Search

Background: Malignant mesothelioma (MM) has distinct histological subtypes (epithelioid, sarcomatoid and biphasic) with variable behaviour and prognoses. It is well recognised that survival time varies with the histological subtype of MM. It is not known, however, if asbestos exposure characteristics (type of asbestos, degree of exposure) are associated with different histological subtypes., Aim: To determine if the pathological MM subtype is associated with the type of asbestos or the attributes of asbestos exposure., Methods: Cases of MM for the period 1962 until 2012, their main histological subtype and their most significant source of asbestos exposure were collected from the Western Australian Mesothelioma Registry. Exposure characteristics included, degree of asbestos exposure (including total days exposed, years since first exposure and, for crocidolite only, calculated cumulative exposure), source of exposure (occupational or environmental), form of asbestos handled (raw or processed) and type of asbestos (crocidolite only or mixed fibres)., Results: Patients with the biphasic subtype were more likely to have occupational exposure (OR 1.83, 1.12 to 2.85) and exposure to raw fibres (OR 1.58, 1.19 to 2.10). However, differences between subtypes in the proportions with these different exposure characteristics were small and unlikely to be biologically relevant. Other indicators of asbestos exposure were not associated with the histological subtype of mesothelioma., Conclusions: There was no strong evidence of a consistent role of asbestos exposure indicators in determining the histological subtype of MM., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Objective:: To describe diagnostic and treatment aspects of hard metal lung disease (HMLD) and to review the current literature on the topic., Methods:: This was a retrospective study based on the medical records of patients treated at the Occupational Respiratory Diseases Clinic of the Instituto do Coração, in the city of São Paulo, Brazil, between 2010 and 2013., Results:: Of 320 patients treated during the study period, 5 (1.56%) were diagnosed with HMLD. All of those 5 patients were male (mean age, 42.0 ± 13.6 years; mean duration of exposure to hard metals, 11.4 ± 8.0 years). Occupational histories were taken, after which the patients underwent clinical evaluation, chest HRCT, pulmonary function tests, bronchoscopy, BAL, and lung biopsy. Restrictive lung disease was found in all subjects. The most common chest HRCT finding was ground glass opacities (in 80%). In 4 patients, BALF revealed multinucleated giant cells. In 3 patients, lung biopsy revealed giant cell interstitial pneumonia. One patient was diagnosed with desquamative interstitial pneumonia associated with cellular bronchiolitis, and another was diagnosed with a hypersensitivity pneumonitis pattern. All patients were withdrawn from exposure and treated with corticosteroid. Clinical improvement occurred in 2 patients, whereas the disease progressed in 3., Conclusions:: Although HMLD is a rare entity, it should always be included in the differential diagnosis of respiratory dysfunction in workers with a high occupational risk of exposure to hard metal particles. A relevant history (clinical and occupational) accompanied by chest HRCT and BAL findings suggestive of the disease might be sufficient for the diagnosis., Objetivo:: Descrever aspectos relacionados ao diagnóstico e tratamento de pacientes com doença pulmonar por metal duro (DPMD) e realizar uma revisão da literatura., Métodos:: Estudo retrospectivo dos prontuários médicos de pacientes atendidos no Serviço de Doenças Respiratórias Ocupacionais do Instituto do Coração, localizado na cidade de São Paulo, entre 2010 e 2013., Resultados:: Entre 320 pacientes atendidos no período do estudo, 5 (1,56%) foram diagnosticados com DPMD. Todos os pacientes eram do sexo masculino, com média de idade de 42,0 ± 13,6 anos e média de tempo de exposição a metal duro de 11,4 ± 8,0 anos. Os pacientes foram submetidos a avaliação clinica, história ocupacional, TCAR de tórax, prova de função pulmonar, broncoscopia com LBA e biópsia pulmonar. Todos apresentaram distúrbio ventilatório restritivo. O achado de imagem à TCAR de tórax mais frequente foi de opacidades em vidro fosco (em 80%). Em 4 pacientes, o LBA revelou presença de células gigantes multinucleadas. Em 3, foi diagnosticada pneumonia intersticial por células gigantes na biópsia pulmonar. Houve o diagnóstico de pneumonia intersticial descamativa associada à bronquiolite celular em 1 paciente e de pneumonite de hipersensibilidade em 1. Todos foram afastados da exposição e tratados com corticoide. Houve melhora em 2 pacientes e progressão da doença em 3., Conclusões:: Apesar de ser uma entidade rara, a DPMD deve ser sempre considerada em trabalhadores com risco ocupacional elevado de exposição a metais duros. A história clínica e ocupacional associada a achados em TCAR de tórax e LBA sugestivos da doença podem ser suficientes para o diagnóstico.

Objective: To document laboratory transmission of brucellosis and identify the likely mechanism of transmission of brucellosis at Her Royal Highness (HRH) Princess Sirindhorn Medical Center, Thailand., Material and Method: Using small subunit ribosomal RNA (rRNA) sequencing technique to analyze Brucella melitensis cultured from the first 2 patients of the hospital and an infected laboratory technician, and using brucellosis serologic test to rule out infections in all other involved technicians., Results: We had encountered the first 2 cases of brucellosis. Both had infected from community exposure with goat. The first case had pancreatic abscess and spinal bone involvement with a positive blood culture. The second case presented with fever of unknown origin and had a positive blood culture. A few weeks later, 1 of our laboratory technicians presented with fever, myalgia and fatigue. Blood culture grew B. melitensis. He never had any associated community-acquired risk factors for brucellosis. The presumed mechanism of transmission was an inhalation while taking photographs of the bacterial plate of the first patient. B. melitensis identified from our laboratory technician and both patients were analyzed based on 16S-23S rRNA intergenic transcribed spacer (ITS) region. Results of 16S-23S rRNA ITS sequence testing confirmed a match from all patients and laboratory technician’s isolate. All other 10 potentially exposed laboratory technicians were asymptomatic. A brucellosis serologic test was negative in all non-infected technicians but was only positive in the 1 infected technician., Conclusion: This is the first report in Thailand of occupational brucellosis transmitted in microbiologic laboratory. The most likely mechanism is air-borne inhalation of bacterial organisms on culture media in the absence of adequate precautions. Laboratory technicians should handle Brucella cultivation with caution utilizing appropriate measures to prevent inhalation.

