Key demands and characteristics of occupations performed by individuals with spinal cord injury living in Switzerland.

STUDY DESIGN: Descriptive qualitative and quantitative study using cross-sectional data from the Swiss Spinal Cord Injury Cohort Study (SwiSCI). OBJECTIVE: To determine the key demands and characteristics of occupations performed by individuals with spinal cord injury (SCI). SETTING: Swiss community. METHODS: Job titles indicated by SwiSCI participants were linked to occupational titles from the Occupational Information Network (O*NET) and then frequency-analyzed across sociodemographic and injury-related factors. Subsequently, average O*NET relevance values ranging from 0 to 100 were calculated for the occupations' demands and characteristics, both in general and stratified by injury-related factors. RESULTS: The 1549 study participants indicated a total of 717 job titles and were primarily employed in administrative and management occupations (22.1% and 16.4%, respectively). The participants' occupations predominantly required verbal abilities (average relevance [AR]=68.4) and complex problem solving skills (AR=55.8) and were characterized by conventional work tasks (AR=62.9) and social relationships (AR=58.6). Both the occupations' frequency distribution as well as the average relevance levels of their demands and characteristics differed by SCI severity. CONCLUSIONS: Individuals with SCI perform a broad range of occupations that are mainly characterized by cognitive and communicative demands, while physical demands are of minor importance. By informing the development of job matching profiles for vocational guidance, our study facilitates the determination of well-matching jobs for persons with SCI and may contribute to a more sustainable return to work of the affected persons.

[Breastfeeding Rates and Duration in Germany - A Systematic Review]. / Stillhäufigkeit und Stilldauer in Deutschland ­ eine systematische Übersicht.

Aim: 20 years after establishment of the National Breastfeeding Committee, the present work, based on published data on breastfeeding, is aimed at providing insight into the development of breastfeeding behaviour in Germany. Methods: To identify relevant publications, a comprehensive literature search was conducted in PubMed and Web of Science using the search terms "breast feeding" or "breastfeeding" in combination with "Germany". The publication period was limited to the period 1995-2014. Results: A total of 35 studies with data on breastfeeding for the birth cohorts of 1990-2012 were identified. Most of the data had been collected in regional or local surveys, often retrospectively. About 60% of the studies had been conducted with the primary aim of collecting data on breastfeeding or infant nutrition. Over the past 2 decades, breastfeeding rates were always relatively high at the beginning (72-97%). However, they declined significantly within the first 2 months, and by the age of 6 months, only about 50% of infants were still breastfed. Conclusion: Breastfeeding support and early assistance should be offered to a greater extent in order to achieve sustainable improvement of breastfeeding frequency and duration in Germany. Regarding the quality of data collected on breastfeeding, it seems crucial to implement standardised approaches to monitor breastfeeding in Germany.

[Breast-feeding training programme as intervention approach at the hospital level: results of evaluation of the first phase of the STELLA study]. / Personalschulung als Interventionsansatz auf Klinikebene zur Stillförderung: Evaluationsergebnisse der ersten Phase der STELLA-Studie.

BACKGROUND: The health-promoting short- and long-term effects of breast-feeding are supported by a vast scientific literature. The Bavarian prospective cohort study 2005/2006 showed regional variations of breast-feeding rates. Furthermore, improvement in counselling mothers, particularly with regard to prevention and handling of breast-feeding problems, has a great potential for health promotion. The objective of this study is to promote breast-feeding in maternity clinics by improving the surrounding conditions. STUDY DESIGN: A clinic-based and community-related intervention trial was carried out in Lower Bavaria as a model region with below average breast-feeding rates. (1) INTERVENTION: an advanced training of maternity ward professionals of 10 hospitals and after-care midwives was performed from May until December 2008. The training programme was based on the WHO/UNICEF criteria of the "Ten Steps to Successful Breastfeeding" to deepen the breast-feeding knowledge and to improve the breast-feeding management. (2) EVALUATION: A singular assessment of the advanced training programme was undertaken concerning an increase of knowledge and the practicability in clinical everyday life by participants; improvements of the maternity wards were assessed via structural interviews with maternity ward staff before and after intervention. RESULTS: Approximately 85% (n=378) of the staff of the 10 maternity clinics attended the training course. The survey after the training programme (response rate 83%) indicated that more than 80% of the participants stated to have learned something new and to be able to use the knowledge acquired for their own practice. Results of the clinic interviews showed a transfer of training contents into clinical work routines. Improvements at interview date were shown best for bonding (all 10 maternity clinics), for additional feeding (8 maternity clinics) as well as for 24-h rooming-in and mother counselling (7 maternal clinics each). CONCLUSION: Training of maternity ward professionals accounts for baby-friendly conditions in maternity clinics. Most willingness for improvements was shown by maternity ward staff particularly for bonding between mother and child as well as for additional feeding. Considerable differences between the hospitals were observed for the promotion of infant formulas before and after the intervention.

