Association of the role of personal variables and nonoccupational risk factors for work-related carpal tunnel syndrome.

OBJECTIVES: The purpose of this study was to identify personal variables and nonoccupational risk factors for carpal tunnel syndrome and to analyse the strength of association of these factors. METHODS: We performed a case-control study with 162 cases and 300 controls. We studied consecutive patients with an electrophysiologically confirmed diagnosis of symptomatic carpal tunnel syndrome. Univariate analysis was performed in the case group and control comparing them for presence of various risk factors. Multivariate analysis was carried out through logistic regression. RESULTS: The mean BMI and age were greater in the case group than in the control. Multivariate analysis showed that BMI (OR = 1.05, 95% CI = 1.01-1.11) and arterial hypertension (OR = 4.63, 95% CI = 2.88-7.44) were the only factors significantly associated with carpal tunnel syndrome. The age, cigarette smoking and alcohol drinking were at the edge of significance. CONCLUSIONS: Carpal tunnel syndrome is the most common peripheral neuropathy and has been related to occupational activities in some but not all studies. Clarifying this relationship has important implications for workers' compensation systems. Based on our findings, BMI and arterial hypertension are considered to be the most significant risk factors of carpal tunnel syndrome in our study.

SNPs rs11240569, rs708727, and rs823156 in SLC41A1 Do Not Discriminate Between Slovak Patients with Idiopathic Parkinson's Disease and Healthy Controls: Statistics and Machine-Learning Evidence.

Gene SLC41A1 (A1) is localized within Parkinson's disease-(PD)-susceptibility locus PARK16 and encodes for the Na+/Mg2+-exchanger. The association of several A1 SNPs with PD has been studied. Two, rs11240569 and rs823156, have been associated with reduced PD-susceptibility primarily in Asian populations. Here, we examined the association of rs11240569, rs708727, and rs823156 with PD in the Slovak population and their power to discriminate between PD patients and healthy controls. The study included 150 PD patients and 120 controls. Genotyping was performed with the TaqMan® approach. Data were analyzed by conventional statistics and Random Forest machine-learning (ML) algorithm. Individually, none of the three SNPs is associated with an altered risk for PD-onset in Slovaks. However, a combination of genotypes of SNP-triplet GG(rs11240569)/AG(rs708727)/AA(rs823156) is significantly (p < 0.05) more frequent in the PD (13.3%) than in the control (5%) cohort. ML identified the power of the tested SNPs in isolation or of their singlets (joined), duplets and triplets to discriminate between PD-patients and healthy controls as zero. Our data further substantiate differences between diverse populations regarding the association of A1 polymorphisms with PD-susceptibility. Lack of power of the tested SNPs to discriminate between PD and healthy cases render their clinical/diagnostic relevance in the Slovak population negligible.

Interactions of DNA repair gene variants modulate chromosomal aberrations in healthy subjects.

Human cancers are often associated with numerical and structural chromosomal instability. Structural chromosomal aberrations (CAs) in peripheral blood lymphocytes (PBL) arise as consequences of direct DNA damage or due to replication on a damaged DNA template. In both cases, DNA repair is critical and inter-individual differences in its capacity are probably due to corresponding genetic variations. We investigated functional variants in DNA repair genes (base and nucleotide excision repair, double-strand break repair) in relation to CAs, chromatid-type aberrations (CTAs) and chromosome-type aberrations (CSAs) in healthy individuals. Chromosomal damage was determined by conventional cytogenetic analysis. The genotyping was performed by both restriction fragment length polymorphism and TaqMan allelic discrimination assays. Multivariate logistic regression was applied for testing individual factors on CAs, CTAs and CSAs. Pair-wise genotype interactions of 11 genes were constructed for all possible pairs of single-nucleotide polymorphisms. Analysed individually, we observed significantly lower CTA frequencies in association with XPD Lys751Gln homozygous variant genotype [odds ratio (OR) 0.64, 95% confidence interval (CI) 0.48-0.85, P = 0.004; n = 1777]. A significant association of heterozygous variant genotype in RAD54L with increased CSA frequency (OR 1.96, 95% CI 1.01-4.02, P = 0.03) was determined in 282 subjects with available genotype. By addressing gene-gene interactions, we discovered 14 interactions significantly modulating CAs, 9 CTAs and 12 CSAs frequencies. Highly significant interactions included always pairs from two different pathways. Although individual variants in genes encoding DNA repair proteins modulate CAs only modestly, several gene-gene interactions in DNA repair genes evinced either enhanced or decreased CA frequencies suggesting that CAs accumulation requires complex interplay between different DNA repair pathways.

