The attitudes of occupational health personnel to smoking at work.

Attitudes of occupational health care professionals toward smoking and their activity to address smoking issues were investigated by a questionnaire survey. Data were also collected on employees' exposure to environmental tobacco smoke and on smoking policies that existed in workplaces. Questionnaires were mailed to all occupational health care centers (n = 1,004) in Finland. The prevalence of daily smokers was 9.6% among physicians and 3.6% among nurses; 15% and 11%, respectively smoked occasionally. Smoking restrictions were enforced in more than 70% of all workplaces, but only 3.6% of them had a total smoking ban. Nonsmoking professionals were in favor of smoke-fee workplaces and smoking restrictions significantly more often than their smoking colleagues. Nonsmokers also regarded smoking as a serious problem to the organizational climate of workplaces. Almost half of nonsmoking respondents, but only 11% of daily smokers, would totally ban smoking in workplaces. Although the personal smoking status of the respondent had a strong effect on attitudes to smoking regulations, it did not have a clear influence on interest in discussing smoking issues when seeing patients. Nurses were more active in addressing smoking issues than physicians. Occupational health professionals of large companies reported stricter smoking policies at work than those who represented small enterprises

Risk of nervous system cancer among workers exposed to lead.

Experimental animal studies suggest that lead compounds may increase the risk of gliomas. To study whether occupational exposure to lead increases the risk, we followed nervous system cancer incidence among 20,741 employees biologically monitored for their blood lead (B-Pb) concentrations. We also performed a nested case-referent study, comprising 26 male cases of nervous system cancer (16 of which had gliomas). Those cases a B-Pb > or = 1.4 mumol/L had a twofold increase in the odds ratio of nervous system cancer as compared with those employees whose B-Pb had not exceeded 0.7 mumol/L. The excess was confined to gliomas (odds ratio 11, 95% confidence interval 1.0 to 630 for B-Pb > or = 1.4 mumol/L; overall P value for trend, 0.037). We obtained lifetime information on exposure and potential confounders for 58% of the cases. The odds ratio of glioma was associated with indices of lifetime exposure to lead, and potential confounders seemed not to explain the effects. The results suggest that there may be an association between occupational lead exposure and the risk of gliomas. No firm conclusions can be drawn because of the small number of cases and loss of material.

Excess lung cancer among workers exposed to lead.

OBJECTIVE: Studies on experimental animals suggest that inorganic lead is a carcinogen. The purpose of the study was to examine whether occupational exposure to lead increases the risk of cancer. METHODS: The study population comprised 20,700 workers who had been biologically monitored for their blood lead (B-Pb) concentrations during 1973-1983. The mortality and cancer incidence rates were followed among the monitored workers and compared with those of the Finnish general population. An internal comparison of the cancer incidence rates was also done between subcohorts formed according to individual B-Pb levels. Questionnaire-based information was also collected on lifetime occupational history and potential confounders, and exposure history was assessed on an individual basis with a nested case-referent design for lung cancer. RESULTS: The internal comparison within the cohort showed a 1.4-fold increase in the overall cancer incidence and a 1.8-fold increase in the incidence of lung cancer among those who had ever had a blood lead level of > or = 1.0 mumol.l-1. In the case-referent study, an increased odds ratio for lung cancer was found for concomitant exposure to lead and engine exhaust. The odds ratio for squamous-cell carcinoma of the lung was increased even when the blood lead level had been slightly elevated. Bias or confounding did not explain the risks. CONCLUSIONS: The results suggest that exposure to lead increases the risk of lung cancer. Co-exposure to engine exhaust and lead may be associated with the risk.

Analysis of chromosomal aberrations, sister chromatid exchanges and micronuclei among power linesmen with long-term exposure to 50-Hz electromagnetic fields.

