Laura Georgiana Moise, Sonia Bădulici, Agripina Rașcu and Alexandra Maria Rașcu
Acrylates are plastic materials formed by the polymerization of monomers, which are recognized as powerful sensitizers that may cause allergic contact dermatitis both in occupational and non-occupational environment. In the occupational setting, the most exposed workers are the dentists, dental technicians, prosthesis technicians, printers, painters, fiberglass workers and nail technicians. We describe four cases of occupational allergic contact dermatitis in nail technicians caused by acrylic compounds that illustrate numerous clinical manifestations. Clinical manifestations ranged from edema, erythema, scaling and fissuring fingertips to erythematous patches around the chin, mandible and abdomen. Patch testing results revealed positive reaction to 2-hydroxyethyl methacrylate in all patients. Of the four patients, two changed jobs, one stopped exposure because of pregnancy and one patient continued working, showing no improvement, despite undergoing treatment. These cases underline the importance of improvement of preventive measures in the workplace.
Angioedema with life-threatening site is one of the most impressive and serious reasons for presenting to the ENT doctor. Among different causes (tumors, local infections, allergy reactions), an important cause is the side-effect of the angiotensin converting enzyme (ACE) inhibitors drugs. ACE-inhibitors-induced angioedema is described to be the most frequent form of bradykinin-mediated angioedema presented in emergency and also one of the most encountered drug-induced angioedema. The edema can involve one or more areas of the head and neck region, the most affected being the face, the lips, the tongue, followed by the larynx, when it may determine respiratory distress and even death.
There are no specific diagnosis tests available and the positive diagnosis of ACE-inhibitors-induced angioedema is an exclusion diagnosis. The authors performed a review of the most important characteristics of the angioedema caused by ACE-inhibitors and present their experience emphasizing the diagnostic algorithm.
Dorin-Gheorghe Triff, Zorica Triff, Mușata-Dacia Bocoș and Eugenia Naghi
During periodic occupational medical checkup, in a sample including all employees from two high schools, a secondary school and a kindergarten, we administered through voluntary completion, questionnaires which assessed the employees’ occupational stress in terms of individual characteristics, anxiety, sense of self-efficacy, work ability, emotional exhaustion and health status (using ShortForm 36 questionnaire). A number of 233 questionnaires were returned. Only the occupational stressor represented by communication with superiors correlates significantly negatively with work ability in all four units. Work ability and communication with superiors also have average scores which differ significantly and are concordant in all four units. In the secondary school, work ability has the highest average value and the lowest average value of “communication with superiors” stressor. The same values are decreasing for WAI in order, from high school 2 to high school 1 and kindergarten while the stressor represented by communication with superiors has increasing values in order from high school no 2 to high school no. 1, and kindergarten. These results show that programmes to reduce occupational stress in school units should primarily address the school unit leadership in order to improve their communication with employees.
Livia-Cristina Borcan, Florin Borcan, Elena-Ana Păuncu and Mirela Cleopatra Tomescu
Hydrogen sulphide, a highly toxic gas, can be used in crenotherapy to balance all metabolic processes (minerals, fats and proteins). The main aims of this study were to correlate the weather characteristics with the atmospheric H2S level and to evaluate the antidote activity of B12 Vitamin in the case of prolonged exposure to this compound. 46 volunteers, people from the medical staff of an important Romanian thermal water spring spa, with professional exposure at H2S, were enrolled in this study; numerical data about their blood pressure, atmospheric H2S concentration and about the weather conditions were collected every month for one year. The results indicate an improvement in the blood pressure of volunteers treated with Vitamin B12; no significant correlation between the concentration of total urinary sulphur and the concentration of atmospheric H2S level was found.
Employees with diabetes and nephropathy need special medical surveillance that involves occupational medicine specialists. However, diabetes is not a unique phenotype and each patient need to be carefully assessed. Age, gender, body mass index, renal function impairment (eGFR, creatinine, urea, uric acid), indicators of diabetes control (fasting glycaemia and HbA1C), the presence of co-morbidities, dyslipidaemia, level of serum albumin and total protein, cytokines and other inflammatory markers should be considered in a comprehensive evaluation of the severity of the chronic kidney disease and of the treatment plan. Chronic kidney disease in type 2 diabetes has many facets and various degrees of severity; therefore, permanent communication between the occupational medicine specialist and the treating physician should be maintained. For this purpose, this article reviews the current pathological mechanisms proposed for the explanation of the chronic kidney disease, the diagnostic and the general therapeutic recommendations and also the possible occupational interventions in patients with type 2 diabetic nephropathy.
