Central European journal of public health, Jun 1, 2018
As a part of regular revision of the List of Occupational Diseases in the Czech Republic, efforts... more As a part of regular revision of the List of Occupational Diseases in the Czech Republic, efforts have been made to add a new item so that lumbar spine disease caused by overload may be recognized as occupational one, with adherence to the valid national rules, that is, clinical criteria are met and objective assessment confirms working conditions under which, according to recent scientific knowledge, such an occupational disease develops. The aim is to provide information on the use of a proposed method for working condition assessment in a real setting, based on the initial experiences gained from a pilot study carried out to validate the method. Working conditions were assessed in 55 individuals with chronic low back pain (25 males, 30 females; mean age 45.6 years; mean length of employment 15.6 years). The assessment was based on estimating compressive force on the L4/L5 intervertebral disc when performing potentially high-risk work tasks which were entered into four types of ch...
International journal of environmental research and public health, Mar 7, 2017
While working underground, miners are exposed to a number of risk factors that have a negative im... more While working underground, miners are exposed to a number of risk factors that have a negative impact on their health and may be a cause of an increased mortality in miners. The aim of the study was to compare total and specific mortality in black coal miners with acknowledged coal-workers' pneumoconiosis (CWP) and without CWP, and the mortality of the general male population in the Czech Republic in the period 1992-2013. The sample consisted of 3476 coal miners with CWP and 6687 ex-coal miners without CWP, who were removed after achieving the maximum permissible exposure (MPE). The mortality risk differences were analyzed with the use of the standardized mortality ratio (SMR) and 95% confidence interval. Significantly higher total mortality (SMR = 1.10; 95% CI: 1.02-1.17), and mortality from malignant neoplasm (SMR = 1.16; 95% CI: 1.03-1.30), lung cancers (SMR = 1.70; 95% CI: 1.41-2.04), and non-malignant respiratory diseases (SMR = 2.78; 95% CI: 2.32-3.31) were found in the sa...
Methanol mass poisoning occurs across the world quite frequently, but the complete clinical and l... more Methanol mass poisoning occurs across the world quite frequently, but the complete clinical and laboratory data of the patients are only rarely available. Approximately 138 cases of poisoning were documented in the Czech Republic, 107 patients were hospitalized. Another 31 persons died out of hospital. About 60 % of the hospitalized patients survived intoxication without consequences, one half of the remaining 40 % died and the other half survived with the CNS and/or sight impaired. The Czech study successfully used modern diagnostic methods. A positive effect of the prehospital first aid with an oral antidote has been proven and a comparable effect of ethanol and fomepizole has been reached during hospital therapy. Higher efficiency of intermittent therapy has been determined as compared to continual hemodialysis. No connection was found between cerebral hemorrhage and systemic anticoagulation during hemodialysis. Magnetic resonance imaging revealed brain lesions in more than 50 % ...
Preventive measures in Central Europe were successful in suppressing both occupational and enviro... more Preventive measures in Central Europe were successful in suppressing both occupational and environmental lead exposure so that they did not constitute a severe public health problem. However, rare lead intoxications still appear. We report on lead intoxication in four family members where the source was removed lead ceiling paint. The symptoms of the lead intoxication started several weeks after removal and the inhalational exposure to the minimum dust residues lasted for more than three months before the poisoning was diagnosed. Father developed anaemia and saturnine colics. He and his two daughters received antidotal treatment which had to be repeated in the children. Finally, all recovered completely.Lead intoxication may be easily overlooked due to the unspecific symptoms. It is necessary to think of this rare poisoning which may be caused by old paints, historical ceramics and lead shots, in addition to commercial products imported from abroad.
Basic & clinical pharmacology & toxicology, Jan 17, 2016
The purpose of the article was to study unintentional pharmaceutical-related poisonings committed... more The purpose of the article was to study unintentional pharmaceutical-related poisonings committed by laypersons that were reported to the Toxicological Information Centre (TIC) in the Czech Republic. Identifying frequency, sources, reasons and consequences of the medication errors in laypersons could help to reduce the overall rate of medication errors. Records of medication error inquiries from 2013 and 2014 were extracted from the electronic database and the following variables were reviewed: drug class, dosage form, dose, age of the subject, cause of the error, time interval from ingestion to the call, symptoms, prognosis at the time of the call and first aid recommended. Of the calls, 1,354 met the inclusion criteria. Among them, central nervous system affecting drugs (23.6%), respiratory drugs (18.5%) and alimentary drugs (16.2%), were the most common drug classes involved in the medication errors. The highest proportion of the patients was in the youngest age subgroup 0-5 y-o ...
