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1976

CIS 76-1688 Maupas P., Goudeau A., Coursaget P., Drucker J., Bagros P.
Immunisation against hepatitis B in man.
An inactivated vaccine against hepatitis B (serum hepatitis) was administered to 96 people at a hospital in Tours (France). Results in 46 of them (mainly members of the ward staff or relatives of dialysis patients) are reported. A positive response - production of anti-HBs antibodies - was elicited in 35. The vaccine appears to protect against hepatitis B. A general outline of some of the difficulties encountered in developing a vaccine are published in the same issue of Lancet (Zuckerman A.J., p.1396-1397, 20 ref.), together with a general commentary of the question (p.1391).
Lancet, 26 June 1976, Vol.1, No.7974, p.1367-1370. 24 ref.

CIS 76-1228 Basic aspects of the safety philosophy of electrical equipment used in medical practice.
Aspects fondamentaux de la sécurité de l'équipement électrique utilisé dans la pratique médicale. [in French]
This report outlines the measures to safeguard the patient and the operator during the use of electrical equipment in medical practice. The following hazards are considered: electricity, radiation, ultrasound, mechanical hazards, excessive temperatures, fire, harmful liquids and gases, component or power breakdown, etc. The measures indicated concern safety of equipment (particularly electrical safety), safety of the installation (assembly of all wiring, switches, transformers and other parts intended to supply power to electrical equipment) and "application code" for safe use of equipment.
Publication 513, International Electrotechnical Commission, 1 rue de Varembé, 1211 Genève 20, Switzerland, 1976. 29p. Illus. Price: SF.39.00.

CIS 76-1453 Harrington J.M., Shannon H.S.
Incidence of tuberculosis, hepatitis, brucellosis, and shigellosis in British medical laboratory workers.
A retrospective questionnaire survey of 21,000 medical laboratory workers in England and Wales in 1971, and of 3,000 in Scotland in 1973, showed: 21 new cases of tuberculosis (5 times the rate in the general population), 38 cases of hepatitis, 45 cases of shigellosis (microbiology staff were twice as vulnerable as that of other pathology divisions), and one case of brucellosis. Tuberculosis definitely, and hepatitis and shigellosis possible, are still occupational hazards of British medical laboratory workers.
British Medical Journal, 27 Mar. 1976, Vol.1, no.6012, p.759-762. 19 ref.

CIS 76-1075 De Zotti R., Volpe S., Gobbato F.
Ethrane pollution in operation theatres
Inquinamento da ethrane nelle sale operatorie [in Italian]
Measurements of ethrane (2-chloro-1-(difluoromethoxy)-1,1,2-trifluoroethane) concentrations were made in the atmosphere of 4 operating theatres (2 with and 2 without forced ventilation), in the personnel's breathing zone and close to the outlet valve of the anaesthetic apparatus. The kinetics of the gas during the operation were studied. A significant correlation between the ethrane concentrations, which were relatively high when there was no ventilation system, and the logarithm of the exposure time was found. The possibility of pollution of the recovery room by the patient was also examined: the values measured were low. Possible preventive measures (exhaust ventilation, activated carbon filters) are briefly discussed.
Lavoro umano, Jan. 1976, Vol.28, No.1, p.1-9. Illus. 30 ref.

CIS 76-920 May T.W.
Explosion during halothane anaesthesia.
Halothane is generally regarded as a non-explosive anaesthetic. A case of halothane explosion during dental anaesthesia is described, with details of the conditions obtaining at the time of the incident. Possible causes are considered (atmospheric conditions, possibility of a potentially explosive mixture of halothane and nitrous oxide being present in the vaporiser, fired by static electricity. Earthing of apparatus should be considered, and anaesthetists should be reminded that halothane is not non-explosive.
British Medical Journal, 20 Mar. 1976, Vol.1, No.6011, p.692-693.

CIS 76-1148 Employment and conditions of work and life of nursing personnel.
L'emploi et les conditions de travail et de vie du personnel infirmier. [in French]
This report was prepared on the basis of the replies received (from 53 member States) to a questionnaire inviting comments, inter alia, on the conclusions of the ILO/WHO Joint Meeting on Conditions of Work and Life of Nursing Personnel (Geneva, 19-30 Nov. 1973), with a view to placing a corresponding item on the agenda of the 61st (1976) Session of the International Labour Conference (Report VII(1): CIS 76-256). The substance of the replies to each question is reproduced, with those from some non-governmental organisations consulted by the WHO in an annex. One section deals with health protection (paragraphs 147-153 of the ILO/WHO text). Commentary on the opinions expressed by governments, and Proposed Conclusions drafted by the ILO in consultation with the WHO on the basis of the replies.
Report VII (2), International Labour Conference, 61st Session 1976, International Labour Office, 1211 Genève 22, Switzerland, 1976. 85p. Price: SF.15.00.