Chromosomal aberrations, sister chromatid exchanges (SCEs), replication indices and micronuclei in peripheral blood lymphocytes were analysed among 27 nonsmoking power linesmen with considerable long-term exposure to 50-Hz electromagnetic (EM) fields, and among 27 nonsmoking telephone linesmen serving as a reference group, pairwise matched with the exposed workers for age and geographical region. Blood samples from the two groups were collected, cultured and analysed in parallel. No differences between the groups were observed on analysis of SCEs, replication indices or micronuclei. However, the mean rate of lymphocytes with chromatid-type breaks was higher among the power linesmen (0.96% gaps excluded, 1.41% gaps included) than among the reference group (0.44% and 0.70%, respectively). The excess of aberrant cells was concentrated among those power linesmen who had worked earlier in their life. Although the interpretation is somewhat complicated by the confounding effect of previous smoking, these results suggest that exposure to 50-Hz EM fields is associated with a slight increase in chromatid breaks.

Infections and other illnesses of children in day-care centers in Helsinki. I: Incidences and effects of home and day-care center variables.

Illnesses among children attending municipal day-care centers (DCCs) were followed in a prospective study in Helsinki during 1985-1986. The study comprised 1,905 follow-up years among children in 29 DCCs. The mean number of illness periods was 4.9 per follow-up year, 7.9 for those under the age of three years and 3.8 for older children. The corresponding average numbers of days of illness were 23, 39 and 17. The most common diagnoses were upper respiratory tract infections (46.0%), diarrhea (17.2%), otitis media (12.9%), eye infections (4.0%), acute tonsillitis (3.2%), and bronchitis (3.0%). The six most common diagnoses, all infections, caused 86% of periods and 79% of days of illness. The ten most common infectious diseases caused 90.9% of absence periods, surgical operations 1.8%, and injuries 0.8%. In children under three years of age, a small area and volume of a DCC, lack of fully mechanized ventilation, and lack of separate facilities were associated with a higher incidence of one or all of the six most common infections. A large number of children at a DCC and small homes were associated with a high incidence of one or all of the most common infections among both younger and older children. The effects of passive smoking, number of siblings, number of household members, and incomes of families were not statistically significant.

Effect of thymectomy and immunosuppressive therapy on anti-neuroblastoma antibody levels in patients with myasthenia gravis.

Antibodies reacting with human neuroblastoma cells (NBL) are distinct from the "classical" anti-acetylcholine receptor (AChR) antibodies in myasthenia gravis (MG). The influence of therapeutic interventions on serum anti-NBL antibody levels was followed in 42 MG patients. Thymectomy alone was performed in 28 patients while immunosuppressive medication was given to 14 patients out of whom 10 also had a thymectomy. In most patients serum anti-NBL antibody titers declined after thymectomy and/or during immunosuppressive treatment, though individual variations in the antibody response could be observed. Sequential examinations of individual patients revealed an association between the clinical severity of MG and anti-NBL antibody levels. No correlation between the treatment-induced changes of anti-NBL and anti-acetylcholine receptor (AChR) antibody titers could be observed during the follow-up period in MG patients positive for both types of antibodies. These findings further emphasize the immunological complexity of MG. Anti-NBL antibodies represent a pathogenic marker of the disease and display a regulation different from that of the anti-AChR antibodies.

The desmoid tumor. I. Incidence, sex-, age- and anatomical distribution in the Finnish population.

We have (1) estimated the incidence of desmoid tumor (DT) in the Finnish population, and (2) defined statistically four major age components of the DT with different biological properties. The incidence of the DT, based on admissions to four separate hospitals and on the number of pathological biopsy specimens analyzed at the Central Pathological Laboratory of Helsinki University, is 2.4-4.3 new cases per 10(6) inhabitants per annum. Statistical analysis demonstrated four major age components where the site of the tumor and/or sex of the patient were non-randomly distributed: "juvenile" DT, a predominantly extra-abdominal desmoid tumor of the female sex; "fertile" DT, a nearly exclusively abdominal DT of fertile females; "menopausal" DT, a predominantly abdominal tumor where the sex ratio approaches one:one; and "senescent" DT, where abdominal and extra-abdominal varieties are equally frequently encountered and where the sex ratio of the affected patients is one:one.