[Generally accepted engineering standards and Legionella in drinking water : findings from Frankfurt am Main]. / Allgemein anerkannte Regeln der Technik und Legionellen im Trinkwasser : Untersuchungsergebnisse aus Frankfurt am Main.

To investigate the association between the engineering standards of drinking water systems and the extent of the Legionella colonization, we subjected our 2006 published data of the drinking water monitoring of the city's public health services for Frankfurt on Main, Germany, to closer analysis. A total of 413 records were available, with both technical data and results of the Legionella colonization. When comparing the classes of technical deficiencies of the drinking water installations with the Legionella colonization results, 93% of the Legionella data "not dedectable in 100 ml" were found in the group of drinking water installations that were technically assessed as "free of deficiencies". Thus, "good" technical engineering is associated with low or lack of Legionella colonization with a high probability even with hints for a dose-effect phenomenon-the more engineering deficiencies that exist, the higher the Legionella contamination.

[Hygiene ranking in residential homes for the aged in Frankfurt--conception and first results]. / Das Hygiene-Ranking der Frankfurter Altenpflegeheime--Konzept und erste Erfahrungen.

Public health departments are obliged by law to survey hygienic procedures and condition in residential homes for the aged. Based on the annual hygiene control visits, a standardised hygiene ranking was established with the aggregation of more than 60 detailed single observations in the following fields: building, organisation, training of the staff, actual hygiene situation, repeated deficits, food and kitchen hygiene, and drinking water. This hygiene ranking enables not only intra-institutional comparisons in different years but also the comparison between different homes. The data obtained in 2004 to 2006 demonstrated that this method was very well accepted by the institutions and was readily appreciated as a tool for external quality assessment.

[Implementation of the new drinking water regulation section sign 18: monitoring of drinking water systems in houses--water for public use]. / Umsetzung der neuen Trinkwasserverordnung section sign 18: Uberwachung von Hausinstallationen--Wasser für die Offentlichkeit.

The monitoring of drinking water based on the drinking water regulation is one of the central tasks of public health authorities in Germany. With the coming into force of the new drinking water regulation in the year 2003 also water supply plants "from which water is made available for the public, in particular in schools, kindergartens, hospitals, restaurants and other communal facilities" must be supervised for the first time (TrinkwV section sign 18). Thus, for Frankfurt/Main the number of the facilities/objects which are to be supervised rose from approx. 300 to approx. 4,700. Since appropriate expansion of personnel was not possible, innovative solutions were in demand for implementation of these tasks. These are introduced here.

[Hygienic quality of the water of public swimming pools--comments on a current German ordinance draft]. / Anmerkungen zum Entwurf der Schwimm- und Badebeckenwasser-Verordnung (SchwBadebwV) vom März 2002.

In April 2002, a new draft regarding the quality of the water of public swimming pools in Germany was published. This draft was adapted to the new regulations for drinking water in respect of its structure and regulations. Microbiological tests for assessing the quality of bathing water are given priority. With regard to basic differences in facilities for drinking water and such for bath water and to legal aspects, many data (n = 14,425 data) on the practical experience of public health authorities are presented, obtained during the last few years. With regard to the data and in respect of the great delay between sampling and obtaining the results it is concluded that microbiological methods are inappropriate parameters for rapid assessment of the quality of bath water. Hence it is recommended to implement the evaluation of disinfection by chlorination including pH as an indicator for the quality of a bath water, parallel to the guidelines on technical standards. A high frequency of chlorination testing can markedly reduce the number of microbiological tests. Additionally, microbiological tests of the filtrate before disinfection by chlorination are recommended. This procedure has proved successful in legionella control.

[Hygienic procedures in operation theatres--guidelines and reality. Data obtained on hygiene control measures by public health service at Frankfurt am Main]. / Anforderungen der Hygiene beim Operieren---Richtlinie und Realität. Ergebnisse der intensivierten Uberwachung der Operationseinheiten in Krankenhäusern in Frankfurt am Main durch das Gesundheitsamt.

