A new cationic palladium(II) dithiocarbamate exhibits anti-inflammatory, analgesic, and antipyretic activities through inhibition of inflammatory mediators in in vivo models

Inflammation is being a protective mechanism of the body towards the injury. However, chronic and progressive inflammation may lead to some chronic diseases. Due to the serious unwanted effects associated with available drugs, new and safe anti-inflammatory agents are still required. Therefore, the present study was designed to investigate the anti-inflammatory, analgesics, and antipyretic properties of a new compound (4-benzylpiperidine-1-carbodithioato-κ2S,S')(1,4-bis-(diphenylphosphino)butane)palladium(II)chloride monohydrate (compound-1) in albino mice models. Compound-1 was characterized by elemental analysis, FT-IR, and multinuclear NMR spectroscopy. Initially, compound-1 was evaluated for cytotoxicity, anti-inflammatory, and analgesic activities by performing MTT assay, carrageenan-, histamine-, serotonin-, and CFA-induced paw edema, mechanical hyperalgesia, thermal hyperalgesia, and mechanical allodynia (0.1, 1, and 10 mg/kg, b.w). Antipyretic activity was evaluated in brewer's yeast-induced model. The pro-inflammatory cytokines were measured by using commercially available ELISA kits. Additionally, nitrite production, antioxidant enzymes, H&E staining, muscle activity and motor coordination, and kidney and liver function tests were also determined. The results demonstrated that compound-1 significantly inhibited inflammation, pain, and febrile responses in all models at a dose of 10 mg/kg without effecting viability of cells in vitro at concentrations up to 100 μM. Similarly, the data clearly demonstrated significant reduction in the pro-inflammatory cytokines and nitrite production while enhancing antioxidant enzymes. Furthermore, pretreatment with compound-1 did not produce any prominent side effect on kidney, liver, stomach, and muscles. These findings suggest that compound-1 has potent anti-inflammatory-, pain-, and pyrexia-relieving properties. Hence, compound-1 might be a potential candidate for the therapeutic management of chronic inflammation and pain.

Rapid Colorimetric Detection of Cartap Residues by AgNP Sensor with Magnetic Molecularly Imprinted Microspheres as Recognition Elements

The overuse of cartap in tea tree leads to hazardous residues threatening human health. A colorimetric determination was established to detect cartap residues in tea beverages by silver nanoparticles (AgNP) sensor with magnetic molecularly imprinted polymeric microspheres (Fe₃O₄@mSiO₂@MIPs) as recognition elements. Using Fe₃O₄ as supporting core, mesoporous SiO₂ as intermediate shell, methylacrylic acid as functional monomer, and cartap as template, Fe₃O₄@mSiO₂@MIPs were prepared to selectively and magnetically separate cartap from tea solution before colorimetric determination by AgNP sensors. The core-shell Fe₃O₄@mSiO₂@MIPs were also characterized by FT-IR, TEM, VSM, and experimental adsorption. The Fe₃O₄@mSiO₂@MIPs could be rapidly separated by an external magnet in 10 s with good reusability (maintained 95.2% through 10 cycles). The adsorption process of cartap on Fe₃O₄@mSiO₂@MIPs conformed to Langmuir adsorption isotherm with maximum adsorption capacity at 0.257 mmol/g and short equilibrium time of 30 min at 298 K. The AgNP colorimetric method semi-quantified cartap ≥5 mg/L by naked eye and quantified cartap 0.1–5 mg/L with LOD 0.01 mg/L by UV-vis spectroscopy. The AgNP colorimetric detection after pretreatment with Fe₃O₄@mSiO₂@MIPs could be successfully utilized to recognize and detect cartap residues in tea beverages.

Analysis on curative effects and safety of 2% liranaftate ointment in treating tinea pedis and tinea corporis & cruris

The paper is intended to analyze and evaluate the specific curative effect and safety of 2% liranaftate ointment in treating patients with tinea pedis and tinea cruris. 1,100 cases of patients with tinea pedis and tinea corporis & cruris were selected as research objects and were divided into two groups according to the random number table method. They were treated with different methods: 550 cases of patients were treated with 2% liranaftate ointment for external use in the observation group and the rest 550 cases of patients were treated with 1% bifonazole cream in the control group. The treatment time was two weeks for patients with tinea corporis & cruris and four weeks for those with tinea pedis respectively. Meanwhile, the one-month follow-up visit was conducted among the patients to compare the curative effects of two groups. After the medication, the curative effectiveness rate was 87.65% (482/550) in the observation group, while that was 84.91% (467/550) in the control group. After the average follow-up visits of (15.5±2.4), the curative effectiveness rate 96.55% (531/550) in the observation group, while that was 91.45% (503/550) in the control group. Two groups of patients recovered well with a low incidence of adverse reactions in the treatment, and the overall curative effect was good with the inter-group difference at P>0.05, so it was without statistical significance. The curative effect of 2% liranaftate ointment is safe and obvious in treating tinea pedis and tinea corporis & cruris, so it is valuable for clinical popularization and application.

