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The aim of the study was to assess the effectiveness of the specific design of a poisoning prevention intervention. This controlled before-after study followed Solomon design for educational interventions using two groups (the educational intervention group and the control group). Participants comprised parents of children attending kindergartens under the jurisdiction of the City of Zagreb and in the vicinity of Zagreb. The intervention group (N = 336) underwent an educational intervention during parents' meetings comprising oral presentation by the Croatian Poison Control Centre (CPCC) and distribution of gift packages containing child-proof locks, flyers, and stickers with the CPCC contact number. After the intervention they more frequently started keeping the CPCC's number by their telephone or in the list of important numbers than parents in the control group, and this association remained significant when tested by generalized estimating equations for binary outcomes, after the adjustment for parents' characteristics (age, gender and educational level), and clustered by kindergartens (p < 0.001). This means parents acknowledged the CPCC as an adequate and accessible way for initial management of poisoning incidents.

In the present study, air quality in a cage-housed laying hen house was investigated throughout the seasons by assessing dust and endotoxin concentrations. Measurements were done twice a month during the 1-year production cycle. The mean levels of dust and endotoxins ranged from 0.60 mg/m3 in May to 2.83 mg/m3 in November, and from 203.15 EU/m3 in August to 745.53 EU/m3 in April. Significantly higher concentrations of dust and endotoxins in the poultry house were determined in the autumn and winter seasons, and endotoxins in the spring season as well, compared to the summer (P, U ovom radu istraživana je kvaliteta zraka u nastambi kavezno držanih kokoši nesilica u svim godišnjim dobima utvrđivanjem koncentracije prašine i endotoksina. Mjerenja su provođena dva puta na mjesec tijekom jednogodišnjeg proizvodnog ciklusa. Srednje vrijednosti koncentracije prašine i endotoksina kretale su se od 0,60 mg/m3 (svibanj) do 2,83 mg/m3 (studeni), odnosno od 203,15 EU/m3 (kolovoz) do 745,53 EU/m3 (travanj). Značajno veće koncentracije prašine i endotoksina u peradarniku ustanovljene su ujesen i zimi, endotoksini također i u proljeće, u usporedbi s ljetom (P

When studies in meta-analysis include different sets of confounders, simple analyses can cause a bias (omitting confounders that are missing in certain studies) or precision loss (omitting studies with incomplete confounders, i.e. a complete-case meta-analysis). To overcome these types of issues, a previous study proposed modelling the high correlation between partially and fully adjusted regression coefficient estimates in a bivariate meta-analysis. When multiple differently adjusted regression coefficient estimates are available, we propose exploiting such correlations in a graphical model. Compared with a previously suggested bivariate meta-analysis method, such a graphical model approach is likely to reduce the number of parameters in complex missing data settings by omitting the direct relationships between some of the estimates. We propose a structure-learning rule whose justification relies on the missingness pattern being monotone. This rule was tested using epidemiological data from a multi-centre survey. In the analysis of risk factors for early retirement, the method showed a smaller difference from a complete data odds ratio and greater precision than a commonly used complete-case meta-analysis. Three real-world applications with monotone missing patterns are provided, namely, the association between (1) the fibrinogen level and coronary heart disease, (2) the intima media thickness and vascular risk and (3) allergic asthma and depressive episodes. The proposed method allows for the inclusion of published summary data, which makes it particularly suitable for applications involving both microdata and summary data. Copyright © 2016 John Wiley & Sons, Ltd.

Summary Background The risk of developing occupational skin diseases (OSDs) is high in hairdressers, but may differ between countries. Objective To evaluate safety at work measures, and the prevalence and severity of skin symptoms and their impact on quality of life (QoL), among Croatian hairdressing apprentices. Methods Data on self-reported skin symptoms, safety measures and QoL were collected for 101 final-year apprentices. The presence and severity of skin lesions were assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). Transepidermal water loss (TEWL) was measured on the forearm and hand. Results Ninety-one percent of apprentices reported wearing gloves while dyeing hair, 45% while rinsing hair dyes, and 4% while washing hair. A history of skin symptoms was found in 35% of apprentices, and a history of dry hands in 37%. Skin changes were clinically observed in 40% of apprentices, most frequently erythema, infiltration, and desquamation. The OHSI score ranged from 0 to 6. Only washing hands >20 times per day was positively associated with TEWL. A history of skin symptoms negatively correlated with self-esteem, and social and mental functioning, and positively with anxiety and depression. Conclusions The results indicate the need for the continuation of efforts to establish effective primary preventive programmes for OSDs at national and EU levels.

The aim of this study was to examine mental health and cognitive functions in older Croatian workers (50–65 years) taking into account their employment status, self-assessed health, and a set of demographic characteristics. We analysed the data collected on 650 older workers (71 % employed) in the Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Unemployed workers reported symptoms of loneliness more often than the employed, while in rural areas unemployment was additionally associated with more pronounced symptoms of depression. Feeling of loneliness was also higher in those living without a partner in the household and in those with poorer health. In urban residents symptoms of depression were more severe in women, respondents with higher education, those living without a partner, and those who rated their health as poorer. As for cognitive functions, unemployment significantly predicted poorer subtraction in the rural subsample. Women in general showed less efficient numerical abilities. In the urban subsample poorer numerical abilities were also associated with lower education and living without a partner in the household. Better verbal recall was predicted by higher education and better self-rated memory. Higher scores in verbal fluency were predicted by urban residency and better self-rated health. Our results indicate that the protective factors for good mental health and cognitive functioning in older Croatian workers are being employed, having more education, living with a partner in the household, and being healthier. These findings stress the importance of implementing broader social policy strategies covering employment, education, and health., Cilj ovog rada bio je ispitati mentalno zdravlje i kognitivne funkcije starijih radnika u Hrvatskoj (50–65 godina), uzimajući u obzir njihov radni status, samoprocjenu zdravlja i skupinu demografskih karakteristika. Analizirani su podaci o 650 starijih radnika (71 % zaposlenih) iz šestog vala Istraživanja o zdravlju, starenju i umirovljenju u Europi (SHARE). Nezaposleni stariji radnici značajno su češće navodili simptome usamljenosti nego zaposleni, a u sudionika iz ruralnih područja nezaposlenost je dodatno bila povezana s izraženijim simptomima depresivnosti. Osjećaj usamljenosti također je bio izraženiji u onih koji žive bez partnera u istom domaćinstvu i onih slabijeg zdravlja. Kad je riječ o sudionicima koji žive u gradu, simptomi depresivnosti bili su izraženiji u žena, u onih koji imaju više obrazovanje, u onih koji žive bez partnera i u onih koji svoje zdravlje procjenjuju lošijim. Što se tiče kognitivnih funkcija, nezaposlenost je bila značajni prediktor lošijeg rezultata na zadacima oduzimanja u ruralnom poduzorku. Žene su općenito pokazale slabije numeričke sposobnosti. U gradskom poduzorku slabije numeričke sposobnosti bile su također povezane s nižom razinom obrazovanja i životom bez partnera u domaćinstvu. Bolje verbalno dosjećanje bilo je povezano s boljim obrazovanjem i boljom samoprocjenom pamćenja. Prediktori boljih rezultata na testu verbalne fluentnosti bili su stanovanje u gradu i bolja samoprocjena zdravlja. Naši rezultati pokazuju da su zaposlenost, bolje obrazovanje, život s partnerom i bolje zdravstveno stanje protektivni faktori mentalnog zdravlja i kognitivnog funkcioniranja starijih radnika u Hrvatskoj.

