Functional and structural outcomes and complications after pars plana vitrectomy for severe features of proliferative diabetic retinopathy in type 1 and type 2 diabetes mellitus.

PURPOSE: To evaluate the functional and structural outcomes as well as postoperative complications after pars plana vitrectomy (PPV) for severe features of proliferative diabetic retinopathy (PDR) in type 1 and type 2 diabetes mellitus (DM) patients. METHODS: Twenty two eyes of type 1 diabetics (DM1 group) and 27 eyes of type 2 diabetics (DM2 group) were included. Best corrected visual acuity (BCVA), intraocular pressure (IOP), postoperative structural changes in optical coherence tomography (OCT) and postoperative complications such as recurrent vitreous haemorrhage, diabetic macular oedema, secondary glaucoma and persistent tractional retinal detachment (TRD) were assessed and compared between the two groups. RESULTS: Complete reattachment of retina was achieved in 88.9% from the DM1 group and in 95.5% from the DM2 group and remained attached in follow-up. BCVA in DM2 group was significantly lower preoperatively (p = 0.04). Mean postoperative BCVA significantly improved in both studied groups, but it was more evident in eyes of type 2 diabetics compared to type 1 diabetics. In eyes in the DM1 group there was perceptible stabilisation of BCVA. Poor visual acuity or lack of improvement in BCVA in the DM1 group was related to preoperative subretinal haemorrhage in macular region, and TRD involving macula, whereas in the DM2 group-to preoperative subretinal haemorrhage and neovascular glaucoma. The postoperative structural changes (disruption of EZ and ELM) were observed more often in DM2 group, but had the greatest impact on BCVA in eyes of type 1 DM. Complications after PPV for PDR were rare and hadn't a significant influence on the final functional outcomes in both groups. CONCLUSIONS: Functional improvement after PPV for severe features of proliferative diabetic retinopathy were more noticeable in patients with type 2 DM. Postoperative structural changes had more negative impact on BCVA in type 1 diabetics.

Comparison of advanced glycation end products concentration in the skin among patients with rheumatic diseases, with and without comorbid depression: a case-control study.

Patients with rheumatic diseases suffer depression at a far greater rate than the general population. Aside from evident mental health degradation, in this group of patients depression can often lead to failures in the treatment of the basic disease. The aim of the study was to assess the concentration of advanced glycation end-products (AGE) in the skin autofluorescence (SAF) exam in patients with select rheumatic diseases depending on depression concomitance. 139 patients with rheumatic diseases were enrolled into the study-43 (39F/4 M) patients with RA, 31 (24F/7 M) patients with PsA, 27 (22F/5 M) patients with SLE and 38 (33F/5 M) patients with SSc. In all patients, the concentration of AGE was assessed using the AGE Reader device (DiagnOptics BV Groningen, The Netherlands). The Beck Depression Inventory II was used to assess depression in the patients. Patients who scored 14 points or more in the BDI-II were diagnosed with depression. In the studied group, depression was identified in 73 (53%) patients-25 with RA, 21 with PsA, 11 with SLE and 16 with SSc. Mean SAF in patients with depression was 2.8 ± 0.4, and in the group with no depression-2.2 ± 0.5 (p < 0.001). The study results indicate that in the course of rheumatic diseases, the presence of depression may influence the increase in AGE concentration in the skin. Therefore, evaluating AGE levels in the skin may be clinically relevant as it can help identify patients who may be at risk of developing depression.

Vascular density and macular sensitivity in eyes after scleral buckling surgery for macula-on rhegmatogenous retinal detachment.

PURPOSE: To investigate the structure and function of the retina after scleral buckling (SB) surgery due to macula-on rhegmatogenous retinal detachment (RRD). METHODS: Twenty eyes with repaired macula-on RRD and 20 fellow eyes were included. All patients within 6-12 months of the procedure, were examined to evaluate retinal structure using spectral domain optical coherence tomography (SD-OCT) and vessel density (VD) by OCT angiography (OCTA). Best corrected visual acuity (BCVA) and microperimetry (MP) tests were used to assess retinal function. RESULTS: Analysis of the microvascular network using OCTA between the operated and healthy fellow eyes showed a significant reduction on VD in superficial vascular plexus (SVP), deep vascular plexus (DVP) and radial peripapillary capillaries (RPC) (p< 0.001, p = 0.019 and p = 0.008, respectively). Comparison of retinal structure in SD-OCT showed no significant differences on thickness in ganglion cell complex (GCC) and peripaillary retinal nerve fiber layer (pRNFL) (p> 0.05) between examined eyes. Retinal function analysis by MP examination showed a decrease of retinal sensitivity (p = 0.0013) whereas postoperative BCVA showed no differences (p = 0.62) in the operated eyes. Significant Pearson's correlations were observed between retinal sensitivity and VD in SVP, RPC (p< 0.05). CONCLUSION: In the eyes after SB surgery due to macula-on RRD, changes in retinal sensitivity were accompanied by impairment of the microvascular network assessed by the OCTA.

