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    "titulo" => "Pòsters : Salud ocupacional"
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    "textoCompleto" => "<p class="elsevierStylePara"> Jueves 2 de Octubre &#47; Thursday 2&#44; October<br></br> 17&#58;00&#58;00 a&#47;to 18&#58;00&#58;00</p><p class="elsevierStylePara"><span class="elsevierStyleBold">172</span><span class="elsevierStyleBold">BREAST CANCER RISK AMONG FINNISH CABIN ATTENDANTS - A CASE-CONTROL STUDY</span></p><p class="elsevierStylePara"> Katja Kojo&#42;&#44; Eero Pukkala&#42;&#42;&#44; Anssi Auvinen&#42;&#42;&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Research and Environmental Surveillance&#44; Finnish Radiation and Nuclear Safety Authority&#44; Helsinki&#44; Finland&#46; &#42;&#42;Finnish Cancer Registry&#44; Helsinki&#44; Finland&#46; &#42;&#42;&#42;Tampere School of Public Health&#44; University on Tampere&#44; Tampere&#44; Finland&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> Some earlier studies have found elevated breast cancer risk among female cabin crew&#46; This has been suggested to reflect either occupational exposure to cosmic radiation&#44; hormonal alterations due to repeated jet lag&#44; life-style factors or confounding factors&#44; such as age at menarche and menopause&#46; The contribution of various factors has remained unclear&#44; mainly due to the fact that earlier reports have been on cohort studies with limited information on potential confounders&#46; We conducted a nested case-control study among cabin attendants in Finland&#46; Our objective was to assess the contribution of occupational versus life-style factors to breast cancer risk&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> We collected information with standardised self-administered questionnaire on demographic&#44; occupational and lifestyle factors from 1041 cabin attendants&#44; who were identified through Finnair and Finnish Cabin Attendant Association&#46; A total of 28 cases and 516 controls completed the questionnaire&#46; For each case&#44; up to four controls were chosen with matching on year of birth &#40;&#177;1 year&#41;&#46; Breast cancer diagnoses were confirmed by a record linkage with the Finnish Cancer Registry&#46; Exposure to cosmic radiation was estimated based on self-reported flight history&#46; Conditional logistic regression model was used for analysis&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> In a multivariate analysis early menarche &#40;OR&#61;4&#46;0&#44; 95&#37; CI&#58; 1&#46;0&#59;16&#46;1&#41; and family history of breast cancer &#40;OR&#61;6&#46;5&#44; 95&#37; CI&#58; 1&#46;6&#59;26&#46;9&#41; were associated with elevated risk&#44; whereas parity &#40;one or more births versus none&#44; OR&#61;0&#46;7&#44; 95&#37; CI&#58; 0&#46;2&#59;2&#46;8&#41; seemed to have a protective effect&#46; Cumulative radiation dose was not associated with breast cancer risk &#40;OR&#61;1&#46;0 per mSv&#44; 95&#37; CI&#58; 1&#46;0&#59;1&#46;0&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> Our results suggests that breast cancer risk among Finnish cabin attendants is related to general&#44; well-established risk factors of breast cancer&#44; such as early age at menarche and family history&#46; Occupational factors do not exert a strong influence on breast cancer risk&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">173</span><span class="elsevierStyleBold">THE EPIDEMIOLOGY OF WORKPLACE CHEMICAL EXPOSURES AND RISK ASSESSMENT</span></p><p class="elsevierStylePara"> JInky Leialnie Lu</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">College of Arts and Sciences&#44; UNiveristy of teh Philippines&#44; Manila&#46;</span></p><p class="elsevierStylePara"> The aim of the study is to come up with an epidemiological study on chemical exposures at work and related illnesses&#46; Based on the data&#44; a risk exposure assessment will be established as a guide to occupational health practitioners in assessing the indicators and parameters of hazard exposures&#46; The study used a multi-state stratified sampling of manufacturing industries in export zones in the Philippines&#46; Thirty-one industries were measured in terms of noise&#44; heat chemical exposure&#44; radiation and ventilation&#46; Five hundred workers were given questionnaires to assess their chemical exposures and the consequent health effects&#46; There was 100&#37; use of chemicals in the industries used as raw material or solvent for processing&#46; The industries generated dust and vapours&#44; as well as acids and caustics&#46; The blood lead result of the 285 subjects revealed that 40&#46;7 percent of the total number of subjects had blood lead result within the 21-30 ug&#47;dL which is considered by the Department of Health dangerous&#46; When hazards and illness were correlated with alpha set at 0&#46;05&#44; radiation exposure was associated with bone pain&#44; and dust exposure with eye strain&#44; and viral exposure&#44; solvent exposures with respiratory illnesses&#44; abortion&#44; and anemia&#46; Based on the results&#44; a proposed exposure rating for chemical exposure is done&#46; This allows an easy guideline for the assessment of chemical hazards considering factors such as contact with the body surface&#44; generation of vapor within the breathing zone&#44; threshold limit values &#40;TLV&#41; and exposure time&#46; For example&#44; exposure rating estimate of 0 means no exposure either through dermal contact or within the breathing zone of the worker&#46; Very high exposure is exposure above the TLV which varies per chemical and where the exposure time is beyond the 8 hour work duration&#46;</p><p class="elsevierStylePara"> Exposure Ratings for Chemical Exposure</p><p class="elsevierStylePara"> Exposure Rating Estimate Category Qualitative Description Exposure Time</p><p class="elsevierStylePara"> 0 No exposure No contact Not within breathing Zone No exposure time</p><p class="elsevierStylePara"> 1 Low exposure Minimum contactMinimum concentration Within breathing zone Less than the specified TLV-Ceiling</p><p class="elsevierStylePara"> 2 Moderate Moderate ContactModerate concentration Within breathing zone Less than 50&#37; of the 8-hour workday&#46;</p><p class="elsevierStylePara"> 3 High exposure High contactHigh concentration Within breathing zone More than the specified TLV-Ceiling&#59; and TLV-TWA</p><p class="elsevierStylePara"> 4 Very High Exposure Very High contactVery High concentration Within breathing zone More than the specified TLV-Ceiling&#59; and TLV-TWA</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusion&#58;</span> This study looked into actual chemical and other hazard exposures of workers&#46; The proposed hazard rating matrix will allow the concerned to quantify and address problems that may arise from chemical exposures&#46; This study is also seen to significantly contribute to the importance of epidemiology in establishing risk assessment in the workplace and the eventual prevention of occupational illnesses&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">174</span><span class="elsevierStyleBold">ASSOCIATION BETWEEN OCCUPATIONAL LEAD AND CADMIUM EXPOSURE AND SERUM CHOLESTEROL</span></p><p class="elsevierStylePara"> Ligia Fat&#44; Daniela Minailiuc&#44; Botoc Mariana</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Occupational Health&#44; Institute of Public Health&#44; Cluj Napoca&#44; Romania&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The special literature shows that occupational exposure to lead and cadmium affect the human health and generate toxic effects&#46; The monitoring of lead and cadmium exposure is necessary because they can alter the organism reactivity&#44; increase the sensitivity for the pathogen agents&#44; stress and other noxes and so generate a varied pathology with long recovery&#46; In this study we determined the prevalence and associations of risk markers for IHD&#44; by measuring major and minor IHD risk factors&#44; serum cholesterol levels&#44; as well as associations with