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CIS 88-1725 Recommendations for prevention of HIV transmission in health care settings
This report is intended for all health care settings and considers all patients as potentially infective. Covered are: definition of health-care workers; health-care workers with AIDS; risk to health-care workers of acquiring HIV at work; precautions to prevent transmission (universally, during invasive procedures, dentistry, autopsies or morticians' services, dialysis, laboratories); environmental considerations (sterilisation and disinfection of equipment, survival of HIV, housekeeping, blood and other body fluid spills, laundry, infective waste); implementation of recommendations; serologic testing for HIV infection; management of infected health-care workers and of exposures.
Morbidity and Mortality Weekly Report, 21 Aug. 1987, Vol.36, No.2S, 18p. 37 ref.

CIS 88-885 Canga Alonso A., Crespo Aguilera D., Martín Iglesias C., Martínez Noval A., Motto López A., Sánchez Tabar M.A., Suárez González T.V.
Riesgos profesionales de los trabajadores de centros hospitalarios/Riesgos profesionales de los trabajadores de centros hospitalarios
Literature survey of the health hazards of work in hospitals. Contents: classification of hospital workers (sanitary and non-sanitary personnel); conditions of work (working hours, premises and equipment); definition of occupational accidents and diseases; general and specific accident risks; occupational diseases in hospitals (tuberculosis, infectious hepatitis and others); preventive measures and treatment.
Medicina y seguridad del trabajo, July-Sep. 1987, Vol.34, No.136, p.31-39. 11 ref.

CIS 88-324 Gestal J.J.
Occupational hazards in hospitals: risk of infection
In this review of the risk of infection to hospital staff, attention is drawn to the continuing risk presented by hepatitis B and pulmonary tuberculosis, which are more common than diseases such as typhoid fever, brucellosis, histoplasmosis, whooping cough, infectious gastroenteritis, measles, and parotiditis. Other items considered include the susceptibility of female hospital staff to rubella and the importance of their undergoing screening and vaccination; the risks currently presented by epidemic keratoconjunctivitis and by herpes viruses (herpes simplex, varicella zoster, and cytomegalovirus); and the risk of contracting the new infectious diseases (Legionnaires' disease, Marburg disease, Lassa fever, and the acquired immune deficiency syndrome).
British Journal of Industrial Medicine, July 1987, Vol.44, No.7, p.435-442. 154 ref.

CIS 88-323 Lahaye D., Strauss P., Baleux C., Van Ganse W.
Cost-benefit analysis of hepatitis-B vaccination
The cost of vaccinating 40,000 Belgian health-care workers against hepatitis-B has been more than recovered by a very serious reduction in the number of compensable cases of the disease. The Belgian Insurance Fund for Occupational Diseases has been paying the costs of hepatitis-B vaccinations since 1983, and this financial investment has proved to be beneficial to the Fund.
Lancet, 22 Aug. 1987, Vol.2, No.8556, p.441-442. Illus. 4 ref.

CIS 88-320 Recommendations of the Immunization Practices Advisory Committee update on hepatitis B prevention
This Lead from the Centres for Disease Control (Atlanta, Georgia, USA) contains recommendations on immunisation against hepatitis B among persons at risk, including health care workers. It covers: patterns of usage of plasma-derived HB vaccine in the USA; impact on disease incidence; the new recombinant DNA HB vaccine (formulation, immunogenicity, efficacy, safety, dosage and schedule, indications for use, precautions); need for vaccine booster doses.
Journal of the American Medical Association, 24-31 July 1987, Vol.258, No.4, p.437-449. 15 ref.

CIS 87-1091 LaForce F.M.
Immunizations, immunoprophylaxis, and chemoprophylaxis to prevent selected infections
This communication from the United States Preventive Services Task Force presents in a systematic way indications, strategy and implementation, efficacy, contraindications and commentary on vaccination programmes against certain infectious diseases, including those to which certain occupational groups are exposed: hepatitis A (vaccination indicated among travellers to under-developed tropical countries, and among staff at day-care centres and food-handling facilities where hepatitis A has recently occurred); hepatitis B (health-care workers); rabies (veterinarians, animal handlers); malaria (travellers to tropical countries).
Journal of the American Medical Association, 8 May 1987, Vol.257, No.18, p.2464-2470. 55 ref.


CIS 89-1726 Acquired Immune Deficiency Syndrome (AIDS)
This information sheet summarises the preventive measures that should be used in those workplaces where exposure to the AIDS virus may occur, and addresses some issues which have worried workers in both health-care establishments and other settings.
Medical Services Branch, Northern Region Office, 9321 - 48 Street, Edmonton, Alberta T6B 2R4, Canada, 1986. 7p. 2 ref.