1975

CIS 77-1365 Moffa J.P., Guckes A.D., Okawa M.T., Lilly G.E.
An evaluation of non-precious alloys for use with porcelain veneers - Part II: Industrial safety and biocompatibility
Evaluations des alliages non précieux utilisés avec les prothèses dentaires en porcelaine. 2e partie: Sécurité du travail et compatibilité biologique [in French]
Translation of this article published in Journal of Prosthetic Dentistry, St. Louis, USA, Oct. 1973, Vol.30, No.4, Part I, p.432-441. Illus. 9 ref. An air-sampling survey was conducted to determine whether or not the use of beryllium-containing non-precious alloys constitutes a dental occupational hazard. The biocompatibility of certain non-precious alloys was also assessed by means of animal implants. Results show that with proper local exhaust ventilation, non-precious beryllium-containing alloys may be used safely in dental laboratories. The biocompatibility study demonstrates that several non-precious alloys produce a mild histological response not significantly different from that produced by the control gold-based alloy and less than that produced by zinc oxide and engenol cement and silicate cement.
Traduction INRS 94 B-75, Institut national de recherche et de sécurité, 30 rue Olivier-Noyer, 75680 Paris Cedex 14, France, 1975. 19p. Illus. 9 ref.

CIS 77-756 Lévy A., Jourdan R.
Contamination by microorganisms in hospitals
Contaminations intra-hospitalières par microorganismes. [in French]
This book approaches the problem of contamination in hospitals from the dual aspects of epidemiology and prophylaxis. The authors analyse the problem and make suggestions for an optimum rational organisation of methods to prevent infection in hospitals, based on centralised planning, training in hygiene and reassessment of certain architectural concepts. Contents: specific epidemiological aspects of infection in hospitals; contamination sources; transmission and paths of entry of microorganisms; nature of microorganisms; control of infection transmitted within hospitals (sterilisation of equipment, disinfection, decontamination of fluids); services where prophylaxis can be effective (medical services, admissions and diagnosis units, general services, etc.); optimal conditions for efficacious prophylaxis (architectural design of hospitals, hospital hygiene service, recurrent staff training, etc.). Alphabetical subject index.
Editions Masson, 120 boulevard Saint-Germain, 75006 Paris, France, 1975. 227p. Illus. 474 ref.

CIS 77-579 Anthropometric features in relation to the dentist's workplace
Caractéristiques anthropométriques concernant le poste de travail du praticien de l'art dentaire. [in French]
This documentation sheet, which is a sequel to NF S 91-012 "The study of the working space of the dentist" (CIS 75-275), sets out in tabular form the anthropometric values used as a basis for calculating the dimensions of the working space (various body dimensions, interarticular segments), stressing the importance of eye-task distance.
Fascicule de documentation NS S 91-013, French Standards Association (Association française de normalisation), Tour Europe, 92080 Paris la Défense Cedex 7, France, Apr. 1975. 5p. Illus. 2 ref.

CIS 77-251 Centralised preparation of meal trays and dishwashing in hospitals
Central brickdukning och centraldisk [in Swedish]
These directives (entry into force: 1 Mar. 1977) concern the ergonomic design and layout and safety aspects of workposts in centralised facilities in hospitals for preparing meal trays and dishwashing. Contents: layout of tray preparation posts as regards space, working level, arm reach and other body movements; design of tray conveyors, dispensers and tray trolleys; cleaning of trolleys; layout and design of workposts for sorting and washing tableware and crockery (space, working level, arm reach and other body movements); loading and unloading dishwashing machines; labour-saving and safety devices. A note on safety aspects of dishwashing machines for restaurants is appended.
Anvisningar nr.53:1, National Swedish Board of Occupational Safety and Health (Kungliga Arbetarskyddsstyrelsen), Fack, 100 26 Stockholm 34, Sweden, 4 Dec. 1975. 20p. Illus. Price: Swe-cr.6.40.

CIS 76-1887 Heaton B., Brown L.D.
Radiation hazards for hospital staff using radioactive technetium.
Risques d'irradiation du personnel lors de l'utilisation de radiotechnétium en milieu hospitalier. [in French]
Administration of technetium may lead to a radiation hazard for the staff involved at any of the 5 different steps involved: dispensing the radioactive technetium from its generator; preparing the labelled pharmaceutical; transporting the prepared isotope from the "hot" laboratory to the wards or outpatient waiting area; injecting the isotope into the patient; carrying out the final scanning procedure. Preventive measures fall into 3 categories: use of shielded containers for transport (6mm lead shielded pots, shielded trolley); careful injection technique; rotation of personnel. By combining the above precautions, body doses, which were already well below maximum permissible levels, were further appreciably reduced.
Rayonnements ionisants, Oct. 1975, No.4, p.173-178. 3 ref.

CIS 76-1458 Mosley J.W., Edwards V.M., Casey G., Redeker A.G., White E.
Hepatitis B virus infection in dentists.
Of 1,245 dentists, 0.9% were positive for hepatitis B surface antigen, and 12.7% were antibody positive. The frequency of evidence for infection increased with increasing years of professional experience. Dentists appear to have a risk of hepatitis B virus infection about 2-3 times that of the general population. Frequencies did not vary with geographic region in the USA, nor with size of community.
New England Journal of Medicine, 9 Oct. 1975, Vol.293, No.15, p.729-734. 28 ref.

