Incidence of occupational skin conditions in a food manufacturing company: results of a health surveillance programme

BACKGROUND

The food industry has been associated with a high risk of work-related skin problems. Aim To examine the incidence of work-related skin conditions and the likely causative agents in a single large food company.

METHOD

Analysis of a health surveillance programme, conducted over a 7 year period, in a food company with 21 000 employees working in diverse manufacturing processes.

RESULTS

The mean incidence of skin conditions, taking all of the different food manufacturing operations together, was 1310 per million employees per annum. The mean incidence was greatest in the manufacturing sector whose operations involved chilled or frozen product (3180 per million employees per annum). Most of the cases reported (184/192 = 96%) were due to primary irritant dermatitis. The two commonest suspected causes of the dermatitis were contact with ingredients and hand washing. Taken together, these factors accounted for 58% of all cases. Although the wearing of gloves is often considered necessary to prevent dermatitis from exposure to ingredients and to lessen the need for hand washing, this factor itself was responsible for 9% of all cases.

CONCLUSION

Analysis of a company health surveillance scheme showed the average incidence of work-related skin problems to be lower than previously reported in the food industry.

Preventing baker's asthma: an alternative strategy

BACKGROUND

Although baker's asthma has attracted considerable research interest over the last 30 years, success in its prevention has been slow to achieve. This paper describes the results of an alternative preventive strategy, based on an observation that the excess of sensitization in bread bakers is largely due to IgE-mediated allergy to fungal amylase, contained in bread improvers. The practical application of the strategy has been to limit bread improver exposures to <1 mg/m3 [8 h time-weighted average (TWA)], whilst exposures to all other ingredients, including flour, have been limited to <10 mg/m3 (8 h TWA).

METHOD

The paper describes the findings of in-house respiratory health surveillance and dust sampling programmes, from a UK food company whose primary interests are milling and baking, over the period following the introduction of the strategy to target the reduction in bread improver exposure.

RESULTS

Over the 10 year period of surveillance, the incidence of symptomatic sensitization in the bread baking sector (2240 per million employees per annum) was greater than for the other flour-using groups (330 per million employees per annum), despite broadly similar total inhalable dust exposures. There was an overall reduction in the incidence of new cases of symptomatic sensitization, from 2085 per million employees per year in the first 5 years of the surveillance programme, to 405 per million employees per year in the subsequent 5 years.

CONCLUSION

The strategy of targeting bread improver exposure is an effective approach for the prevention of new cases of symptomatic sensitization in bread bakeries.

Mechanisms of Excimer Formation in Poly(acenaphthylene)

Excimer (excited state dimer) formation mechanisms in solution have been investigated for a series of acenaphthyl-containing compounds comprising dimers, higher oligomers, and a poly(acenaphthylene) (PAcN) homopolymer. Excimer fluorescence is observed only for dimers with a threo-diisotactic arrangement of the acenaphthyl groups indicating that interactions between nearest-neighbour chromophores are able to play a role in excimer formation in PAcN. An increase in excimer emission is observed with increasing chain length and attributed to additional excimer formation and energy migration processes.

Time-resolved evanescent wave-induced fluorescence anisotropy for the determination of molecular conformational changes of proteins at an interface

We have shown that the molecular conformation of a protein at an interface can be probed spatially using time-resolved evanescent wave-induced fluorescence spectroscopic (TREWIFS) techniques. Specifically, by varying the penetration depth of the evanescent field, variable-angle TREWIFS, coupled with variable-angle evanescent wave-induced time-resolved fluorescence anisotropy measurements, allow us to monitor how fluorescence intensity and fluorescence depolarization vary normal to an interface as a function of time after excitation. We have applied this technique to the study of bovine serum albumin (BSA) complexed noncovalently with the fluorophore 1-anilinonaphthalene-8-sulfonic acid. The fluorescence decay varies as a function of the penetration depth of the evanescent wave in a manner that indicates a gradient of hydrophobicity through the adsorbed protein, normal to the interface. Restriction of the fluorescent probe's motion also occurs as a function of distance normal to the interface. The results are consistent with a model of partial protein denaturation: at the surface, an adsorbed BSA molecule unfolds, thus optimizing protein-silica interactions and the number of points of attachment to the surface. Further away, normal to the surface, the protein molecule maintains its coiled structure.