CIS 89-1724 AIDS and the workplace
Data sheet containing much useful information on AIDS, written for workers with occupations where contact with HIV may occur in the workplace: barbers, hairdressers and other personal service workers; ambulance drivers, police officers, firefighters and other emergency workers; health-care workers, first aiders and others. It also discusses how employers should deal with employees who have AIDS, and the rights of infected people to work under the Ontario Human Rights Code, which prohibits discrimination in employment based on a disabling condition. Special attention is given to the role of trade unions in the education of their members and to help them get accurate information about AIDS.
Health Information Centre, 9th floor, Hepburn Block, Queen's Park, Toronto, Ontario M7A IS2, Canada, 1986. 5p.

CIS 88-198 Méndez Vargas M.M., Maldonado Torres L.
Guía para el estudio y reconocimiento de las enfermedades broncopulmonares de trabajo/Guía para el estudio y reconocimiento de las enfermedades broncopulmonares de trabajo
Contents of this booklet written for occupational physicians: pneumoconiosis; asthma; hypersensitivity pneumonitis or extrinsic allergic alveolitis; byssinosis or "Monday asthma"; bronchitis; gas exposures; pneumoconiosis or tuberculosis; ornithosis; pulmonary mycosis; neoplasia.
Instituto Mexicano del Seguro Social, Paseo de la Reforma 476, 06698 México, D.F. Mexico, 1986. 1st ed. 18p. 8 ref.

CIS 87-1306 Wakamatsu C.T., Supino E., Buschinelli J.T.P., Leifert R.M.C., Soto J.M.O.G.
Health risks for hospital personnel
Riscos de insalubridade para o pessoal de hospital [en portugués]
This survey covers: biological risks (tuberculosis, hepatitis B, other infectious diseaes); chemical risks (anaesthetics, sterilising substances, allergic dermatoses, cytostatic drugs); physical risks (air conditioning); risks connected with handling and repair (buildings, electrical installations, hydraulic installations); risks connected with cleaning, waste removal and laundry services; noise, heat and lighting; legislative provisions in Brazil; risks in auxiliary services: analytical, pathological and radiological laboratories.
Revista brasileira de saúde ocupacional, Jan.-Mar. 1986, Vol.14, No.53, p.52-60. 34 ref.

CIS 87-1092 Schimmelpfenning W., Konetzke G., Lun A.
Viral hepatitis as an occupational disease
Virushepatitis als Berufskrankheit [en alemán]
During the last 5 years there has been no further decrease of acute viral hepatitis as an occupational disease. Essential aspects of occupational medicine regarding acute viral hepatitis are discussed: recognition as an occupational disease, estimation of the damage affecting the body, fixing the date of re-examination, change of workplace, questions of fitness to work and legislation. Important prophylactic principles: strict observance of hygienic principles, regular checkups and, in future, active immunisation against hepatitis B in risk areas.
Zeitschrift für klinische Medizin, 1986, Vol.41, No.11, p.805-809. 19 ref.

CIS 87-345 Maruna H., Westphal G.
Epidemiology and risk calculation of hepatitis-B as an occupational disease in the Austrian health service
The absolute number of occupation-related cases of hepatitis B increased fourfold over the last 2 decades, while at the same time the number of health service employees only doubled. In comparison with the Austrian population, the hepatitis risk is about 11 times higher for the health service employees. Laboratory personnel, medical doctors and support service personnel are especially exposed. The relative risks according to age, sex and type of occupation were also investigated, and a comparison was made with the findings of other investigations in the literature. First results are reported for the screening of health service employees for immunity against HB-antigens. The prophylaxis against hepatitis that was begun in Austria in 1983 is the first extensive vaccination programme against this liver disease.
International Archives of Occupational and Environmental Health, 1986, Vol.57, No.4, p.259-265. Illus. 13 ref.

CIS 87-347
Protection against blood contamination
Skydd mot blodsmitta [en sueco]
These regulations (effective 1 Apr. 1987) apply to work involving the risk of contamination by non-disinfected human blood; it concerns medical and paramedical personnel, laboratory staff, policemen, social service workers and sanitation workers and relates to the protection from infections such as viral hepatitis and AIDS. Contents: general rules (planning, organisation and performance of work tasks, transportation of contaminated blood); high-risk tasks (they should be performed by trained persons knowing the risks and routes of contamination and familiar with protective measures; use of work aids and protective equipment which enable cuts and punctures to be avoided and prevent any contact with the skin and mucous membranes; skin disinfection and cleansing; warning notice on containers with contaminated blood). Detailed advice and commentaries are appended.
LiberDistribution, 162 89 Stockholm, Sweden, 6 Feb. 1987. 13p.