CIS 76-1302 Keane B.E., Tikhonov K.B.
Manual on radiation protection in hospitals and general practice - Vol.3: X-ray diagnosis
Manuel de radioprotection dans les hôpitaux et en pratique générale - Volume 3: Radiodiagnostic. [in French]
Published under the auspices of the International Labour Organisation, the International Atomic Energy Agency and the World Health Organization, this volume is written for the reader having a basic general knowledge of radiation and biology. It deals with organisation of radiation protection; staff radiation protection facilities; protection of patients and the general public from unnecessary radiation; choice of X-ray equipment from the point of view of radiological safety; building structure and radiation protection; radiation surveys; and monitoring of staff. Annexes cover suggested rules for display, medical aspects of diagnostic X-ray protection, principles and practice of protection, data for protection in the diagnostic X-ray region, and genetically significant dose to the population from this diagnosis. (See also CIS 76-130 and 76-131).
World Health Organization, 1211 Genève 27, Switzerland, 1975. 96p. Illus. 6 ref. Price: SF.18.00.

CIS 76-1092 Lévy A., Jourdan R., Mouret A., Malby M.R.
Occupational viral hepatitis - An acute problem of hospital hygiene
L'hépatite virale professionnelle - Problème aigu d'hygiène hospitalière. [in French]
Statistical data illustrating the magnitude of this problem. Hazards presented by healthy chronic virus carriers, who are more numerous in the hospital environment than in the general population. Economic data (in France, viral hepatitis accounts for 11.6% of occupational diseases). Epidemiological analysis of occupational viral hepatitis at the university hospital of Montpellier, France. Prevention: technical aspects (routine screening for HB antigen, isolation of antigen carriers, observance of hygiene rules); educational aspects (information and education of personnel, teaching of strict rules of hygiene and disinfection); administrative aspects (diagnostic criteria, obligatory notification).
Archives des maladies professionnelles, Sep.1975, Vol.36, No.9, p.465-475. 16 ref.

CIS 76-1114 National Coal Boad Medical Service - Annual report 1974-1975.
This report contains: considerations on the value of routine pre-employment and other examinations, with statistics; definition and distinctive features of simple and complicated pneumoconiosis (progressive massive fibrosis); results of dust measurements; data on workplaces meeting dust standards; effects of the change from 5-yearly to 4-yearly chest X-ray surveys; statistics on pneumoconiosis prevention measures (by area and by area and age for 1959, 1964, 1969 and 1974), progression indices by area, certifications by the Pneumoconiosis Medical Panels; discussion of bias in assessment of X-ray results (percentage of non-attenders at X-ray, variability in reading films); data on beat knee, elbow and hand, tenosynovitis, dermatitis, nystagmus, and hazards (methylenebis(orthochloroaniline), noise, vinyl chloride, chemical burns, etc.), first aid and nursing services, radiological and medical research. Supplement: medical aspects of joining the European Community, with brief reference to pneumoconiosis prevention projects.
National Coal Board (Medical Service), Hobart House, Grosvenor Place, London SW1X 7AE, United Kingdom, no date. 30p. Illus. Price: £1.00.

CIS 76-863 Lunn J.A.
The health of staff in hospitals.
The Tunbridge Report of 1968 revealed great deficiences in the curative and preventive care of National Health Service employees in Britain. The object of this book is to provide help and guidance to nurses, doctors and hospital administrators concerned with creating or improving staff health departments, indicating the general nature of the problems and how to tackle them. Subjects dealt with are delegation of the responsibility for staff care and the ensuing requirements, with attention to accommodation for staff health purposes; role of medical questionnaires and interviews as a substitute for medical examinations; immunisation; periodicity of screening of staff exposed to various risks; follow-up after exposure to infection; facilities for sick staff (G.P. care for residents and other staff) and use of staff for research; sickness absence; incidence, causes and treatment of accidents; environmental control (maintenance areas, kitchens, operating theatres, wards, etc.); notes, records and documentation (with examples); alphabetical index.
William Heinemann Medical Books Limited, 23 Bedford Square, London WC1B 3HT, United Kingdom, Feb. 1975. 104p. Illus. 14 ref. Price: £1.50.

CIS 76-881 Bates E.M., Moore B.N.
Stress in hospital personnel.
After some considerations on the concept of "stress", notably that not only the difficulty of the situation, but also the individual's ability to cope, have a bearing on the level of the stress encountered, the authors report on questionnaire studies in resident medical officers (interns), nurses, nurse aids and assistants, hospital administrators and public servants. Results are regarded comparatively, rather than for their absolute value. Individual concerns of the different groups are outlined, the highest stress scores being obtained by interns and nurses. Reorganisation and reduction of the work load is essential for these front-line workers; other remedies are more effective preparation for hospital life, and efforts to promote the natural adaptation process.
Medical Journal of Australia, 15 Nov. 1975, Vol.2, No.20, p.765-767. 7 ref.

CIS 76-758 Knill-Jones R.P., Newman B.J., Spence A.A.
Anaesthetic practice and pregnancy.
Replies to 5,507 questionnaires relating to male as well as female exposure to anaesthetics were evaluated. Male exposure had no influence on the frequency of spontaneous abortion, but there was an increase in minor congenital abnormalities (p<0.02). On the other hand, the effect of maternal exposure on spontaneous abortion was highly significant (15.5% against 10.9% of controls). It thus appears that male doctors working in operating theatres do not run a risk in respect of pregnancy in their wives, while the risk of miscarriage in women doctors seems to be confirmed.
Lancet, 25 Oct. 1975, Vol.2, No.7939, p.807-809. 7 ref.