Background: Polymorphisms of cytokine genes are an interesting focus for association studies involving atopic diseases due to their role in immune cell communications during inflammation. The aim of this study was to investigate associations of TNFα -308G>A, TNFα -238G>A, IL-1α -889C>T and IL-10 -1082G>A polymorphisms with atopic diseases with adjustment for confounding lifestyle and environmental factors. Methods: This study was performed on 356 Croatian students. The diagnosis of atopic asthma, atopic rhinitis and atopic dermatitis was based on symptoms reported by the modified International Study of Asthma and Allergies in Childhood questionnaire and a positive skin prick test (SPT) to at least one common inhalatory allergen. Genetic polymorphisms were genotyped using the polymerase chain reaction-based technique. The influence of personal (gender, body mass index, parental history of atopic disease), lifestyle (cigarette smoking, pet ownership) and environmental (urban/rural residency, residency in continental/Mediterranean region) factors reported in the questionnaire was investigated by univariate and multivariate analysis. Results: Compared to the control subjects, univariate analysis showed a significant negative association of the TNFα -308G>A polymorphism with atopic asthma, atopic dermatitis, asthma and skin symptoms and positive SPT. These observations were confirmed in a multivariate model only for atopic dermatitis and skin symptoms (atopic dermatitis: OR = 0.27; 95% CI 0.07-1.00; p = 0.050; skin symptoms: OR = 0.29; 95% CI 0.10-0.83; p = 0.021). Conclusions: The results indicate a protective role of TNFα -308G>A genetic polymorphisms regarding atopic dermatitis and skin symptoms even after controlling for personal, lifestyle and environmental factors. Further studies are needed to elucidate the molecular patterns of this association in atopic dermatitis and other chronic inflammatory skin disorders.

The CD14 receptor is expressed on the surfaces of monocytes, macrophages, and, to a lesser extent, of activated granulocytes and B lymphocytes (mCD14). It also exists in soluble form in the serum (sCD14), in which it binds microbial compounds and indoor allergens. The objectives of this study were to see whether serum sCD14 concentrations could be used as a marker of atopic disorders and to estimate the effects of environmental factors (tobacco smoke exposure, childhood residence in urban or rural areas, and having a pet) on sCD14 and IgE values. Mass fraction of sCD14 and total IgE were determined in the sera of atopic (N=53) and non-atopic (N=35) participants using the standard enzyme-linked immunosorbent assay. Exposure to pets and environmental tobacco smoke was estimated based on the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). Median sCD14 concentration was significantly lower in atopic than in non-atopic girls (3.49 vs. 3.83 μg mL-1; p-1, p=0.028). Median total IgE concentration was significantly lower in atopic pet owners than in atopics with no pets (161 vs. 252 kIU L-1; p=0.021). In conclusion, while sex and environmental factors might be involved in sCD14 expression, particularly in atopics, we found no correlation between sCD14 and total IgE concentrations. The usefulness of sCD14 as a marker of atopic disorders should be investigated further, particularly in relation to the severity of allergic disorders.

Diet is the main source of cadmium (Cd) exposure. Gastrointestinal absorption increases during pregnancy. Cadmium accumulated in the placenta may interfere with nutrient transport to the foetus. Data on the potential of Cd to act as a steroid disruptor of pregnancy are limited. We evaluated the effects of oral Cd exposure during pregnancy on placental function in micronutrient transfer to the foetus and steroidogenesis in Wistar rats (regular 4-day cyclers) that mated with unexposed males. Pregnant rats were randomly assigned to a Cd group exposed orally to 50 mg Cd l(-1) (CdCl(2)xH2O dissolved in demineralized water), ≈ 7.5 mg Cd kg(-1) a day, during 20 days of gestation and control (supplied with demineralized water). Non-pregnant rats were treated under the same experimental conditions. On day 20, all of the rats were killed and samples were taken for element analyses (by electrothermal atomic absorption spectrometry). Progesterone and testosterone were measured in serum and placenta-derived samples (by immunoenzymometric assay and/or enzyme-linked immunosorbent assay). In the exposed rats, Cd increased in blood and organs, more in pregnant rats, and in placenta and foetus whereas zinc increased in liver. Iron decreased in maternal organs and in foetus, whereas zinc decreased in maternal kidney and placenta. Liver copper was lower and kidney copper higher in all pregnant vs. non-pregnant rats. Steroids in serum and placenta did not change. In conclusion, oral Cd exposure during rat pregnancy does not affect progesterone and testosterone at term. Transplacental iron and zinc handover are disrupted, which may put at risk the maintenance of foetal nutrition and viability.

