No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992-2001.

BACKGROUND: From 1970 to 1990 increasing rates of asthma and allergic sensitisation were observed in several countries. The aim of this study was to investigate time trends in the prevalence of asthma and allergic sensitisation among school children in Germany between 1992 and 2001. METHODS: Parental reports of asthma, hay fever, and wheezing and measurements of specific serum IgE antibodies were investigated in six serial cross sectional surveys of 9-11 year old school children in three study areas in south west Germany. RESULTS: A total of 6762 school children of mean age 10 years (mean participation rate 77.9%) took part in the investigation in the three study areas. Over the 9 year study period no increase in the prevalence of current wheezing and asthma was observed. In addition, the prevalence of atopic sensitisation remained unchanged during the observation period. CONCLUSIONS: These data, using parental reports and objective measures of allergy, suggest that there has been no further increase in the prevalence of asthma and atopy since 1992. The epidemic may thus have reached a plateau.

[Human biomonitoring investigations of organochlorine compounds -- PCB, DDE, HCB, beta- and gamma-HCH, PCDD/PCDF, Dioxin-like PCB's and polybrominated biphenyl ethers]. / Humanbiomonitoring-Untersuchungen von Organohalogenverbindungen -- PCB, DDE; HCB, beta- und gamma-HCH, PCDD/PCDF, koplanaren PCB sowie polybromierten Biphenylethern.

Although PCB and PCB-containing materials are not processed for a long time, PCB is under discussion again and again caused by the pollution of indoor environments. To objectify the discussion, the dates of the PCB-biomonitoring, the organochlorine-compounds (DDE, HCB, beta-/gamma -HCH, PCDD/PCDF) and the polybrominated biphenyl ethers concerning the investigations within the project "Sentinel Health Departments" in Baden-Wurttemberg are represented. Additionally results from children from Kazakhstan (Aral-Sea area) and from teachers which are working in PCB polluted schools as well as from a long term investigated test person are reported. Blood concentrations of the following compounds decreased from 1996/97 to 2002/03: the sum of the concentration of PCB 138,153 and 180 decreased from 0.46 microg/L to 0.20 microg/L, DDE from 0.32 microg/L to 0.17 microg/, HCB from 0.20 microg/L to 0.08 microg/L, beta-HCH below the level of detection, I-TEQ NATO to 4.8 pg/g blood fat, TEQ WHO (without PCB) to 5.5 pg/g blood fat, PCB 126 to 18,8,pg/g blood fat and PCB 169 to 12.8 pg/g blood fat. The influence of breast feeding and the gender on the level of the pollution is conspicious. No local correlations were found in Baden-Wurttemberg, but they were found in comparison with the results of Kazakhstan (Aral-Sea area). The difficulty to produce time series while the analyzing pollutants are more and more decreasing, as well as the change of the calculation base of the summation of parameters like I-TEQ NATO to TEQ WHO are discussed.

[Determination of mold concentrations in homes and schools in Baden-Württemberg]. / Bestimmung der Schimmelpilzkonzentration in Wohnungen und Schulen Baden-Württembergs.

So far there have been rather few reliable and comparable data available on indoor pollution with mould. Following the publication of the Federal Environmental Agency and the Health Agency Baden-Württemberg which supports the assessment of mould pollution of indoor air, it seemed advisable to investigate as to how far these criteria can be used for the assessing the mould pollution in daily practice. The results of investigations of 130 homes and 117 classrooms in Baden-Württemberg. will be represented.

[10 years of observation by public health offices in Baden-Württemberg--assessment of human biomonitoring for mercury due to dental amalgam fillings and other sources]. / 10 Jahre Beobachtungsgesundheitsämter in Baden-Württemberg--Beurteilung der Human-Biomonitoring-Untersuchungen bezüglich der Quecksilber-Belastung durch Amalgamfüllungen und andere Quellen.

Since 1992, in Baden-Württemberg, ten-year old children have been surveyed in the project "Sentinel Health Departments" to study their exposure to environmental pollutants and possible health effects. In the four study areas 1200 children have been investigated every year initially, since 1996 every second year. The data for mercury in body fluids are reported here. The decrease in the body burden of mercury as a result of the declining usage of dental amalgam fillings, was been verified. In 1992/93, of all the children who had been surveyed, the 95 percentile for the body burden of mercury was 3.1 microg/l and in 2000/01 1.35 microg/l. Also to be discussed is the reason why mercury-based cosmetic ointments seriously exceed the HBM-II-intervention-value. Because of using these ointments, concentrations of mercury in urine up to 1400 microg/l were found. A study within the project "Sentinel Health Departments" compared the concentrations of mercury in the urine of adults with those in blood and salvia. The results support the opinion that mercury in urine is appropriate for estimating the mercury uptake from dental amalgam fillings. It can be assumed that these results reflect the situation in the entire Federal Republic of Germany. The ten years' experience confirms that the concept of the "Sentinel Health Departments" is excellently suited to obtain data relevant for environmental health of children. Environmental health protection and the essential gathering of data for future health observation in Baden-Württemberg.