Objective: To explore whether polymorphic variants of the HTR1B gene are associated with the susceptibility of Raynauds' Phenomenon (RP) coursed by vibration., Methods: 148 subjects exposed to vibration for more than 2 years were classified into either induced white finger (VWF) group (n = 72), or non-VWF group (n = 76). Vibration exposure levels were measured and assessed following ISO 5349-1:2001 protocol. All workers were genotyped by sequencing for the single nucleotide polymorphisms (SNPs) in the 5'-flanking and coding region of HTR1B. Genetic characteristics and linkage disequilibrium (LD) were analyzed with Haploview. Serum serotonin levels of each subject were detected using ELISA. The association between the susceptibility of vascular damage and genotype was analyzed via logistic regression., Results: 7 known SNPs were obtained and their allele frequencies were inserted into the Hardy-Weinberg equilibrium. rs6297 variant genotype had an increased risk of VWF compared with wild genotype (OR = 2.14, 95% CI = 1.04- 4.58, P < 0.05). rs6298 mutant type (AG+GG) was found to have a significant interaction on vibration exposure LN(CEI), accounting for VWF occurrence. LN(5-HT) level is significantly different between the VWF group (x¯±s= 1.99±1.09 ng/mL) and the non-VWF group (x¯±s= 2.72±1.47 ng/mL)., Conclusions: Serotonin levels may affect the progression of secondary RP. Polymorphic variants of the HTR1B gene are associated with the susceptibility of secondary RP in vibration-exposed occupational populations of Chinese Han people.

Objectives: Metalworking fluids (MWF), used to cool and lubricate metal in occupational settings, are linked to several cancers but data on kidney cancer are limited. We examine how MWF influence the rate of renal cell carcinoma (RCC) in a large prospective study., Methods: A cohort of Michigan autoworkers consisting of 33 421 individuals was followed from 1985 to 2009. The cohort was linked to the Michigan Cancer Registry to identify new cases of RCC. We analysed RCC in relation to cumulative exposure to each specific type of MWF (straight, soluble and synthetic) and all 3 types pooled into a single MWF variable, with a 15-year lag. Cox proportional hazards regression with splines were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), controlling for age, gender, race, calendar year, year hired, time since hire, plant and other MWF types., Results: There were 135 incident cases. A linear increase in the log-HR was observed for RCC with increasing cumulative exposure to each MWF type and total MWF exposure. At the mean of total MWF exposure (18.80 mg/m(3)-year), the estimated HR was 1.11 (95% CI 1.04 to 1.19)., Conclusions: Our results provide evidence for a dose-dependent association between MWF exposure and RCC. The influence of components of oil-based and water-based MWF needs further examination., Competing Interests: The authors reported no financial conflict of interest., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

New outbursts of silicosis were recently reported among workers manufacturing an engineered material known as "artificial stone," composed by high percentages of quartz (up to 98%) agglomerated with pigments and polymeric resins. Dusts released by abrasion during artificial stone polishing were characterized for particle size, morphology, and elemental composition and studied for (1) ability to catalyze free radical generation in acellular tests, (2) membranolytic potential on human erythrocytes, (3) cytotoxic activity (lactate dehydrogenase release) on murine alveolar macrophages (MH-S) and human bronchial epithelial (BEAS-2B) cell lines, (4) induction of epithelial-mesenchymal transition (EMT) in BEAS-2B cells. Min-U-Sil 5 was used as reference quartz. Artificial stone dusts exhibited morphological features close to quartz, but contained larger amount of metal transition ions (mainly, Fe, Cu, and Ti), potentially responsible for the high reactivity in free radical generation observed. Opposite to Min-U-Sil 5, they were neither hemolytic nor cytotoxic on MH-S cells, a low cytotoxicity only being observed with BEAS-2B cells. The presence on the particle surface of residues of the resin accounts for this attenuated behavior, as hemolysis appeared and cytotoxicity increased after thermal degradation of the resin, when the free quartz surface was exposed. All dusts induced EMT with loss of E-cadherin expression and increased the expression of mesenchymal proteins (α-smooth muscle actin and vimentin). This may contribute to explain the development of fibrosis on workers exposed to artificial stone dusts., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

In occupational exposures, populations are simultaneously exposed to a mixture of chemicals. We aimed to evaluate DNA damage due to possible carcinogen exposure (phenylhydrazine, ethylene oxide, dichloromethane, and 1,2-dichloroethane) in lymphocytes of pharmaceutical industry workers from the same production line. Population comprised 16 subjects (9 females and 7 males) who were exposed to multiple chemicals for 8 months. Genome damage was assessed using alkaline comet assay, micronucleus assay, and comet assay coupled with fluorescent in situ hybridization (comet-FISH). After 8 months of exposure, the issue of irregular use of all available personal protective equipment (PPE) came into light. To decrease the risk of exposure, strict use of PPE was enforced. After 8 months of strict PPE use, micronuclei frequency and comet assay parameters in lymphocytes of pharmaceutical workers significantly decreased compared with prior period of irregular PPE use. Comet-FISH results indicated a significant shift in distribution of signals for the TP 53 gene toward a more frequent occurrence in the comet tail. Prolonged exposure to possible carcinogens may hinder DNA repair mechanisms and affect structural integrity of TP 53 Two indicators of loss of TP 53 gene integrity have risen, namely, TP 53 fragmentation rate in lymphocytes with persistently elevated primary damage and incidence of TP 53 deletions in undamaged lymphocytes., (© The Author(s) 2015.)

Laboratory-acquired infection is one of the leading occupational health hazards. On a laboratory worker's hands, carbuncles occurred. Staphylococcus aureus was isolated from pus samples of the carbuncles, with the same pulsed field gel electrophoresis band pattern with one of the recently studied strains in the laboratory. Incorrect or inadequate application of infection control measures may result in pathogen acquisition from the clinical samples, and wearing only gloves is not sufficient for the biosafety of laboratory workers in clinical diagnostic laboratories., (Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

The studies revealed specificity of morphologic changes in target organs, depending on acting occupational hazard. Evidences are that inhalation of coal rock dust causes irreversible sclerotic and degenerative changes mostly in lungs and bronchi even on 6th week of the experiment. In liver, changes in parenchyma and stroma are controlled by reparative processes by 9th week. Accumulation of sodium fluoride in the body causes irreversible necrotic changes mostly in liver, on 6th week of the intoxication. With that, morphologic changes in lungs and bronchi are minor, characterized by immune inflammation with degenerative changes only after the 9th week. Irrespective of the acting hazard, vascular changes are characterized by media and intima hypertrophy with endothelial dystrophy and hyalinosis since the 6th week of the experiment.

