Also the melt strength behavior could be improved by using the two peroxide modified LCB-PP blends on the basis of PODIC C126 or PEROXAN LP (dilauroyl peroxide). In addition, the mechanical properties were consistently enhanced or at least kept constant compared to the original material. In particular, the impact tensile strength but also the elongation at break could be increased considerably. This study showed that the blending of LCB-PP can increase the investigated properties and represents a promising option, especially when using recycled PP, which demonstrates a real "up-cycling" process.

Effects of Chemical Compositions on Plating Characteristics of Alkaline Non-Cyanide Electrogalvanized Coatings.

The effects of zinc and sodium hydroxide concentrations in an alkaline non-cyanide zinc bath on the electrodeposition characteristics of zinc deposits are systematically investigated. Using microstructural and phase analyses of specimens with specifically designed geometries, the study indicates that the bath formulations critically control the electrogalvanizing characteristics and affect the coating surface morphology, deposition rate, throwing power, coating uniformity, and residual stresses developed during and after electrogalvanizing. The coatings produced from baths with a moderate Zn-to-NaOH ratio of 0.067-0.092 appear to provide uniform and compact deposits, moderately high deposition rate, and relatively low residual stresses.

Influence of Different Types of Peroxides on the Long-Chain Branching of PP via Reactive Extrusion.

Long-chain branching (LCB) is known as a suitable method to increase the melt strength behavior of linear polypropylene (PP), which is a fundamental weakness of this material. This enables the modification of various properties of PP, which can then be used-in the case of PP recyclates-as a practical "upcycling" method. In this study, the effect of five different peroxides and their effectiveness in building LCB as well as the obtained mechanical properties were studied. A single screw extruder at different temperatures (180 and 240 °C) was used, and long-chain branched polypropylene (PP-LCB) was prepared via reactive extrusion by directly mixing the peroxides. The peroxides used were dimyristyl peroxydicarbonate (PODIC C126), tert-butylperoxy isopropylcarbonate (BIC), tert-Butylperoxy 2-ethylhexyl carbonate (BEC), tert-amylperoxy 2-ethylhexylcarbonate (AEC), and dilauroyl peroxide (LP), all with a concentration of 20 mmol/kg. The influence of the temperature on the competitive prevalent reactions of degradation and branching was documented via melt mass-flow rate (MFR), rheology measurements, and gel permeation chromatography (GPC). However, via extensional rheology, strain hardening could be observed in all cases and the mechanical properties could be maintained or even improved. Particularly, PODIC C126 and LP signaled a promising possibility for LCB in this study.

[Subjective Workload, Job Satisfaction, and Work-Life-Balance of Physicians and Nurses in a Municipal Hospital in a Rural Area Compared to an Urban University Hospital]. / Subjektive Arbeitsbelastung, Arbeitszufriedenheit, Work-Life-Balance von Ärzten und Pflegekräften eines Kommunalklinikums im ländlichen Raum im Vergleich zu einem großstädtischen Universitätsklinikum.

Medical and nursing shortages in rural areas represent a current serious public health problem. The healthcare of the rural population is at risk. This study compares perceived workload, job satisfaction and work-life balance of physicians and nurses at a clinic in a rural area with two clinics of a University hospital. Physicians and nurses were interviewed anonymously with a standardized questionnaire (paper and pencil), including questions on job satisfaction, subjective workload and work-life balance. The response rate was almost 50% in the University hospital as well as in the municipal hospital. 32 physicians and 54 nurses from the University hospital and 18 physicians and 137 nurses from the municipal hospital participated in the survey. Nurses at the University hospital assessed the organization of the daily routine with 94.1% as better than those at the municipal hospital (82.4%, p=0.03). Physicians at the University hospital were able to better implement acquired knowledge at a University clinic with 87.5% than their counterparts at the municipal hospital (55.5%, p=0.02). In contrast to their colleagues at the municipal hospital, only 50% of the physicians at the University hospital subjectively considered their workload as just right (83.3% municipal, p=0.02). 96.9% of the physicians at the University hospital were "daily" or "several times a week" under time pressure (municipal 50%, p<0.01). Nurses of both hospitals had sufficient opportunity to reconcile work and family life (62.9% University hospital, 72.8% Municipal hospital). In contrast, only 20% of the physicians at the University Hospital but 42.9% of the physicians of the municipal hospital had sufficient opportunities to balance workload and family (p=0.13). The return rate of almost 50% can be described as good. Due to the small number of physicians, especially from the municipal hospital, it can be assumed that some interesting differences could not be detected. There were only slight differences between the nurses from the two hospitals. In contrast, subjective workload and stress factors reported by physicians at the University Hospital were significantly higher than those by doctors at the municipal hospital.

