Common Health Hazards Research Articles

The Intensive Care Management of Children with Scorpion Envenomation

Objective: Scorpion envenomation is a serious health problem worldwide, and a common health hazard in the southern region of Israel. Cardiac dysfunction is the leading cause of morbidity and death. Early bedside echocardiography showed to identify all victims with cardiac involvement. We looked for our management of stung children using clinical evaluation, serum troponin, and early echocardiography in cases of moderate and severe envenomation. Materials and methods: Retrospective cohort study of children admitted to the Pediatric Intensive Care Unit after scorpion sting during 5 years, 2008-2013. Review of electronic medical records for demography, clinical and laboratory data, especially echocardiography and serum troponin T level, treatment and outcome. Results: Total number of envenomated children was 185. Age ranged between 1 month and 18 years, 53 were below 3 years of age. Main clinical presentation included decrease level of consciousness (22%) and respiratory failure (15%). Echocardiography on arrival was performed on 117 (63%) children and was abnormal in 29, of whom 25 received inotropic support and 10 required mechanical ventilation. Serum troponin T was measured on arrival in 170 (92%) children and was elevated in 29, of whom 15 (52%) had abnormal echocardiogram; Comparing troponin results to echocardiography; it had a low sensitivity (52%) in identifying cardiac dysfunction. 17 infants below 3 years of age required ventilation for (central) hypopnea and apneic episodes. All children below age 3 had normal echocardiogram. All 185 children survived the envenomation and discharged without sequel. Conclusion: Early echocardiography should be preferably performed in all scorpion envenomated children. Early serum troponin misses sensitivity for cardiac dysfunction. In our patient population cardiac involvements was not present in children under age 3. Respiratory failure is mainly secondary to central CNS effect in young infants and cardiac dysfunction in older children.

Hymenoptera stings: a study of clinical profile, complication and outcome from a teaching hospital of central Nepal

Background Hymenoptera sting is a common health hazard in the tropics. Wasp and Bee stings can produce symptoms ranging from local allergic reactions to serious complications including anaphylaxis and multiple organ dysfunction syndromes.Objective To evaluate the clinical profile, management and early outcome of patients with gallbladder cancer.Methods We prospectively analyzed all the consecutive patients with Hymenopterid sting (Wasp and Bee stings), who were admitted in Nephrology Unit in college of Medical Sciences Teaching hospital over a period of two year; from June 2010 to May 2012. Data including demographic profile, clinical profile, complications and outcomes associated with the Hymenopterid stings were entered in a designated profroma and were analyzed.Results A total of 15 cases with Hymenopterid stings (Wasp and Bee stings) were analyzed. Majority of the cases were females (n=8). The male to female ratio was 0.88. The mean age of the case was 37.1± 17.38years. Most of the cases (n=11) were younger subjects d"45 years and majority of them felt in the age group of 21-30 years; (n=4). Mean number of stings (Wasp or Bee stings), were 46 ± 18.4 (12-74) and the mean time to reach the hospital from the bite time was 78.23±82.24 hours (30 minutes-13 days). Black Wasps were the commonest species to inflict the stings in (n=10) cases and Bees in (n=5) cases. The Hymenoptera stings were observed more frequently in the month of July to September in (n=8). The commonest site of bite was head and face seen in (n=11) cases. Among the clinical presentations the commonest clinical presentation was local burning pain and pruritus which was present in all the cases (n=15) followed by nausea (n=10). The commonest clinical sign was bipedal edema which was seen in (n=7) cases. Low Hb (defined as Hb <10gm/dl) was seen in (n=5) cases of Hymenopterid stings. Low platelet (defined as Platelet < 100X109/L) was documented in (n=10) cases. Serum creatinine >1.5mg /dl was seen in (n=7) cases. Low serum albumin (defined as Serum Albumin (<3.5gm/dl) was seen in (n=6) cases. Among the complications, the most common complication was Hepatitis which was seen in (n=9) cases, followed by Acute Kidney Injury. There was no mortality associated with Hymenopterid stings in our study. However 1 patient left against medical advice.Conclusion Black Wasps were the commonest species to inflict the stings in (n=10) cases. The most common complication of Hymenoptera sting was Hepatitis, which was seen in (n=9) of cases, followed by Acute Kidney Injury. Majority of complications were seen in Wasp stings which caused significant morbidity. No mortality was observed in our study except one case; that left hospital against medical advice. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 17-24