Objective: The noninvasive biomarkers of respiratory impairment were assessed in 15 swine confinement (SC) workers and 9 respiratory healthy, nonsmoking volunteers (HV). Methods: Spirometry, fraction of exhaled nitric oxide (FeNO), and exhaled breath condensate (EBC) pH were assessed in SC workers after one working shift and one working week and in HV after 5-hour exposure in SC. Results: Half of the respiratory symptoms (in 8 of 15 SC workers) were work-related. Basal FeNO values were 7.5 ppb higher in the SC workers compared with HV. In the SC workers, EBC pH increased for 0.17 at the end of a working week (P < 0.001). In HV, 5-hour exposure in SC induced 8% drop in forced expiratory flow at 25% of the pulmonary volume (FEF25 )( P = 0.008), EBC pH drop for 0.10 units (P = 0.003), and FeNO drop by 1.8 ppb (P = 0.047). Conclusions: EBC pH was suggested as a biomarker of acute airway acidification in HV, whereas the SC workers showed signs of the “healthy worker effect.”

Flashover training (FOT) for firefighters is a simulation of the flashover phenomenon under controlled conditions. This study assessed arterial blood pressure (BP) and its response to thermal and physical strain during FOT in 48 professional and 18 volunteer firefighters. A high prevalence of obesity (27%), basal hypertensive (53%) and prehypertensive (33%) BP values was found. FOT induced mild hyperthermia and physical strain (average increase of 1.1 °C in tympanic temperature and 61% of the maximal heart beat predicted for age). Compared to professional firefighters, FOT in the volunteers induced a higher increase in pulse (P = 0.050) and tympanic temperature (P = 0.025). Systolic BP did not vary significantly, and diastolic BP slightly decreased in both groups. Results confirm that FOT induced only physiological cardiovascular responses to thermal and physical strain in firefighters. High prevalence of obesity and elevated BP values indicate the need for better physical fitness and BP control among firefighters.

Background and Study Design It is well documented that copper (Cu) blood levels are elevated in combination oral contraceptive (COC) users. The aim of this study was to establish the range of Cu increase in OC users compared to nonusers through a systematic literature overview and quantitative data analysis. Results Twenty-six articles were included in the meta-analysis. The increase in Cu level exponentially decreased in COC users over time, with a rapid decline through the 1960s and 1970s. After controlling for the publication year, use of COC increases the mean serum/plasma Cu level by 0.57 mg/L (95% confidence interval 0.49–0.66 mg/L). Conclusion COCs commonly raise serum Cu to levels between 1.5 and 2 mg/L, which are above reference levels. Although these levels are not considered toxic, there are suggestions that such Cu increase could be implicated in oxidative pathophysiological processes in the body. Further research on safety of COCs use, including oxidative-stress-related effects, is warranted.

Pregnant and lactating women and infants are vulnerable population groups for adverse effects of toxic metals due to their high nutritional needs and the resultant increased gastrointestinal absorption of both, essential and toxic elements. Although breastfeeding is recommended for infants worldwide, as human milk is the best source of nutrients and other required bioactive factors, it is also a pathway of maternal excretion of toxic substances including toxic metals and thus a source of infant exposure. The aim of this research was to assess health risks in breastfeeding women in the coastal area of the Republic of Croatia and their infants (N=107) due to maternal exposure to Cd and Pb via cigarette smoking, and Hg via seafood and dental amalgam fillings, and their interaction with essential elements. Biological markers of exposure were the concentrations of main toxic metals Pb, Cd and Hg in maternal blood and three types of breast milk throughout lactation stages. Biological markers of effects were the levels of essential elements Ca, Fe, Cu, Zn and Se in maternal serum and breast milk. With regard to cigarette smoking as a source of exposure to Cd and Pb, there were effects of smoking on Cd concentration in blood and correlations between the smoking index and Cd concentrations in maternal blood (ρ=0.593 ; P

PURPOSE: The aim of the study was to evaluate exhaled breath condensate acidity (EBC pH) as a biomarker of airway response to occupational respiratory hazards present in sawmill. METHODS: Sixty-one sawmill workers in total (26 from Sawmill 1 and 35 from Sawmill 2) provided EBC samples at the beginning and at the end of the working week. Respiratory symptoms, lung function, bronchodilator test and atopy status were assessed. Occupational environment was checked for the levels of respiratory hazards. RESULTS: Airborne dust concentrations were below threshold limit value. Endotoxin in Sawmill 1 and Sawmill 2, and moulds in Sawmill 1 were at the levels able to induce inflammatory response in the airways. Mould levels were 2.5 times higher in Sawmill 1 than in Sawmill 2. Compared to Sawmill 2 workers, lower spirometry values, higher prevalence of dry cough and positive bronchodilator test were found in Sawmill 1 workers. Monday EBC pH values did not differ between sawmills, but declined after one working week in Sawmill 1 workers (from 7.88 to 7.49, P = 0.012) and not in Sawmill 2 workers. Similar results were obtained when only respiratory healthy non-smokers were analysed. Monday-to-Friday change of other respiratory parameters was not observed. CONCLUSION: The results suggest EBC pH as a biomarker of acute respiratory effects related to occupational exposure to respiratory hazards in sawmills, presumably increased mould levels. The effect was present even at subclinical level, namely in respiratory healthy subjects. The long-term health implications remain unclear and should be evaluated in a follow-up study.

Cadmium and other metallic ions can act as metalloestrogens and endocrine disruptors of reproductive tissues and fetal development in mammals, including humans. The detrimental effects occur with respect to the synthesis of both steroid and polypeptide hormones in the placenta. Leptin is produced by the trophoblast and may regulate fetal organogenesis and development. In human term placentas, concentrations of toxic metals and their effects on steroidogenesis were assessed in healthy parturients (109 non-smokers and 99 smokers) in relation to tobacco smoking. Trace elements (cadmium, lead, iron, zinc and copper) were analyzed in placentas using atomic absorption spectroscopy, and steroid hormones (progesterone and estradiol) were assayed in placental samples by an enzyme-immunometric method. Cadmium concentrations were doubled in placentas of smokers as compared with non-smokers, and placental lead and zinc concentrations increased significantly. Placental concentrations of iron, copper, progesterone and estradiol did not differ. In addition, human trophoblast cells were co-cultured with 0, 5, 10 or 20 microm CdCl(2) for 96 h and leptin mRNA assessed by quantitative polymerase chain reaction. Leptin mRNA declined dose-responsively as a result of CdCl(2) exposure. Collectively, the results confirm that human placental tissue offers a unique opportunity to biomonitor cadmium exposure in both the maternal and the internal fetal environments. In addition, the results strongly suggest that cadmium may cause a decline in placental leptin synthesis, as we have previously shown for placental progesterone production. This may constitute further evidence of the endocrine-disrupting effects of cadmium, as a constituent of tobacco smoke, on reproduction in women.