Purpose: Coal workers' pneumoconiosis (CWP) is caused by an accumulation of coal particles in the lung parenchyma. Reactive oxygen species (ROS) play an important role in the pathogenesis of CWP. It is well documented that ROS stimulate platelet activation, adhesion, and aggregation. The aim of the present study was to investigate the relationship between platelet indices and CWP., Methods: The demographic features, occupational and medical history, exposure time, and complete blood count of retired coal miners were retrospectively analysed. The control group comprised healthy subjects who had not worked underground. Chest radiographs were evaluated according to the CWP classification of the International Labour Office., Results: The study population was divided into following groups: 50 controls, 97 without CWP, 142 simple pneumoconiosis (SP), 157 progressive massive fibrosis (PMF). The platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were significantly higher in patients with CWP compared to those in patients without CWP and controls. The platelet count, MPV, and PCT were higher in patients with PMF compared to those in the SP group (p < 0.05). The results of multiple logistic regression analyses indicated that the platelet count, MPV, and PCT were independently associated with the development of CWP., Conclusions: Platelet indices may be considered as disease markers for pneumoconiosis in coal miners and as a useful indicator of the progression of pneumoconiosis.

The Purpose of the Research: The aim of this work was to study associations between varicocele and the various types of karyopathologic abnormalities in epithelial urogenital tract cells or teratozoospermia in oil field shift workers of the north of Siberia., Materials and Methods: We examined 139 male individuals in several oil field of the north of Tomsk and Tyumen regions. The examined individuals were divided in 4 groups: 1) driller-workers with varicocele; 2) driller-workers without varicocele; 3) oil field administrative staff with varicocele, and 4) oil field administrative staff without varicocele. Samples of both the sperm ejaculate and the epithelial urogenital tract cells were obtained from all the individuals for microscopic assay., Results: It was found that the frequencies of both the teratozoospermia and the various karyopathologic abnormalities in epithelial urogenital cells were significantly higher in the workers with varicocele compared to all the other groups. There were correlations between karyopathologic abnormalities in epithelial urogenital cells and teratozoospermia in both the driller-workers with varicocele and the oil field administrative staff with varicocele. However, the frequencies of damaged cells in this workers group were significantly higher than the ones in the administrative staff with varicocele, which can be associated with the genotoxic effects of work conditions at oil fields of the north of Siberia., Conclusions: From the data it was concluded that the increased frequencies of the abnormalities in the epithelial urogenital cells and the sperm in the driller-workers with varicocele may be associated with both the diseases endogenous factor and the genotoxic effects of work conditions at the oil fields.

Secondary alveolar proteinosis is a rare lung disease which may be triggered by a variety of inhaled particles. The diagnosis is made by detection of anti-granulocyte-macrophage colony-stimulating factor antibodies in bronchoalveolar lavage fluid, which appears milky white and contains lamellar bodies. Aluminium has been suggested as a possible cause, but there is little evidence in the literature to support this assertion. We report the case of a 46-year-old former boilermaker and boat builder who developed secondary alveolar proteinosis following sustained heavy aluminium exposure. The presence of aluminium was confirmed both by histological examination and metallurgical analysis of a mediastinal lymph node. Despite cessation of exposure to aluminium and treatment with whole-lung lavage which normally results in improvements in both symptoms and lung function, the outcome was poor and novel therapies are now being used for this patient. It may be that the natural history in aluminium-related alveolar proteinosis is different, with the metal playing a mediating role in the disease process. Our case further supports the link between aluminium and secondary alveolar proteinosis and highlights the need for measures to prevent excessive aluminium inhalation in relevant industries., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Tuberculosis is a common problem in Turkey, and cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis. Herein, the authors describe a case of cutaneous tuberculosis (lupus vulgaris) occurring after contact with a sheep., Case: A 15-year-old boy was admitted to Marmara University School of Medicine Pendik Training and Research Hospital (Istanbul, Turkey) with delayed wound healing on the left index finger and left axillary lymphadenopathy. His medical history was unremarkable except for a wound incurred when he slaughtered a sheep 3 months before. One month after this injury, the patient developed enlargement of the left axillary lymph node on the side of the wounded extremity, and the wound turned a dark black color. The biopsy specimens obtained from the wounded skin and lymph nodes showed granulomatous reaction, but acid-fast bacilli (AFB) could not be shown with Ehrlich-Ziehl Neelsen staining. The patient tested positive in an interferon-gamma release assay. Computerized tomography scans of the thorax were normal, and early morning gastric lavage specimen was negative for AFB. The wound and axillary lymphadenopathy disappeared after institution of anti-tuberculosis therapy., Conclusion: Tuberculosis infection must be considered in chronic skin lesions with granulomatous reaction occurring in countries with high prevalence of tuberculosis.

Background: An outbreak of cholangiocarcinoma has been reported among workers of an offset color proof-printing department at a printing company in Japan. In this study, we compared the clinicopathological findings of this type of intrahepatic cholangiocarcinoma (occupational ICC) and non-occupational ICC., Methods: The clinical records of 51 patients with perihilar-type ICC who underwent liver resection, including five patients with occupational ICC were retrospectively reviewed. The clinicopathological features were compared., Results: In the occupational group, the patients were significantly younger (P < 0.01), while serum γ-glutamyl transpeptidase activity and the proportions of patients with regional dilatation of the bile ducts without tumor-induced obstruction were significantly higher (P = 0.041 and P < 0.01, respectively); the indocyanine green retention rate at 15 min was significantly lower (P = 0.020). On pathological examinations, precancerous or early cancerous lesions, such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct, were observed at various sites of the bile ducts in all occupational ICC patients; such lesions were observed in only six patients in the control group (P < 0.01)., Conclusions: The clinicopathological findings including age, liver function test results, diagnostic imaging findings, and pathological findings differed between the occupational and control groups., (© 2016 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

ALDH2 is involved in the metabolism of styrene, a widely used industrial material, but no data are available regarding the influence of this enzyme on the metabolic fate as well as toxic effects of this chemical. In this study, we recruited 329 workers occupationally exposed to styrene and 152 unexposed controls. DNA strand breaks, DNA-base oxidation in leukocytes and urinary 8-hydroxydeoxyguanosine (8-OH-dG) were assayed as biomarkers to measure genotoxic effects. Meanwhile, we examined the genetic polymorphisms, including ALDH2, EXPH1, GSTM1, GSTT1 and CYP2E1, and also analyzed the levels of styrene exposure through detecting urinary styrene metabolites and styrene concentration in air. In terms of DNA damage, the three genotoxic biomarkers were significantly increased in exposed workers as compared with controls. And the styrene-exposed workers with inactive ALDH2 *2 allele were subjected to genotoxicity in a higher degree than those with ALDH2 *1/*1 genotype. Also, lower levels of urinary styrene metabolites (MA + PGA) were observed in styrene-exposed workers carrying ALDH2 *2 allele, suggesting slower metabolism of styrene. The polymorphisms of other enzymes showed less effect. These results suggested that styrene metabolism and styrene-induced genotoxicity could be particularly modified by ALDH2 polymorphisms. The important role of ALDH2 indicated that the accumulation of styrene glycoaldehyde, a possible genotoxic intermediate of styrene, could account for the genotoxicity observed, and should be taken as an increased risk of cancer., Competing Interests: The authors declare that there are no conflicts of interest.

