Ramona Hambach

Co-exposure to lead increases the renal response to low levels of cadmium in metallurgy workers.

PURPOSE Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on biomarkers of early renal effect. METHODS Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers, i.e., microalbumin (μ-Alb), beta-2-microglobulin (β₂-MG), retinol binding protein (RBP), N-acetyl-β-d-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. RESULTS AND CONCLUSIONS The median Cd-B, Cd-U, Pb-B were: 0.8 μg/l (IQR = 0.5, 1.2), 0.5 μg/g creatinine (IQR = 0.3, 0.8) and 158.5 μg/l (IQR = 111.0, 219.3), respectively. The impact of Cd-B on the urinary excretion of NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., μ-Alb and β2-MG). Our findings indicate that Pb increases the impact of Cd exposure on early renal biomarkers.

Hepatitis B and influenza vaccines: Important occupational vaccines differently perceived among medical students

Healthcare personnel (HCP) are at risk from occupational exposure to airborne and bloodborne pathogens, and the risk of infection among HCP is greater than among the general population. The aim of the study was to characterize attitudes toward occupational recommended vaccines as well as the perception of risks of occupationally acquired infections. We surveyed 650 medical students to assess their perception of influenza and hepatitis B and their opinions and beliefs about influenza and hepatitis B vaccines. We found differences between pre-clinical and clinical students regarding the uptake of influenza and hepatitis B vaccines, about the chances of being occupationally infected with influenza or hepatitis B, and about the likelihood of suffering from severe side-effects following immunization. Interestingly, the risk perception varied drastically between the two vaccine-preventable diseases hepatitis B and influenza. Medical students rated the probability of contracting hepatitis B due to a work-related exposure and the severity of disease significantly higher than for influenza, and this may be an explanation for the greater acceptance of the hepatitis B vaccine. Furthermore, our findings suggest that medical students are frequently inaccurate in assessing their own risk level, and their specific knowledge about both diseases and the severity of these diseases proved to be unsatisfactory.

Hepatitis E virus infection: an emerging occupational risk?

BACKGROUND Hepatitis E virus (HEV) infection is endemic in many developing countries, causing substantial morbidity. Transmission is primarily faeco-oral and is associated with both sporadic infections and epidemics in areas where poor sanitation and weak public health infrastructures exist. Recently, it has become clear that HEV is also an endemic disease in industrialized countries. Moreover, a porcine reservoir and growing evidence of zoonotic transmission have been reported in these countries, suggesting the possibility of occupational transmission to man. AIMS To summarize the current knowledge on the epidemiology and prevention of transmission of HEV infection in occupational settings. METHODS The following key words were used to explore PubMed: hepatitis E, disease, epidemiology, profession(al), occupation(al). RESULTS After screening of the results, 107 publications were retained. In non-endemic regions, seroprevalence varied from a few per cent (2-7.8%) in Europe, Japan and South America to 18.2-20.6% in the USA, Russia, UK, southern France and Asia. A meta-analysis of 12 cross-sectional studies evaluating HEV immunoglobulin G (IgG) seroprevalence in individuals occupationally exposed to swine showed greater odds of seropositivity in the exposed group but also a high degree of heterogeneity. A funnel plot suggested publication bias. CONCLUSIONS There was a significant association between occupational exposure to swine and HEV IgG seroprevalence, but the level of prevalence detected depended also on the type of HEV IgG kits used. Further research, including on mechanisms and risk factors for infection, as well as the development of better serological tests for identification of infection, is required.

Work-related health symptoms among compost facility workers: a cross-sectional study

BackgroundIndustrial composting is a relatively new and expanding activity. Several studies indicate that compost workers are at risk to develop health symptoms. The aim of this study was to assess the prevalence of work-related health symptoms among compost workers compared with control subjects.MethodsA questionnaire was distributed among 62 workers (31 exposed and 31 non-exposed workers). Data were analyzed using simple and multiple logistic regression analyses.ResultsWorkers exposed to organic dust reported significantly more often respiratory, irritation (e.g., eyes, nose and throat), gastrointestinal, and skin symptoms than the non-exposed group. Moreover, all work-related symptoms were significantly more often reported by exposed than non-exposed workers. After adjustment for smoking status and age, the associations between exposure and respiratory, gastrointestinal, and skin symptoms remained statistically significant, in particular if these symptoms were work-related.ConclusionsThis study confirms that workers at compost facilities are at risk to develop occupational health problems, most likely related to organic dust exposure.