Influence of the Molar Mass on Long-Chain Branching of Polypropylene.

Long-chain branching (LCB) with peroxydicarbonates (PODIC) is known as a suitable post-reactor process to introduce strain-hardening behaviour and an increase of melt strength to a linear polypropylene (PP). This opens up new possibilities for processing and therefore application. Especially in the case of adding value to PP post-consumer waste, LCB is a promising approach. LCB takes place by a combination of chain scission and recombination after radical activation of the PP macromolecule. However, chemical modification of post-consumer waste is challenging because of the inhomogeneous composition and the manifold number of PP grades. The influence of the molar mass of the linear PP precursor on this reaction was studied with different PP grades ranging from extrusion grade to injection moulding grade. To exclude side effects, all PP grades had similar polydispersity indices. A PP with higher molar mass undergoes significant chain scission during the LCB process compared to a PP with low molar mass for injection moulding. Therefore, the two grades differ significantly in their branching number, which influences their behaviour in elongational flow.

[Assessment of occupational cancer: important facts to consider]. / Berufsbedingte Tumorerkrankungen: Was ist bei der Begutachtung zu beachten?

Background | Persons suffering from malignant tumors who had been exposed to carcinogens at their workplace must be compensated if occupational exposure probably caused the disease. However, the assessment of the causes of cancers is particularly difficult.Method | For the evaluation the authors analyzed selectively researched literature and considered publications of the German Social Accident Insurance and legal regulations.Result | Often the quantification of the occupational exposure is not possible. Cumulative exposures neglect important factors, e.g. high peak concentrations. Even in the general population exposure to noxious agents occurs. This raises the question what amount of occupational exposure must be considered as sufficient for compensation and how non-occupational factors, such as genetic susceptibility, should influence the expert's opinion. Syncancerogenetic effects are currently not sufficiently considered in the legal ordinance on occupational diseases.Conclusion | At best, only a very rough estimate of the probability of causation can be stated. If there is insufficient scientific evidence then there is a need of "makeshift" recommendations within the social consensus, which occupational exposure is considered to be relevant for occupational disease. If there are no reliable data on occupational exposure due to failure of the employer, this should not be stacked against the insured.

Well prepared for work? Junior doctors' self-assessment after medical education.

BACKGROUND: Apart from objective exam results, the overall feeling of preparedness is important for a successful transition process from being a student to becoming a qualified doctor. This study examines the association between self-assessed deficits in medical skills and knowledge and the feeling of preparedness of junior doctors in order to determine which aspects of medical education need to be addressed in more detail in order to improve the quality of this transition phase and in order to increase patient safety. METHODS: A cohort of 637 doctors with up to two years of clinical work experience was included in this analysis and was asked about the overall feeling of preparedness and self-assessed deficits with regard to clinical knowledge and skills. Three logistic regression models were used to identify medical skills which predict the feeling of preparedness. RESULTS: All in all, about 60% of the participating doctors felt poorly prepared for post-graduate training. Self-assessed deficits in ECG interpretation (aOR: 4.39; 95% CI: 2.012-9.578), treatment and therapy planning (aOR: 3.42; 95% CI: 1.366-8.555), and intubation (aOR: 2.10; 95% CI: 1.092-4.049) were found to be independently associated with the overall feeling of preparedness in the final regression model. CONCLUSIONS: Many junior doctors in Germany felt inadequately prepared for being a doctor. With regard to the contents of medical curricula, our results show that more emphasis on ECG-interpretation, treatment and therapy planning and intubation is required to improve the feeling of preparedness of medical graduates.

Mercapturic acids as metabolites of alkylating substances in urine samples of German inhabitants.