Phthalates and their metabolites in breast milk--results from the Bavarian Monitoring of Breast Milk (BAMBI).

Phthalates have long been used as plasticizers to soften plastic products and, thus, are ubiquitous in modern life. As part of the Bavarian Monitoring of Breast Milk (BAMBI), we aimed to characterize the exposure of infants to phthalates in Germany. Overall, 15 phthalates, including di-2-ethylhexyl phthalate (DEHP), di-n-butyl phthalate (DnBP), di-isobutyl phthalate (DiBP), di-isononyl phthalate (DiNP), three primary metabolites of DEHP [mono-(2-ethylhexyl) phthalate (MEHP), mono-isobutyl phthalate (MiBP), and mono-n-butyl phthalate (MnBP)], and two secondary metabolites of DEHP were analyzed in 78 breast milk samples. We found median concentrations of 3.9 ng/g for DEHP, 0.8 ng/g for DnBP, and 1.2 ng/g for DiBP, while other parent phthalates were found in only some or none of the samples at levels above the limit of quantitation. In infant formula (n=4) we observed mean values of 19.7 ng/g (DEHP), 3.8 ng/g (DnBP), and 3.6 ng/g (DiBP). For MEHP, MiBP, and MnBP, the median values in breast milk were 2.3 µg/l, 11.8 µg/l, and 2.1 µg/l, respectively. The secondary metabolites were not detected in any samples. Using median and 95th percentile values, we estimated an "average" and "high" daily intake for an exclusively breast-fed infant of 0.6 µg/kg body weight (b.w.) and 2.1 µg/kg b.w., respectively, for DEHP, 0.1 µg/kg b.w. and 0.5 µg/kg b.w. for DnBP, and 0.2 µg/kg b.w. and 0.7 µg/kg b.w. for DiBP. For DiNP, intake values were 3.2 µg/kg b.w. and 6.4 µg/kg b.w., respectively, if all values in milk were set half of the detection limit or the detection limit. The above-mentioned "average" and "high" intake values corresponded to only about 2% to 7%, respectively, of the recommended tolerable daily intake. Thus, it is not likely that an infant's exposure to phthalates from breast milk poses any significant health risk. Nevertheless, other sources of phthalates in this vulnerable phase have to be considered. Moreover, it should be noted that for infants nourished with formula, phthalate intake is of the same magnitude or slightly higher (DEHP) than for exclusively breast-fed infants.

[Occurrence and relevance to health of persistent organic substances and phthalates in breast milk]. / Vorkommen und gesundheitliche Bedeutung von persistenten organischen Substanzen und Phthalaten in der Muttermilch.

The aim of this study is to give an overview of the concentrations of persistent organic pollutants like the polychlorinated dibenzo- P-dioxins (PCDD), polychlorinated dibenzofurans (PCDF), polychlorinated biphenyls (PCB), polybrominated diphenyl ether (PBDE), perfluorinated compounds (PFC) and of phthalates in breast milk. On the basis of median and 95 (th) percentile values an "average" and a "high" intake were calculated for a 3-month-old infant exclusively breast-fed. Moreover, the actual daily intake was compared with tolerable daily intakes (TDI) recommended by scientific institutions. On this basis, we found an "average" ("high") daily intake of 70 (140) pg TEQ/kg body weight (b. w.) for PCDD/F and dioxin-like PCB (dl-PCB), 10 (20) ng/kg b. w. for PFOS (perfluorooctanesulfonate), 20 (50) ng/kg b. w. for PFOA (perfluorooctanoate), 1.7 (7.5) ng/kg b. w. for BDE 47, and 0.6 (2.1) ng/kg b. w. for BDE 99. For di-2-ethylhexyl phthalate (DEHP) and di- N-butyl phthalate (DnBP) an "average" and "high" intake of 400 ng/kg b. w. and 2,000 ng/kg b. w. and of 100 and 500 ng/kg b.w. were assumed, respectively. For all of these substances we found a daily intake via breast milk below the TDI, established on a livelong basis. On contrary, the daily intake for the sum of the PCDD/F and dl-PCB considerably exceeded the recommended TDI value. Even with regard to the "high" daily intake values the share of PBDE, PFC, and phthalates on the TDI was only in the lower percentage. Scientific organisations assume that an exceeding of the PCDD/F and dl-PCB intake in relation to the TDI value is acceptable only on the basis of the still declining levels in breast milk and the fact that this high exposure only occurs during some months of the entire life when breast milk is consumed. On the basis of the recent exposure situation mothers can exclusively breast-feed their infants for 6 months without any hesitation. The well established health benefits for mothers and infants when exclusively breast-feeding should be utilised. There is also no health concern if the mother decides to breast-feed the baby for longer than 6 months when the infant also receives additional food.