PROBLEM: Good hygienic practice in hospitals and other medical institutions is mandatory to avoid or to minimise nosocomial infections. In Germany, official recommendations of the commission for hospital hygiene and infection control have been published as guidelines for hygiene management in hospitals as well as guidelines for control measures of the public health services who are obliged by law to control the hygienic situation in hospitals. In this paper the degree of implementation of these guidelines in the hospitals is studied in respect of the hygiene management in the operation theatre. MATERIAL AND METHOD: The constructive and functional situation and the personal hygienic management were documented in 22 community and private hospitals in Frankfurt am Main, including 40 operation suites with 111 operation theatres. Data of the layout of the rooms were obtained by questionnaire and the hygienic management was observed by means of standardised checklists. RESULTS: Layout of rooms was not compatible with the recommendations of the Guidelines of 1990 and 2000 in many cases--especially with regard to the demand that doors to the operating theatres be closed. Automatic door closers were often either not available or defective. In some theatre areas correct hand disinfection while entering the suite was not possible for lack of disinfectant distributors at appropriate sites. Recommendations regarding surgical drapes and gowns were correctly observed in most cases, with the exception of changing gowns after having gone to the toilet room. Quite often, omission of hand disinfection after glove removal was observed. A discrepancy in hygienic procedures of nursing service and physicians was seen. In 40 % of the operation suites, powdered gloves were still in use. Though in all but one suite air conditioning systems were available, they were not correctly serviced in many cases. Cleaning and disinfection after single operations and at the end of the operating day were carried out correctly in most cases--except in operation theatres for ophthalmologic operations. Here too, manual preparation and disinfection/sterilisation of surgical instruments was common, and inappropriate use of sterilisers as well as the use of so-called "quick"-sterilisers. CONCLUSIONS: The recommendations of the commission for hospital hygiene and infection prevention are generally accepted as guidelines, although the degree of translation into practice was often unsatisfactory.

[Legionellas in domestic warm water--effects on the health of residents]. / Legionellen im hauseigenen Warmwasser--Auswirkungen auf die Gesundheit der Bewohner.

Only few epidemiological data on legionella diseases are available in Germany and studies on the prevalence of legionella antibody response in the population are scarce. We report on an epidemiological study on immune response in residents of homes with heavy and with minor legionella contamination in their hot-water system. 53 inhabitants of houseblocks with central hot-water system and high legionella contamination (6,049 +/- 17,995 cfu/l; 40% > 1,000 cfu/l) were studied. 92 persons living in 1-2 family houses with decentral hot water systems (244 +/- 1,434 cfu/l; 3% > 1,000 cfu/l) served as controls. All persons filled in a questionnaire on bronchial and fever diseases etc; blood specimen were tested for legionella antibodies (different methods: immunofluorescence, and ELISA), and urine specimens were analysed for legionella antigen. During this investigation in the population exposed to Legionella no cases of legionellosis were reported. The prevalence of legionella antibodies was twice as high in the exposed versus the control persons. Significant correlation between cfu/l and legionella antibody titer in the inhabitants were found. One person with high antibody titer and with legionella-free hot-water system in his home had reported about pulmonary problems after having stayed in a hotel. The positive antibodies of the other persons are most likely the result of asymptomatic infections caused by permanent exposure in their home hot-water supply. In conclusion, with regard to the increased prevalence of antibody titers against legionellae in the exposed inhabitants and the significant correlation between antibody titers and cfu/l in hot-water samples, the necessity to control and redevelop hot-water systems in homes is confirmed--even though no cases of legionelloses in the exposed population were reported.

[Public health in homes for the aged and nursing homes--experiences from monitoring by the public health office in Frankfurt am Main from 1989 to 1998]. / Hygiene in Alten- und Pflegeheimen--Erfahrungen aus der Uberwachung des Gesundheitsamtes der Stadt Frankfurt am Main von 1989 bis 1998.