CIS 86-2058 Helmick C.G., Webb P.A., Scribner C.L., Krebs J.W., McCormick J.B.
No evidence for increased risk of Lassa fever infection in hospital staff
A prospective serological study of staff from 3 Sierra Leone hospitals in an area where Lassa fever is endemic, revealed that there was no increased risk of contracting the disease among any groups of hospital personnel. These findings support the proposal that patients with Lassa fever need not be confined to isolators in order to prevent infecting the staff.
Lancet, 22 Nov. 1986, Vol.2, No.8517, p.1202-1204. Illus. 20 ref.

CIS 86-1761 Steinbuch M., Gaeuman J.V.
Risk of hepatitis B in hospital personnel
Epidemiologic study involving 1,323 employees of Ohio State University Hospital, in the USA. 105 employees with present or past evidence of hepatitis B virus infection were identified. Statistical analysis indicated that nonwhites, males, discontinuity of employment, and frequency of contact with blood products constituted the most important risk factors in acquiring hepatitis B virus infections.
Journal of Occupational Medicine, Apr. 1986, Vol.28, No.4, p.276-281. 21 ref.

CIS 86-1447 Nixon A.D., Law R., Officer J.A., Cleland J.F., Goldwater P.N.
Simple device to prevent accidental needle-prick injuries
Use of a needle guide, consisting of a plastic shield with a central hole into which the covered needle is placed, led to a 79% reduction in needle pricks suffered by phlebotomists working at a medical laboratory in New Zealand. A reduction in needle pricks results in lowered exposure risk to hepatitis B and to AIDS.
Lancet, 19 Apr. 1986, Vol.1, No.8486, p.888-889. Illus. 5 ref.


CIS 92-324 Breuer B., Friedman S.M., Millner E.S., Kane M.A., Snyder R.A., Maynard J.E.
Transmission of hepatitis B virus to classroom contacts of mentally retarded carriers
The risk of the spread of hepatitis B virus infection from deinstitutionalised, mentally retarded carriers to pupil and staff school contacts in the New York City public school system was measured serologically in a 3-phase study from 1978 to 1982. In the third phase, undertaken in 1982, blood samples were drawn and questionnaires were completed on students and staff tested in either of the first 2 phases and on comparison groups with intermediate and no known school exposure to deinstitutionalised carriers. Logistic regression analyses revealed that staff and pupils with a history of classroom exposure to a hepatitis B virus carrier had significantly increased prevalences of hepatitis B virus infection (13.4%, odds ratio = 1.9; 9.3%, odds ratio = 2.5, respectively). Similarly, yearly seroconversion rates of 1.3% and 0.67% indicate that staff and, to a lesser extent, pupils are at increased risk of infection.
Journal of the American Medical Association, Dec. 1985, Vol.254, No.22, p.3190-3195. 13 ref.

CIS 86-1681 Døssing M., Skinhøj P.
Occupational liver injury - Present state of knowledge and future perspective
Epidemiological studies using immunological methods have mapped the occurrence of hepatitis B among health-care personnel and thereby made rational, effective preventive precautions possible, and hepatitis B vaccine has offered further improvements. However, in the field of chemically-induced occupational liver damage, only a few of the thousands of industrial chemicals have been sufficiently tested for hepatotoxicity and the list of suspected and confirmed hepatotoxic agents is still growing. The example of vinyl chloride-induced liver disease among plastics workers calls for intensified activities in the field of occupational toxicology. However, the clinical, biochemical, and morphological features of liver disease are often vague and unspecific. A non-invasive, convenient quantitative liver function test is needed. Circumstantial evidence and a few epidemiological studies suggest that so-called cryptogenic liver diseases, such as liver cirrhosis, may be caused by occupational exposure to chemicals.
International Archives of Occupational and Environmental Health, 1985, Vol.56, No.1, p.1-21. 164 ref.

CIS 86-1378 Hubačová L., Borský I., Strelka F.
Morbidity of female health-care workers according to their work category
Chorobnos@t6 zdravotníckych pracovníčok v súvislosti s ich pracovným zaradením [en eslovaco]
Morbidity of 1,183 health-care personnel in two city hospitals was monitored for 1 year. Most frequent were: respiratory illness (22.4%), musculoskeletal disorders (20.2%), urogenital disorders (14.1%), digestive tract disorders (10.2%), diseases of the skin and subcutaneous tissues (7.1%). In comparison with sick leave of employed women in the city as a whole, nurses suffered from a higher incidence of musculoskeletal, urogential, dermatological and circulatory disorders and of infectious hepatitis. Measures for improvement are recommended.
Pracovní lékařství, 1985, Vol.37, No.1, p.16-19. Illus. 25 ref.

CIS 86-746 Summary: Recommendation for preventing transmission of infection with HTLV-III/LAV in the workplace
This two-part recommendation was published as part of the Morbidity and Mortality Report of the Centers for Disease Control in Atlanta (Georgia, USA). The recommendations deal with preventive measures against acquired immuno-deficiency syndrome (AIDS) in the workplace. The primary group at risk is that of health workers, and the preventive measures similar to those employed against hepatitis B infection (careful handling of sharp objects likely to be contaminated, wearing of gloves and other protective equipment when the possibility of exposure to blood and other body fluids exists, minimising the need for emergency mouth-to-mouth resuscitation). Particular problems discussed: precautions for health care workers involved in home care, precautions during emergency health care, management of parenteral and mucous membrane exposure, serologic testing of patients, precautions against transmission of virus from health care workers to patients, appropriate sterilisation measures. There are also comments on possible dangers to other workers (personal services - hairdressers, cosmetologists etc; food service workers). No known risk of AIDS infection exists in other work settings, and fear of working with people infected by the virus is unwarranted.
Journal of the American Medical Association, 6 Dec. 1985, Vol.254, No.21, p.3023-3026; 13 Dec. 1985, No.22, p.3162-3167. 26 ref.

CIS 86-843 Bennett N.M., Carson J.A., Fish B.S., George L.J.W., Puszet P.J., Rankin D.W., Wilkinson P., Norman A.F., Stevens K., Maynard J.H., Menzies J.W.
An assessment of the prevalence of hepatitis B among health care personnel in Victoria
Data for this assessment was collected by means of a questionnaire, a serological survey and a review of notified cases. The only occupational group clearly at risk of acquiring hepatitis B infection is the dental profession (dentists, oral surgeons, dental therapists and nurses). There may also be an added risk for nursing and medical staff in institutions for mentally retarded children. Vaccination programmes for these two groups are recommended in the State of Victora (Australia).
Medical Journal of Australia, 25 Nov. 1985, Vol.143, No.11, p.495-499. 6 ref.

CIS 86-726 Osterholm M.T., Garayalde S.M.
Clinical viral hepatitis B among Minnesota hospital personnel
A 10-year survey of clinical hepatitis B virus (HBV) infections among Minnesota hospital personnel showed a drop from an annual incidence of 127 per 100,000 workers in 1975 to 8 per 100,000 workers in 1983. A similar drop was observed among personnel in hospitals with long-term haemodialysis (from 418 to 16 per 100,000). This drop in hepatitis B incidence occurred before the introduction of HBV vaccine and is probably due to improved infection control procedures. Conclusions of the study are (1) that most studies of HBV seroprevalence among hospital workers significantly overestimate the incidence of HBV infections, and (2) that vaccination of hospital employees against HBV, except in employees particularly at risk, would not be cost-effective.
Journal of the American Medical Association, 13 Dec. 1985, Vol.254, No.22, p.3207-3212. Illus. 54 ref.

CIS 86-257 Ndumbe P.M., Cradock-Watson J.E., MacQueen S., Dunn H., Holzel H., André F., Davies E.G., Dudgeon J.A., Levinsky R.J.
Immunisation of nurses with a live varicella vaccine
34 nurses with no history of chickenpox and who were seronegative to varicella zoster virus (VZV) were immunised with a live attenuated varicella vaccine (OKA-RIT strain) and were followed up for up to 3 years. There were no major reactions to the vaccine. After 1 year, 94% of the nurses had antibodies to VZV, but after 3 years only 64% had them. 2 of 13 vaccinated nurses who looked after children with chickenpox became infected, but 1 of them had never seroconverted. 6 out of 7 unvaccinated nurses who were exposed to chickenpox developed the disease. Thus this strain of VZV vaccine is shown to be safe and immunogenic in adults likely to be exposed to chickenpox. These tests also showed that both cell-mediated and antibody tests are needed for long-term assessment of immunity to chickenpox after vaccination.
Lancet, 18 May 1985, Vol.1, No.8434, p.1144-1147. 22 ref.

CIS 86-255 Employment and conditions of work in health and medical services
Emploi et conditions de travail dans les services médicaux et de santé [en francés]
This worldwide survey of working conditions in the health services includes a chapter on the major occupational hazards affecting health care personnel. The following aspects are covered: statistical data for some countries; communicable diseases; tuberculosis; hepatitis; rubella; AIDS; cytomegalovirus infection; chemical hazards (anaesthetic and sterilising agents - particularly ethylene oxide, hexachlorophene and formaldehyde); cytotoxic agents; pharmaceutical drugs and preparations; mercury; allergic disorders (dermatitis and asthma); physical hazards (ionising radiation, noise, high temperatures and exposure to asbestos); ergonomics and manual handling; psychosocial hazards (stress, solitary work, drug abuse and shift work); accidents and injuries; problems of special groups (women, domiciliary health care); problems encountered in practice in the implementation of safety and health measures.
International Labour Office, 1211 Genève 22, Switzerland, 1985. 142p. Bibl. Price: SF.20.00.

