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

Occupational exposure to blood and body fluids is an important hazard for health care workers, which places them at a high risk for blood-borne infections including hepatitis B virus, hepatitis C virus and human immunodeficiency virus and results in psychological and emotional stresses. Several preventive measures have been proposed including pre-exposure (e.g., education, use of standard precautions, use of needle protective devices, and vaccination) and post-exposure (e.g., post-exposure prophylaxis and early detection of disease) prevention. In this article, the importance of occupational exposure to blood and body fluids and the basic concepts of exposure prevention and management are reviewed.

Inhalational lung diseases are among the most important occupational diseases. Pneumoconiosis refers to a group of lung diseases result from inhalation of usually inorganic dusts such as silicon dioxide, asbestos, coal, etc., and their deposition in the lungs. The resultant pulmonary disorders depend on the susceptibility of lungs; size, concentration, solubility and fibrogenic properties of the inhaled particles; and duration of exposure. Radiographic manifestations of pneumoconiosis become apparent several years after exposure to the particles. However, for certain types of dusts, e.g., silicone dioxide crystal and beryllium, heavy exposure within a short period can cause an acute disease. Pulmonary involvement in asbestosis is usually in the lower lobes. On the contrary, in silicosis and coal worker pneumoconiosis, the upper lobes are involved predominantly. For imaging evaluation of pneumoconiosis, high-resolution computed tomography (CT) is superior to conventional chest x-ray. Magnetic resonance imaging (MRI) and positron emission tomography (PET) scan are helpful in those with suspected tumoral lesions. In this essay, we reviewed the imaging aspects of inhalational lung disease

Silicosis is known in industrial workers for centuries. Till recently, the mainstay of its diagnosis and progress was clinical examination of the respiratory system, pulmonary function test and chest radiography. Several biomarkers such as serum angiotensin converting enzyme (ACE) activity have been examined to determine the extent of silicosis. To elucidate the effect of age, gender, duration of exposure to silica dust, smoking habit, and pulmonary function status on the serum ACE activity among quartz stone workers without disease. A cross-sectional study was carried out on 134 (111 men and 14 women) workers of quartz stone crushing units were studied. Standard diagnostic criteria were used for diagnosing silicosis and tuberculosis. Pulmonary functions of the participants were also assessed. The mean±SD age for participants was 26.1±6.3 years (26.6±6.3 for men and 21.9±4.3 for women). The mean±SD duration of exposure was 1.1±1.9 years. In the present study, only one case of silicosis and eight cases of tuberculosis were found. The mean±SD serum ACE levels for those with and without respiratory disease were 68.44±11.61, and 66.9±14.4 IU/L, respectively (p>0.05). We could not observe any association between serum ACE activity and age, gender, duration of exposure, smoking habits and pulmonary function status. However, elevated levels of serum ACE was found in a solitary case of silicosis

Occupational lead poisoning is a health problem in Iran. It has not previously been studied in traditional tile makers. To determine the prevalence of lead poisoning and its complications in traditional tile workers in Mashhad, Northwest of Iran. We visited workers in two traditional tile factories and collected data by direct history taking and physical examination. Blood and urine lead concentrations were measured by heated graphite atomization technique. Overall, 108 men with mean±SD age of 37±7.8 years were studied. The mean±SD length of daily lead exposure was 9.8±6 years. The mean±SD blood lead concentration was 520.5±323.2 μg/L. The main objective clinical findings were the presence of lead line (64.8%), peripheral neuropathy of the upper extremities (37%), depressed deep tendon reflexes in the upper extremities (25.7%), tremor (23.3%), peripheral neuropathy of the lower extremities (17%) and abdominal tenderness (15.1%). The subjective findings were mainly attributed to the central nervous system and included loss of memory (57%), moodiness (56.1%), agitation (47.7%), drowsiness (36.4%) and headache (29.9%). There was no statistically significant correlation between the blood lead concentration and glomerular filtration rate. However, there were significant correlations between the blood lead concentration and each of the urine lead concentration (p<0.001), diastolic blood pressure (p=0.04), serum triglyceride level (p=0.043), high density lipoprotein level (p=0.012), and basophilic stippling (p=0.048). Blood lead level, however, did not have any significant correlation with the presence of lead line. In traditional tile workers, lead toxicity is not uncommon and the toxic effects of lead were found more often on the teeth (bone), central and peripheral nervous system, hematological and lipid profiles than on the renal function.