Student Nurses' Risk Perceptions of Home Environmental Hazards

This study described nursing students' perceptions of home health risks. Nursing students (N = 254) at two large urban universities completed a cross-sectional survey during the 2011-2013 academic years. From a list of 22 common home health hazards, students identified what they perceived as the three: (a) most dangerous hazards, (b) most common hazards in their state, (c) hazards most likely to be present in their current home, and (d) hazards they would most afraid to find in their home. Students also rated perceived dangerousness of the hazards, how healthy they perceived their home to be, and the perceived effect of their home on their own health. Tobacco smoke, asbestos, and cleaning products were the most commonly identified home hazards. Individual characteristics, hazard experiences in personal homes, and university geographic location (state) were associated with perceptions of home hazards. Students who identified hazards in their own homes were more likely to identify them as hazards in general and for their own state. These results fill a foundational knowledge gap by describing the risk perceptions of near-future health care providers about home environmental hazards.

A study of autonomic function tests in obese people

Background: Obesity is one of the common significant health hazards and is associated with autonomic dysfunction. Aims and objectives: The present study was designed to assess the underlying autonomic neuropathy in obese subjects and to compare it with age-matched controls. Material and Methods: Thirty obese subjects in the age group of 21-40 years were recruited for the study. Six non-invasive autonomic function tests were performed out of which four were based mainly on parasympathetic control (Heart rate response to standing (30:15 ratio), The S:L (standing to lying) ratio, The Valsalva ratio, Heart rate response to deep breathing ) and the other two were mainly sympathetic (Isometric Handgrip Exercise Test and Cold Pressor Test). Statistical Analysis: Results were analysed by ANOVA with SPSS version 17.0 using unpaired't' test. Results: Results showed that Heart rate response to standing(30:15 ratio), The S:L (standing to lying) ratio, The Valsalva ratio, Heart rate response to deep breathing, Isometric Handgrip Exercise Test and Cold Pressor Test were significantly lower (p <0.05) in obese subjects as compared to control subjects . Conclusions: Latent autonomic neuropathy may be present in otherwise healthy obese individuals. Early and regular screening of obese individuals is necessary to prevent any future complications.

Knowledge, awareness and practice regarding needle stick injuries in dental profession in India: A systematic review

Background:Hundreds of thousands of healthcare workers remain susceptible to deadly viruses throughout the year, including blood-borne pathogens. Needle stick injuries (NSI) constitute one of the most common occupational health hazards in healthcare profession. Dental professionals are at more risk of acquiring NSI due to their limited and restricted working area. The present systematic review was carried out to determine knowledge, awareness and practice regarding NSI in dental professionals and students in India.Materials and Methods:A systematic review of cross-sectional studies available in the literature on the knowledge, attitude and practice among dental professionals and students in India was carried out. We identified relevant articles through electronic and manual search such as Pubmed and MEDLINE. Two investigators independently identified studies that were included in the review.Results:Four articles were finally selected for inclusion in the review. All the studies were done involving dental students; 89.23% of the students had correct knowledge about NSI and 91.55% of the students had adequate level of awareness regarding its management in one of the studies. Also, 89% of students in one of the studies were aware of taking post-exposure prophylaxis after accidental NSI. In another study, 44% of the students destroyed the needles using a needle destroyer and 15% destroyed them in puncture-resistant containers.Conclusion:The knowledge and awareness of the dental students is adequate, although there is considerable variation in practice and management of NSI among different studies. There is a need for more studies involving dental professionals.