[Dangerous cucumbers - Leylls syndrome]

Leylls syndrome (syndrome of toxic epidermal necrolysis) is a rare disease, firstly described by Scottish doctor of medicine Allan Lyell in 1956. It is characterized by huge skin and mucosa necrolysis, which affects at least 30 % of body surface, and systemic symptoms. According to the frequency of the occurrence it is an extremely rare condition, with an incidence of 0.5-2 cases per million residents per year. Leylls syndrome is considered as a toxoallergic reaction, triggered mostly by some medication and it is associated with a very high mortality rate (in the literature reported between 30 to 90 %). Adequate and timely local and systemic treatment at the Intensive Care Unit or at the specialized clinic can improve the overall poor prognosis of the patients. In our case report we describe a very rare case of the Lyells syndrome after exposure to the antifungal organosulfur compound, which is widely used by the homegardners and farmers.

Chemical changes in rubber allergens during vulcanization

Allergic contact dermatitis to rubber is caused by residues of chemicals used in manufacturing a rubber product. Several different additives are used to achieve a final product of the desired characteristics. Accelerators such as thiurams, dithiocarbamates, and mercaptobenzothiazoles are often among the additives responsible for allergic reactions recognized by dermatologists. The chemistry of the vulcanization process is complicated; as it occurs at an elevated temperature with a mixture of reactive chemicals, the compositions of the initial and final products differ. This paper investigates the changes in composition of common allergens during vulcanization, doing so by chemically analysing various rubber formulations at different stages of the process. Major changes were found in which added chemicals were consumed and new ones produced. An important observation is that thiuram disulfides rarely appear in the final rubber although they may have been used as additives. Instead, thiurams are often converted to dithiocarbamates or to products formed by addition to mercaptobenzothiazole structures, if these have been used together with thiurams as accelerators.

[Safety, biodistribution, and dosimetry of myocardial imaging agent 99Tc(m)N-NOET in healthy volunteers]

OBJECTIVE

To study the safety, biodistribution, and dosimetry of myocardial perfusion imaging agent 99Tc(m)N-NOET in 10 healthy volunteers.

METHODS

744-792 MBq of 99Tc(m)N-NOET was injected to each volunteer. Safety parameters and adverse event was measured in 24 hours of injection. Biodistribution was studied by whole-body imaging 1, 30 minutes, 1, 2, 4, 8, and 24 hours after the injection of 99Tc(m)N-NOET. The estimation of dosimetry was based on the standard medical internal radiation dose method using MIRDOSE 3.0 analysis program. Myocardial single photon emission computed tomography (SPECT) imaging was performed at 1 and 4 hours after injection.

RESULTS

No undesirable effects were reported by the subject during 24 hours after injection of 99Tc(m)N-NOET. No clinically significant changes were found in vital signs (heart rate, blood pressure, and electrocardiogram). No biochemical aspects and serology changes were measured. The myocardial SPECT imaging was clear. Cardiac uptake of 99Tc(m)N-NOET was as high as 2.68% at 2 hours after injection. The heart to lung ratio was more than 1 from 30 minutes after injection, reaching a maximum of 1.91 +/- 0.53 at 2 hours after injection. Radiation dosimetry calculations indicated an effective absorbed dose of 1.28 x 10(-5) Sv/MBq. The dosimetry in each main organ is lower then 50 mGy given 740 MBq of 99Tc(m)N-NOET in once imaging.

CONCLUSIONS

99Tc(m)N-NOET exhibits high cardiac uptake and low estimated effective absorbed dose. It's a safe myocardial perfusion imaging agent.

