Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in serum samples of workers at intermittently burning municipal waste incinerators in Japan.

OBJECTIVES: To find whether or not incinerator workers employed at intermittently burning municipal incineration plants are exposed to high concentrations of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). METHODS: 20 Workers employed at three municipal waste incineration plants (incinerator workers) and 20 controls were studied. The previous job, dietary, smoking, and body weight and height were obtained from a questionnaire survey. Concentrations of PCDDs and PCDFs were measured in serum samples of the workers and the deposited dust of the plants. The influence of occupational exposure on concentrations of PCDDs and PCDFs in serum samples was examined by multiple regression analysis. RESULTS: Dust analysis showed that dominant constituents were octachlorodibenzo-p-dioxin (OCDD) and 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (HpCDD) among the PCDDs, and 1,2,3,4,6,7,8-heptachlorodibenzofuran (HpCDF) and octachlorodibenzofuran (OCDF) among the PCDFs. The toxicity equivalents (TEQs) of summed PCDDs and PCDFs in the deposited dust were 0.91, 33, and 11 ng TEQ/g, respectively, for plants I, II, and III. The means of TEQ in serum samples of summed PCDDs and PCDFs in the incinerator workers and controls were 22.8 and 16.4 pg TEQ/g lipid for area I, 29.4 and 19.3 pg TEQ/g lipid for area II, and 22.8 and 24.9 pg TEQ/g lipid for area III, which were almost the same as for the general population of Japan. No significant differences in the TEQ of PCDDs and TEQ of PCDDs and PCDDs were found between the incinerator workers and the controls. However, the TEQ of PCDFs was significantly higher among the incinerator workers in areas I and II, and the 1,2,3,4,6,7,8-HpCDF concentration was also significantly higher for all three areas. When the occupational exposure index for each constituent of PCDDs and PCDFs was defined as the product of the duration of employment at the incineration plant and the concentration of the constituent in the deposited dust, multiple regression analysis showed that the concentrations of HxCDF, HpCDF, and TEQ of PCDFs in serum samples increased with the occupational exposure index. The multiple regression analysis also suggested that significant factors affecting the concentrations in serum samples were area for HxCDD, age for TCDD, PeCDD, PeCDF, TEQ of PCDDs, TEQ of PCDFs, and TEQ of summed PCDDs and PCDFs, and BMI for HxCDD, HpCDD, and OCDD. CONCLUSION: This study showed that incinerator workers employed at intermittently burning incineration plants were not necessarily exposed to high concentrations of PCDDs and PCDFs. However, the increases in the concentrations in serum of HxCDF, HpCDF and TEQ of PCDFs with the occupational exposure index suggest that the incinerator workers had inhaled dust containing PCDDs and PCDFs during their work.

Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in the serum samples of workers at continuously burning municipal waste incinerators in Japan.