blood lead and blood cadmium&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> We examined 145 lead and cadmium exposed workers from a metallurgical plant&#44; with the mean age&#61;38&#46;22&#177;6&#46;69 years and mean time of exposure&#61;16&#46;42&#177;7&#46;04 years&#46; We made&#58; clinical examination&#44; completed a standard questionnaire regarding the effect of Pb and Cd on the human organism&#44; an interview including cardiological and family history&#44; ECG registering&#44; ambulatory blood pressure monitoring&#44; biochemical and biotoxicological investigation&#46; Air concentration of lead and cadmium by AAS were performed&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> From the total workers 57&#46;34&#37; were smokers and 7&#46;69&#37; ex-smokers&#59; 55&#46;94&#37; had family history of cardiovascular disease and hypertension&#59; 9 workers had ECG alteration suggestive for ischemic heart disease&#59; 10&#46;48&#37; had high blood pressure&#59; 18&#46;18&#37; had heart pains and 18&#46;88&#37; had alteration of the cardiac rythm&#46; High values of blood lead&#44; over 40 mg&#47;dl&#44; were found in 4&#46;37&#37; of workers &#40;exposure over 10 years&#41; and 0&#46;72&#37; &#40;exposure above 10 years&#41;&#59; values between 15-40 mg&#47;dl were found in 27&#46;73&#37; of workers &#40;exposure over 10 years&#41; and 13&#46;13&#37; &#40;exposure above 10 years&#41;&#59; values above 15 mg&#47;dl was found in 39&#46;41&#37; of workers &#40;exposure over 10 years&#41; and 14&#46;59&#37; &#40;exposure above 10 years&#41;&#46; Values of blood cadmium over 1&#46;5 mg&#47;dl were found in 9&#46;61&#37; of workers &#40;exposure over 10 years&#41; and 5&#46;76&#37; &#40;exposure above 10 years&#41;&#59; values above 1&#46;5 mg&#47;dl were found in 73&#46;07&#37; of workers &#40;exposure over 10 years&#41; and 11&#46;53&#37; &#40;exposure above 10 years&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> The coronary risk level was&#58; low &#61; 41&#46;25&#37;&#59; mild &#61; 36&#46;36&#37;&#59; moderate &#61; 20&#46;27&#37;&#59; high &#61; 2&#46;09&#37;&#46; Regarding the HDL-cholesterol values&#58; 0&#46;69&#37; had good prognostic&#59; 28&#46;47&#37; had standard risk&#59; 70&#46;83&#37; had high risk&#46; Air lead exceeded the maximum accepted value&#46; There were no significant differences between workers aged up and under 40 years&#44; and with the length of exposure above and less than 10 years regarding the blood and cadmium values&#46; Occupational exposure to lead is associated with alterations in lipid metabolism&#46; The impact of high lead-inducing alteration of cholesterol levels on the morbidity and mortality of cardiovascular disease deserves further study&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">175</span><span class="elsevierStyleBold">NURSES AND OCCUPATIONAL HIV EXPOSURE - AN OBSERVATIONAL STUDY</span></p><p class="elsevierStylePara"> Maria Ga&#241;czak&#44; Marta Milona&#44; Zbigniew Szych</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Department of Hygiene and Epidemiology&#44; Pomeranian Medical University&#44; Szczecin&#44; Poland&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Objective&#58;</span> To record descriptions of occupational exposures to blood&#44; determine factors predictive of these exposures and identify interventions that might reduce their frequency&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Design&#58;</span> An anonymous questionnaire prepared by A&#46; Lowenfels from N&#46;Y&#46; Medical College&#44; USA&#44; distributed between January and March 2003&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Setting&#58;</span> 7 hospitals located in the city of Szczecin&#44; Poland &#40;2 academic&#44; 5 municipal&#41;&#44; 11 situated within 70 miles radius&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Participants&#58;</span> Representative group of 601 members of active nurse staff&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Statistical analysis&#58;</span> Between - group differences were determined using CHI2 test or U Mann-Whitney&#96;s test&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> The responding nurses ranged in age from 20 to 58 &#40;median 38 years&#41;&#44; most of them were women &#40;99&#44;3&#37;&#41;&#46; Almost half of the respondents &#40;257&#59; 42&#44;8&#37;&#41; practised in municipal hospitals&#44; over one third &#40;229&#59; 38&#44;1&#37;&#41; in hospitals situated in the country&#46; For the majority of respondents &#40;565&#59; 94&#37;&#41; it was a full time job&#46; Over one-fourth of the respondents &#40;162&#59; 27&#37;&#41; had one or more occupational contacts with HIV infected patients during their professional carrier&#44; almost three-fourths &#40;450&#59; 74&#44;9&#37;&#41; participated in a special HIV&#47;AIDS training&#46; Almost one half of respondents &#40;276&#59; 46&#37;&#41; reported at least one puncture injury in the preceding year&#44; 134 &#40;22&#44;3&#37;&#41; - sustained contacts via mucous membrane&#46; In individuals with percutaneous contact reported&#44; 215 sustained injuries caused by hollow-bore needles &#40;total number of such injuries reported - 745&#59; 63&#37;&#41;&#44; 108 - by instruments &#40;total - 282&#59; 23&#44;8&#37;&#41;&#44; 62 - by suture needles &#40;total - 156&#59; 13&#44;2&#37;&#41;&#46; The numbers of injuries were independent of age &#40;p&#62;0&#44;26&#41;&#44; years in practice &#40;p&#62;0&#44;21&#41; and workplace &#40;p&#62;0&#44;78&#41;&#44; but were dependent of the number of HIV&#47;AIDS training attendance &#40;p&#60;0&#44;03&#41;&#46; Nurses supplied information about the most recent injury&#58; it most often involved palm &#40;117&#59; 40&#44;5&#37;&#41; and fingers II-V &#40;113&#59; 39&#37;&#41;&#44; was the self-injury &#40;236&#59; 81&#44;7&#37;&#41;&#44; took place during elective procedure &#40;154&#59; 53&#44;3&#37;&#41; and was underreported &#40;215&#59; 74&#44;6&#37;&#41;&#46; The most common reasons for underreporting were conviction that source-patient was not infected or that reporting would not result in avoiding infection&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span><span class="elsevierStyleItalic">1&#41;</span> Because of the large number of professional blood contacts&#44; nurses should adopt more adequate behavioural strategies to prevent the transmission of blood-borne pathogens&#44; among them HIV&#46; <span class="elsevierStyleItalic">2&#41;</span> The efforts to prevent sharp injuries caused by hollow-bore needles - the most frequent among nurses surveyed - should be centred around eliminate the practice of recapping through education and convenient placement of puncture-resistant containers for the disposal of used sharps&#46; <span class="elsevierStyleItalic"> 3&#41;</span> As one-fourth of the nurses surveyed has never attended HIV&#47;AIDS training&#44; the more complete information of the benefit of pre-exposure prophylaxis and blood exposures reporting should be supplied in order to provide a safer workplace&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">176</span><span class="elsevierStyleBold">SQUAMOUS CELL SKIN CANCER AND OCCUPATIONAL EXPOSURE TO CHEMICALS IN SWEDISH MEN</span></p><p class="elsevierStylePara"> Alicia Estirado&#42;&#44; Beatriz P&#233;rez-G&#243;mez&#42;&#44; Marina Poll&#225;n&#42;&#44; Per Gustavsson&#42;&#42;&#44; Nils Plato&#42;&#42;&#44; Birgitta Floderus&#42;&#42;&#42;&#44; Nuria Aragon&#233;s&#42;&#44; Berta Su&#225;rez&#42;1&#44; Mario C&#225;rdaba&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;National Centre for Epidemiology&#44; Carlos III Institute of Health&#44; Madrid&#44; Spain&#46; &#42;&#42;Department of Public Health Sciences&#44; Karolinska Institutet&#44; Stockholm&#44; Sweden&#46; &#42;&#42;&#42;Institute of Environmental Epidemiology&#44; Karolinska Institutet&#44; Stockholm&#44; Sweden&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The incidence rates for squamous cell skin carcinoma &#40;SCC&#41; have steadily increased with time&#46; The