Jovanka Karadžinska-Bislimovska, Jordan Minov, Sašo Stoleski, Dragan Mijakoski, Snežana Risteska-Kuc and Snežana Milkovska
Environmental and Occupational Health Risks Among Agricultural Workers Living in a Rural Community Near Petroleum Refinery and Motorway in Skopje Region
To assess health risks in agricultural workers associated with environmental exposure to pollutants released from a petroleum refinery and from traffic, we performed a cross-sectional study that included 119 randomly selected subjects divided in two groups. Group 1 included 60 agricultural workers living in a rural community near the petroleum refinery and a motorway overpass, whereas Group 2 consisted of 59 agricultural workers performing similar activities and living in a rural community with no exposure to industrial and traffic pollutants. Risk assessment included a questionnaire, blood pressure measurement, spirometry, laboratory tests, and toxicological analysis. The groups showed a similar prevalence of health problems, with exception of muscle pain in the extremities, headache, and fatigue, which were significantly more common in Group 1. Diastolic blood pressure was higher in Group 1, but not significantly (p=0.057). The same is true for blood carbon monoxide. Significantly higher in Group 1 were blood haemoglobin (p=0.001) and blood lead (p<0.001). Serum cholinesterase activity was similar in both groups. Our findings indicate the need of regular medical exams, ambient monitoring and environmental impact assessment in agricultural population in order to detect individuals at risk and to institute adequate preventive measures.
We assessed the prevalence and socioeconomic and behavioural correlates of hypertension in the young to middle-aged population of Albania, a transitional post-communist country in the Western Balkans. We analysed a sample of 2,837 men and 3,580 women aged 15 to 49 from the 2008/2009 Albanian Demographic and Health Survey. Hypertension was defined as SBP≥140 mm Hg, or DBP≥90 mm Hg, or if the subjects were under treatment for hypertension. Data on demographic and socioeconomic characteristics and behavioural factors were also collected. Logistic regression was used to assess the association of hypertension with covariates. Hypertension was significantly higher among men (27.3 %) than women (20.0 %), and significantly increased with age. The harmful effect of excessive weight and obesity on hypertension was stronger among women than among men and this effect increased with age, especially in women. Smoking and alcohol were risk factors for hypertension in men, but not women. Education had a protective effect on hypertension in women but not in men.
Effects of Exposure to Mixed Organic Solvents on Blood Pressure in Non-Smoking Women Working in a Pharmaceutical Company
Some studies suggest that exposure to industrial solvents can affect blood pressure. The objective of this study was to investigate the effect of a mixture of organic solvents on blood pressure in women working in a pharmaceutical company in Iran. Four hundred and thirty-three women were included in the study. Women working in packing units (group 1) were not exposed to the mixture of organic solvents, women in new laboratory units (group 2) were exposed to the mixture within the permitted range and women working in old laboratory units (group 3) were exposed to the mixture above the permitted limit. We compared systolic and diastolic blood pressures (SBP & DBP) and prevalence of hypertension and pre-hypertension among groups. The results revealed a significant difference in SBP and pre-hypertension (p<0.001) and hypertension (p<0.05) prevalence between the exposed and the control group, but DBP did not differ significantly. Logistic regression analysis showed a significant association between hypertension and exposure to mixed solvents. Odds ratio for hypertension in the group 2 and group 3 (exposed) workers was 2.36 and 3, respectively, compared to controls. Our results suggest that exposure to a mixture of organic solvents may increase SBP and hypertension and pre-hypertension prevalence in drug manufacture workers. Therefore, more attention should be paid to workers that work in such settings by periodically measuring blood pressure and implementing accurate and comprehensive programs to reduce exposure to organic solvents.
Mladen Pavlović, Sanja Milković-Kraus, Veljko Jovanović and Mira Hercigonja-Szekeres
Ageing, Arterial Blood Pressure, Body Mass Index, and Diet
For three decades we followed up for longevity indicators, including diet, arterial blood pressure, and body mass index 379 mobile, long-living persons from Croatia, now aged 70 to 92 years, of whom 167 men aged (78.6±4.0) years and 212 women aged (77.9±4.1) years. One hundred and ninety-five were from the continental and 184 from the coastal Croatia. The participants were examined in 1972, 1982, and again in 2006/7. Changes in body mass index (BMI), arterial blood pressure (ABP), and in answers to our Food Frequency Questionnaire about dietary habits were analysed using log-linear models. Over the last 24 years of aging (age 55 to 78 years) the subjects showed a statistically significant decrease in body mass and height and a significant increase in the systolic blood pressure. Diastolic blood pressure and BMI showed no significant changes over this period. Consumption of preserved and fresh meat, bread, and starch (potato, pastry and rice) dropped significantly with age, while the consumption of fish, fresh and cooked vegetables, fruit, and dairy products significantly increased. These dietary changes were not associated with changes in the systolic and diastolic ABP. About 80 % were overweight (BMI >25 kg m-2) throughout the follow-up, even though their body mass dropped significantly after the age of 55. However, their survival suggests that BMI may not be the best indicator of longevity or healthy aging.
In his famous novel ‘Anna Karenina’ Konstantin Levin, a farmer who is commonly considered to represent the author Leo Tolstoy himself, listens to another farmer's opinions on the land reform. He highly respects these opinions which, as he says, ‘had been brought not by a desire of finding some exercise for an idle brain, but a thought which had grown up out of the conditions of his life’.