The association of age, smoking, alcohol, superoxide dismutase (SOD), glutathione peroxidase (GPx), blood lead (BPb) and cadmium (BCd) levels, and serum levels of copper (SCu), zinc (SZn) and selenium (SSe) with atopic status and ventilatory function was examined in the groups of 166 women and 50 men with no occupational exposure to metals or other xenobiotics. Markers of atopy included serum total IgE, skin prick test (SPT) to common inhalatory allergens, non-specific nasal reactivity (NNR) and non-specific bronchial reactivity (NBR). Parameters of ventilatory function included forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1 ). Significantly (P

Reports about the increasing prevalence of atopy and atopic diseases are common, but recently they have been critically reviewed and the need for relevant research methods has been established.This study evaluated a 15-year trend in the prevalence of atopy markers [elevated total IgE, positive skin prick test (SPT) to common aeroallergens and positive atopic symptoms] in Croatian adults, separately for women and men.The study included 721 subjects (445 men and 276 women), 18-45 years old, examined for allergies within a pre-employment preventive examination. All subjects underwent medical history, SPT with common inhalatory allergens and total serum IgE measurement. The trend analysis of atopy prevalence was performed after stratification of subjects into three consecutive 5-year periods from 1985 to 1999.The prevalence of concurrently elevated total IgE and positive atopic symptoms significantly increased during the studied period in men [odds ratio (OR) 2.44, 95% confidence interval (CI) 1.39-4.29, P=0.002]. Women showed an increased prevalence of positive SPT only, with borderline significance (OR 1.65, 95% CI 1.00-2.71, P=0.050). In women, rural residence was found to be a predictor of elevated total IgE (OR 5.36, 95% CI 2.41-11.93, P=0.000) and smoking to be a predictor of concurrently elevated total IgE and positive SPT (OR 6.20, 95% CI 1.67-23.07, P=0.006).An increasing trend in the prevalence of concurrently elevated total IgE and positive atopic symptoms was found in the Croatian adult male population between 1985 and 1999, but not in the female population. Sex differences responsible for the production and regulation of IgE were suggested.

The risk of developing occupational skin disease (OSD) is high in hairdressers, but may differ between countries.To evaluate safety at work measures, and the prevalence and severity of skin symptoms and their impact on quality of life (QoL), among Croatian hairdressing apprentices.Data on self-reported skin symptoms, safety measures and QoL were collected for 101 final-year apprentices. The presence and severity of skin lesions were assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). Transepidermal water loss (TEWL) was measured on the forearm and hand.Ninety-one percent of apprentices reported wearing gloves while dyeing hair, 45% while rinsing hair dyes, and 4% while washing hair. A history of skin symptoms was found in 35% of apprentices, and a history of dry hands in 37%. Skin changes were clinically observed in 40% of apprentices, most frequently erythema, infiltration, and desquamation. The OHSI score ranged from 0 to 6. Only washing hands20 times per day was positively associated with TEWL. A history of skin symptoms negatively correlated with self-esteem, and social and mental functioning, and positively with anxiety and depression.The results indicate the need for the continuation of efforts to establish effective primary preventive programmes for OSDs at national and EU levels.

Polymorphisms of cytokine genes are an interesting focus for association studies involving atopic diseases due to their role in immune cell communications during inflammation. The aim of this study was to investigate associations of TNFα -308GA, TNFα -238GA, IL-1α -889CT and IL-10 -1082GA polymorphisms with atopic diseases with adjustment for confounding lifestyle and environmental factors.This study was performed on 356 Croatian students. The diagnosis of atopic asthma, atopic rhinitis and atopic dermatitis was based on symptoms reported by the modified International Study of Asthma and Allergies in Childhood questionnaire and a positive skin prick test (SPT) to at least one common inhalatory allergen. Genetic polymorphisms were genotyped using the polymerase chain reaction-based technique. The influence of personal (gender, body mass index, parental history of atopic disease), lifestyle (cigarette smoking, pet ownership) and environmental (urban/rural residency, residency in continental/Mediterranean region) factors reported in the questionnaire was investigated by univariate and multivariate analysis.Compared to the control subjects, univariate analysis showed a significant negative association of the TNFα -308GA polymorphism with atopic asthma, atopic dermatitis, asthma and skin symptoms and positive SPT. These observations were confirmed in a multivariate model only for atopic dermatitis and skin symptoms (atopic dermatitis: OR = 0.27; 95% CI 0.07-1.00; p = 0.050; skin symptoms: OR = 0.29; 95% CI 0.10-0.83; p = 0.021).The results indicate a protective role of TNFα -308GA genetic polymorphisms regarding atopic dermatitis and skin symptoms even after controlling for personal, lifestyle and environmental factors. Further studies are needed to elucidate the molecular patterns of this association in atopic dermatitis and other chronic inflammatory skin disorders.

Thiomersal is used as a preservative in vaccines given to small children. The metabolic product of thiomersal is ethylmercury and its distribution and kinetics are still not known, especially at this early age. The purpose of this study was to compare the body distribution of two forms of mercury: organic (thiomersal) and inorganic (mercury(2+) chloride) in very young, suckling rats. Mercury was applied subcutaneously three times during the suckling period on days 7, 9 and 11 of pups age, imitating the vaccination of infants. A single dose of mercury was equimolar in both exposed groups, i.e. 0.81 micromol Hg kg(-1). At 14 days of age the animals were killed and the total mercury analysed in blood and organs (kidney, liver and brain). The analytical method applied was total decomposition, amalgamation, atomic absorption spectrometry. The results showed that the level of mercury was higher in the liver and kidney of the inorganic mercury group than in the thiomersal exposed group. However, the brain and blood concentrations of mercury were higher in the thiomersal exposed group. These results need to be clarified by additional data on the kinetic pathways of ethylmercury compared with inorganic mercury.