Contact dermatitis to a rubber allergen with both dithiocarbamate and benzothiazole structure

Contact dermatitis to rubber products are often caused by additives used during manufacture, and diagnosed from patch test with established rubber allergen series. In these series the compounds are divided into separate groups such as thiurams, dithiocarbamates and mercaptobenzothiazoles. The objectives were to investigate the substances with allergenic structures present in a diving mask giving rise to facial dermatitis, also those substances including structures from different groups of rubber chemicals. The rubber material was analysed by high-performance liquid chromatography and diode-array detector. The patient was tested by epicutaneous tests using pure substances, extracts and authentic rubber material. 2-Benzothiazolyl-N,N-diethylthiocarbamylsulfide, was found in the diving mask and the patient showed positive reaction to the pure compound and to extracts of the diving mask. This compound has structures of both mercaptobenzothiazole and thiuram/dithiocarbamate in its formulae. Besides the established groups of rubber accelerators, uncommon allergens with structures from more than one group can be formed or added at vulcanization. Chemical analysis of the product is needed to find these allergens.

Our recent experiences with sarin poisoning cases in Japan and pesticide users with references to some selected chemicals

Attention has been paid to neurobehavioral effects of occupational and environmental exposures to chemicals such as pesticides, heavy metals and organic solvents. The area of research that includes neurobehavioral methods and effects in occupational and environmental health has been called "Occupational and Environmental Neurology and Behavioral Medicine." The methods, by which early changes in neurological, cognitive and behavioral function can be assessed, include neurobehavioral test battery, neurophysiological methods, questionnaires and structured interview, biochemical markers and imaging techniques. The author presents his observations of neurobehavioral and neurophysiological effects in Tokyo subway sarin poisoning cases as well as in pesticide users (tobacco farmers) in Malaysia in relation to Green Tobacco Sickness (GTS). In sarin cases, a variety effects were observed 6-8 months after exposure, suggesting delayed neurological effects. Studies on pesticide users revealed that organophosphorus and dithiocarbamate affected peripheral nerve conduction and postural balance; subjective symptoms related to GTS were also observed, indicating the effects of nicotine absorbed from wet tobacco leaves. In addition, non-neurological effects of pesticides and other chemicals are presented, in relation to genetic polymorphism and oxidative stress.

Screening for pesticide exposure: a case study

Pesticide use is ubiquitous in the United States in both agricultural and urban environments. Although pesticide exposure can occur anywhere, migrant and seasonal farmworkers in medically underserved communities are at particular risk. Health care providers often feel ill-equipped to recognize or manage pesticide exposure or pesticide-related illness. In 2002, the National Environmental Education Foundation published a series of reports that describe national goals for improving the recognition, management, and prevention of pesticide-related health conditions. This article illustrates how to diagnose and manage pesticide exposures by analyzing a pesticide exposure case using a framework suggested by the National Environmental Education Foundation. Basic screening techniques and available resources for use in the primary care setting are presented.

Weed control in rice with metham-sodium

Metam-sodium is a soil fumigant with herbicidal properties. A field experiment was conducted in 2000 at Copiano (Pavia, Italy) to determine the efficacy of three rates of metam-sodium (300, 450 and 600 l/ha) at three different planting times (5, 12 and 18 days after chemical treatments) for the control of weeds in rice cultivation. The study mainly focused on the control of red rice (Oryza sativa var. selvatica), a weed which is worldwide distributed in rice fields and difficult to eradicate Test design was a split-plot with four replications. The main plot size was 13, 5 by 15 m and the subplot size was 13, 5 by 5 m. The chemical treatments were carried out as pre-sowing. Two days after chemical treatments, all field plots were flooded with 10 cm of water as practiced locally. An early variety of rice (Loto) was sown at 150 kg/ha. Weed control was visually evaluated as a percentage of ground covering by all weeds and by each weed individually at three, four and five weeks after treatments. Observations were made also on rice selectivity, and rice grain yield was assessed at the end. Metam-sodium did not injure the rice plants. Metam-sodium at 450 l/ha controlled 100%, 97% and 92% of red rice at the first, second and third observations, respectively. Good results were also obtained with metam-sodium at 300 and 600 l/ha, which controlled 94 to 82% of red rice during the season. Echinochloa crus-galli was better controlled with the higher rates of metam-sodium, particularly in the early part of the season. Metam-sodium did not show enough efficacy in this study against Heteranthera reniformis, Bulboschoenus maritimus and Lindernia spp. The best rice grain yield was obtained with all rates of metam-sodium, when rice was sown 5 days after treatment.