Marina Ruxandra Oțelea, Anca Streinu-Cercel, Daniela Manolache, Andreea Mutu, Lavinia Călugăreanu, Dana Mateș and Oana Săndulescu
In many large cohort studies, the night shift constitutes a risk factor for developing cardiovascular disease and diabetes in workers. Current screening tests for people working in night shift include fasting glycaemia and electrocardiography. In fact, there are few studies focused on the description of the electrocardiographic changes after the night shift. This article describes the protocol of the “ECG modifications induced by the disturbance of the circadian rhythm in night-shift workers (ECGNoct)” study, which was initiated by the National Institute for Infectious Diseases “Prof. Dr. Matei Balș”. Nurses represent the target population.
The protocol includes a full medical and occupational history, lifestyle habits (smoking, alcohol, nutrition), anthropometric and blood pressure measurements, blood tests (fasting glycemia, total cholesterol, triglycerides and high density lipoprotein cholesterol) and electrocardiogram recording. For nurses working in (night) shifts, we will record the electrocardiogram before and soon after the night shift. A cross sectional study will analyze the incidence of the metabolic syndrome criteria, the cardio-metabolic diseases and the electrocardiographic modifications and will compare the results between the group of nurses working and the group of nurse who do not. Based on these results, a longitudinal study will test the hypothesis that night shift increases the risk for cardio-metabolic diseases and that the electrocardiographic modifications precede the clinical symptoms. The results of the study will provide data on the association of night shifts and other non-occupational risk factors with the cardio-metabolic diseases in this specific population of healthcare workers that potentially will integrate into the occupational medicine policies.
Agripina Rașcu, Paraschiva Postolache, Doina Carmen Mazilu and Marina Ruxandra Oțelea
Understanding the factors influencing the rationing of nursing care is crucial for any quality control intervention in healthcare services. Occupational factors such as workload, night shifts, management style and organization of work have a potential influence. There are few studies specifically designed to evaluate these factors in relation with nurses’ work. In this study, we investigate several occupational factors influencing the quality of work in a sample of hospital nurses in order to identify the most important influencers of stress at work. The article describes the conceptual framework of the study, the population, the methods and the expected results. We also present a brief review of recent studies related to occupational risk factors and the perceived quality of care provided by Romanian nurse population.
We present the particularities of the morbidity with temporary labor incapacity (TLI) of the employees of confection factories during the years 2011 - 2017. We placed emphasis on the risk factors affecting the health of the employees. It is an established fact that the main risk factors are unfavorable microclimate, vibration, dust, noise, and others. Morbidity with TLI according to frequency index (IFc) has practically a constant character. The highest level of IFc was registered in 2013, reaching 93.3 cases per 100 workers, while the severity index being oscillatory in nature constituted 1311.2 days in 100 workers in the same year. Both indices have shown a growth trend towards the end of 2017. The average duration of a case remained at the same level of 13-14 days. There were also particularities of morbidity based on gender, profession, etc. The data obtained can be the basis for the elaboration of the prophylaxis measures.
Alexandra Maria Rașcu, Marina Ruxandra Oțelea and Călin Giurcăneanu
Modern medicine has increasingly directed its interest towards discovering the etiology of occupational dermatitis, but unfortunately it is not completely elucidated. As with other occupational diseases, the presence of the exposure and the temporal relation between the exposure and the appearance of the characteristic signs is a defining element, but obtaining the information on the etiological factors is not always easy, therefore the attention must be directed to a systematic collection of these data. Clinical diagnosis is not sufficient, so additional paraclinical tests are needed for a complete diagnosis. Currently, more and more emphasis is being placed on experimental studies targeting the discovery of molecular or genetic markers that complement the idea of individual susceptibility in the appearance of contact dermatitis. As frequent as it is difficult to diagnose, occupational dermatitis is still a public health problem.