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Objective. To quantify the exposure–response relationship between hand–arm vibration exposure and the risk of musculoskeletal disorders of the upper extremities (UMSDs), a case–control study was carried out among workers in the construction, mining, metal and woodworking industries. Methods. In total, 209 male cases and 614 controls were recruited. Cases were newly reported patients with UMSDs. Controls were a random sample of persons with compensable occupational injuries. Standardized personal interviews were performed among cases and controls by well-trained safety engineers. In addition to leisure activities and comorbidities, work histories of all participants were collected in detail. To quantify hand–arm vibration exposures, a database of vibration measurements of over 700 power tools was used. This database allows the detailed quantification of vibration exposures over time. A dose–response relationship between hand–arm vibration exposure and UMSDs was quantified by conditional logistic regression analyses. Results and conclusions. After adjusting for relevant confounders, statistically significant exposure–response relationships between cumulative hand–arm vibration exposure and UMSDs were established. A cumulative hand–arm vibration exposure of Dhv (vibration total value in three measuring directions) = 142,300 (95% confidence interval [CI] [90,600–333,200]) m2/s4·day or Dhw (vibration value in the direction along the forearm) = 38,700 (95% CI [25,400–80,900]) m2/s4·day is associated with a doubled risk of UMSDs. [ABSTRACT FROM AUTHOR]

In an epidemiological case-control study, exposure-response relationship between hand-arm vibration exposure and the risk of musculoskeletal disorders (MSDs) of the upper extremities were examined among 209 male cases and 614 controls in the German construction, mining, metal, and wood-working industries. To quantify individual vibration exposures, a database of industrial hygiene measurements of over 700 power tools was established. In addition, individual work histories were collected in detail. The dose-response relationships between hand-arm vibration exposure and the risk of MSDs were quantified based on multivariable logistic regression analysis. After adjusting for relevant confounders, statistically significant dose-response relationships between cumulative hand-arm vibration exposure doses and MSDs of the upper extremities could be established. [ABSTRACT FROM AUTHOR]

In order to analyse the exposure-response relationship between hand--arm-vibration exposure and the risk of musculoskeletal disorders (MSDs) of upper extremities in an epidemiological case-control study, a database was established to provide technical characteristics such as vibration exposure data and its frequency component measured at workplaces. This hand-arm vibration database consists of over 730 technical tools and devices, whereas 422 devices were used for exposure assessment in the epidemiological case-control study. The devices used were divided into a total of 13 device groups: hammers, grinding machines, compactors, screwdrivers and saws were the most frequently used devices. [ABSTRACT FROM AUTHOR]

Abstract Background Excessive wound healing, with scarring of the episcleral tissue or encapsulation of the filtering bleb is the main reason for failure in trabeculectomy. Ranibizumab, an inhibitor of the Vascular Endothelial Growth Factor (VEGF), is seen as a promising candidate to prevent or treat extensive wound healing. We describe the design of a two phased study, i) assessing the local tolerability and safety of topical ranibizumab and ii) assessing the efficacy of topical ranibizumab against placebo in patients who underwent trabeculectomy with mitomycin C combined with phacoemulsification and intra ocular lens (IOL) implantation. Methods/Design In the first phase five patients that had trabeculectomy with mitomycin C combined with phacoemulsification and IOL implantation will be treated with topical ranibizumab (Lucentis®) eye drops (2 mg/ml) four times daily for one month. The treatment will be started at the first postoperative day. Patients will be assessed for local and systemic side effects using a standardised schedule. In the second phase, after successful completion of phase 1, consenting eligible patients who underwent trabeculectomy with mitomycin C combined with phacoemulsification and IOL implantation will be randomised to either receive topical ranibizumab eye drops (2 mg/ml) four times daily for 1 month or placebo (BSS 4x/d for 1 month). Patients will be reviewed weekly for 4 weeks until conjunctival sutures are removed. Further follow up examinations are planned after 3 and six months. Assessment of differences in the intraocular eye pressure will be considered primary, and bleb appearance/vascularisation using a standardized photography and the Moorfields bleb grading system, postoperative intraocular pressure and conjunctival wound healing problems will be considered secondary outcome parameters. Discussion Anti-VEGF-antibodies might be more effective in preventing scaring and might have fewer toxic side effects than the currently used anti-metabolites and may replace them in the long term. Trial Registration ISRCTN: ISRCTN12125882

Background: Human exposure to silica dust is very common in both working and living environments. However, the potential long-term health effects have not been well established across different exposure situations. Methods and Findings: We studied 74,040 workers who worked at 29 metal mines and pottery factories in China for 1 y or more between January 1,1960, and December 31, 1974, with follow-up until December 31, 2003 (median follow-up of 33 y). We estimated the cumulative silica dust exposure (CDE) for each worker by linking work history to a job-exposure matrix. We calculated standardized mortality ratios for underlying causes of death based on Chinese national mortality rates. Hazard ratios (HRs) for selected causes of death associated with CDE were estimated using the Cox proportional hazards model. The population attributable risks were estimated based on the prevalence of workers with silica dust exposure and HRs. The number of deaths attributable to silica dust exposure among Chinese workers was then calculated using the population attributable risk and the national mortality rate. We observed 19,516 deaths during 2,306,428 person-years of follow-up. Mortality from all causes was higher among workers exposed to silica dust than among non-exposed workers (993 versus 551 per 100,000 person-years). We observed significant positive exposure-response relationships between CDE (measured in milligrams/cubic meter-years, i.e., the sum of silica dust concentrations multiplied by the years of silica exposure) and mortality from all causes (HR 1.026, 95% confidence interval 1.023-1.029), respiratory diseases (1.069, 1.0641.074), respiratory tuberculosis (1.065, 1.059-1.071), and cardiovascular disease (1.031, 1.025-1.036). Significantly elevated standardized mortality ratios were observed for all causes (1.06, 95% confidence interval 1.01-1.11), ischemic heart disease (1.65, 1.35-1.99), and pneumoconiosis (11.01, 7.67-14.95) among workers exposed to respirable silica concentrations equal to or lower than 0.1 mg/[m.sup.3]. After adjustment for potential confounders, including smoking, silica dust exposure accounted for 15.2% of all deaths in this study. We estimated that 4.2% of deaths (231,104 cases) among Chinese workers were attributable to silica dust exposure. The limitations of this study included a lack of data on dietary patterns and leisure time physical activity, possible underestimation of silica dust exposure for individuals who worked at the mines/factories before 1950, and a small number of deaths (4.3%) where the cause of death was based on oral reports from relatives. Conclusions: Long-term silica dust exposure was associated with substantially increased mortality among Chinese workers. The increased risk was observed not only for deaths due to respiratory diseases and lung cancer, but also for deaths due to cardiovascular disease. Please see later in the article for the Editors' Summary., Introduction Crystalline silica is one of the most ubiquitous minerals on earth, with widespread exposure in working and living environments. Multiple serious diseases and increased mortality have been associated with [...]