Hydroxyalkyl mercapturic acids (HAMA) are the main urinary metabolites of several alkylating substances that possess a carcinogenic potential, like acrolein, 1,3-butadiene, ethylene oxide, propylene oxide and glycidol. These alkylating substances are used extensively in industrial processes, but they do also occur environmentally, e.g. in tobacco smoke. The aim of this study was the determination of six HAMA, as biomarkers of exposure, in human urine of smokers and non-smokers. We applied a sensitive analytical method, using hydrophilic interaction liquid chromatography with tandem mass spectrometry (HILIC-MS/MS) for the determination of 2-hydroxyethyl mercapturic acid (HEMA, biomarker for ethylene oxide), 2-hydroxypropyl mercapturic acid (2-HPMA, biomarker for propylene oxide), 3-hydroxypropyl mercapturic acid (3-HPMA, biomarker for acrolein), 2,3-dihydroxypropyl mercapturic acid (DHPMA, biomarker for glycidol) as well as 3,4-dihydroxybutyl mercapturic acid and 3-monohydroxybutenyl mercapturic acids (DHBMA and MHBMA, biomarkers for 1,3-butadiene). Background concentrations of four HAMA were detected in each urine sample we analyzed. The mercapturic acids HEMA and MHBMA were detected in 55% and 10% of the samples, respectively. In the urine of non-smokers (n = 54) we observed median levels of 206, 1.6, 12.1, 146, 159, and <5.0 µg/g creatinine for DHPMA, HEMA, 2-HPMA, 3-HPMA, DHBMA and MHBMA, respectively. Among smokers (n = 40) median levels of DHPMA, HEMA, 2-HPMA, 3-HPMA, DHBMA and MHBMA were determined to be 217, 4.9, 46.2, 884, 211 and <5.0 µg/g creatinine, respectively. The excretion rate of the biomarkers HEMA, 2-HPMA and 3-HPMA was distinctly higher in smokers than in non-smokers. Furthermore, our study revealed a comparatively high background level of DHPMA in urine of smokers and non-smokers whose origin is still unknown. The presented data may contribute to the evaluation of reference values for urinary HAMA levels in the general population.

Stress and recovery in junior doctors.

OBJECTIVE Junior doctors are thought to experience increased mental strain in comparison to other occupations. The aim of the present study was to analyse selected work related influencing factors of strain and recovery in junior doctors. METHODS In September 2006, 1494 young doctors were asked to participate in a postal questionnaire study featuring the Recovery Stress Questionnaire (RESTQ) and additional questions on job specific risk factors. Using hierarchical linear regression analyses the answers of 637 participants with less than 1.5 years work experience in patient care were analysed. RESULTS Results revealed that overtime work, as well as lack of performance related feedback from supervisors, were consistently related to increased levels of strain among junior doctors. These risk factors were also predominantly related to recovery. In addition, feedback from colleagues was significantly associated with the recovery sub-scales (except with sleep quality). CONCLUSIONS Overtime work and performance related feedback from supervisors seem to be important work related factors concerning junior doctors' levels of strain and recovery. In addition, performance feedback from colleagues seems to be a major resource for recovery. The findings have implications regarding work time regulations and the necessity of leadership skill development training regarding feedback talks and fostering a desirable social climate in the healthcare system for the wellbeing of junior doctors.

Radon in indoor spaces: an underestimated risk factor for lung cancer in environmental medicine.

BACKGROUND: Occupational medicine has long recognized radon to be a cause of lung cancer, especially among miners working under ground. Until recently, however, little scientific evidence was available about the risk to the general population caused by indoor radon. METHODS: The authors analyzed literature that they found by a selective search in the light of the recently published S1 guideline of the German Society of Occupational and Environmental Medicine (Deutsche Gesellschaft für Arbeitsmedizin und Umweltmedizin) and a recent publication of the German Commission on Radiological Protection (Strahlenschutzkommission). RESULTS: Exposure to indoor radon and its decay products is a major contributor to the radiation exposure of the general population. In Germany, the mean radiation exposure due to radon in living rooms and bedrooms is about 49 Bq/m(3). It is well documented in the scientific literature that indoor radon significantly increases the risk of lung cancer, probably in a linear dose-response relationship with no threshold. Every 100 Bq/m(3) increase in the radon concentration is estimated to increase the relative risk for lung cancer by 8% to 16%. After cigarette smoking, radon is the second main cause of lung cancer in the general population without occupational exposure. CONCLUSIONS: From the point of view of preventive environmental medicine, it is important to identify buildings with high radon concentrations, initiate appropriate measures, and minimize radon exposure, particularly in new buildings.

Associations between being overweight, variability in heart rate, and well-being in the young men.

Abnormalities of the autonomic nervous system have been repeatedly shown in hypertension. We studied the associations between being overweight, blood pressure, cardiac vagal tone as measured by variability in heart rate, and well-being in a large cohort of young men. We hypothesised an inverse correlation between body mass index and the variability in heart rate. Further, we assessed systolic and diastolic blood pressure as traditional indicators of cardiovascular risk. Exclusion criteria were the use of drugs or pharmaceuticals. The following data from 786 men with a mean age of 19.4 years (standard deviation = 1.4, with a range from 16 to 24 years) were analysed in a cross-sectional study: body mass index, sleep duration, sporting activities, psychological well-being, blood pressure, heart rate, and variability in heart rate. Despite the young age of the men in this study, increased values for the body mass index were already associated with a shift in sympathovagal balance trending towards sympathetic dominance. There was also a significant positive correlation between body mass index and systolic and diastolic blood pressure. A multiple stepwise regression analysis showed that significant factors, which were associated with variability in heart rate, were body mass index and sporting activities. In addition, sporting activity and sleep duration had a significant positive impact on psychological well-being. Even in young men, being overweight is associated with increased cardiovascular risk, especially an increased sympathetic and/or lowered cardiovascular tone and increased blood pressure. Our study gives additional motivation for the early prevention and treatment of obesity in childhood and adolescence.

