Evidence-based study of chromate exposed workers' health surveillance indexes / 中华预防医学杂志

<p><b>OBJECTIVE</b>The health surveillance proposal for chromate exposed workers was provided and analyzed on the evidence-based study and then to be improved.</p><p><b>METHOD</b>Firstly, the related literatures were searched about liver damage, micronuclei, urinary chromium and hexavalent chromium exposure in Evidence Based Medicine Reviews such as Cochran library, OVID Medline, Web of knowledge in December 2011; and then, these literatures were reviewed in according to inclusion and exclusion criteria; 22 articles totally were retrieved, evaluated and classified in according to the grading standard by Oxford Centre for Evidence-based Medicine.Finally, field epidemiological investigation was further adopted to confirm the efficiency and feasibility of this proposal, combined with cost-effectiveness analysis:the ratio of total cost divided survival years was used to express the cost-effectiveness.</p><p><b>RESULT</b>Only the glutamic pyruvic transaminase test could not reflect liver damage caused by chromate exposure well; Urinary chromium correlated well with the index reflecting body damage caused by chromate exposure; Binucleated cells micronucleus index in peripheral blood lymphocyte could reflect the genetic damage caused by chromate exposure. As for health economic evaluation of chromate lung cancer, the value of cost/effectiveness was ¥42 321.61 per year that was far below the value of common people (¥252 868.97 per year) .</p><p><b>CONCLUSION</b>It was suggested that serum glutamic pyruvic transaminase test should be replaced by liver function test, urinary chromium should be classified as a compulsory index and binucleated cells micronucleus index in peripheral blood lymphocyte should be supplied as a recommended index.</p>

Application of regionalized critical neonatal emergency transport system / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the application of the regional critical neonatal emergency transport system (NETS) to provide evidence for the optimization of NETS in Beijing.</p><p><b>METHODS</b>All the transported neonates in four hospitals in Haidian District, Beijing, between January 2009 and September 2010 were enrolled. The relevant clinical information of two referral hospitals was analyzed.</p><p><b>RESULTS</b>The top three conditions requiring transport were pre-term delivery, diseases requiring surgical treatment, and respiratory diseases, which accounted for 33.1%, 18.3%, and 14.8%, respectively. Active transport was performed in 95 cases (66.9%) and passive transport in 47 cases (33.1%). The age distribution of the neonates requiring transport was as follows: <6 hrs after birth (24.1%); 6-12 hrs (9.3%); 12-24 hrs (25.9%); and >24 hrs (40.8%). The mean time for transport from the hospital to a referral ward by ambulance was 28.0±11.1 minutes. Diseases requiring emergency surgical treatment were the leading cause of death, accounting for 53.8% of total deaths. The mortality rate was not significantly different between the neonates aged <6 hrs and ≥6 hrs groups.</p><p><b>CONCLUSIONS</b>Active transport remains the main transport pattern among these four hospitals. Neonates requiring surgical treatment have a high mortality rate, and thus special attention should be paid to their transport.</p>

Effect of occupational combined exposure of chromium and iron on erythrocyte metabolism / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of combined occupational exposure of chromium and iron on erythrocyte metabolism, and the possible mechanism.</p><p><b>METHODS</b>A total of 115 chromate production workers were selected in a chemical factory of Jinan as exposure group, Dec, 2008, and 60 healthy residents from a community which was far away from the factory were enrolled as control group. Environmental concentrations of chromium and iron were collected by filter membrane sampling and determined. The peripheral blood of subjects were collected for determination of chromium, iron, copper in whole blood and folate, vitamin B₁₂ in serum, mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) and correlation analysis was conducted.</p><p><b>RESULTS</b>The median (quartile interval) concentration of air-chromium and air-iron in workplace were 9.0 (10.5) and 11.2 (10.1) µg/m³, respectively, which were significantly higher than that of the control (0.1 (0.1) and 7.2 (2.5) µg/m³) (all P values < 0.01). Blood-chromium and blood-iron of the exposed group were 15.5 (14.1) µg/L and (895.1 ± 90.2) mg/L, which were significantly higher than the counterpart of the control (3.6(2.0) µg/L, (563.7 ± 49.3) mg/L) (all P values < 0.01). Serum folate ((6.9 ± 2.5) µg/L), serum vitamin B₁₂ ((396.4 ± 177.0) µg/L) and blood copper ((777.6 ± 103.5) µg/L) of the exposed group were all significantly lower comparing to the control group ((558.0 ± 330.8), (8.1 ± 3.8), (812.1 ± 94.6) µg/L) (all P values < 0.05). The relationships between blood chromium and serum folate, serum vitamin B₁₂ were statistical significant (r = -0.319 and -0.293, P < 0.01). Both serum vitamin B₁₂ and blood copper correlated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) (r = -0.223, -0.242, -0.261, -0.292, all P values < 0.01).</p><p><b>CONCLUSION</b>Combined chromium and iron exposure existed in the workplace. Adverse effect of Chromium on human erythrocyte may via folate and vitamin B₁₂ metabolism, while iron may via copper metabolism.</p>

