Circadian study of decompression sickness symptoms and response-associated variables in rats

Perspectives on the relevance of the circadian time structure to workplace threshold limit values and employee biological monitoring

The circadian time structure (CTS) and its disruption by rotating and nightshift schedules relative to work performance, accident risk, and health/wellbeing have long been areas of occupational medicine research. Yet, there has been little exploration of the relevance of the CTS to setting short-term, time-weighted, and ceiling threshold limit values (TLVs); conducting employee biological monitoring (BM); and establishing normative reference biological exposure indices (BEIs). Numerous publications during the past six decades document the CTS substantially affects the disposition - absorption, distribution, metabolism, and elimination - and effects of medications. Additionally, laboratory animal and human studies verify the tolerance to chemical, biological (contagious), and physical agents can differ extensively according to the circadian time of exposure. Because of slow and usually incomplete CTS adjustment by rotating and permanent nightshift workers, occupational chemical and other contaminant encounters occur during a different circadian stage than for dayshift workers. Thus, the intended protection of some TLVs when working the nightshift compared to dayshift might be insufficient, especially in high-risk settings. The CTS is germane to employee BM in that large-amplitude predictable-in-time 24h variation can occur in the concentration of urine, blood, and saliva of monitored chemical contaminants and their metabolites plus biomarkers indicative of adverse xenobiotic exposure. The concept of biological time-qualified (for rhythms) reference values, currently of interest to clinical laboratory pathology practice, is seemingly applicable to industrial medicine as circadian time and workshift-specific BEIs to improve surveillance of night workers, in particular. Furthermore, BM as serial assessments performed frequently both during and off work, exemplified by employee self-measurement of lung function using a small portable peak expiratory flow meter, can easily identify intolerance before induction of pathology.

A new measure of decompression sickness in the rat

In this study we assessed the reliability of a tilting-board grip score as a measure of decompression sickness in rats. In experiments using a hyperbaric compression/decompression protocol, rats were observed for signs of decompression sickness and their grip strength measured on a tilting particle board hinged to a metal frame. Angles at which rats lost grip were converted to gravitational vectors. Decreased mean grip scores following decompression were fitted to a logistic regression model with strain, age, and weight. Decrease in grip score was significantly associated with observed decompression sickness (P = 0.0036). The log odds ratio for decompression sickness = 1.40 (decrease in grip score). In rats with no decrease in mean grip score there was a 50% probability of decompression sickness (pDCS). This increased steadily with decreases in mean grip score. A decrease of 0.3 had a 60% pDCS, a decrease of 0.6 had a 70% pDCS, and a decrease of 2.1 had a 95% pDCS. The tilting board grip score is a reliable measure of the probability of decompression sickness.

Hypobaric impact on clinical tolerance and 24-h patterns in iron metabolism markers and plasma proteins in men

Long-distance flights can cause a number of clinical problems due to mild hypoxia resulting from cabin pressurization. Using a chronobiological approach, the aim of this work was to assess the clinical tolerance and biological impact of daytime exposure to hypobaric hypoxia on markers of iron metabolism and plasma proteins. Fourteen healthy, male volunteers, ages 23 to 39 yrs, spent 8.5 h in a hypobaric chamber (from 07:45 to 16:15 h) simulating an altitude of 8000 ft. This was followed by another 8.5-h session 4 wks later simulating conditions at an altitude of 12,000 ft. Biological variables were assayed every 2 h over two 24-h spans (control and hypoxia spans, respectively) per simulated altitude. Whereas most of the subjects tolerated the 8000 ft exposure well, eight subjects (57%) presented clear clinical signs of hypoxic intolerance at 12,000 ft. The 24-h blood iron profile showed a biphasic pattern at both altitude simulations, with a significant (∼40%) increase during hypoxia, followed by a (∼25%) decrease during the first hours of recovery. The iron circadian rhythm showed a significant phase delay during the hypoxic exposure at 8000 ft vs. reference. Mean 24-h ferritin levels decreased at both altitudes, but mainly during the nighttime after the 12,000 ft exposure in accordance with Cosinor analysis. The transferrin and total plasma proteins 24-h profiles did not show significant change. Moreover, significant differences, mainly in iron, ferritin, and transferrin, were found at 12,000 ft according to the clinical tolerance to hypoxia, and significant correlations were found between the mid-range crossing times, i.e., here half-descent times (d-T(50)), for ferritin and total plasma proteins and the reported level of clinical discomfort under hypoxia. This study shows that an 8.5-h exposure to mild hypoxia is able to alter very quickly the 24-h pattern of iron and ferritin. These alterations seem to depend, at least in part, on the clinical tolerance to hypoxia and may help explain the interindividual differences observed in the tolerance to hypoxia.