Efficacy and Safety of a Hyaluronic Acid-Containing Cream in the Treatment of Chronic, Venous, or Mixed-Origin Leg Ulcers: A Prospective, Multicenter Randomized Controlled Trial.

INTRODUCTION: Topical applications of hyaluronic acid (HA)-containing formulations, based on the complex and vital role of HA in all stages of the wound-healing process, are routinely used with standard therapy to promote faster healing of chronic wounds. However, evidence to guide clinical decisions on the use of topical HA in the healing of vascular leg ulcers is limited. OBJECTIVE: This study compared the efficacy and safety of topical application of a hyaluronic acid cream vs a neutral comparator (identical cream without HA) in treating subjects with chronic leg ulcers of vascular origin. MATERIALS AND METHODS: This was a prospective, multicenter double-blind randomized controlled trial. One hundred sixty-eight subjects with chronic leg ulcers of venous or mixed (venous and arterial) origin were randomized to receive either topical applications of 0.2% HA cream or neutral comparator cream for a maximum of 20 weeks. The primary efficacy endpoint was complete ulcer healing (100% reepithelialization of the wound area centrally assessed at 20 weeks or before and confirmed 3 weeks later). In both groups, topical treatment was associated with standard therapy (ulcer cleansing and optimized compression). RESULTS: The proportion of subjects with centrally assessed complete healing of the target ulcer that was confirmed 3 weeks later (primary efficacy endpoint) was substantially higher in the HA cream group (31.3%) than in the neutral cream group (14.8%; P =.009). Results in the full analysis, per protocol, and as assessed by the investigator were consistent with primary results. No significant difference in treatment effect was observed when subjects were stratified according to baseline ulcer size (≤20 cm2 or >20 cm2) regardless of topical treatment. Safety and tolerability were comparable between treatments. CONCLUSIONS: Treatment of subjects with chronic leg ulcers of venous or mixed origin with HA cream is safe, well tolerated, and results in a higher rate of healing than a neutral comparator cream.

The response surface methodology for optimization of tyrosinase immobilization onto electrospun polycaprolactone-chitosan fibers for use in bisphenol A removal.

Composite polycaprolactone-chitosan material was produced by an electrospinning method and used as a support for immobilization of tyrosinase by mixed ionic interactions and hydrogen bonds formation. The morphology of the fibers and enzyme deposition were confirmed by SEM images. Further, multivariate polynomial regression was used to model the experimental data and to determine optimal conditions for immobilization process, which were found to be pH 7, temperature 25 °C and 16 h process duration. Under these conditions, novel type of biocatalytic system was produced with immobilization yield of 93% and expressed activity of 95%. Furthermore, as prepared system was applied in batch experiments related to biodegradation of bisphenol A under various remediation conditions. It was found that over 80% of the pollutant was removed after 120 min of the process, in the temperature range 15-45 °C and pH 6-9, using solutions at concentration up to 3 mg/L. Experimental data collected proved that the stability and reusability of the tyrosinase were significantly improved upon immobilization: the immobilized biomolecule retained around 90% of its initial activity after 30 days of storage, and was still capable to remove over 80% of bisphenol A even after 10 repeated uses. By contrast, free enzyme was able to remove over 80% of bisphenol A at pH 7-8 and temperature range 15-35 °C, and retained less than 60% of its initial activity after 30 days of storage.

Evaluation of TGF-Beta 2 and VEGFα Gene Expression Levels in Epiretinal Membranes and Internal Limiting Membranes in the Course of Retinal Detachments, Proliferative Diabetic Retinopathy, Macular Holes, and Idiopathic Epiretinal Membranes.

