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Background: Lead exposure causes a wide range of vascular diseases through oxidative stress, sympathetic hyperactivity and impairment in nitric oxide bioavailability. In this study, the association between the effects of lead exposure on left ventricular diastolic indices and erectile function were assessed., Methods: A total of 94 lead-exposed workers without known cardiovascular diseases or risk factors and 30 healthy subjects were enrolled. Systolic and diastolic functions were measured using transthoracic echocardiography. All participants were non-smokers. The International Index of Erectile Function Questionnaire (IIEF-5) was used to diagnose and grade erectile dysfunction (ED). Echocardiographic parameters, IIEF-5 score and blood lead level (BLL) were analyzed., Results: The mean age and median BLL were 32.3 ± 6.4 years and 19 μg/dL in the workers, respectively. Sixty-five (69.1%) workers and 9 control subjects (30%) had ED. The IIEF-5 score was lower in the workers (17.0 ± 6.1) than in the controls (22.7 ± 2.1). In the workers, E and e' waves and E/A ratio were lower, and A wave, E/e' ratio, and left atrial volume index (LAVI) were higher than in the controls. Additionally, BLL was correlated with IIEF-5 score, e' wave, and E/e' ratio. IIEF-5 score was correlated with e' wave, E/e' ratio and LAVI. BLL was an independent risk factor for a decreased e' wave and IIEF-5 score and increased E/e' ratio in the lead-exposed workers., Conclusions: Impairment of diastolic and erectile functions, despite a younger age and in the absence of accompanying risk factors, was correlated with increased BLL.

Di(2-ethylhexyl)phthalate (DEHP) is the most widely used phthalate. DEHP is highly used in PVC floorings and PVC windows and carpeting. The objective of this study was to determine sex hormone levels, oxidative stress parameters, selenium levels, DNA damage, and phthalate levels in plastics workers (n = 24, age = 20-58 years) working in the production of rubber mechanical goods and exposed to DEHP in workplace. The control group (n = 29, age = 25-54, all male) was selected from age-matched healthy adults. Antioxidant parameters and DNA damage were determined by spectrophotometry. Selenium levels were determined by atomic absorption spectroscopy. Plasma hormone levels were measured by chemiluminescence microparticle immunoassay. Plasma phthalate levels were determined by high-pressure liquid chromatography. Plastic workers had lower serum testosterone and free T4 levels and higher follicle-stimulating hormone levels vs. controls. Liver enzyme activities were markedly higher in workers vs. controls. There were also increases in plasma glutathione peroxidase levels and marked decreases in plasma selenium and erythrocyte total glutathione levels in plastics workers (P < 0.05 vs. control). Plasma 8-hydroxy-2'-deoxyguanosine levels were 14-fold higher in plastics workers than in controls. Plasma DEHP and mono(2-ethylhexyl)phthalate were also markedly higher in workers vs. controls. The results of this study show that occupational exposure to DEHP may lead to disturbances in sex hormones, increased liver problems, higher oxidative stress and DNA damage levels, and lower trace element concentrations in workers. More comprehensive and mechanistic studies with higher numbers of subjects are needed to show the unwanted effects of occupational exposure to DEHP.

Background/aim: The central nervous system is one of the major targets in lead exposure. Biomarkers for the diagnosis and follow-up of lead exposure have not been identified. In this study, serum S100B, neuron-specific enolase (NSE), and glutamate receptor 1 (GRIA1) levels were determined as possible biomarkers for lead neurotoxicity. Material and methods: Twenty-five subjects with chronic lead exposure and 25 controls were included in the study. NSE and S100B were measured by electrochemiluminescence immunoassay with a Cobas E601 analyzer. GRIA1 levels were measured with an ELISA kit using a quantitative sandwich enzyme immunoassay technique. Results: GRIA1 levels were significantly higher in the lead exposure group than in the control group. No significant differences for NSE, S100B, ALT, AST, or creatinine in sera were found between lead exposure and control groups. Conclusion: Subjects with chronic lead exposure are found to have increased glutamate receptor levels and do not seem to have glial or neuronal damage, which can be demonstrated with the elevation of NSE and S100B levels. GRIA1 levels might be used as a biomarker for the neurotoxicity of lead.

This study evaluates the redox state in occupationally arsenic-exposed workers (n = 71) by assessing the dynamic serum thiol-disulfide homeostasis. We determined the serum thiol-disulfide homeostasis parameters of exposed workers and controls (n = 43) using a novel automated colorimetric assay. Median urinary As and 8-isoprostane levels of exposed group were significantly higher than control group (16.40 μg/L vs 2μg/L, p < .001 and 2.28 ng/ml vs 0.54 ng/ml, p < .001, respectively). Disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio were significantly higher in exposed group. The mean ceruloplasmine and myeloperoxidase activities of As-exposed group were significantly higher than control group (117.15 U/L vs 87.02 U/L, p = .035 and 148.53 U/L vs 97.75 U/L, p = .000, respectively). The median catalase activity did not differ in the two groups. Our findings revealed that As disrupts the thiol-disulfide homeostasis in favor of disulfide.

It is known that ceramic workers are potentially exposed to complex mixture of chemicals such as silica, inorganic lead, lime, beryllium and aluminum that can be associated with an increased risk of several diseases. All operations in the ceramic industries such as mixing, moulding, casting, shaking out and finishing jobs, have been associated with the higher exposure levels and in most of the silica-related industries, average overall exposure exceeded permissible exposure levels for respirable crystalline silica. The aim of this study was to evaluate the possible genotoxic damage in ceramic workers exposed to complex mixture of chemicals mainly crystalline silica. For this purpose, the blood and buccal epithelial cell samples were taken from the ceramic workers (n = 99) and their controls (n = 81). The genotoxicity was assessed by the alkaline comet assay in isolated lymphocytes and whole blood. Micronucleus (MN), binucleated (BN), pyknotic (PYC), condensed chromatin (CC), karyolytic (KYL), karyorrhectic (KHC) and nuclear bud (NBUD) frequencies in buccal epithelial cells and plasma 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) levels were also evaluated. In the study, 38 workers were diagnosed with silicosis, 9 workers were suspected to have silicosis, whereas 52 workers were found to be healthy. DNA damage in blood and lymphocytes; MN, CC + KHC, PYC frequencies in buccal epithelial cells and 8-oxodG levels in plasma were increased in workers compared to their controls. These results showed that occupational chemical mixture exposure in ceramic industry may cause genotoxic damage that can lead to important health problems in the workers.