Comparative efficacy of different dithiocarbamates to induce tibial dyschondroplasia in poultry

Tibial dyschondroplasia (TD) is a metabolic cartilage disease in poultry the natural etiology of which is not known. In the absence of biomarkers to monitor the initiation and progression of the naturally occurring disease, experimentally induced TD can provide a suitable venue to study the mechanism of its pathogenesis. Therefore, the objective of this study was to establish a streamlined experimental protocol to induce TD using dithiocarbamates and to determine a time course of its progression. Three different dithiocarbamates, dimethyldithiocarbamate, pyrrolidine dithiocarbamate, and tetramethyl thiuram disulfide (thiram), were tested with respect to their abilities to induce TD and affect different physiological factors. Our results show that chickens fed thiram during the first 2 wk of age showed a maximum TD index. Thiram appeared to be the most potent of the 3 dithiocarbamates with dimethyldithiocarbamate having the least ability to induce TD and pyrrolidine dithiocarbamate showing an intermediate potency. A transient exposure to thiram for a day or 2 was sufficient to markedly increase the incidence of TD and produce lasting damage as determined by the presence of severe lesions in a high percentage of birds at 2 to 3 wk after the treatment. Thiram affected the chondrocyte morphology of maturing zone cartilage evident by nuclear shrinkage and emptied chondrocyte lacunae during later times and also involutions of capillary vessels. Such changes were not seen in prehypertrophic zone chondrocytes of the same growth plates. Thiram reduced the BW, increased blood heterophil-to-lymphocyte ratios, and elevated serum corticosterone concentrations indicating physiological stress. However, there was no change in relative liver weights or blood clinical chemistry including the serum concentrations of Ca, P, and Cu in thiocarbamate-fed chickens. Induction of TD in young chickens by means of a short feeding protocol with thiram may be useful to study the mechanisms of pathogenesis of TD and to identify micronutrients that can provide protection against this disease.

Occupational rubber glove allergy: results of the Information Network of Departments of Dermatology (IVDK), 1995-2001

About 21% of the patients with occupational contact dermatitis registered in the Information Network of Departments of Dermatology (IVDK) in the years 1995-2001 were patch tested due to suspected rubber glove allergy. We analysed reaction frequencies to thiurams, dithiocarbamates, mercaptobenzothiazole (MBT) and its derivatives, thioureas, and 1,3-diphenylguanidine (1,3-DPG). Thiurams were by far the most frequent rubber allergens in these patients (16.2% positive reactions, age- and sex-standardized), and the reaction frequency showed a decline from 20.9% in 1997 to 12.8% in 2000. However, this trend was not statistically significant, and was followed by an increase to 16.5% in 2001. All other rubber allergens showed no time trend at all. Although, according to manufacturers' information, the use of dithiocarbamates and MBT derivatives in rubber glove production increased in recent years, these allergens elicited positive reactions in only about 3% of the patients tested, and showed no increasing trend. Thioureas and 1,3-DPG are not widely used in rubber glove production, and play only a minor role in rubber glove contact allergy. Most of the positive reactions to 1,3-DPG are probably false-positive, irritant reactions.

Synthesis of a new platinum(II) complex: anticancer activity and nephrotoxicity in vitro

New mixed dithiocarbamate-amino Pt(II) complex ([Pt(ESDT)(Py)Cl]) has been recently synthesised with the aim to produce potential anticancer drug able to conjugate cytostatic activity with lack of nephrotoxicity. This complex contains: (1) an amino ligand; (2) a good leaving group (halide); and (3) an S-containing chelating agent potentially able to protect the metal centre from its interaction with S-containing protein-legating sites that are believed to be at the basis of the nephrotoxicity of Pt(II)-based drugs. This complex has been found to be effective as an antiproliferative agent (more active than cis-platin) towards a normal human adenocarcinoma cell line and the corresponding cis-platin-resistant C13 strain. Toxicity tests on the kidney were performed by means of a renal cortical slice model. The slices, prepared with a Brendel-Vitron slicer, were incubated with different doses (0.125-5.0 x 10(-4) M, final concentration) of [Pt(ESDT)(Py)Cl] or cis-platin dissolved in methyl sulphoxide. The platinum(II) complex showed very low renal cytotoxicity as compared with cis-platin; in particular, lipid peroxidation induced by cis-platin appeared about five-fold higher than that induced by [Pt(ESDT)(Py)Cl]. In conclusion, besides being less toxic for the kidney, the results showed that the new synthesised platinum(II) complex appeared in vitro more effective than cis-platin when tested on sensitive and resistant cis-platin tumour cell lines.