Background: The strong interactions between asthma and rhinitis, and the influence of rhinitis in the severity and/or control of asthma, have clearly been demonstrated. Nevertheless, no specific study has been conducted in the occupational setting., Objective: The aim of the study was to assess the severity of occupational asthma and rhinitis and evaluate whether rhinitis is a predictor for increased asthma severity., Methods: We retrospectively reviewed the clinical charts of 72 patients who received a diagnosis of allergic occupational asthma, with or without associated occupational rhinitis., Results: Our findings suggested that persistent asthma tended to be more common in subjects with associated occupational asthma and rhinitis, and occupational asthma severity was associated with occupational rhinitis severity. Moderate-severe persistent occupational rhinitis is a risk factor for persistent occupational asthma., Conclusions: We demonstrated, for the first time in the occupational setting, a significant association between occupational rhinitis and asthma severity.

Introduction: The aim of this study was to analyse whether patients with occupational asthma (OA) caused by low molecular weight (LMW) agents differed from patients with OA caused by high molecular weight (HMW) with regard to risk factors, asthma presentation and severity, and response to various diagnostic tests., Methods: Seventy-eight patients with OA diagnosed by positive specific inhalation challenge (SIC) were included. Anthropometric characteristics, atopic status, occupation, latency periods, asthma severity according to the Global Initiative for Asthma (GINA) control classification, lung function tests and SIC results were analysed., Results: OA was induced by an HMW agent in 23 patients (29%) and by an LMW agent in 55 (71%). A logistic regression analysis confirmed that patients with OA caused by LMW agents had a significantly higher risk of severity according to the GINA classification after adjusting for potential confounders (OR = 3.579, 95% CI 1.136-11.280; p = 0.029). During the SIC, most patients with OA caused by HMW agents presented an early reaction (82%), while in patients with OA caused by LMW agents the response was mainly late (73%) (p = 0.0001). Similarly, patients with OA caused by LMW agents experienced a greater degree of bronchial hyperresponsiveness, measured as the difference in the methacholine dose-response ratio (DRR) before and after SIC (1.77, range 0-16), compared with patients with OA caused by HMW agents (0.87, range 0-72), (p = 0.024)., Conclusions: OA caused by LMW agents may be more severe than that caused by HMW agents. The severity of the condition may be determined by the different mechanisms of action of these agents.

Background: The association between lung cancer and occupational exposure to organic solvents is discussed. Since different solvents are often used simultaneously, it is difficult to assess the role of individual substances., Objectives: The present study is focused on an in-depth investigation of the potential association between lung cancer risk and occupational exposure to a large group of organic solvents, taking into account the well-known risk factors for lung cancer, tobacco smoking and occupational exposure to asbestos., Methods: We analysed data from the Investigation of occupational and environmental causes of respiratory cancers (ICARE) study, a large French population-based case-control study, set up between 2001 and 2007. A total of 2276 male cases and 2780 male controls were interviewed, and long-life occupational history was collected. In order to overcome the analytical difficulties created by multiple correlated exposures, we carried out a novel type of analysis based on Bayesian profile regression., Results: After analysis with conventional logistic regression methods, none of the 11 solvents examined were associated with lung cancer risk. Through a profile regression approach, we did not observe any significant association between solvent exposure and lung cancer. However, we identified clusters at high risk that are related to occupations known to be at risk of developing lung cancer, such as painters., Conclusions: Organic solvents do not appear to be substantial contributors to the occupational risk of lung cancer for the occupations known to be at risk., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Objective: Motor control of the muscles of the face, lips, and tongue of horn players has traditionally been described from externally observed phenomena. Developments in real-time, high-speed magnetic resonance imaging (MRI) extend the scope of study to include descriptive and quantitative information from within the mouth. We employed these developments to compare oral movement strategies between 12 elite horn players and 5 horn players with embouchure dystonia (ED)., Methods: Serial images with an acquisition time of 33.3 ms were obtained from each subject as they performed 6 exercises on an MRI-compatible horn: 1) a slurred ascending harmonic sequence, 2) a slurred descending harmonic sequence, 3-6) sustained high and low notes, each performed softly and loudly. Temporal changes in pixel luminescence along a series of lines positioned within the oral cavity were calculated using a customized MATLAB toolkit. This allowed the extraction of temporal line profiles for comparative analyses between elite and dystonic horn players., Results: Differing motor strategies of controlling the tongue and jaw were observed during ascending and descending exercises. In ascending exercises, the elite players employed a strategy of elevation and anterior tongue displacement and elevation of the jaw, whereas dystonic players exhibited more variability in their responses. With descending exercises, both groups exhibited a lowering of the tongue and jaw, though this was more pronounced and consistent in the elite horn players. Sustained note exercises also elicited differences between groups. We suggest that elite strategies are more efficient and that the less-efficient patterns of dystonic players may exacerbate muscular tension with ED.

We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2(nd), 3(rd), and 4(th) quartiles, respectively, compared to the 1(st) quartile. The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.