Inspecting asylum seekers upon entry: a medico-ethical complex.

In September 2007, the UN Refugee Agency UNHCR summarized the main asylum application levels and trends during the first six months of the year in 36 industrialized countries, including 26 European Union (EU) Member States. Based on the assumption of unchanged yearly patterns, the total number of new asylum claims lodged in these 36 countries over 2007 is about 300 000. The overall number of claims has decreased continuously over the past few years, but this trend was reversed in the second half of 2006. The current numbers represent the first increase since 2001.1 Asylum seekers are considered a vulnerable group. Many of them leave their country in difficult circumstances and hope to find a new home elsewhere. In many cases they were exposed to poverty, persecution or violence before they left. Their countries of origin are often unstable in economic, political and social respect. The geographical origin of asylum seekers in the mentioned 36 countries is very heterogenous.1 In the first half of 2007, Iraqi applicants remained the largest group, with about 14% of all claims. Iraq was followed by China as the second most important source country, with 6% of the claims. Also Pakistan, Serbia and Montenegro and the Russian Federation belong to the leading countries, each of them with 4–5%. In addition, asylum seekers and other migrants usually cross pronounced interpersonal, socio-economic and cultural boundaries.2 These factors together should be taken into account when planning adequate health screening programmes. Medical reception and screening of asylum seekers upon entry is closely interlinked with fundamental human rights. This medico–ethical complex should reconcile the basic needs and rights of the individuals involved and those of the host country. Psychosocial and psychiatric problems …

Adverse effects of low occupational cadmium exposure on renal and oxidative stress biomarkers in solderers

Objectives Recent studies suggest adverse health effects after low exposure to cadmium (Cd). Brazing with Cd-containing solder exposes workers to Cd. The purpose of this study was to assess: (1) indicators of Cd exposure in blood (Cd-B)/ urine (Cd-U); (2) the association between Cd-B, Cd-U and renal and oxidative stress biomarkers. Methods In this cross-sectional study Cd-B, Cd-U, renal (ie, N-acetyl-β-D-glucosaminidase/urinary intestinal alkaline phosphatase (IAP)/microalbumin/beta-2-microglobulin/retinol binding protein and oxidative stress markers (ie, derivatives of reactive oxygen metabolites/glutathione peroxidase/superoxide dismutase (SOD)/ advanced oxidation protein products/8-hydroxy-2′-deoxyguanosin/8-isoprostanes) were determined in 36 solderers. Results Multiple linear regression analysis adjusting for age and pack-years of smoking show that IAP is statistically significantly associated with Cd-B (B=0.24; SE=0.11) and Cd-U (B=0.15; SE=0.07). Also SOD is statistically significantly associated with Cd-B (B=62.96; SE=29.62). The association between SOD and Cd-U is of borderline statistical significance (B=37.69; SE=19.59). Conclusions While there is still some debate as whether the Cd-induced tubular effects are reversible or not, IAP and SOD appear as sensitive and potentially useful early biomarkers for the health surveillance of workers exposed to low levels of Cd.

Hepatitis E Virus Infection in a Student Healthcare Worker: A Case Report

Citation: De Schryver A, Wijnants I, Bonanni P, Hambach R, van Sprundel M, et al. (2017) Hepatitis E Virus Infection in a Student Healthcare Worker: A Case Report. Int Arch Nurs Health Care 3:081. doi. org/10.23937/2469-5823/1510081 Received: June 13, 2017: Accepted: September 21, 2017: Published: September 23, 2017 Copyright:

O16-2 Hepatitis E virus infection: an emerging occupational risk in pig handlers?