First data on background levels of non-ortho and mono-ortho PCBs in blood of residents from southern Germany.

Blood-fat concentrations of polychlorinated biphenyls (PCB) congeners: no. 105, 118, 156 (mono-ortho-substituted) and no. 77, 126, 169 (non-ortho-substituted) and PCB congeners no. 28, 52, 101, 138, 153 and 180 were measured. The investigations were carried out in pooled samples from children and in individual samples from adults. Additionally polychloro-p-dibenzodioxins and -furans (PCDD/PCDF) were investigated.

[Sentinel public health offices--a new approach to determining public health relevant data by the public health service]. / Beobachtungsgesundheitsämter--ein neuer Ansatz zur Erhebung gesundheitsrelevanter Daten durch den OGD.

The discipline of environment-related health protection lacks continuously recorded data. Therefore, a three-year pilot project "Sentinel Public Health Offices" was initiated by the Ministry of Labour, Health and Social Welfare of Baden-Württemberg in 1992. Selected public health offices were instructed to conduct a series of three cross-sectional surveys of biological and effect monitoring among children attending the fourth grade of primary schools. The surveys were coordinated by the Provincial Public Health Office. During the pilot project the system of " Sentinel Public Health Offices" has proved successful not only in the continuous recording of data relevant to health. Its continuation as a permanent institution is contemplated.

[Duplicate study on the dietary intake of some metals/metalloids by children in Germany. I. Arsenic and mercury]. / Duplikatstudie zur Aufnahme von einigen Metallen/Metalloiden bei Kindern in Deutschland. Teil I: Arsen und Quecksilber.

The dietary intake of arsenic and mercury by 47 children (aged 5-8 years) living in West-Germany (Duisburg) is reported. Duplicate portions of all food and beverages were obtained on 2 days. Arsenic and mercury were measured by atomic absorption spectrometry under careful quality control. Results of are shown in the following table. [table: see text] Fish was consumed at 3 of 94 sampling days only. The arsenic and mercury intake on days with fish consumption was much higher compared with the other days (median, range): arsenic 8821; 4431-11954; mercury 123.7; 80, 0-167.5 ng/kg b.w. and day. The dietary arsenic and mercury intake was much lower than the FAO/WHO PTWI. For mercury the median intake amounted to 1.7% on days without and to 16.6% on days with fish consumption, for arsenic on days without fish consumption to 5.2% PTWI (only for inorganic arsenic compounds established) and on days with fish consumption (in fish mainly organic arsenic occur) 411% of PTWI. Based on the PTWI our data indicate no health risks for German 5-8-year-old children due to arsenic and mercury dietary intake.

[Duplicate study on the dietary intake of some metals/metalloids by children in Germany. part II. Aluminum, cadmium and lead]. / Duplikatstudie zur alimentären Aufnahme von einigen Metallen/Metalloiden bei Kindern in Deutschland. Teil II: Aluminium, Cadmium und Blei.

The dietary intake of aluminium, cadmium and lead by 47 children (aged 5-8 years) living in West-Germany (Duisburg) is reported. Duplicate portions of all food and beverages were obtained on 2 days. Aluminium, cadmium and lead were measured by atomic absorption spectrometry under careful quality control. Results are shown in the following table. [table: see text] The dietary intake of aluminium was low. The median amounted to 2.9% and the maximum value to 11.2% of the FAO/WHO PTWI. The correspondent data for cadmium were 30.2 and 98.7% and for lead 22.2% and 72.1% respectively.

Influence of intratracheal application of fluorocarbon 72 and different lipid-mixtures on mechanical behavior of isolated immature pig lungs.

Substitution of surfactant in immature lungs has two functional targets: the reduction of the overall alveolar surface tension and the mechanical stabilization of the system of alveoli having different diameters. Indeed, the lowering of the surface tension facilitates the inflation of the lungs, but according to Laplace's law small and large alveoli are not in pressure equilibrium as long as the surface tension is equal in both small and large alveoli. In the present work, we tried to stabilize the lungs and to compare the effect of bolus surfactant substitution with the two-step substitution of fluorocarbons and surfactant. In all, 24 fetal immature lungs were used. For our experiments we used fluorocarbon 72 (FC-72) with a surface tension of 12 mN/m. In groups 1 and 2, a mixture of dipalmitoylphosphatidylcholine (DPPC): cholesterol 9:1 (molar ratio) or DPPC: phosphatidylglycerol (PG) 9:1 (molar ratio) was administered intratracheally as a bolus. In the case of groups 3 and 4, the immature lungs were rinsed first with FC-72. After removing the fluorocarbon, the lungs were artificially ventilated and the DPPC: cholesterol 9:1 (group 3) or DPPC:PG 9:1 mixture (group 4) was given in aerosol form. Static pressure-volume curves (p-v) of the mean values of the 6 lungs in each group were registered at the beginning (0 min) and after 20 and 40 min of artificial ventilation. Airway opening pressure, weight-specific end-inspiratory lung compliance, and phospholipid contents were investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

Positive influence of nifedipine on early-stage minipig shock lung.