dominant risk factor is exposure to solar UV radiation&#44; but several chemical carcinogens have been linked to an increased risk&#46; The objective of this study is to estimate the risk of SCC by anatomic site related to occupational exposure to chemicals in Swedish men&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> The base-population of this historical cohort included all Swedish men recorded as gainfully employed in 1970 census and who were also registered in 1960 census&#46; Information about SCC incidence for the period 1971-1989 was obtained from the Swedish Cancer-Environment Registry&#46; Exposure to 13 chemicals was assessed by linking every combination of occupation and industry to a Swedish job exposure matrix &#40;JEM&#41; which classified them as probable&#44; possible and non exposed&#44; although the analysis was made grouping probable and possible categories due to small number of subjects&#46; The country of Sweden was divided in two geographical regions based on latitude &#40;north and south&#41; as a proxy for sunlight exposure&#46; Relative risks &#40;RRs&#41; adjusted by age&#44; period&#44; geographical area&#44; town size and occupational sector were obtained fitting log-linear Poisson models for each location&#46; Risk estimators were also computed in every latitude category&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> After JEM linkage 4127 SCC cases were available for the analysis&#46; For all locations an increased risk was observed for men with occupational exposure to textile dust &#40;RR 1&#46;10&#44; 95&#37; CI 0&#46;97 - 1&#46;27&#41; and peak of pesticides &#40;RR 1&#46;18&#44; 95&#37; CI 1&#46;00 - 1&#46;38&#41;&#46; A similar profile was found for head and neck tumours &#40;textile dust&#58; RR 1&#46;11&#44; 95&#37; CI 0&#46;95 - 1&#46;31&#44; and peak of pesticides&#58; RR 1&#46;17&#44; 95&#37; CI 0&#46;97 - 1&#46;40&#41; and lower extremities &#40;textile dust&#58; RR 1&#46;85&#44; 95&#37; CI 1&#46;09 - 3&#46;14&#41;&#46; Upper extremities presented a different pattern&#44; with an almost statistically significant risk excess for those exposed to chromium&#47;nickel &#40;RR 1&#46;62&#44; 95&#37; CI 0&#46;98 - 2&#46;67&#41; and oil mixtures &#40;RR 1&#46;42&#44; 95&#37; CI 1&#46;00 - 2&#46;03&#41;&#46; Our study failed to detect any significant association between these chemicals and thoracic SCC&#46; No association was detected with arsenic or polycyclic aromatic hydrocarbons for any SCC location&#46; For all the above-mentioned exposures&#44; RRs were greater in the south area&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> We have found a different risk pattern in upper extremities SCC respect to the rest of locations&#44; suggesting site-differences in etiological mechanisms&#46;</p><p class="elsevierStylePara"> The higher effect estimators found in the south compared to the north may reflect the influence of sunlight exposure&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">177</span><span class="elsevierStyleBold">Respiratory Symptoms of Coke Oven Workers from 1990 to 2000</span></p><p class="elsevierStylePara"> Jian Wu&#42;&#44; Irene Kreis&#42;&#44; David Griffiths&#42;&#42;&#44; Chris Darling&#42;&#42;&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Graduate School of Public Health&#44; University of Wollongong&#44; Wollongong&#44; Australia&#46; &#42;&#42;School of Mathematics and Applied Statistics&#44; University of Wollongong&#44; Wollongong&#44; Australia&#46; &#42;&#42;&#42;BHP Steel&#44; Port Kembla&#44; Australia&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Aim&#58;</span> To investigate the association between exposure to coke oven emissions and respiratory symptoms in men using cross-sectional and longitudinal data&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> Data for respiratory symptoms &#40;cough&#44; phlegm&#44; wheeze and shortness of breath&#41; were repeatedly collected from 764 male coke oven workers between 3 July 1990 and 31 May 2000 in the context of a lung function surveillance system&#46; The last sets of data for all subjects were pooled and analysed cross-sectionally&#46; Longitudinal lung function analyses were conducted for 515 subjects with two or more sets of tests&#46; Stepwise logistic regressions were used to select the risk factors for the presence of respiratory symptoms&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> Cross-sectional analyses of the pooled last sets of symptoms showed that working in the most exposed position of &#39;Operation&#39; increased the risk for cough &#40;odds Ratio &#40;OR&#41;&#61;2&#46;37&#44; 95&#37; CI&#58; 1&#46;48 to 3&#46;81&#41;&#44; phlegm &#40;OR&#61;2&#46;55&#44; 95&#37; CI&#58; 1&#46;63 to 3&#46;99&#41;&#44; and shortness of breath &#40;OR&#61;1&#46;52&#44; 95&#37; CI&#58; 1&#46;01 to 2&#46;27&#41;&#46; The stepwise logistic regressions fitted for the aggregated symptom data over time had similar findings&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusion&#58;</span> Exposure to coke oven emissions increased the risk for respiratory symptoms despite the exposure levels being within allowable limits for occupational exposure&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">178</span><span class="elsevierStyleBold">ASSESSING THE VALIDITY OF SMOKING HISTORIES - A COMPARISON OF COMPANY HEALTH RECORDS WITH QUESTIONNAIRES IN AN OCCUPATIONAL COHORT OF FORMER GERMAN URANIUM MINERS</span></p><p class="elsevierStylePara"> Ga&#235;l P&#46; Hammer&#44; Bernd Grosche</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Radiation Epidemiology&#44; Federal Office for Radiation Protection&#44; Munich&#44; Germany&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The German Federal Office for Radiation Protection is conducting an occupational historical cohort mortality study of 58619 employees of the former Eastern German uranium mining company Wismut&#46; We investigate risk factors for lung cancer in a nested case-control study including 2000 subjects&#44; in which further data on smoking behavior is collected from two different sources&#58; company health records &#40;CHR&#41; and questionnaires&#46; A comparison of these data gives insights about their quality and the reliability of the data sources&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> Company health records are available for all study subjects&#46; They cover a period starting around 1970 until the end of employment or longer and contain better smoking information than the data collected for the cohort study&#46; Questionnaires sent to all living study subjects and next-of-kin of deceased persons cover the total life of the subjects&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> We present the evaluation of the 514 questionnaires and CHR files of all 1344 controls by comparing <span class="elsevierStyleItalic">a&#41;</span> their completeness&#44; <span class="elsevierStyleItalic">b&#41;</span> their agreement in terms of non&#47;cigarette&#47;pipe smokers&#44; <span class="elsevierStyleItalic">c&#41;</span> abstracted smoking duration&#44; and <span class="elsevierStyleItalic">d&#41;</span> smoking prevalence rates&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> The comparisons show here are important&#44; because both data sources complement each other&#58; Despite their completeness&#44; the CHR files do not cover the entire smoking history&#44; while questionnaires suffer from a low response rate &#40;38&#37;&#41;&#46; The evaluation of both sources is therefore essential to the correct evaluation of the case control study&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">179</span><span class="elsevierStyleBold">EVOLUCI&#211;N DEL H&#193;BITO TAB&#193;QUICO EN EL HOSPITAL GENERAL DE VIC&#44; 1988-2001</span></p><p class="elsevierStylePara"> Anna Arnau Bartes&#42;&#44; Joan Serra Batlles&#42;&#42;&#44; Jaume Castellano Pluj&#224;&#42;&#42;&#44; Margarita Ros&#233;s Vi&#241;olas&#42;&#42;&#44; Francesc Sol&#224; Roige&#42;&#42;&#44; Asun Mart&#237;nez Torrent&#42;&#42;&#44; Carme Guiteras