The aim of the study was to develop a computational module for the prediction of compressive forc... more The aim of the study was to develop a computational module for the prediction of compressive force on the L4/L5 disc suitable for use in field settings. The value of compressive force is intended to be used as a proxy measure of the mechanical burden of low-back when performing work activities. The compressive force predicted by the module in a particular worker should be compared with the NIOSH limit value of 3,400 N for the assessment of lumbar spine load during manual lifting tasks. Exceeding the limit will be considered as the fulfilment of "hygienic criterion" that should be met to acknowledge low-back disorder as an occupational disease. To develop the computational module we used the ergonomic software TECNOMATIX Classic Jack taking into account the anthropometric parameters of a worker and ergonomic parameters of his/her work activity. We calculated compressive forces on the L4/L5 disc in about 1,300 simulated combinations of various factors influencing compressive...
Markers of oxidative stress and inflammation were analysed in the exhaled breath condensate (EBC)... more Markers of oxidative stress and inflammation were analysed in the exhaled breath condensate (EBC) and urine samples of 14 workers (mean age 43 ± 7 years) exposed to iron oxide aerosol for an average of 10 ± 4 years and 14 controls (mean age 39 ± 4 years) by liquid chromatography-electrospray ionization-mass spectrometry/mass spectrometry (LC-ESI-MS/MS) after solid-phase extraction. Aerosol exposure in the workplace was measured by particle size spectrometers, a scanning mobility particle sizer (SMPS) and an aerodynamic particle sizer (APS), and by aerosol concentration monitors, P-TRAK and DustTRAK DRX. Total aerosol concentrations in workplace locations varied greatly in both time and space. The median mass concentration was 0.083 mg m(-3) (IQR 0.063-0.133 mg m(-3)) and the median particle concentration was 66 800 particles cm(-3) (IQR 16 900-86 900 particles cm(-3)). In addition, more than 80% of particles were smaller than 100 nm in diameter. Markers of oxidative stress, ma...
Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practit... more Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupati...
Clinical toxicology (Philadelphia, Pa.), Jan 12, 2015
Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are gener... more Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are generally transient. The subjective symptoms of visual toxicity may resolve within few weeks and fundoscopic signs of acute optic neuropathy subside within 1-2 months; therefore, the prevalence of long-term visual sequelae in the population of survivors of poisonings may be underestimated. To study the prevalence and character of long-term visual sequelae of acute methanol poisonings based on the data from the Czech mass methanol outbreak in 2012. A total of 50 patients with confirmed methanol poisoning were included in this longitudinal cross-sectional study, median age: 48 (range, 23-73) years. The following tests were performed: optical coherence tomography or OCT with evaluation of the retinal nerve fibers layer (RNFL), visual evoked potentials (VEP), magnetic resonance imaging (MRI) of brain, complete ocular examination (visual acuity/field, color vision, contrast sensitivity, and fundus...
Asbestos manufacturing has been banned in the Czech Republic; however, about 280 workers in the 2... more Asbestos manufacturing has been banned in the Czech Republic; however, about 280 workers in the 2nd-4th work category have been exposed during the remediation of asbestos, and the health consequences of the former use of asbestos will be apparent for many years. The incidence of mesothelioma in the Czech Republic is about 0.5/100,000 inhabitants, which places it among the lowest incidences of mesothelioma in Europe, and ranks the Czech Republic among the countries with the lowest rates in the world. The proportion of occupational mesotheliomas is only about one-tenth of these malignancies. These data show an underreporting of occupational cancers, most probably due to low awareness of the association of exposures more than 40 years ago with this disease. Physicians should focus more on the occupational history of these patients and refer them to the Departments of occupational diseases. Benefits are available for all patients with mesothelioma, in whom industrial hygienists confirm ...