CIS 76-743 Desbaumes E., Ducel G., Imhoff C., Rouge J.C.
Hazards of chronic exposure to halothane for operating theatre personnel
Danger de l'exposition chronique à l'halothane pour le personnel d'un bloc opératoire. [in French]
Results of an occupational hygiene survey in an operating theatre of a Swiss hospital, prompted by the incidence of malaise and fatigue in personnel exposed to vapours of halothane (2-bromo-2-chloro-1,1,1-trifluoroethane). Continuous measurement of the halothane concentration in air yielded average values of 5-30ppm, with peaks of 50-70ppm. Inhalation of halothane was confirmed by the presence of brominated metabolites in the urine (average 14.59mg/l in female anaesthetists). Halothane in the ambient air may thus be responsible for the symptoms. To prevent the risk of poisoning, in the absence of a ventilation system renewing the air more than 20 times/h, a device to exhaust the halothane vapours should be installed, or they should be removed by recycling the polluted air via an active carbon filter. A permanent monitoring system incorporating an audible and visual alarm is recommended.
Annales de l'anesthésiologie française, Oct. 1975, Vol.16, No.6, p.437-445. Illus. 20 ref.

CIS 76-612 Fire safety training in health care institutions.
This manual stresses organisation and procedure in training employees of these institutions in preventing fire and in handling fire until professional firefighters arrive; in safeguarding patients, visitors and staff. It enjoins the executive officer and fire marshal first to organise; second, to set up a procedure and put it in writing; and third, to train and drill staff, obtaining help from local professional firefighters in these endeavours. Appendices: fire hazard inspection report; extinguishers; available motion pictures.
American Hospital Association, 840 North Lake Shore Drive, Chicago, Illinois 60611, USA, 1975. 51p. Illus. 19 ref. Price: US-$2.25.

CIS 76-555 Grady D.F., Lee V.A.
Hepatitis B immune globulin - Prevention of hepatitis from accidental exposure among medical personnel.
Less than 1% of medical workers who were anti-HB_s-positive developed hepatitis, against 11% of anti-HB_s-negative subjects. Trials were performed with immune-serum globulin preparations of varying titres. The incidence of hepatitis in groups passively immunised with globulin having a titre of 1:50, 1:5,000 and 1:500,000, respectively, was 7, 5, and 2%. The significantly lower incidence in the last group (p<0.25) was offset by additional cases found at follow-up after 9 months. Various psssible explanations of this delayed onset are put forward.
New England Journal of Medicine, 20 Nov. 1975, Vol.293, No.21, p.1067-1070. Illus. 8 ref.

CIS 76-554 Redeker A.G.
Hepatitis B - Risk of infection from antigen-positive medical personnel and patients.
The greater the physical contact between medical personnel and patients, the frequency of antigenaemia among patients, the number of blood transfusions given, and the number of blood specimens handled, the higher will be the attack rate for hepatitis among medical personnel. The extent of the risk for health-care personnel can ony be defined by testing for hepatitis antigen and antibody on a voluntary basis. However, caution must be exercised in recommending job changes to personnel found repeatedly to be chronic asymptomatic antigen carriers. Antigen positivity is not necessarily life-long.
Journal of the American Medical Association, 8 Sep. 1975, Vol.233, No.10, p.1061-1062. 14 ref.

CIS 76-410 Dunlap J.H.
Radiation protection considerations in the cardiac catheterization laboratory.
This note is concerned with reducing exposure to radiation of both patients and medical personnel during fluoroscopy. Among the various recommendations made are the use of as small a radiation beam as possible and of lead drapes hanging from the image intensifier. Personnel can control individual exposure by: wearing a protective apron of at least 0.25mm lead equivalent; keeping hands out of the X-ray beam; wearing 2 X-ray dosimeters. Other measures are: rotating personnel, especially the senior physician; remaining distal to the fluoroscopic table when possible; locating the cardiac monitoring equipment and operator remote from the fluoroscopic table; using video tape recording to avoid repeat examinations.
Health Physics, Sep. 1975, Vol.29, No.3, p.415-417. 11 ref.

CIS 76-403
Department of Health and Social Security, London.
Radiological protection in dental practice.
Intended to be complementary to the more comprehensive document, "Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use" (CIS 74-423), the purpose of this booklet is to give dentists some basic information on the safe use of X-rays. Contents: why protection from X-rays?; responsibility for radiation protection; protection during a dental examination; ensuring a safe installation; sources of further information. Appendices: maximum permissible doses; useful addresses; summary of relevant recommendations from the Code of Practice; notes on film processing.
H.M. Stationery Office, P.O. Box 569, London S.E.1, United Kingdom, Mar. 1975. 18p. 9 ref.