The effects of occupational soluble chromate exposure on immunological function of T-cell / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the early changes of some immunological function of T-cell in chromate workers.</p><p><b>METHODS</b>A total of 115 workers exposed to different levels of soluble chromate were enrolled in exposed group; while 90 non-exposure workers who lived far away from the chromate plant were enrolled as control. The air concentration of soluble chromate was determined by atomic absorption spectrometry. CD3(+), CD3(+)CD4(+), CD3(+)CD8(+) and CD4(+)/CD8(+) of T-cell were determined by flow cytometry analysis.</p><p><b>RESULTS</b>The individual air chromate concentration in the exposed group was (27.51 +/- 33.25) microg/m(3), and the control group was (0.16 +/- 0.15) microg/m(3). The significant difference between the two groups was observed (z = 8.045, P < 0.01). The levels of the lymphocyte subsets (CD3(+), CD3(+)CD4(+), CD3(+)CD8(+) and CD4(+)/CD8(+)) in exposed group were (30.08 +/- 17.75)%, (1.04 +/- 1.73)%, (11.94 +/- 9.78)%, 0.10 +/- 0.14. While, those of control group were (63.00 +/- 13.57)%, (30.51 +/- 5.16)%, (14.82 +/- 4.59)%, 2.17 +/- 0.53, higher than that of the exposed group (z values were 4.484, 5.227, 1.976, -5.218, respectively, P < 0.05).</p><p><b>CONCLUSION</b>On the basis of individual air monitoring, the cellular immune function affected by soluble chromate is mainly based on T lymphocyte inhibition. The indicators CD3(+)CD4(+) mentioned above may be considered as efficient biomarkers in further research.</p>

The effect of inhalable titanium dioxide on the oxidative stress among occupational population / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the inhalable titanium dioxide exposure level and make an assessment of its oxidative effect on occupational exposed population.</p><p><b>METHODS</b>A total of 7 workers occupationally exposing to inhalable titanium dioxide were recruited into the study. The basic information and occupational history were collected by interview, while their blood sample (10 ml for each subject) were collected before and after the investigation, respectively. Pre- and post-work shift urine samples (60 ml for each subject) were collected for 29 days consecutively. The daily personal titanium dioxide exposure level, temperature and relative humidity were detected too. Urinary 8-hydroxy-deoxyguanosine (8-OHdG) and serum high-sensitivity C-reactive protein (hs-CRP) were detected by ELISA and latex immunoturbidimetric assay, respectively.</p><p><b>RESULTS</b>The mean concentration of air inhalable titanium dioxide was (1.194 ± 1.015) mg/m(3). Serum hs-CRP level before and after the investigation was (1.13 ± 1.08), (1.33 ± 1.01) mg/L, respectively. No statistical significance was observed between hs-CRP level before and after the investigation (t = -0.848, P = 0.425). Pre- and post-work shift urinary 8-OHdG was (3.51 ± 1.39), (3.65 ± 1.06) µmol/mol Cr, respectively. A positive correlation was found between the concentration of inhalable titanium dioxide and the changes of 8-OHdG level (r = 0.192, t = 2.09, P = 0.039). Linear mixed-effect models, adjusted by work shift, years of employment, age, body mass index, smoking status, temperature and relative humidity, showed no significant exposure-respond trend between the inhalable titanium dioxide concentration and 8-OHdG level (β = 0.288, t = 1.940, P = 0.055).</p><p><b>CONCLUSION</b>Our findings do not support the potential link between occupationally exposure to inhalable titanium dioxide and high induction of DNA oxidative stress.</p>