Introduction Hepatitis E virus (HEV) infection is endemic in many developing countries, causing substantial morbidity. Transmission is primarily faeco-oral and is associated with both sporadic infections and epidemics in areas without drinkable water. In industrialised countries, HEV infection was thought to occur only in individuals infected in endemic areas. However, sporadic cases have been reported in persons from industrialised regions with no history of recent travel. Such reports and the availability of more comprehensive molecular and serological data have changed HEV epidemiology, accepting that autochthonous HEV is a problem and an endemic disease in industrialised countries. Moreover, a porcine reservoir and growing evidence of zoonotic transmission have been reported in these countries, suggesting the possibility of occupational transmission to man. This review summarises the current knowledge on the epidemiology and prevention of transmission of HEV infection in occupational settings. Methods The following keywords were used to explore PubMed: hepatitis E, disease, epidemiology, profession(al), occupation(al). The results were further screened and 107 publications were retained. Results In nonendemic regions, seroprevalence varies from a few percent (2–7.8%) in Europe, Japan and South America to several percent (18.2–20.6%) in the USA, Russia, UK, southern France and Asia. A meta-analysis of 12 cross-sectional studies evaluating potential association between HEV IgG seroprevalence in individuals occupationally exposed to swine showed greater odds of seroposivity in the exposed group but also a high degree of heterogeneity. The funnel plot suggests publication bias. Conclusions There is a significant association between occupational exposure to swine and HEV IgG seroprevalence, but the level of prevalence detected depends also on the type of HEV IgG kits used. Further research, including on mechanisms and risk factors for infection, as well as the development of better serological tests for identification of infection, are required.

119 Renal effects induced by occupational co-exposure to cadmium and lead in metallurgy workers

Objectives Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on early renal biomarkers. Methods Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers i.e., microalbumin (µ-Alb), beta-2-microglobulin (β2-MG), retinol binding protein (RBP), N-acetyl-β-D-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. In order to explore the effect of Pb on the association between Cd and renal biomarkers (i.e., effect modification or interaction), we performed a multiple linear regression analysis (adjusting for age and pack-years of smoking) including an interaction term Pb x Cd. Results The median Cd-B, Cd-U, Pb-B were: 0.8 µg/l (IQR = 0.5, 1.2), 0.5 µg/g creatinine (IQR = 0.3, 0.8) and 158.5 µg/l (IQR = 111.0, 219.3), respectively. The statistically significant interaction term Pb-B x Cd-B indicates that the impact of Cd-B on the enzymes NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., µ-Alb and β2-MG). Conclusions Our findings indicate that Pb modifies (increases) the strength of the association between Cd and early renal biomarkers.

Evaluation of heavy metal exposure in blood and urine of workers performing silver brazing

Objectives Silver brazing activities expose workers to metal fumes of which the health effects are not well studied yet. The aim of this study was to assess a number of biochemical parameters (heavy metals, renal markers, and oxidative stress markers) in workers performing brazing with silver alloys. Methods Blood (B) concentrations of Pb, Cd, Mn and urine (U) concentrations of Cd, Mn, Cu and Zn were determined in 40 refrigeration industry workers frequently brazing with silver alloys and 31 non-exposed control subjects. Renal markers (NAG, IAP, microalbumin, β2micro, RBP) and oxidative stress markers (d-ROM, AOPP, GPx, SOD, 8-OHdG) were measured as well. Results Significantly higher geometric mean levels (s.e.m.) of Cd-B (1.64 (1.11) vs 0.23 (1.17) µg/l), Cd-U (0.71 (1.24) vs 0.14 (1.16) µg/g creatinine) and Cu-U (5.55 (1.08) vs 4.55 (1.06) µg/g creatinine) were found in exposed workers than in control subjects. In addition, significantly increased levels of IAP were found among exposed workers. Also, higher levels (not statistically significant) of d-ROM, AOPP, SOD, and 8-OHdG were detected in exposed subjects than in control subjects. Conclusions The results suggest relatively low occupational exposure levels to heavy metals. Nevertheless, Cd-B, Cd-U and Cu-U were significantly higher in exposed subjects, as well as levels of IAP, a marker associated with Cd toxicity. In addition, elevated levels of oxidative stress markers were found among exposed workers, though not significantly higher than among non-exposed subjects.