[Some etiologic factors in condom-induced allergic contact balanitis]

Clinical cases presenting allergic contact balanitis from condoms are studied using a combination of patch testing and chemical analysis by gas chromatography and high-resolving liquid chromatography to identify the causative agents involved. It has been previously established that zinc ethylphenyl dithiocarbamate (ZEPC)--a dithiocarbamate-type accelerant (DTC)--is an etiological factor in the event of contact allergy to condoms. Later it is confirmed that DTCs, such as zinc dimethyl dithiocarbamate (ZDMC), zinc diethyl dithiocarbamate (ZDEC) and zinc dibutyl dithiocarbamate and amines, such as dimethylamine (DMA), diethylamine (DEA) and piperidine (PIP) are likewise implicated in condom-induced contact balanitis. As shown by the investigation along this line, although thiurams are believed to be more allergenic, as compared to the corresponding DTCs and amines, both DTCs (ZDMC, ZDEC, ZDBC, ZEPC) and amines (DMA, DEA and PIP) are noteworthy etiological factors of allergic contact balanitis from condoms.

Patch testing discordance alert: false-negative findings with rubber additives and fragrances

From July 1996 through June 1998, the North American Contact Dermatitis Group evaluated 318 patients for suspected contact dermatitis by patch testing simultaneously with Finn Chambers and the T.R.U.E. Test allergen system. Discrepancies between the two systems were found in some of the results, particularly with fragrance and rubber allergens. These results suggest that positive reactions to fragrance, thiuram, and carba mix allergens may be missed if the T.R.U.E. Test is used alone.

An exploratory analysis of the effect of pesticide exposure on the risk of spontaneous abortion in an Ontario farm population

The toxicity of pesticides on human reproduction is largely unknown--particularly how mixtures of pesticide products might affect fetal toxicity. The Ontario Farm Family Health Study collected data by questionnaire on the identity and timing of pesticide use on the farm, lifestyle factors, and a complete reproductive history from the farm operator and eligible couples living on the farm. A total of 2,110 women provided information on 3,936 pregnancies, including 395 spontaneous abortions. To explore critical windows of exposure and target sites for toxicity, we examined exposures separately for preconception (3 months before and up to month of conception) and postconception (first trimester) windows and for early (< 12 weeks) and late (12-19 weeks) spontaneous abortions. We observed moderate increases in risk of early abortions for preconception exposures to phenoxy acetic acid herbicides [odds ratio (OR) = 1.5; 95% confidence interval (CI), 1.1-2.1], triazines (OR = 1.4; 95% CI, 1.0-2.0), and any herbicide (OR = 1.4; 95% CI, 1.1-1.9). For late abortions, preconception exposure to glyphosate (OR = 1.7; 95% CI, 1.0-2.9), thiocarbamates (OR = 1.8; 95% CI, 1.1-3.0), and the miscellaneous class of pesticides (OR = 1.5; 95% CI, 1.0-2.4) was associated with elevated risks. Postconception exposures were generally associated with late spontaneous abortions. Older maternal age (> 34 years of age) was the strongest risk factor for spontaneous abortions, and we observed several interactions between pesticides in the older age group using Classification and Regression Tree analysis. This study shows that timing of exposure and restricting analyses to more homogeneous endpoints are important in characterizing the reproductive toxicity of pesticides.

Agricultural exposure to carbamate pesticides and risk of non-Hodgkin lymphoma

Recent epidemiological studies have suggested an increased risk of non-Hodgkin lymphoma (NHL) from carbamate insecticide use among farmers. To further explore the possible relationships, we conducted a pooled analysis of three population-based case-control studies conducted in four midwestern states in the United States. A total of 985 white male subjects and 2895 control subjects were included in this analysis. Unconditional logistic regression was used to estimate the association and control for confounding. Compared with nonfarmers, farmers who had ever used carbamate pesticides had a 30% to 50% increased risk of NHL, whereas farmers without carbamate pesticide use showed no increased risk. Analyses for individual carbamate pesticides found a more consistent association with Sevin but not carbofuran, butylate, or S-ethyl dipropylthiocarbamate plus protectant. Among farmers using Sevin, the risk of NHL was limited to those who personally handled the product, those who first used the product for > or = 20 years before their disease diagnosis, and those who used the product for a longer period. These associations persisted after adjusting for other major classes of pesticides. These results suggest an increased risk of NHL associated with carbamate pesticide use, particularly Sevin. Further investigation of the association is warranted.