It was suggested that ascorbic acid as a natural chelating agent can influence lead toxicokinetics and improve chelating properties of dimercaptosuccinic acid (DMSA) in adult rats. In this paper potential benefits of ascorbic acid supplementation, alone or combined with DMSA, in decreasing lead retention in suckling rats were evaluated. Such data in young mammals are not available. L-Ascorbic acid (daily dose 650 mg/kg b.wt.) and/or DMSA (daily dose 91 mg/kg b.wt.) were administered orally to suckling Wistar rats either during ongoing 8-day oral lead exposure (as acetate; daily dose 2 mg lead/kg b.wt.) or after 3-day lead exposure (total dose 12 mg lead/kg b.wt.). Lead concentrations were analysed in the carcass (skeleton), liver, kidneys and brain by atomic absorption spectrometry. By ascorbic acid supplementation lead retention was not reduced under either lead exposure condition. Lead concentration was even increased in the carcass. Treatment with DMSA under both exposure conditions significantly reduced lead in all analysed tissues. Combined treatment with ascorbic acid and DMSA during ongoing lead exposure was substantially less effective than DMSA treatment alone, and did not affect DMSA efficacy when administered after lead exposure. It was concluded that ascorbic acid administered either during or after lead exposure in suckling rats has no beneficial effect on either lead retention or DMSA chelation effectiveness.

Health risk of exposure to three major toxic metals Cd, Pb and Hg were assessed in healthy breastfeeding women aged 29.5±4.9 (19-44 yrs) who gave birth during 2012/13 in the maternity ward of General County Hospital in Zadar, the largest city in mid-coastal Croatia. Data on smoking and dietary habits (with focus on seafood consumption) by self-ascertainment and stated number of amalgam dental fillings as sources of toxic metal exposure were collected by questionnaire. Metal levels in maternal blood and breast milk samples (elements were analysed by ICP-MS) served as biomarkers of exposure. As biomarkers of toxic metal effects, we measured total antioxidant status (TAS) in breast milk samples (in total N=147) of three lactation stages: colostrum (up to day 4), transitory milk (between days 5 and 14) and mature milk (between days 20 and 30 postpartum) by Antioxidant Assay Kit (Cayman Chemical Company, USA) based upon the ability of antioxidants to inhibit the oxidation of ABTS. Maternal cigarette smoking was positively correlated with Cd concentrations in maternal blood and mature milk and Pb in transitory milk. Positive correlations were also found between seafood consumption and total Hg in maternal blood and mature milk and between the number of maternal amalgam dental fillings and total Hg in colostrum and transitory milk. Values of TAS (expressed in mmol/L of Trolox equivalents) determined in colostrum, transitory milk and mature milk samples were: 1.35±0.74, 1.49±0.79 and 1.48±0.80. The absence of differences in TAS values between different breast milk types in relation to maternal smoking and dietary habits suggest that exposure to potential oxidative agents, including three main toxic metals, in the study cohort did not reach levels to disrupt the protective antioxidant capacity of breast milk, which might point to possible health risks in postpartum women and their progeny.

The CD14 receptor is expressed on the surfaces of monocytes, macrophages, and, to a lesser extent, of activated granulocytes and B lymphocytes (mCD14). It also exists in soluble form in the serum (sCD14), in which it binds microbial compounds and indoor allergens. The objectives of this study were to see whether serum sCD14 concentrations could be used as a marker of atopic disorders and to estimate the effects of environmental factors (tobacco smoke exposure, childhood residence in urban or rural areas, and having a pet) on sCD14 and IgE values. Mass fraction of sCD14 and total IgE were determined in the sera of atopic (N=53) and non-atopic (N=35) participants using the standard enzyme-linked immunosorbent assay. Exposure to pets and environmental tobacco smoke was estimated based on the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). Median sCD14 concentration was significantly lower in atopic than in non-atopic girls (3.49 vs. 3.83 μg mL-1; p, Receptor CD14 izražen je na površini monocita, makrofaga, te u manjoj mjeri na aktiviranim granulocitima i B limfocitima (mCD14). Također, CD14 postoji u topivom obliku u serumu (sCD14), koji ima važnu ulogu u vezanju nekih komponenata mikroorganizama i alergena unutarnjeg okoliša. Cilj je ovog istraživanja bio utvrditi mogu li se vrijednosti koncentracije sCD14 u serumu koristiti kao biljeg atopičnih poremećaja, te ustanoviti utjecaj čimbenika okoliša (pušenje, stanovanje u gradskom-ruralnom području tijekom djetinjstva te kućni ljubimci) na vrijednosti sCD14 i IgE. Koncentracija sCD14 i ukupni IgE određeni su u serumu atopičara (N=53) i neatopičara (N=35) standardnim enzim-imunokemijskim metodama. Izloženost okolišnim čimbenicima (kućni ljubimci, pušenje) procijenjeni su prema Upitniku iz Međunarodne studije o astmi i alergiji (ISAAC). Medijan koncentracija sCD14 bio je značajno niži u atopičnih djevojaka nego u neatopičnih (3.49 vs. 3.83 μg mL-1; p

The effect of calcium supplementation on absorption and retention of cadmium in the suckling period was evaluated in Wistar rat pups of both sexes. Animals were maintained in the litters with the mother rats and supplemented with 1%, 3% or 6% calcium (as CaHPO4×2H2O) in cow's milk by artificial feeding from day of birth 6 through 14. All rats were exposed to cadmium (as CdCl2×H2O) either orally or parenterally. Oral cadmium dose of 0.5 mg/kg body weight a day was administered through nine-day period of calcium supplementation and parenteral cadmium dose was injected subcutaneously in a single dose of 0.5 mg Cd/kg body weight prior to calcium supplementation. On experimental day 10 (at the age of pups of 15 days) all animals were killed and the liver, kidneys, brain and carcass (body without organs and skin) were removed for element analyses. Cadmium and essential elements calcium, zinc and iron were analysed in the tissues by atomic absorption spectrometry. Results showed that after oral exposure cadmium concentrations in all calcium-supplemented groups were significantly decreased in the organs and carcass and that the effect was dose-related. No such effect of calcium was found after parenteral cadmium exposure. Calcium supplementation per se significantly increased calcium concentration in the carcass and had no effect on iron in organs and zinc in carcass. It was concluded that calcium supplementation during the suckling period could be an efficient way of reducing oral cadmium absorption and retention without affecting tissue essential trace element concentrations.

