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MEDICINE

 

ISSN: 1582-5388

 

 

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Publichealth

 

Medical technology and health

Nicolae Tudor Racoveanu

Abstract. Health Technology (HT) or Medical Technology is at present one of the important reasons of inequity in Health Care visible in our world as demonstrated very clearly by the UNSCEAR 2000. Data of this document demonstrate that less than 25% of the world population has reasonable access to diagnostic radiology and that situation is not improving but on the contrary, deteriorating. The main reason are the high cost of Health Devices which are not designed with the view to serve the world at large. The solution to this situation is to change the actual policy imposed by the industry and to adopt the approach used in the field of "essential drugs", which means to design appropriate HT devices responding to the following criteria: 1- scientifically and technically valid-producing better outcome; 2-reliable and reproducible; 3- affordable by those who need the HT; 4-clear, unambiguous in functions; 5-multidisciplinary in concept, maintenance and utilization; 6-periodically revised and improved; 7- adequately documented and certified. With such approach supported by the users and producers of HT it will be possible to offer to the majority of those deprived today the opportunity to see the improvement of the health status they deserve.

Key words: radiological equipment, diagnostic radiology, QA programmes FULL TEXT.PDF

 

Does the diagnostic radiology pattern change?†††††††††

Cornelia Diaconescu, Olga Iacob

Abstract. Diagnostic radiology is the major contributor to population exposure in Romania. Previous estimates have put the contribution of medical X-ray examination at about 93% from all artificial sources. The pattern of radiological diagnosis at national level have been analized for the last decade as annual totals of X-ray examinations and the relative frequencies of different procedures. During 1990-1999, the number of all diagnostic X-rays per head of population decreased from 0.60 (1990) to 0.54 (1999). The relative frequency of different examinations, beside the large reduction of photofluorographies and in a smaller extent of fluoroscopies, remained unchanged. After 1995, computed tomography rise constantly so, in 1999 its contribution to total annual exxaminations was of 4%. Large differences between districts as CT annual relative frequencies (from 0.1 up to 24) appeared. A careful consideration of CT growth is necessary because substantially higher doses involved.

Key words: diagnostic radiology, X-ray exams, annual frequencies, tendency, CT FULL TEXT.PDF

 

Population exposure from diagnostic nuclear medicine practice: 2000 update

Olga Iacob, Cornelia Diaconescu

Abstract. This survey represents a update of the Romanian population exposure from in vivo diagnostic nuclear medicine procedures, focused on the year 2000. The new estimates are:3.2 for the average annual number of diagnostic nuclear medicine procedures per 1000 population, 12.7 mSv a-1 for the average effective dose per patient undergoing diagnostic nuclear medicine procedures, 910 man Sv for the annual collective effective dose and 40 mSv for the annual effective dose per capita. As in previous surveys conducted during 1990 and 1995, the most important examination both, by frequency and contribution to annual collective dose, was the thyroid investigation. Although the frequency of the 99mTc use has increased since the last survey (1995) by 44 per cent, 131I is still the radionuclide of choice for more than 50% of thyroid investigations, imparting continuously high doses to patients.

Key words: diagnostic nuclear medicine, radiopharmaceuticals, effectivedose FULL TEXT.PDF

 

Occupational hygiene

 

Evaluation of airborne and endotoxin in corn storage and processing facilities in Colorado

Roy M. Buchan, Pabitra Rijal, Delvin Sandfort, Tom Keefe

Abstract. The main objectives of this research were to determine what aerosols were present by taking total dust (TD) samples and thoracic particulate mass samples (TPM) on farms and in grain elevators. Cascade impactors were used to characterize size distribution of dust and endotoxins at each site. Total dust concentrations on farms had a geometric mean 3.4 mg/m3 and 3.3 mg/m3 in elevators. The geometric mean (GM) concentrations for the TPM were 2.4 mg/m3 on farms and 1.0 mg/m3 in elevators. Endotoxin concentrations as geometric means were alarming at 3,175 EU/m3 total dust and 983 EU/m3 by TPM on farms.In elevators, the GM concentrations for endotoxins were 2,534 EU/m3total dust and 526 EU/m3 by TPM. The mass median aerodynamic diameter (MMAD) for endotoxins on farms was 8.0 mm and 6.5 mm in elevators. The paired t-test was applied to the log radios of endotoxin concentrations (EU/m3) and dust concentrations (mg/m3), for paired samples of the TD and TPM. A higher content of endotoxin was associated with TPM for farms but not elevators. It was concluded that althought the TPM fraction (dust) may represents a small part of the total mass, the aerosol size is optimum for deposition in the lungís tubular airways, and might cause airway inflammation due to the endotoxins. The TPM fraction of corn dust represents the best measure of exposure with regard to the potential development of long-term airways inflammation, and the potential of chronic obstructive pulmonary disease among chronically exposed workers. All endotoxin concentrations were well above recommended exposure levels of several researchers familiar with endotoxin health effects.

