Urinary 1-hydroxypyrene levels in offshore workers.

OBJECTIVES: To compare differences in pre- and post-shift urinary 1-hydroxypyrene (1OHP) levels as a measure of internal dose of polycyclic aromatic hydrocarbons (PAHs) between two groups of oil production workers offshore assumed to be exposed to PAH, and to compare the exposed group to an unexposed control group. METHODS: Participants' (n = 42) urine samples, collected over a study period of three consecutive 12-h work days (pre-shift on the first day and post-shift on the third day), were analyzed using high performance liquid chromatography (HPLC) with fluorescence detection. Analysis of covariance was used in the statistical models. RESULTS: (1) Post-shift 1OHP levels were significantly higher in the exposed workers compared to the controls. (2) Tank workers and process operators did not show statistically significant different post-shift 1OHP levels. CONCLUSION: Altogether, this study indicates the presence of a low level PAH exposure among offshore oil production workers.

Cluster of deaths from group A streptococcus in a long-term care facility--Georgia, 2001.

BACKGROUND: Invasive group A streptococcus (GAS) affects approximately 10,500 persons annually; 1 in 5 patients >/=65 years die. In August 2001, CDC investigated a cluster of GAS deaths in a Georgia long-term care facility (LTCF). METHODS: We screened LTCF residents and staff for GAS carriage and conducted a retrospective cohort study among residents. We defined a case as GAS isolation associated with clinical infection. RESULTS: Eight cases were identified (median age: 79 years); 6 (75%) patients died. Carriage was similar in residents (10%) and staff (9%). All isolates among residents and 63% among staff were type emm 77. Risk factors for GAS disease or carriage among residents were receiving skin treatment (relative risk [RR] = 4.0, 95% confidence interval [CI] = 1.9-11.0) and having an infected or colonized roommate (RR = 2.0, 95% CI = 1.10-5.0). No wound care nurse carried GAS. Interventions included education about standardized infection control guidelines and appropriate hand hygiene; carriers were treated with antibiotics. No subsequent GAS cases were identified in the following year. CONCLUSIONS: Transmission of GAS in this outbreak likely occurred during wound care and ended with improved hand hygiene. This investigation highlights additional research and policy needs for control of severe GAS infections among the high-risk LTCF population.