Bio-effects of water soluble taurine multi-wall carbon nanotubes on lungs of mice / 中华预防医学杂志

<p><b>OBJECTIVE</b>To track the translocation of water soluble taurine multi-wall carbon nanotubes (14C-tau-MWCNTs) in lungs of the Kunming mice and evaluate the acute lung toxicity of intratracheally instilled tau-MWCNTs in Kunming mice.</p><p><b>METHODS</b>Healthy adult Kunming mice were randomly grouped by their body weight (5 mice in each group). The lungs of mice were intratracheally instilled with 0.125, 0.25, 0.5 and 1 mg/kg of water soluble tau-MWCNTs and phosphate-buffered saline (PBS) as negative control. After exposure of 1, 7, 14 and 28 days, the blood and lung tissue were collected. Blood were assessed by using biochemical biomarkers of alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and angiotensin converting enzyme (ACE). Lung tissues were assessed by histopathology. The intratracheal instillation of 14C-tau-MWCNTs was conducted in the same way, after 1, 3, 7, 14, 21, 28 days, 14C-activity of the samples was counted in several organs, tissues, blood and feces etc.</p><p><b>RESULTS</b>14C-activities were detected only in lungs, and with the exposure time proceeding the radioactivity descending from (80 +/- 7.7)% of the 1st day to (22 +/- 6.9)% of the 28th day. Activity of all groups of ALP and LDH went to the highest level on the 7th day postexposure, and back to the control level on the 28th day post-exposure, but LDH of 1 mg/kg group[(14.18 +/- 1.70) micromol x s(-1) x L(-1)] was still higher than that of control [(10.95 +/- 3.51) micromol x s(-1) x L(-1)] after 28 days' exposure. There was no significant changes observed in the activity of ACE. Histopathology found that lungs of all groups presented significant increase in pulmonary inflammation, lung cell proliferation. Many tau-MWCNTs were clearly found in some alveolar macrophages and bronchial epithelial cells.</p><p><b>CONCLUSION</b>Intratracheal instillation of water soluble tau-MWCNTs could induce slight bio-effects on lungs of Kunming mice.</p>

The correlation between personal occupational exposure to soluble chromate and urinary chromium content / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore and provide the possible biological limit of urinary chromium for population occupationally exposure to soluble chromate, as to providing scientific evidences for health monitoring and risk assessment.</p><p><b>METHODS</b>A cross-sectional study was conducted. The studied population contained 83 workers from different processes of the chromate plant, in addition, 10 farmers without exposure to chromate matched with exposed subjects by age, gender and smoking status were identified as a control group. The air chromium concentration for personal exposure during 8-hours shift and the urinary chromium concentration post-shift were determined and their relationship was analyzed statistically. Meanwhile, the literatures of the biological limit of urinary chromium for occupational exposure to soluble chromate were studied.</p><p><b>RESULTS</b>For the control group, the air chromium concentration had a range from 0.00 microg/m(3) to 0.08 microg/m(3) and the urinary chromium concentration from 0.40 microg/g Cre to 1.02 microg/g Cre. For the exposure group, the air chromium concentration was from 0.10 microg/m(3) to 287.00 microg/m(3) and the urinary chromium concentration was from 1.14 microg/g Cre to 79.07 microg/g Cre. The positive relationship existed in between air chromium concentration and urinary concentration. The urinary chromium concentration was increased depending on the chromate exposed level. The regress equation was that Urinary chromium concentration (microg/g Cre) = 4.16 + 236.86 x air concentration for chromate (mg/m(3)), r = 0.976. The recommendation of ACGIH (USA, 2004) was 65.1 micromol/mol Cre (30 microg/g Cre) with the same TLV-TWA of 0.05 mg/m(3) as our National standard about the air chromate concentration.</p><p><b>CONCLUSION</b>Our findings suggested that the post-shift urinary chromium concentration might be used as an exposed biomarker for chromate. Considering the recommendation of ACGIH (USA, 2004) and the feasibility of the standard performed, we suggest that the biological threshold limit of urinary chromium for occupational exposure to soluble chromate in China should be 65.1 micromol/mol Cre (30 microg/g Cre) (post-shift urine for consecutive 5 work days.).</p>

Chromium content in erythrocytes serving as the exposure biomarker for workers exposed to soluble chromate / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore biological exposure markers, we investigated the chromium content in peripheral erythrocytes from occupational population with broad ranges of soluble chromate exposure, as the candidate biomarker may provide the scientific evidence for health risk assessment in occupational chromate-exposed population.</p><p><b>METHODS</b>A cross-sectional study was conducted in chromate exposed workers employed at a chromate factory in a district of Jinan city, Shandong Province. The studied population contained 114 workers from different processes of the chromate plants, which included 74 males and 40 females, with an age range from 25 to 52 years old, averaging at (35.83 +/- 6.14) years old; the length of service was ranging from 1 year to 37 years, an average of (14.20 +/- 6.77) years. In addition, 30 farmers in the countryside one hundred kilometers away from the factory, without exposure to chromate matched with exposed subjects by age, gender and smoking status were identified as a control group, which included 22 men and 8 women, with age ranging from 25 years old to 47 years old, having an average age of (36.13 +/- 6.17) years old. Personal information on age, chromate exposure, medical history, smoking habit and alcohol consumption was obtained at an interview. The air concentration of personal exposure was determined by individual sampling for 8 hours per day as shift work, and chromium was assayed by atomic absorption spectrometry. The chromium content in the erythrocytes from peripheral blood was determined by graphite furnace atomic absorption spectrometry. The potential plasma reduction capacity was determined by dibenzene anthracoamid dihydrazide spectrophotometry. The content of total vitamin C and reductive ascorbic acid were determined by 2, 4-dinitrobenzene hydrazine. The data were analyzed by SPSS10.0 software for statistical significance.</p><p><b>RESULTS</b>(1) The results showed that the chromium levels in erythrocytes in the exposed group [(15.79 +/- 31.01) microg/L] were significantly higher than those in the control group [(3.21 +/- 2.20) microg/L] (P < 0.01). (2) There existed a dose-response relationship between the personal airborne chromate concentration and the chromium content in erythrocytes. As airborne chromate concentration lowered to 106.00 microg/m(3), the chromium content in erythrocytes increased, depending on the air concentration of chromate. (3) Correlation analysis showed that there was a significant positive correlation between airborne chromate concentration and the chromium content in erythrocytes (P < 0.01). (4) In multiple regression analysis, it was found that the potential plasma reduction capacity and reductive ascorbic acid may be a good indicator for oxidative stress produced by chromate exposure and be used to evaluate the effects on intracellular uptake of chromium (VI).</p><p><b>CONCLUSION</b>Our findings suggested that the chromium content in erythrocytes should be used as an effective exposed biomarker in the risk assessment for occupational chromate-exposure.</p>

Study on DNA strand breaks in workers exposed to soluble chromate / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the biological effective markers, we investigated DNA strand breaks in peripheral lymphocytes from occupational population with broad ranges of soluble chromate exposure.</p><p><b>METHODS</b>We conducted a cross-sectional study in the chromate exposed workers employed at a chromate factory in a district of Jinan, Shandong Province. The studied population contained 114 workers from different processes of the chromate plants, in addition, 30 farmers in the countryside about one hundred kilometers away from the factory, without exposure to chromate were matched with the exposed subjects by age, gender and smoking status being identified as a control group. Personal information on age, chromate exposure, medical history (including acute infection and medicine usage), smoking habit and alcohol consumption was obtained by questionnaire. DNA strand breaks in lymphocytes were detected by single-cell gel electrophoresis assay (comet assay) and the DNA damaged degree was evaluated by the score weighted by comet type. The air concentration of chromate was determined by individual sampling for 8 hours per day as shift work and chromium was assayed by atomic absorption spectrometry. The chromium content in the erythrocytes from peripheral blood was determined by graphite furnace atomic absorption spectrometry. The data were analyzed by SPSS10.0 software for statistical significance.</p><p><b>RESULTS</b>(1) The results showed that the score for DNA strand breaks in lymphocytes were 54.52 +/- 23.51 in the exposed group, which was significantly higher than those in the control group (24.70 +/- 11.84) (P < 0.01). (2) The degree of DNA strand breaks in lymphocytes was increased in a dose-dependent manner ranging from 0 microg/m(3) to 106.00 microg/m(3). (3) Correlation analysis showed that there was a significant positive correlation between airborne chromate concentration and the degree of DNA strand break in lymphocytes (P < 0.01). (4) By multiple regression analysis, it was found that the airborne concentrations, chromium contents in red blood cells and smoking habits were factors which might affect the degree of DNA breaks.</p><p><b>CONCLUSION</b>Our findings suggest that DNA strand break in lymphocytes should be an effective biomarker for occupational chromate-exposed population and be applied in biological monitoring and health risk assessment for occupational chromate-exposed population.</p>