CIS 86-137 Maruna H., Rücker W.
Hepatitis B as an occupational disease in medical and health services
Die Hepatitis-B als Berufskrankenheit im Gesundheitswesen [en alemán]
This report analyses the results of serological tests involving 12,000 persons employed in public health services in Austria as a whole, and compares these results with data involving 1,900 employees of a large regional hospital. Hepatitis B antigens were found in the blood of 14.4% of the health service workers in Austria as a whole, and in the blood of 13.2% of the workers in the hospital (with particularly high rates in high-risk area: 50% in dialysis services and 20% in laboratory workers). There is further analysis by service, profession, age and length of employment in the field. There was a 45% reduction in the incidence of the disease after a vaccination campaign.
Allgemeine Unfallversicherungsanstalt, Abteilung für Unfallverhütung und Berufskrankheitenbekämpfung, Adalbert-Stifter-Strasse 65, 1200 Wien, Austria, 1985. 21p. Illus. 13 ref.

CIS 85-1688 Zourbas J., Le Hesran J.
Sero-epidemiologic study of hepatitis B markers among dental surgeons in the Department of Ille-et-Vilaine (France)
Etude séro-épidémiologique des marqueurs de l'hépatite B chez des chirurgiens-dentistes d'Ille-et-Vilaine [en francés]
Epidemiologic study of hepatitis B infection in dentists. Among 163 dentists surveyed, 17 had virus B markers (3 of whom had hepatitis during their professional life). Preventive methods are described: non-specific (disinfection of professional equipment, identification of hepatitis B virus carriers, personal protection) and specific (vaccination).
La Presse médicale, 1985, Vol.14, No.17, p.959-962. 18 ref.

CIS 85-1686 Saraux J.L., Buffet C., Etienne J.P.
Viral hepatitis B in health workers
Hépatite virale B chez le personnel de santé [en francés]
Study of the incidence and prevalence of clinical hepatitis B and of its markers according to professional category and hospital department. Survey of factors influencing the transmission of virus B: contact with blood derivatives, accidental injection by dirty needles, frequent contacts with patients, length of occupational exposure, age, size of locality. Study of virus transmission to patients in contact with carriers among the health staff. Conclusions in favour of vaccination against virus B as soon as possible, starting with the most exposed workers, and preferably before or at the beginning of employment.
La Presse médicale, 1985, vol.14, n°17, p.971-975. 25 ref.

CIS 85-1739
Health and Safety Commission, Health Services Advisory Committee
Safety in health service laboratories: Hepatitis B
This guidance note is intended to minimise the risk of infection from specimens potentially infected with hepatitis B. It covers: potential sources of infection (clinical material in general, but particularly blood; airborne sources); precautions (training of staff who collect blood, vaccination, use of automated equipment, eye protection, labelling of specimens, transport and postage of specimens, reception of specimens, testing for hepatitis B antigens or antibodies). Principles for general laboratory work on potentially infectious specimens are outlined, and recommended disinfectants (hypochlorites or aldehydes) are listed with the appropriate concentrations.
HM Stationery Office, 49 High Holborn, London WC1V 6HB, United Kingdom, 1985. 8p. Price: £2.00.


CIS 90-1523 Guidance on the protection against infectious liver disease for police, prison and customs personnel and for inspection personnel
Vejledning om beskyttelse mod smitsom leverbetændelse for politi-, fængsels- og toldpersonale samt visitationspersonale [en danés]
Contents of this training booklet giving practical advice on how to avoid infection from hepatitis: description of the disease and its transmission, general precautions, examination rooms, cells, equipment of patrol vehicles, cleaning of premises and vehicles, infection control instructions in case of an accident where there is risk of contagion. A list of relevant Danish directives is appended.
Branchesikkerhedsrådet for service- og tjenesteydelser, Arbejdsgiversekretariatet, Rosenørns Allé 1, 1970 Fredriksberg C, Denmark, 1984. 6p. 7 ref.