PURPOSE: To evaluate the expression profiles of the VEGFα and TGFß in the ERMs and ILMs in retinal disorders. METHODS: In this nonrandomized prospective study, 75 patients (34 females and 41 males) referred to pars plana vitrectomy (PPV) due to different retinal diseases were enrolled to the study. The samples of ERMs and ILMs collected during PPV were immediately put in TRIzol® Reagent (Life Technologies, USA) and stored at -70°C until RNA extraction. Gene expression analysis was done with TaqMan® Gene Expression Assays (Applied Biosystems, USA) following the manufacturer's instructions. RESULTS: The gene expression levels of VEGFα as well as of TGFß2 were significantly higher in ERMs than in ILMs in all studied groups. The level of TGFß2 expression exhibits a significantly lower values in iERMs as compared with the RRD group (p = 0.043). There were differences in TGFß2 expression in ILM in groups studied: DR versus RRD, p = 0.003; DR versus iERM, p = 0,047; and iERM versus RRD, p = 0.004. CONCLUSIONS: Our results revealed that factors associated with angiogenesis and wound healing processes in eyes with RRD, PDR, iERM, and MH were more upregulated in ERMs than in ILMs. This may indicate that ILM is not responsible for reproliferation and its peeling should be avoided in routine PPV.

Long-Term Anatomic and Functional Outcomes after Macular Hole Surgery.

AIM: To evaluate the structural and functional outcomes in patients who underwent macular hole (MH) surgery in the long-term follow-up. MATERIALS AND METHODS: Forty-four eyes of 40 patients (28 females and 12 males) were examined. The examination included visual acuity, optical coherence tomography, and colour vision testing. The same evaluation was performed in 30 fellow eyes. RESULTS: MH closure was obtained in 42 eyes (95.45%). There was no reopening of the initially closed MHs. In long-term postoperative examination, we observed IS/OS junction defects in 28 (63.6%) eyes and ELM defects in 19 (43.2%) eyes. We found that the IS/OS junction defects correlated with the diameter of the MH (p=0.016), whereas ELM defects correlated with both the diameter of the MH (p=0.001) and duration time of the MH (p=0.008). The presence of ELM defects in OCT was the cause of inferior BCVA in long-term observation time (p=0.004). The mean BCVA before the MH surgery was 0.15. It improved significantly both in early (p < 0.001) and long-term postoperative observation (p < 0.005). Generally, the functional outcomes were better in eyes with short-time duration of the MH, when a smaller diameter (<400 µm) of the hole was measured and a V-shaped closure of the MH and the restoration of the ELM line on OCT were present. Pseudoprotanomaly was noted in 13 (35.1%) eyes. In the fellow eye group, mean BCVA was 0.95 (range, 0.6-1.0). In 3 eyes, we detected vitreomacular traction, and in 4 eyes, initial cataract. These conditions, as well as probably early stage of diabetes mellitus, influenced functional outcomes of studied eyes. CONCLUSIONS: The anatomic and functional outcomes after macular surgery are satisfactory and improve with time. After a successful closing of the MH, the restoration of the retina progresses at a slower pace than improvement in visual acuity.

Prevalence of Impaired Hearing and Vision in Patients with Vitiligo.

Vitiligo is a common dermatosis occurring with a frequency of about 0.2-4.0% in world population. The main skin symptom of disease are white patches appearing as a result of destruction or dysfunction of pigment cells (melanocytes). Melanocytes are localized not only in epidermis and bulge region of hair follicle, but also in inner ear and eyeball structures, and therefore vitiligo may coexists with auditory and visual disorders. The most frequent auditory and visual disturbances occurring in vitiligo patients are discussed in this article.

Synthesis, crystal structure and spectroscopic properties of a novel yttrium(III) fluoride dimolybdate(VI): YFMo2O7.

Thermal treatment of a mixture of Y2O3, YF3 and MoO3 in a 1 : 1 : 6 molar ratio at 850 °C in evacuated silica ampoules yielded colorless, platelet-shaped single crystals of YFMo2O7. SiO2 was dissolved from the ampoule wall in small amounts, but could be removed from the crude product by treatment with hydrofluoric acid (20%). The title compound crystallizes monoclinically in the space group P2/c with two formula units per unit cell with the dimensions a = 4.2609(2), b = 6.5644(4), c = 11.3523(7) Å, and ß = 90.511(2)°. Its crystal structure contains crystallographically unique Y(3+) cations in a pentagonal bipyramidal environment consisting of two F(-) anions in the apical positions and five O(2-) anions in the equatorial positions. These polyhedra are connected to {[YFO](8-)} chains along [100] by sharing common F(-) vertices. The likewise crystallographically unique Mo(6+) cations exhibit a coordination number of five and reside in the centers of distorted square pyramids built up of oxide anions. These entities are fused to chains along [001] by sharing common edges and vertices according to {[MoOOO](-)}. Taking a sixth oxygen ligand further away from the Mo(6+) cations into account, the aforementioned chains assemble to corrugated {[MoOOO](-)} layers perpendicular to [010] with the {[YFO](8-)} chains situated between these sheets. Since Y(3+) represents a non-luminescent rare-earth metal(iii) cation, YFMo2O7 is a suitable host material for doping with luminescence-active lanthanoid(iii) cations, such as Eu(3+).