Central European journal of public health, Jun 1, 2018
As a part of regular revision of the List of Occupational Diseases in the Czech Republic, efforts... more As a part of regular revision of the List of Occupational Diseases in the Czech Republic, efforts have been made to add a new item so that lumbar spine disease caused by overload may be recognized as occupational one, with adherence to the valid national rules, that is, clinical criteria are met and objective assessment confirms working conditions under which, according to recent scientific knowledge, such an occupational disease develops. The aim is to provide information on the use of a proposed method for working condition assessment in a real setting, based on the initial experiences gained from a pilot study carried out to validate the method. Working conditions were assessed in 55 individuals with chronic low back pain (25 males, 30 females; mean age 45.6 years; mean length of employment 15.6 years). The assessment was based on estimating compressive force on the L4/L5 intervertebral disc when performing potentially high-risk work tasks which were entered into four types of ch...
International journal of environmental research and public health, Mar 7, 2017
While working underground, miners are exposed to a number of risk factors that have a negative im... more While working underground, miners are exposed to a number of risk factors that have a negative impact on their health and may be a cause of an increased mortality in miners. The aim of the study was to compare total and specific mortality in black coal miners with acknowledged coal-workers' pneumoconiosis (CWP) and without CWP, and the mortality of the general male population in the Czech Republic in the period 1992-2013. The sample consisted of 3476 coal miners with CWP and 6687 ex-coal miners without CWP, who were removed after achieving the maximum permissible exposure (MPE). The mortality risk differences were analyzed with the use of the standardized mortality ratio (SMR) and 95% confidence interval. Significantly higher total mortality (SMR = 1.10; 95% CI: 1.02-1.17), and mortality from malignant neoplasm (SMR = 1.16; 95% CI: 1.03-1.30), lung cancers (SMR = 1.70; 95% CI: 1.41-2.04), and non-malignant respiratory diseases (SMR = 2.78; 95% CI: 2.32-3.31) were found in the sa...
Methanol mass poisoning occurs across the world quite frequently, but the complete clinical and l... more Methanol mass poisoning occurs across the world quite frequently, but the complete clinical and laboratory data of the patients are only rarely available. Approximately 138 cases of poisoning were documented in the Czech Republic, 107 patients were hospitalized. Another 31 persons died out of hospital. About 60 % of the hospitalized patients survived intoxication without consequences, one half of the remaining 40 % died and the other half survived with the CNS and/or sight impaired. The Czech study successfully used modern diagnostic methods. A positive effect of the prehospital first aid with an oral antidote has been proven and a comparable effect of ethanol and fomepizole has been reached during hospital therapy. Higher efficiency of intermittent therapy has been determined as compared to continual hemodialysis. No connection was found between cerebral hemorrhage and systemic anticoagulation during hemodialysis. Magnetic resonance imaging revealed brain lesions in more than 50 % ...
Preventive measures in Central Europe were successful in suppressing both occupational and enviro... more Preventive measures in Central Europe were successful in suppressing both occupational and environmental lead exposure so that they did not constitute a severe public health problem. However, rare lead intoxications still appear. We report on lead intoxication in four family members where the source was removed lead ceiling paint. The symptoms of the lead intoxication started several weeks after removal and the inhalational exposure to the minimum dust residues lasted for more than three months before the poisoning was diagnosed. Father developed anaemia and saturnine colics. He and his two daughters received antidotal treatment which had to be repeated in the children. Finally, all recovered completely.Lead intoxication may be easily overlooked due to the unspecific symptoms. It is necessary to think of this rare poisoning which may be caused by old paints, historical ceramics and lead shots, in addition to commercial products imported from abroad.
Basic & clinical pharmacology & toxicology, Jan 17, 2016
The purpose of the article was to study unintentional pharmaceutical-related poisonings committed... more The purpose of the article was to study unintentional pharmaceutical-related poisonings committed by laypersons that were reported to the Toxicological Information Centre (TIC) in the Czech Republic. Identifying frequency, sources, reasons and consequences of the medication errors in laypersons could help to reduce the overall rate of medication errors. Records of medication error inquiries from 2013 and 2014 were extracted from the electronic database and the following variables were reviewed: drug class, dosage form, dose, age of the subject, cause of the error, time interval from ingestion to the call, symptoms, prognosis at the time of the call and first aid recommended. Of the calls, 1,354 met the inclusion criteria. Among them, central nervous system affecting drugs (23.6%), respiratory drugs (18.5%) and alimentary drugs (16.2%), were the most common drug classes involved in the medication errors. The highest proportion of the patients was in the youngest age subgroup 0-5 y-o ...