Background: Arsenic exposure is associated with various cardiovascular diseases. The aim of the present study was to assess cardiac autonomic function via heart rate response to exercise and recovery period of treadmill testing in arsenic-exposed workers., Methods: Sixty-five (65) occupationally arsenic-exposed workers and 35 healthy controls were enrolled. Blood and urinary arsenic levels were analyzed and symptom limited maximal treadmill exercise test were performed. Chronotropic response to exercise including age-predicted maximal heart rate (APMHR), heart rate reserve (HR reserve ), age-predicted HR reserve (APHR reserve ) and adjusted HR reserve and 1st-, 2nd-and 3rd-min heart rate recovery (HRR) indices were calculated., Results: Baseline clinical and echocardiographic parameters, exercise test duration, resting and maximal heart rate, peak exercise capacity, HR reserve , APMHR, APHR reserve , and adjusted HR reserve were found to be similar between groups. HRR 1 (22.0 ± 4.3 vs. 24.3 ± 3.1 bpm, p = .003) and HRR 2 (43.2 ± 6.2 vs. 46.7 ± 6.4 bpm, p = .012) were significantly lower in arsenic-exposed workers compared to controls. Blood and urinary arsenic levels negatively correlated with HRR 1 (r = -.477, p < .001 and r = -.438, p < .001, respectively) and HRR 2 (r = -.507, p < .001 and r = -.412, p < .001 respectively)., Conclusions: Arsenic-exposed workers had lower HRR indices than normal subjects but chronotropic response were similar. Cardiac autonomic dysregulation may be one of the cardiovascular consequences of arsenic exposure., (© 2017 Wiley Periodicals, Inc.)

Objectives: Occupational lead (Pb) exposure is still an important health problem in the world. Long-term Pb exposure causes several adverse effects. The aim of this study was to investigate the changes of inflammation markers with chronic Pb exposure by analyzing neopterin levels and kynurenine (Kyn) to tryptophan (Trp) ratio that reflects indolamine 2,3-dioxygenase activity and to compare with healthy volunteers' parameters., Methods: Blood lead levels (BLLs) were analyzed by atomic absorption spectrometry. Urinary neopterin and serum Kyn and Trp levels were analyzed by high-performance liquid chromatography., Results: According to our results, mean BLL of the 29 workers was 20.4±9.6 μg/dl. Urinary neopterin levels, serum Kyn levels, and Kyn/Trp of Pb workers (188±52 μmol/mol creatinine, 2.70±0.66 μM, and 43.19±10.38 μmol/mmol, respectively) were significantly higher than controls (144±35 μmol/mol creatinine, 2.08±0.34 μM, and 32.24±7.69 μmol/mmol, respectively). Pb-exposed workers were divided into further three groups according to their BLLs: as 10-19 μg/dl (n=18), 20-29 μg/dl (n=8), and 30-49 μg/dl (n=3). Neopterin levels of the workers with BLL of 30-49 μg/dl were significantly higher than those of BLL with 10-29 μg/dl, while Trp levels decreased. Kyn/Trp of workers with BLL of 30-49 μg/dl were elevated significantly compared with the workers with BLL<30 μg/dl. In addition to neopterin, Kyn and Kyn/Trp levels were positively influenced by Pb exposure., Conclusions: Increased level of inflammation markers confirms the adverse effects of Pb even low BLLs, and we suggest that monitoring BLLs with inflammation markers could help to prevent serious occupational health problems.

Objective: Lead exposure has been associated with various cardiovascular disorders. It may also cause increased inflammation and fibrosis in the arterial system resulting in an increase in arterial stiffness. In this study, the ambulatory arterial stiffness index (AASI), which is a technique that measures arterial stiffness, was evaluated in occupationally lead-exposed workers., Methods: In this cross-sectional study, 68 lead-exposed workers without known cardiovascular risk factors and 68 healthy subjects were evaluated according to the 24-hour ambulatory blood pressure monitorization (ABPM) profiles and blood and 24-hour urine lead levels. A regression slope of diastolic over systolic blood pressure (BP) was computed in each participant. AASI was defined as 1 minus the regression slope., Results: There were no significant differences in terms of baseline demographic, clinical, echocardiographic characteristics, and ABPM profiles between the groups. In lead-exposed workers, the mean age was 34.7±8.1 years, and the median blood and urine lead levels were 40.5 µg/dL and 34.9 µg/L, respectively. AASI was 0.42±0.10 in lead-exposed workers and 0.37±0.10 in control subjects (p=0.007). In correlation analysis, AASI was correlated with both blood (r=0.417, p<0.001) and urine lead (r=0.242, p=0.047) levels. In regression analysis, blood lead level was found to be associated with AASI (ß=0.086, p<0.001)., Conclusion: AASI, which is an indicator of arterial stiffness, was found to be higher in lead-exposed workers than in healthy individuals. Increased AASI may be considered an early sign of arterial involvement in case of lead exposure.