Mauri&#42;&#42;&#44; Maria Lurdes Comas Mongay&#42;&#42;&#44; Laura Montero Aliguer&#42;&#42;&#44; et al</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Unidad De Epidemiolog&#237;a Cl&#237;nica&#44; Hospital General De Vic&#44; Vic&#44; Espa&#241;a&#46; &#42;&#42;Grup Hospital Sense Fum&#44; Hospital General De Vic&#44; Vic&#44; Espa&#241;a&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introducci&#243;n&#58;</span> Los profesionales sanitarios son el colectivo con mayor capacidad para influir sobre los h&#225;bitos tab&#225;quicos de la poblaci&#243;n&#46; Los objetivos del estudio fueron determinar la prevalencia de fumadores en el Hospital General de Vic &#40;HGV&#41;&#44; conocer la evoluci&#243;n durante los &#250;ltimos 14 a&#241;os&#44; as&#237; como las opiniones y actitudes frente a una campa&#241;a de prevenci&#243;n del tabaquismo&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">M&#233;todos&#58;</span> Estudio transversal descriptivo mediante un cuestionario an&#243;nimo autoadministrado&#46; Per&#237;odo de estudio&#58; octubre 2001-febrero 2002&#46; Estos datos se compararon con los obtenidos mediante el mismo cuestionario y la misma categorizaci&#243;n del h&#225;bito tab&#225;quico en los a&#241;os 1988 y 1994&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Resultados&#58;</span> Respondieron 357 personas al cuestionario &#40;52&#37; de 9&#44;0 a&#241;os y un 75&#37; de mujeres&#46; La distribuci&#243;n&#40;participaci&#243;n&#41; de edad media 37&#44;2 seg&#250;n el grupo profesional y el sexo fue representativa del resto del personal&#46; La prevalencia de fumadores fue del 33&#44;9&#37; &#40;IC95&#37;&#58;29&#44;0-39&#44;0&#41;&#44; de ex fumadores del 22&#44;4&#37; &#40;IC95&#37;&#58;18&#44;2-27&#44;1&#41; y de no fumadores del 43&#44;7&#37; &#40;IC95&#37;&#58;38&#44;5-49&#44;0&#41;&#46; Se observ&#243; un mayor porcentaje de fumadores entre las mujeres &#40;34&#44;0&#37;&#41; que entre los hombres &#40;32&#44;9&#41;&#44; sin diferencias significativas&#46; El porcentaje de fumadores por grupo profesional fue&#58; auxiliares de enfermer&#237;a 41&#44;2&#37;&#44; diplomados en enfermer&#237;a 35&#44;2 &#37;&#44; administraci&#243;n 32&#44;6&#37;&#44; m&#233;dicos y otros facultativos 30&#44;2&#37; y servicios generales 23&#44;5&#37;&#44; p&#60;0&#46;05&#46; Desde el a&#241;o 1988 se observa una disminuci&#243;n significativa del h&#225;bito tab&#225;quico en la poblaci&#243;n de estudio&#44; por sexo&#44; edad y en todos los grupos profesionales&#46; La proporci&#243;n de fumadores ha disminuido significativamente un 13&#44;0&#37; &#40;IC95&#37;&#58;-19&#44;9 a -6&#44;9&#41; entre el per&#237;odo comprendido entre 1988 y 1994&#44; y un 8&#44;5&#37; &#40;IC95&#37;&#58;-15&#44;2 a -2&#44;0&#41; entre 1994 y 2001&#44; mientras que el grupo de ex fumadores se ha incrementado en un 8&#44;5&#37; durante el per&#237;odo de 14 a&#241;os&#46; Sobre las opiniones y actitudes ante el tabaco&#44; un 45&#37; del personal considera que deber&#237;an existir zonas muy restringidas para fumadores&#44; mientras que el 30&#37; considera que deber&#237;a estar totalmente prohibido fumar en el hospital&#46; El 56&#37; de los fumadores aceptar&#237;a recursos para dejar de fumar y el 98&#37; aceptan la campa&#241;a de prevenci&#243;n&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusiones&#58;</span> La prevalencia de fumadores en el HGV continua siendo elevada&#44; sin embargo&#44; destacamos una importante disminuci&#243;n del h&#225;bito tab&#225;quico por sexos&#44; edad y grupo profesional&#46; En los &#250;ltimos a&#241;os se observa una elevada motivaci&#243;n por parte del personal sanitario para lograr un &#34;hospital sense fum&#34;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">180</span><span class="elsevierStyleBold">OCCUPATIONAL FACTORS ASSOCIATED WITH PRETERM DELIVERY AND LOW BIRTHWEIGHT AMONG MEDICAL DOCTORS</span></p><p class="elsevierStylePara"> Teresa Rodrigues&#42;&#44; Elvira Pinto&#42;&#42;&#44; Henrique Barros&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Servi&#231;o de Higiene e Epidemiologia&#44; Faculdade de Medicina do Porto&#44; Porto&#44; Portugal&#46; &#42;&#42;Centro de Sa&#250;de Bar&#227;o do Corvo&#44; Vila Nova de Gaia&#44; Portugal&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The role of occupational factors on the risk of preterm and low birthweight is still controversial&#46; The aim of the study was to evaluate these associations among medical doctors&#46; This professional group represents a socioeconomic privileged and homogeneous population&#44; that can be exposed to several types of strenuous work&#44; and is likely to provide accurate information on pregnancy related events&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Participants and methods&#58;</span> Between January 2000 and December 2001&#44; all female medical doctors working in the north region of Portugal were surveyed through a mailed questionnaire&#46; A total of 1001 questionnaires were returned&#44; from approximately 3000 that were sent&#46; The questionnaire was structured and comprised questions on obstetric history and the most recent pregnancy of at least 22 weeks duration &#40;index pregnancy&#41;&#46; Detailed information was obtained on working conditions during the index pregnancy &#40;medical specialty&#44; hours worked per week&#44; description of working conditions and degree of tiredness at the end of the day&#41;&#46; Age&#44; anthropometric characteristics&#44; lifestyle and complications during pregnancy &#40;hypertensive diseases&#44; diabetes&#44; intrauterine growth retardation&#44; hydramnios&#44; bleeding and others&#41; were also evaluated&#46; We grouped reported specialties into four groups &#40;primary care&#44; hospital medical specialties&#44; surgical specialties and laboratory specialties&#41;&#46; Received questionnaires from women with no delivery were excluded from further analysis&#46; The associations between occupational factors and preterm or low birthweight were evaluated through the calculation of odds ratios and respective 95&#37; confidence intervals&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> In a total of 654 women with at least one delivery&#44; 8&#46;4&#37; reported a preterm and 4&#46;1&#37; a low birthweight baby&#46; The frequency of preterm was 6&#46;3&#37; in primary care physicians&#44; 9&#46;5&#37; in hospital medical physicians&#44; 8&#46;4&#37; in surgical doctors and 12&#46;8&#37; in laboratory physicians&#46; The frequency of low birthweight in these specialties was 2&#46;5&#37;&#44; 3&#46;1&#37;&#44; 4&#46;6&#37; and 12&#46;8&#37; respectively&#46; Statistically significant differences between specialties were seen only for low birthweight&#46; Data showed no statistically significant association between the number of hours worked per week or the degree of tiredness and the studied outcomes&#46; Although not statistically significant we found stronger point estimates for the association between some occupational factors and low birthweight than between the same factors and preterm&#46; Odds ratios and 95&#37; CI for preterm and low birthweight were respectively 0&#46;3 &#40;0&#46;13-0&#44;88&#41; and 0&#46;77 &#40;0&#46;34-1&#46;78&#41; in office practice&#44; 2&#46;0 &#40;0&#46;55-8&#46;63&#41; and 1&#46;0 &#40;0&#46;47-2&#46;14&#41; in emergency service&#44; 1&#46;3 &#40;0&#46;50- 3&#46;30&#41; and 1&#46;0 &#40;0&#46;50- 2&#46;01&#41; for operating activity and 1&#46;5 &#40;0&#46;59- 3&#46;84&#41; and 0&#46;8 &#40;0&#46;48-1&#46;64&#41; for nocturnal shifts&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> In this sample&#44; occupational characteristics were more related to low birthweight than preterm delivery&#46; Type of medical specialty was significantly associated only with low birthweight&#46; Further studies are needed to investigate whether these findings can be explained by low study statistical power&#44; gestational age misclassification or stronger effect of occupational factors on birthweight&#46;</p>"