Occupational viral hepatitis in the Slovak and the Czech Republic.

BACKGROUND: The proportion of occupational infectious diseases (ID) in the total number of occupational diseases reported in the Slovak Republic (SR) and the Czech Republic (CR) was decreasing from 1973 to 2010. Our study presents a longitudinal analysis of the occurrence of occupational infectious diseases in the Slovak Republic and the Czech Republic in the period from 1973-2010 with special focus on viral hepatitis. METHODS: The sources of data were national health statistics of Czechoslovakia, the Czech Republic and the Slovak Republic. Descriptive statistical methods were used for data analysis. Incidence rate of reported diseases was calculated per 100,000 general population or per 100,000 people insured. RESULTS: During the studied period, a total of 2,931 and 8,318 cases of occupational viral hepatitis (VH) were reported in the Slovak Republic and the Czech Republic, respectively. The incidence culminated in the late 1970s when hepatitis represented almost 50% of all reported occupational infectious diseases. Most cases of occupational hepatitis occurred in health and social services. Since the early 1980s, a steep decrease in the incidence of hepatitis has been observed due to the gradual implementation of mandatory vaccination against hepatitis A and B in risk groups. In SR in 1973, the incidence rate of occupational infectious diseases and that of occupational viral hepatitis was 10.85/100,000 and 1.86/100,000, respectively. In 2010, these rates decreased to 0.74/100,000 and 0.20/100,000, respectively. In CR, the incidence rates of occupational infectious diseases and that of occupational viral hepatitis reported in 1973 were 11.75/100,000 and 3.69/100,000. In 2010, reported incidence rates were 1.71/100,000 and 0.10/100,000, respectively. CONCLUSION: Although the incidence of occupational viral hepatitis has dramatically decreased in the Slovak and the Czech Republic as well as in other Visegrad group countries during the studied period, we emphasize the necessity of continuing epidemiological surveillance of hepatitis, especially with regard to the recent incidence increase of viral hepatitis C.

Validation of the Slovakian Version of the "Post­acute (Long) COVID­19 Quality of Life Instrument" and Pilot Study.

Purpose: The aim of our study was to validate a Slovakian translation of the PAC­19QoL instrument among Slovakian patients with post COVID-19 syndrome. Patients and Methods: The PAC-19QoL instrument was translated into the Slovakian language and administrated to patients with post COVID-19 syndrome. Cronbach's alpha coefficient was used to analyse the internal consistency of the instrument. Construction validity was evaluated by using Pearson's correlation coefficient and Spearman's rank correlation. Scores of patients and controls were compared using Mann-Whitney U-test. Results: Forty-five asymptomatic and forty-one symptomatic participants were included. Forty-one patients with post COVID-19 syndrome completed the PAC-19QoL and EQ-5D-5L questionnaires. PAC-19QoL domain scores were significantly different between symptomatic and asymptomatic participants. All items achieved a Cronbach alpha greater than 0.7. There was a significant correlation between all domains on the test (p < 0.001), with the highest correlation of Total (r = 0.994) and Domain 1 (r = 0.991). Spearman's rank correlation analysis confirmed that the instrument items correlated with the objective PAC-19QoL examination findings. Conclusion: The Slovakian version of the instrument is valid, reliable and can be a suitable tool for research and daily clinical practice among patients with post COVID-19 syndrome.

Chromosomal aberrations in tire plant workers and interaction with polymorphisms of biotransformation and DNA repair genes.