Head and neck injuries in fatal motorcycle collisions as determined by detailed autopsy

Detailed layer-by-layer autopsy of the head and neck was performed on a prospective series of 73 fatally injured motorcyclists in order to identify occult injuries, particularly soft tissue neck injuries such as hemorrhage of vertebral and carotid arteries. The fatal cases were gathered as part of a larger study of 1,082 on-scene in-depth motorcycle crash investigations in Thailand. Detailed neck dissection was done on nearly all fatal cases. Injuries were coded using the 1990 revision of the Abbreviated Injury Scale (AIS 90) and an Injury Severity Score (ISS) was determined for each case. Additional AIS codes are proposed for neck injuries that were often identified during the detailed autopsy procedures, but which are not listed explicitly among existing AIS codes. Helmet use was determined based on analysis of injury patterns and helmet damage with consideration also given to witness statements. Both helmeted and unhelmeted motorcyclists showed a high frequency of occult neck injuries such as hemorrhages in the carotid sheath or surrounding the vertebral arteries, phrenic nerve, or brachial plexus. These soft tissue neck injuries sometimes accompanied more obvious injuries to cervical vertebrae or spinal cord, but about one-third of riders had no obvious injury to suggest the presence of occult neck injury. Twenty-eight motorcyclists had been wearing a helmet at the start of the collision sequence, but only nine helmets remained in place through the entire collision event. Helmeted riders showed more severe somatic (below-the-neck) injuries than unhelmeted riders, suggesting helmeted riders are less likely to die in low-threat accidents with somatic injuries below AIS-3. The most significant finding of this study was the identification of serious internal neck injuries despite the absence of external physical evidence of trauma to the neck. Virtually all riders with significant head injuries showed some of these soft tissue neck injuries. Approximately one-third of the critically injured riders who survived at least a few hours before death showed serious occult soft tissue neck injuries.

Shedding Light on the Conformation of Proteins and Other Macromolecules at an Interface

An attractive way to probe interfacial phenomena is through the utilization of total internal reflection-based spectroscopic methods, in which the evanescent field is used to photo-excite an absorbing species situated within the penetrating field. In this paper we discuss both absorbance and time-resolved fluorescence evanescent wave techniques that we have developed. We highlight how these techniques can be utilized successfully for interrogating the adsorption behaviour of proteins and polymers as a function of distance from a solid/solution interface into bulk solution. Information provided by these methods regarding how protein and polymer molecular conformation is affected by their adsorption/interaction at a surface is discussed with specific reference to poly(2-vinylpyridine), hen egg white lysozyme, and bovine serum albumin.

Head and neck injuries in fatal motorcycle collisions as determined by detailed autopsy

Detailed layer-by-layer autopsy of the head and neck was performed on a series of seventy-three fatally injured motorcyclists in order to identify occult soft tissue injuries such as subluxation of the cervical spine or hemorrhage of vertebral or internal carotid arteries. The fatal cases were gathered as part of a larger study of 1082 on-scene in-depth motorcycle crash investigations in Thailand. Injuries were coded using the 1990 Abbreviated Injury Scale (AIS 90) and an Injury Severity Score (ISS) was determined for each case. Twenty-eight motorcyclists had been wearing a helmet at the start of the collision sequence, but only nine helmets remained in place through the entire collision event. Both helmeted and unhelmeted motorcyclists showed a high frequency of neck injuries such as hemorrhages in the carotid sheath compressing the vagus nerve, hemorrhages surrounding the phrenic nerves or the brachial plexus, or hemorrhages surrounding the vertebral arteries. The most significant finding of this study was the identification of serious internal neck injuries even when there was no external physical evidence of trauma to the neck. Virtually all riders with significant head injuries showed some of these soft tissue neck injuries. This may be important for trauma physicians, who are presented with critically injured motorcyclists with complex multiple trauma, which may include occult soft tissue neck injuries.