Background: We have conducted a population-based study of pleural mesothelioma patients with occupational histories and measured asbestos lung burdens in occupationally exposed workers and in the general population. The relationship between lung burden and risk, particularly at environmental exposure levels, will enable future mesothelioma rates in people born after 1965 who never installed asbestos to be predicted from their asbestos lung burdens., Methods: Following personal interview asbestos fibres longer than 5 µm were counted by transmission electron microscopy in lung samples obtained from 133 patients with mesothelioma and 262 patients with lung cancer. ORs for mesothelioma were converted to lifetime risks., Results: Lifetime mesothelioma risk is approximately 0.02% per 1000 amphibole fibres per gram of dry lung tissue over a more than 100-fold range, from 1 to 4 in the most heavily exposed building workers to less than 1 in 500 in most of the population. The asbestos fibres counted were amosite (75%), crocidolite (18%), other amphiboles (5%) and chrysotile (2%)., Conclusions: The approximate linearity of the dose-response together with lung burden measurements in younger people will provide reasonably reliable predictions of future mesothelioma rates in those born since 1965 whose risks cannot yet be seen in national rates. Burdens in those born more recently will indicate the continuing occupational and environmental hazards under current asbestos control regulations. Our results confirm the major contribution of amosite to UK mesothelioma incidence and the substantial contribution of non-occupational exposure, particularly in women., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Background: In the last few years, the incidence of upper limbs tendon injuries has seen a dramatic increase among workers. Conservative treatment is the first choice to relieve symptoms, allowing a safe return to work. However, the scientific evidence of its  efficacy is widely debated., Objective and Methods: Research and literature review on the efficacy of conservative treatment of upper limbs tendon injuries in occupational settings., Results: A total of 271 references were found on Medline and Embase up to May 2015. 116 papers were excluded, 155 articles were included and the full text read., Conclusions: After a timely diagnosis, a prompt start of the rehabilitation programme and a limitation of complete rest are useful to relieve pain, increase functionality and reduce work absenteeism in the long term. Conservative treatment combinations, such as manual therapy, specific exercises focused on increasing flexibility and muscle strength and specific-gesture training, achieves more significant results than a single isolated treatments. Currently, there is no strong scientific evidence to support prolotherapy and Platelet-Rich Plasma (PRP). However, current promising results will encourage further studies. Awareness among both employers and employees about prevention and risk factors should be enhanced.

We had a forensic autopsy case that required additive pathological examination for the asbestos-related lung disease compensatory application afterwards. A man in his sixties with a history of occupational asbestos inhalation who had neither visited a hospital nor received a physical examination received forensic autopsy because of his death from unknown cause. An inmate said, "He developed cough and dyspnea, and died in the progression of the symptoms." The autopsy revealed widespread pleural plaques on both sides of the parietal pleura and multiple tumors in both sides of the lungs. The cause of death was diagnosed as lung cancer. Additional pathological examination was asked by his family to certify that he had suffered from asbestos-related lung disease in order to apply to the Asbestos-related Damage Relief Law. The Japanese criteria of the compensation law of asbestos-related lung cancer is the detection of more than 5,000 asbestos bodies per gram of dry lung tissue, while his number of asbestos bodies was 4,860. Asbestos bodies were reported to be accumulated in the distal lung parenchyma with no pathological changes. The present lung samples were collected from proximal section around the tumor, which might have made the number of asbestos bodies less than the criteria. Both the number of patients suffering from asbestos-related lung disease and the number of forensic autopsy cases have increased in Japan. Collecting lung samples from the appropriate lung section is essential and should be noted when the lung cancer is suspected at forensic autopsy in order to apply for asbestos-related lung disease compensation.

Background: We aimed to identify the pathological characteristics of occupational cholangiocarcinoma., Methods: We examined the location and distribution of the carcinomas: atypical epithelium including biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile duct (IPNB); and chronic bile duct injuries in operative or autopsy liver specimens from 16 patients. We examined the detailed pathological findings and diagnostic imaging of three patients. Immunohistochemical analysis using primary antibodies against γH2AX and S100P was performed., Results: BilIN and chronic bile duct injury were observed in 16 patients, and IPNB or invasive IPNB was observed in 11 patients. BilIN, IPNB, and/or chronic bile duct injury were observed in almost all the large bile ducts. Regional dilatation of the bile ducts without tumor-induced obstruction revealed such pathological changes. Highly positive results for the γH2AX and S100P markers were noted in invasive carcinoma, BilIN, and IPNB, whereas positive results for γH2AX and negative results for S100P were noted in non-neoplastic biliary epithelium., Conclusions: The carcinogenic process of occupational cholangiocarcinoma comprised chronic bile duct injury and DNA damage in almost all the large bile ducts, along with induction of precancerous lesions and development of invasive carcinoma. Such pathological findings reflected radiological changes on diagnostic imaging., (© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)

Background: The inference of the state of wealth or poverty from human skeletal remains is a difficult task, as the limited number of skeletal changes are mediated by numerous other physiological, biomechanical and pathological events. In recent years, identified skeletal collections have become valuable resources in enabling aetiologies of these changes to be understood while controlling for some known causative factors, e.g. age, sex and occupation. This has favoured more rigorous data analysis and interpretation., Aim: This study compares the presence of osteological makers of occupation - specifically degenerative joint changes (DJC) - between socio-economically framed occupational groups whilst controlling for age-at-death., Materials and Methods: A total of 603 individuals were distributed into seven occupational groups used as a proxy for their socio-economic status., Results: The results demonstrated that age was a contributing factor for DJC. Differences between occupational groups were only found for the hips, right shoulder and ankle., Conclusions: Differences found were not necessarily representative of low vs high socio-economic status. Furthermore, there are limitations associated with the use of occupation-at-death, based on documentary evidence, which does not necessarily reflect wealth-status.

The paper reviews literature on the current aspects of the diagnosis and expert appraisal of focal osteoplastic masses in the lung upon dust exposure to dust factors. It considers different aspects of the pathogenesis of osteoplastic changes in the tissue structural elements of pulmonary histione. Current views on the prevalence, etiology, and pathogenesis, as well as morphological changes in the development of this abnormality, its association with the dust damaging effects of human activities are reflected.

Context: Cervical cancer is the second most common malignancy among women in India. There is thus a need to identify unexplored risk factors such as occupational exposure to tobacco dust to justify its increasing trend so as to recommend suitable preventive measures., Aims: The aim was to study the association between occupational exposure to tobacco dust with development of carcinoma cervix., Settings and Design: Case-control study done in two tertiary care hospitals in Mangalore., Methodology: 239 histologically confirmed new cases of cervical cancer and the equivalent number of age-matched controls from 2011 to 2012 were interviewed about occupational history of beedi rolling and related factors., Statistical Analysis: Chi-square test, unpaired t-test, logistic regression., Results: Exposure rate to tobacco dust following beedi rolling was 63 (26.4%) among cases and 38 (15.9%) among controls (P = 0.005, odds ratio [OR] =1.893). The latent period from occupational exposure of tobacco dust subsequent to beedi rolling and development of cervical cancer was found to be 26.5 ± 8.5 years. Adjusted OR of beedi rolling with development of cervical cancer was found to be 1.913 (P = 0.005) after controlling the confounding effect of tobacco usage and was 1.618 (P = 0.225) after controlling the effects of all confounders. Three-quarters of beedi rollers were working in conditions of inadequate ventilation and hardy anybody used face mask during work. About a quarter of participants underwent voluntary screening for cervical cancer., Conclusion: Occupational exposure to tobacco dust was found to be associated with risk of developing cervical cancer. Measures to promote awareness, timely screening of this disease along with the improvement in working conditions is required for improving the health status of beedi rollers and to minimize the incidence of carcinoma cervix in the community.