Lead is a toxic heavy metal, and prevention of human exposure to lead has not been accomplished yet. The toxicity of lead is continually being investigated, and the molecular mechanisms of its toxicity are still being revealed. In this study, we used a novel method to examine thiol (SH)/disulfide homeostasis in workers who were occupationally exposed to lead. A total of 80 such workers and 70 control subjects were evaluated, and their native and total SH values were measured in serum using a novel method; their blood lead levels were also assessed. The novel method used for SH measurements was based on the principle of measuring native SH, after which disulfide bonds were reduced and total SHs were measured. These measurements allowed us to calculate disulfide amounts, disulfide/total SH percent ratios, disulfide/native SH percent ratios, and native SH /total SH percent ratios. We found that disulfide levels were significantly higher in workers who were exposed to lead (21.08(11.1-53.6) vs. 17.9(1.7-25), p < 0.001). Additionally, the disulfide/native SH and disulfide/total SH percent ratios were higher in exposed workers, while the native SH/total SH percent ratios were higher in the control subjects. Furthermore, the lead and disulfide levels showed a positive correlation, with p < 0.001 and a correlation coefficient of 0.378. Finally, the novel method used in this study successfully showed a switch from SH to disulfide after lead exposure, and the method is fully automated, easy, cheap, reliable, and reproducible. Use of this method in future cases may provide valuable insights into the management of lead exposure.

Background: To evaluate electrocardiographic parameters which are related with atrial and ventricular arrhythmias measured from 12-lead surface electrocardiogram (ECG) in workers occupationally exposed to lead., Methods: Sixty lead-exposed workers and 60 healthy controls were enrolled. Twelve-lead surface ECG was recorded and measurements of P wave durations (Pmax, Pmin) and P wave dispersion (PWD), QT durations and dispersion (QTd), corrected QT (QTc), Tp-e interval, and Tp-e/QT ratio were analyzed., Results: The lead-exposed and control groups were similar with respect to baseline demographic, laboratory, and transthoracic echocardiographic indices. PWD (26.3 ± 9.7 vs 22.0 ± 9.0 ms, P = 0.014), Pmin (89.9 ± 13.8 vs 79.2 ± 10.1 ms, P < 0.001), and Pmax (116.2 ± 15.0 vs 101.2 ± 14.2 ms, P < 0.001), QT maximum (377.0 ± 27.6 vs 364.9 ± 28.5 ms, P = 0.02), QTd (38.4 ± 16.5 vs 30.5 ± 12.4 ms, P = 0.004), Tp-e interval (78.9 ± 16.5 vs 70.3 ± 14.5 ms, P = 0.003), and Tp-e/QT ratio (0.22 ± 0.04 vs 0.20 ± 0.04, P = 0.013) were significantly higher in lead-exposed workers. QT minimum and QTc values did not differ significantly. QT maximum, QTd, and Tp-e/QT ratio were correlated with urine lead level and Tp-e interval was correlated with both blood and urine lead levels., Conclusions: Lead-exposed workers have a higher risk for atrial and ventricular arrhythmias even without overt cardiac diseases compared with healthy subjects. These workers should be followed closely for adverse cardiovascular outcomes especially arrhythmias., (© 2016 Wiley Periodicals, Inc.)

Silica is the second most common element after oxygen, and therefore, exposures to crystalline silica dust occur in a large variety of occupations such as metal foundries, constructions, and ceramic, quarry, and pottery industries. Since crystalline silica exposure has been linked with silicosis, lung cancer, and other pulmonary diseases, adverse effect attributed to this element has be a cause for concern worldwide. Silica dust exposure in workers is still considered to be important health problem especially in developing countries. The aim of the study was to investigate the effects of occupational silica exposure on oxidative stress parameters including the activities of superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), glutathione peroxidase (GPx), and levels of total glutathione (GSH) and thiobarbituric acid reactive substance (TBARS) as well as immune system parameters such as interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, and IL-10 and tumor necrosis factor (TNF)-α in Turkish ceramic workers. In this study, nearly 50% of Turkish ceramic workers were diagnosed with silicosis. Eighty-four percent of these silicotic workers were found to present with profusion category 1 silicosis, whereas controls (n = 81) all displayed normal chest radiographs. Data demonstrated a significant decrease in levels of GSH and activities of CAT, SOD, and GPx, but a significant increase in MDA levels and activity of GR in all workers. Further, workers possessed significantly higher levels of IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, and TNF-α. These observations suggest that ceramic workers may have impaired antioxidant/oxidant status and activated immune system indicative of inflammatory responses.

Introduction: The aim of this study was to evaluate the effects of short-, moderate- and long-duration treadmill exercise (15, 30 and 60 min) on the mean frequency and amplitude of penicillin-induced epileptiform activity in rats., Material and Methods: In this study, 32 rats were assigned to 15, 30, and 60 min running exercise groups and the control group, each consisting of 8 rats. According to the specified protocol, the rats were submitted to running exercises at the same hour of each day for 90 days. After the exercise program, the rats were administered (500 IU/2.5 µl) of penicillin into the left cortex by the microinjection method. An electrocorticogram (ECoG) recording was performed for 3 h using a data acquisition system. The frequency and the amplitude of the recordings were analyzed., Results: Short-duration treadmill exercise (15 min) caused a decrease in the frequency of penicillin-induced epileptiform activity at 70 min after penicillin injection ( p < 0.001). The mean frequency of epileptiform activity decreased at 90 min after penicillin injection in the 30 and 60 min treadmill exercise groups ( p < 0.01). The mean amplitude of epileptiform activity was not changed in any of the exercise groups compared to the control ( p > 0.05)., Conclusions: The results of the present study demonstrate for the first time that short-, moderate- and long-duration treadmill exercises decreased the frequency of penicillin-induced epileptiform activity. These findings may contribute to improving the quality of life in epileptic patients.