University of Kentucky community-based field experience: program description

Community-based field experiences (CBFE) provide students with exemplary experiential learning opportunities. The purposes of this paper are to describe the University of Kentucky College of Dentistry (UKCD) CBFE and report the results of a two-year, self-report survey that assessed the primary course goal, students' perceptions of change in knowledge and skills related to nineteen areas of patient care (n = 90, 100% return rate), and their overall rating of the program. Knowledge and skill data were analyzed using the non-parametric binomial test for comparing proportions. A significant (.05 level) majority of students reported increases in knowledge in all areas to which they were exposed. Descriptive frequencies summarizing the results of the total CBFE experience indicate that the majority of students felt it was a positive experience. The CBFE continues to be a meaningful element in the UKCD curriculum as it provides students with a relevant, authentic educational experience.

Functionalized iminium salt systems for catalytic asymmetric epoxidation

A range of dihydroisoquinolinium salts containing alcohol, ether, and acetal functionalities in the nitrogen substituent has been prepared and tested as asymmetric epoxidation catalysts, providing ee's of up to ca. 60%.

Type A gamma-aminobutyric acid (GABAA) receptor subunits and benzodiazepine binding: significance to clinical syndromes and their treatment

Gamma (gamma)-aminobutyric acid (GABA) acting via GABAA receptors is the brain's major inhibitory neurotransmitter system and exerts a crucial role in regulating brain excitability. A number of drugs interact with binding sites on GABAA receptors, and these include benzodiazepines, anticonvulsants, anaesthetics and neurosteroids (e.g. the progesterone metabolite pregnalone). GABAA receptors comprise five subunits (19 are known currently), and are classified into three major groups (alpha, beta and gamma) and several minor ones. The subunit make-up of a receptor, particularly its alpha-subunit content, determines its pharmacological characteristics. Thus, receptors that include an alpha1 subunit have a benzodiazepine (BZ) type I (BZ[I]) pharmacology and bind zolpidem and CL218,872 with high affinity, whilst receptors with alpha2, alpha3 or alpha5 subunits have a BZ type II (BZ[II]) pharmacology and bind these drugs with low affinity. In contrast to receptors that contain alpha4 and alpha6 subunits, which are diazepam-insensitive, both BZ(I) and -(II) bind diazepam and other benzodiazepines. The ligand selectivity of receptor subunits assists in their characterisation. Using immunochemical and ligand-binding techniques, the subunit composition of GABAA receptors has been shown to exhibit a degree of brain regional specificity. GABAA receptors are of great clinical significance in several disorders, including epilepsy, anxiety and alcoholism. In addition to treating epilepsy with drugs that target GABAA and BZ binding sites, epileptic lesions can be localised presurgically using radiolabelled BZ ligands. BZs are used commonly to treat anxiety, and studies suggest that BZ antagonists and inverse agonists (which induce the opposite effect to agonists at receptors) may be useful in alcohol rehabilitation.

Pancreatic cancer presenting as bleeding gastric varices

Given the extremely poor prognosis of pancreatic adenocarcinoma, early diagnosis is crucial; however, clinical signs and symptoms of the disease are neither sensitive nor specific. In the two cases described, previously undiagnosed pancreatic cancers initially presented with upper gastrointestinal tract hemorrhage. Endoscopic surveys to identify the origin of the bleeding revealed gastric varices secondarily attributed to splenic vein thrombosis. Upon further investigation, the splenic vein occlusions were found to be caused by pancreatic tumors. A review of the incidence, pathogenesis, diagnostic modalities, and implications of splenic vein occlusion is included.

Child mortality and malaria transmission intensity in Africa

The desirability of controlling malaria transmission in the areas of highest endemicity of Plasmodium falciparum has long been debated. Most recently, it has been claimed that rates of malaria morbidity are no higher in areas of very high transmission in Africa than they are in places with lower inoculation rates. We now review the literature on the relationship of morbidity and mortality to malaria transmission intensity, and have linked published child mortality and malaria transmission rates to examine how age-specific mortality actually varies with the inoculation rate of P. falciparum.