Background: Arc welders who have been exposed to high concentrations of steel welding fume for prolonged periods of time may develop pulmonary fibrosis but the nature of the fibrotic changes has been debated over the last 80 years without any clear international consensus., Aims: To characterize the nature of the pulmonary fibrosis that develops in response to steel welding fume exposure and to provide a working hypothesis that would explain the findings of the existing research, to provide a platform for future research and to inform future occupational and clinical management of welders with pulmonary effects from welding fume., Methods: Review of the world literature on pulmonary fibrosis and welding of steel in all languages using PubMed, with further secondary search of references in the articles found in the primary search. Google and Reference Manager were used as further confirmatory search tools., Results: Only case series and case reports were found but these provided consistent evidence that the consequence of exposure to steel welding fume at high levels for a prolonged period of time is a type of pulmonary fibrosis similar to, and possibly the same as, respiratory bronchiolitis which eventually develops into desquamative interstitial pneumonia with ongoing exposure., Conclusions: Steel welding fume may cause an occupational respiratory bronchiolitis which may develop into de squamative interstitial pneumonia with ongoing exposure. This concept may explain the difficulties in interpreting the wider literature on welding fume and lung function at lower exposures and may also explain the increased risk of lung cancer in welders., (© The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The United States Environmental Protection Agency (EPA) developed a quantitative exposure-response model for the non-cancer effects of Libby Amphibole Asbestos (LAA) (EPA, 2014). The model is based on the prevalence of localized pleural thickening (LPT) in workers exposed to LAA at a workplace in Marysville, Ohio (Lockey et al., 1984; Rohs et al., 2008). Recently, Lockey et al. (2015a) published a follow-up study of surviving Marysville workers. The data from this study increases the number of cases of LPT and extends the observation period for a number of workers, thereby providing a strengthened data set to define and constrain the optimal exposure-response model for non-cancer effects from inhalation exposure to LAA. The new data were combined with the previous data to update the exposure-response modeling for LPT. The results indicate that a bivariate model using cumulative exposure and time since first exposure is appropriate, and the benchmark concentration is similar to the findings previously reported by EPA (2014). In addition, the data were also used to develop initial exposure-response models for diffuse pleural thickening (DPT) and small interstitial opacities (SIO)., (Published by Elsevier Inc.)

Trichloroethylene (TCE) has long been well known as a major pollutant that affects both occupational and general environments. Occupational medicamentosa-like dermatitis induced by TCE (OMLDT) is an autoimmune disease, which has become one of the critical occupational health issues in China. In this study, we analyzed 18 OMLDT patients and 29 professional TCE contact people on serum proteomic analysis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and ClinProTools bioinformatics software. The intensities of 35 protein/peptide peaks were significantly different between TCE contact controls and OMLDT patients. A pattern of six peaks (m/z 1,450.33, 1,866.16, 3,262.39, 4,109.55, 5,064.85 and 5,956.57) were selected to construct a diagnostic model to discriminate the OMLDT patients from controls with sensitivity and specificity of both 93.8 %. Our findings provide an alternative proteomic approach to differentiate the OMLDT patients from TCE contact workers with high sensitivity and high specificity, which will be of potential value in clinical diagnosis for occupational disease.

Aim: Moderate and chronic paronychia is a common disease affecting the hand. Treatment can be effective but the affection is often recurrent, especially as an occupational disease. Moreover, this condition may be complicated by a Candida spp or by bacterial infections. Therefore, general preventive measures can be useful in maintaining health. The aim of this study was to investigate the efficacy and tolerability of a new combination of topical medications in the treatment and prevention of moderate and chronic paronychia. This formulation includes an insulating polymer (Syn-cell barrier), two topical antifungals (octopirox and climbazole) and a molecule with anti-inflammatory activity (corticoid-like repair)., Methods: Thirty adult subjects (age, 16-78 years; 24 females and 6 males) affected by moderate or chronic paronychia, with or without nail alterations, were evaluated. Included in the study were patients with allergic contact dermatitis (8), irritant contact dermatitis (19), psoriatic paronychia (2 patients), lichen planus of the nails (1 patient). Sometimes Candida spp or bacteria overlapped with paronychia (16 patients positive for Candida spp and 4 patients with bacterial paronychia), sometimes infectious paronychia was not associated with dermatitis of the hands. All 30 subjects were treated with a new cream formulation, three applications per day for 2 months. In 8 patients with proven and severe candidiasis of the nails, oral fluconazole 100 mg was added for 20 days. All patients with bacterial perionyxis took clarithromycin 500 mg twice daily for six days. Patients were then followed for 8 weeks., Results: After two months of treatment, 26 patients responded to therapy. In particular, the treatment evaluation at the end of the follow-up period showed a clinical cure in 46.6% (14 patients), improvement in 40% (12 patients), and failure in 13.4% (4 patients). There was a side effect (moderate skin irritation) in 2 patients, but the drug was not discontinued., Conclusion: Results of the present study, based on its safety, effectiveness and innovative features, indicate that this combination of topical cream may be considered as a new alternative for treatment and prevention of paronychia, especially in case of occupational hand disease where prolonged treatment and continuous prevention are needed.