Objective: The aim of the present study was to assess cardiac autonomic function via indices of exercise heart rate recovery (HRR) in workers occupationally exposed to lead., Methods: A total of 98 lead-exposed workers and 98 healthy controls were enrolled. All underwent exercise testing and transthoracic echocardiography. HRR indices were calculated by subtracting 1st- (HRR1), 2nd- (HRR2), and 3rd-minute (HRR3) heart rates from maximal heart rate (HR). Exercise test parameters- HRR in particular- were compared between groups, and correlation analysis of blood, 24-hour urine lead levels, and test parameters was performed., Results: Baseline demographic and clinical characteristics were found to be similar between groups. Mean HRR1 (26.2±3.6 vs 29.0±4.1 bpm, p<0.001), HRR2 (42.6±3.9 vs 46.9±3.7 bpm, p<0.001), and HRR3 (56.6±4.5 vs 61.8±4.3 bpm, p<0.001) values were significantly lower in the lead-exposed group than in the healthy controls. HRR1 was found to be significantly correlated with blood (r:-0.415; p<0.001) and 24-hour urine lead levels (r:-0.446; p<0.001). HRR2 and HRR3 were significantly correlated with 24-hour urine lead level (r:-0.396; p<0.001 and r:-0.233; p=0.021, respectively)., Conclusion: Lead-exposed workers had lower HRR indices than normal subjects. Blood and 24-hour urine lead levels were significantly associated with HRR indices. Cardiac autonomic functions may be affected by exposure to lead, and those occupationally exposed should be closely followed for adverse cardiovascular outcome.

Objective: The purpose of the study was to evaluate the bone mineral density (BMD) and 25-hydroxyvitamin D (25(OH)D) levels in patients with silica exposure., Materials and Methods: The study included 104 male subjects with silica exposure and 36 healthy subjects. Posterior-anterior radiographs were classified according to the International Labour Office (ILO) Classification. Category 0 patients were classified as Group I (n = 54), category I patients were classified as Group II (n = 25), Category II and III patients were classified as Group III (n = 25)., Results: Femoral neck BMD values were significantly lower in Group III (p = 0.007). Lumbar vertebrae BMD values were significantly lower in all groups with silica exposure than in the control group (p = 0.000). The osteoporosis rate was significantly higher in Group III (p = 0.000). Subjects with silica exposure were determined to have diminished 25(OH)D levels (p = 0.012)., Conclusion: The results of this study demonstrated that subjects with silica exposure have diminished BMD and 25(OH)D levels.

Objectives: This study aims to evaluate the relationship between serum uric acid levels and renal functions in asymptomatic subjects who had occupational lead exposure, particularly for shorter durations whereby saturnine gout has also been discussed., Patients and Methods: In this retrospective study, files of 100 males (mean age 34.5±5.9 years; range, 21 to 47 years) with occupational risk for lead exposure and 100 healthy male controls (mean age 34.47±5.8 years; range 21 to 47 years) were reviewed. Demographic characteristics of the subjects and laboratory test results were recorded from the files. Creatinine clearance and 24-hour urinary creatinine were measured in the lead-exposed group., Results: In the lead-exposed group, mean serum uric acid level was higher than those of the control group (p<0.001). Lead exposure time was negatively correlated with 24-hour urinary creatinine levels (r= -0.373, p<0.001). In addition, serum uric acid levels were positively correlated with serum creatinine levels (r=0.412, p<0.001) in the exposed group. Six patients had hyperuricemia (serum uric acid level >6.8 mg/dL) in the lead- exposed group; however, all subjects' serum uric acid level was lower than 6.8 mg/dL in the control group (p=0.029). Although 22 subjects had higher uric acid levels than 6.0 mg/dL in the lead-exposed group, only one control had higher uric acid level than 6.0 mg/dL (p<0.001)., Conclusion: In light of our results, we may conclude that workers with lead exposure have higher frequency of hyperuricemia and higher serum uric acid levels than those of the control group. Therefore, we may imply that higher serum uric acid levels may be associated with renal impairment in lead-exposed subjects even in the earlier stages of exposure., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Purpose: Arsenic is a toxic metalloid that carries number of potential risks to human health, although there is little evidence of the ototoxic effect of arsenic. The aim of this study was to identify the relationship between arsenic exposure and hearing loss by measuring blood arsenic concentrations and hearing among miners., Materials and Methods: This research is a retrospective case control study. Included in the study were miners employed in a single silver mine whose blood arsenic concentrations were high. A comparison was made on the pure tone audiometry measurements taken from miners exposed only to arsenic (Group 1), those exposed to both arsenic and noise (Group 2) and a control group exposed to neither arsenic nor noise (Group 3)., Results: It was found that for both ears at all frequencies, the hearing level of Group 3 was better than the hearing levels of both Group 1 and Group 2. There was no correlation between the blood arsenic levels and hearing levels in both ears., Conclusion: This study has revealed the ototoxic effects of arsenic. As blood arsenic concentrations do not reflect long-term exposure, no correlation was identified between blood arsenic concentrations and hearing levels. Further studies will be needed to clarify the mechanisms involved in the effect of arsenic on hearing. This paper represents the largest study to date focusing on the isolated effects of arsenic on hearing through the use of a clinical auditory test., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background and Aim. Contact dermatitis (CD) is the most prevalent occupational skin disease with a significant impact on quality of life. Patch testing is used for the identification of responsible allergens which may improve protective and preventive measures in the workplace. Herein, we aim to identify the demographic characteristics and occupation of patients with early diagnosis of occupational CD and compare patch test results. Materials and Methods. The study included 330 patients referred to our clinic between April 2009 and April 2011 and who were patch-tested with 28-allergen European Standard Test. Results. 126 (38%) patients were female and 204 (62%) were male with a mean age of 36.12 (±13.13) years. Positive allergic reactions were observed in 182 (55%) patients. Nickel sulphate (41/126) and potassium dichromate (39/204) were significantly the most common allergens in women and men, respectively ( P < 0.005). Additionally, the most common occupation in women was household activities (83/126) and in men was manufacturing (80/204). Conclusion. The allergens to which people become sensitized differ according to their working environment and occupation. Classification of occupations is important for identification of sensitization risks and monitoring of changes in allergen distribution of different occupations.