Blood plasma levels of microelements in patients with history of optic neuritis.

PURPOSE: To determine the concentration of microelements in the blood of patients with a history of retrobulbar optic neuritis (ON). MATERIALS AND METHODS: We examined 36 patients (18-63 years of age) - 11 with demyelinating ON (Group 1) and 25 with isolated ON (Group 2) - all of whom had been treated for retrobulbar ON. The control group comprised 38 healthy volunteers. Using atomic absorption spectroscopy, blood levels of zinc (Zn), iron (Fe), copper (Cu) and cadmium (Cd) were evaluated. RESULTS: Compared with the control group, concentrations of Cd were elevated in Groups 1 and 2 (p = 0.003 and p = 0.003, respectively); Group 1 had higher levels of Cu (p = 0.02). Patients from both groups had significantly lower levels of Fe (p = 0.0003) compared with controls. No difference in the concentration of any of the microelements was found between Groups 1 and 2. CONCLUSION: Disturbances in Cd, Cu and Fe homeostasis may be associated with the inflammatory process of ON.

The borosulfate story goes on--from alkali and oxonium salts to polyacids.

The structural principles of borosulfates derived from the B/S ratio are confirmed and extended to new representatives of this class showing novel motifs. According to the composition, Na[B(S2O7)2] (P2(1)/c; a=10.949(6), b=8.491(14), c=12.701(8) Å; ß=110.227(1)°; Z=4) and K[B(S2O7)2] (Cc; a=11.3368(6), b=14.662(14), c=13.6650(8) Å; ß=94.235(1)°; Z=8) contain isolated [B(S2O7)2](-) ions, in which the central BO4 tetrahedron is coordinated by two disulfate units. The alkali cations have coordination numbers of 7 (Na) and 8 (K), respectively. The structure of Cs[B(S2O7)(SO4)] (P2(1)/c; a=10.4525(6), b=11.3191(14), c=8.2760(8) Å; ß=103.206(1); Z=4) combines, for the first time, sulfate and disulfate units into a chain structure. Cs has a coordination number of 12. The same structural units were found in H[B(S2O7)(SO4)] (P2(1)/c; a=15.6974(6), b=11.4362(14), c=8.5557(8) Å; ß=90.334(3)°; Z=8). This compound represents the first example of a polyacid. The hydrogen atoms were located and connect the chains to form layers through hydrogen-bonding bridges. H3O[B(SO4)2] (P4/ncc; a=9.1377(6), c=7.3423(8) Å; Z=4) is the first oxonium compound of this type to be found. The BO4 tetrahedra are linked by SO4 tetrahedra to form linear chains similar to those in SiS2. The chains form a tetragonal rod packing structure with H3O(+) between the rods. The structures of borosulfates can be classified following the concept described by Liebau for silicates, which was extended to borophosphates by Kniep et al. In contrast to these structures, borosulfates do not comprise B-O-B bonds but instead contain S-O-S connections. All compounds were obtained as colourless, moisture-sensitive single crystals by reaction of B2O3 and the appropriate alkali salt in oleum.

Exploring a new structure family: alkali borosulfates Na5[B(SO4)4], A3[B(SO4)3] (A = K, Rb), Li[B(SO4)2], and Li[B(S2O7)2].

