[Monitoring methods and their results in environmental medicine - implications for medical counsellors]. / Monitoringverfahren in der Umweltmedizin und die ärztliche Befunderstellung.

Besides effect and environmental monitoring, human biomonitoring (HBM) offers an attractive method for analyzing the distribution and intensity of anthropogenic environmental pollutants in individuals or in particular groups of the population. However, no assessment values of comparable reliability are available to enable an interpretation of the results of environmental studies from the viewpoint of environmental health. This must be taken into account when reporting findings of such studies as well as in medical consultation, in order to avoid overdiagnosis and unnecessary anxiety for the participant. In medical practice, care should be taken when dealing with monitoring results outside the normal range! Environmental or biomonitoring results provide only a part of the available information alongside medical history and clinical examinations. In the case of tests performed for private interests as well as tests carried out within the framework of an epidemiological environmental survey, communication of results and findings can be problematic. In epidemiological studies, a close co-operation between the participant's consultant physician and physicians conducting the study is beneficial in order to ensure professional advisory counselling for subjects with results outside the normal range.

Isothiazolone emissions from building products.

Adding biocides to dispersion products is a well-known practice to control microbial deterioration. Isothiazolones are among the most commonly used preservatives, in particular a mixture of 2-methyl-2H-isothiazol-3-one (MIT) and 5-chloro-2-methyl-2H-isothiazol-3-one (CIT). In recent years, for health reasons, due to its strong sensitizing effect, CIT has been replaced by 1,2-benzisothiazol-3-one (BIT). Furthermore, numerous products are now available for interiors containing the fungicidal active substance 2-octyl-2H-isothiazol-3-one (OIT). So far nearly nothing is known of the emission behavior of BIT and OIT. An analytical method was developed for these two isothiazolones and interior products containing BIT respectively OIT have been investigated in an emission chamber and in test rooms. The chamber tests revealed maximum concentrations of 6.7 µg OIT/m3, 1.9 µg BIT/m3, and 187 µg MIT/m3. Concentrations obtained in the test rooms were at levels up to 1.4 µg OIT/m3 and 29 µg MIT/m3. A noticeable finding was the very slight subsidence of OIT and BIT levels over several weeks. While MIT outgassed quickly, OIT in particular showed low concentrations, but prolonged evaporation.

[Environment-related contact allergies]. / Umweltbedingte Kontaktallergien.

Contact allergies are frequent diseases and often lead to social and economic consequences for the patients. The incidence of the clinically manifest allergic contact eczema is between 1.8 and 7 per 1,000 per year, according to the data of the Information Network of Departments of Dermatology (IVDK; http://www.ivdk.org). Contact allergies are frequently acquired at the workplace, but a sensitisation and subsequent manifest disease (elicitation) occurs even more often in the private sphere and then poses a special problem. Even if occupational exposure to the allergen is prevented, e. g. by giving up the job, a full remission is only achieved in about half of the cases due to the ubiquitous existence of the responsible allergens. Contact with substances that have a high sensitisation potential can be avoided to a great extent. Prevention can be achieved by personal protective measures, a decrease of the applied concentration of the allergen, or even restrictions concerning certain chemicals. The prerequisite for this is continuous monitoring of the frequency of sensitizations towards known allergens, as well as an understanding of the substances in use in the environment, including newly introduced chemicals, and the education of the public.

[Use of fragrances. What about the side effects?]. / Anwendung von Duftstoffen. Was ist mit den Nebenwirkungen?

Fragrances are increasingly used in private and public domains. Over recent years the olfactory sense has been paid more and more scientific and economic attention. While on the one hand bad smells are counteracted by fragrances, marketing experts are now trying to introduce this sense into multimedia-based experiences. Technical means are used to address positively and directly the sense of smell. The aim is to make the smell a unique feature for a certain brand or location. When it comes to "style of living" or "special shopping experience" nowadays the olfactory design plays an important role. Although fragrances are applied very frequently, there is still a lack of knowledge about the potential consequences for health and the environment. Certain substances (musk compounds) have been proven persistent and accumulative, and others belong to the most common causes of contact eczema. Some people also report special sensitivities towards certain smells for unknown reasons. Unlike audiovisual attractions it is very difficult for humans to avoid olfactory stimuli. The question arises whether fragrance materials constitute a group of substances that should receive more attention concerning their risk for health and the environment.

Amoxicillin-induced exanthema in young adults with infectious mononucleosis: demonstration of drug-specific lymphocyte reactivity.

BACKGROUND: Teenagers and young adults frequently develop maculopapular exanthema following amoxicillin intake within infectious mononucleosis. The underlying pathomechanisms are still largely unknown. OBJECTIVES: To investigate whether amoxicillin-induced exanthema in florid infectious mononucleosis is a disease-associated phenomenon or results from specific sensitization to the drug. METHODS: Four patients with amoxicillin-induced exanthema within infectious mononucleosis were analysed in vivo by prick, intradermal and patch tests and in vitro by means of the lymphocyte transformation test (LTT) employing amoxicillin, ampicillin, benzylpenicillin and phenoxymethylpenicillin. RESULTS: Drug-specific sensitization to amoxicillin in the LTT was observed in three patients, two of whom showed a side-chain-specific sensitization to amoxicillin and ampicillin. The in vitro results were confirmed in vivo by skin tests. CONCLUSIONS: These data suggest that real sensitization to amoxicillin and ampicillin may occur within infectious mononucleosis and may be detected in vivo and in vitro by means of skin tests and the LTT.