Unlabelled: Chronic silica exposure has been associated to cancer and silicosis. Furthermore, the induction of oxidative stress and the generation of reactive oxygen species have been indicated to play a main role in the carcinogenicity of respirable silica. Therefore, we conducted a cross-sectional study to evaluate the prevalence of 3-(2-deoxy-β-D-erythro-pentafuranosyl)pyrimido[1,2-α]purin-10(3H)-one deoxyguanosine (M1dG) adducts, a biomarker of oxidative stress and peroxidation of lipids, in the nasal epithelium of 135 silica-exposed workers, employed in pottery, ceramic and marble manufacturing plants as well as in a stone quarry, in respect to 118 controls living in Tuscany region, Italy. The M1dG generation was measured by the (32)P-postlabelling assay. Significant higher levels of M1dG adducts per 10(8) normal nucleotides were observed in the nasal epithelium of smokers, 77.9±9.8 (SE), and in those of former smokers, 80.7±9.7 (SE), as compared to non-smokers, 57.1±6.2 (SE), P = 0.001 and P = 0.004, respectively. Significant increments of M1dG adducts were found in the nasal epithelium of workers that handle artificial marble conglomerates, 184±36.4 (SE), and in those of quarry workers, 120±34.7 (SE), with respect to controls, 50.6±2.7 (SE), P = 0.014 and P < 0.001, respectively. Null increments were observed in association with the pottery and the ceramic factories. After stratification for different exposures, silica-exposed workers that were co-exposed to organic solvents, and welding and exhaust fumes have significantly higher M1dG levels, 90.4±13.4 (SE), P = 0.014 vs., Control: Our data suggested that silica exposure might be associated with genotoxicity in the nasal epithelial cells of silica-exposed workers that handle of artificial marble conglomerates and quarry workers. Importantly, we observed that co-exposures to other respiratory carcinogens may have contributed to enhance the burden of M1dG adducts in the nasal epithelium of silica-exposed workers., (© The Author 2015. Published by Oxford University Press on behalf of the UK Environmental Mutagen Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Asbestos-related diseases persist, because millions of workers have had prior exposure and many industrializing countries continue to use asbestos. Globally, an estimated 107,000 people die annually from lung cancer, malignant mesothelioma, and asbestosis due to occupational asbestos exposure. Malignant mesothelioma and lung cancer are caused by all major types of asbestos. Asbestos causes more lung cancer deaths than malignant mesothelioma of the pleura; most cases of the latter are due to asbestos exposure. The cancer risk increases with cumulative asbestos exposure, with increased risk even at low levels of exposure to asbestos. Based on empirical studies, an estimated cumulative occupational exposure to asbestos of 1 fiber/mL-year substantially raises malignant mesothelioma risk. No safe threshold for asbestos exposure has been established for lung cancer and mesothelioma. The validity of fiber-type risk assessments depends critically on the quality of exposure assessments, which vary considerably, leading to a high degree of uncertainty. Asbestos exposure without asbestosis and smoking increases the risk of lung cancer. The joint effect of asbestos and smoking is supra-additive, which may depend in part on the presence of asbestosis. Asbestos workers who cease smoking experience a dramatic drop in lung cancer risk, which approaches that of nonsmokers after 30 years. Studies to date show that longer, thinner fibers have a stronger association with lung cancer than shorter, less thin fibers, but the latter nonetheless also show an association with lung cancer and mesothelioma. Low-dose chest computed tomographic scanning offers an unprecedented opportunity to detect early-stage lung cancers in asbestos-exposed workers., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Background: A recent Monographs Working Group of the International Agency for Research on Cancer concluded that there is limited evidence for a causal association between exposure to asbestos and stomach cancer., Methods: We performed a meta-analysis to quantitatively evaluate this association. Random effects models were used to summarise the relative risks across studies. Sources of heterogeneity were explored through subgroup analyses and meta-regression., Results: We identified 40 mortality cohort studies from 37 separate papers, and cancer incidence data were extracted for 15 separate cohorts from 14 papers. The overall meta-SMR for stomach cancer for total cohort was 1.15 (95% confidence interval 1.03-1.27), with heterogeneous results across studies. Statistically significant excesses were observed in North America and Australia but not in Europe, and for generic asbestos workers and insulators. Meta-SMRs were larger for cohorts reporting a SMR for lung cancer above 2 and cohort sizes below 1000., Conclusions: Our results support the conclusion by IARC that exposure to asbestos is associated with a moderate increased risk of stomach cancer.

Milker's nodule is an occupational viral skin disease of universal distribution, caused by the Paravaccinia virus and that occurs in individuals who deal with dairy cattle herds. We describe a case acquired due to lack of use of PPE (Personal Protective Equipment) and perform a literature review.

Objective: To analyze the clinical features and investigate the clinical diagnostic methods of hard metal lung disease (HMLD), then provide reference for the diagnostic criteria of occupational HMLD., Methods: Retrieved the open published case reports associated with HMLD from January, 2000 to June, 2014. Regarding the ages, sex, types and years of work, clinical features and laboratory results for analyzing., Results: Collected 21 clinical cases of HMLD belonged to 6 internal reports and 15 oversea reports. Among them 15 male and 6 female, ages were from 22 to 58, length of service between 1 year and 43 years. Clinical presentations included cough (20 cases), dyspnea on progressive (10 cases), and pulmonary function testing showed a restrictive abnormality. The imaging features presented as bilateral areas of ground-glass attenuation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The finding of giant cell interstitial pneumonia (GIP) was almost pathognomonic for hard metal pneumoconiosis. The main pathological findings contained a different levels of lymphocyte, acidophilic cell infiltration, hyperplasia of fibrous tissue and numerous large multinucleated histiocytes which ingested inflammatory cells were admixed with macrophages. 16 cases of the 21 reports showed GIP., Conclusions: Clinical presentations include cough and dyspnea on progressive, and pulmonary function testing show a restrictive abnormality. The imaging features present as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities and traction bronchiectasis. The prime pathological findings contain interstitial pneumonia with intra-alveolar macrophages and a large amount of multinucleated histiocytes.

1,2-Dichloroethane (DCE) is commonly used as an industrial organic solvent and causes occupational diseases. Toxic encephalopathy is the most common and serious disorder resulting from DCE intoxication. Five patients who worked in shoemaking, pipemaking or a paint factory were identified as suffering from severe encephalopathy due to DCE intoxication. DCE-induced toxic encephalopathy manifests as various neurological deficits, with changes observable by neuroimaging. The main clinical manifestation is headache accompanied by intracranial hypertension. The typical cranial CT/MR scan of DCE toxic encephalopathy shows extensive brain edema and diffuse, symmetric, abnormal signal intensities in the cerebellar dentate nucleus, basal ganglia, and white matter in the bilateral cerebral hemispheres. The diagnosis of DCE toxic encephalopathy can be confirmed by the typical clinical and neuroimaging characteristics together with a history of exposure to substances contaminated with DCE. Dehydrating agents and glucocorticoids are the primary treatments. With early diagnosis and prompt treatment, promising results and recovery can be achieved. Effective prevention is expected to reduce the incidence of DCE toxic encephalopathy., (Copyright © 2015. Published by Elsevier B.V.)

Purpose of Review: The purpose of this study is to review the relevant literature concerning work-associated irritable larynx syndrome (WILS), a hyperkinetic laryngeal disorder associated with occupational irritant exposure. Clinical symptoms are variable and include dysphonia, cough, dyspnoea and globus pharyngeus. WILS is a clinical diagnosis and can be difficult to differentiate from asthma. Treatment options for WILS include medical and behavioural therapy., Recent Findings: Laryngeal-centred upper airway symptoms secondary to airborne irritants have been documented in the literature under a variety of diagnostic labels, including WILS, vocal cord dysfunction (VCD), laryngeal hypersensitivity and laryngeal neuropathy and many others. The underlying pathophysiology is as yet poorly understood; however, the clinical scenario suggests a multifactorial nature to the disorder. More recent literature indicates that central neuronal plasticity, inflammatory processes and psychological factors are all likely contributors., Summary: Possible mechanisms for WILS include central neuronal network plasticity after noxious exposure and/or viral infection, inflammation (i.e. reflux disease) and intrinsic patient factors such a psychological state. Treatment is individualized and frequently includes one or more of the following: environmental changes in the workplace, GERD therapy, behavioural/speech therapy, psychotherapy counselling and neural modifiers.

