The International Atomic Energy Agency action plan on radiation protection of patients and staff in interventional procedures: Achieving change in practice

IntroductionThe International Atomic Energy Agency (IAEA) organized the 3rd international conference on radiation protection (RP) of patients in December 2017. This paper presents the conclusions on the interventional procedures (IP) session.Material and methodsThe IAEA conference was conducted as a series of plenary sessions followed by various thematic sessions. “Radiation protection of patients and staff in interventional procedures” session keynote speakers presented information on: 1) Risk management of skin injuries, 2) Occupational radiation risks and 3) RP for paediatric patients. Then, a summary of the session-related papers was presented by a rapporteur, followed by an open question-and-answer discussion.ResultsSixty-seven percent (67%) of papers came from Europe. Forty-four percent (44%) were patient studies, 44% were occupational and 12% were combined studies. Occupational studies were mostly on eye lens dosimetry. The rest were on scattered radiation measurements and dose tracking. The majority of patient studies related to patient exposure with only one study on paediatric patients. Automatic patient dose reporting is considered as a first step for dose optimization. Despite efforts, paediatric IP radiation dose data are still scarce. The keynote speakers outlined recent achievements but also challenges in the field. Forecasting technology, task-specific targeted education from educators familiar with the clinical situation, more accurate estimation of lens doses and improved identification of high-risk professional groups are some of the areas they focused on.ConclusionsManufacturers play an important role in making patients safer. Low dose technologies are still expensive and manufacturers should make these affordable in less resourced countries. Automatic patient dose reporting and real-time skin dose map are important for dose optimization. Clinical audit and better QA processes together with more studies on the impact of lens opacities in clinical practice and on paediatric patients are needed.     

A neutron activation technique for manganese measurements in humans

Manganese (Mn) is an essential element for humans, animals, and plants and is required for growth, development, and maintenance of health. Studies show that Mn metabolism is similar to that of iron, therefore, increased Mn levels in humans could interfere with the absorption of dietary iron leading to anemia. Also, excess exposure to Mn dust, leads to nervous system disorders similar to Parkinson's disease. Higher exposure to Mn is essentially related to industrial pollution. Thus, there is a benefit in developing a clean non-invasive technique for monitoring such increased levels of Mn in order to understand the risk of disease and development of appropriate treatments.To this end, the feasibility of Mn measurements with their minimum detection limits (MDL) has been reported earlier from the McMaster group. This work presents improvement to Mn assessment using an upgraded system and optimized times of irradiation and counting for induced gamma activity of Mn. The technique utilizes the high proton current Tandetron accelerator producing neutrons via the ⁷Li(p,n)⁷Be reaction at McMaster University and an array of nine NaI (Tl) detectors in a 4π geometry for delayed counting of gamma rays. The neutron irradiation of a set of phantoms was performed with protocols having different proton energy, current and time of irradiation. The improved MDLs estimated using the upgraded set up and constrained timings are reported as 0.67 μgMn/gCa for 2.3 MeV protons and 0.71 μgMn/gCa for 2.0 MeV protons. These are a factor of about 2.3 times better than previous measurements done at McMaster University using the in vivo set-up. Also, because of lower dose-equivalent and a relatively close MDL, the combination of: 2.0 MeV; 300 μA; 3 min protocol is recommended as compared to 2.3 MeV; 400 μA; 45 s protocol for further measurements of Mn in vivo.     

Vanadium levels in urine and cystine levels in fingernails and hair of exposed and normal persons

Vanadium was determined by radiochemical neutron activation analysis (RNAA) with proven accuracy in urine of workers occupationally exposed to vanadium-rich dust in a vanadium pentoxide production plant, and values in the range of 3.02–762 ng/mL (median 33.0 ng/mL) were found. In a control group consisting of administrative workers of the plant, urinary vanadium levels were found in the range of 1.05–53.4 ng/mL (median 2.53 ng/mL), whereas in an another control group of occupationally nonexposed persons, these values amounted to 0.066–0.489 ng/mL (median 0.212 ng/mL). Accuracy of the results was tested by analysis of reference material IAEA A-13 Animal Blood and NIST SRM-1515 Apple Leaves, and very good agreement was found with literature and the NIST certified values, respectively. Unlike urine, no significant differences were found for cystine levels in fingernails and hair of exposed and control persons.     