Key words: respiratory hazards, aerosols, agriculture, corn dust†† FULL TEXT.PDF

 

Contaminants old and new Ė innovation in prevention

Harry Aiking

Abstract. Environmental issues are becoming increasingly complex, however, multidisciplinary co-operation may yield unprecedented opportunities for innovative solutions. Two extreme and opposing cases are used to illustrate the potential and pitfalls of this approach for prevention. Metal mining is one old industry which presents a clear and present danger to man and the environment. During the 1998 calamity in Spain 5 million cubic metres of acidic mining waste washed into the vulnerable Donana Wetlands, a well-known bird sanctuary. In order to prevent similar catastrophes in the future, a preliminary EU risk inventory was made by combining environmental toxicology and remote sensing. Meat production is another old industry. It is increasingly recognized that a steadily growing world population plus a rapidly increasing per capita meat consumption will pose unprecedented environmental problems in the near future. Therefore, the PROFETAS (Protein Foods, Environment, Technology And Society) research programme studies the potential of a (partial) transition from predominantly animal to plant protein consumption. Major social, environmental, and occupational consequences of a partial transition from meat to novel (plant) protein foods (NPFs) are discussed in the light of recent food scares (BSE, GM, etc.).

Key words: prevention, environment, society, technology, contaminants, innovation, multidisciplinarity,metal mining, meat industry, industrial transformation FULL TEXT.PDF

 

Control banding Ė a practical approach to judging control methods for chemicals††††††††† †††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††

Paul Oldershaw

Abstract There is widespread concern over the risks, real or feared, from the rapidly increasing inventory of chemicals in commercial use. Many users of chemicals rely for their information on their supplier and safety data sheets (SDS).These summaries of properties are difficult for the average user to convert into practical control action.It is possible to take the classification data (the Risk Phrases) which are globally harmonised and link these directly to control advice given a knowledge of the process and purpose of the chemical - information immediately available to many.A level of control can be introduced, which although lacking the specific assurance of a professional hygiene and toxicological assessment does present sensible action.This approach has received widespread support by employers, workers and professional hygienists in the UK, and is now being taken forward in other countries, through the European Commission, and globally through ILO.

Key words: control banding, safety data sheets, Risk Phrases, Occupational exposure limits†† FULL TEXT.PDF

 
Occupational hygiene in Romania: particular issues
Radu Brănişteanu

Abstract. Occupational Hygiene plays an important role in many Occupational Health Safety and The Environment projects, but the efficiency of this activity is strongly influenced by factors exogenous to the profession. This paper undertakes a partialanalysis of the Occupational Hygiene (OH) practise in Romania. In order to illustratethe drawbacks encountered in practise, some of the implications of the political, economic and social context are first emphasised. Further trends are then presented:the perpetuation of the extensive industries, the increasing the number of small companies, the low perception of the workers towards the efficiency of the OH, the development of the non-industrial activities. A further discussion that underscores the improvement of the human potential as the driving force of OH efficiency suggest some solutions of improvement.

Key words: Occupational Hygiene, hazard identification, hazard control†† FULL TEXT.PDF

 
Analysis of nicotine and cotinine in tobacco industry workers
Rodica Stănescu Dumitru, Carmen Ruxandra Artenie, Eleonora Cerbu, Vali Constantinescu

Abstract. The present study aimed to follow up the levels of nicotine and its major metabolite, cotinine, in workersí urine of tobacco industry, using a reliable gas chromatographic method. The limit of detection for both nicotine and cotinine was 10ng ml-1. We consider that the urinary nicotine and cotinine levels might be served as biological monitoring index for estimation of the exposure level for the non-smoking workers in tobacco industry.