The CD14 receptor is expressed on the surfaces of monocytes, macrophages, and, to a lesser extent, of activated granulocytes and B lymphocytes (mCD14). It also exists in soluble form in the serum (sCD14), in which it binds microbial compounds and indoor allergens. The objectives of this study were to see whether serum sCD14 concentrations could be used as a marker of atopic disorders and to estimate the effects of environmental factors (tobacco smoke exposure, childhood residence in urban or rural areas, and having a pet) on sCD14 and IgE values. Mass fraction of sCD14 and total IgE were determined in the sera of atopic (N=53) and non-atopic (N=35) participants using the standard enzyme-linked immunosorbent assay. Exposure to pets and environmental tobacco smoke was estimated based on the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC). Median sCD14 concentration was significantly lower in atopic than in non-atopic girls (3.49 vs. 3.83 μg mL(-1); p0.010). The number of smokers at home positively correlated with the sCD14 level in atopics, and urban atopics had significantly lower sCD14 levels than rural atopics (3.47 vs. 3.92 μg mL(-1), p=0.028). Median total IgE concentration was significantly lower in atopic pet owners than in atopics with no pets (161 vs. 252 kIU L(-1); p=0.021). In conclusion, while sex and environmental factors might be involved in sCD14 expression, particularly in atopics, we found no correlation between sCD14 and total IgE concentrations. The usefulness of sCD14 as a marker of atopic disorders should be investigated further, particularly in relation to the severity of allergic disorders.

The hypothesis that two known chelators 1,2-dimethyl-3-hydroxypyrid-4-one (L1) and desferrioxamine (DFO) might be more efficient as combined treatment than as monotherapies in removing aluminium from the body was tested in a new acute rat model. Five-week old female rats received chelators: L1 (p.o.), DFO (i.p.) or L1+DFO as 100 or 200 mg/kg dose half an hour after a single i.p. administration of 6 mg Al/kg body weight in the form of chloride. Serum aluminium concentration and urinary aluminium and iron excretions were determined by electrothermal or flame atomic absorption spectrometry. Both chelators were effective only at the higher dose level. While DFO was more effective than L1 in enhancing urinary aluminium excretion, L1 was more effective than DFO in enhancing urinary iron excretion. In the combined treatment group L1 did not increase the DFO effect on aluminium and DFO did not increase the effect of L1 on iron elimination. However, in this group a simultaneous increase in both aluminium and iron elimination was observed. Our results support the usefulness of this animal model for preliminary in vivo testing of aluminium chelators. Urinary values were more useful because of the high variability of serum results. Result of combined chelators treatment should be confirmed in a different experimental model before extrapolation to other systems. This testing procedure of course does not provide all the relevant answers for evaluating the efficiency of chelating agents in aluminium toxicity.

Female rats were loaded with lead acetate (5 mg Pb/kg) during 2 weeks (10 times) intraperitoneally. Four-day chelation treatment started 1 week later with CaNa2 ethylenediaminetetraacetate (EDTA, 0.3 mmol/kg i.p. at 4:00 p.m.), and meso- or racemic-2,3-dimercaptosuccinic acid (meso- or rac-DMSA, 0.5 mmol/kg p.o. at 10:00 a.m.). One group was administered EDTA as monotherapy, and two groups received combined treatment with EDTA plus either meso-DMSA or rac-DMSA. Lead was determined in femur, kidneys, and brain. Urinary eliminations of lead, iron, zinc, and copper were also evaluated. With EDTA monotherapy, lead was reduced in kidneys. Combined treatment with EDTA plus meso-DMSA reduced lead in kidneys and brain, and EDTA plus rac-DMSA treatment reduced lead in femur, kidneys, and brain. Urine lead elimination was increased by EDTA monotherapy 10 times, and by both combined treatments 14–15 times. Urine zinc excretion was increased by both EDTA monotherapy and in combined treatment with meso-DMSA 3–4 times, and in combined treatment with rac-DMSA 5–6 times. Both combined treatments increased copper urinary excretion 3–4 times. Best results in reducing tissue lead were obtained when EDTA therapy was combined with rac-DMSA treatment. Since this combination also caused highest urinary trace element elimination, more data are needed before recommending rac-DMSA for use in combined treatment of lead poisoning. J. Trace Elem. Exp. Med. 13:277–284, 2000. © 2000 Wiley-Liss, Inc.

The maximum likelihood estimator of intraclass correlation coefficient (ICC) has not yet been suggested nor used in reproducibility studies with grouped data. Using data simulated from one-way random-effects model, we show that its bias is negligible regardless of the choice of categories, in contrast to commonly used midpoint ICC and weighted kappa. Implementation is provided in R package iRepro.

Background/Aims: The aim of this study was to obtain insight into the clinical course and prognosis of allergic contact dermatitis (ACD), including potential effects of genetic and environmental factors. Methods: Eighty-two patients with previously defined ACD acquired occupationally (OACD) or non-occupationally (NOACD) were patch retested and evaluated for the presence of persistent eczema, atopy and filaggrin mutations. Results: The crude risk for the persistence of a positive patch test (PT) reaction was 6.3 times higher (95% CI 3.63-11.0) for PT reactions assessed as ‘+++' compared to ‘++' reactions at the first PT. Among the categories of OACD, NOACD, age, gender, atopy, and the number of positive PT reactions at the first and second PT, only OACD (OR 10.0, 95% CI 1.95-51.2) and number of positive PT reactions at retesting (OR 3.85, 95% CI 1.57-9.44) were found to be predictors of persistent eczema. Conclusions: Occupationally acquired contact allergy was emphasized as the most important factor in predicting poor prognosis of ACD.

