A systematic review of experimental animal studies on microbial bioaerosols: Dose-response data for the derivation of exposure limits.

Although exposure to high levels of microbial bioaerosols can be linked to the deterioration of the human respiratory system, precise exposure levels responsible for such effects are still unknown. A previous systematic review concluded that there was not enough information in the studies in humans to derive an exposure-response relationship. Thus, the aim of this systematic review was to derive exposure limits for microbial bioaerosols based on health effects in experimental animal studies.

Evaluation of exposure-response relationships for health effects of microbial bioaerosols - A systematic review.

Studies suggest adverse health effects following exposure to bioaerosols in the environment and in particular at workplaces. However, there is still a lack of health-related exposure limits based on toxicological or epidemiological studies from environmental health or from the working environment. The aim of this study was to derive health-based exposure limits for bioaerosols that can protect the general population as group "at risk" via environmental exposure using analysis of peer-reviewed studies related to occupational medicine, indoor air and environmental health.

Aircraft noise and quality of life around Frankfurt Airport.

In a survey of 2,312 residents living near Frankfurt Airport aircraft noise annoyance and disturbances as well as environmental (EQoL) and health-related quality of life (HQoL) were assessed and compared with data on exposure due to aircraft, road traffic, and railway noise. Results indicate higher noise annoyance than predicted from general exposure-response curves. Beside aircraft sound levels source-related attitudes were associated with reactions to aircraft noise.

Physicians appeals on the dangers of mobile communication--what is the evidence? Assessment of public health data.

In October 2002 German physicians appealed to persons in the field of health care, politicians and the public with "great concern" ("Freiburger Appell", "Appeal of Freiburg") claiming "soaring incidences of symptoms and diseases in the general population" to be causally related to the "commence of radio (wave) burden", i.e. due to mobile radio technology.

Urinary di(2-ethylhexyl)phthalate (DEHP)--metabolites and male human markers of reproductive function.

Introduction: Phthalates are suspected to act as endocrine modulators in humans and exert reproductive toxicity. The general population is exposed to phthalates through nutrition, consumer products, medications and medical devices. The aim of the present study is to explore whether internal phthalate exposure represented by metabolites of di(2-ethylhexyl) phthalate (DEHP) can be related to human markers of reproductive function (i.

Clinical environmental medicine.

Introduction: Clinical environmental medicine deals with environmental effects on human health in individual patients. Patients seek medical advice for problems of many different kinds that may be due to environmental exposures; such exposures must be considered carefully along with other potential causes. An environmental medical assessment should include thorough medical history-taking and physical examination, the formulation of a differential diagnosis, and (whenever indicated) human biomonitoring, site inspections, and ambient monitoring.

Three questions to screen for postdischarge surgical site infections.

In-hospital surveillance of surgical site infections (SSI) was conducted on 599 patients in a German university hospital. On a subgroup of 342 patients, SSI was assessed after discharge from hospital based on data of a questionnaire and telephone interviews. Postdischarge surveillance revealed substantially higher infection rates than in-hospital surveillance.

The German Multicentre Study on Multiple Chemical Sensitivity (MCS).

In this multicentre study on multiple chemical sensitivity (MCS) 291 consecutive environmental medicine (EM) outpatients were examined in several environmental medicine outpatient centres/units throughout Germany in 2000/2003. Of the EM outpatients, 89 were male (30.6%) and 202 were female (69.

Assessment of somatic complaints in environmental health.

In patients attributing their health complaints to environmental factors (EnvPat) evidence based medical diagnostics usually do not confirm environmental and somatic causes of symptoms. Many symptoms remain unexplained. Aim of the study was the systematic assessment of medically unexplained physical symptoms (MUPS) in EnvPat and comparison to symptom rates reported by subjects of an environmental study exposed to environmental odors (EnvExp).

Implementation of a novel on-ward computer-assisted surveillance system for device-associated infections in an intensive care unit.

For the presented study a computer-based surveillance system for detecting nosocomial infections (NI) with direct data input from attending on-ward physicians was implemented. During a 12-month period surveillance of ventilator-associated pneumonia (VAP) and catheter-associated bloodstream infections (BSI) was performed prospectively by on-ward physicians guided by infection control specialists on an 11-bed medical intensive care unit in a German university hospital. In 603 patients 3282 patient days were assessed.

Assessment of environmental worry in health-related settings: Re-evaluation and modification of an environmental worry scale.