CIS 86-791 Manual of accident prevention in livestock raising
Manual de prevenção de acidentes na pecuária [en portugués]
This illustrated manual, written in simple language, is aimed at workers directly working with farm animals (mainly, cattle and horses) in Brazil. Chapter 2 covers the main sources of risk: accidents during the handling of animals; diseases transmitted by animals (brucellosis, foot and mouth disease, anthrax, tuberculosis, rabies, leptospirosis, hydatid disease (echinococcosis), cysticercosis, tetanus); risks associated with the administration of drugs and vaccines to animals; inadequate buildings used for animal housing; exposure to animal excrement; exposure to dangerous chemicals; hand tools; machinery and equipment; electricity; horse- and ox-drawn transportation. Chapter 3 covers general and specific first-aid measures: artificial respiration; cardiac arrest; injuries; fracture; burns; poisoning (tables present symptoms and treatment connected with commonly used pesticides and herbicides, and with commonly ocurring poisonous plants); stings and bites by poisonous animals (spiders, bees, wasps, snakes); transport of the injured. Chapter 4 covers the accident insurance coverage of rural workers in Brazil.
Fundacentro, C.P. 11484, CEP 05499 São Paulo, SP, Brazil, 1984. 73p. Illus. 36 ref.

CIS 86-258 Jílek D., Richter J., Haasová L., Švejda J.
Monitoring antibody activity with the ENC-HEM Sevac set in the staff of infectious disease departments in North Bohemia
Sledování protilátkové aktivity s použitím soupravy ENC-HEM Sevac u pracovníků infekčních oddělení v Severočeském kraji [en checo]
Antibodies against basic encephalitogenic protein, determined with the ENC-HEM Sevac hemagglutination set, were found in 50% (10 of 20 examined) of workers with antirabies vaccine. In one worker with a high titre of encephalitogenic antibodies, specific antirabies antibodies in low tire were detected. The findings indicate possible immunological response to the antigen in the work environment.
Časopis lékařů českých, 1984, Vol.123, No.38/39, p.1195-1197. Illus. 8 ref.

CIS 86-256 Farník J., Slováček R., Topolčan O., Karlíček V., Vilím V.
Risk of infection with viral hepatitis in pediatric workers
Riziko infekce virovou hepatitidou u zaměstnanců v pediatrii [en checo]
The serum of 61 nurses who had worked only in children's hospitals was examined radioimmunologically for the presence of hepatitis B antigens (HBsAg) and antibodies. The number of persons with antibodies increases with the length of employment and is considerably higher than in women of the same age in the normal population. The higher number of HBsAg-negative cases of viral hepatitis in pediatric workers in comparison with other health workers indicates the increased risk of infection with hepatitis A.
Československá pediatrie, 1984, Vol.39, No.2, p.99-100. Illus. 5 ref.

CIS 85-1447 Occupational safety and health and working environment in the food and drink industries
L'hygiène, la sécurité et le milieu de travail dans les industries des produits alimentaires et des boissons [en francés]
Chapter 1 deals with the factors to be considered from an OSH point of view (the size of the undertaking, level of skills, irregularity of work, rural workforce, training). Chapter 2 gives examples of occupational accidents in these industries in the developed world and discusses the difficulties in obtaining and interpreting these results. Chapter 3 is devoted to infectious occupational diseases (respiratory and skin) and diseases due to chemical hazards. Chapter 4 deals with adverse effects of the physical environment and the problems caused by rotating shift work. Chapter 5 is on prevention methods (machine guarding, personal protection, environmental protection, ergonomic design and workload analysis). Chapter 6 is on medical supervision and personal hygiene.
Report III, Food and Drinks Industries Committee, International Labour Office, First Session, 1984. ILO, 1211 Genève 22, Switzerland, 61p. Price: SF.12.50.

CIS 85-1069 Zuckerman A.J.
Palaeontology of smallpox
A discussion of whether archaeologists and anthropologists who handle incompletely decomposed bodies (possibly victims of smallpox) are at risk of being infected with smallpox. It is suggested that scientists in this kind of research be immunised against the disease, not only for their own protection, but also to prevent the reintroduction of smallpox into the general population.
Lancet, 22/29 Dec. 1984, Vol.2, No.8417/8, p.1454. 5 ref.

CIS 85-1189 Decree No.84-492 of 22 June 1984 revising and completing the schedules of occupational diseases annexed to decree No.46-2959 of 31 Dec. 1946
Décret n°84-492 du 22 juin 1984 révisant et complétant les tableaux des maladies professionnelles annexés au décret n°46-2959 du 31 déc. 1946 [en francés]
Schedules of occupational diseases subject to compensation in France (a comparison with older schedules was done under CIS 85-473). Classification of the diseases: diseases caused by ionising radiations; by halogenated aromatic hydrocarbons; by tuberculosis bacteria; occupational viral hepatitis; occupational mycoses of the skin; occupational diseases caused by amoeba. 4 new schedules are created: cancers caused by chromic acid, by alkaline and alkaline-earth chromates and bichromates and by zinc chromate; diseases caused by furfural and by furfuryl alcohol; infectious diseases contracted in hospitals; diseases resulting from exposure to selenium and its compounds.
Journal officiel de la République française, 25, 26 June 1984, Vol.116, No.148, p.1972-1975.

