TB Exposure Research Articles

Comparison of response to 17β‐estradiol and 17β‐trenbolone among three small fish species

Three small fish species, medaka (Oryzias latipes), fathead minnow (Pimephales promelas), and zebrafish (Danio rerio), were exposed to an estrogen, 17 beta-estradiol (E2), and an androgen, 17 beta-trenbolone (TB), for 21 d under flow-through conditions to compare the susceptibility among these three small fish species to the substances. Effects on gross morphology, including secondary sex characteristics and gonadosomatic index, as well as on blood or liver vitellogenin (VTG) levels were assessed. In E2 exposures, significant increases in estrogenic activity were observed in both sexes of all three fish species. The lowest-observed-effect concentrations (LOECs) of E2 for VTG induction in males of medaka, fathead minnow, and zebrafish were less than or equal to 8.94, 28.6, and 85.9 ng/L, respectively. In TB exposures, we observed masculinization of secondary sex characteristics in females as a result of the androgenic activity of TB in medaka with a LOEC of 365 ng/L and in fathead minnow with a LOEC of 401 ng/ L. We also found VTG reduction in females of all three fish species. These results suggest that the susceptibility of medaka to estrogenic chemicals may be higher than those of fathead minnow and zebrafish and that the susceptibility of medaka to androgenic chemicals may be almost equal to that of fathead minnow in the 21-d fish assay.

A practical guide for the use of biologic agents in the treatment of rheumatoid arthritis*

A practical guide for the use of biologic agents in the treatment of rheumatoid arthritis*

Comparison of Vitellogenin Induction, Sex Ratio, and Gonad Morphology Between Zebrafish and Japanese Medaka After Exposure to 17α-Ethinylestradiol and 17β-Trenbolone

The pharmaceutical estrogen 17alpha-ethinylestradiol (EE2) and the anabolic androgen 17beta-trenbolone (Tb) can interfere with the endocrine and reproductive systems of fish. The potency of these chemicals in zebrafish (Danio rerio) and Japanese medaka (Oryzias latipes) was assessed using the core end points vitellogenin (Vtg) concentration at 38 days post-hatch and sex ratio and gonad morphology at 60 days post-hatch. Vtg concentrations were measured in fish whole-body homogenate samples using enzyme-linked immunosorbent assay. Increased Vtg concentration and feminization of fish after exposure to 10 ng/L EE2, as well as masculinization after exposure to 50 ng/L of Tb, were observed in zebrafish. Intersex was observed in medaka exposed to EE2. A decrease in Vtg production after Tb exposure (50 ng/L) was measured in both zebrafish and medaka. Analyses of gonad morphology revealed increased testicular area and sperm percentage in Tb-exposed zebrafish, whereas increased sperm percentage was measured in Tb-exposed medaka. The higher sensitivity of zebrafish compared with medaka to both EE2 and Tb was revealed in the study.

Mycobacterial Infections After Kidney Transplant

We looked at mycobacterial infections occurring after a kidney transplant to determine incidence, risk factors, and outcomes. Of 3921 kidney transplants performed between 1984 and 2002, 18 (0.45%) (10 men, eight women; 11 cadaveric donor, seven living donor graft) were identified as having mycobacterial infection at some time posttransplant. Mean age at transplant was 38.3 years. Racial background was: Caucasian ( n = 12), African-American ( n = 2), Native Indian ( n = 2), Hispanic ( n = 1), and Middle Eastern ( n = 1). The majority had a kidney alone ( n = 14). Four recipients had simultaneous transplant of a second organ: pancreas ( n = 2), islets ( n = 1), and liver ( n = 1). None of the 18 recipients had documented mycobacterial infection pretransplant. One recipient had a positive Mantoux test at the time of transplant and then developed pulmonary tuberculosis 4 months posttransplant; the remaining 17 patients had either negative ( n = 10) or unavailable ( n = 7) pretransplant Mantoux results. Mean time to infection was 3.2 years (range 1 week to 12 years). The most common site of infection was respiratory ( n = 8). Other sites included musculoskeletal ( n = 4), skin ( n = 3), gyn ( n = 1), and other ( n = 2). Only three of the infections were with mycobacterial tuberculi; the others were with avium ( n = 5), chelonae ( n = 2), or other nontuberculous mycobacteria. Risk factors included previous TB exposure, occupational exposure, or accidental soft tissue injury. Soft tissue infections often presented as chronic unhealed wounds and required extensive surgical debridements. With mean follow-up of 12.5 years since transplant and 9.2 years since infection, 13 of the recipients are alive and well; causes of death included cardiovascular ( n = 3) and sepsis ( n = 2).