Allergologically relevant rubber accelerators in single-use medical gloves

To prevent contact with specific rubber accelerators, sensitized patients have to know in which glove brands these accelerators are present. Additionally, quantitative measurements of the bioavailable amounts of accelerators are needed to assist consumers in selecting gloves with the lowest possible amount of residual rubber accelerators. The aim of the study was to develop an analytical method by which residuals of rubber accelerators in single-use medical gloves could be determined qualitatively and quantitatively. 19 different glove brands were analysed for content of accelerators, and the results were compared to manufacturers' ingredient claims of the identical gloves. ZDEC, ZDBC, ZMBT and ZPC were the most frequently detected chemicals. In 9 of 15 gloves discrepancies were found, usually minor, between content of accelerators declared by manufacturers to be present and accelerators detected by analysis. Both phosphate buffer and acetone were tested as extraction media. No accelerators were detectable with the described chemical analysis in phosphate extracts, whereas acetone was demonstrated to be a technically suitable medium for extraction. However, more kinetic studies of the extraction procedure and studies of skin penetration are needed to document that the extraction procedure simulates the clinical situation.

Fumigant-related illnesses: Washington State's five-year experience

OBJECTIVE

Exposure to fumigants may have severe or persistent health effects. Washington State's fumigant-related illnesses were reviewed to better understand the circumstances surrounding exposure and resultant health effects.

METHODS

Fumigant-related illnesses reported to and investigated by the Washington State Department of Health were reviewed. Illnesses considered by Department of Health to be definitely, probably, or possibly related to pesticide exposure were then analyzed.

RESULTS

From 1992-1996, 39 (3.3%) of 1192 definite, probable, or possible cases of pesticide-related illnesses involved exposures to fumigants. Fumigant exposures during this period were to aluminum phosphide (15), methyl bromide (12), metam-sodium (9), and zinc phosphide (3). Symptoms included respiratory problems and eye and/or skin irritation for the majority of exposures, and no deaths were reported. The nature of exposure for these cases included exposure to applicators (17), reentry into a fumigated structure (9), improper storage or disposal (6), reentry into treated agricultural fields (4), drift from treated fields (2), and other (1).

CONCLUSIONS

Review of fumigant exposures should be used to prevent future events through continued enforcement of established regulations and training of applicators.

Value of patch testing in atopic dermatitis

BACKGROUND

Because patients with atopic dermatitis are less prone to type IV allergies, there has been controversy regarding the role of patch testing in these patients.

OBJECTIVE

The present study was conducted to evaluate the role of patch testing in atopic individuals.

METHODS

One-hundred patients with hand eczema were patch tested using the standard patch test battery (HERMAL, Kurt Herrmann, Reinbek, West Germany) and the Finn chamber units. The total immunoglobulin class E (IgE) level was determined and correlated to the results of patch testing.

RESULTS

Eighty-seven patients had positive patch test reactions. Among the 87 patients, 39 (44.8%) had atopic dermatitis. The most common allergens yielding positive results were nickel sulfate, 2.5%, (58.6%); potassium dichromate, 0.25% (56.3%); carba mix, 3%, (44.82%); formaldehyde, 1% in H2O, (40.22%); neomycin sulfate, 20%, (33.3%); and balsam of Peru 25%, (17.24%) respectively. Patients with atopic dermatitis were more frequently sensitive to neomycin sulfate than nonatopics.

CONCLUSION

Patients with atopic dermatitis should be patch tested when indicated because they also develop contact allergic sensitization to a significant degree. Our observations indicate that patch testing with standard allergens often adds valuable information about contact sensitivity in these patients.

Delayed and immediate orofacial reactions following contact with rubber gloves during dental treatment

Allergic reactions during or after dental examination are uncommon. However, such reactions may be serious and distressing. Allergy to local anaesthetics and dental materials may be considered, but reactions to rubber in gloves worn by the dentist should be remembered. Two patients are reported who experienced symptoms following contact with rubber gloves worn by their dentists, with skin tests subsequently showing an allergic reaction to glove constituents, and in one case latex. With the increasing use of rubber gloves by dental and medical personnel, reactions in sensitised patients are likely to become more common. In patients with a history of symptoms related to dental work, it is important to remember delayed and immediate reactions to rubber.