Background: The purpose of this study was to present a monocentric retrospective study designed to compare oncologic results and morbidity between transfacial surgery and endoscopic endonasal surgery for nasal adenocarcinomas., Methods: Between 1998 and 2003, 31 patients were operated on via transfacial surgery, and between 2004 and 2009, 43 patients were operated on via endoscopic endonasal surgery. Overall and specific survival, local control, and morbidity (length of hospitalization, intensive care unit [ICU] monitoring, need for nasal packing, and complications) were compared., Results: There was no difference in prognostic factors between groups, but the median age was significantly higher for endoscopic endonasal surgery. Three-year overall survival, specific survival, and local control were not different between groups (respectively, 76.7%, 86%, and 81.4% for endoscopic endonasal surgery vs 61.3%, 67.7%, and 71% for transfacial surgery). Morbidity was significantly lower with endoscopic endonasal surgery for all criteria., Conclusion: Endoscopic surgery may replace transfacial surgery in the treatment of woodworker's adenocarcinomas. Older patients can be operated on by decreasing morbidity and mortality with at least similar oncologic results., (© 2014 Wiley Periodicals, Inc.)

Objective: to assess mutational events in exons 5, 7, and 8 of the p53 gene and to reveal mutant p53 protein in verified cases of morphologically altered (proliferative and precancerous changes, lung cancer) and histologically unaltered, lung tissues in workers exposed to occupational radiation., Material and Methods: The investigation used formalin-fixed paraffin-embedded unaltered and altered lung tissue blocks (FFPBs) obtained from the human radiobiological tissue repository. The shelf-life of FFPBs was 5-31 years. An immunohistochemical technique using mouse antibodies against p53 protein (<>, Denmark), stained with diaminobenzidine (DAB) chromogen, was employed to determine p53 protein. DNA was isolated from lung tissue FFPBs with QIAmp DNA FFPE Tissue Kit, (<>, USA). Polymerase chain reaction (PCR) was performed to amplify the p53 gene exons 5, 7, and 8 selected for examination, by applying the sequences of genes and primers, the specificity of which was checked using the online resource (http://www.ncbi.nlm.nih.gov/blast). PCR products were detected by temporal temperature gradient gel-electrophoresis and the Sanger sequencing method. The obtained DNA fragments were analyzed on a sequencer ABI Prism 3100 Genetic Analizer (<>, USA). Computer-aided DNA analysis was made using the BLAST program. A package of applied Statistica 6.0 programs was employed for statistical data processing. Results. Immunohistochemical analysis showed that mutant p53 protein was absent in the cells of unaltered lung tissue and the number of cells with mutant p53 protein increased in all the patients with proliferative and precancerous changes and lung cancer, suggesting p53 protein dysfunction. The total number of p53 gene mutations in exons 5, 7, and 8, if there were proliferative and precancerous lung tissue changes and lung cancer, were 25, 20, and 40%, respectively. All the found mutations were transversions (the substitution of purine for pyrimidine or, conversely), indicating the action of exogenous mutagens., Conclusion: The results of this investigation have confirmed other investigators' data showing that p53 gene mutations in lung cancer are observed in 40-70% of cases. The differences in the number of cases of altered lung tissue with mutations in the p53 gene (not more than 40%) and in those of p53 protein expression were found in 100%, suggesting the regulation of p53 gene function in the cell at multiple levels.

Vascular manifestations can be seen early in the pathogenesis of inflammatory rheumatic diseases. Animal experiments, laboratory and clinical findings indicated that acute or long-term vibration exposure can induce vascular abnormalities. Recent years, in addition to Raynaud's phenomenon (RP), vibration as a risk factor for other rheumatic diseases has also received corresponding considered. This review is concentrated upon the role of vibration in the disease of systemic sclerosis (SSc). In this review, we are going to discuss the main mechanisms which are thought to be important in pathophysiology of vascular injury under the three broad headings of "vascular", "neural" and "intravascular". Aspects on the vibration and vascular inflammation are briefly discussed. And the epidemiological studies related to vibration studies in SSc and other rheumatic diseases are taken into account.

Coal workers' pneumoconiosis (CWP) is characterized as a chronic inflammation of the lung associated with activation of macrophages and endothelial cells in the lung. The aim of the present study was to compare the levels of serum interleukin-8 (IL-8), macrophage inflammatory protein-1α (MIP-α), and intercellular adhesion molecule-1 (ICAM-1) as biomarkers for progressive massive fibrosis (PMF) in 106 subjects (27 non-CWP and 79 CWP patients). The levels of serum IL-8 (P<0.001) and ICAM-1 (P=0.001) of subjects with PMF were higher than those of non-CWP subjects. The IL-8 levels of PMF subjects were also higher than those of simple CWP subjects (P=0.003). Among the subjects without PMF, IL-8 levels in the subjects with International Labour Organization (ILO) category II or III were higher than those in the subjects with ILO category 0 (P=0.006) and with category I (P=0.026). These results suggest that high serum levels of IL-8 and ICAM-1, which are important as neutrophil attractants and adhesion molecules, are associated with PMF.

The Erasmus syndrome describes the association of generalised systemic sclerosis following exposure to silica with or without silicosis. This is a case report on a male patient presenting with this syndrome. Radiological changes of silicosis have preceded the diagnosis of systemic sclerosis by 6 years and occupational exposure has been stopped. The clinical features did not differ from systemic sclerosis in general. The evolution was marked by a progression of skin lesions whereas pulmonary lesion remained stable., (2015 BMJ Publishing Group Ltd.)

Buccal epithelium cytograms were analyzed in workers of chrysotile-asbestos production "Kostanaiskiye mineraly" JSC. Findings are that 10-20 years of service are associated with increased number of 4th differentiation grade cells and correspondingly decreased number of 5th differentiation grade cells. Later, with 20 years of service, numbers of 4th and 5th grade epitheliocytes reach initial values. With 10-20 years of service, integral parameters of differentiation index, cornification index and intracellular relations decrease. Findings are that 10-20 years of service are connected with domination of proliferation over differentiation processes. Length of service over 20 years is with adaptive processess in the workers. These data are important in evaluation of mucosal system in variable length of occupational service.