International Journal of Occupational and Environmental Medicine
Volume:1 Issue: 4, Oct 2010

Testicular cancer is one of the commonest cancers in men of working age, and is increasing in incidence in Europe and North America. One suggested mechanism of causation is that there is impaired differentiation of germ cells in the pre- or perinatal period, followed by malignant transformation in later life, possibly by a hormonal mechanism. Endocrine disrupting chemicals (EDCs) have been a major focus of interest for etiological research into testicular cancer because they interact with various hormonal pathways. Several EDCs including bisphenol A, phthalates, metals, polychlorinated biphenyls, and organochlorines have been investigated, but there are few studies and those that exist have not been able to assess exposure well. In addition, several studies, particularly those with better exposure assessment, have suggested that workers in electrical occupations have increased risks of testicular cancer. Electromagnetic radiation may have subthermal effects or may disrupt hormone release. Chronodisruption such as due to shift-work could potentially increase the risk of testicular cancer via disruption of hormonal cycles, but only one study has so far investigated this possibility. Lastly, solvent exposure, particularly to dimethylformamide, has been suggested to be associated with testicular cancer, but almost all these studies are based on job title only, with no specific assessment of solvent exposure. In conclusion, there is little evidence available on which to base definitive statements about occupational causes of testicular cancer. Future studies need to improve exposure assessment and develop ways to adjust for possible prenatal factors.

Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Almost two-thirds (64.0%) of the respondents were very knowledgeable of universal precautions with significantly more females (75.4%) than males (42.9%) (p<0.0001). More nurses (90.0%), medical doctors (88.0%) and medical technologists (70%) were very knowledgeable of universal precautions (p<0.0001). More respondents (92.9%) who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001). 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001). There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

The presence of hyperuricemia and renal function impairment, especially in the absence of urate stone formation is strongly suggestive of lead nephropathy. The evaluation of this association is essential in areas where lead exposure is still prevalent and uncontrolled. To determine the relationship between serum uric acid and renal function indices in lead-exposed workers. A cross-sectional study of 190 adults with occupational lead exposure and 80 adults (comparison group), matched for age and sex was performed in Port Harcourt, South-south Nigeria. Blood lead was used as the biomarker of lead exposure while serum urea, serum creatinine, urine albumin (using urine albumin:creatinine ratio), estimated glomerular filtration rate (GFR) and serum uric acid were the renal function indices measured. Occupationally lead-exposed subjects had a significantly (p = 0.008) higher mean±SD blood lead levels (50.37±24.58 μg/dL) than the comparison group (41.40±26.85). The mean±SD serum urea (8.6±2.3 mg/dL), creatinine (1.0±0.2 mg/dL) and serum uric acid (4.6±1.2 mg/dL) were significantly (p < 0.01) higher in the study subjects than the comparison group (7.6±2.4, 0.9±0.2, and 3.9±1.1 mg/dL, respectively). The mean±SD creatinine clearance was significantly (p = 0.002) lower in the study subjects than the comparison group (98.9±21.3 vs. 108.2±25.2 mL/min/1.72 m2). Serum uric acid level correlated positively with serum creatinine (r = 0.134) and negatively with GFR (r = ‑0.151). People with occupational lead exposure are at risk of developing hyperuricemia and renal impairment.

Occupational asthma (OA) is the most common occupational lung disease in developed countries. One of the causative agents is metal fume that may be encountered in steel industries. Screening for the OA is mainly performed by questionnaire but in our country spirometry is used more commonly. To compare the diagnostic value of the Venables standardized respiratory questionnaire and pre-shift spirometry as screening tools for OA. In a cross-sectional study, we investigated 450 workers of a steel industry by the Venables standardized questionnaire. We also performed a pre-shift spirometry as the screening spirometry and a post-shift spirometry. A person with 10% drop in post-shift FEV1 compared with the pre-shift value was considered as asthmatic (our gold-standard). The results of the questionnaire and the pre-shift spirometry were then examined against the gold-standard test results. For each test, sensitivity, specificity, positive and negative predictive values were calculated. The overall prevalence of OA among our studied workers was 3.9% (95% CI: 1.9%–5.9%). The highest rate was seen in those working in catering (25%) and welding (10%) units. Pre-shift spirometry and the questionnaire had low sensitivity (42.9% and 28.6%, respectively) and positive predictive values (16.7% and 3.6%, respectively); moderate specificity (92.4% and 71.6%, respectively) and high negative predictive values (97.9% and 96.5%, respectively). Taking into account the ease of use of the questionnaire, it seems that it is more feasible to use questionnaire as the primary screening tool for the diagnosis of OA.

Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident.