[Patient Care in German Outpatient Clinics for Environmental Medicine Illustrated by the Examples of Hamburg and Munich University Hospitals]. / Versorgung von Patient*innen an umweltmedizinischen Ambulanzen in Deutschland am Beispiel der Universitätskliniken in Hamburg und München.

People can be affected by various environmental factors (e. g., odor, noise) which can lead to medical complaints or illnesses. Few adequate contact points are available for patients with suspected environmental complaints in Germany. Illustrated by the outpatient clinics for environmental medicine in Hamburg and Munich, this report shows how patients with suspected environmental medical diseases are cared for in Germany. For the exemplary presentation, the data of the environmental medicine outpatient clinics of both the university hospitals from 01.01.2019 to 31.03.2021 are presented and compared. Overall, more female than male patients were treated at both facilities. Suspected exposure to "heavy metals" was most frequently mentioned by patients as the assumed reason for their complaints. Nonetheless, the suspected exposure or "intoxication" could be ruled out in the majority of cases by appropriate examination methods in accordance to current medical guidelines. The data provided by the environmental medicine outpatient clinics show that there is a continuous demand for environmental medical care. A close cooperation between the private practice sector and the outpatient clinics for environmental medicine providing medical care to patients should therefore be sought.

A method for reliable quantification of mercury in occupational and environmental medical urine samples by inductively coupled plasma mass spectrometry.

Over the last years, inductively coupled plasma mass spectrometry (ICP-MS) has been applied as a method for human-biomonitoring of metals in the concentration range of occupational and environmental medicine. In large scale routine monitoring, the determination of mercury (Hg) by ICP-MS remains challenging due to several reasons. Amongst others, stability of dissolved Hg and avoiding memory effects are the key facts for reliable quantification. To address these issues, we developed a robust approach for biomonitoring of mercury in human urine samples by ICP-MS. Using a solution containing HNO3, HCl and thiourea, prepared samples and calibrators were stabilized for up to 72 h. A rinse time of only 30 seconds efficiently prevented contamination of consecutive samples with Hg concentrations up to 30 µg L-1, hence significantly reducing acquisition times compared to published methods. Recovery experiments revealed iridium as an ideal internal standard to compensate matrix effects independently from creatinine concentration. Recoveries of 95.0-104.0% were obtained for Hg levels covering the range of biomonitoring guidance values established by the German Human-Biomonitoring Commission. Excellent intra-day precision and inter-day precision of ≤3.0% for two different Hg levels were achieved. The detection and quantification limit accounted for 21.7 ng L-1 and 65.6 ng L-1, respectively, enabling reliable quantification even in the range of environmental background exposures. Additionally, the method was externally validated by successful participation in the inter-laboratory comparison program G-EQUAS. With the developed method, we hence provide a sensitive and robust tool for mercury exposure assessments in future large scale human-biomonitoring studies.

Workplace health promotion for employees working in offshore wind parks in the German exclusive economic zone: a mixed-methods study.

OBJECTIVES: To investigate the awareness and use of health promotion offers among offshore wind workers and to study associations with demographic and workplace characteristics. To examine employees' reasons for (non-)participation and their wishes for health promotion activities offshore. DESIGN: Mixed-methods study presenting the results from semistructured telephone interviews and a web-based cross-sectional survey. SETTING: Offshore wind parks in the German exclusive economic zone in the North and Baltic Seas. PARTICIPANTS: 21 offshore workers in the qualitative study (19 male/2 female; all German). 303 offshore workers in the quantitative study (287 male/13 female; 275 German/24 other nationalities). OUTCOME MEASURES: Awareness and use of workplace health promotion offers and associations with demographic and workplace characteristics (age, work schedule and wind park phase); reasons for (non-)participation; needs and wishes for health promotion offers. RESULTS: Few workers indicated being aware of health promotion programmes at their workplace. Single offers were reported, with fitness facilities being the most common offer employees recognised and had used (n=168, 55.6%). Employees with a regular work schedule were more likely to have used fitness facilities offshore (adjusted OR (AOR)=3.22, 95% CI 1.53 to 6.80). Workers in the construction phase were more likely to have used massages (AOR=8.19, 95% CI 2.82 to 23.77). Younger workers were less likely to belong to the group of those who were aware of fitness facilities but had not used them (AOR=0.43, 95% CI 0.19 to 0.98). Employees expressed various needs and wishes for behavioural and environmental preventive measures offshore. CONCLUSIONS: The results demonstrate a perceived need among the workers for the development of health promotion programmes offshore. Since the awareness and use of offers may partly depend on personal and organisational characteristics, this should be taken into account in the planning of health promotion activities.