Objective: The aim of this study was to assess exercise heart rate recovery (HRR) indices in mercury-exposed individuals when evaluating their cardiac autonomic function., Subjects and Methods: Twenty-eight mercury-exposed individuals and 28 healthy controls were enrolled. All the subjects underwent exercise testing and transthoracic echocardiography. The HRR indices were calculated by subtracting the first- (HRR1), second- (HRR2) and third-minute (HRR3) heart rates from the maximal heart rate. The two groups were evaluated in terms of exercise test parameters, especially HRR, and a correlation analysis was performed between blood, 24-hour urine and hair mercury levels and the test parameters., Results: The mercury-exposed and control groups were similar in age (37.2 ± 6.6 vs. 36.9 ± 9.0 years), had an identical gender distribution (16 females and 12 males) and similar left ventricular ejection fractions (65.5 ± 3.1 vs. 65.4 ± 3.1%). The mean HRR1 [25.6 ± 6.5 vs. 30.3 ± 8.2 beats per min (bpm); p = 0.009], HRR2 (43.5 ± 5.3 vs. 47.8 ± 5.5 bpm; p = 0.010) and HRR3 (56.8 ± 5.1 vs. 59.4 ± 6.3 bpm; p = 0.016) values were significantly lower in the mercury-exposed group than in the healthy controls. However, there were no significant correlations between blood, urine and hair mercury levels and exercise test parameters., Conclusions: Mercury-exposed individuals had lower HRR indices than normal subjects. In these individuals, mercury exposure measurements did not show correlations with the exercise test parameters, but age did show a negative correlation with these parameters. Therefore, cardiac autonomic functions might be involved in cases of mercury exposure., (© 2016 S. Karger AG, Basel.)

Purpose: To investigate the current status of exposure to mercury (Hg) among dental health workers in Turkey., Methods: A total of 115 persons working in the same hospital were included in the study and were divided into three groups. Group 1 consisted of 67 dentists; group 2 consisted of 21 dental personnel who work with amalgam, and group 3 consisted of 27 control subjects who work in the same hospital but are non-dental personnel. The number of amalgam fillings that have been made by the dentists and the number of own fillings of the subjects were recorded., Results: Plasma Hg levels were found to be 3.76 ± 1.84, 3.54 ± 1.83, and 2.69 ± 0.97 µg/L in groups 1, 2, and 3, respectively. Hg concentrations in group 1 were significantly higher than the control group. There was no significant difference between groups 1 and 2. The number of amalgam fillings made by the dentists in the previous year correlated significantly with plasma Hg levels (r = 0.378, p < 0.01). There was no significant correlation between the own amalgam fillings in the teeth of the subjects and Hg levels., Conclusion: Preventive measures for protection from exposure to Hg are necessary for occupational health in dentistry and proper industrial hygiene rules should be emphasized to avoid contamination during work., (© The Author(s) 2013.)

The objective of the present study is to compare distal femoral cartilage thicknesses of patients with occupational lead exposure with those of healthy subjects by using ultrasonography. A total of 48 male workers (a mean age of 34.8±6.8 years and mean body mass index (BMI) of 25.8±3.1 kg/m(2)) with a likely history of occupational lead exposure and age- and BMI-matched healthy male subjects were enrolled. Demographic and clinical characteristics of the patients, that is, age, weight, height, occupation, estimated duration of lead exposure, and smoking habits were recorded. Femoral cartilage thickness was assessed from the midpoints of right medial condyle (RMC), right lateral condyle (RLC), right intercondylar area (RIA), left medial condyle (LMC), left lateral condyle (LLC), and left intercondylar area (LIA) by using ultrasonography. Although the workers had higher femoral cartilage thickness values at all measurement sites when compared with those of the control subjects, the difference reached statistical significance at RLC (P=0.010), LMC (P=0.001), and LIA (P=0.039). There were no correlations between clinical parameters and cartilage-thickness values of the workers. Subjects with a history of lead exposure had higher femoral cartilage thickness as compared with the healthy subjects. Further studies, including histological evaluations, are awaited to clarify the clinical relevance of this increase in cartilage thickness and to explore the long-term follow-up especially with respect to osteoarthritis development.

The benefits of regular exercise on brain health are undeniable. Long-term exercise increases the production of reactive oxygen species in brain. Therefore, athletes often consume antioxidant supplements to remedy exercise-related damage and fatigue during exercise. The aim of this study is to evaluate the role of ascorbic acid in the effects of different intensities of swimming exercise on the brain susceptibility to experimental epilepsy in rats. Ascorbic acid was administered intraperitoneally (ip) during three different swimming exercise programme for 90 days (15 min, 30 min, 90 min/day). The anticonvulsant activity regarding the frequency of epileptiform activity appeared in the 80 min after 500 units intracortical penicillin injection in 30 min and 90 min/day exercise groups. The administration of ascorbic acid (100 mg/kg, ip) did not alter the anticonvulsant properties seen in the in short-duration (15 min/day) swimming exercise group. The amplitude of epileptiform activity also became significant in the 110 and 120 min after penicillin injection in the moderate (30 min/day) and long duration (60 min/day) groups, respectively. The results of the present study provide electrophysiologic evidence that long-term administration of ascorbic acid causes anticonvulsant activities in the moderate and long-duration swimming exercise. Antioxidant supplementation such as ascorbic acid might be suggested for moderate and long-duration swimming exercise in epilepsy.

Background: As shown in several studies, besides being used in breast cancer, tamoxifen is also known for its antifibrotic effects via reducing the serum TGF-beta levels. We investigated the possible preventive effect of tamoxifen in rats exposed to silica particles depending on the antifibrotic effect., Materials and Methods: A total of 102 adult female Wistar Albino rats were divided into five groups. First two groups (control and tmx) were free of silica and the last three groups (slc, tmx1 and tmx 10) were exposed to crystalline silica. The rats in tmx, tmx1 and tmx10 groups received 10 mg/kg, 1 mg/kg and 10 mg/kg of body weight tamoxifen, respectively. On day 84, all rats were sacrified and tissue samples were obtained together with blood samples. The differences in serum TGF-β levels, histological grades of fibrosis and inflammation in the lung and liver tissues together with addional biochemical markers were calculated between the groups., Results: Silicosis occurred in slc, tmx1 and tmx10 groups in 100%, 91.7% and 52.1%, respectively. Liver fibrosis did not occur. The highest mean lung fibrosis scores were obtained in slc group while the scores were lower in tmx1 group and the lowest in tmx10 within silica-exposed rats. Nevertheless, the inflammation scores were higher in tamoxifen-administered rats in a dose-dependent pattern., Conclusion: Silica inhalation did not result in liver fibrosis. Tamoxifen is found to prevent lung fibrosis and reduce serum TGFβ-1 levels while increasing lung inflammation (Tab. 3, Fig. 3, Ref. 27).