Airborne fungi were collected over a one year period at 2-month intervals at 2 sawmills in Croatia (SM 1 and SM 2) processing mainly beech wood and oak wood. A questionnaire concerning respiratory symptoms and skin prick test (SPT) with common inhalatory allergens and moulds Cladosporium herbarum, Alternaria alternata, Aspergillus niger, Penicillium notatum, and Rhizopus nigricans were performed in 96 workers from the same sawmills. Average concentrations of airborne fungi were 1,696-7,316 cfu/m(3) in SM 1 and 1,706-4,819 cfu/m(3) in SM 2, respectively. Health hazardous levels of airborne fungi (above 10 4 /m(3)) were present only in SM 1. These levels were related to saw working sites and were season-dependent, i.e. present only during the summer. Penicillium (50-100%), Paecilomyces (43-100%) and Chrysonilia (33-100%) dominated among 17 fungal genera identified in both sawmills. Symptoms of rhinitis, asthma, and dry cough were most frequently recorded among analysed workers. SPT to moulds was negative in all tested workers, except one positive to R. nigricans, indicating that moderate airborne fungi levels found in the analysed sawmills were not related to IgE-mediated sensitization to moulds in exposed workers, even in atopics. Atopy was present among woodworkers in similar proportions to the general population of Croatia, suggesting that the wood-processing industry is not selective for atopic workers.

Introduction. Mercury is an environmental contaminant. It is present in fish and seafood mostly in the form of methylmercury, a highly toxic compound that could cause nerodevelopmental disorders with lifelong disability. Placenta does not act as a barrier to methylmercury and it easily passes to unborn child. Materials and Methods. We assessed perinatal exposure to mercury in 101 healthy postpartum women (aged 29±4.7 years) who gave birth at term by vaginal delivery during 2010 in General Hospital of Zadar County, coastal Croatia. Personal information, collected by a questionnaire, included data on dietary fish and seafood consumption and number of amalgam fillings. Maternal venous blood and umbilical cord blood samples were taken after delivery. Total mercury concentration (T-Hg) was determined in blood and serum using ICP-MS method. Results. Median and range of T-Hg were 1.83 (0.18-25.3) and 3.11 (0.10-46.9) µg/L in maternal blood and umbilical cord blood and 0.62 (0.10-4.59) and 0.44 (0.05-4.03) µg/L in maternal serum and umbilical cord serum. T-Hg in maternal and umbilical cord blood was associated with weakly fish consumption (p

The objective of this study was to examine induced sputum (IS) cells profile from restorers/conservators of cultural heritage (restorers) with no lower airway symptoms and normal ventilatory lung function. The study involved 22 restorers and 48 control workers. Medical interview, physical examination, spirometry, skin prick testing to inhalatory allergens, and IS collection were performed. Compared with control workers, restorers demonstrated higher percentage of neutrophils (34% vs 15.5%; p = .004). This pattern was found only in male workers. They had almost 9 times greater chance to have increased proportion of sputum neutrophils than male controls (odds ratio [OR] 8.98, 95% confidence interval [CI] 1.98–40.7). The mobilization of eosinophils or macrophages into the airways was not established regardless of workers sex. Additional gender difference in sputum cells distribution was found for occupationally unexposed subjects, with higher proportion of sputum neutrophils in women.

Tijekom 2010. godine u Centru za kontrolu otrovanja zabilježeno je 1474 poziva u kojima su se tražile informacije o 1503 slučaja. U 38 slučajeva radilo se o sumnji na profesionalno otrovanje, većinom u radnika muškog spola. U 35 slučajeva radnici su bili izloženi kemijskim štetnostima, u jednom slučaju zabilježena je kontaktna izloženost radnika listovima duhana, a u 2 slučaja vrsta štetnosti nije utvrđena. Najčešći uzroci profesionalnih otrovanja bili su dimovi zavarivanja i plinovi, kiseline i lužine, organska otapala, te pesticidi. Teške kliničke slike otrovanja zabilježene su u 2 slučaja: pri ingestiji korozivnog sredstva prilikom pipetiranja u obliku težeg oštećenja sluznice probavnog sustava, te pri kroničnoj inhalacijskoj i kontaktnoj izloženosti organskim otapalima pri radu u tiskari u vidu težih poremećaja rada centralnog i perifernog živčanog sustava.

Acute effects of food and cigarette consumption on exhaled breath condensate (EBC) acidity are insufficiently explored. The study aimed to evaluate potential changes in EBC pH within 2 hours following cigarette or food consumption. In 15 healthy smokers, samples were obtained after 10 hours of abstinence from smoking and then 15, 30, 60, and 120 minutes after smoking 1 cigarette. In 19 healthy nonsmoking adults, EBC samples were obtained in the morning after an overnight fast, and then 30, 60, and 120 minutes following standardized breakfast. Smoking of 1 cigarette after overnight tobacco abstinence induced significant increase in EBC pH during the 2-hour observation period, for approximately 0.60 logarithmic units (repeated-measures analysis of variance [ANOVA], P < .0001). The average presmoking pH value in smokers (7.00 ± 0.50) was significantly lower than average value in nonsmokers (7.62 ± 0.31 ; P = .0001). No effect of food consumption was found. These results show that cigarette smoking acutely increases EBC pH in healthy smokers. Smoking status and abstinence from smoking before EBC sampling seems to be important in studies evaluating EBC pH and should be standardized or at least stated in the methodology. Acute effects of food were not found under described study conditions in healthy adults.

BACKGROUND There is a paucity of data regarding respiratory health in restorers of cultural heritage or similar occupations, such as visual artists or museum workers, although they are exposed to a complex mixture of various respiratory hazards. AIMS To evaluate atopy and respiratory health parameters, including bronchial and nasal non-specific reactivity, in restorers and conservators of cultural heritage (restorers). METHODS Fifty-six restorers and 62 controls provided general data and data on ever experienced rhinitic or asthma-like symptoms, spirometry, non-specific bronchial and nasal responsiveness to histamine, skin prick testing to common inhalational allergens and serum total IgE levels. RESULTS Spirometry values were in the range of normal values in 55 of 56 restorers and did not differ significantly from those in control subjects. However, restorers had more than two times higher prevalence of nasal hyper-responsiveness (NHR), with 2.3 times higher risk of NHR compared to controls [95% confidence interval (CI): 1.4-3.6, P < 0.001]. The risk of NHR was slightly reduced by increasing age (odds ratio 0.95, 95% CI: 0.91-0.99, P < 0.05). NHR was not associated with gender, smoking status, bronchial hyperresponsiveness (BHR), upper or lower respiratory symptoms or atopy status. CONCLUSIONS Compared with controls, the studied group of workers occupationally exposed to respiratory hazards during restoration/conservation activities had no deterioration of lung function but had an increased non-specific nasal responsiveness that was not correlated with upper and lower respiratory symptoms, BHR or atopy. The relationship of this finding to future clinical outcome should be investigated in a longitudinal study.