OBJECTIVES: To find whether concentrations of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in serum increased in workers at municipal incinerators that burn continuously. METHODS: 30 Workers employed at three municipal waste incineration plants (incinerator workers) and 30 control workers were studied. The incinerator workers had worn dust masks or airline masks during the periodic repair work inside the incinerators. Previous job, dietary habit, smoking habit, distance from residence to the incineration plant, and body weight and height were obtained from a questionnaire survey. Concentrations of PCDDs/PCDFs were measured in the serum of the workers and the dust deposited in the plants. The influence of various factors on serum concentrations of PCDDs/PCDFs was examined by multiple regression analysis. RESULTS: Dust analysis showed the greatest amount of octachlorodibenzo-p-dioxin (OCDD), followed by 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (HpCDD), 1,2,3,4,6,7,8-heptachlorodibenzofuran (HpCDF), and octachlorodibenzofuran (OCDF). The toxicity equivalents (TEQs) of PCDDs and PCDFs in the deposited dust were 4.8, 1.0, and 6.4 ng TEQs/g, respectively, for plants A, B, and C. The mean serum TEQs of PCDDs and PCDFs in the incinerator workers and control workers were 19.2 and 22.9 pg TEQs/g lipid, respectively, for area A, 28.8 and 24.5 pg TEQs/g lipid for area B, and 23.4 and 23.6 pg TEQs/g lipid for area C. No significant differences were found between the incinerator workers and the controls for TEQs of PCDDs and PCDFs separately, and TEQs of PCDDs and PCDFs together. However, the serum 1,2,3,4,6,7,8-HpCDF concentration was significantly higher in the incinerator workers than in the controls for all the three areas. When the exposure index to 1,2,3,4,6,7,8-HpCDF is defined as the product of the concentration of 1,2,3,4,6,7,8-HpCDF in the deposited dust and duration of employment, the concentration of 1,2,3,4,6,7,8-HpCDF in serum increased as the exposure index increased. Multivariate analysis suggested that the serum concentration of HpCDF increased with duration of employment at the incineration plants and OCDF increased with employment of > or = 21 years. The other significant variables (p < 0.01 or p < 0.001) were area for hexachlorodibenzo-p-dioxin (HxCDD) and tetrachlorodibenzofuran (TCDF), Brinkman index for HpCDD, and body mass index (BMI) for tetrachlorodibenzo-p-dioxin (TCDD), HpCDD, and TEQs of PCDDs. CONCLUSION: The serum TEQs of PCDDs and PCDFs was not significantly higher among the incinerator workers, but the serum concentration of 1,2,3,4,6,7,8-HpCDF was. This suggests that the incinerator workers had inhaled dust containing PCDDs and PCDFs while working in plants equipped with incinerators that burn continuously.

[A Japanese language version of the health-promoting lifestyle profile].

The development and initial psychometric evaluation of a Japanese version of the Health-Promoting Lifestyle Profile II (HPLP II) is described. The 52-item instrument was translated into Japanese and was found to be culturally relevant and reliable in a pilot study. The Japanese version was then administered to adiverse but predominantly Japanese group of 337 subjects residing in northern Japan. The Japanese version of the HPLP II was evaluated using factor analysis and reliability measurement. Six factors similar to those isolated previously during psychometric assessment of the English language version were extracted. Those six dimensions comprise the HPLP II subscales of: 1. Health responsibility, 2. Spiritual growth, 3. Physical activity, 4. Interpersonal relations, 5. Nutrition, and 6. Stress management. The alpha reliability coefficient for the total scale was 0.94 and the 2-week retest reliability was 0.91; the alpha coefficients for the subscales ranged from 0.70 to 0.87. The Japanese language version of the HPLP II appears to have sufficient validity and reliability for use by researchers who wish to describe the health-promoting components of lifestyle among the Japanese population and to explore differences and similarities in the health-promoting lifestyle of Japanese and American subjects or those of other ethnic groups. Further evaluations of measurement with different populations appears warranted. This instrument will enable researchers to investigate patterns and determinants of health-promoting lifestyle, as well as the effects of interventions to alter the lifestyle.

[An epidemiological study on low back pain and occupational risk factors among clinical nurses].

Recently medical services and nursing system are being reformed due to high medical costs and shortage of clinical nurses. The shortage of clinical nurses influences not only their working conditions but also their own health problems. In European countries and the United States, low back pain (LBP) has been reported to be one of the most common and costly health problems among clinical nurses. To estimate the occupational risk factors of LBP among nurses, a questionnaire survey of LBP and occupational risk factors was carried out in 1987 on 947 clinical nurses and as well as on 300 female clerical workers of three local governments. First, to examine the prevalence and the magnitude of the problem, we analyzed several kinds of prevalence rates of LBP and its characteristics among nurses and clerical workers. Second, a case-control study was conducted to investigate the relationship between LBP and occupational risk factors. In analyzing occupational risk factors of LBP, odds ratios, age adjusted odds ratios and 95% confidence intervals were computed. Finally, to estimate simultaneously the effect of multiple risk factors of LBP and to confirm univariate age adjusted odds ratio analyses, several multivariate analyses were performed. Point, period (a month), and lifetime prevalence rates of LBP and prevalence rate of severe LBP among clinical nurses were significantly higher than those of clerical workers (p less than 0.05-0.001, respectively). Demographic and occupational items, such as being an assistant nurse (as opposed to a registered nurse), and working in certain departments (internal medicine, orthopedic surgery, neurosurgery, psychiatry, tuberculosis ward) showed significantly higher odds ratios for LBP (p less than 0.05-0.001, for all). Many items pertaining to working conditions connected with shift work, hospitalized conditions of patients, taking breaks and holidays, working postures, weight of patients and equipment lifting and moving, working environments and so on had significantly elevated age adjusted odds ratios (p less than 0.05-0.001, for all). Intensity of work loads estimated subjectively such as 'caring for patients who are in bed', 'supporting patients when transporting and bathing them', 'preparing drugs and injections, and treating', 'observing and monitoring patients' conditions', 'instructing and explaining procedure to patients and their family' and so on also had significantly elevated age adjusted odds ratios (p less than 0.05-0.001, for all). Moreover, many items on the problems connected with working life and interpersonal relationships showed significantly higher age adjusted odds ratios (p less than 0.05-0.001). In multivariate analyses, independent variables which made a significant contribution to the model were similar to the items which had significantly elevated age adjusted odds ratios.(ABSTRACT TRUNCATED AT 400 WORDS)

[Midluteal progesterone/estradiol ratio as an indicator of pregnancy potential].

In an effort to determine the reliability of the midluteal progesterone(P)/estradiol(E2) ratio as an index of the potential for conception, we measured the midluteal P and E2 levels in 76 infertile women who had been treated at our infertility clinic. This parameter in conception cycles was compared with that in non-conception cycles. Eighty cycles of the 76 women were classified into two groups, depending upon whether pregnancy occurred or not. Group 1 and group 2 were composed of 31 conception cycles and 49 drug-induced cycles, respectively. Midluteal concentrations of P and E2 did not show any significant differences between the two groups. The P/E2 ratios were 106.4 +/- 71.3 (mean +/- SD) and 71.5 +/- 44.16, respectively. This difference was statistically significant (p less than 0.05). Discriminant function analysis showed that the smallest probability of misclassification between the two groups decreased from 44% when using P only to 36% when using the combined P and E2. The following equation: Y = 0.0727X1 - 0.00456X2 - 0.130 was obtained (when X1 = P, X2 = E2). These results suggest that the midluteal P/E2 ratio gives clinicians the best indication of luteal function for the achievement of pregnancy.

[Effects of ethyl alcohol ingestion on the disturbance of porphyrin metabolism by lead].

A study was made on the possibility of synergistic effects of ethyl alcohol and lead on porphyrin metabolism in rabbits. Experimental rabbits were divided into 4 groups. Group A was the control group not given any treatment, and the other 3 groups (Groups B, C and D) were treated with ethyl alcohol, lead, and ethyl alcohol and lead respectively, for 2 months. Ethyl alcohol solution (5%) was administered to rabbits in Groups B and D as drinking water on every weekday. The average dose of alcohol was 6 ml/kg/day (18 ml/cap/day). Lead was injected intravenously to rabbits in Groups C and D at a dose of 0.5 mg Pb/kg on alternate days (3 times per week). Furthermore, a large dose of Pb was administered to other rabbits (Group C'). In rabbits treated with alcohol alone (Group B), no effect was observed in the biochemical indicators related to porphyrin metabolism. In the groups treated with lead (Groups C and C') and with lead and alcohol combined (Group D), some biochemical changes in porphyrin metabolism developed with increase of Pb-B, i.e. increase of ALA-S activity and total porphyrin content in the bone marrow, elevation of FEP level, increase of ALA-U and CP-U, and decrease of ALA-D activity in erythrocytes. Comparison of Groups C and D showed that CP-U and ALA-U increased significantly in Group D, but no significant difference was observed between both groups in FEP and in ALA-S activity in the bone marrow and liver. The other laboratory measurements, such as total porphyrin contents in the liver and plasma, and GOT or GPT level in serum, showed no significant change in all the groups. In the present study, the biochemical changes suggesting synergism of lead and ethyl alcohol were observed slightly in ALA-U and CP-U but not in ALA-S and FEP. These results suggest that these changes are essentially due to lead rather than mutual enhancement of the direct effects of these two toxins on porphyrin metabolism. However, it still remains to be determined whether or not ethyl alcohol affects the liver and kidney functions which may be related to ALA and CP excretion.