Electrocardiographic changes in workers occupationally exposed to lead.

BACKGROUND: The significance of heavy metals in pathogenesis of the circulatory system diseases remains unresolved. The aim of the study was to evaluate electrocardiographic changes in workers occupationally exposed to lead without clinical presentation of cardiac involvement. METHODS: A group of 60 smelters and refiners and 45 healthy men, as a control group, were enrolled. Twelve-lead electrocardiogram (ECG) and 24-hour Holter monitoring were performed. Further analysis included heart rate variability (HRV) in time and frequency domains and heart rate turbulence (HRT). RESULTS: Analysis of 12-lead ECG recordings revealed various pathologies in 27 out of 60 men occupationally exposed to lead. Twenty-four-hour ECG Holter monitoring showed the higher mean heart rate in copper smelters than in healthy subjects (85.8 ± 14.1 bpm vs 72.6 ± 9.2 bpm; P < 0.05) and more premature supraventricular and ventricular contractions (298 ± 235 vs 27 ± 45; P < 0.05 and 152 ± 138 vs 18 ± 18; P < 0.05, respectively). The majority of time domain and frequency domain HRV parameters were significantly lower, and the LF:HF ratio was higher when compared with the control group. Turbulence onset was abnormal in six copper smelters and turbulence slope in five men exposed to lead. CONCLUSIONS: Electrocardiographic evaluation showed that various heart rhythm disorders were more frequent in metallurgists, as compared to the control group, and the decreased HRV and abnormal parameters of HRT were observed. Noninvasive electrocardiographic evaluation could be a valuable method of the early prediction of cardiovascular disorders in men occupationally exposed to lead.

[The cardiovascular risk in chemical factory workers exposed to mercury vapor]. / Ryzyko sercowo-naczyniowe u narazonych na dzialanie par rteci pracowników zakladów chemicznych.

BACKGROUND: Cardiovascular diseases, including hypertension, are a leading cause of death in developing and developed countries. Mercury can induce hypertension and atherosclerosis in experimental animals and humans. The assessment of the effect of mercury on the occurrence of cardiovascular system disturbances in the population is an essential task. The aim of this study was to assess the association between mercury concentration in urine and the risk of fatal cardiovascular disease during ten coming years. MATERIAL AND METHODS: The study included chemical factory workers who used mercury in the chlorine production. RESULTS: The mean urine concentration of mercury in 154 workers was 4.9 +/- 11.2 microg/g creatinine. The most common disease was hypertension. CONCLUSIONS: The cardiovascular risk was higher in workers exposed to small or moderate mercury levels than in workers exposed to mercury vapor in high concentrations. Furthermore, the negative association was observed between mercury exposure and smoking in workers with low urinary excretion of mercury.

[Can angiography system with large-area flat digital panel induce higher irradiation in a patient during coronary angiography]. / Czy angiografy z plaskim panelem cyfrowym o dutej powierzchni powoduja wieksze napromieniowanie chorego poddanego koronarografii.

BACKGROUND: Nowadays, angiography systems with flat digital panel are used in cardiology and invasive radiology as the detector of irradiation. The so called universal systems with a magnified panel are becoming more common. In this study we tried to find out whether in practice the increased surface area of detectors may increase the absorption dose in a patient. MATERIAL AND METHODS: The study included 486 patients who underwent coronary angiography carried out by the same physicians. In 268 subjects the procedure was performed in cathlab A equipped with a cardiac angiography system, whereas in 218 subjects in cathlab B using universal angiography system. In the study the absorbed dose of irradiation by the patient was determined and its ratio to body mass, body mass index (BMI) and body surface area (BSA) was evaluated. RESULTS: The mean dose absorbed by the person under study did not differ between both catheterization laboratories. Similarly, there were no differences in the ratio of the absorbed dose and BMI. But the comparison of the ratio of the absorbed dose and the body mass showed significantly higher values in cathlab A, where. higher values of the ratio of the absorbed dose and BSA were also found (p < 0.01). CONCLUSIONS: In the present study it was found that the use of universal angiography systems with a larger surface area of the detecting panel is not connected with the increase in the irradiation dose absorbed by the patent during coronary angiography as compared with classical cardiac angiography systems.