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    "textoCompleto" => "<p class="elsevierStylePara"> Jueves 2 de Octubre &#47; Thursday 2&#44; October<br></br> 17&#58;00&#58;00 a&#47;to 18&#58;00&#58;00</p><p class="elsevierStylePara"><span class="elsevierStyleBold">172</span><span class="elsevierStyleBold">BREAST CANCER RISK AMONG FINNISH CABIN ATTENDANTS - A CASE-CONTROL STUDY</span></p><p class="elsevierStylePara"> Katja Kojo&#42;&#44; Eero Pukkala&#42;&#42;&#44; Anssi Auvinen&#42;&#42;&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Research and Environmental Surveillance&#44; Finnish Radiation and Nuclear Safety Authority&#44; Helsinki&#44; Finland&#46; &#42;&#42;Finnish Cancer Registry&#44; Helsinki&#44; Finland&#46; &#42;&#42;&#42;Tampere School of Public Health&#44; University on Tampere&#44; Tampere&#44; Finland&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> Some earlier studies have found elevated breast cancer risk among female cabin crew&#46; This has been suggested to reflect either occupational exposure to cosmic radiation&#44; hormonal alterations due to repeated jet lag&#44; life-style factors or confounding factors&#44; such as age at menarche and menopause&#46; The contribution of various factors has remained unclear&#44; mainly due to the fact that earlier reports have been on cohort studies with limited information on potential confounders&#46; We conducted a nested case-control study among cabin attendants in Finland&#46; Our objective was to assess the contribution of occupational versus life-style factors to breast cancer risk&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> We collected information with standardised self-administered questionnaire on demographic&#44; occupational and lifestyle factors from 1041 cabin attendants&#44; who were identified through Finnair and Finnish Cabin Attendant Association&#46; A total of 28 cases and 516 controls completed the questionnaire&#46; For each case&#44; up to four controls were chosen with matching on year of birth &#40;&#177;1 year&#41;&#46; Breast cancer diagnoses were confirmed by a record linkage with the Finnish Cancer Registry&#46; Exposure to cosmic radiation was estimated based on self-reported flight history&#46; Conditional logistic regression model was used for analysis&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> In a multivariate analysis early menarche &#40;OR&#61;4&#46;0&#44; 95&#37; CI&#58; 1&#46;0&#59;16&#46;1&#41; and family history of breast cancer &#40;OR&#61;6&#46;5&#44; 95&#37; CI&#58; 1&#46;6&#59;26&#46;9&#41; were associated with elevated risk&#44; whereas parity &#40;one or more births versus none&#44; OR&#61;0&#46;7&#44; 95&#37; CI&#58; 0&#46;2&#59;2&#46;8&#41; seemed to have a protective effect&#46; Cumulative radiation dose was not associated with breast cancer risk &#40;OR&#61;1&#46;0 per mSv&#44; 95&#37; CI&#58; 1&#46;0&#59;1&#46;0&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> Our results suggests that breast cancer risk among Finnish cabin attendants is related to general&#44; well-established risk factors of breast cancer&#44; such as early age at menarche and family history&#46; Occupational factors do not exert a strong influence on breast cancer risk&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">173</span><span class="elsevierStyleBold">THE EPIDEMIOLOGY OF WORKPLACE CHEMICAL EXPOSURES AND RISK ASSESSMENT</span></p><p class="elsevierStylePara"> JInky Leialnie Lu</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">College of Arts and Sciences&#44; UNiveristy of teh Philippines&#44; Manila&#46;</span></p><p class="elsevierStylePara"> The aim of the study is to come up with an epidemiological study on chemical exposures at work and related illnesses&#46; Based on the data&#44; a risk exposure assessment will be established as a guide to occupational health practitioners in assessing the indicators and parameters of hazard exposures&#46; The study used a multi-state stratified sampling of manufacturing industries in export zones in the Philippines&#46; Thirty-one industries were measured in terms of noise&#44; heat chemical exposure&#44; radiation and ventilation&#46; Five hundred workers were given questionnaires to assess their chemical exposures and the consequent health effects&#46; There was 100&#37; use of chemicals in the industries used as raw material or solvent for processing&#46; The industries generated dust and vapours&#44; as well as acids and caustics&#46; The blood lead result of the 285 subjects revealed that 40&#46;7 percent of the total number of subjects had blood lead result within the 21-30 ug&#47;dL which is considered by the Department of Health dangerous&#46; When hazards and illness were correlated with alpha set at 0&#46;05&#44; radiation exposure was associated with bone pain&#44; and dust exposure with eye strain&#44; and viral exposure&#44; solvent exposures with respiratory illnesses&#44; abortion&#44; and anemia&#46; Based on the results&#44; a proposed exposure rating for chemical exposure is done&#46; This allows an easy guideline for the assessment of chemical hazards considering factors such as contact with the body surface&#44; generation of vapor within the breathing zone&#44; threshold limit values &#40;TLV&#41; and exposure time&#46; For example&#44; exposure rating estimate of 0 means no exposure either through dermal contact or within the breathing zone of the worker&#46; Very high exposure is exposure above the TLV which varies per chemical and where the exposure time is beyond the 8 hour work duration&#46;</p><p class="elsevierStylePara"> Exposure Ratings for Chemical Exposure</p><p class="elsevierStylePara"> Exposure Rating Estimate Category Qualitative Description Exposure Time</p><p class="elsevierStylePara"> 0 No exposure No contact Not within breathing Zone No exposure time</p><p class="elsevierStylePara"> 1 Low exposure Minimum contactMinimum concentration Within breathing zone Less than the specified TLV-Ceiling</p><p class="elsevierStylePara"> 2 Moderate Moderate ContactModerate concentration Within breathing zone Less than 50&#37; of the 8-hour workday&#46;</p><p class="elsevierStylePara"> 3 High exposure High contactHigh concentration Within breathing zone More than the specified TLV-Ceiling&#59; and TLV-TWA</p><p class="elsevierStylePara"> 4 Very High Exposure Very High contactVery High concentration Within breathing zone More than the specified TLV-Ceiling&#59; and TLV-TWA</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusion&#58;</span> This study looked into actual chemical and other hazard exposures of workers&#46; The proposed hazard rating matrix will allow the concerned to quantify and address problems that may arise from chemical exposures&#46; This study is also seen to significantly contribute to the importance of epidemiology in establishing risk assessment in the workplace and the eventual prevention of occupational illnesses&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">174</span><span class="elsevierStyleBold">ASSOCIATION BETWEEN OCCUPATIONAL LEAD AND CADMIUM EXPOSURE AND SERUM CHOLESTEROL</span></p><p class="elsevierStylePara"> Ligia Fat&#44; Daniela Minailiuc&#44; Botoc Mariana</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Occupational Health&#44; Institute of Public Health&#44; Cluj Napoca&#44; Romania&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The special literature shows that occupational exposure to lead and cadmium affect the human health and generate toxic effects&#46; The monitoring of lead and cadmium exposure is necessary because they can alter the organism reactivity&#44; increase the sensitivity for the pathogen agents&#44; stress and other noxes and so generate a varied pathology with long recovery&#46; In this study we determined the prevalence and associations of risk markers for IHD&#44; by measuring major and minor IHD risk factors&#44; serum cholesterol levels&#44; as well as associations with blood lead and blood cadmium&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> We examined 145 lead and cadmium exposed