The aim of this article was to re-evaluate and possibly modify the standardized Environmental Worry Scale (EWS) by Hodapp et al. [1996. Evaluation eines Fragebogens zur Erfassung von Umweltbesorgnis.

[Psychiatric disorders of environmental outpatients--results of the standardized psychiatric interview (CIDI) from the German multi-center study on Multiple Chemical Sensitivity (MCS)].

Background: A nationwide, environmental outpatient-based multi-center two-phase study on Multiple Chemical Sensitivity (MCS) was conducted from 1999 until 2004. The aim of the study was to characterize more precisely the health-complaints relevant for the MCS-phenomenon. A standardized psychiatric interview (CIDI), used to identify frequency, character and duration of psychiatric disorders and their chronological relation to the environment-related health complaints of the patients, formed part of the extensive diagnostic procedure.

The German view: effects of nitrogen dioxide on human health--derivation of health-related short-term and long-term values.

The presented overview concerning health relevant effects caused by nitrogen dioxide (NO2) resumes the current state of results from animal experiments and human studies (epidemiology and short-term chambers studies). NO2 concentrations applied in animal experiments were mostly considerably higher than in ambient air. Therefore, short- and long-term limit values were derived from human data.

Health effects of particles in ambient air.

Unlabelled: A summary of a critical review by a working group of the German commission on Air Pollution Prevention of VDI and DIN of the actual data on exposure and health effects (excluding cancer) of fine particulate air pollution is presented.

Exposure: Typical ambient particle concentrations for PM10 (PM2.5) in Germany are in the range of 10-45 (10-30) microg/m3 as annual mean and 50-200 (40-150) microg/m3 as maximum daily mean.

Health effects associated with exposure to residential organic dust.

Background: This study aimed at relating self-reported health complaints to bioaerosol pollution in the residential outdoor air and to duration of storing organic waste indoors.

Methods: In a cross-sectional study, double blinded to ongoing environmental microbial measurements, physicians collected questionnaires in a neighborhood with a composting site and in unexposed controls. Self-reported prevalence of health complaints, physician diagnoses as well as residential odor annoyance and home hygiene were assessed.

Interdisciplinary diagnostics in environmental medicine--findings and follow-up in patients with chronic medically unexplained health complaints.

Problem: In patients attributing their chronic, medically unexplained complaints to environmental factors the greatest challenge is to overcome their disabling belief in toxicogenic explanations.

Method: Patients presenting with health complaints that they attributed to environmental causes in an environmental outpatient department (EOPD) within a university medical center in Germany were studied. An interdisciplinary review of previously diagnosed medical conditions, current clinical consultations, personal risk communication and therapeutic advice is presented.

Health effects associated with indoor storage of organic waste.

Objectives: The storing of organic waste indoors for several days can be considered a risk factor for microbial contamination of homes. This has become relevant in the scope of modern waste management programmes. This study specifically addresses possible health aspects in this context.

Additional costs for preventing the spread of methicillin-resistant Staphylococcus aureus and a strategy for reducing these costs on a surgical ward.

Objective: To determine the added costs of hygienic measures (barrier precautions, isolation, and decontamination) required for MRSA carriers in German hospitals and possible strategies for cost reduction.

Design: On a septic surgical ward caring for 35% of all MRSA cases in a university hospital (1,182 beds), additional costs for personnel time and materials were calculated and medical charts of all MRSA cases admitted to the ward during 1 year were analyzed retrospectively. Twelve of the ward's 13 beds were located in rooms with at least 2 beds.

Ranking and frequency of somatic symptoms in residents near composting sites with odor annoyance.

The presented study reports the prevalence of somatic symptoms in three study samples living in the vicinity of composting plants. Microorganisms were measured in the air of the residential areas closest to the plants at the same time an epidemiological investigation was performed in the neighborhood near (150 to 1,500 m) to three plants and in corresponding control residential areas of the same district. Nine hundred and seventy-nine residents were questioned about the odor annoyance in their vicinity.

Influences on human internal exposure to environmental platinum.

Different influences on internal exposure to platinum are investigated and for the first time weighted in environmentally exposed subjects as far as individual internal platinum concentrations are concerned. Detailed medical and environmental histories as well as oral cavity status were assessed in 84 dermatological patients, and internal platinum exposure was determined by analyzing platinum in urine using adsorptive voltammetry (AV). Platinum concentrations ranged from <0.