Effects on serum glucose and lipids in chronic exposure to lanthanum chloride in rat / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the effects of serum glucose and lipids by on chronically lanthanum exposure in rat.</p><p><b>METHODS</b>The Wistar rats were treated with oral exposure dose 0.1, 2 and 40 mg/kg of lanthanum chloride (LaCl(3)) respectively, after 90 days the rats were sacrificed and the blood was collected for measuring the glycosylated hemoglobin A (HbA1c), the serum was used for measuring glucose, total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) levels.</p><p><b>RESULTS</b>There were no any differences among the control and 3 dose LaCl(3) exposed rats on the blood HbA1c and serum Glu, TG and LDL-C levels (P > 0.05). The serum TC in 0.1 and 2 mg/kg LaCl(3) dose group rats were (1.38 +/- 0.14) mmol/L and (1.37 +/- 0.26) mmol/L respectively. It was lower than that of the controls (1.57 +/- 0.14) mmol/L significantly (P < 0.05), the serum HDL-C in 0.1 mg/kg dose group rats was (0.79 +/- 0.12) mmol/L and obviously lower than that of control group rats (0.93 +/- 0.10) mmol/L (P < 0.05).</p><p><b>CONCLUSION</b>0.1 - 40 mg/kg LaCl(3) chronically exposed have not greater effect on serum glucose, TG and LDL-C levels in rats, but the lower dose LaCl(3) chronic exposure might cause serum TC and HLD-C level decreasing.</p>

The recent effect of ovary dislocation on ovary function during the operation of cervical squamous carcinoma / 中国基层医药

Objective To study the recent effect of ovary dislocation during the operation of cervical squa- mous carcinoma with stageⅠon ovary function.Methods 12 cases with cervical squamous carcinoma of stageⅠwere treated with surgery.During the operation bilateral ovaries with blood vessels were dislocated the abdominal cavity over the umbilical line through postperitoneum and fixed on the postperitoneum.12 cases were hysterec- tomized simply as the control.The change of ovary function was observed in one year after the operation.Results The levels of FSH and E_2 were decreased in the dislocating group(P

Relationship between Serum Interleukin-18 and Changes of Heart Function in Children with Viral Myocarditis / 实用儿科临床杂志

Objective To analyze the correlation between serum interleukin-18(IL-18) level and changes of heart function in children with viral myocarditis(VM).Methods Seventy-two cases with VM were selected from Tianjin Children's Hospital.Control group were selected from the patients in surgery outpatient department.The patient group was divided into 3 groups which were named non-heart failure group,heart failure group and cardiogenic shock group.The Pillip Sonos 5500 type echocardiogram was applied to measured the left ventricular fractional shortening(LVFS),ejection fraction (EF),left atrium inner diameter(LAD),left ventricular end diastolic inner diameter (LVEDD)and left ventricular end systolic inner diameter(LVESD) in patient group,descripted function change of their heart.ELISA method was used to measure the content of IL-18 in 15 cases of control group and 36 cases of patient group.All data were analyzed by SPSS 11.5 software.Results 1.The LVESD in shock group were larger than that in non-heart failure group and heart failure group,abnormality probability of LVFS and EF step up from non-heart failure group to heart failure group and to shock group.2.The serum IL-18 level in patient group was higher than that in control group (P