Cues from injured Daphnia and from cyclopoids feeding on Daphnia can modify life histories of conspecifics

Size, age and number of offspring at the first and subsequent tworeproductions were compared in Daphnia treated with cues frominvertebrate predators (adult Cyclopoida fed Daphnia)and from crushed conspecifics. Daphnia in the presence ofinvertebrate predators had earlier maturation, greater size atfirst and subsequent reproductions and a larger number of offspringthan control animals, while the opposite (later maturation andsmaller size at subsequent reproductions) happened when Daphnia were treated with homogenate from crushedconspecifics.     

Curcumin-loaded cockle shell-derived calcium carbonate nanoparticles: A novel strategy for the treatment of lead-induced hepato-renal toxicity in rats

Lead (Pb) toxicity affects the hepatic and renal systems resulting to homeostasis imbalance. Curcumin is a strong antioxidant but has restrained clinical applications due to its poor bioavailability. Nanomedicine showed promising potentials in drug delivery and has brought forth the use of cockle shell-derived aragonite calcium carbonate nanoparticles (CSCaCO₃NP) to enhance the effectiveness and targeted delivery of curcumin (Cur). Thus, this study aimed at evaluating the therapeutic effect of curcumin-loaded CSCaCO₃NP (Cur- CSCaCO₃NP) on lead-induced hepato-renal toxicity in rats. Thirty-six male adults Sprague-Dawley rats were randomly assigned into five groups. All groups contained six rats each except for group A, which contained 12 rats. All rats apart from the rats in group A (control) were orally administered a flat dose of 50 mg/kg of lead for four weeks. Six rats from group A and B were euthanized after four weeks of lead induction. Oral administration of curcumin (100 mg/kg) for group C and Cur-CSCaCO₃NP (50 and 100 mg/kg) for groups D and E respectively, commenced immediately after 4 weeks of lead induction which lasted for 4 weeks. All rats were euthanized at the 8th week of the experiment. Further, biochemical, histological and hematological analysis were performed. The findings revealed a biochemical, hematological and histological changes in lead-induced rats. However, treatments with the Cur-CSCaCO₃NP and free curcumin reversed the aforementioned changes. Although, Cur-CSCaCO₃NP presented better therapeutic effects on lead-induced toxicity in rats when compared to free curcumin as there was significant improvements in hematological, biochemical and histological changes which is parallel with attenuation of oxidative stress. The findings of the current study hold great prospects for Cur-CSCaCO₃NP as a novel approach for effective oral treatment of lead-induced hepato-renal impairments.     

油田野外作业工人慢性疾病调查及职业紧张与神经递质的相关性研究

目的:调查油田野外作业工人慢性疾病患病情况,分析职业紧张与神经递质的相关性。方法:通过整群抽样的方式选取油田野外作业工人2000例作为研究对象,采用自制的慢性非传染性疾病调查量表对所有工人的慢性疾病情况予以调查,采用职业紧张量表对所有工人的职业紧张情况予以调查。采用酶联免疫吸附法检测所有工人血清五羟色胺、去甲肾上腺素以及神经肽Y水平,并采用偏相关分析油田野外作业工人职业紧张与神经递质的相关性。结果:2000例油田野外作业工人慢性疾病发病率最高的前三种疾病分别为颈腰部疾病、高血压、高血脂,占比分别为20.60%、15.35%、11.20%。油田野外作业工人中男性职业任务、个体应对资源评分高于女性,而锻炼工人的个体紧张反应评分低于不锻炼工人(P0.05)。油田野外作业工人中饮酒工人神经肽Y水平低于不饮酒工人,锻炼工人的去甲肾上腺素水平高于不锻炼工人(P0.05)。经偏相关分析可得:油田野外作业工人的职业任务评分与五羟色胺、去甲肾上腺素水平呈正相关(P0.05),个体紧张反应评分与神经肽Y水平呈负相关(P0.05)。结论:油田野外作业工人慢性疾病患病情况不容乐观,且其职业紧张与神经递质存在密切相关,在临床工作中可通过改善油田野外作业工人的职业紧张,从而达到改善其神经递质水平的目的。     