UNLABELLED: Hygiene conditions in residential homes for the aged must be surveyed by the Public Health services according to German legislation (Bundesseuchengesetz, Law for Protection against Infectious Diseases). We report here on the data of the routine controls of the public health department in Frankfurt am Main in all of the 31 residential homes for the aged of the city. RESULTS: In 1989, a special plan for cleaning and disinfection was available in one home only, whereas a hygiene plan was not available in any of the homes. Up to 1998, plans for cleaning and disinfection were established in 29 of the homes, and more than 50% of them had fulfilled their hygiene plan. The supply and maintenance of dispersers for disinfectants, the usage of disinfectants and the knowledge regarding proper disinfection and sterilisation procedures could be improved. The same was true of the kitchens: there, up to 1998 testing of samples set aside for later reassessment was properly done in most of the homes. CONCLUSION: Hygiene in the homes and the knowledge of the staff members were markedly improved during the last years. Some of the most relevant hygienic problems are today: wearing private clothing instead of special working clothes, or deficits in the knowledge of the management of MRSA-colonised residents.

Crank-angle-resolved laser-induced fluorescence imaging of NO in a spark-ignition engine at 248 nm and correlations to flame front propagation and pressure release.

Inside the combustion chamber of a spark-ignition engine, NO fluorescence is excited with a narrow-band tunable KrF excimer laser. The fluorescence light is detected by an intensified CCD camera that yields images of the NO distributions. Rotational-vibrational transitions of NO are excited by the A(2)Σ+ ? X(2)Π (0, 2) band system around 248 nm. Single laser shot planar NO distributions are obtained with good signal-to-noise ratio at all crank angles and allow us to locate areas of NO formation during combustion. The pressure within the combustion chamber is measured simultaneously with the NO distributions, which allows the evaluation of correlations between indicated work and NO formation. The crank-angle-resolved sequences of two-dimensional NO distributions and averaged pressure traces are presented for different engine-operating conditions. In addition, laser-induced predissociation fluorescence of OH excited by the same laser source is measured in order to visualize the corresponding flame front propagation and to compare the time of formation of NO relative to that of OH.

[Benzene emissions in the neighbourhood of filling stations]. / Benzol-Immissionen in Wohnungen im Umfeld von Tankstellen.

BTXE-Immissions (benzene, toluene, ethylbenzene, xylene) were measured in 32 flats in the neighbourhood of 12 filling stations in Frankfurt on the Main. Mean benzene-concentration in the indoor air nearby filling stations was 10.2 micrograms/m3, whereas in reference flats 5.6 micrograms/m3 were measured. Maximum levels were 22.4 micrograms/m3 and 8.0 micrograms/m3. Indoor air levels were slightly higher than outdoor air contaminations. High Toluene-concentrations were not caused by the filling stations but by other commercial enterprises, such as paint shops. Mean ethylbenzene or xylene-concentrations in the neighbourhood of filling stations did not differ from the concentrations measured in the reference flats. Because of the cancerogenicity of benzene the benzene-contaminations in the neighbourhood of filling stations have to be lowered. The newly established German law to prevent gas leakage in filling stations will lead to some improvement in the future.

[Legionella contamination in warm water systems of a large German city]. / Das Problem der Legionellenkontamination in den Warmwassersystemen einer deutschen Grossstadt.

Since 1988 the Frankfurt City Health Department examined the hot water systems of all public indoor swimming pools, old age homes and hospitals, and made subsequent checks on the corrective measures introduced. In the 6 public indoor swimming pools the percentage of positive legionella findings, after corrective measures has dropped since 1988: at the central hot-water supply units from 47% to 23%, and at the peripheral tap connections from 66% to 22%. The number of negative samples rose from 43% to 77%. Thus the favourable effect of the corrective measures is demonstrated. Since 1988 samples have been taken from the shower water at old age homes. An increase in negative findings could be shown (from 58% to 70%). From 1990, however, an increase of high-level legionella contamination (> 10,000 Legionella colonies per litre) was detected as well. In one home with a generally high legionella contamination level (up to 75,000 legionella colonies per litre) an investigation of the legionella antibodies was done in the blood of 44 residents whose medical history included fever or bronchial symptoms. In no case a previous infection could be demonstrated. However, there was one patient with a definite legionella pneumonia in the home: this patient usually had been showering for at least 20 minutes a day. Legionella were found in the hot water systems of 16 of the 17 hospitals in Frankfurt. In 1991 more than half to the 204 samples were legionella positive. 5% of the samples had legionella contamination levels of more than 100,000 per litre. Corrective measures have been taken.(ABSTRACT TRUNCATED AT 250 WORDS)

Identification and imaging of OH (nu'' = O) and O(2) (nu'' = 6 or 7) in an automobile spark-ignition engine using a tunable KrF excimer laser.