Some Health Disorders among Workers in a Glass Factory

Introduction: The common Health hazards associated with glass manufacturing processes include noise, exposures to respirable airborne particulates [especially silica (SiO2) that leads to chronic effects such as decreased pulmonary function, lung disease, complicated pneumoconiosis (silicosis, the most important and oldest occupational lung diseases worldwide specially in developing countries) and silico-tuberculosis], ergonomic hazards, physical hazards, radiant energy, heat stress disorders and infrared radiation. Aim of the study: Studying some health disorders among Egyptian workers in a glass industry as well as to assessing workplace environment in the same factory. Participants and methods: A cross sectional comparative study was carried out over 250 worker in a glass factory and 250 non-occupational exposed group. Environmental study of dust and fumes, and noise levels was done. Spirometric measurements as well as X-ray film to any worker with abnormal spirometry and air conduction audiometric examination were applied. Results: The mean value of both free crystalline silica concentration and noise level is higher than the national and international permissible levels. Glass factory workers had a higher significant prevalence of chest, auditory and heat related manifestations as well as deteriorated spirometric measurements and abnormal audiometric findings. Conclusion: Exposure to high level of silica dust and noise are blamed to increase the frequency of chest manifestations, early spirometric changes, few X-ray findings and occupationally induced hearing loss. Using automated cullets crushing machine to decrease exposure to dust and using good quality of personal protective equipments especially masks and ear muffles are must.

Poisoning and envenomation registry: analysis of 200 case reports

Poisoning and envenomation are common health hazards for the Armed Forces personnel. This study was undertaken to analyse the problem in a systematic way so that meaningful data can be generated for policy formulation regarding treatment of such cases. Data were collected from various service hospitals on a 16-point format of all patients treated for any kind of poisoning or envenomation. The data so collected were fed into an electronic database established at the Poisoning and Envenomation Registry for the Armed Forces and analysed for various parameters. During the observation period of 18 months, the poisoning registry received 202 reports from all over the country, of which 182 were of poisoning and the rest were of envenomation due to snake bites. The maximum numbers reported to the registry were the cases pertaining to soldiers who were poisoned during train travel and were robbed of their belongings. The number of such case reports equals that of incidents due to pesticides for deliberate self-harm. As far as envenomation data are concerned, it is felt that we have received far less number of reports than what actually occurred. Among the ones that we received, all except one were venomous bites which were given polyvalent ASV, and they survived the envenomation. Poisoning and envenomation are important health problems in the Armed Forces. The soldiers travelling by train are the most important group where interventions can be planned for prevention of poisoning and subsequent financial loss during travel. In most of the poisoning cases, there were few diagnostic measures used, which emphasises the need of an analytical and therapeutic poison centre for the Armed Forces. Activated charcoal could have been incorporated in the treatment of many poisoned patients.

The possible influence of noise frequency components on the health of exposed industrial workers - A review

Noise is a common occupational health hazard in most industrial settings. An assessment of noise and its adverse health effects based on noise intensity is inadequate. For an efficient evaluation of noise effects, frequency spectrum analysis should also be included. This paper aims to substantiate the importance of studying the contribution of noise frequencies in evaluating health effects and their association with physiological behavior within human body. Additionally, a review of studies published between 1988 and 2009 that investigate the impact of industrial/occupational noise on auditory and non-auditory effects and the probable association and contribution of noise frequency components to these effects is presented. The relevant studies in English were identified in Medknow, Medline, Wiley, Elsevier, and Springer publications. Data were extracted from the studies that fulfilled the following criteria: title and/or abstract of the given study that involved industrial/occupational noise exposure in relation to auditory and non-auditory effects or health effects. Significant data on the study characteristics, including noise frequency characteristics, for assessment were considered in the study. It is demonstrated that only a few studies have considered the frequency contributions in their investigations to study auditory effects and not non-auditory effects. The data suggest that significant adverse health effects due to industrial noise include auditory and heart-related problems. The study provides a strong evidence for the claims that noise with a major frequency characteristic of around 4 kHz has auditory effects and being deficient in data fails to show any influence of noise frequency components on non-auditory effects. Furthermore, specific noise levels and frequencies predicting the corresponding health impacts have not yet been validated. There is a need for advance research to clarify the importance of the dominant noise frequency contribution in evaluating health effects.

