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The article presents a study on the development of acute respiratory distress syndrome (ARDS) in Maniitsoq, Greenland. The study showed that inhalation of aerosols of surface active substances is a known risk factor for the development of ARDS. The country's healthcare system has a set-up that makes it capable of managing acute situations even up to a larger scale.

Per- and polyfluorinated alkyl substances (PFAS) are a group of man-made extremely persistent chemicals that have been spread worldwide since the 1950s due to their properties as effective water- and grease-repellent and heat- and temperature-resistant. They are associated with an increasing number of health effects including immune and hormonal disturbances and some types of cancer. We present a review of PFAS pollution in Denmark, the current human exposure, suspected health effects, and patient management in environmental medicine., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

This review investigates the correlation between atopic dermatis and educational performance. Atopic dermatitis (AD) leads to intense itching, affecting sleep and health-related quality of life. AD negatively influences working life and poses a financial burden on society. Information about the impact of AD in childhood/adolescence on school life and the completion of education is sparse and previous studies have not found an association between AD and educational attainment. Recent studies have found AD to be associated with learning disability and decreased educational attainment. Future studies should investigate causality and the effects of optimised treatment.

Introduction: The seafood industry is the largest industry in Greenland. Work-related diseases and accidents appear to constitute health risks in this sector. The aim was to describe the prevalence of work-related diseases and accidents among workers in the seafood industry in Greenland., Methods: Data from 311 workers included a questionnaire, lung function measurements, skin prick tests, blood samples, clinical examinations, personal inhalable dust samples and stationary dust measurements. Accident risk was evaluated by work site observations and safety walks. Statistical analyses included mean values and percentage distribution., Results: Exposure levels were highest in shrimp production; 16.1% were sensitised to snow crab, 10.1% to shrimp and 0.3% to fish; 5.2% had probable occupational asthma. Regarding accidents, the annual incidence rate per 100 workers was 10.3%., Conclusions: Workers in the seafood industry in Greenland have a high prevalence of sensitisation to work-related allergens and occupational asthma closely related to high exposures to shrimp and snow crab allergens. The rate of severe workplace injuries was high. Preventive measures are required., Funding: The Health Science Research Council; The Work Environment Council of Greenland; The Greenlandic Workers' Union; Greenland Business Association; Royal Greenland; Polar Seafood; The BANK of Greenland; The Danish Working Environment Research Fund., Trial Registration: The Scientific Ethical Committee for Greenland (2015-11317); The Danish Data Protection Agency, the Central Denmark Region (2012-58-006)., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Occupational hand eczema (HE) has continuously been the most frequently recognised occupational disease, comprising > 95% of all recognised occupational skin diseases. Irritant contact dermatitis constitutes > 70%, where wet work is the main eliciting factor. Knowledge on the dose-response relationship between wet work and HE is pivotal concerning preventive interventions, job counselling and medico-legal regulations, which is summarised in this review. New findings indicate a significant risk of having HE at an exposure level of no more than 30 minutes of wet work per day.

The use of lower cut-off values/concentration limits for the calculation of mixture classification in UN GHS/EU CLP versus the previous regulatory scheme (EU Dangerous Preparations Directive, DPD), has resulted in an increased number of classifications in the highest eye hazard category. Herein, a semi-quantitative categorisation of severity of eye effects, following accidental human exposures to detergents, was compared to the classification category of the products. Three schemes were evaluated: EU DPD; EU CLP (based on all available data and information, including weight of evidence); and EU CLP (based entirely on the calculation method). As reported by four EU Poison Centres, the vast majority of exposures had caused minor or no symptoms. Classification was a poor predictor of effects in man subjected to accidental exposure. Note however that this is also because effects are not only driven by the intrinsic hazard (as reflected in the classification), but also by the exposure conditions and mitigation (i.e. rinsing). EU CLP classification using all available data and information was more predictive of medically relevant symptoms than the EU CLP calculation method. The latter led to a poorer differentiation between irritating products versus products potentially causing serious eye damage., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

This case report describes a 55-year-old man, who was admitted to hospital with acute abdominal pain. The only positive finding was elevated levels of bilirubin and alanine transaminase and dilation of the intrahepatic bile ducts. Due to the nature of the abdominal pain acute porphyria was suspected. A urinalysis for porphyria indicated intoxication with a heavy metal, in this case lead. Lead poisoning is a rare cause of acute abdominal pain, and in this case further workup was left for the occupational health specialists, who have experience in metal intoxication.

