Detection of occult lung impairment in welders by induced sputum particles and breath oxidation.

BACKGROUND: We evaluated particulate matter in combined induced sputum (IS) and oxidation in exhaled breath condensate (EBC) to test whether underlying inflammatory changes are present in asymptomatic welders. METHODS: Thirty welders from the Israel Defense Forces exposed to aluminum/iron (Group 1) or to cadmium/chromium/iron/lead/nickel (Group 2, N = 16) and 27 non-exposed administrators were studied. IS was recovered, particle size distribution, hydrogen peroxide and pH were measured, and exhaled breath condensate was collected. RESULTS: Group 2 had a higher % neutrophils than all other participants (P = 0.0001) and a higher % particles >2 microm in diameter (P = 0.0017). Percent particles and years of exposure highly correlated (P = 0.051). All welders EBC samples had higher concentrations of hydrogen peroxide than controls (P = 0.0001). pH was lower only for Group 2 (P = 0.0001). CONCLUSIONS: Combined IS and EBC measurements detect underlying inflammation in airways of asymptomatic welders. It emerged that airway inflammation is present in asymptomatic welders, and that the particle burden, inflammatory cells, and level of oxidative stress are a function of the type and the duration of welding. Am. J. Ind. Med. 51:503-511, 2008.

Lead Exposure in Military Outdoor Firing Ranges.

BACKGROUND: Several studies have reported significant airborne lead exposures during training at indoor firing ranges. Scarce attention has been given to airborne lead exposures in outdoor shooting ranges with automatic weapons. OBJECTIVE: To assess the prevalence and magnitude of airborne and blood lead levels (BLL) among firing instructors and shooters in military outdoor ranges. METHODS: Exposure assessment, for both trainees and instructors, included airborne and BLL during basic and advanced training at outdoor firing ranges. Personal airborne samples were collected in both day and night shooting during both training periods. RESULTS: During basic training, there is 95% likelihood that up to 25% of instructors and 99% likelihood that up to 5% of trainees might be exposed above the action level (AL) (25 µg/m(3)). During advanced training, there is 90% likelihood that 10% of instructors and 99% likelihood that up to 10% of trainees might be exposed above the AL. CONCLUSIONS: Military personnel participating in automatic weapon marksmanship training can be exposed to considerable levels of airborne lead during outdoor firing range training. As a result, the Israel Defense Force Medical Corp has classified firing range instructors as workers that require periodic medical examinations.

[Antiviral prophylaxis following possible sexual exposure to HIV].

In Israel, as in certain European countries, national health guidelines exist for preventive treatment after possible post-coital exposure to the HIV virus. Scientifically, this treatment is still regarded as experimental, though over the past years there is a mounting level of evidence of its efficacy. The administration of prophylaxis for HIV after unprotected coitus may be justified by the similar risk of HIV transmission for certain sexual and occupational exposures. Other considerations include: biological plausibility, the effectiveness of post-exposure prophylaxis in animal studies and occupational exposures in humans, efficacy in the prevention of vertical HIV transmission, and cost effectiveness studies. The preventive post-exposure treatment bears many side effects and possible complications, and therefore, each case should be cautiously analyzed before starting such treatment. This article reviews the scientific evidence on this topic, the considerations taken by the physician in initiating post coital HIV exposure treatment, and the guidelines available in Israel and throughout the world.