[Atypical lipomatous tumors of the stomach. Clinical, morphological and molecular findings]. / Atypische lipomatöse Tumoren des Magens. Klinische, morphologische und molekularbiologische Befunde.

Two cases of primary gastric atypical lipomatous tumors (ALT) are presented. In case No.1, a 7x4x3 cm submucosal ALT (lipoma-like subtype) of the antrum/pyloric region in a 60-year-old woman was completely resected. Using interphase dual-color-FISH, MDM2- and CDK4 amplifications could be detected in distinguished amplicons. The patient was continuously free of disease after 56 months. In case No. 2, a 3.5 cm (in diameter) submucosal ALT (lipoma-like subtype) of the gastric body in a 56-year-old woman was completely resected. FISH revealed MDM2 amplification while the CDK4 gene remained in diploid copies. This patient was continuously free of disease after 36 months. The morphologic and molecular biological findings of this rare primary gastric mesenchymal tumor are discussed in comparison with the corresponding soft tissue lesions.

[Nickel levels in female dermatological patients]. / Innere Nickelbelastung von dermatologischen Patientinnen.

Nickel levels in urine were determined among 163 female dermatological patients aged 18 to 46 years. Data on life-style factors were collected in parallel via a questionnaire. Urinary nickel excretion was in the normal range of the German female population (0.2-46.1 microg Ni/g creatinine). The 95th percentile (3.9 microg Ni/l urine) exceeded the German reference value (3.0 microg Ni/l urine). In the multivariate regression analyses we found a statistically significant increase of ln-transformed nickel levels with increase in age and in women using dietary supplements. The following variables were not associated with Nickel urine levels: suffering from nickel eczema, smoking, drinking stagnated water, eating foods with high nickel contents and using nickel-containing kitchen utensils as, for example, an electric kettle with an open heater coil. We conclude that personal urinary levels should be assessed with simultaneous consideration of habits and life-style factors. A German national survery would be useful. Those patients who experience the exacerbation of their eczema in cases of oral provocation, for example, by a high nickel diet should be aware of potential sources of nickel, such as supplements.

[Smoking, alcohol and caffeine consumption of mothers before, during and after pregnancy--results of the study 'breast-feeding habits in Bavaria']. / Rauchen, Alkoholkonsum und koffeinhaltige Getränke vor, während und nach der Schwangerschaft - Ergebnisse aus der Studie "Stillverhalten in Bayern"

AIM OF THE STUDY: The aim of this analysis of the study 'Breast-feeding habits in Bavaria' is to describe the smoking habits, alcohol and caffeine consumption of mothers in Bavaria before, during and after pregnancy. Furthermore, we asked about the environmental tabacco smoke exposition of pregnant women and infants. The influence of consumption habits on breast-feeding is quantified and the distribution of the risky habits in the population is characterised. METHODS: The study 'Breast-feeding habits in Bavaria' is a prospective cohort study which was carried out from April 2005 to January 2006. Some 3 822 mothers throughout Bavaria who had delivered a baby in April 2005 participated in the basic survey. Methods and first results have already been published. The participants were asked in 4 follow-up questionnaires about breast-feeding habits, smoking habits, and alcohol and caffeine consumption. The follow-up rate was 82%. Only participants with a complete follow-up were included into this analysis (n=3 103). RESULTS: Some 23.7% of the mothers smoked before pregnancy. The percentage of women reporting any smoking during pregnancy was 9.8%. More than half (53%) of the ex-smokers started to smoke again up to the end of month 9 after delivery. 25.3% of the mothers reported any alcohol consumption during pregnancy, 69.0% of pregnant women were drinking caffeine-containing beverages. The consumption rates were reduced clearly during pregnancy. Smoking had a higher prevalence in the group of young women with low school education, alcohol consumption in the group of elder women with high school education. Mothers born in Germany smoked significantly more than mothers with a migration background. Smoking had a significant, dose-dependent negative influence on a breast-feeding duration of <4 full months exclusive breast-feeding (1-5 cigarettes/day, odds ratio (OR) 2.04, 95% confidence interval (CI) 1.31-3.18; >5 cigarettes/day, OR 2.54, 95% CI 1.42-4.54). Caffeine consumption also had a significant negative influence on the breast-feeding duration (OR 1.49, 95% CI 1.25-1.79), whereas alcohol consumption did not. CONCLUSION: Alcohol consumption, smoking and coffee consumption are common in the population of pregnant women. Apart from established preventive initiatives, additional measures focussed on young pregnant women with low school education can lower smoking rates in this risk group. More attention should be given to the topic alcohol consumption in pregnancy.