The aim of this study was to investigate the association between DNA damage and blood lead levels in individuals occupationally exposed to lead. To evaluate this association, 61 workers exposed to lead were monitored in terms of DNA damage in blood lymphocytes. The levels of DNA damage were measured according to 3 comet assay parameters, including tail intensity (TI), tail moment (TM), and DNA tail (DNAt). A statistically significant positive correlation was found between the lead levels and TI, TM, and DNAt (p < .01). Smoking had independent effects on DNA damage. A statistically significant difference was observed between smokers and nonsmokers in regards to DNA damage parameters (p < .05). In addition, the lead and DNA damage levels in smokers were found to be significantly higher than the levels observed in nonsmoking workers (p < . 05). Our results show that exposure to lead induces genotoxic effects in peripheral lymphocytes, as measured by comet assays.

Purpose: Early studies on manganese (Mn) exposure have demonstrated that this transition metal affects dopamine neurotransmission. Dopamine serves as a tonic inhibitor of prolactin release in the anterior hypophysis. Our aim was to determine the relation between serum prolactin levels and manganese-exposure., Methods: Whole blood was collected from 95 non-exposed control subjects and 179 manganese-exposed male welders. Whole blood manganese was analyzed by Inductively Coupled Plasma--Mass Spectrometer on Agilent 7700 (Agilent Technologies, USA). Serum prolactin levels (PRL), aspartate transaminase (AST), alanine transaminase (ALT), urea, creatinine, soduim (Na), potassium (K) were analyzed by immunological and spectrophotometric methods on Roche E170 Modular System (Roche Diagnostics, Mannheim, Germany)., Results: The mean ages for control and manganese-exposed group were 40.5 ± 7.8 and 39.5 ± 8.7, respectively (p = 0.258). The mean working period (years) for control and manganese-exposed group were 17.4 ± 9.8 and 18.2 ± 7.7 years, respectively (p = 0.581). Serum AST and potassium levels were significantly higher in control group than manganese-exposed group (p = 0.002 and p = 0.048, respectively) and body-mass index (BMI) was significantly lower in control group than manganese-exposed group (p = 0.033). There was a significantly positive correlation between whole blood manganese levels and serum prolactin (r = 0.860, p < 0.001). Serum ALT levels were positively correlated with serum AST, urea and sodium (r = 0.315, p < 0.001; r = 0.121, p = 0.046; r = 0.130, p = 0.031)., Conclusions: Serum prolactin level is a diagnostic marker for determining the effect of manganese-exposure.

Objective: Arsenic (As) exposure may cause several medical problems. There were a few studies investigated whether it has affected bone tissue in women. However, there was no study in men. The aim of this study was to evaluate associations between bone mineral density (BMD) and As exposure in men subjects., Material and Methods: We enrolled in this study 254 subjects who due to chronic As exposure suspected and 82 subjects as a control group. Hair As levels were detected by a hair analysis (Varian AA240Z Zeeman Atomic Absorption Spectrometer, USA). BMD measurements were obtained using dual-energy X-ray absorptiometry instrumentation. We investigated associations between the hair As levels and BMD measurements., Results: The frequency of osteoporosis and osteopenia was found to be 0.8% and 54.5%, respectively, in the As exposure group. The frequency of osteoporosis was found to be 1% and osteopenia was 32.4% in control subjects. There was significant difference between two groups (p < 0.001). Hair As level has a median 1.01 (min: 0.06 and max: 25.71). There were no significant correlation between hair As levels and BMD measurements., Conclusion: According to our observations, As exposure was associated with bone metabolism. Possible cause of osteopenia may be exposure to As. Further investigations are needed to estimate the relationship between As and bone metabolism.

Arterial hypertension is one of the physical complications of chronic lead exposure. Hypertension has effects on aortic elastic properties. The aim of this study was to evaluate the aortic elastic properties in workers occupationally exposed to lead. Forty-one workers who were exposed to lead and 39 healthy controls were included in the study. All patients underwent transthoracic echocardiography for detecting aortic elastic parameters. There were no differences in baseline characteristics between the lead-exposure group and controls. Aortic strain (9.4% ± 4.5% vs 12.4% ± 4.2%, P = .004) and aortic distensibility (0.45 ± 0.21 cm(2) /dyn vs 0.55 ± 0.20 cm(2) /dyn, P = .046) were decreased in patients with lead exposure compared with controls. There was a negative significant weak correlation between aortic strain and (r = -0.294, P = .008) lead levels. There was no significant correlation between aortic distensibility and any other echocardiographic parameters. This study suggests that chronic exposure to lead is related to impairment of aortic elasticity parameters., (© 2014 Wiley Periodicals, Inc.)

Objective: Lead exposure linked to osteoporosis in women. However, there is no direct evidence whether lead exposure has effects on bone metabolism in middle-aged male subjects. Therefore, the present study investigated the relationship between bone mineral densitometry measurements, bone markers, endocrine hormones and blood lead levels., Material and Methods: The present study included lead exposure patients (n: 30) and control subjects (n: 32). We recorded information on patient demographics and risk factors of osteoporosis. Blood lead levels were evaluated using Varian AA 240Z atomic absorption spectrophotometry. Bone mineral density measurements were measured using dual-energy X-ray absorptiometry., Results: Each lumbar T and Z scores in the lead exposure group were lower than the control group. There were no significant differences in femur neck and femur total T and Z scores between two groups. Blood lead levels were also negatively correlated with lumbar 2-4 T score, total lumbar T score, lumbar 2-4 Z score and total lumbar Z score. Urinary hydroxyproline and urinary deoxypyridinoline levels in the lead exposure group were significantly higher compared to controls. Blood lead levels were strong, positively correlated with urinary deoxypyridinoline. Endocrine hormone levels and 1,25-dihydroxy-vitamin D3 levels were comparable between lead exposure and control group., Conclusion: Lead exposure in male workers is an important factor for deterioration in bone mineral density. We should be screening blood lead levels and history of lead exposure in male osteoporosis.

