The physical and physiological workload of refuse collectors.

In order to secure a safer and healthy work situation, the heavy physical loads imposed on 23 refuse collectors (aged 26-54) working in the city of Haarlem, in The Netherlands, were studied in a series of three experiments between 1984 and 1987. The aims were respectively (1) to study the load for workers collecting dustbins or polythene bags; (2) to introduce changes to reduce the load to avoid exceeding the overload criteria by individual refuse collectors; and (3) to investigate the effects of interventions to improve the efficiency of refuse collecting. The maximal isometric lifting force (Fmax) and the maximal aerobic power (VO2max) of 23 refuse collectors were measured in the laboratory. Fmax was measured with an isometric dynamometer pulling with one arm from the floor; the mean value was 912 (+/- 127)N. VO2max was measured running on a treadmill; the mean value was 43.3 (+/- 0.8)ml O2 per kg body mass per min. The physical load on the oxygen transport system was measured through work analysis and by a continuous registration of the heart rate over three working days. Criteria for overload were set at a mean external load of 20% Fmax and a mean energy expenditure of 30% VO2max and an energy expenditure of 50% VO2max or more for a maximum of 60 min per day. Replacement of dustbins by polythene bags resulted in a 70% increase in the total amount of refuse collected, an increase in throwing frequency, but a lower mean load per throw, and no significant differences in the mean heart rate over the working day. When polythene bags were used the mean values did not exceed the overload criteria, but 39% of the individual collectors did have a workload that was too high with respect to one of the criteria. In the last experiment the collectors were advised to reduce their work load by (a) lifting no more than two bags at a time; (b) reducing their walking pace; and (c) taking more breaks. Although compliance with the recommendations was good, and the weight lifted and the walking speed decreased, the physiological load remained the same. This may have been caused by a 15% increase in the total amount of refuse that had to be collected at that time.

Determination of the half-life of C3 in patients and its relation to the presence of C3-breakdown products and/or circulating immune complexes.

Measurement of complement components in serum may not accurately assess the degree of activation of the complement system. An alternative approach is the measurement of conversion products of the complement components. The relation between the presence of an increased concentration of C3-conversion products and the metabolism of C3 was investigated. In a group of patients, circulating immune complexes were also measured (Clq-binding test) to see whether the combination of those markers yielded information on the C3 metabolism. In this study it is shown that static measurements of serum C3 levels is of no value for the degree of complement activation. Measurement of C3-conversion products may indicate C3 hypercatabolism (in 8 of the 11 patients with C3-conversion products), but it does not imply depressed C3 synthesis. Detection of circulating immune complexes by the C1q-binding assay did not always indicate a C3 hypercatabolism. Of 12 SLE patients studied, in 9 of them, a C3 hypercatabolism was detected, and 5 of these patients were clinically characterized by the presence of minor disease symptoms. Overall, the results indicated that detection of circulating immune complexes and/or C3-conversion products could not be used as an absolute measure for insight into the C3 metabolism.