We evaluated chromosomal aberrations in lymphocytes of 177 workers exposed to xenobiotics in a tire plant and in 172 controls, in relation to their genetic background. Nine polymorphisms in genes encoding biotransformation enzymes and nine polymorphisms in genes involved in main DNA repair pathways were investigated for possible modulation of chromosomal damage. Chromosomal aberration frequencies were the highest among exposed smokers and the lowest in non-smoking unexposed individuals (2.5+/-1.8% vs. 1.7+/-1.2%, respectively). The differences between groups (ANOVA) were borderline significant (F=2.6, P=0.055). Chromosomal aberrations were higher in subjects with GSTT1-null (2.4+/-1.7%) than in those with GSTT1-plus genotype (1.8+/-1.4%; F=7.2, P=0.008). Considering individual groups, this association was significant in smoking exposed workers (F=4.4, P=0.040). Individuals with low activity EPHX1 genotype exhibited significantly higher chromosomal aberrations (2.3+/-1.6%) in comparison with those bearing medium (1.7+/-1.2%) and high activity genotype (1.5+/-1.2%; F=4.7, P=0.010). Both chromatid- and chromosome-type aberration frequencies were mainly affected by exposure and smoking status. Binary logistic regression analysis revealed that frequencies of chromatid-type aberrations were modulated by NBS1 Glu185Gln (OR 4.26, 95%CI 1.38-13.14, P=0.012), and to a moderate extent, by XPD Lys751Gln (OR 0.16, 95%CI 0.02-1.25, P=0.081) polymorphisms. Chromosome-type aberrations were lowest in individuals bearing the EPHX1 genotype conferring the high activity (OR 0.38, 95%CI 0.15-0.98, P=0.045). Present results show that exposed individuals in the tire production, who smoke, exhibit higher chromosomal aberrations frequencies, and the extent of chromosomal damage may additionally be modified by relevant polymorphisms.

Chromosomal damage among medical staff occupationally exposed to volatile anesthetics, antineoplastic drugs, and formaldehyde.

OBJECTIVES: Structural chromosomal aberrations in blood lymphocytes represent a biomarker for cellular damage caused by genotoxic carcinogens and are an indicator of increased cancer risk. We evaluated the association between frequencies of total chromosomal aberrations, chromatid- and chromosome-type aberrations, and occupational exposures to volatile anesthetics, antineoplastic agents, and formaldehyde among 601 medical professionals. METHODS: Chromosomal damage among exposed individuals and unexposed controls was determined by conventional cytogenetic analysis. We used binary logistic regression to evaluate the effects of workplace exposures and major confounders on chromosomal damage. RESULTS: Significantly higher frequencies of total chromosomal, chromatid-type and chromosome-type aberrations were observed among subjects occupationally exposed to volatile anesthetics, antineoplastic agents, and formaldehyde compared to age- and sex-matched controls (P<0.0001). The risk of an increased frequency of chromosomal aberrations was associated with exposure to anesthetics [odds ratio (OR) 3.9, 95% confidence interval (95% CI) 2.7-5.8], cytostatics (OR 2.7, 95% CI 1.9-3.9), and formaldehyde (OR 1.7, 95% CI 1.1-2.7). No other covariate contributed significantly to the model. Chromatid- and chromosome-type aberrations were associated with exposure to anesthetics and cytostatics without any contribution of other variables. Stratified data analysis showed the risk of increased chromosomal aberrations among non-smoking female nurses and physicians exposed to anesthetics, cytostatics and, partially, formaldehyde. Chromatid and chromosome exchanges were significantly higher in the exposed groups than among controls. CONCLUSION: Our findings indicate that the presence of genotoxic compounds in operating rooms, oncological units, and pathological departments results in a significant increase of chromosomal damage (impair of chromosomal integrity) among medical workers employed in these facilities.

Effect of occupational exposure to cytostatics and nucleotide excision repair polymorphism on chromosomal aberrations frequency.