Introduction: Welder's lung disease originated from a mixed exposure to different kinds of metals and chemicals from welding fumes. Because of these various harmful effects, irreversible morphological changes may occur in all parts of the respiratory tract, airways and lung parenchyma. Parenchymal changes are the main lesions that define the severity of exposure. The grade of these lesions is the main criteria for compensation claims and the clinical threshold for the occupational health physician's decision making of work change in order to protect the worker's health. In this study, our aim was to compare the diagnostic performance of chest X-ray (CXR) and high-resolution computed tomography (HRCT) for welders' lung disease., Objectives: Seventy-four male welders aged between 25 and 55 years were enrolled to this study., Methods: Clinical diagnoses were compared by CXR and HRCT. Same radiologists evaluated the scans without any knowledge about the medical history of the patient (double-blinded evaluation). The agreement between radiologists was compared with Cohen's kappa statistics., Results: The mean age for 74 welders was 40.7 years. The mean duration of exposure was 18.9 years. Although all were found to be nonpathological on the CXR, 27 mild nodular and nine mild linear opacities, five emphysematous changes, three ground glass infiltrates and one pleural thickening were detected by HRCT., Conclusions: HRCT provides better diagnostic performance compared to CXR for the diagnosis of welders' lung disease., (© 2013 John Wiley & Sons Ltd.)

Dental amalgam fillings are widely used all over the world. However, their mercury content can lead to various side effects and clinical problems. Acute or chronic mercury exposure can cause several side effects on the central nerve system, renal and hepatic functions, immune system, fetal development and it can play a role on exacerbation of neuromuscular diseases. In this case, we will present a patient with vacuolar myopathy whose symptoms were started and aggravated with her dental amalgam fillings., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

The aim of this study was to determine 8-hydroxydeoxyguanosine (8-OH-dG) levels in trichloroethylene (TCE)-exposed workers. Oxidative stress biomarkers and biochemical parameters were monitored among 26 TCE-exposed workers and 78 age-matched control subjects. Levels of urinary 8-OH-dG were analyzed by liquid chromatography tandem mass spectrometry. Urinary 8-OH-dG levels were significantly higher for TCE-exposed group (p < .001). Spearman's correlation test revealed positive correlations between urinary trichloroacetic acid levels and age, urinary 8-OH-dG, urinary total oxidant status, and urinary total antioxidant status (p = .042, p < .001, p < .001, and p < .001, respectively). 8-OH-dG may be a useful marker to determine the extent of TCE exposure.

Titanium dioxide (TiO2) is increasingly widely used in industrial, commercial and home products. TiO2 aggravates respiratory symptoms by induction of pulmonary inflammation although the mechanisms have not been well investigated. We aimed to investigate lung inflammation in rabbits after intratracheal instillation of P25 TiO2. One ml of 10, 50 and 250µg of P25 TiO2 was instilled into one of the lungs of rabbits, chest computed-tomography was performed, and bronchoalveolar lavage (BAL) fluid was collected before, at 1 and 24 h after P25 TiO2 exposure. Changes in inflammatory cells in the BAL fluids were measured. Lung pathological assay was also carried out at 24 h after P25 TiO2 exposure. Ground glass opacities were noted in both lungs 1 h after P25 TiO2 and saline (control) instillation. Although the control lung showed complete resolution at 24 h, the lung exposed to P25 TiO2 showed persistent ground glass opacities at 24 h. The eosinophil counts in BAL fluid were significantly increased after P25 TiO2 exposure. P25 TiO2 induced a dose dependent increase of eosinophils in BAL fluid but no significant differences in neutrophil and lymphocyte cell counts were detected. The present findings suggest that P25 TiO2 induces lung inflammation in rabbits which is associated with eosinophilic inflammation.

Asphalt has a highly complex structure and it contains several organic compounds including polycyclic aromatic hydrocarbons and heterocyclic compounds. In this study, comet assay was used to detect the DNA damage in blood lymphocytes of 30 workers exposed to asphalt fumes and 30 nonexposed controls. This is the first report on Turkish asphalt workers' investigated DNA damage using the alkaline single cell gel electrophoresis (SCGE). The DNA damage was evaluated by the percentage of DNA in the comet tail (% tail DNA) for each cell. According to our results, workers exposed to asphalt fumes had higher DNA damage than the control group (p < 0.01). The present study showed that asphalt fumes caused a significant increase in DNA damage and the comet assay is a suitable method for determining DNA damage in asphalt workers.

Workers in denim sandblasting are at a high risk of developing silicosis, an occupational lung disease caused by inhaling crystalline silica dust. The development and progress of silicosis is associated with the activation of the immune system and oxidative stress. In the former, interferon-gamma induces both neopterin release and the enzyme indoleamine [2, 3]-dioxygenase (IDO) in various cells. The determination of the kynurenine-to-tryptophan ratio and neopterin concentration has proven to be an efficient method to monitor the activation status of IDO and cellular immunity. The present study aimed to investigate whether occupational silica exposure leads to any alterations in neopterin levels, tryptophan degradation, and activities of superoxide dismutase (SOD) and catalase (CAT), agents in the antioxidant defense system. Fifty-five male denim sandblasting workers and twenty-two healthy men as controls were included. Mean neopterin and kynurenine levels, kynurenine-to-tryptophan ratio, and SOD activity were higher in subjects with silicosis compared to non-exposed controls (all, p<0.05). Neopterin levels and kynurenine-totryptophan ratios were positively correlated (p<0.05); however, no correlation was observed between length of employment and the measured parameters. Some of the measured parameters were significantly affected by the severity of the pathology. Our results suggest that silica exposure activates the cellular immune response. The increased neopterin levels and tryptophan degradation confirm the possibility of their use as an indicator of cellular immune response.