CIS 85-857 Harris J.R., Finger R.F., Kobayashi J.M., Hadler S.C., Murphy B.L., Berkelman R.L., Bussell K.E.
The low risk of hepatitis B in rural hospitals
A questionnaire survey and serum analysis of 2064 hospital employees in the rural areas of Washington state (USA). 96 employees (4.7%) had hepatitis B virus markers, significantly below the rate for hospital employees in urban areas. Significant risk factors were prior residence in a city with more than 100,000 people, regular contact with blood, increasing patient contact, length of employment and race.
Journal of the American Medical Association, 21 Dec. 1984, Vol.252, No.23, p.3270-3272. 18 ref.

CIS 85-709
Advisory Committee on Dangerous Pathogens
Categorisation of pathogens according to hazard and categories of containment
A classification of pathogens (bacteria, fungi, parasites, and viruses) according to the hazards they represent. Requirements for safe operation of laboratories are listed for 4 levels of containment, as well as for the handling of vertebrate animals experimentally infected with one of these 4 categories of pathogens. In the appendix: safe use of microbiological safety cabinets; use of respiratory protective equipment; containment of latently infected animals; safe use of invertebrate animals in laboratories; handling of patients infected with pathogens, and safe use of associated laboratory specimens; handling rabies and hepatitis B virus; training of laboratory personnel.
H.M. Stationery Office, 49 High Holborn, London WC1V 6HB, United Kingdom, 1984. 48p. Illus. 16 ref. Price: £4.50.

CIS 85-799 Congo-Crimean hemorrhagic fever - Republic of South Africa
Case reports transmitted by the Centers for Disease Control (Atlanta, USA) involving 7 cases of severe illness in South Africa (1 death). 6 of the victims had worked with cattle, the 7th with sheep. The disease was identified by immunofluorescence assay testing as Congo-Crimean haemorrhagic fever, a disease spread from cattle to man directly or by ticks.
Journal of the American Medical Association, 9 Nov. 1984, Vol.252, No.18, p.2533-2537. Illus. 6 ref.

CIS 85-852 Venkitaraman A.R., John T.J.
The epidemiology of varicella in staff and students of a hospital in the tropics
A 5-year epidemiological survey of the incidence of varicella (chickenpox) among staff and students (2874 persons in all) of a hospital in India revealed an annual rate of 0.72 cases per 100. The incidence was highest among 17-24 year old student nurses (3.22 cases per 100 per year). Most cases occurred during the cooler and more humid parts of the year. Complement-fixing antibodies to varicella-zoster virus were found in only 44 of 102 serum samples taken from student nurses, showing a much lower level of immunity to varicella than in the USA. A programme of preventive immunisation among hospital workers is recommended.
International Journal of Epidemiology, Dec. 1984, Vol.13, No.4, p.502-505. Illus. 13 ref.

CIS 85-473 New schedules of occupational diseases - Decree No.84-492 of 22 June 1984
Nouveaux tableaux de maladies professionnelles - Décret n°84-492 du 22 juin 1984 [en francés]
New schedules of compensable occupational diseases in France, accompanied by comments on the changes made since the publication of the previous schedule: diseases due to ionising radiation; diseases caused by derivatives of aromatic hydrocarbons; cancers caused by chromic acid, by alkaline and alkaline-earth chromates and bichromates and by zinc chromate; diseases caused by tuberculosis bacilli; occupational viral hepatitis; occupational dermatomycoses; occupational amoebic diseases; occupational disease caused by furfural and furfuryl alcohol; diseases caused by selenium and its inorganic derivatives; infectious diseases contracted in hospital environments. Duplicate of CIS 85-1189.
Cahiers de notes documentaires - Sécurité et hygiène du travail, 4th quarter 1984, No.117, Note No.1506-117-84, p.531-552.

CIS 84-554 Catelle A., Christmann D., de Lavergne E.
Investigation of genetic markers for hepatitis B virus in 204 hospital workers
Recherche des marqueurs génétiques du virus de l'hépatite B chez 204 personnes travaillant en milieu hospitalier [en francés]
To determine the best strategy for vaccination against hepatitis B among hospital staff, 4 genetic markers were looked for systematically by doing serologic tests on 204 hospital workers (medical and laboratory staff). More than 30% of the subjects had at least 1 marker, showing a fairly high incidence of infection. It is suggested that hospital staff at a high infection risk should be screened by serologic tests, and only those with a negative result should be immunised. Among staff with a low infection risk, vaccination without prior serological tests is more cost-effective, however.
Semaine des hôpitaux, 1983, Vol.59, No.32, p.2225-2227. 10 ref.