The aim of the study was to develop a computational module for the prediction of compressive forc... more The aim of the study was to develop a computational module for the prediction of compressive force on the L4/L5 disc suitable for use in field settings. The value of compressive force is intended to be used as a proxy measure of the mechanical burden of low-back when performing work activities. The compressive force predicted by the module in a particular worker should be compared with the NIOSH limit value of 3,400 N for the assessment of lumbar spine load during manual lifting tasks. Exceeding the limit will be considered as the fulfilment of "hygienic criterion" that should be met to acknowledge low-back disorder as an occupational disease. To develop the computational module we used the ergonomic software TECNOMATIX Classic Jack taking into account the anthropometric parameters of a worker and ergonomic parameters of his/her work activity. We calculated compressive forces on the L4/L5 disc in about 1,300 simulated combinations of various factors influencing compressive...
Markers of oxidative stress and inflammation were analysed in the exhaled breath condensate (EBC)... more Markers of oxidative stress and inflammation were analysed in the exhaled breath condensate (EBC) and urine samples of 14 workers (mean age 43 ± 7 years) exposed to iron oxide aerosol for an average of 10 ± 4 years and 14 controls (mean age 39 ± 4 years) by liquid chromatography-electrospray ionization-mass spectrometry/mass spectrometry (LC-ESI-MS/MS) after solid-phase extraction. Aerosol exposure in the workplace was measured by particle size spectrometers, a scanning mobility particle sizer (SMPS) and an aerodynamic particle sizer (APS), and by aerosol concentration monitors, P-TRAK and DustTRAK DRX. Total aerosol concentrations in workplace locations varied greatly in both time and space. The median mass concentration was 0.083 mg m(-3) (IQR 0.063-0.133 mg m(-3)) and the median particle concentration was 66 800 particles cm(-3) (IQR 16 900-86 900 particles cm(-3)). In addition, more than 80% of particles were smaller than 100 nm in diameter. Markers of oxidative stress, ma...
Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practit... more Low-back pain diseases (LBPD) belong to the most frequent diagnoses determined by general practitioners, and constitute one of the most common reasons for sick leave and permanent disability pension in the Czech Republic and other European countries. Epidemiological studies have shown a statistically significant association between LBPD and certain types of occupational burden. However, in the Czech Republic, LBPD caused by overload and/or whole-body vibrations have not yet been included in the list of occupational diseases. The aim of this study was to collect and compare the systems, criteria and diagnoses used to recognize LBPD as occupational diseases in other European countries. A questionnaire focused on LBPD was distributed and answered by specialists in occupational diseases in European countries. It included items concerning LBPD in the national list of occupational diseases, and work-related and diagnostic criteria that need to be fulfilled for recognizing LBPD as occupati...
Clinical toxicology (Philadelphia, Pa.), Jan 12, 2015
Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are gener... more Visual disturbances due to the toxic effect of formic acid in acute methanol poisonings are generally transient. The subjective symptoms of visual toxicity may resolve within few weeks and fundoscopic signs of acute optic neuropathy subside within 1-2 months; therefore, the prevalence of long-term visual sequelae in the population of survivors of poisonings may be underestimated. To study the prevalence and character of long-term visual sequelae of acute methanol poisonings based on the data from the Czech mass methanol outbreak in 2012. A total of 50 patients with confirmed methanol poisoning were included in this longitudinal cross-sectional study, median age: 48 (range, 23-73) years. The following tests were performed: optical coherence tomography or OCT with evaluation of the retinal nerve fibers layer (RNFL), visual evoked potentials (VEP), magnetic resonance imaging (MRI) of brain, complete ocular examination (visual acuity/field, color vision, contrast sensitivity, and fundus...
Asbestos manufacturing has been banned in the Czech Republic; however, about 280 workers in the 2... more Asbestos manufacturing has been banned in the Czech Republic; however, about 280 workers in the 2nd-4th work category have been exposed during the remediation of asbestos, and the health consequences of the former use of asbestos will be apparent for many years. The incidence of mesothelioma in the Czech Republic is about 0.5/100,000 inhabitants, which places it among the lowest incidences of mesothelioma in Europe, and ranks the Czech Republic among the countries with the lowest rates in the world. The proportion of occupational mesotheliomas is only about one-tenth of these malignancies. These data show an underreporting of occupational cancers, most probably due to low awareness of the association of exposures more than 40 years ago with this disease. Physicians should focus more on the occupational history of these patients and refer them to the Departments of occupational diseases. Benefits are available for all patients with mesothelioma, in whom industrial hygienists confirm ...
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