The use of fine-wire EMG to investigate shoulder muscle recruitment patterns during cello bowing: The results of a pilot study

The physical mechanics of music making is important both in the prevention of injuries and in guiding how music is performed and taught. Electromyography has potential as a resource in understanding the loads involved in instrumental playing; however, only a small number of projects have been undertaken, and little is understood on the muscle activity used during bowing on string instruments. This study aimed to measure the muscle activity at the bowing shoulder of a cellist during cello playing and to establish if fine-wire EMG is useful in understanding muscle recruitment in string players without interfering with normal playing ability. This project used a combination of fine-wire and surface EMG to evaluate the muscular load placed on the right shoulder of a professional cellist whilst playing a set of various bowing exercises. The results indicated that different bowing techniques produced statistically different muscle activity levels, with the supraspinatus muscle in particular maintaining higher mean contraction (20% MVC) during all bowing patterns tested. Fine-wire EMG was useful in measuring shoulder muscle load and did not interfere with normal playing technique of the subject. Overall, the study presents a working protocol from which future studies may be able conduct further research.     

alpha-Fluoro beta alanine in urine of workers occupationally exposed to 5 fluorouracil in a 5 fluorouracil producing factory

Because of possible harmful health effects increased attention is being paid to the occupational exposure to cytostatic drugs of workers in hospitals and industry. In this study a biomarker for exposure to 5-fluorouracil (5FU) based on GC-MSMS was applied to study the occupational exposure of four workers in a pharmaceutical factory producing 5FU. The four workers all excreted-fluoro--alanine (FBAL), a metabolite of 5FU, via the urine (range excretion rates: 0-88 9 g per 8h). This is in accordance with the presence of 5FU and/or its precursor ethoxyfluorouracil (EFU) in stationary and personal air wipe samples taken from the the workplace.     

Effects of Lifetime Exposure to Shiftwork on Fitness for Duty in Police Officers

Aging and demographic changes in Europe and other global economies have led to a discussion about postponing the legal retirement age; however, health and safety consequences for the workforce have not yet been examined. Thus, the aim of this study was to investigate the effects of lifetime exposure to shiftwork on health impairments and fitness for duty. Two samples of the police force from one of the states of the Federal Republic of Germany were used. One sample was collected in 2008–2009 with a self-administered Internet questionnaire (n?=?705); the other sample was derived from employment records provided by the police force of the same federal state for the years 2002–2009 (n?=?2460). Both samples contained information about the number of years worked in shiftwork across the entire working life and impairments to fitness for duty assessed by occupational physicians. Thus, the number of years of shiftwork until the diagnosis of the first reduction in fitness for duty could be calculated. Survival analyses were performed to estimate the risk (hazard rate) for experiencing a reduction in fitness for duty across lifetime exposure to shiftwork in years, controlling for age, sex, work type, and police district. Hazard estimates were compared across both samples to cross-validate the results. The findings indicated an increase in the risk of reduced fitness for duty with increasing number of years in shiftwork during the working life in both samples. The hazard rates followed an exponential trend, indicating a rapid increase in health impairments in particular beyond 20 yrs of shiftwork. These findings were consistent in both samples, collected with different methods and over different time periods, thus indicating high validity. Therefore, occupational stress factors, such as exposure to shiftwork, need to be taken into account when discussing the postponement of the legal retirement age. (Author correspondence: anna.wirtz@gawo-ev.de)