Objectives: To clarify whether the intensity of exposure to organic acid anhydrides (OAAs) is associated with the risk of sensitisation to these allergens.
Methods: The investigations were carried out in three different manufacturing plants (A, B, and C) where OAAs were used in the production of epoxy resins. Methyltetrahydrophthalic acid anhydride (MTHPA) was used in all three plants. The exposure assessment included stationary and ambient air monitoring (OAAs in the air) and biological monitoring (metabolites in urine). In plant A 20, in plant B 86 and in plant C 113 employees were examined by a physician (anamnesis, skin-prick test, specific IgE, spirometry). In plants B and C, the exposure areas were classified as high, medium, and low, without the results of the exposure assessment being known.
Results: The ambient air concentrations (in microg/m3) of MTHPA were 37.2 and 58.5 in plant A (number of samples n = 2), ranged from <0.5-26.2 in plant B (n = 5) and from 2.1-57.9 in plant C (n = 3) with stationary air collecting, and from 8-45 (n = 6), from < 4.7-35.7 (n = 3) and from 2-37.8 (n = 3) with personal air collection. The metabolites of OAAs in urine (in nmol/mmol creatinine) ranged from 5.7-645 (median of MTHPA: 346) in plant A, from < 1-213 (median of MTHPA: 10.1) in plant B and from 0.1-830 (median of the sum of the OOA metabolites: 108.6) in plant C. The prevalence of sensitisation was 35% in plant A, 21% in plant B and 29% in plant C. A higher prevalence in the highly exposed areas, however, could not be seen. Levels of IgE specific for conjugates of MTHPA were not associated with the metabolites in the end of shift urine. Levels of IgG specific for conjugates of MTHPA, however, were associated with the metabolites in the end of shift urine.
Conclusions: The data showed that biological monitoring is a useful tool in the exposure assessment of OAAs. Comparing the prevalence of sensitisation and the results of biological monitoring, between the three plants, we found that sensitisation increased with increasing exposure. Within a plant a higher risk of sensitisation in persons working in highly exposed areas at the time of the examination could not be seen, possibly due to frequent job rotation.
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http://dx.doi.org/10.1007/s004200050422 | DOI Listing |
JAMA Health Forum
January 2025
Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Importance: The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing regulatory concern. However, little is known about the role of these pharmacies in Medicare, in which pharmacy network protections may influence market dynamics.
Objective: To evaluate the prevalence of insurer-PBM-owned pharmacies and the extent to which insurer-PBMs steer patients to pharmacies they own in Medicare.
JAMA Netw Open
January 2025
Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.
Importance: Understanding environmental risk factors for gestational diabetes (GD) is crucial for developing preventive strategies and improving pregnancy outcomes.
Objective: To examine the association of county-level radon exposure with GD risk in pregnant individuals.
Design, Setting, And Participants: This multicenter, population-based cohort study used data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort, which recruited nulliparous pregnant participants from 8 US clinical centers between October 2010 and September 2013.
Am J Phys Med Rehabil
January 2025
Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
People with disabilities have recently been declared a population at increased risk of health disparities, and research has cited a lack of physician training as a cause of that increased risk. Prior studies demonstrate that physicians lack confidence in caring for people with disabilities, but there is little research on disability competency among medical students. This study assessed medical students' confidence in six disability-related competencies and tested for associations between perceived confidence and students' personal demographics and institutional characteristics.
View Article and Find Full Text PDFInt J Legal Med
January 2025
Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu, 550169, Romania.
The burnout phenomenon is a subject of considerable interest due to its impact on both employee well-being and scientific inquiry. Workplace factors, both intrinsic and extrinsic, play a pivotal role in its development, often leading to job dissatisfaction and heightened burnout risk. Chronic stress and burnout induce significant dysregulation in the autonomic nervous system and hormonal pathways, alongside structural brain changes.
View Article and Find Full Text PDFArch Dermatol Res
January 2025
Department of Dermatology, Venereology and Leprosy, Sree Uthradom Thirunal Academy Of Medical Sciences, Trivandrum, 695028, India.
Background: Exposure to hairs of caterpillars and moths are collectively termed as lepidopterism. Clinical manifestations include cutaneous presentation of localized stinging reaction with wheals or vesiculation, acute urticarial papules and plaques, ophthalmic, oropharyngeal involvement to severe life-threatening anaphylactic reactions with angioedema.
Aims: In this study we have determined the prevalence of various cutaneous, oropharyngeal and ophthalmic manifestations of lepidopterism at a tertiary health care center.
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