workers from a metallurgical plant&#44; with the mean age&#61;38&#46;22&#177;6&#46;69 years and mean time of exposure&#61;16&#46;42&#177;7&#46;04 years&#46; We made&#58; clinical examination&#44; completed a standard questionnaire regarding the effect of Pb and Cd on the human organism&#44; an interview including cardiological and family history&#44; ECG registering&#44; ambulatory blood pressure monitoring&#44; biochemical and biotoxicological investigation&#46; Air concentration of lead and cadmium by AAS were performed&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> From the total workers 57&#46;34&#37; were smokers and 7&#46;69&#37; ex-smokers&#59; 55&#46;94&#37; had family history of cardiovascular disease and hypertension&#59; 9 workers had ECG alteration suggestive for ischemic heart disease&#59; 10&#46;48&#37; had high blood pressure&#59; 18&#46;18&#37; had heart pains and 18&#46;88&#37; had alteration of the cardiac rythm&#46; High values of blood lead&#44; over 40 mg&#47;dl&#44; were found in 4&#46;37&#37; of workers &#40;exposure over 10 years&#41; and 0&#46;72&#37; &#40;exposure above 10 years&#41;&#59; values between 15-40 mg&#47;dl were found in 27&#46;73&#37; of workers &#40;exposure over 10 years&#41; and 13&#46;13&#37; &#40;exposure above 10 years&#41;&#59; values above 15 mg&#47;dl was found in 39&#46;41&#37; of workers &#40;exposure over 10 years&#41; and 14&#46;59&#37; &#40;exposure above 10 years&#41;&#46; Values of blood cadmium over 1&#46;5 mg&#47;dl were found in 9&#46;61&#37; of workers &#40;exposure over 10 years&#41; and 5&#46;76&#37; &#40;exposure above 10 years&#41;&#59; values above 1&#46;5 mg&#47;dl were found in 73&#46;07&#37; of workers &#40;exposure over 10 years&#41; and 11&#46;53&#37; &#40;exposure above 10 years&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> The coronary risk level was&#58; low &#61; 41&#46;25&#37;&#59; mild &#61; 36&#46;36&#37;&#59; moderate &#61; 20&#46;27&#37;&#59; high &#61; 2&#46;09&#37;&#46; Regarding the HDL-cholesterol values&#58; 0&#46;69&#37; had good prognostic&#59; 28&#46;47&#37; had standard risk&#59; 70&#46;83&#37; had high risk&#46; Air lead exceeded the maximum accepted value&#46; There were no significant differences between workers aged up and under 40 years&#44; and with the length of exposure above and less than 10 years regarding the blood and cadmium values&#46; Occupational exposure to lead is associated with alterations in lipid metabolism&#46; The impact of high lead-inducing alteration of cholesterol levels on the morbidity and mortality of cardiovascular disease deserves further study&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">175</span><span class="elsevierStyleBold">NURSES AND OCCUPATIONAL HIV EXPOSURE - AN OBSERVATIONAL STUDY</span></p><p class="elsevierStylePara"> Maria Ga&#241;czak&#44; Marta Milona&#44; Zbigniew Szych</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Department of Hygiene and Epidemiology&#44; Pomeranian Medical University&#44; Szczecin&#44; Poland&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Objective&#58;</span> To record descriptions of occupational exposures to blood&#44; determine factors predictive of these exposures and identify interventions that might reduce their frequency&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Design&#58;</span> An anonymous questionnaire prepared by A&#46; Lowenfels from N&#46;Y&#46; Medical College&#44; USA&#44; distributed between January and March 2003&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Setting&#58;</span> 7 hospitals located in the city of Szczecin&#44; Poland &#40;2 academic&#44; 5 municipal&#41;&#44; 11 situated within 70 miles radius&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Participants&#58;</span> Representative group of 601 members of active nurse staff&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Statistical analysis&#58;</span> Between - group differences were determined using CHI2 test or U Mann-Whitney&#96;s test&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> The responding nurses ranged in age from 20 to 58 &#40;median 38 years&#41;&#44; most of them were women &#40;99&#44;3&#37;&#41;&#46; Almost half of the respondents &#40;257&#59; 42&#44;8&#37;&#41; practised in municipal hospitals&#44; over one third &#40;229&#59; 38&#44;1&#37;&#41; in hospitals situated in the country&#46; For the majority of respondents &#40;565&#59; 94&#37;&#41; it was a full time job&#46; Over one-fourth of the respondents &#40;162&#59; 27&#37;&#41; had one or more occupational contacts with HIV infected patients during their professional carrier&#44; almost three-fourths &#40;450&#59; 74&#44;9&#37;&#41; participated in a special HIV&#47;AIDS training&#46; Almost one half of respondents &#40;276&#59; 46&#37;&#41; reported at least one puncture injury in the preceding year&#44; 134 &#40;22&#44;3&#37;&#41; - sustained contacts via mucous membrane&#46; In individuals with percutaneous contact reported&#44; 215 sustained injuries caused by hollow-bore needles &#40;total number of such injuries reported - 745&#59; 63&#37;&#41;&#44; 108 - by instruments &#40;total - 282&#59; 23&#44;8&#37;&#41;&#44; 62 - by suture needles &#40;total - 156&#59; 13&#44;2&#37;&#41;&#46; The numbers of injuries were independent of age &#40;p&#62;0&#44;26&#41;&#44; years in practice &#40;p&#62;0&#44;21&#41; and workplace &#40;p&#62;0&#44;78&#41;&#44; but were dependent of the number of HIV&#47;AIDS training attendance &#40;p&#60;0&#44;03&#41;&#46; Nurses supplied information about the most recent injury&#58; it most often involved palm &#40;117&#59; 40&#44;5&#37;&#41; and fingers II-V &#40;113&#59; 39&#37;&#41;&#44; was the self-injury &#40;236&#59; 81&#44;7&#37;&#41;&#44; took place during elective procedure &#40;154&#59; 53&#44;3&#37;&#41; and was underreported &#40;215&#59; 74&#44;6&#37;&#41;&#46; The most common reasons for underreporting were conviction that source-patient was not infected or that reporting would not result in avoiding infection&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span><span class="elsevierStyleItalic">1&#41;</span> Because of the large number of professional blood contacts&#44; nurses should adopt more adequate behavioural strategies to prevent the transmission of blood-borne pathogens&#44; among them HIV&#46; <span class="elsevierStyleItalic">2&#41;</span> The efforts to prevent sharp injuries caused by hollow-bore needles - the most frequent among nurses surveyed - should be centred around eliminate the practice of recapping through education and convenient placement of puncture-resistant containers for the disposal of used sharps&#46; <span class="elsevierStyleItalic"> 3&#41;</span> As one-fourth of the nurses surveyed has never attended HIV&#47;AIDS training&#44; the more complete information of the benefit of pre-exposure prophylaxis and blood exposures reporting should be supplied in order to provide a safer workplace&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">176</span><span class="elsevierStyleBold">SQUAMOUS CELL SKIN CANCER AND OCCUPATIONAL EXPOSURE TO CHEMICALS IN SWEDISH MEN</span></p><p class="elsevierStylePara"> Alicia Estirado&#42;&#44; Beatriz P&#233;rez-G&#243;mez&#42;&#44; Marina Poll&#225;n&#42;&#44; Per Gustavsson&#42;&#42;&#44; Nils Plato&#42;&#42;&#44; Birgitta Floderus&#42;&#42;&#42;&#44; Nuria Aragon&#233;s&#42;&#44; Berta Su&#225;rez&#42;1&#44; Mario C&#225;rdaba&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;National Centre for Epidemiology&#44; Carlos III Institute of Health&#44; Madrid&#44; Spain&#46; &#42;&#42;Department of Public Health Sciences&#44; Karolinska Institutet&#44; Stockholm&#44; Sweden&#46; &#42;&#42;&#42;Institute of Environmental Epidemiology&#44; Karolinska Institutet&#44; Stockholm&#44; Sweden&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The incidence rates for squamous cell skin carcinoma &#40;SCC&#41; have steadily increased with time&#46; The dominant risk factor is exposure to solar UV radiation&#44; but several chemical carcinogens have been linked to an increased