The influence of the call with a mobile phone on heart rate variability parameters in healthy volunteers.

It is possible that electromagnetic field (EMF) generated by mobile phones (MP) may have an influence on the autonomic nervous system (ANS) and modulates the function of circulatory system. The aim of the study was to estimate the influence of the call with a mobile phone on heart rate variability (HRV) in young healthy people. The time and frequency domain HRV analyses were performed to assess the changes in sympathovagal balance in a group of 32 healthy students with normal electrocardiogram (ECG) and echocardiogram at rest. The frequency domain variables were computed: ultra low frequency (ULF) power, very low frequency (VLF) power, low frequency (LF) power, high frequency (HF) power and LF/HF ratio was determined. ECG Holter monitoring was recorded in standardized conditions: from 08:00 to 09:00 in the morning in a sitting position, within 20 min periods: before the telephone call (period I), during the call with use of mobile phone (period II), and after the telephone call (period III). During 20 min call with a mobile phone time domain parameters such as standard deviation of all normal sinus RR intervals (SDNN [ms]--period I: 73.94+/-25.02, period II: 91.63+/-35.99, period III: 75.06+/-27.62; I-II: p<0.05, II-III: p<0.05) and standard deviation of the averaged normal sinus RR intervals for all 5-mm segments (SDANN [ms]--period I: 47.78+/-22.69, period II: 60.72+/-27.55, period III: 47.12+/-23.21; I-II: p<0.05, II-III: p<0.05) were significantly increased. As well as very low frequency (VLF [ms2]--period I: 456.62+/-214.13, period II: 566.84+/-216.99, period III: 477.43+/-203.94; I-II: p<0.05), low frequency (LF [ms(2)]--period I: 607.97+/-201.33, period II: 758.28+/-307.90, period III: 627.09+/-220.33; I-II: p<0.01, II-III: p<0.05) and high frequency (HF [ms(2)]--period I: 538.44+/-290.63, period II: 730.31+/-445.78, period III: 590.94+/-301.64; I-II: p<0.05) components were the highest and the LF/HF ratio (period I: 1.48+/-0.38, period II: 1.16+/-0.35, period III: 1.46+/-0.40; I-II: p<0.05, II-III: p<0.05) was the lowest during a call with a mobile phone. The tone of the parasympathetic system measured indirectly by analysis of heart rate variability was increased while sympathetic tone was lowered during the call with use of a mobile phone. It was shown that the call with a mobile phone may change the autonomic balance in healthy subjects. Changes in heart rate variability during the call with a mobile phone could be affected by electromagnetic field but the influence of speaking cannot be excluded.

[Sepsis in the sphenoiditis patient]. / Posocznica u pacjentki z zapaleniem zatoki klinowej.

INTRODUCTION: We present a case of sepsis caused by isolated sphenoiditis. MATERIAL AND METHOD: The case being described concerns 61-year-old woman treated at the Department of Occupational Diseases of Wroclaw Medical University due to body temperature maintaining for 2 months at above 38 degrees C, leucocytosis reaching 14-16 thousand and weight loss of about 4 kg. Detailed diagnostics did not confirm the preliminary diagnosis of system or neoplastic disease. Bacteriological blood examination revealed the presence of staphylococcus aureus susceptible to Vancomycin and Tienam. The attempt of pharmacological treatment did not produced the expected effect. NMR examination of the facial skeleton proved partial shadowing of the Sphenoidal sinus. The patient was admitted for surgical treatment. After the sphenoidal sinus was cut open, mucopurulent contents was found inside. During microbiological examination, staphylococcus aureus with identical susceptibility was cultured from the mucopurulent contents. After 3-week guided antibiotic therapy, permanent temperature regression and permanent improvement of the patient's condition were achieved. RESULTS: Surgical treatment combined with intensive antibiotic therapy caused the complete regression of symptoms. CONCLUSION: Isolated sphenoiditis occurs rarely but it still is a serious diagnostic and therapeutic problem. Diagnosis delay and disease progress may lead to life-threatening complications.