Immunohistochemical analysis of anaplastic lymphoma kinase expression in deep soft tissue calcifying fibrous pseudotumor: evidence of a late sclerosing stage of inflammatory myofibroblastic tumor?

Calcifying fibrous pseudotumor (CFT) is a rare benign soft tissue lesion composed of dense hyalinized fibrous tissue containing bland spindle-shaped cells admixed with a lymphoplasmacytic infiltrate and foci of dystrophic and often psammomatous calcifications. It has been suggested that CFT represents a late sclerosing stage of inflammatory myofibroblastic tumor (IMT). Recently, clonal cytogenetic abnormalities involving the anaplastic lymphoma kinase (ALK) gene on chromosome 2p have been identified in IMT, particularly those arising in deep soft tissue sites. We evaluated seven cases of deep soft tissue CFT diagnosed at the Cleveland Clinic Foundation and the University of Florida with available paraffin-embedded blocks using a monoclonal antibody to ALK (Dako, Carpenteria, CA) and a modified avidin-biotin complex method. The cohort included six women and one man with a median age at diagnosis of 43 years (range, 26 to 67 years). Sites of CFT included mesentery (3), peritoneum (1), omentum (1), serosa of small bowel (1), and anterior mediastinum (1). Immunohistochemically, only one case showed focal staining for ALK. The remaining six cases were negative, with appropriate positive and negative control staining. In conclusion, unlike IMT, CFT in deep soft tissue locations rarely expresses ALK by immunohistochemistry, suggesting that CFT is a different clinicopathologic entity than IMT, as opposed to representing a "burned out" IMT. Ann Diagn Pathol 5:10-14, 2001.

Occupational skin conditions in the food industry

The study presents the findings of a questionnaire survey of skin conditions in a selective sample of the UK food industry, covering companies who employ occupational physicians. The mean incidence of skin conditions in food manufacturing operations was 2103 per million employees per annum. The mean incidence in retail or catering organizations was 1414 per million employees per annum.

Treatment of SW620 cells with Tomudex and oxaliplatin induces changes in 2-deoxy-D-glucose incorporation associated with modifications in glucose transport

Many studies suggest that changes in the uptake of the glucose analog FDG after therapy, compared with pretreatment uptake, predicts tumor response to therapy. However, clinical interpretation is compromised by a limited understanding of the effect of therapy on FDG and 2-deoxy-D-glucose (DG) uptake at the tumor cell level.

METHODS

Uptake of 2-deoxy-D-[1-(3)H]glucose (3H-DG) by SW620 colonic tumor cells was measured before and 8, 16, 24, and 48 h after treatment with the novel platinum drug oxaliplatin and the novel thymidylate synthase inhibitor Tomudex. Glucose transport was determined by measuring the initial rate of uptake of the nearly nonmetabolized glucose analog 3-O-methyl-D-[1-(3)H]glucose (3H-OMG). The effect of these drugs on cell cycle kinetics was determined using flow cytometry.

RESULTS

Treatment of SW620 cells with oxaliplatin was found to decrease uptake of 3H-DG after up to 24 h, but uptake returned to control levels after longer treatment. The initial decrease in 3H-DG incorporation was associated with a lower rate of glucose transport. Treatment of cells with Tomudex induced an increase in 3H-DG uptake that depended on treatment duration. Both glucose transport and the volume of distribution of 3H-OMG were higher in Tomudex-treated cells than in control cells. Flow cytometry showed that oxaliplatin induced a G2 and M arrest, whereas a buildup of cells in the S phase was associated with Tomudex treatment. Both treatments induced apoptosis in SW620 cells.

CONCLUSION

Changes in uptake of DG by SW620 colonic tumor cells responding to therapy is specific to the drug type. Modulation of glucose transport was associated with changes in 3H-DG uptake.