[An interventional study to improve breast-feeding conditions in obstetric clinics of a model region in Bavaria]. / Eine Interventionsstudie zur Verbesserung von Stillbedingungen in Geburtskliniken einer Modellregion in Bayern.

Breastfeeding is influenced amongst other aspects by the support of the medical staff in clinics. Therefore WHO and UNICEF have implemented the programme "ten steps to successful breastfeeding" and the certificate "Baby friendly hospital" to promote breastfeeding in clinics. When the study "Breastfeeding in Bavaria" was started only two clinics in Bavaria were certified as baby friendly. In a Bavarian region where breastfeeding rates were significantly lower than in other regions an intervention study will be conducted. The aim of the study is to educate the clinic staff in the support of breastfeeding mothers. This paper describes the aims and methods of this intervention study.

[Breast milk monitoring in Bavaria]. / Muttermilchmonitoring in Bayern.

Up to now breast milk analyses of the Bavarian Health and Food Safety Authority are limited to organochlorine pesticides, polychlorinated biphenyls (PCB) and nitro musks. These chemicals have revealed decreasing background levels in breast milk over the past two decades. To implement a monitoring program with an extended spectrum of substances suspected to be of concern a new concept for breast milk monitoring in Bavaria has been developed.

[Breast-feeding, frequency and problems - results of the bavarian breast-feeding study]. / Stillfrequenz und Stillprobleme - Ergebnisse der Bayerischen Stillstudie.

AIMS: The aim of the present evaluation is to describe the frequency of breast-feeding as well as breast-feeding problems of mothers in Bavaria and to derive practical measures to promote breast-feeding. METHODS: The study "Breast-Feeding Behaviour in Bavaria" is a prospective cohort study that was carried out from April 2005 to January 2006. 3 822 mothers who had given birth in April 2005 from all of Bavaria participated in the study. The methods and preliminary results have already been described. The participants of the study were questioned about their breast-feeding habits in 4 follow-ups. The follow-up quota was 82%. RESULTS: The frequency of breast-feeding exclusively according to needs at 2-6 days following delivery was about 62%. At the end of the infants' second month of life only 46.7% of the infants were breast-fed at least 7 times. In the first 2 months the prevalence of breast-feeding problems in mothers who still breast-feed and those who had stopped was about the same. In mother-infant pairs who no longer breast-feed, the concerns about too little milk, sore nipples and drinking or sucking problems of the infant predominated. CONCLUSIONS: Breast-feeding problems that lead to termination of nursing are often due to a lack of milk or, respectively, a mother's concern about giving too little milk. Prospective, quality-assured counselling should focus on increasing the frequency of breast-feeding and on an improvement of suckling techniques in the first weeks of life. The medical necessity to supplementary feeding should be critically assessed and clearly explained to the mother in order to avoid giving her the feeling that she is unable to adequately feed her own child.

[Differences in small area prevalence of respiratory diseases in children: challenges of an investigation initiated by parents]. / Kleinräumige Prävalenzunterschiede von Atemwegserkrankungen bei Kindern: Grenzen der Erkenntnismöglichkeiten einer von Eltern angeregten Studie.