Authors evaluated the incidence of total chromosomal aberrations (CA) and their types - chromatid-type (CTA) and chromosome-type (CSA) in peripheral blood lymphocytes from 72 oncologic unit's workers occupationally exposed to cytostatics in relationship to polymorphisms of DNA repair genes XPD, XPG and XPC. The cytogenetic analysis was used for determination of chromosomal aberrations frequency and PCR-RFLP method for polymorphisms of genes. Statistically higher frequency of total CA was detected in exposed group as compared to control (1.90±1.34% vs. 1.26±0.93%; Mann-Whitney U-test, p=0.001). There was not detected any difference between CTA and CSA (0.92±1.04% vs. 0.98±1.17%). Similarly, in genes XPD exon 23 and XPC exon 15 wasn't detected any difference neither in total chromosomal aberrations nor in CTA and CSA types. Statistically significant decrease of total chromosomal aberrations and CTA-type with presence of variant allele C was detected in gene XPG exon 15. Authors pointed out the importance of individual susceptibility factors in evaluation of effects of genotoxic agents, in that event, when the concentration does not meet the occupational exposure limit.

Comparison of chromosomal aberrations frequency and polymorphism of GSTs genes in workers occupationally exposed to cytostatics or anaesthetics.

Authors compared the incidence of chromosomal aberrations (CAs) of workers occupationally exposed to cytostatics (group EXP1) or anaesthetics (group EXP2) in relationship to polymorphism of GSTM1, GSTP1 and GSTT1 genes. The cytogenetic analysis for chromosomal aberrations frequency and for polymorphisms of genes the PCR and PCR-RFLP method were used. Statistically higher frequency of total CAs was detected in both exposed groups: group EXP1 1.90±1.34%; Mann-Whitney U-test, p=0.001; group EXP2 2.53±1.46%, p=0.0008) as compared to control (1.26±0.93%). In group EXP2 was detected statistically higher frequency of aberrations CSA-type as compared to CTA-type. In xenobiotic metabolizing genes for GST higher frequency of total CAs and constituent types chromatid-type aberrations (CTAs) and chromosome-type aberrations (CSAs) of genes GSTM1 and GSTT1 with null genotype was detected. Statistically significant difference was detected only in CSA-type of aberrations in GSTT1 gene. In gene GSTP1 was not detected any difference in frequency of aberrations in presence of the variant allele. Presented results point out importance of individual susceptibility in evaluation of genotoxic agents of anaesthetics or cytostatics.

Skeletal fluorosis from the point of view of an occupational exposure to fluorides in former Czechoslovakia.

Electrolytic production of aluminium in former Czechoslovakia started in the year 1953 in the Ziar valley in the central Slovakia. However, till 1995 the hygienic conditions for health protection were not met in the factory. It underwent a reconstruction afterwards.The authors demonstrate cases of occupational skeletal fluorosis (currently rare in Europe) in 14 metallurgists which were all disclosed in foundry workers in Ziar nad Hronom as to the year 2005. The occupational disease was diagnosed after 17.7 ± 7.67 years (x±SD) of exposure in the foundry.The authors describe the clinical conditions, haematological and biochemical tests (decreased level of ionising calcium was found in serum). The content of fluorides in urine was increased (254.4±130.95 µmol/l). The average age of patients at the time of recognition of the professional etiology of the disease was 57.93±7.95 years. Eight patients were older than 60 years. Skeletal abnormalities were evaluated by using X-ray skiagraphy, estimating the Stage I-III of the skeletal fluorosis. Typically an increase of bone density was found, the compact part of long bones was coarsed, there were calcifications of the interosseous membrane between radius and ulna and some ossifications of the sacrospinal and sacrotuberous ligaments. Twelve patients suffered sensorimotor polyneuropathy of extremities, chronic bronchitis was found in 6 patients (two of them were smokers).The last occupational case was registered in the year 2001. The authors assume that aluminium production with modern technology of better safety and protection of health of workers is the key which will make the skeletal fluorosis the history in the Czech and Slovak Republic.