risk&#46; The objective of this study is to estimate the risk of SCC by anatomic site related to occupational exposure to chemicals in Swedish men&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> The base-population of this historical cohort included all Swedish men recorded as gainfully employed in 1970 census and who were also registered in 1960 census&#46; Information about SCC incidence for the period 1971-1989 was obtained from the Swedish Cancer-Environment Registry&#46; Exposure to 13 chemicals was assessed by linking every combination of occupation and industry to a Swedish job exposure matrix &#40;JEM&#41; which classified them as probable&#44; possible and non exposed&#44; although the analysis was made grouping probable and possible categories due to small number of subjects&#46; The country of Sweden was divided in two geographical regions based on latitude &#40;north and south&#41; as a proxy for sunlight exposure&#46; Relative risks &#40;RRs&#41; adjusted by age&#44; period&#44; geographical area&#44; town size and occupational sector were obtained fitting log-linear Poisson models for each location&#46; Risk estimators were also computed in every latitude category&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> After JEM linkage 4127 SCC cases were available for the analysis&#46; For all locations an increased risk was observed for men with occupational exposure to textile dust &#40;RR 1&#46;10&#44; 95&#37; CI 0&#46;97 - 1&#46;27&#41; and peak of pesticides &#40;RR 1&#46;18&#44; 95&#37; CI 1&#46;00 - 1&#46;38&#41;&#46; A similar profile was found for head and neck tumours &#40;textile dust&#58; RR 1&#46;11&#44; 95&#37; CI 0&#46;95 - 1&#46;31&#44; and peak of pesticides&#58; RR 1&#46;17&#44; 95&#37; CI 0&#46;97 - 1&#46;40&#41; and lower extremities &#40;textile dust&#58; RR 1&#46;85&#44; 95&#37; CI 1&#46;09 - 3&#46;14&#41;&#46; Upper extremities presented a different pattern&#44; with an almost statistically significant risk excess for those exposed to chromium&#47;nickel &#40;RR 1&#46;62&#44; 95&#37; CI 0&#46;98 - 2&#46;67&#41; and oil mixtures &#40;RR 1&#46;42&#44; 95&#37; CI 1&#46;00 - 2&#46;03&#41;&#46; Our study failed to detect any significant association between these chemicals and thoracic SCC&#46; No association was detected with arsenic or polycyclic aromatic hydrocarbons for any SCC location&#46; For all the above-mentioned exposures&#44; RRs were greater in the south area&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> We have found a different risk pattern in upper extremities SCC respect to the rest of locations&#44; suggesting site-differences in etiological mechanisms&#46;</p><p class="elsevierStylePara"> The higher effect estimators found in the south compared to the north may reflect the influence of sunlight exposure&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">177</span><span class="elsevierStyleBold">Respiratory Symptoms of Coke Oven Workers from 1990 to 2000</span></p><p class="elsevierStylePara"> Jian Wu&#42;&#44; Irene Kreis&#42;&#44; David Griffiths&#42;&#42;&#44; Chris Darling&#42;&#42;&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Graduate School of Public Health&#44; University of Wollongong&#44; Wollongong&#44; Australia&#46; &#42;&#42;School of Mathematics and Applied Statistics&#44; University of Wollongong&#44; Wollongong&#44; Australia&#46; &#42;&#42;&#42;BHP Steel&#44; Port Kembla&#44; Australia&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Aim&#58;</span> To investigate the association between exposure to coke oven emissions and respiratory symptoms in men using cross-sectional and longitudinal data&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> Data for respiratory symptoms &#40;cough&#44; phlegm&#44; wheeze and shortness of breath&#41; were repeatedly collected from 764 male coke oven workers between 3 July 1990 and 31 May 2000 in the context of a lung function surveillance system&#46; The last sets of data for all subjects were pooled and analysed cross-sectionally&#46; Longitudinal lung function analyses were conducted for 515 subjects with two or more sets of tests&#46; Stepwise logistic regressions were used to select the risk factors for the presence of respiratory symptoms&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> Cross-sectional analyses of the pooled last sets of symptoms showed that working in the most exposed position of &#39;Operation&#39; increased the risk for cough &#40;odds Ratio &#40;OR&#41;&#61;2&#46;37&#44; 95&#37; CI&#58; 1&#46;48 to 3&#46;81&#41;&#44; phlegm &#40;OR&#61;2&#46;55&#44; 95&#37; CI&#58; 1&#46;63 to 3&#46;99&#41;&#44; and shortness of breath &#40;OR&#61;1&#46;52&#44; 95&#37; CI&#58; 1&#46;01 to 2&#46;27&#41;&#46; The stepwise logistic regressions fitted for the aggregated symptom data over time had similar findings&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusion&#58;</span> Exposure to coke oven emissions increased the risk for respiratory symptoms despite the exposure levels being within allowable limits for occupational exposure&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">178</span><span class="elsevierStyleBold">ASSESSING THE VALIDITY OF SMOKING HISTORIES - A COMPARISON OF COMPANY HEALTH RECORDS WITH QUESTIONNAIRES IN AN OCCUPATIONAL COHORT OF FORMER GERMAN URANIUM MINERS</span></p><p class="elsevierStylePara"> Ga&#235;l P&#46; Hammer&#44; Bernd Grosche</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Radiation Epidemiology&#44; Federal Office for Radiation Protection&#44; Munich&#44; Germany&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The German Federal Office for Radiation Protection is conducting an occupational historical cohort mortality study of 58619 employees of the former Eastern German uranium mining company Wismut&#46; We investigate risk factors for lung cancer in a nested case-control study including 2000 subjects&#44; in which further data on smoking behavior is collected from two different sources&#58; company health records &#40;CHR&#41; and questionnaires&#46; A comparison of these data gives insights about their quality and the reliability of the data sources&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods&#58;</span> Company health records are available for all study subjects&#46; They cover a period starting around 1970 until the end of employment or longer and contain better smoking information than the data collected for the cohort study&#46; Questionnaires sent to all living study subjects and next-of-kin of deceased persons cover the total life of the subjects&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> We present the evaluation of the 514 questionnaires and CHR files of all 1344 controls by comparing <span class="elsevierStyleItalic">a&#41;</span> their completeness&#44; <span class="elsevierStyleItalic">b&#41;</span> their agreement in terms of non&#47;cigarette&#47;pipe smokers&#44; <span class="elsevierStyleItalic">c&#41;</span> abstracted smoking duration&#44; and <span class="elsevierStyleItalic">d&#41;</span> smoking prevalence rates&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> The comparisons show here are important&#44; because both data sources complement each other&#58; Despite their completeness&#44; the CHR files do not cover the entire smoking history&#44; while questionnaires suffer from a low response rate &#40;38&#37;&#41;&#46; The evaluation of both sources is therefore essential to the correct evaluation of the case control study&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">179</span><span class="elsevierStyleBold">EVOLUCI&#211;N DEL H&#193;BITO TAB&#193;QUICO EN EL HOSPITAL GENERAL DE VIC&#44; 1988-2001</span></p><p class="elsevierStylePara"> Anna Arnau Bartes&#42;&#44; Joan Serra Batlles&#42;&#42;&#44; Jaume Castellano Pluj&#224;&#42;&#42;&#44; Margarita Ros&#233;s Vi&#241;olas&#42;&#42;&#44; Francesc Sol&#224; Roige&#42;&#42;&#44; Asun Mart&#237;nez Torrent&#42;&#42;&#44; Carme Guiteras Mauri&#42;&#42;&#44; Maria Lurdes Comas Mongay&#42;&#42;&#44; Laura Montero Aliguer&#42;&#42;&#44; et