OBJECTIVE: The aim of our study was to assess the prevalence of respiratory diseases in children living in a rural area in Bavaria in a systematic and standardised way to clarify whether a disease cluster exists. Reports from a parents' initiative claiming an increase of diseased children and assuming an association with air pollution due to nearby industrial sources and heavy traffic were the reason for the study. METHODS: Parents of all children living in small towns specified by the parents' initiative as affected region (central area) and parents of those children aged 6-7 or 13-14 years living in adjacent areas (control area) were asked to complete a written questionnaire. In bivariate analysis, differences in prevalences between the central area and the control area were assessed by the chi (2) test. In multivariate analysis, confounder-adjusted odds ratios with 95 % confidence intervals were calculated by logistic regression. In addition, generalized linear mixed models were used to control for potential clusters in families. RESULTS: The response rate was rather low (total 46 %, central area 53 %, control area 34 %). The study population comprised 121 girls and 141 boys. There was a pattern of increased prevalences of cough, wheeze and respiratory diseases caused by infections in children living in the central area compared to the control area. However, statistical significance was rarely observed. No systematic differences were observed for the prevalence of allergic rhinitis and atopic dermatitis. Selection bias due to varying response rates in the central versus the control area and information bias introduced by the preceding intensive public discussion could not be excluded. The comparison of prevalences detected in the small area with published data from other epidemiological studies in Germany did not indicate a systematically increased prevalence of respiratory symptoms or physician-diagnosed respiratory diseases in children from the whole area as well as in children from the central area only. CONCLUSION: This study exemplifies the challenges of small area investigations initiated by the residential community to clarify an assumed disease cluster caused by environmental pollution. The prior comparison of small area prevalence data with results of other epidemiological studies aids the decision making as to whether a detailed study with comprehensive assessment of individual exposure is justifiable.

Cutaneous manifestations in inflammatory bowel disease.

UNLABELLED: Numerous extraintestinal manifestations in various organ systems have been reported to be associated with inflammatory bowel disease (IBD). Aim of the present paper was to evaluate the frequency of cutaneous manifestations in Crohn's disease (CD) and ulcerative colitis (UC) with respect to their location, the activity and location of the underlying disease, the treatment options and the time to remission. METHODS: The medical records of 1043 inpatients with CD and UC were screened retrospectively for extraintestinal symptoms with special regard to cutaneous manifestations. RESULTS: The prevalence of cutaneous manifestations in IBD was 22/1043 (2.1%; 18 women, 4 men; age: 31.41 +/- 9.9 [21-51] yrs.). In 15/22 patients (68.2%) the cutaneous manifestations were associated with CD, in 7/22 patients (31.8%) UC was confirmed. In 6/22 patients (27.3%) pyoderma gangrenosum (PG) was diagnosed, in 16/22 patients (72.7%) erythema nodosum (EN). EN and PG predominately occurred at the lower legs: in 68.1% the tibia was the main affection site. Other locations like breast or anus were rare. In 16/22 patients (72.7%) an acute phase of the underlying disease was evident, in 6/22 patients (27.3%) CD or UC were in remission. In patients with CD a colonic involvement was found in 86.7%. Arthritis was the most frequent coexisting extraintestinal manifestation in CD (53.3%) and UC (28.8%). Drug treatment was performed with high doses of glucocorticoids and salicylates. The time to remission in patients with EN was significantly shorter as compared to PG (5.3 +/- 1.8 vs. 19.6 +/- 14.2 weeks; p < 0.001). In 5/22 patients (22.7%) cutaneous manifestations reoccurred after a symptom-free interval. All efflorescenses reoccurred during an active phase of the underlying disease at the same manifestation site as the initial presentation. CONCLUSION: In this series the prevalence of cutaneous manifestations in IBD was 22/1043 (2.1%). EN and PG were more frequent in women with IBD, in CD, and during the acute phases of the underlying disease. EN and PG predominately affect the lower legs. Cutaneous manifestations respond well to an acute phase therapy of the underlying disease. The time to remission was significantly shorter in EN as compared to PG. However, relapses have to be considered in a relevant subgroup of patients.

Orthograde whole gut irrigation with mannite versus paromomycine + lactulose as prophylaxis of hepatic encephalopathy in patients with cirrhosis and upper gastrointestinal bleeding: results of a controlled randomized trial.