Is there a need for special preventive medical check-ups in employees exposed to experimental animal dust?

OBJECTIVE: Due to new legal requirements in Germany, the employer must request preventive medical check-ups for activities involving exposure to dust from experimental animals in the rooms in which the animals are kept. The objective is to report our first experiences with these medical check-ups in the context of academic research. METHODS: The check-ups were carried out since November 2005 and comprised a questionnaire and a medical examination, including a pulmonary function test with whole-body plethysmography. Respiratory, nasal and ocular symptoms related to occupational exposure to animals were documented. Participation in skin prick tests (ubiquitous inhalation allergens and laboratory animal allergens), a bronchial provocation test with methacholine, and serological examinations for total IgE and specific IgE antibodies was voluntary. RESULTS: Data on 132 persons are presented. One hundred and six of these had already been exposed for at least 1 year. Main complaints at the workplace were sneezing and runny nose. Ocular symptoms and bronchial asthma were reported infrequently. The development of at least one of these symptoms occurred in 34% of employees with an exposure of at least 1 year. If the weekly exposure duration was at least 5 h, the proportion of employees with complaints rose to 44.9%. In employees occupationally exposed to mice and rats, work-related complaints occurred in 33.7 and 37.8%, respectively, and sensitisation rates were 12.7 and 16.3%, respectively. Employees with and without complaints differed in history of allergic symptoms, and workplace safety measures. CONCLUSIONS: In employees with occupational contact with laboratory animal dust, the frequency of complaints was high. The results confirm the necessity of regular medical check-ups for employees with contact with laboratory animal dust. Nevertheless, the medical check-ups must be part of a prevention strategy including education, engineering controls, administrative controls, use of personal protective equipment and vocational integration.

[Influence of rescue service personnel's shift work on psycho-physical parameters]. / Einfluss der Schichtarbeit im Rettungsdienst auf psychophysische Parameter.

BACKGROUND: The aim of the investigation was to receive information about the interaction between psycho-physical parameters as a function of the strain by shift work for rescue service personnel. MATERIAL AND METHODS: We examined 26 persons, who are active in the rescue service. The investigations always took place in the morning between 7.00 and 8.00 o'clock, either after 3 days off (n = 26), after 3 night shifts (n = 14) or in the morning of the third day shift (n = 14). The investigations included measurements of blood pressure, heart rate variability, and salivary cortisol. Additionally, standardized questionnaires (WHO-5, EBF 72/3) were used. RESULTS: A significant rise of the quotient LF/HF--as indicator for a sympathetic dominance--could be proven by means of a simple three minute arithmetic task at every investigation (after 3 days off from 0.81 to 2.30; p < 0.001). By means of the EBF a clear impairment could be demonstrated after 3 night shifts. Fatigue and somatic complaints were the main outcomes. In our study a more impaired well-being was associated with a more pronounced decrease of salivary cortisol (r = 0.538; p < 0.05) as well as lower blood pressure values (r = 0.547; p < 0.05), and a lower LF/HF quotient (r = 0.836; p < 0.01), indicating lower sympathetic and/or increased vagale activation, after three night shifts. CONCLUSIONS: After three night shifts a lower sympathetic activation seems to negatively affect the well-being. Due to the provable specific strain night- and shift-workers should be a priority target group for prevention and workplace health promotion.

Investigations on permeation of mitomycin C through double layers of natural rubber gloves.