Endotoxin Exposure Assessment in Wood-Processing Industry: Airborne Versus Settled Dust LevelsWood processing is usually performed in environments with large amounts of endotoxin-rich bioaerosols that are associated with a variety of health effects. The aim of this preliminary study was to assess the relation between endotoxin levels in settled and airborne dust in wood-processing industry. Ten pairs of airborne and settled dust samples were collected in a sawmill and parquet manufacture of two wood-processing plants in Croatia. Endotoxin was assayed with a chromogenic end-point LAL (Limulus amebocyte lysate) method. The results showed that endotoxin levels in airborne respirable dust were above the proposed occupational exposure limit of 125 EU m-3 and could be considered hazardous for the respiratory system. In settled dust they ranged between 229.7 EU mg-1 and 604.3 EU mg-1 and in airborne dust between 166.8 EU mg-1 and 671.6 EU m-3, but there was no significant correlation between them (Spearman's rho=0.358, P=0.310). This study points to sawmill settled dust as endotoxin reservoir and suggests that it may add to already high exposure to airborne endotoxins associated with wood processing. Investigations of the relation between settled and airborne endotoxin levels should be continued to better understand the sources and sites of endotoxin contamination in wood-processing industry.

Wood processing is usually performed in environments with large amounts of endotoxin-rich bioaerosols that are associated with a variety of health effects. The aim of this preliminary study was to assess the relation between endotoxin levels in settled and airborne dust in wood-processing industry. Ten pairs of airborne and settled dust samples were collected in a sawmill and parquet manufacture of two wood-processing plants in Croatia. Endotoxin was assayed with a chromogenic end-point LAL (Limulus amebocyte lysate) method. The results showed that endotoxin levels in airborne respirable dust were above the proposed occupational exposure limit of 125 EU m-3 and could be considered hazardous for the respiratory system. In settled dust they ranged between 229.7 EU mg-1 and 604.3 EU mg-1 and in airborne dust between 166.8 EU mg-1 and 671.6 EU m-3, but there was no signifi cant correlation between them (Spearman’s rho=0.358, P=0.310). This study points to sawmill settled dust as endotoxin reservoir and suggests that it may add to already high exposure to airborne endotoxins associated with wood processing. Investigations of the relation between settled and airborne endotoxin levels should be continued to better understand the sources and sites of endotoxin contamination in wood-processing industry., Drvoprerađivačka industrija radna je sredina s izloženošću velikim količinama bioaerosola bogatog endotoksinom, što je povezano s učincima na zdravlje izložene radne populacije. Cilj ove studije bio je procijeniti odnos između razina endotoksina u sedimentiranoj prašini i zraku (aerosoliziranoj prašini) drvoprerađivačkih radnih prostora. Deset parova uzoraka zraka i sedimentirane prašine skupljeno je u dvije tvornice za preradu drva (pilanama i pogonima za proizvodnju parketa) u Hrvatskoj. Endotoksin je izmjeren kromogenom “end-point” LAL (Limulus amebocitni lizat) metodom. Rezultati su pokazali da razine endotoksina u aerosoliziranoj respirabilnoj prašini drvoprerađivačkih pogona prelaze preporučene granice izloženosti za radne prostore od 125 EU m-3, pa se mogu smatrati štetnima za dišni sustav izloženih radnika. Razine endotoksina izmjerene u sedimentiranoj i aerosoliziranoj prašini kretale su se u sličnu rasponu [(229.7 do 604.3) EU mg-1 i (166.8 do 671.6) EU m-3], ali nije utvrđena značajna korelacija razina endotoksina između parova uzoraka sedimentirane i aerosolizirane prašine (Spearman rho=0.358, P=0.310). Ovi rezultati upućuju na to da uz velike količine proizvedene i aerosolizirane drvne prašine u sklopu radnih operacija u pilanama, razini endotoksina u aerosoliziranoj respirabilnoj prašini može pridonijeti i uskovitlana sedimentirana prašina koja je dodatni rezervoar endotoksina. Istraživanje odnosa između razina endotoksina u sedimentiranoj i aerosoliziranoj prašini treba nastaviti kako bi se bolje defi nirali izvori i mjesta kontaminirana endotoksinom u pilanama.

Whole Atlantic mackerel (Scomber scombrus), sardine (Sardina pilchardus) and Mediterranean hake (Merluccius merluccius) from the Croatian Adriatic were stored at 22 degrees C and changes in histamine, putrescine, tyramine and cadaverine levels were monitored in relation to bacterial endotoxin. After 12 h, histamine levels in sardine were above the legal limit of 50 mg kg(-1), set by the US Food and Drug Administration, and an increase in putrescine content preceded the increase in histamine. After 24 h, histamine contents in mackerel and sardine reached 1090 +/- 101 and 577 +/- 275 mg kg(-1), respectively, which exceeded the toxic threshold of 500 mg kg(-1). At the same time, the putrescine content was also high in both fish (353-420 mg kg(-1)). The time-course of endotoxin production was similar in all fish species stored at 22 degrees C. A high correlation was found between endotoxin and histamine, and between endotoxin and putrescine in mackerel and sardine. On the other hand, high endotoxin levels in hake, after 24 h, were associated with the low histamine and putrescine content (40-60 mg kg(-1)).

Purpose. The aim of the study was to evaluate exposure to moulds and house dust mite Dermatophagoides pteronyssinus in poultry farms, and related health effects in poultry workers (PW). Methods. The study involved 41 PW and 45 control office workers. Working environment was evaluated for D. pteronyssinus allergen (Der p 1), moulds and endotoxin. In workers, eye, skin and respiratory symptoms, ventilatory lung function, atopy markers (skin prick test to inhalatory allergens, total IgE) and specific IgG to moulds were assessed. Results. Der p 1 levels ranged