BACKGROUND/AIMS: In patients with liver cirrhosis and upper gastrointestinal bleeding development of hepatic encephalopathy is a major problem. The aim of the present study was to evaluate the efficacy of the mannite lavage in a controlled randomized trial with respect to the Child-Pugh classification. METHODOLOGY: After initial gastroscopy (+/- sclerotherapy) 39 patients with cirrhosis (18 F, 21 M; age: 57.5 +/- 11.9 yr; Child A: 6, Child B: 16, Child C: 17) and upper gastrointestinal-bleeding were classified according to the Child-Pugh-criteria (A,B,C) and randomized in 2 groups (A,B) for each Child-Pugh level. Patients in group A (n = 18) were initially treated with 2000 mL mannite solution (10%) during the first 2 hours using a naso-gastric tube. Treatment was continued using 2000 mL mannite solution (10%) per day until no rectal blood could be observed. Patients in group B (n = 21) were treated with paromomycine ter in die (1 g tid) and lactulose (10 mL tid). There were no statistical differences between both groups concerning age, sex, Child-Pugh-scores, severity or source of bleeding, initial hemoglobin-levels, number of given blood-transfusions or number of patients with sclerotherapy. RESULTS: Patients in group A were treated with a total of 3325 +/- 1897 mL mannite solution. The application was well tolerated. In addition, kinetics of serum creatinine, potassium and sodium levels did not show any significant changes. No significant differences between both groups could be shown with respect to clinical criteria of encephalopathy according to O'Grady and the length of intensive care unit treatment. Moreover, kinetic of ammonia-levels showed a pronounced decrease (P = 0.05) on day 2 versus day 1 in group A (110.0 +/- 24.2 vs. 156.4 +/- 98 mg/dL) as compared to group B (210.0 +/- 52.7 vs. 162.0 +/- 45 mg/dL). In group A, 6 patients (33.3%) died during the study as compared to 3 patients (14.3%) in group B (P > 0.05). The lethality rate was strongly associated with the larger proportion of Child-C-patients in group A. CONCLUSIONS: The data indicate that whole gut irrigation with mannite is equally efficacious as compared to standard treatment for prophylaxis of hepatic encephalopathy after upper gastrointestinal bleeding in liver cirrhosis. In contrast to previously published controlled studies, no impact of the lavage on the mortality rate or duration of intensive care unit treatment could be shown. With respect to the lower costs for the mannite solution as compared to paromomycine and lactulose (ROTE LISTE, Germany), the mannite lavage should be recommended for the prophylaxis of hepatic encephalopathy after upper gastrointestinal bleeding in patients with liver cirrhosis.

[Jaundice and progressive liver failure: delayed diagnosis of autoimmune hepatitis due to abrupt termination of steroid therapy?]. / Ikterus und progrediente Leberinsuffizienz: verzögerte Diagnosestellung einer Autoimmunhepatitis aufgrund abrupt beendeter Steroidtherapie?

A 27-year-old woman was successfully treated with a highly dosed steroid therapy over several months during summer 1994 in the event of urticaria. In October 1994, when the patient was complaint free, therapy was abruptly terminated. In November 1994 jaundice, nausea and loss of appetite occurred. Biochemical results showed markedly elevated serum transaminases, negative hepatitis serology, normal immunoglobulins and inconspicious autoantibodies. Histology showed a florid hepatitis. In January 1995 the patient was hospitalized again in very low general and nutritional condition with a marked jaundice, high serum transaminases, insufficient liver synthesis function, established ANA(+), ASMA(+2) and normal immunoglobulins. This time histology painted out an active hepatitis going into liver cirrhosis. Evaluation in view of liver transplantation was carried out in this case of liver failure. At that time, tests showed a distinct gamma globulin fraction increase although the antibody pattern had remainded identical. An immunosuppressive therapy with azathioprine and steroids was decided upon under suspicion of an autoimmune hepatitis leading to a prompt positive response and therefore confirmation of the diagnosis. Complete biochemical remission was attained in April 1995 and a complete histological remission in March 1998.

[Limit values for polycyclic aromatic hydrocarbons in soil of children's playgrounds--basic criteria and recommendations]. / Richtwerte für polyzyklische aromatische Kohlenwasserstoffe im Boden von Kinderspielplätzen--Ableitungskriterien und Empfehlungen.