Prevalence of tuberculin skin test positivity and conversions among healthcare workers in New York City during 1994 to 2001.

To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees. Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1, 1994, to December 31, 2001. HCWs in high-risk and low-risk settings for occupational TB exposure. Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR, 5.7; CI95, 1.7-19.2; P < .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95, 1.7-5.8; P < .001); OCME HCWs (OR, 4.7; CI95, 2.3-9.4; P < .001), those of Asian ethnicity (OR, 4.3; CI95, 1.4-13.5; P < .01), and older HCWs (OR, 1.0; CI95, 1.0-1.1; P < .05) were at a higher risk for conversion. Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.

An Alternative to Regulation in the Control of Occupational Exposure to Tuberculosis in Homeless Shelters

Five million U.S. workers are exposed to TB in the course of their work each year. The occupational risk of exposure to TB at homeless shelters is particularly acute. TB rates among the homeless are estimated to be 150 to 300 times the nationwide rate. The U.S. Occupational Safety and Health Administration (OSHA) responded to the risk to homeless shelter workers by proposing a regulation mandating that shelters take prescribed actions to identify shelter residents who represent a potential risk and to remove those residents from the homeless shelter environment. This article concludes that the risk of TB exposure within homeless shelter workers is best viewed as a public health problem rather than as exclusively a worker protection problem. Accordingly, in addition to seeking worker protections through regulatory controls, OSHA should seek to promote occupational health and safety through a public health response as well.

Federal regulations update: EEOC chairman resigns; regs to be issued on waiver of right to sue under ADEA; proposed OSHA regs on TB exposure

Employment Relations TodayVolume 24, Issue 4 p. 83-90 Department Federal regulations update: EEOC chairman resigns; regs to be issued on waiver of right to sue under ADEA; proposed OSHA regs on TB exposure Morgan D. Hodgson, Morgan D. Hodgson is a partner in Steptoe & Johnson LLP in Washington, DC, specializing in employment law and general litigation. She advises clients on a broad range of employment law issues and litigates on behalf of management in such areas as whistleblower claims, EEO and affirmative action issues, early retirement programs, and disability discrimination.Search for more papers by this authorRonald S. Cooper, Ronald S. Cooper is a partner at Steptoe & Johnson LLP specializing in federal regulation of employment. He has litigated cases in the federal district courts and courts of appeals throughout the country and has participated in several U.S. Supreme Court cases. He is principal author of a book on the Fair Labor Standards Act Amendments of 1985, published by the International City Management Association.Search for more papers by this author Morgan D. Hodgson, Morgan D. Hodgson is a partner in Steptoe & Johnson LLP in Washington, DC, specializing in employment law and general litigation. She advises clients on a broad range of employment law issues and litigates on behalf of management in such areas as whistleblower claims, EEO and affirmative action issues, early retirement programs, and disability discrimination.Search for more papers by this authorRonald S. Cooper, Ronald S. Cooper is a partner at Steptoe & Johnson LLP specializing in federal regulation of employment. He has litigated cases in the federal district courts and courts of appeals throughout the country and has participated in several U.S. Supreme Court cases. He is principal author of a book on the Fair Labor Standards Act Amendments of 1985, published by the International City Management Association.Search for more papers by this author First published: 31 January 2011 https://doi.org/10.1002/ert.3910240410 AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume24, Issue4Winter 1997Pages 83-90 RelatedInformation