CIS 76-131 Frost D., Jammet H.
Manual on radiation protection in hospitals and general practice - Vol.2: Unsealed sources.
Manuel de radioprotection dans les hôpitaux et en pratique générale - Vol.2: Sources non scellées. [in French]
Published under the auspices of the International Labour Organisation, the International Atomic Energy Agency and the World Health Organization, this volume, the second of a series of 5, reviews the radiation protection requirements in hospitals using unsealed radioactive sources and discusses the problems associated with the administration, handling, and transportation of these sources: characteristics of unsealed sources and radiation hazards; diagnostic and therapeutic applications of radionuclides; organisation and staffing; planning of facilities and general layout of a department for the use of unsealed sources, with examples; safe handling of unsealed sources; waste treatment and disposal; monitoring; special problems relating to tritium and carbon-14; decontamination; protection of patients; handling of cadavers with incorporated radionuclides; protection of personnel and members of the public; measures for dealing with accidents. Characteristics of some commonly used radionuclides and doses used in diagnostic examination, are appended.
World Health Organization, 1211 Genève 27, Switzerland, 1975. 113p. Illus. 10 ref. Price: SF.24.00.

CIS 76-188 Domey R.G.
Metallic mercury contamination of the dental operatory.
A summary review of the properties of metallic mercury, its use and potential sources of contamination in dentistry, as well as literature data on patient and worker exposure, are followed by the description and results of a detailed survey conducted by dental students in 60 dental practices managed by 30 dentists. The current TLV (0.05mg Hg/m³ of air) was frequently exceeded. Significant differences in atmospheric contamination were found between laboratories, sites of measurements and times of day, correlated with mercury consumption, number of amalgams per day, age of laboratories, thickness of carpeting and frequency of cleaning.
Human Factors, Aug. 1975, Vol.17, No.4, p.346-355. 21 ref.

CIS 76-256 Employment and conditions of work and life of nursing personnel.
L'emploi et les conditions de travail et de vie du personnel infirmier. [in French]
Preliminary report prepared by the ILO in collaboration with WHO, for communication to governments and for a first discussion of the above question by the International Labour Conference at its 61st Session (June, 1976). Among other subjects, the report considers overtime and exacting and inconvenient work schedules, etc. and Chapter X is devoted to safety and health protection (international standards; national situations; the risk of employment injury; sick leave and preventive leave; maternity protection; works safety committees; occupational health services). The report reproduces the conclusions of the ILO-WHO Joint Meeting on Conditions of Work and Life of Nursing Personnel (Geneva, 19-30 Nov. 1973) and the minutes of the discussions of the Executive Board of WHO (54th Session, Geneva, 27-28 May 1974) on the report of the Joint Meeting.
Report VII(1), International Labour Conference, 61st Session, 1976. International Labour Office, 1211 Genève 22, Switzerland, 1975. 108p. Price: SF.17.50.

CIS 76-141 Whitcher C., Piziali R., Sher R., Moffat R.J.
Development and evaluation of methods for the elimination of waste anesthetic gases and vapors in hospitals.
The sources and atmospheric distribution of trace concentrations of inhalation anaesthetics in the operating theatre are discussed. Scavenging systems (collection of waste gases at the anaesthetic breathing system and disposal procedures) are outlined, and recommendations made for "low-leakage" practices by the anaesthetist, equipment maintenance, and an air monitoring programme to establish the efficacy of the control measures. Careful application will yield an air concentration in the operating theatre of <30ppm nitrous oxide and <0.5ppm halothane. Appendices: fundamentals of physiology, anaesthetic techniques and agents, breathing systems, and test lung; diffusion leakage; distribution of waste gases in air; diagrams and pressure-flow relationships of scavenging components; gas analysis and calibration techniques.
HEW Publication No.(NIOSH)75-137, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, Ohio 45226, USA, May 1975. 123p. Illus. 60 ref.

CIS 76-259 Slavík V., Kachlík Z., Zelinková D.
Evaluation of the risk of salmonella and shigella infection in pathological anatomy and forensic medical services
Příspěvek k hodnocení rizika nákazy salmonelami a shigelami v provozu patologickoanatomických a soudně lékařských oddělení [in Czech]
Study of occupational exposure to infection in the medical profession and ancillary medical services. In addition to the risk of tuberculosis and viral hepatitis there is also a salmonellosis and shigellosis hazard. The authors obtained 9 positive cultures from autopsy tissue from the small intestine, colon, gall bladder and spleen of 200 deceased subjects who had shown no symptoms of disease of the digestive tract while alive. Hygienic conditions in dissection rooms are criticised and improvements suggested.
Pracovní lékařství, Feb. 1975, Vol.27, No.1-2, p.32-36. 14 ref.

CIS 75-1959 Magnaval J.P., Magnaval R.F., Karhausen L.R.
Mercury in dental surgeries: An occupational hazard
Le mercure dans les cabinets dentaires: un risque professionnel. [in French]
Literature review of the mercury hazard for dentists and their assistants, giving the results of measurements of mercury vapour or mercury particle concentrations carried out in various dental surgeries, compared with the U.S. (50µg/m³) and USSR (10µg/m³) TLVs. The mercury levels in the hair and nails, urine and blood very often exceed the mean value. Attention is drawn to the possible hazard of mercury methylation in man. Preventive measures: local exhaust ventilaton in the surgery; wearing of gloves; use of drills incorporating a water-cooling system for exploring cavities.
Revue d'épidémiologie, médecine sociale et santé publique, Jan.-Feb. 1975, Vol.23, No.1, p.53-62. Illus. 19 ref.

CIS 75-1765 Rudolph J., Codino R.S.
Environmental hazards of hepatitis.
The ways in which medical and paramedical personnel may contract viral hepatitis are briefly described. Accidental puncture and non-parenteral spread, during blood handling, are the predominant modes of transmission of the disease. Health-care facilities handling blood should develop precautions and enforce internal regulations to minimise human exposure to the infective antigen. Detailed laboratory safety guidelines cover sample collection, handling materials in the laboratory, disposal of contamination, accidents, and general hygiene precautions.
Journal of Environmental Health, Jan.-Feb. 1975, Vol.37, No.4, p.359-362. 23 ref.

CIS 75-858 Anaesthetists' environment.
Editorial review of conditions and hazards in this field. Anaesthetists may show high rates of cancer and other disease of the liver and kidney, and the suicide rate is high among them. The risk of spontaneous abortion is increased in women anaesthetists, as is the incidence of congenital defects in anaesthetists' children. Repeated exposure to inhalational agents and lack of adequate rest and food may impair important functions. Closed-circuit apparatus or exhaust ventilation is recommended, and it is suggested that charcoal absorbents, which do not clear nitrous oxide, should be used only when agents such as halothane are used alone.
British Medical Journal, 15 Feb. 1975, Vol.1, No.5954, p.353-354. 9 ref.

1974

CIS 77-264
Ministry of Public Health (Ministerstvo na narodnoto zdrave) and Central Council of Bulgarian Trade Unions (Centralen săvet na bălgarskite profesionalni săjuzi), Sofija.
Ordinance No.130 concerning the organisation of medical services for workers
Naredba No.130 na organizirane na medicinskoto obslužvane na rabotnicite [in Bulgarian]
This Ordinance repeals previous legislation on the subject and makes provision for: medical services for workers organised according to region and industrial sector; collaboration of public health physicians in in-plant occupational medical work in their district, in the prevention of occupational diseases and in periodic analysis of occupational disease incidence; medical treatment centres mandatory in plants employing 200 or more workers; specialised consultation rooms for workers in regional policlinics; special workers' hospitals with at least 250 beds as well as out-patient facilities. Groups of undertakings and large industrial complexes may build prophylactic centres with at least 100 beds.
Dăržaven vestnik, 31 Dec. 1974, p.1-2 (English, French and Spanish translations published in Legislative Series, 1974-Bul.1, International Labour Office, 1211 Genève 22, Switzerland).

CIS 76-1485 Bedford General Hospital Occupational Health Service - 7th and final report.
This report describes the activities of a typical hospital staff occupational health service in the United Kingdom for the period 1 Jan. 1968-31 Dec. 1974: medical examinations; immunisations; sickness absence recordings; environmental investigations (operating theatres, X-ray departments, temperature, humidity, lighting); safety (information presented in tabular form: analyses of accidents according to type and site of injury, category of staff involved, prime causes (falls, slips, sharp objects in garbage, laboratory processes, lifting patients or materials, drugs, bottles, splashes or foreign bodies in the eye, etc.)).
Bedfordshire Area Health Authority, Northern District, Bedford, United Kingdom, 1974. 46p.

CIS 76-453
Anvisningar nr. 102, National Board of Occupational Safety and Health (Kungliga Arbetarskyddsstyrelsen), Stockholm, Nov. 1974.
Directives for anaesthetics
Narkosanvisningar [in Swedish]
These directives, which entered into force on 1 Apr. 1975, contain rules concerning adequate ventilation of operating theatres (indicating minimum air-renewal rates) and periodic inspection and testing of ventilation systems for the health protection of hospital staff.
Liber Förlag, Fack, 16289 Vällingby, Sweden, 1974. 7p. Price: Swe-cr.4.50.

CIS 76-130 Braestrup C.B., Vikterlöf K.J.
Manual on radiation protection in hospitals and general practice - Vol.1: Basic protection requirements.
Manuel de radioprotection dans les hôpitaux et en pratique générale - Vol.1: Normes fondamentales de protection. [in French]
Published under the auspices of the International Labour Organisation, the International Atomic Energy Agency and the World Health Organization, this volume, the first of a series of 5, comprises a general review of the radiation protection requirements common to all medical applications of ionising radiation and radionuclides. Following general considerations on different types of radiation, dosimetry and the biological effects of ionising radiations, it deals with: principal objectives of radiation protection; radiation equipment and operating procedures; planning of radiation facilities; shielding design; organisation of radiation protection; radiation surveys; and personnel monitoring and health supervision. A list of commonly used radionuclides and examples of designs of protective shielding are appended.
World Health Organization, 1211 Genève 27, Switzerland, 1974. 86p. Illus. 5 ref. Price: SF.12.00.

CIS 76-21 Nonflammable medical gas systems.
This standard, which supersedes the previous edition (1973), was approved as American National Standard ANSI MD4.1-1974 on 11 Dec. 1974. Definitions and general remarks on material and oxygen compatibility are followed by provisions on: source of supply; warning systems; pipeline systems; installation and testing of piping systems; small systems in non-hospital-based facilities.
NFPA No.56F-1974, National Fire Protection Association, 470 Atlantic Avenue, Boston, Massachusetts 02210, USA, 1974. 28p. Illus. Price: US-$3.50.

CIS 75-1110 Filjušina Z.G.
Allergic neutrophil changes under dynamic conditions in persons suffering from occupational diseases induced by antibiotics
Allergičeskaja al'teracija nejtrofilov krovi v dinamike u bol'nyh professional'nymi zabolevanijami, vyzvannymi antibiotikami [in Russian]
Results of follow-up allergy tests (positive neutrophil reactions to antigens) on 42 persons exposed to antibiotics (pharmaceutical workers and nurses). It was found that 37 of them suffered from allergies to 1, 2 or 3 antigens contained in penicillin and streptomycin. The sensitisation thus acquired is resistant to desensitisation and anticandidiasis therapy. According to the author's hypothesis, this type of sensitisation is due to the candida antigen.
Gigiena truda i professional'nye zabolevanija, May 1974, No.5, p.12-14. 5 ref.

CIS 75-860 Kajland A., Lindvall T., Nilsson T.
Occupational medical aspects of the dental profession.
The study comprised a social and medical inquiry and an ergonomic appraisal of 147 dentists, with particular attention to disorders of the musculoskeletal system. There was no proof of a higher incidence of illness absence among the dentists compared with a control group. However, there was a significantly higher frequency of reported absence because of troubles from the musculoskeletal system, and of the reported incidence of skin disorders other than eczema and, in older age groups, of haemorrhoids. Troubles affecting the shoulders and the back were found to be more frequent among the dentists compared with the controls. The results indicate a relation between medical ailments of the musculoskeletal system and the dentists' strained working position.
Work - Environment - Health, 1974, Vol.11, No.2, p.100-107. Illus. 12 ref.

CIS 75-485 Pattison C.P., Boyer K.M., Maynard J.E., Kelly P.C.
Epidemic hepatitis in a clinical laboratory.
During a 6-month period an outbreak of hepatitis occurred in 5 employees concerned with blood-specimen control at a hospital clinical laboratory. The laboratory had recently adopted a computerised system for specimen collection and data dispersal, and a significant correlation was found between accidental cuts from computer cards and the development of clinical hepatitis. Because blood is frequently spilt on these computer cards, the authors speculate that the presumed increase in hepatitis and the growing use of computerised requisition systems in hospitals, the occupational hazard to medical, paramedical and dental personnel may increase at an alarming pace.
Journal of the American Medical Association, 11 Nov. 1974, Vol.230, No.6, p.854-857. Illus. 12 ref.

CIS 75-270 Koren H.
Environmental health and safety.
Detailed survey of environmental health practice in hospitals (food sanitation, housekeeping, illumination, insect and rodent control, laundry, physical therapy, noise control, maintenance and plumbing), followed by chapters on infection control, fire safety, patient and employee safety. A chapter deals with hospital occupational health programmes, and particularly with their organisation and the responsibilities and the functions of the physicians. Guidance is given on detergents and disinfectants, patient isolation procedures, microbiological testing, and sterilisation.
Pergamon Press Ltd., Headington Hill Hall, Oxford OX3 OBW, United Kingdom, 1974. 315p. Illus. 259 ref. Price: US-$8.75.

CIS 74-1932 Lund I., Skulberg A., Helle I.
Occupational hazard of halothane.
An account of a case of hepatitis proved irrefutably to have been caused by occupational exposure to halothane. That few develop liver damage among anaesthetic and operating-room personnel and among workers engaged in the manufacture of halothane may be explained by the fact that small frequent exposures to halothane may cause desensitisation.
Lancet, 31 Aug. 1974, Vol.2, No.7879, p.528. Illus. 6 ref.

CIS 74-1601 Notification No.4/1974 concerning the evacuation of anaesthetic gases from operating theatres, recovery rooms, etc.
Meddelelse nr.4/1974 om bortledning af anæstesigasser fra operationsstuer, opvågningsstuer m.v. [in Danish]
These directives call for effective exhaust ventilation of operating theatres and recovery rooms. The ventilation system should be designed in such a way that the air exhausted cannot be recirculated and that the vapour concentration in the air does not exceed 25% of the lower explosion limit.
Directorate of Labour Inspection (Direktoratet for Arbejdstilsynet), Upsalagade 20, 2100 København Ø, Denmark, 8 Feb. 1974. 2p. Gratis.

CIS 74-1702 Grandbesançon Y.
Virus hepatitis B: an occupational disease - Epidemiological and prophylactic study in haemodialysis centres
Hépatite virale B: maladie professionnelle - Etude épidémiologique et prophylactique dans les centres d'hémodialyse. [in French]
The first part of this MD thesis is devoted to background information on virus hepatitis as an occupational disease, and to the following aspects: frequency of virus hepatitis B among the staff of haemodialysis units, role of the Australia antigen, modes of transmission. The second part is devoted to medico-social problems: French legislation, absence from work, course of the disease and treatment. Prophylaxis is discussed in one chapter: general hygiene (organisation of working conditions, staff training), preventive measures to cope with antigen-carrying patients and immunisation. Prevention by means of specific immunoglobulins has gone beyond the experimental stage and the manufacture of a vaccine against hepatitis B is at present being studied.
Université de Paris VI, Faculté de médecine Pitié - Salpêtrière, Paris, France, 1974. 42p. 27 ref.

CIS 74-1701 Laurin C.
Viral hepatitis, an occupational disease
Hépatite virale, maladie professionnelle. [in French]
Individual sections of this MD thesis are devoted to: the epidemiology of viral hepatitis (history, virology, immunity); prevalence (according to season, region, sex, age, occupational category, etc.); clinical picture and course; histology; biology and liver function tests; immunological methods for the detection of Australia antigen; curative and preventive treatment; compensation. Viral hepatitis, which affects mainly the health care professions and particularly young persons, has been compensated for as an occupational disease in France since 1967.
Université de Paris - Val-de-Marne, Faculté de médecine de Créteil, 94-France, 1974. 63p. 17 ref.

1973

CIS 76-404
Department of Health and Social Security, London.
The safe use of ionizing radiations - A handbook for nurses.
Based on the "Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use" (CIS 74-423), this handbook shows how hospital staff can avoid exposing themselves and others to these hazards. It is designed particularly for junior and student nurses. Contents: ionising radiations - their types and characteristics; their uses and dangers; basic principles in their safe use; safe use in practice; explanation of terms.
H.M. Stationery Office, P.O. Box 569, London S.E.1, United Kingdom, 1973. 17p. Illus.

CIS 76-101 Colours - Gas cylinders for medical use - Identification of gases by conventional colours
Couleurs - Bouteilles à gaz à usage médical - Identification des gaz par couleurs conventionnelles. [in French]
This standard, which is in technical conformity with international Recommendation ISO/R 32, prescribes the identifying colours for 7 gases used in medicine: carbon dioxide (dark grey); nitrogen (black); cyclopropane (orange-grey); ethylene (violet); helium (dark brown); oxygen (white); nitrous oxide (bright blue-violet). It also prescribes the colour code for identifying cylinders containing gas mixtures, the colours for connecting hoses, and the qualities required of products used in manufacturing the colours.
Norme française enregistrée NF X 08-107, French Standards Association (Association française de normalisation), Tour Europe, 92080 Paris-la-Défense Cedex 7, France, Dec. 1973. 3p. Illus.

CIS 75-1003 Medical X-ray and gamma-ray protection for energies up to 10MeV - Equipment design and use.
This report contains a number of recommendations concerning the design and performance characteristics of medical radiation-producing equipment and the operating conditions. Following general guidelines on the clinical use of radiation, recommendations and guidelines are given for X-ray and gamma-beam therapy equipment. Further sections give guidance for calibration, radiation protection surveys and working conditions. Definitions of terms, tables with biological and technical radiation data, and an example of emergency procedure are appended.
NCRP Report No.33, National Council on Radiation Protection and Measurements, P.O. Box 30175, Washington, D.C. 20014, USA, 1 Mar. 1973. 66p. Illus. 23 ref. Price: US-$2.00.

CIS 75-275 Dentistry - The study of the working space of the dentist
Art dentaire - Etude du poste de travail du praticien de l'art dentaire. [in French]
This standard, which conforms to draft international standard ISO/DIS 3246 on the same subject, gives, after a number of definitions, the principles for the evaluation of the workpost of a dental practitioner (rationalisation, application of the principles of ergonomics, studies of different work postures, importance attached to environmental factors). To facilitate exchange of information, it lays down a certain number of agreed specifications concerning the following points: relative position of the patient, measurement of height of dentist chair above floor level (sitting posture), classification of movements, various working postures of the dentist and his assistant.
Fascicule de documentation NF S 91-012, French Standards Association (Association française de normalisation), Tour Europe, Cedex 7, 92080 Paris-la-Défense, France, June 1973. 3p. Illus.

CIS 74-1471 6th national preventive medicine days for hospital staff
VIe Journées nationales de médecine préventive du personnel hospitalier. [in French]
Proceedings of this congress (10-12 May 1973, Tours, France) at which 2 reports were presented: Psychological approach among hospital staff (Meau R., Sudre M.C., Paquiet J.); Standards of aptitude to be met by hospital personnel (Doumert J., Barbier C., Cherif S., Jallet M.F., Pigney F., Ronot P.). These reports were supplemented by various communications dealing with the following subjects among others: absenteeism due to psychic factors; psychiatric pathology among hospital staff; psychosomatic disturbances among female hospital staff; psychological difficulties which confront practitioners responsible for preventive medicine among hospital staff; epidemiology and prophylaxis of viral hepatitis in hospitals.
Archives des maladies professionnelles, Dec. 1973, Vol.34, No.12, p.681-781. Illus.

CIS 74-1032 Gamberale F., Svensson G., Andersson B.
Effect of anaesthetic gases on psychomotor functions in anaesthesist nurses
Narkosgasers effekt på psykomotoriska funktioner hos narkossköterskor [in Swedish]
20 anaesthetic nurses and 20 control nurses working in intensive care units were tested for reaction time and perceptual speed at the beginning and at the end of a work day. While the anaesthetic nurses were exposed to anaesthetic gases in their daily work, the control nurses worked in rooms in which they were not exposed to anaesthetics. No measurable impairment in reaction time and perceptual speed was detected in anaesthetic nurses as compared with the control group. However, intraindividual variation in one of the reaction time tests was found to be greater for anaesthetic nurses than for the control group at the end of the work day, but not 16 h after cessation of the exposure.
Arbete och hälsa - vetenskaplig skriftserie, 1973:5, Arbetarskyddsstyrelsen, Fack, S-100 26 Stockholm 34, Sweden, 1973, 13p. 14 ref. Price: Swe-cr.6.OO.

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