Key words: nicotine, cotinine, chromatography, occupational exposure†† FULL TEXT.PDF

 
ďSick Building SyndromeĒ in actuality

Elena-Ana Păuncu, Liliana SÓrb, Carmen Oros, Marius Fernolendt, Gabriela Papoe, Mioara Bocşa

Abstract. The study have been performed a new established factory near Timişoara. People working in offices presented different discomfort complaints in short time after starting the work. The working conditions are very modern. Tests for chemical hazard identification and microclimate measurements in different workplaces have been performed. The concentration of alveolar fraction of the dust was higher than that in the factory and exceeded the maximum allowable concentration. Other investigated airborne toxicants, such aromatic hydrocarbons, formaldehyde, carbon monoxide, ozone were found in normal limits. The relative humidity values were of 30-40% in offices. We performed an ergonomic evaluation of the occupational activity, clinical examination, laboratory tests, electrocardiogram and pulmonary function tests in two groups of workers. An adequate questionnaire was used. The group "O" with occupational exposure in offices consisted of 15 subjects with the average age 29.8Ī5.2 years. The control group "W" consisted of 22 workers with respiratory exposure to synthetic fibbers and the average age 35.4Ī8.5 years. Irritative and allergic symptoms in both groups were noted. In office personnel we found headache, fatigue, and for women, abdominal pain, nausea, headache, dizziness, behavioral changes, memory disturbances; these findings were statistically significant. The modifications of some laboratory and functional tests proofs for pre-existing complains, tobacco smoking and occupational exposure.

Key words: sick building syndrome, air pollution, health statusFULL TEXT.PDF

 

Axillary temperature measurement as a possible diagnostic element of organic dust toxic syndrome (ODTS) for workers exposed to jute dust

Cristina Cordoneanu, Ioan Grinea, Radu Brănişteanu, Raul Hreniuc

Abstract. The screening type study emphasizes the part played by axillary temperature measurement as a first step in ODTS diagnosis in workers exposes to organic dust (jute). An exposed group of 110 workers (98 females): age = 39 years, working duration = 12 years, exposed to jute, has been examined. Workplaces of: squashing; carding; laminating; spinning; twisting; starching; rolling were investigated. Noxious agents were: fibers and dust of jute; noise; adverse microclimate. Workers exposed to wood and chemical noxious agents (57 persons each) were also investigated. There were 5 examinations: (1) Monday 6.00 a.m.; (2) Monday 2.00 p.m.; (3) Friday 6.00 a.m.; (4) Friday 2.00 p.m.; (5) consultation. The control group consisted of 68 subjects. The percentages of the temperature measurements of 37o C and over, and respectively the averaged values were: jute = 42% (36.83o C); wood = 32.98% (36.74o C); chemicals = 25.26% (36.64o C); controls = 9.31% (36.53o C). The statistical significance was: jute vs. control group (χ2 = 70.27; p = .0000; OR = 7.05); jute vs. chemicals (χ2 = 22.03; p= .0000; Odds Ratio (OR) = 2.14; Relative Risk (RR) = 1.66). Significant statistical changes of the phenomenon are noticed lasting during the work time, both daily and weekly, at workers exposed to jute: Monday 2.00 p.m. vs. Monday 6.00 a.m.: χ2 = 27.25; p = .0000; OR = 4.73; RR = 2.56; Friday 2.00 p.m. vs. Monday 6.00 a.m.: χ2 = 15.48; p = .0000; OR = 3.28; RR = 2.16; Monday 2.00 p.m. vs. Friday 6.00 a.m.: χ2 = 14.40; p = .0001; OR = 2.98; RR = 1.83; Friday 2.00 p.m. vs. Friday 6.00 a.m.: χ2 = 6.11; p = .01; OR = 2.07; RR = 1.54. The testís sensibility (jute vs. control) = 92.4%. Important steps are to be taken for creating basic, regular attitudes of occupational hygiene in order to prevent ODTS.

Keywords: ODTS; jute; axillary temperature; occupational hygiene FULL TEXT.PDF

 

History of medicine

 

Beginnings of social medicine and labour medicine in Romania

Cristina Ionescu

The influence of external environment on human body was noticed since ancient times.Hyppocrate made some written observations on the influence of outer world (climate, geographical area, waters, wind, diet, social system) upon the human being, in other words of macrocosms on the microcosmos.

During the past centuries, subsequent to industrial revolution, development of agriculture, diversification of crafts and occurrence of new social classes, the diseases caused by noxious agents, inadequate diet or consumption of altered food and physical exhaustion due to the long work program of 10-12 hours appeared.FULL TEXT.PDF

 

Scientific meetings

 

Thirteenth Conference of the International Society of Environmental Epidemiology (ISEE)

Gabriela Mancaş

The 2001 Annual Conference of ISEE was hosted by the Institute of Epidemiology, GSF - National Research Center for Environment and Health, Neuherberg, Germany.

The purpose of the meeting was to attract participants from America, Asia, Africa, Australia and Europe, to discuss the various environmental problems in their countrie as well as global aspects of environmental health. The conference considered especially the health impact of environmental influences during drastical political and economic changes. FULL TEXT.PDF

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