Prevalence of hearing loss and accuracy of self-report among factory workers

Noise represents one of the most common occupational health hazards. A Healthy People 2020 objective aims to reduce hearing loss in the noise-exposed public. The purpose of this study was to describe and compare perceived and measured hearing, and to determine the prevalence of hearing loss among a group of factory workers. Data collected as part of an intervention study promoting hearing protector use among workers at an automotive factory in the Midwest were used. Plant employees (n=2691) provided information regarding their perceived hearing ability, work role, and other demographics. The relationships among audiograms, a single-item measure of perceived hearing ability, and demographic data were explored using chi-square, McNemar's test, Mann-Whitney U-test, sensitivity, and specificity. The prevalence of hearing loss among noise-exposed factory workers was 42% (where hearing loss was defined as >25 dB loss at the OSHA-recommended frequencies of 2, 3, and 4 kHz in either ear). However, 76% of workers reported their hearing ability as excellent or good. The difference in perceived hearing ability was significant at each tested frequency between those with and without measured hearing loss. Self-reported hearing ability was poorly related to results of audiometry. Although this group of workers was employed in a regulated environment and served by a hearing conservation program, hearing loss was highly prevalent. These findings, together with national prevalence estimates, support the need for evaluation of hearing conservation programs and increased attention to the national goal of reducing adult hearing loss.

在宅高齢者における転倒自己効力感に影響を与える因子の検討

Falling is one of the most common health hazards for the elderly. Tinetti et al. (1990) proposed the concept of falls self-efficacy, which explored fear of falling from the perspective of self-efficacy. Falls self-efficacy and its associated factors have not been extensively studied in Japan. This study examined the impact of various factors associated with daily life on falls self-efficacy. We conducted individual interviews with 180 elderly participants (men=93; women=87) on topics such as falls self-efficacy, perceived health status, and time spent on physical activities. Multiple linear regression analysis revealed that the main factors influencing falls self-efficacy were perceived health status, past experience of falling, age, chronic pain, average time spent sitting during a weekday, and moderate or vigorous physical activity time per week. Falls self-efficacy was not significantly associated with gender, human environment, recent falling of acquaintances, or walking time per week. The results indicated that moderate or vigorous physical activity could enhance falls self-efficacy. Moreover, past falling experiences were negatively associated with falls self-efficacy, whereas perceived health status and chronic pain had a significant impact. Future fall prevention programs should adopt a multifactorial approach that focuses on enhancing falls self-efficacy.

Common Health Hazards in French Pilgrims During the Hajj of 2007: A Prospective Cohort Study

The majority of published studies on Hajj-related diseases were based on hospitalized patient cohorts. A total of 545 Hajj pilgrims from Marseille were enrolled in a prospective epidemiological study to evaluate the incidence of common health hazards. They were administered a questionnaire before traveling addressing demographic factors and health status indicators and a post-travel questionnaire about travel-associated diseases. Respondents had a median age of 61 years and originated mainly from North Africa (81%). A significant proportion of individuals had chronic medical disorders such as walking disability (26%), diabetes mellitus (21%), and hypertension (21%). A total of 462 pilgrims were administered a questionnaire on returning home. A proportion of 59% of travelers presented at least one health problem during the pilgrimage and 44% of the cohort attended a doctor during travel; 3% were hospitalized. Cough was the main complaint among travelers (attack rate of 51%), followed by headache, heat stress, and fever. Few travelers suffered diarrhea and vomiting. Cardiovascular diseases, neurological disorders, trauma, skin and gastrointestinal problems were not frequently observed in our survey, suggesting that their prevalence among the causes of admission to Saudi hospitals reflects a bias of selection. Cough episodes were significantly more frequent in individuals >55 years. We also evidenced that women were more likely to present underlying chronic cardiovascular disorder and diabetes compared to men and that they more frequently suffered from cough episodes associated with fever during the Hajj. Health risks associated with the Hajj in our experience are much more related to crowding conditions than to travel. Our work suggests that the studies performed in Saudi specialized units probably overestimate the part of certain diseases within the spectrum of Hajj-associated diseases. Our results also suggest that old female Hajjes should be considered as a high-risk population and that preventive measures should be reinforced before departing for Saudi Arabia.