[Occupational medicine as a science for the future]. / Medycyna pracy jako nauka przyszlosci.

Paper presents future trends of occupational medicine development, main issues of research and medical education. In paper authors also indicate the crucial role of occupational medicine in the field of health policy, health promotion and prevention.

[Coexistence of pneumoconiosis with myelodysplastic syndrome in a coal miner occupationally exposed to coal dust]. / Przypadek pylicy pluc wspotistniejacy z zespolem mielodysplastycznym u górnika narazonego na pyl weglowy.

Pneumoconiosis is the most common occupational disease of the respiratory system. The aim of this paper is presentation of case of pneumoconiosis coexisting with myelodysplastic syndrome in a former coal miner occupationally exposed to coal dust. In a mineral coal miner, aged 56 year, with a 15-year duration of work underneath, suffering from pneumoconiosis, pancytopenia was detected. He was admitted to the hospital, where myelodysplastic syndrome was diagnosed. The patient's condition was gradually worsening, even though chemotherapy was applied, he died from thrombocytopenia manifested by bleeding from the digestive tract in a relatively short time since diagnosis. The presented case seems to be interesting not only in view of possible development of pneumoconiosis as a result of occupational exposure to coal dust, typical in this case, but also in view of the occurrence of clonal disease of blood several years after cessation of exposure.

[Genotoxicity effect of chronic lead exposure assessed using the comet assay]. / Genotoksyczny efekt przewleklej ekspozycji na olów w tescie kometkowym.

BACKGROUND: Lead, an important xenobiotic, is globally well distributed. The IARC has classified inorganic lead compounds as possibly carcinogenic to humans. The study was designed to assess genotoxic effects in workers occupationally exposed to Pb. MATERIALS AND METHODS: The study comprised 62 male workers with chronic exposure to lead and 22 matched non-exposed men. DNA damage was assessed by single cell gel electrophoresis (known as comet assay) using peripheral blood lymphocytes. The level of DNA damage was determined as the percentage of cells with comets. RESULTS: Mean blood Pb (PbB) concentrations in workers exposed to lead were significantly higher than in controls (422.6 +/- 181.2 microg/l vs. 81.0 +/- 37.84 microg/; p< 0.01). The level and the grade of DNA damage were significantly higher in workers exposed to lead (total--12.55 +/- 7.93%; grade 1--9.05 +/- 5.78%; grade 3--1.05 +/- 1.28%; p < 0.05) than in controls (total--6.63 +/- 3.05%; grade 1--5.68 +/- 2.32%; grade 3--0.35 +/- 1.04%; p < 0.05). The highest level and the degree of DNA damage were observed in workers with PbB over 500 microg/l and the lowest in workers with PbB lower than 200 microg/l. CONCLUSIONS: Our results suggest that lead, particularly in people with chronic occupational Pb exposure and high PbB may induce DNA damage in peripheral lymphocytes detected by the comet assay, and thus should be regarded as a potential agent harmful to the human chromosome. The comet assay can be used to monitor and evaluate biological toxic effects in humans occupationally exposed to lead.

[Coexistence of occupational exposure to lead and sleep apnea syndrome as a cause of hypertension and arrhythmias. A case report]. / Wspólistnienie zawodowego narazenia na dzialanie olowiu oraz zespolu bezdechu sennego przyczyna nadcisnienia tetniczego i zaburzen rytmu serca. Opis przypadku.

A case of a 54-year-old man occupationally exposed to lead with diagnosed obstructive sleep apnea, hypertension and implanted artificial pacemaker due to atrioventricular dissociation of the third degree and pauses in sinus rhythm is presented.