Irritant dermatitis among workers cleaning up a pesticide spill: California 1991

An outbreak of dermatitis occurred among county jail inmates who removed dead fish from the Sacramento River in California after a spill of metam sodium. The spilled chemical decomposes to methylisothiocyanate (MITC), a known skin irritant. A retrospective cohort study was conducted among the inmates and their crew leaders. Among 42 jail group members, 27 had dermatitis involving the feet and ankles; dermatitis was associated with lower extremity water contact (RR = 3.4, 95% CI 1.0-11.8); the attack rate increased with length of time spent in the water. For comparison, other state and federal employees who worked in the river at the same time were also interviewed. None reported dermatitis. Over three-quarters (24/31) of these other clean-up workers whose feet became wet changed to dry clothing immediately; none of the jail group changed immediately. The river concentration of MITC measured 20-40 ppb at the time of exposure. We speculate that prolonged wetness, occlusive boots, friction, and heat contributed to chemical irritation at this low concentration; the experience of the other clean-up workers suggests that this outbreak could have been prevented.

Persistent respiratory health effects after a metam sodium pesticide spill

STUDY OBJECTIVE

To report the occurrence of persistent respiratory disorders, including irritant-induced asthma, among adults living and working near an environmental spill of the pesticide, metam sodium, after the derailment of a tank car.

DESIGN

Retrospective clinical case series.

SETTING

California communities situated within one-half mile of the Sacramento River, from Mt. Shasta City to Shasta Lake.

PATIENTS

197 adults referred to a university occupational/environmental health clinic or to a private occupational/environmental health practitioner for evaluation of health problems potentially related to the spill.

MEASUREMENTS AND RESULTS

History, physical examination, review of medical records, spirometry, and methacholine challenge testing revealed 20 cases of persistent irritant-induced asthma and 10 cases of persistent exacerbation of asthma.

CONCLUSIONS

This is the first reported series of cases of persistent irritant-induced asthma involving both community residents and occupationally exposed individuals.

Dermatitis among workers cleaning the Sacramento River after a chemical spill--California, 1991

On July 14, 1991, a train tanker car derailed in northern California, spilling 19,000 gallons of the soil fumigant metam sodium (sodium methyldithiocarbamate) into the Sacramento River north of Redding (Figure 1). The major breakdown product of metam sodium, methylisothiocyanate (MITC), is a known skin irritant at high concentrations (greater than 1%). By July 21, the concentration of MITC in the river, at multiple test sites, measured 20-40 parts per billion (0.01%). On August 6, Shasta County health officials notified the California Department of Health Services (CDHS) of an outbreak of dermatitis among Shasta County jail inmates and crew leaders who had assisted in removing dead fish from the river on July 21-22 in greater than 100 F (greater than 38 C) ambient temperature.

[Experimental study of cardiotoxic effect of the pesticide sulfocarbathione]

Cardiotoxic and atherogenic effects of sulfocarbathione++ administered perorally and by inhalation to sexually mature white rats were studied. Besides, cardiotoxic effect was studied on the embryos and offspring of the exposed dams. Unfavourable effects of the pesticide on the myocardium of sexually mature animals, embryos, offspring were detected, as well as biochemical disorders of atherogenic character.

Ethylenethiourea in air and in urine as an indicator of exposure to ethylenebisdithiocarbamate fungicides

Ethylenethiourea (ETU) is a ubiquitous impurity of the ethylenebisdithiocarbamate (EBDC) fungicides widely used in agriculture and forestry. In the present study, ETU was used as a measure of the exposure to EBDC on potato farms and in pine nurseries during the application of EBDC fungicides and the weeding of the sprayed vegetation. Biological and hygienic monitoring was carried out through the analysis of ETU in the breathing zone and the urine of exposed workers. Even if the concentrations of ETU in the ambient air of pine nurseries exceeded those of potato farms, the concentrations of ETU in the urine of potato farmers exceeded those of pine nursery workers. This result may have been due better protective equipment in the pine nurseries. The excretion rate was 6-10 ng/h during the first 60 h after the cessation of exposure, and it diminished thereafter to 0.2 ng/h over a 22-d observation period.