Commercialization and Late-Stage Development of a Semisynthetic Antifungal API: Anidulafungin/d-Fructose (Eraxis)

Many years ago anidulafungin 1 was identified as a potentially useful medicine for the treatment of fungal infections. Its chemical and physical properties as a relatively high molecular weight semisynthetic derived from echinocandin B proved to be a significant hurdle to its final presentation as a useful medicine. It has recently been approved as an intravenous treatment for invasive candidaisis, an increasingly common health hazard that is potentially life-threatening. The development and commercialization of this API, which is presented as a molecular mixture of anidulafungin and d-fructose is described. This includes, single crystal X-ray structures of the starting materials, the echinocandin B cyclic-peptide nucleus (ECBN·HCl) and the active ester 1-({[4′′-(pentyloxy)-1,1′:4′,1′′-terphenyl-4-yl]carbonyl}oxy)-1H-1,2,3-benzotriazole (TOBt). Details of the structure and properties of starting materials, scale-up chemistry and unusual crystallization phenomena associated with the API formation are discussed.

Appendectomy due to lead poisoning: a case-report

BackgroundLead poisoning is a common occupational health hazard in developing countries and many misdiagnoses and malpractices may occur due to unawareness of lead poisoning symptoms.Case presentationWe report a case of occupational lead poisoning in an adult battery worker with abdominal colic who initially underwent appendectomy with removal of normal appendix. Later on he was diagnosed with lead poisoning and was treated appropriately with lead chelator (CaNa2EDTA).ConclusionLead poisoning is frequently overlooked as the differential diagnosis of acute abdomen which may result in unnecessary surgery. Appropriate occupational history taking is helpful in making a correct diagnosis. Occupational lead poisoning is a preventable disorder and a serious challenge for the health and labor authorities in developing countries.

Lower urinary tract symptoms, incontinence and falls in elderly people: time for an intervention study

Falls in older people constitute a common health hazard, which has attracted much attention and research. There are many evidence-based interventions, which have been shown to reduce the subsequent risk of falls. There is good evidence for an association between the risk of falling and the presence of urinary incontinence in older people, but incontinence has not been routinely included in interventions targeted to reduce falls. This article reviews the evidence for current falls intervention and the association between falls and urinary incontinence, making the case for an intervention study.

Knowledge, attitudes and behavior regarding secondhand smoke among Asian Americans

Background This study seeks to measure exposure to secondhand smoke and to evaluate potential differences in knowledge, attitudes, and tolerance of secondhand smoke among subgroups of Asian Americans in the Delaware Valley region of Pennsylvania and New Jersey. Methods A cross-sectional study was conducted among 1374 Asian Americans, which included Chinese, Koreans, Vietnamese, and Cambodians. The sample was selected by using a stratified-cluster proportional sampling technique. Study measures included demographic variables, smoking status, exposure to secondhand smoke, and knowledge, attitudes, and behavior regarding secondhand smoke. Data were analyzed using SPSS. Results Involuntary exposure to secondhand smoke remains a common public health hazard among Asian Americans, with 38.3% reporting exposure at home and 40.3% at the worksite. Knowledge and tolerance differed significantly by ethnic groups, gender, education, and smoking status. Knowledge level had a significant effect on tolerance behavior. Conclusions Findings indicate an urgent need for a smoke-free policy at home, in the work place, and in public areas. Tobacco prevention/intervention and cessation programs for Asian Americans should emphasize the adverse health effects of secondhand smoke and promote a smoke-free environment. Further studies are needed to explore the unexplained differences in tolerance levels regarding secondhand smoke across ethnic groups.

Addiction Training Scale: Pilot Study of a Self-Report Evaluation Tool for Psychiatry Residents

Alcohol and drug dependence disorders have become common public health hazards. Psychiatrists encounter these problems in a major portion of their patients. However, recent data suggest that their training does not provide them the confidence to treat these disorders. Current methods of evaluating residents fail to adequately ascertain the lack of confidence in substance abuse training. Here, we present the Addiction Training Scale (ATS) that we developed to help trainers identify deficits in residents' substance abuse training. We developed the ATS and conducted a pilot study with the psychiatry residents at the Creighton University Department of Psychiatry, to test the validity of the ATS as a self-report evaluation tool to measure the level of psychiatry residents' preparedness in treating substance abuse disorders. Our results suggest that the ATS is related to the confidence and preparedness that residents express in their ability to treat substance abuse problems. The ATS may be beneficial in assessing psychiatry residents' substance abuse training and identifying deficits, which may be addressed during training.