Treating peritoneal carcinomatosis by the aggressive cytoreductive surgery with the hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) surgeons expose their gloved hands for up to 90 min to a peritoneal dialysis solution (PDS) containing mitomycin C (MMC). We investigated the permeation of MMC through the material of three different natural rubber gloves under conditions similar to the in-use during HIPEC as well as under worst-case exposure scenario. Two different methods, a two-chamber diffusion cell and a single-chamber glass chamber method, were used to demonstrate the permeation capability. The permeation of MMC dissolved in 0.9% NaCl solution and PDS through double natural rubber glove material was tested over 2 h using four concentrations (c = 0.004, 0.008, 0.016 and 0.4 mg ml(-1)) and three receptor fluids (0.9% NaCl solution, PDS and a novel artificial sweat). In none of four glass chamber experiments and in only one of 40 diffusion cell experiments was permeation through glove material detected. The permeation occurred between 15 and 30 min under worst-case exposure scenario at a approximately 100-fold higher MMC concentration than under in-use conditions during HIPEC. The double-layer natural rubber gloves tested were effective to prevent a permeation of MMC in vitro under HIPEC-similar exposure. Our results support the glove wearing procedure in our university hospital. However, occupational exposure to antineoplastic drugs should be minimized, since there is insufficient knowledge regarding harmful effects from a long-term exposure to low doses.

Transepidermal water loss and incidence of hand dermatitis in a prospectively followed cohort of apprentice nurses.

The purpose of the study was to evaluate the incidence of hand dermatitis, the impact of potential risk factors and the efficacy of skin bioengineering in a prospectively followed cohort of apprentice nurses. 104 participants were prospectively followed for 3 years. Before the start of training, after about 1 year and in the third year of occupational exposure, a standardized questionnaire was distributed, and a clinical examination with skin bioengineering of the dorsum of hand and forearm was performed. The 12-month period prevalence of self-reported symptoms of hand dermatitis was 36.5%[95%-confidence interval (CI) 27.3-46.6] at intermediate follow-up and 43.3% (95%-CI 33.6-53.3) at the final examination. Apprentices with self-reported symptoms at the final examination showed a significant increase of transepidermal water loss (TEWL) at the dorsal hand from 10.15 g/m2h to 13.55 g/m2h. TEWL at this site did, at the initial examination, not differ significantly between persons who later reported symptoms of hand dermatitis at the final examination and those who did not (10.50 g/m2h versus 10.15 g/m2h, respectively). Our results do not support the notion that an increased basal TEWL is a good indicator for hand dermatitis risk.

Student health policy of a German medical school--results of a cross sectional study concerning students' immunity to vaccine-preventable diseases.

Medical students come into contact with infectious materials early in their medical education. Aim of this study was to assess medical students' immunity to vaccine-preventable diseases and to ensure immunity against hepatitis B. An occupational health medical was offered to all medical students with special emphasis on preclinical students. The examination included a check of the certificates of vaccination and serological tests concerning hepatitis B virus, hepatitis C virus and, on request, HIV. A lecture on occupational risks and general precautions was given to the students. In 7 of 804 tested students serological markers of a previous hepatitis B infection were discovered, fortunately none of the students was infectious. No case of infection with the hepatitis C virus (n=804) or HIV (n=700 tested voluntary) was identified. For 52 percent of the students vaccination against hepatitis B was necessary to guarantee protective immunity. Documented protection against other vaccine-preventable diseases as tetanus (71%), diphtheria (67%), poliomyelitis (56%), pertussis (2%), measles (32%), mumps (24%) and rubella (25%) was also insufficient. As a result a vaccination against hepatitis B in childhood without documented response doesn't guarantee a sufficient protection. An occupational health medical at the beginning of preclinical training seems to be an adequate method of making medical students aware of occupational risks, immunization policies and the importance of occupational medicine.

Latex sensitization in dental students using powder-free gloves low in latex protein:a cross-sectional study.

In Germany, employers must provide low-protein, powder-free gloves. This study was carried out to determine the current prevalence of latex sensitization in dental students using these gloves and to compare our results with a study of the same design dating from 1990/1991 at our university. A cross-sectional study was performed by questionnaire, prick testing and determination of specific IgE antibodies. 226 of 403 dental students underwent prick testing with a panel of 8 aero-allergens, 1 commercially available latex extract and 5 high-ammonia accelerator-free latex fluids. 39 of 226 dental students (17.3%) had a positive prick test response to at least 1 of the 6 latex substances tested. The prick test positivity was similar in preclinical education (semester 1-6) and in clinical education (semester 7-10), at 17.1% and 17.4%, respectively. In 9 of 32 persons with positive prick tests, specific IgE antibodies to latex could be detected. Within the past 10 years, prick test positivity increased from 8.7% to 17.3%. 14 students (6.2%) reported a history of glove intolerance, 3 of them (1.3%) showing a positive prick test to latex. By the use of low-protein, powder-free gloves less students with glove intolerance were observed. The observed reactions to between 1 and 3 of 6 latex substances tested may indicate a decrease in intensity and spectrum of sensitization. Additionally non-occupational sensitization may be of importance.