Planar laser-induced predissociative fluorescence is applied to image state-specific densities of OH and hot O(2) inside an internal-combustion car engine. Improved instrumentation is described. It includes better imaging optics and a spectrometer that permits desired molecular quantum states to be selected and identified in real time. The OH (nu'' = 0) images are cleanly separated from the isooctane fuel and they display a thin superequilibrium region at the flame front. In contrast, vibrationally excited O(2) (nu'' = 6 or nu'' = 7) is uniformly distributed behind the front. Uneven and broken flame fronts are commonly observed.

Fluorescence imaging inside an internal combustion engine using tunable excimer lasers.

Tunable excimer lasers are used to obtain 2-D images of molecular (and some state-specific) density distributions inside a cylinder of a modified four-cylinder in-line engine that has optical access. Natural fluorescence (i.e., without a laser) is used for some OH pictures, normal laser-induced fluorescence (LIF) for those of NO and of the isooctane fuel, and laser-induced predissociative fluorescence (LIPF) for other OH pictures and for those of O(2). Relevant spectroscopy is done to find the laser and fluorescence frequencies needed to measure isolated species. LIPF works well at high pressures, is state specific, and is ideally suited to follow turbulent processes. No similar measurements in engines have been previously reported. Pictures are taken in succeeding engine cycles. Their sequence is either at a particular point of the engine's cycle to show cyclic fluctuations, or at succeeding portions of the cycle to illustrate the progress of the gasdynamics or of the combustion.

Laser in situ monitoring of combustion processes.

Several examples of laser in situ monitoring of combustion processes are presented. Using a frequency modulated (13)CO(2) waveguide laser, in situ concentrations of NH(3) down to 1 ppm were measured at temperatures up to 600 degrees C in waste incinerators and power or chemical plants. Following ignition of CH(3)OH-O(2) mixtures by a TEA CO(2) laser, gas temperature profiles were measured using rapid scanning tunable diode laser spectroscopy of CO molecules. In laminar CH(4)-air counterflow diffusion flames at atmospheric pressure absolute concentrations, temperatures, and collisional lifetimes of OH radicals were determined by 2-D and picosecond LIF and absorption spectroscopy. Two-dimensional LIF and Mie scattering were used to observe fuel injection and combustion in a diesel engine.

Isolation of heparan sulfates with antithrombin III affinity and anticoagulant potency from BALB/c 3T3, B16.F10 melanoma, and cutaneous fibrosarcoma cell lines.

The heparan sulfates synthesized in vitro by three cell lines were isolated by proteolysis and preparative anion exchange chromatography and purified free of other glycosaminoglycans by selective enzymatic degradation. The isolates from the medium of BALB/c 3T3 fibroblasts, B16.F10 melanoma cells, and a cutaneous fibrosarcoma line, along with that from the detergent-extracted cell layer of the fibroblasts, were affinity-fractionated on columns of matrix-immobilized human antithrombin III. Each heparan sulfate contained subfractions with high affinity for the proteinase inhibitor, ranging from 3-34% of the starting material. The high affinity species possessed measurable anticoagulant activities by a clotting assay (6 to 30 units/mg). Since none of the lines were derived from cell types having any known biological role in vascular homeostasis, we suggest that anticoagulant activity of the glycosaminoglycan is a random property of its primary structure.

[Cavitation bubble dynamics and shock wave generation in eye surgery using the pulsed neodymium:YAG laser]. / Kavitationsblasendynamik und Stosswellenabstrahlung bei der Augenchirurgie mit gepulsten Neodym:YAG-Lasern.