New alkali borosulfates were obtained by precipitation from oleum, solid-state reactions, or thermal decomposition. The crystal structures were characterized with single-crystal data. They are all based on corner-linked BO4 and SO4 tetrahedra with varying coordination of the alkali cations. According to the ratio of BO4 and SO4 tetrahedra, different frameworks are observed, i.e., noncondensed complex anions (1:4), one-dimensional chains (1:3), or three-dimensional (3D) networks (1:2). This is in analogy to silicates, where the ratio Si/O relates to the dimensionality also. For Na5[B(SO4)4], which exists in two different polymorphs, there are noncondensed pentameric units. Na5[B(SO4)4]-I: space group Pca21, a = 10.730(2) Å, b = 13.891(3) Å, c = 18.197(4) Å. Na5[B(SO4)4]-II: space group P212121, a = 8.624(2) Å, b = 9.275(2) Å, c = 16.671(3) Å. A3[B(SO4)3] (A = K, Rb) are isotypic with Ba3[B(PO4)3] adopting space group Ibca [K3[B(SO4)3], a = 7.074(4) Å, b = 14.266(9) Å, c = 22.578(14) Å; Rb3[B(SO4)3], a = 7.2759(5) Å, b = 14.7936(11) Å, c = 22.637(2) Å] with vierer chains of BO4tetrahedra based on two bridging and two terminal SO4 tetrahedra. Li[B(SO4)2] [space group Pc, a = 7.6353(15) Å, b = 9.342(2) Å, c = 8.432(2) Å, and ß = 92.55(2)°] comprises a 3D network that is closely related to ß-tridymite. Li[B(S2O7)2] [space group P212121, a = 10.862(2) Å, b = 10.877(2) Å, c = 17.769(4) Å] represents the first example of a disulfate complex with noncondensed [B(S2O7)2](-) units. Vibrational spectra were recorded from all compounds, and the thermal behavior was also investigated.

Endothelial cell markers in patients with pseudoexfoliation syndrome.

The aim of the study was the assessment of the von Willebrand antigen (vWF Ag), E-selectin, and P-selectin concentration in blood plasma of patients with pseudoexfoliation syndrome (PEX). The group studied comprised 30 patients with PEX, aged from 50 to 86 years (mean 73, SD ± 8 years). Patients with cardiovascular and cerebrovascular diseases, diabetes mellitus, infectious disease, cancer, renal or liver insufficiency, connective tissue disease, current smoking, and hormone, antiplatelet, hypolipidemic, antioxidant, or antihypertensive drug therapy were excluded from the study. Each subject underwent a complete ophthalmological examination. Venous blood samples from the cubital vein were taken into sodium citrate solution. VWF Ag, sP-selectin, and sE-selectin concentration were determined by a commercially available enzyme-linked immunosorbent assay (MedSystems, Diagnostica Stago/Roche, R&D). Concentrations of vWF Ag, soluble E-selectin, and soluble P-selectin in blood plasma in the study group were compared with the levels in blood plasma in the control group. No significant differences were found between the groups. Our results indicate that there might be no correlation between PEX and such endothelial cell markers as vWF Ag, sP-selectin, and sE-selectin concentrations. Since the study size is limited, further investigations to confirm that there is no association between endothelial dysfunction in PEX and risk of future cardiovascular disease are necessary.

Surprising luminescent properties of the polyphosphates Ln(PO3)3:Eu (Ln = Y, Gd, Lu).

The optical emission properties of the lanthanoid catena-polyphosphates Ln(PO(3))(3) (Ln = Y, Gd, Lu) doped with europium were investigated. Incommensurately modulated ß-Y(PO(3))(3):Eu (super space group Cc (0|0.364|0)0) and Gd(PO(3))(3):Eu (space group I2/a) show the usual emission characteristics of Eu(3+), while in Lu(PO(3))(3):Eu (space group Cc) the europium is unprecedentedly partially reduced to the divalent state, as proven by both a broad emission band at 406 nm excited at 279 nm and an EPR spectroscopic investigation. (151)Eu-Mössbauer spectroscopy showed that only a very small part of the europium is reduced in Lu(PO(3))(3):Eu. An explanation for this unusual behaviour is given.

Oral acetaminophen (paracetamol) for additional analgesia in phacoemulsification cataract surgery performed using topical anesthesia Randomized double-masked placebo-controlled trial.