Environmental health and nursing practice

This is the first book for nurses on how the environment affects nursing practice. Nurses should be concerned with environmental issues for two reasons: many diseases (such as asthma, lead poisoning, and some cancers) are caused by exposures to toxins in the environment; and hospitals themselves are sources of pollutants, through release of mercury and dioxin (a byproduct of incinerating plastic PVC products). The book includes information on basic environmental health principles and common environmental health hazards (e.g., in our water, air, schools, hospitals, and homes). It offers a patient assessment tool for exposure to these hazards and strategies for greener use of hospital resources. This is both a nursing textbook and a practice manual.

Management of oesophageal foreign bodies in children.

To evaluate the pattern and outcome of management of retained oesophageal foreign bodies in children. Retrospective study. Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, January 1991 to December 2000. One hundred and eight paediatric patients, aged 0-14 years managed for retained oesophageal foreign bodies. The foreign bodies were removed endoscopically, using either a larynoscope or a rigid oesophagoscope, under general anaesthesia. There were 108 patients, with a mean age of 3.0 +/- 0.8 years and age range of 23 days to 14 years. The male to female ratio was 1.5: 1. Sixty four (59.3%) patients were within 1-5 year age group. Coins constituted 79.6% of the retained foreign bodies. Over 90% of patients presented within the first four days of the incidence. The dominant complaints were drooling of saliva in 37 (40.2%) and difficulty in swallowing in 35 (38.1%) patients. The commonest sites of the foreign body retention were the upper third of oesophagus 52(48.2%) and the hypopharynx 36(33.3%). The main complications following the foreign body removal were oesophageal perforations 4(3.7%) and lacerations 16(15%). Retained oesophageal foreign body is a common childhood health hazard. Early diagnosis and prompt skillful removal are necessary for a satisfactory outcome.

Occupational health hazards among health care workers in an obstetrics and gynaecology unit of a Nigerian teaching hospital

The occupational health hazards among health-care workers in an obstetrics and gynaecology unit were investigated. A total of 78 pretested questionnaires were administered to the doctors, nurses and ward orderlies in the unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The common occupational health hazards were work-related stress (83·3%), needle-stick injuries (75·6%), bloodstains on skin (73·1%), sleep disturbance (42·3%), skin reactions (37·2%) assault from patients (24·3%) and hepatitis (8·9%). Nearly half of the staff used diazepam, lexotan or alcohol to cope with the stress of work. A greater percentage of doctors compared to nurses and ward orderlies used safety precautions such as gloves, facemasks and aprons. All the staff employed regular handwashing after various procedures. However no category of staff adopted regularly proper disposal of needles and sharps into separate puncture-resistant containers. About 59% of the staff recap used needles. The implications of the findings were discussed and recommendations made appropriately.

Risques infectieux des animaux de compagnie

Domestic pets can transmit numerous infectious—bacterial, parasitic, fungic, viral—diseases. We need to improve our knowledge about the real epidemiology of pet-transmitted zoonoses. The routes of transmission are various. Bites and scratches are the most common health hazards and result in localized infections. Pasteurellosis, various aerobic and anaerobic-infections, and cat scratch disease are predominant. Bites are treated by cleaning the wound, rabies and tetanus prophylaxis, and appropriate use of antibiotics. Other infections are transmitted through cutaneous, mucous, digestive or respiratory routes, by direct contact with the pets or excreta or by arthropods. The most common are gastrointestinal (campylobacter, salmonella, yersinia, parasites, etc.), dermatologic (dermatophytoses, scabies, cutaneous larva migrans, etc.), respiratory (psittacosis, etc.), and multi-systemic (toxoplasmosis, toxocariasis, leishmaniasis, etc.). Some persons are at high risk for diverse diseases: small children (toxocariasis, helminthiasis), pregnant women (toxoplasmosis), immunodeficient patients (cryptosporidiosis, salmonellosis, systemic pasteurellosis). These infectious diseases can be partly prevented by avoiding contact with sick animals, and by washing hands following exposure to pets or pet-derived excreta. Specific vaccines of humans and pets, and worming pets regularly are important parts of the prevention. Veterinarians must discourage the keeping of wild or exotic animals as pets.