Elevated concentrations of polycyclic aromatic hydrocarbons (PAK) are often found in the soil of former waste disposal sites, industrial areas, etc. It is desirable and useful to determine orientation values to facilitate and unify the evaluation of contaminations under the aspects of present or planned uses of an area, health protection and decision-making on remedial measures. In the present paper we wish to draw attention to, and discuss problems resulting from, particular characteristics of PAK, e.g. the toxicological property "complete carcinogens" or the necessity of taking into account oral, inhalative and dermal exposure of children on a playground. Based on the discussion, orientation values for benzo[a]pyrene and PAK ("normal" pattern) of 0.5 mg/kg soil and 5 mg/kg soil, respectively, are recommended for top soil of vegetation-free playgrounds. In comparison, deductions carried out by other working groups are presented.

Benzene metabolism in rodent hepatocytes: role of sulphate conjugation.

1. Hepatocytes isolated from the adult male NMRI mouse or Wistar rat were incubated for 1 h with 0.5 mM 14C-benzene, the supernatant was separated from the cells, and analysed for benzene metabolites. Separately, formation of sulphate conjugates during benzene metabolism was studied in hepatocytes in the presence of 35S-sulphate. In addition sulphate conjugation of the benzene metabolites hydroquinone and 1,2,4-trihydroxybenzene was investigated in mouse liver cytosol supplemented with 3'-phosphoadenosine-5'-phospho-35S-sulphate. 2. Two novel metabolites, not detectable in rat hepatocyte incubations, were found in mouse hepatocytes, and were identified as 1,2,4-trihydroxybenzene sulphate and hydroquinone sulphate. Formation of the 35S-labelled conjugates could be demonstrated in incubations of mouse liver cytosol with hydroquinone or 1,2,4-trihydroxybenzene supplemented with 3'-phosphoadenosine-5'-phospho-35S-sulphate, and in mouse hepatocytes incubated with benzene and 35S-sulphate. 3. In comparison with hepatocytes from the Wistar rat, hepatocytes from the NMRI mouse were almost three times more effective in metabolizing benzene. The higher formation of hydroquinone, and the formation of trihydroxybenzene sulphate and hydroquinone sulphate, mainly contributed to the higher rate of benzene metabolism. 4. In conclusion, qualitative and quantitative differences in benzene metabolism may contribute to the higher susceptibility of mouse towards the myelotoxic and leucaemogenic action of benzene.

[Evaluation of wood preservative pollutants of indoor air]. / Beurteilung von Holzschutzmittelbelastungen in Innenräumen.

The evaluation of indoor pollution by wood preservatives and pesticides has been a matter of increasing interest for the past years. The present paper reviews actual knowledge. The so-called "wood preservative syndrome" is referred to. Basics and evaluation criteria concerning the investigation of external exposure (wood, dust, air) and human biomonitoring is summarized. Several substances, in particular pentachlorophenol, lindane and pyrethroids, and principle possibilities to decrease exposure are considered.

Enhanced superoxide anion release of normal neutrophil granulocytes primed with sera of patients with inactive inflammatory bowel disease.

During active inflammatory bowel disease (IBD) the respiratory burst of neutrophil granulocytes has been shown to be impaired using isolated circulating neutrophil granulocytes of patients with active disease. Using normal neutrophil granulocytes of healthy volunteers the present study examines the potential priming effect of sera of patients with active and quiescent IBD. The superoxide anion (O2-)-release of normal neutrophil granulocytes in response to N-formyl-methionyl-leucyl-phenylalanine (FMLP) has been investigated after incubation with sera of patients with active and inactive Crohn's disease and ulcerative colitis. O2(-)-release was measured using the superoxide dismutase inhibitable reduction of ferricytochrome c. The O2(-)-release of normal neutrophil granulocytes primed with sera of patients with inactive Crohn's disease (607.1 +/- 218.2 nmol/60 min, n = 10, p = 0.001) or cultured with sera of patients with quiescent ulcerative colitis (497.4 +/- 94.9 nmol/60 min, n = 3, p = 0.005) was significantly enhanced when compared with sera of normal controls (319.8 +/- 86.5 nmol/60 min, n = 10). There was no significant difference between priming with sera of patients with quiescent or active Crohn's disease (481.0 +/- 113.0 nmol/60 min, n = 5). Normal neutrophil granulocytes primed with sera of patients with active ulcerative colitis produce significantly larger amounts of O2- (809.5 +/- 256.9 nmol/60 min, n = 4, p = 0.001) when compared with sera of normal controls. The study shows that sera of patients with quiescent IBD as well as sera of patients with active disease have the potential to prime normal neutrophil granulocytes for an enhanced O2(-)-release in response to FMLP.(ABSTRACT TRUNCATED AT 250 WORDS)