PURPOSE: To evaluate the clinical analgesic efficacy of 1.0 g oral acetaminophen (paracetamol) given in addition to topical anesthesia before phacoemulsification cataract surgery. SETTING: Inpatient and outpatient ophthalmology clinics, Bydgoszcz, Poland. METHODS: Consecutive patients with age-related cataract having phacoemulsification under topical anesthesia (tetracaine 0.5%) were enrolled in a prospective double-blind randomized placebo-controlled study. Patients were randomly assigned to preoperative oral administration of a placebo medication or to oral administration of 1.0 g acetaminophen. The main outcome measure was intensity of pain during and after surgery. Pain intensity was measured using a 10 cm baseline visual analog scale and a discrete 5-category verbal rating scale. RESULTS: The study comprised 160 consecutive patients (80 in each group). Intraoperatively, the mean visual analog scale pain intensity score was 2.17 +/- 1.81 in the placebo group and 1.45 +/- 1.17 in the acetaminophen group and the mean verbal rating scale score, 1.11 +/- 0.73 and 0.67 +/- 0.66, respectively (P<.01). Postoperatively, the mean visual analog scale score for pain was 1.47 +/- 1.39 in the placebo group and 0.56 +/- 0.61 in the acetaminophen group and the mean verbal rating scale score, 0.94 +/- 0.79 and 0.28 +/- 0.41, respectively (P<.01). There was no significant difference in patient behavior during surgery and no significant adverse effects of acetaminophen use. CONCLUSION: Preoperative oral administration of acetaminophen 1.0 g was effective, convenient, safe, and cost effective in reducing intraoperative and postoperative pain in phacoemulsification performed using topical anesthesia.

[Changes in the colour vision and contrast sensitivity in diabetic patients without retinopathy]. / Zaburzenia widzenia barwnego i wrailiwosci na kontrast u chorych z cukrzyca typu II bez cech retinopatii.

PURPOSE: The aim of the study was to examine the colour vision and contrast sensitivity of the patients with type II diabetes, without retinopathy. MATERIAL AND METHODS: The study included 25 patients with diabetes without retinopathy or any other ocular diseases (50 eyes were tested). The control group was represented by 15 healthy people. Both anomaloscopic test, Rayleigh (red-green axis) and Moreland (blue-yellow axis) were used to test colour vision. Contrast senstivity was measured in spatial frequency of 2, 4, 6, 12 and 18 cycles/degree by using Gratings Contrast Sensitivity Test. RESULTS: The contrast sensitivity was lower in the spatial frequency of 6, 12 and 18 cycles/degree. The colour vision changes were observed (especially in the blue-yellow axis) more often than in healthy people. CONCLUSIONS: The colour vision examination and contrast sensitivity measurement in patients with diabetes without retinopathy can detect visual function disturbances in the early, subclinical stage of the disease.

[Retrobulbar optic neuritis and multiple sclerosis]. / Pozagalkowe zapalenie nerwu wzrokowego a stwardnienie rozsiane.

PURPOSE: The aim of the study was to analyze the cases of retrobulbar neuritis and their connection with multiple sclerosis. MATERIAL AND METHODS: We follow in a retrospective (1989-2004) study 86 patients with retrobulbar optic neuritis, 59.3% of whom were females and 40.7% males. RESULTS: Recurrent retrobulbar optic neuritis was observed in 8 patients (9.3%), it was 7% of all eyes and in 27 patients (31.4%), that is 47.8% of all eyes, it was bilateral. Multiple sclerosis was diagnosed in 8 cases, the same number of the patients was already treated because of SM. The most common initial symptom was decrease in visual acuity, which was poor (0.1 or worse) in 60% of the cases at the beginning. Pain occurred in 29.7%, pupillary defects in 28.7%, temporal or total pallor of the optic disc in 32.6% of the patients. Central field defect was rather rare in the group studied (22.7%), to compare with paracentral or peripheral one (46.6%). In most cases of the visual evoked potentials we noticed the elongation in the latency of P100. Among 31 cases of MRI examination of the central nervous system demyelination lesions have been revealed in 25.8%. CONCLUSIONS: We observed more cases of bilateral optic neuritis and paracentral defects than other authors. A number of diagnosed multiple sclerosis patients was high taking into consideration relatively short period of observation.

An integrated analysis of ergonomics and time consumption in Swedish 'craft-type' car disassembly.

Car disassembly is at the edge of extensive rationalization due to increased legislative demands for recycling. This study focused on (1) assessing current mechanical exposures (physical work loads) for comparison with future rationalised systems, with particular emphasis on time aspects, (2) analysing disassembly work in terms of time consumption and exposures in constituent tasks as defined by a loss analysis technique, and (3) predicting the consequences of car disassembly rationalisation for mechanical exposures. The study showed that disassembly implied pronounced circulatory loads, and that more walking and higher lumbar peak loads were found than in studies of assembly work. Value-adding tasks comprised 30% of the total working time, and implied higher postural exposures for the head, arm, trunk and wrist, as well as less opportunities to recover, as compared to non-value-adding tasks. Organisational-type rationalization can be expected to increase the time spent in value-adding work, thus increasing local exposures for the average worker, while a concurrent increase in mechanization level might reduce circulatory exposures, the amount of walking, and peak lumbar loads.