al</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Unidad De Epidemiolog&#237;a Cl&#237;nica&#44; Hospital General De Vic&#44; Vic&#44; Espa&#241;a&#46; &#42;&#42;Grup Hospital Sense Fum&#44; Hospital General De Vic&#44; Vic&#44; Espa&#241;a&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introducci&#243;n&#58;</span> Los profesionales sanitarios son el colectivo con mayor capacidad para influir sobre los h&#225;bitos tab&#225;quicos de la poblaci&#243;n&#46; Los objetivos del estudio fueron determinar la prevalencia de fumadores en el Hospital General de Vic &#40;HGV&#41;&#44; conocer la evoluci&#243;n durante los &#250;ltimos 14 a&#241;os&#44; as&#237; como las opiniones y actitudes frente a una campa&#241;a de prevenci&#243;n del tabaquismo&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">M&#233;todos&#58;</span> Estudio transversal descriptivo mediante un cuestionario an&#243;nimo autoadministrado&#46; Per&#237;odo de estudio&#58; octubre 2001-febrero 2002&#46; Estos datos se compararon con los obtenidos mediante el mismo cuestionario y la misma categorizaci&#243;n del h&#225;bito tab&#225;quico en los a&#241;os 1988 y 1994&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Resultados&#58;</span> Respondieron 357 personas al cuestionario &#40;52&#37; de 9&#44;0 a&#241;os y un 75&#37; de mujeres&#46; La distribuci&#243;n&#40;participaci&#243;n&#41; de edad media 37&#44;2 seg&#250;n el grupo profesional y el sexo fue representativa del resto del personal&#46; La prevalencia de fumadores fue del 33&#44;9&#37; &#40;IC95&#37;&#58;29&#44;0-39&#44;0&#41;&#44; de ex fumadores del 22&#44;4&#37; &#40;IC95&#37;&#58;18&#44;2-27&#44;1&#41; y de no fumadores del 43&#44;7&#37; &#40;IC95&#37;&#58;38&#44;5-49&#44;0&#41;&#46; Se observ&#243; un mayor porcentaje de fumadores entre las mujeres &#40;34&#44;0&#37;&#41; que entre los hombres &#40;32&#44;9&#41;&#44; sin diferencias significativas&#46; El porcentaje de fumadores por grupo profesional fue&#58; auxiliares de enfermer&#237;a 41&#44;2&#37;&#44; diplomados en enfermer&#237;a 35&#44;2 &#37;&#44; administraci&#243;n 32&#44;6&#37;&#44; m&#233;dicos y otros facultativos 30&#44;2&#37; y servicios generales 23&#44;5&#37;&#44; p&#60;0&#46;05&#46; Desde el a&#241;o 1988 se observa una disminuci&#243;n significativa del h&#225;bito tab&#225;quico en la poblaci&#243;n de estudio&#44; por sexo&#44; edad y en todos los grupos profesionales&#46; La proporci&#243;n de fumadores ha disminuido significativamente un 13&#44;0&#37; &#40;IC95&#37;&#58;-19&#44;9 a -6&#44;9&#41; entre el per&#237;odo comprendido entre 1988 y 1994&#44; y un 8&#44;5&#37; &#40;IC95&#37;&#58;-15&#44;2 a -2&#44;0&#41; entre 1994 y 2001&#44; mientras que el grupo de ex fumadores se ha incrementado en un 8&#44;5&#37; durante el per&#237;odo de 14 a&#241;os&#46; Sobre las opiniones y actitudes ante el tabaco&#44; un 45&#37; del personal considera que deber&#237;an existir zonas muy restringidas para fumadores&#44; mientras que el 30&#37; considera que deber&#237;a estar totalmente prohibido fumar en el hospital&#46; El 56&#37; de los fumadores aceptar&#237;a recursos para dejar de fumar y el 98&#37; aceptan la campa&#241;a de prevenci&#243;n&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusiones&#58;</span> La prevalencia de fumadores en el HGV continua siendo elevada&#44; sin embargo&#44; destacamos una importante disminuci&#243;n del h&#225;bito tab&#225;quico por sexos&#44; edad y grupo profesional&#46; En los &#250;ltimos a&#241;os se observa una elevada motivaci&#243;n por parte del personal sanitario para lograr un &#34;hospital sense fum&#34;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">180</span><span class="elsevierStyleBold">OCCUPATIONAL FACTORS ASSOCIATED WITH PRETERM DELIVERY AND LOW BIRTHWEIGHT AMONG MEDICAL DOCTORS</span></p><p class="elsevierStylePara"> Teresa Rodrigues&#42;&#44; Elvira Pinto&#42;&#42;&#44; Henrique Barros&#42;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">&#42;Servi&#231;o de Higiene e Epidemiologia&#44; Faculdade de Medicina do Porto&#44; Porto&#44; Portugal&#46; &#42;&#42;Centro de Sa&#250;de Bar&#227;o do Corvo&#44; Vila Nova de Gaia&#44; Portugal&#46;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction&#58;</span> The role of occupational factors on the risk of preterm and low birthweight is still controversial&#46; The aim of the study was to evaluate these associations among medical doctors&#46; This professional group represents a socioeconomic privileged and homogeneous population&#44; that can be exposed to several types of strenuous work&#44; and is likely to provide accurate information on pregnancy related events&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Participants and methods&#58;</span> Between January 2000 and December 2001&#44; all female medical doctors working in the north region of Portugal were surveyed through a mailed questionnaire&#46; A total of 1001 questionnaires were returned&#44; from approximately 3000 that were sent&#46; The questionnaire was structured and comprised questions on obstetric history and the most recent pregnancy of at least 22 weeks duration &#40;index pregnancy&#41;&#46; Detailed information was obtained on working conditions during the index pregnancy &#40;medical specialty&#44; hours worked per week&#44; description of working conditions and degree of tiredness at the end of the day&#41;&#46; Age&#44; anthropometric characteristics&#44; lifestyle and complications during pregnancy &#40;hypertensive diseases&#44; diabetes&#44; intrauterine growth retardation&#44; hydramnios&#44; bleeding and others&#41; were also evaluated&#46; We grouped reported specialties into four groups &#40;primary care&#44; hospital medical specialties&#44; surgical specialties and laboratory specialties&#41;&#46; Received questionnaires from women with no delivery were excluded from further analysis&#46; The associations between occupational factors and preterm or low birthweight were evaluated through the calculation of odds ratios and respective 95&#37; confidence intervals&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results&#58;</span> In a total of 654 women with at least one delivery&#44; 8&#46;4&#37; reported a preterm and 4&#46;1&#37; a low birthweight baby&#46; The frequency of preterm was 6&#46;3&#37; in primary care physicians&#44; 9&#46;5&#37; in hospital medical physicians&#44; 8&#46;4&#37; in surgical doctors and 12&#46;8&#37; in laboratory physicians&#46; The frequency of low birthweight in these specialties was 2&#46;5&#37;&#44; 3&#46;1&#37;&#44; 4&#46;6&#37; and 12&#46;8&#37; respectively&#46; Statistically significant differences between specialties were seen only for low birthweight&#46; Data showed no statistically significant association between the number of hours worked per week or the degree of tiredness and the studied outcomes&#46; Although not statistically significant we found stronger point estimates for the association between some occupational factors and low birthweight than between the same factors and preterm&#46; Odds ratios and 95&#37; CI for preterm and low birthweight were respectively 0&#46;3 &#40;0&#46;13-0&#44;88&#41; and 0&#46;77 &#40;0&#46;34-1&#46;78&#41; in office practice&#44; 2&#46;0 &#40;0&#46;55-8&#46;63&#41; and 1&#46;0 &#40;0&#46;47-2&#46;14&#41; in emergency service&#44; 1&#46;3 &#40;0&#46;50- 3&#46;30&#41; and 1&#46;0 &#40;0&#46;50- 2&#46;01&#41; for operating activity and 1&#46;5 &#40;0&#46;59- 3&#46;84&#41; and 0&#46;8 &#40;0&#46;48-1&#46;64&#41; for nocturnal shifts&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conclusions&#58;</span> In this sample&#44; occupational characteristics were more related to low birthweight than preterm delivery&#46; Type of medical specialty was significantly associated only with low birthweight&#46; Further studies are needed to investigate whether these findings can be explained by low study statistical power&#44; gestational age misclassification or stronger effect of occupational factors on birthweight&#46;</p>"
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