Objective: Firefighters are exposed to numerous respiratory hazards, but large studies on the risk of pulmonary disease are scarce. The objective of this study was to examine incidence of asthma and chronic obstructive pulmonary disease (COPD) in a nationwide cohort of Danish firefighters., Methods: We used individual historical employment records on 11 968 Danish male firefighters primarily supplied by trade unions and fire agencies. Furthermore, we used the Supplementary Pension Fund Register to form an occupational reference group consisting of military employees. Information on respiratory incidence was retrieved from the nationwide Danish National Patient Registry. Age and calendar time standardised incidence ratio (SIR) and Poisson regression analyses (incidence rate ratio) were used for estimation of risks, including 95% CIs., Results: Compared with military employees, the overall age and calendar-time adjusted risk for asthma was significantly increased among full-time firefighters (SIR=1.58, 95% CI 1.32 to 1.88), but not among part-time/volunteer firefighters. Full-time firefighters' risk for asthma did not vary by duration of employment. No consistent evidence of an increased risk for chronic obstructive pulmonary disease was detected., Conclusion: Danish firefighters have an increased risk of asthma, but the causes, whether occupational or not, remain to be established., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

This article presents recommendations regarding early management of patients after intake of corrosive chemicals, based on best evidence and clinical experience. Risk assessment built on clinical history, presentation and endoscopy is discussed as well as initial treatment, surgical appraisal and observation. Controversy still surrounds the need for endoscopy in asymptomatic patients, the use of computed tomography in assessing the severity of lesions as well as pharmacological treatment for preventing strictures.

Experiments have suggested reduction of neurological sequelae from carbon monoxide (CO) poisoning by treatment with hyper-baric oxygen (HBO). Randomised clinical trials have, however, been ambiguous. The discrepancy may be explained by timing of HBO relative to exposure. For other asphyxiants data are too sparse for a qualified judgement. Until more evidence is available, we suggest that HBO is used exclusively for moderate and severe CO poisoning within a time window of 12 hours.

Death cap (Amanita phalloides) is commonly found and is one of the five most toxic fungi in Denmark. Toxicity is due to amatoxin, and poisoning is a serious medical condition, causing organ failure with potential fatal outcome. Acknowledgement and clarification of exposure, symptomatic and focused treatment is of primary importance. No data from randomised, controlled trials on management exists, and there is not international consensus on treatment regime. We present amatoxin-case contacts to the Danish Poison Centre from 2006-2012 and summarize current knowledge and Danish recommendations in amatoxin poisoning management.

Introduction: Skin cancer may, in some cases, be caused by occupational exposures. The aim of this study was to investigate the prevalence of and exposures leading to occupationally induced skin cancers in Denmark during a ten-year period., Material and Methods: The study is a descriptive, register-based study comprising all patients with recognized occupational malignant and premalignant skin conditions in Denmark in the 01/01 2000-31/12 2009 period. Data were obtained from The National Board of Industrial Injuries and comprise information about diagnosis, occupational and domestic exposure, anatomic localization, occupation, degree of permanent disability, age and sex., Results: A total of 36 patients were recognized as occupational skin cancer cases. The mean age was 61 years (44-75 years), 31 men and five women. The most frequent diagnosis was basal cell carcinoma followed by squamous cell carcinoma. No cases of malignant melanoma were recognized. The primary risk factor for development of occupational skin cancer was ultraviolet (UV) exposure during outdoor working., Conclusion: Data based on recognized cases of occupational skin cancer during a ten-year period in Denmark show that non-melanoma skin cancer was the most frequent diagnosis, while the primary risk factor was UV radiation in outdoor occupations. A total of 36 cases were reported over a period of ten years, and underreporting may be suspected. The purpose of the present study was to raise the awareness of occupational skin cancer, and on the basis of existing data to contribute to criteria for the diagnosis of occupational skin cancer., Funding: not relevant., Trial Registration: not relevant.

The use of waterproofing spray has been associated with the development of respiratory symptoms, but the pathogenetic mechanisms are unclear. We describe a case of acute respiratory disease with impaired diffusion developed after the use of a painting primer product spray (stain stop). Further investigation in aerosol-toxicology is needed.

Introduction: Lifestyle factors are important for clinical outcome. Systematic and early identification of these factors is important in order to offer relevant lifestyle intervention programmes. The objective was to evaluate whether basic registration of risk factors was understandable, applicable and sufficient in the clinical workday., Materials and Methods: Eleven clinical specialists participated from a broad range of departments. They performed identification and registration of malnutrition, overweight, physical inactivity, smoking and harmful alcohol consumption based on medical records from own departments (in total 2420 times). The specialists then evaluated the understanding, applicability and sufficiency (363 times). Their comments were noted., Results: Identification and registration was accomplished for 85% (0-100%) of the records. Except for two fields--"measurements of waist" and "other training programs"--the specialists found the basic registration understandable, applicable and sufficient. They lacked more details regarding stress-response in the information material and pointed out inconsistencies in the wording. Ten specialists found that the recommended clinical approach was possible to implement in the present routines., Conclusion: Basic registration of lifestyle factors for adult patients is possible and clinical relevant. It is recommended that the Danish National Board of Health uses the results in future.

Essential oils are used widespread by the Danish population. In Denmark a severe case of poisoning from anis oil has occurred.

The occurrence of non-specific low back pain (LBP) in 14-16-year-old adolescents has almost reached the level in adults. Among other things, the ranges of reported prevalences are wide, owing to the use of various outcome measures, questionnaire terminology, and differences in age and gender. A review of the literature points out some important possible risk factors for LBP: minimal physical activity, intensive sports, genetics, psychosocial factors, smoking and leisure-time activities with a high physical impact. However, the causal relations are not clear, and the morbidity related to non-specific LBP in adolescents has not yet been elucidated. Few intervention studies have been published, and the means of prevention have not yet been found. Research in LBP in adolescents deserves a high priority in the future to provide evidence for a relevant prevention strategy.