Mechanical and biochemical lesions can be observed in shock lung. To investigate the influence of the calcium antagonist nifedipine on these lesions, we produced shock lung in male minipigs. Three groups (control, thrombin, and thrombin + nifedipine; n = 5) were formed. In the second and third group thrombin was administered intravenously (400 IU/kg body weight) over a period of 2 h. After that the animals received aminocaproic acid (100 mg/kg body weight/h) throughout the rest of the study. Nifedipine was administered in the third group at a dosage of 46 micrograms/kg body weight/h. During the investigation period coagulation and hemodynamic status were examined as well as blood gas levels. Then the isolated lungs were examined. Without nifedipine there was a significant decrease in arterial PO2, an increase in airway opening pressure (Pi), and a decrease in weight-specific end-inspiratory lung compliance (Ci). These changes were not observed under the influence of nifedipine, after which the results were similar to the control group. This demonstrates a positive influence of nifedipine on the acid-base status and the investigated lung mechanical parameters.

Mechanical properties of fetal minipig lungs after substitution of surfactant with fluorocarbon and dipalmitoylphosphatidylcholine.

Respiratory distress syndrome (RDS) is characterized by quantitative and qualitative disturbances of surface active substances (surfactant). Therefore, intratracheal surfactant substitution is a favored subject of clinical investigations. In our study we tried to inflate and stabilize lungs in two steps: first, lungs were rinsed with a fluorocarbon and, second, artificially ventilated with a dipalmitoylphosphatidylcholine (DPPC) aerosol, the mean component of surfactant. Sixteen isolated fetal minipig lungs of day 95 (85% of the total gestation period) were used. From one pair of lungs one lung served as control (group 1), whereas the other was treated with DPPC (group II). In both groups the lungs were rinsed first with a fluorocarbon (FC-72, surface tension 12 mN/m). This maneuver was followed by an artificial ventilation with an aerosol of either salt solution (group I) or DPPC (group II) for 40 min. To characterize lung mechanics, static pressure volume curves were registered at 0, 20, and 40 min after fluorocarbon lavage. Airway opening pressure (pi), end-inspiratory volume (vi), and weight-specific end-inspiratory lung compliance (ci) were investigated. As biochemical parameters of the lungs we determined phospholipidphosphate content and DPPC, sphingomyelin (SM), and lysophosphaditylcholine (LPC) of the lung tissue. Significant differences were found with regard to phospholipidphosphate and DPPC content. No difference was seen in static pressure volume diagrams at the end of the investigation period.

Mechanical properties of isolated fetal miniature pig lungs after substitution with fluorocarbons.

In our present study we tried to inflate and stabilize isolated immature lungs of fetal minipigs in gestation age of 95 days (= 85% of total normal gestation period) with different fluorocarbons. Based on our previous experiences, the immature lungs at day 95 are almost non inflatable with air. For our experiments we used fluorocarbon 43 (FC-43) with a surface tension of 16 mN/m and fluorocarbon 72 (FC-72) with a surface tension of 12 mN/m. Eighteen fetal immature lungs were used. In group 1 the lungs were rinsed with FC-43; in group 2 the rinse solution was FC-72, and in group 3 the lungs were untreated. After removing the fluorocarbon, in the case of groups 1 and 2, the lungs were artificially ventilated. Pressure-volume (p-v) curves were registered in the beginning (immediately after FC lavage), after 10 and 20 min of artificial ventilation. Airway opening pressure (pi) and weight-specific end-inspiratory lung compliance (ci) were investigated. Statistically significant differences in weight-specific end-inspiratory compliance were found between FC groups and untreated group 3, but no stabilization could be seen during the investigation period of 20 min. No statistically significant improvement in weight-specific end-inspiratory compliance was observed between group 1 and 2, although the compliances of group 2 with FC-72 were better than those of group 1 with FC-43 in three p-v diagrams registered in the beginning and after 10 and 20 min of artificial ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Causes of the antibacterial action of amniotic fluid (author's transl)]. / Ursachen der antibakteriellen Wirkung von Fruchtwasser.

The activity of E. coli, Group B Streptococci, Strept. faecalis, Stap. epidermidis and Staph. aureus in human amniotic fluid was studied. In comparison to Standard I broth an inhibited growth of test organisms was observed. The bacteriostatic effect of amniotic fluid was most significant with Staph. epidermidis. We further investigated the causes for this bacterial growth inhibition with Staph. epidermidis. We showed that it is independent from the initial number of bacteria as well as from zinc and phosphate content, the phosphate-to-zinc ratio and from the protein content in amniotic fluid samples. It could neither be influenced by heating nor by autoclaving, but was immediately lost by adding Standard I both to amniotic fluid samples. In the concentrations we investigated the bacteriostatic effect was independent from the influence of steroid hormones.