Researchers and policy makers, far from the realities of primary health care, seem to be more interested in brief alcohol interventions for hazardous drinkers than do general practitioners or other professionals working in this setting. Should brief intervention be removed to some other setting, buried forever as not being suitable for real life, or would it just now be perfect time for general practitioners and nurses in primary health care to take command of brief interventions and make it suitable for their own setting?
Objectives. The aim of the study is to assess the weight loss programme with regards to the long-term effectiveness of weight reduction and weight maintenance, using completion rate and BMI, blood sugar, cholesterol and blood pressure levels as outcomes. The aim of the study also includes identifying the factors associated with adherence to the programme.
Methods. The programme was developed by a multidisciplinary team. It included 6 months of introduction and another 18 months of maintenance. The data for 397 participants was collected after 24 months.
Results. 346 participants have completed the introduction and 123 have completed the programme. In the introduction, the average weight loss was 12% of the initial weight. The participants, who completed the full programme, lost 9.4% of their initial weight. The participants also significantly (p<0.05) reduced their blood sugar and cholesterol levels, as well as their blood pressure. The factors associated with adherence to the programme are: age over 50, lower educational levels, lower initial weight and higher weight loss in the introduction.
Conclusions. The multi-disciplinary approach to obesity treatment was effective for a selected group of people. The proportion of dropouts was relatively high, but still low compared to similar programmes. Group treatment and mutual support are of a great importance in bringing about and maintaining the changes.
Nina Softič, Mateja Smogavec, Zalika Klemenc-Ketiš and Janko Kersnik
Ocena Pogostosti Kroničnih Bolezni Med Polnoletnimi Prebivalci Slovenije
Izhodišča: Raziskava, ki jo predstavljamo v prispevku, je del raziskovalne naloge »Razširjenost samozdravljenja v slovenski populaciji«. Prikazati želimo razširjenost kroničnih bolezni v Sloveniji ter značilnosti posameznikov z obravnavanimi boleznimi. Posebno pozornost namenjamo prevalenci kroničnih bolezni v populaciji ter njihovi pojavnosti glede na starost, izobrazbo in zaposlitveni status.
Metode: Raziskava je presečna in temelji na anonimnem vprašalniku, ki smo ga aprila 2009 poslali na dom 1.000 iz telefonskega imenika naključno izbranim polnoletnim prebivalcem Republike Slovenije. Podatke smo statistično analizirali z metodo hi-kvadrat in s t-testom glede na naravo spremenljivk ter opravili multivariatno analizo.
Rezultati: V analizo smo vključili 41,0% vsebinsko pravilno izpolnjenih anket. Ugotovili smo, da je imelo v letu 2008 zdravstvene težave kar 70,5 % anketiranih oseb. Anketirani s kroničnimi boleznimi so bili v povprečju 15 let starejši od anketiranih brez kroničnih težav. Najvišjo povprečno starost smo ugotovili pri anketiranih osebah s sladkorno boleznijo (66,7±11,4), pri bolnikih z rakom (65,1±18,7) in pri bolnikih z revmatskimi boleznimi (64,5±14,6). Bolezni, kot so zvišan krvni tlak, revmatske bolezni, kožne bolezni in sladkorna bolezen, so pogostejše pri anketiranih osebah z nižjo stopnjo izobrazbe. Prav tako je prevalenca vseh bolezni višja pri skupini upokojenih kot pri ostalih anketiranih.
Zaključki: Raziskava je pokazala, da je prevalenca kroničnih bolezni v Sloveniji visoka. Znatno višja je pri ljudeh z nižjim socialno-ekonomskim statusom ter pri upokojenih, zato svetujemo, da v prihodnje posebno pozornost namenimo predvsem odkrivanju in obravnavanju kroničnih bolezni pri omenjenih skupinah slovenskega prebivalstva.
Lead Toxicity in a Family as a Result of Occupational Exposure
This article describes an entire family manufacturing lead acid batteries who all suffered from lead poisoning. The family of five lived in a house, part of which had been used for various stages of battery production for 14 years. Open space was used for drying batteries. They all drank water from a well located on the premises. Evaluation of biomarkers of lead exposure and/or effect revealed alarming blood lead levels [(3.92±0.94) μmol L-1], 50 % reduction in the activity of δ-aminolevulinic acid dehydratase [(24.67±5.12) U L-1] and an increase in zinc protoporphyrin [(1228±480) μg L-1]. Liver function tests showed an increase in serum alkaline phosphatase [(170.41±41.82) U L-1]. All other liver function test parameters were normal. Renal function tests showed an increase in serum uric acid [(515.81±86.29) μmol L-1] while urea and creatinine were normal. Serum calcium was low [(1.90±0.42) mmol L-1 in women and (2.09±0.12) mmol L-1 in men], while blood pressure was high in the head of the family and his wife and normal in children. Lead concentration in well water was estimated to 180 μg L-1. The family was referred to the National Referral Centre for Lead Poisoning in India, were they were received treatment and were informed about the hazards of lead poisoning. A follow up three months later showed a slight decrease in blood lead levels and a significant increase in haemoglobin. These findings can be attributed to behavioural changes adopted by the family, even though they continued producing lead batteries.