Environmental and biological monitoring of exposure to ethylenebisdithiocarbamate fungicides and ethylenethiourea

Exposure of workers to ethylenebisdithiocarbamates (EBDCs; maneb or mancozeb) in 29 potato farms was evaluated during the control of potato late blight. Concentrations of EBDCs and ethylenethiourea (ETU), an impurity and degradation product in EBDC formulations, in ambient air were evaluated during pesticide application. Biological monitoring of exposure to EBDCs was carried out by measuring the concentrations of ETU, a metabolite of EBDCs, in urine for 22 days after the end of the exposure. The estimated inhaled doses of ETU and EBDCs during the average four hour application period were 0.07 and 1.8 micrograms/kg, respectively. Only 1-10% of ETU on the clothes reached the skin. The creatinine corrected concentrations of ETU in urine were 0.1-2.5 micrograms/mmol creatinine 24 hours after exposure ended. The estimated half life for eliminating ETU through the kidneys was close to 100 hours. These results indicate that the measurement of ETU in urine is suitable for biological monitoring of exposure to EBDCs.

Acute renal failure and nephrotic syndrome after maneb exposure. A new case with light and electron microscopic study

A new case of nephrotoxic effect of Maneb is related. The patient used this product as fungicide and developed a progressive illness with acute renal failure. The study by light and electron microscopy revealed severe tubular lesions that disappeared some months later with tubular cell regeneration. However, in spite of the renal function returning to normal, a steroid-dependent nephrotic syndrome persisted with glomerular minimal change like lesions.

Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication

Manganese (Mn) poisoning, a well-known hazard in miners and industrial workers, shares many features with Parkinson's disease. Two young agricultural workers with a parkinsonian syndrome, who mentioned exposure to the fungicide maneb (manganese ethylene-bis-dithiocarbamate), led us to investigate a new possible source of Mn intoxication. Fifty male rural workers with occupational exposure to maneb were compared with 19 rural workers without fungicide exposure. We noted significantly higher prevalence of plastic rigidity with cogwheel phenomenon, headache, fatigue, nervousness, memory complaints, and sleepiness in the exposed group. In addition, we saw other neurologic signs, such as postural tremor, cerebellar signs, and bradykinesia, although without statistical significance. The data suggest that occupational exposure to pesticides containing Mn is a possible source of Mn intoxication of the CNS.

Henoch-Schönlein purpura following thiram exposure

Henoch-Schönlein purpura (HSP) is an uncommon, nonthrombocytopenic hypersensitivity vasculitis that is often idiopathic, but may be induced by infectious agents, drugs, foods, environmental chemicals, or insect bites. To our knowledge, we report the first recognized case of HSP following exposure to the widely used industrial and agricultural agent, tetramethylthiuram disulfide. Few reports of HSP or other vasculitides resulting from exposure to structurally similar compounds are available. Despite the widespread use of tetramethylthiuram disulfide, many cases of exposure may remain unrecognized, resulting in a subsequent failure to properly identify sequelae.

Place of radioactive iodine in treatment of thyrotoxicosis

The effect of treatment of thyrotoxicosis with drugs, radioactive iodine, or surgery in different age groups is reviewed. In Graves' disease and toxic multinodular goitre the remission rate is about 40-50% after antithyroid drugs, but these drugs have little effect in toxic adenoma. Hypothyroidism developed in 35-49% of patients who had had thyroidectomy, and the risks of operation are high. The risk of malignant disease and genetic abnormalities was not significantly greater after treatment with radioactive iodine in any age group. In general, treatment with radioactive iodine should have priority over thyroidectomy at all ages.

Tibial dyschondroplasia in single-comb White Leghorn chicks fed tetramethylthiuram disulfide (a fungicide)

Supplementing a practical chick starter diet with 30 mg tetramethylthiuram disulfide per kg of diet produced tibial dyschondroplasia (TD) in single-comb white leghorn chicks without compromising growth or bone mineralization. The incidence and severity of the lesion increased over time, with the highest incidence (40%) occurring in 4-week-old chickens. Microscopically, the lesion was consistent with the description of TD in broilers. This is the first known report of TD in the layer-type chick, which heretofore was felt to be highly resistant to TD.

The problem of the sensitization to dithiocarbamates in thiuram-allergic patients

Because of the occurrence of hand dermatitis in members of a surgical staff due to allergy to thiuram-containing rubber gloves, an investigation was performed about cross-sensitization between thiuram compounds and dithiocarbamates. Positive reactions to dithiocarbamates were compared with reactions to 8 brands of hypo-allergenic or dithiocarbamate-containing surgical gloves. There appeared to be a marked difference in reactions to the dithiocarbamate-containing gloves. Some brands gave negative or nearly always negative reactions, while other brands caused many positive reactions. Thiuram-allergic patients were advised to wear nonreacting rubber gloves or PVC gloves.