PULMONARY TOXICITY OF SYSTEMIC TERBIUM CHLORIDE IN MICE

Terbium (Tb) is a rare earth metal that finds use in several emerging technologies. However, little is known about the biological effects of Tb. Thus, in this study the pulmonary toxicity of systemic Tb in mice was investigated. Mice were treated intravenously with a single dose of 20 or 200 mumol Tb/kg, as TbCly and killed at 3, 6, 12, 24, 48, or 72 h later. Administration of Tb at a dose of 200 mumol/kg increased pulmonary weight, lipid peroxidation, and protein content but decreased pulmonary glutathione content. Pulmonary gamma-glutamyl transpeptidase (gamma-GTP) activity was increased after Tb administration at a dose of 200 mumol/kg. Pulmonary alkaline phosphatase (ALP) activity was also increased after Tb administration at a dose of 200 mumol/kg. Investigation of the defense system against oxidative damage in the lung showed that superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities were all decreased after Tb administration at the higher dose. The concentrations of Tb, Ca, and P in lung was increased by the dose of 200 mumol/kg. These results suggest that pulmonary lipid peroxidation may be an early and sensitive consequence of Tb exposure and that SOD, CAT, and GSH-Px might be considered as potential modulators of Tb-induced lipid peroxidation. The mechanisms involved in Tb-induced pulmonary lipid peroxidation deserve further study.

Reducing TB Exposures

Reducing TB Exposures

OSHA Issues Enforcement Policy for TB Exposure Guidelines

OSHA Issues Enforcement Policy for TB Exposure Guidelines

Assessment of Tuberculin Screening in an Urban Pediatric Clinic

The American Lung Association (ALA) and Center for Disease Control (CDC) have stated that routine screening of children is an inefficient and ineffective method for detection of tuberculosis in the United States. This is at variance with prior recommendations. Our objective, therefore, was to assess prospectively tuberculin screening for our urban, primarily low socioeconomic, clinic population. A prior chart review revealed that only 36% of tuberculin tests had written documentation of results. The following improvements were made: (1) One trained technician administered all tests and recorded data. (2) One hospital mail box was used for receiving tuberculin test postcard results. (3) Telephone follow-up was begun. This resulted in an increase of results documented to 84% (P .001). After these improvements, we prospectively studied the next 1,233 routine screening tests over a period of eight months. The written documentation rate during the study was 90%. Thirteen positive tuberculin tests were found. Three patients had subsequent negative tuberculin tests. One patient received Calmette-Guérin bacillus (BCG) as an infant and had multiple positive tuberculin tests in the past. One patient was lost to follow-up. Eight positive patients were confirmed as new converters. Of these eight patients, six had histories of prior positive tuberculin tests, recent TB exposure, foreign travel, or symptoms. We conclude that: (1) Prior to the study, recording of tuberculin tests was severely deficient. (2) Reorganization significantly increased the documentation rate. (3) Of 1,233 consecutive tests, eight unsuspected cases were found. This is below the 1% conversion rate recommended by the CDC for routine TB screening in children. (4) The data support the ALA-CDC statement regarding the low yield of routine tuberculin testing of healthy children. (5) However, abandoning tuberculin screening of healthy children would leave undetected a few children with unsuspected tuberculosis infection, who would then be in danger of developing serious illness.

Urea in the treatment of epibulbar malignancies.

Eight patients with epibulbar malignancies of the eyes were sucessfully treated with urea. One of them presented a malignant melanoma, one a tumour of Kaposi's disease, and six had squamous cell carcinomas. At least four out of these eight patients would have required enucleation of the globe or exenteration of the orbit as an alternative to urea therapy.