Objectives: Long-term organic solvent exposure may cause toxic effects in central nervous system . Trichloroethylene (TCE) is known to be one of the neurotoxic chlorinated organic solvents. Trichloroacetic acid (TCA) is an oxidative pathway metabolite of TCE. S100B, a calcium-binding protein in glial cells, and neuron specific enolase (NSE) in neuron cytoplasma are protein markers of astrocyte and neuron damage, respectively., Materials and Methods: Clinical and laboratory assesments were performed in 25 participants with organic solvent exposure history. Control group included 25 healthy age and sex-matched individuals. Measurements of serum S100B and NSE were performed using Roche Cobas E 601 compatible kits and elechtrochemiluminescence immunoassay. The levels of TCA in urine were measured by the headspace GC technique, after methyl esterification by methanol., Results: Median value of urine TCA in solvent-exposed group was 12.30 mg/L with 10.20 mg/L and 35.00 mg/L minimum and maximum values, respectively. The difference between serum S100B levels of solvent-exposed group (0.064 μg/L) and control group (0.049 μg/L) was statistically significant (p < 0.05). Serum NSE levels of control group (15.61 ng/ml) were higher than solvent-exposed group (13.90 ng/ml) but difference was not statistically significant (p > 0.05)., Conclusions: Serum S100B levels were found to be higher in solvent-exposed group when compared with control group. NSE levels were comparable between two groups. Increased Serum S100B levels in organic solvent exposure may indicate a preventive response to neuronal damage caused by reactive oxygen species (ROS) produced through oxidative metabolic pathways of organic solvents.

Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 μg/L (min, 2.40 μg/L; max, 4,687 μg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its symptomatology is variable, particularly in children. Therefore, school staff and children should be aware of the risk of mercury toxicity. Pediatricians also need to warn parents and children about the hazards of playing with any chemical.

Despite the fact that asbestos is a known carcinogen to humans, it is still used in industrialized countries, especially Asian countries. The global incidence of asbestos-related diseases (ARDs) due to the past use of asbestos, continues to increase, although many countries have adopted a total ban on asbestos use. The implementation of effective strategies to eliminate ARDs is therefore an important challenge in Asia, where asbestos is still mined and consumed. Collaborative efforts and strategies at the local and international levels are vital, in the pursuit toward the elimination of ARDs in this region.

We report a case of Demodex infestation in a 35 year old coal miner presenting with a 5 year history of scally papulopustular eruption on his face. He had been working inunderground coal tunnels in a humid- hot- dusty environment and he had been used to bath twice a day with hot water and multiple cleaners. The patient was treated successfully with oral metronidazol, topical permethrin, topical steroids and avoidance of undergraund mining . We believe his occupational environment made him prone to infestation by changes in sebum composition and/or viscosity, his bath habituation facilitated infestation, damaging the epidermal barrier function and his previous treatments exaggerated his infestation. During evaluation of the patient, specific occupational factors and habituations will be related with higher succession rates of treatment. We need to conduct further studies in order to draw a definite conclusion about the effect of the occupational environment on Demodex infestation.

In parallel with industrial advancements, number of the occupational diseases secondary to chemical exposure is increasing. The chemical agents in the work places affect various organ and tissue systems, leading to chronic diseases. In this study, the cases diagnosed with occupational disease due to exposure to lead were studied and importance of the environmental forensic sciences on this issue was emphasized. A hundred and ninety patients diagnosed with occupational disease related to lead intoxication in Ankara Occupational Diseases Hospital between 01/01/2009 and 31/12/2009 were included in the study. Twenty cases were used as the controls. Sociodemographic characteristics, serum chemical parameters and hematological parameters of the patients were retrospectively assessed. Mean age of the cases included in the study was 35.3±8.69. Hemoglobin (Hb) (p=0.018) and Mean corpuscular volume (MCV) (p<0.001) values were found significantly lower in the patients with lead exposure than in the controls. Gamma glutamyl transferase (GGT) was significantly lower in the patients with lead exposure than in the controls (p=0.002), whereas alkaline phosphatase (ALP) was found higher (p<0.001). In thyroid function test (TFTs) panel, free triiodothyronine (fT3) levels were found significantly higher in the patients with lead exposure than in the control group (p=0.01), while Thyrotrophin-stimulating hormone (TSH) levels were lower (p<0.001). No significant difference was found in terms of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values. In the correlation analysis; serum level of serum lead (Pb) was correlated positively with ALP values and negatively with Hb, MCV and TSH. Considering its effects on the biochemical and hematological parameters, a detailed investigation should be carried out in the cases with lead exposure, which occupies an important place among the occupational diseases., (Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

The aim of the present study is to understand the basic relationship between swimming exercise and natural course of epilepsy in animals by performing an electrophysiological study. For this purpose, male Wistar rats were submitted to daily swimming exercise program of three different durations. Animals were swim-exercised for 90 days with either 15 minutes, 30 minutes or 60 minutes/day. Thereafter, the epileptiform activity was induced by a single microinjection of penicillin (500 units) into the left somatomotor cortex. Short-duration swimming exercise (15 min per day for 90 days) decreased the mean frequency and amplitude of penicillin-induced epileptiform activity in the 70 and 90 minutes after penicillin injection compared to penicillin administered group, respectively. Moderate-duration (30 min per day for 90 days) and long-duration (60 min per day for 90 days) swimming exercise did not alter either the frequency or amplitude of epileptiform activity. The results of the present study provide electrophysiologic evidence that short-duration swimming exercise partially inhibits penicillin-induced epileptiform activity. These data also suggest that moderate and long-duration swimming exercise do not increase either the frequency or severity of seizure in the model of penicillin-induced epilepsy.