Observational study on occupational exposure of dairy farmers to formaldehyde.

OBJECTIVES: To provide insights into exposure of Dutch dairy farmers to formaldehyde derived from formalin footbaths used for cows. Dutch safety norms are set at a limit of 0.122 ppm during an 8-hour time-weighted average (TWA) and 0.407 ppm for a 15-min TWA. METHODS: At 20 farms formaldehyde air concentrations were determined using stationary active air sampling with impingers next to the footbath and in the milking parlour during footbath usage. Formalin footbath concentrations were tested and meteorological conditions were collected using a climate monitor to assess associations with formaldehyde concentrations. A structured interview inquired on potential exposure routes and exposure duration. RESULTS: Formaldehyde concentrations next to the footbath ranged from <0.003 to 0.316 ppm, with seven measurements exceeding the 8-hour TWA threshold. None of the measurements exceeded the 15-min TWA threshold at either location. Formaldehyde air concentrations in the milking parlour were generally lower, yet at two farms exceeded the 8-hour TWA limit during sampling. Self-reported exposure time of the dairy farmers to the formalin footbath never exceeded 15 min. Although due to the small sample size, no significant associations between most predictor variables and formaldehyde levels in the air were found, the direction of effects were as expected. CONCLUSIONS: The exposure of Dutch dairy farmers presumably falls within the established safety norms. Nonetheless, substantial levels of formaldehyde could be detected. This study further emphasises the importance of substitution of formalin in dairy practice and the relevance of informing dairy farmers on proper handling of formalin to reduce exposure.

Broad-spectrum infrared thermography for detection of M2 digital dermatitis lesions on hind feet of standing dairy cattle.

Low-effort, reliable diagnostics of digital dermatitis (DD) are needed, especially for lesions warranting treatment, regardless of milking system or hygienic condition of the feet. The primary aim of this study was to test the association of infrared thermography (IRT) from unwashed hind feet with painful M2 lesions under farm conditions, with lesion detection as ultimate goal. Secondary objectives were to determine the association between IRT from washed feet and M2 lesions, and between IRT from unwashed and washed feet and the presence of any DD lesion. A total of 641 hind feet were given an M-score and IRT images of the plantar pastern were captured. Multivariable logistic regression analyses were done with DD status as dependent variable and maximum infrared temperature (IRTmax), lower leg cleanliness score and locomotion score as independent variables, and farm as fixed effect. To further our understanding of IRTmax within DD status, we divided IRTmax into two groups over the median value of IRTmax in the datasets of unwashed and washed feet, respectively, and repeated the multivariable logistic regression analyses. Higher IRTmax from unwashed hind feet were associated with M2 lesions or DD lesions, in comparison with feet without an M2 lesion or without DD, adjusted odds ratio 1.6 (95% CI 1.2-2.2) and 1.1 (95% CI 1.1-1.2), respectively. Washing of the feet resulted in similar associations. Dichotomization of IRTmax substantially enlarged the 95% CI for the association with feet with M2 lesions indicating that the association becomes less reliable. This makes it unlikely that IRTmax alone can be used for automated detection of feet with an M2 lesion. However, IRTmax can have a role in identifying feet at-risk for compromised foot health that need further examination, and could therefore function as a tool aiding in the automated monitoring of foot health on dairy herds.

Differences in interaction and subgroup-specific effects were observed between randomized and nonrandomized studies in three empirical examples.

OBJECTIVE: To determine the comparability of subgroup-specific and interaction effects (differences between subgroups) between different study designs. STUDY DESIGN AND SETTING: We compared effects of interventions based on observational studies, randomized clinical trials (RCTs), and individual patient data meta-analyses (IPDMAs) of RCTs (reference) on three clinical topics: (1) mammography screening and breast cancer mortality, (2) coronary artery bypass surgery (CABG) and all-cause mortality, and (3) statins and incidence of major coronary events. Main, subgroup-specific, and interaction effects were compared. RESULTS: Main and subgroup-specific effects were comparable with respect to the direction of the effects. Differences in the magnitude of subgroup-specific effects in observational studies yielded different interactions compared with those in IPDMA. In the mammography example, the ratio of risk ratios (RRR) (i.e., interaction effect) among observational studies was 1.46 [95% confidence interval (CI): 1.09, 1.96] compared with an IPDMA effect of 1.10 (95% CI: 0.89, 1.37). For the CABG studies, the observational RRR was 1.03 (95% CI: 0.84, 1.26), whereas in the IPDMA, this was 1.40 (95% CI: 1.08, 1.1.81). Finally, in the statin example, the RRR was 1.35 (95% CI: 1.13, 1.61) and 0.90 (95% CI: 0.84, 0.97) for observational studies and IPDMA, respectively. CONCLUSION: Main and subgroup-specific effects based on observational data were similar to main and subgroup-specific effects in IPDMAs based on RCTs, yet interactions differed.

Prognostic factors in canine appendicular osteosarcoma - a meta-analysis.

BACKGROUND: Appendicular osteosarcoma is the most common malignant primary canine bone tumor. When treated by amputation or tumor removal alone, median survival times (MST) do not exceed 5 months, with the majority of dogs suffering from metastatic disease. This period can be extended with adequate local intervention and adjuvant chemotherapy, which has become common practice. Several prognostic factors have been reported in many different studies, e.g. age, breed, weight, sex, neuter status, location of tumor, serum alkaline phosphatase (SALP), bone alkaline phosphatase (BALP), infection, percentage of bone length affected, histological grade or histological subtype of tumor. Most of these factors are, however, only reported as confounding factors in larger studies. Insight in truly significant prognostic factors at time of diagnosis may contribute to tailoring adjuvant therapy for individual dogs suffering from osteosarcoma. The objective of this study was to systematically review the prognostic factors that are described for canine appendicular osteosarcoma and validate their scientific importance. RESULTS: A literature review was performed on selected studies and eligible data were extracted. Meta-analyses were done for two of the three selected possible prognostic factors (SALP and location), looking at both survival time (ST) and disease free interval (DFI). The third factor (age) was studied in a qualitative manner. Both elevated SALP level and the (proximal) humerus as location of the primary tumor are significant negative prognostic factors for both ST and DFI in dogs with appendicular osteosarcoma. Increasing age was associated with shorter ST and DFI, however, was not statistically significant because information of this factor was available in only a limited number of papers. CONCLUSIONS: Elevated SALP and proximal humeral location are significant negative prognosticators for canine osteosarcoma.