In a model experiment using polyethylene membrane in balanced salt solution the processes which take place during posterior capsulotomy with pulsed Nd:YAG lasers were investigated by means of high-speed photography and hydrophone measurements. It was found that cavitation bubbles with a maximum diameter of 1.5 to 2.3 mm develop at the focal point even with a pulse energy of 5 mJ; i.e., their spatial extent is much greater than that of the ruptures observed. Furthermore, during optical breakthrough and when the bubble collapses shock waves are generated with a pressure amplitude of 9 to 16 bat at a distance of 18 mm or 162 to 288 bar at 1 mm. Previous estimates ranged from more than 0.1 bat at 15 mm to several kilobar at 1 mm. Above a certain threshold value the energy of the cavitation bubble and of the shock waves is approximately proportional to the energy of the laser pulses with which they are generated. At the same time pulse energy the diameter of the bubbles generated by Q-switched lasers is around 1.5 times as large as those generated by model-locked lasers--the bubble energies are more than three times as great. The shock wave amplitudes after O-switched pulses are likewise 1.5 times as great as after mode-locked pulses and the energy of the shock waves is approximately double. Nevertheless, the size of the holes caused in a polyethylene membrane with a pulse energy of 2 mJ to 5 mJ does not depend on the laser operating mode. Thus, with the polyethylene membrane, no great correlation was found between the mechanical energy acting on it and the size of the holes thus created.(ABSTRACT TRUNCATED AT 250 WORDS)

Cavitation bubble dynamics and acoustic transient generation in ocular surgery with pulsed neodymium: YAG lasers.

The authors have investigated the application of mode-locked and Q-switched Neodymium:YAG (Nd:YAG) lasers in ocular surgery by means of high-speed photography and hydrophone measurements. The incisive effect relies on the optical breakdown at the laser focus. Cavitation bubbles and acoustic transients are thereby generated. Their size and pressure amplitude have been measured at various laser-pulse energies. With a pulse energy of 5 mJ, the bubble is 1.5 to 2.3 mm in diameter and the pressure of the acoustic transient is 9 to 16 bar (130 to 230 psi) at a distance of 18 mm from the focal point. Bubble size and amplitude of the pressure pulse are always approximately 50% higher with a Q-switched laser than with a mode-locked laser. However, the size of the ruptures produced in a polyethylene membrane by the laser pulses is the same for both modes of operation. The energy balance shows that not only mechanical effects, but also thermal mechanisms are responsible for photodisruption.

[Results and problems of a questionnaire study on the incidence of some selected bronchopulmonary diseases in 3,302 students beginning school in the city of Frankfurt/Main]. / Ergebnisse und Problematik einer Fragebogenerhebung zur Inzidenz einiger ausgewählter bronchopulmonaler Erkrankungen bei 3302 Einschülern der Stadt Frankfurt/Main.

During the last years between air pollution and respiratory illness has been suggested increasingly often. There are no exact data about prevalence and longitudinal development of bronchopulmonary diseases. This study will propose a method to get these data by questionnaire. Although a relatively simple questionnaire was selected it was soon apparent that the answers of German parents differed substantially from those of parents of other nationalities. It was felt that this difference could be due to anxiety or misunderstanding on part of the parents, so in the interest of accuracy only the data concerning the German children were analysed. Analysis of 2,214 questionnaires revealed the following tendencies in the 5 to 6 year old age group: infectious diseases 30.4%, asthma 1.4% croup syndrome 4.5%, recurrent croup 4.1%. There is a very high percentage of pupils suffering from recurrent croup because this kind of croup most probably is associated with air pollution. We believe that the extension of data collection in this age group is practicable and would produce useful data to establish a correlation between air pollution and bronchopulmonary diseases.

Erythrocyte cation transport activities as a function of cell age.

Erythrocyte cation transport systems were evaluated on cell fractions from 17 subjects. Density centrifugation was used to separate washed red cells into fractions enriched with younger and older cells; the cell age differences in these fractions were verified by reticulocyte counts (means are 3.5% for younger cell fractions and 0.7% for older cell fractions). Red cell age has a pronounced effect on several cation transport activities. The older cell fractions had increases in lithium-potassium cotransport (p less than 0.001), the rate constant for the lithium-potassium cotransport (p less than 0.001) and cellular cation permeability. The older cells had decreases in the number of ouabain binding sites (p less than 0.001), the rate constant for sodium efflux via the sodium-potassium adenosine triphosphatase pumps (p less than 0.001) and the sodium-lithium countertransport (p less than 0.025). In subjects with markedly different cell ages, these effects should be considered when evaluating red cell cation transport activities.