CIS 84-1042 Vézina N., Beauvais A., Mergler D.
Warts: an occupational disease
Les verrues: une maladie professionnelle [en francés]
The aim of this survey was to evaluate the prevalence of warts among workers in 8 poultry slaughterhouses in Quebec and to determine the specific environmental factors that could favour the development and propagation of the viruses causing warts. The distribution by age, seniority and sex of those responding to the questionnaire (569) was similar to that of those sent the questionnaire (1194). The prevalence of warts among the workers was 28.5% (Papilloma virus), while only 5.9% had warts before their employment in slaughterhouses. In the general population, the prevalence of warts is between 7 and 10%, with a peak around the age of 14 years. In poultry slaughterhouses, the highest incidence (38.17%) occurs among workers of 25-29 years. Among workers with 4-6 years of seniority, the incidence is 40.6%. Factors significantly associated with warts are: high humidity, wearing of steel-mesh gloves that were too large, work with saws and the handling of cold objects.
Archives des maladies professionnelles, 1983, Vol.44, No.8, p.551-558. Illus. 26 ref.

CIS 84-502 Desmyter J., Johnson K.M., Deckers C., LeDuc J.W., Brasseur F., Van Ypersele de Strihou C.
Laboratory rat associated outbreak of haemorrhagic fever with renal syndrome due to Hantaan-like virus in Belgium
3 or 4 people handling laboratory rats suffered acute renal failure. Hantaan-like virus was identified as the cause. Serological studies revealed infected rat strains at different sites on the university campus where the patients worked, and 50% of the exposed staff showed evidence of past infection. Monitoring of laboratory rats for Hantaan-like viruses (originating in East Asia) is recommended.
Lancet, 24-31 Dec. 1983, Vol.2, No.8365/6, p.1445-1448. 19 ref.

CIS 84-498 Saxinger W.C., Blayney D.W., Postal M., Blattner W.A.
Risk of infection of laboratory workers with the human T-cell leukaemia virus
Viral antibodies were looked for in 125 workers at virology, tissue culture, pathology, and cytogenetics laboratories and patient care areas, all of whom were studying human T-cell leukaemia virus (HTLV) or HTLV-infected patients. One (black female) laboratory worker had serum antibodies to HTLV, probably acquired before she began work in the USA. The use of safety procedures similar to those for hepatitis appears to have been adequate. The results demonstrate the usefulness of pre-employment serum storage for biological workers.
Lancet, 30 July 1983, Vol.2, No.8344, p.274-275. 10 ref.

CIS 84-473 Dworsky M.E., Welch K., Cassady G., Stagno S.
Occupational risk for primary cytomegalovirus infection among pediatric health care workers
The prevalence of cytomegalovirus (CMV) antibody was determined in medical students, house staff, nurses and physicians, and pregnant and non-pregnant women in the community. Exposure of health-care workers was estimated by determining the prevalence of CMV infection in 3 groups of asymptomatic infants for whom they provided care. CMV was excreted in the urine or saliva of 1.6% of 2,899 newborns, 13% of 24 premature infants hospitalised for over a month, and 5% of 44 older infants seen as outpatients. Annual attack rates in the hospital students and staff were not higher than in the women in the community, and the risk of occupational contact is no larger than that faced by young women in the community at large.
New England Journal of Medicine, 20 oct. 1983, Vol.309, No.16, p.950-953. 15 ref.

CIS 83-1977 Young A.B., Reid D., Grist N.R.
Is cytomegalovirus a serious hazard to female hospital staff?
The findings of a working party set up to study this question in Scotland are reported. The main impact of cytomegalovirus (CMV) infection occurs during pregnancy. Epidemiological data from Scotland, the rest of the United Kingdom and other countries are reviewed: the risk of congenital infection among the general population is similar (3-6 per 1000 births). There is a possibility of a slight occupational risk to hospital personnel. In children's hospitals, hygiene practices may affect the risk. Routine screening of staff for CMV antibody is not recommended. Recommendations for the prevention of cross-infection are given.
Lancet, 30 Apr. 1983, Vol.I, No.8331, p.975-976. 11 ref.

CIS 83-1748 Nogueira D.P.
Occupational risks of dentists and their prevention
Riscos ocupacionais de dentistas e sua prevenção [en portugués]
A review article describing the occupational health risks run by dentists, and the corresponding preventive measures. Problems include: stress of mental work; standing posture; use of sharp metallic tools; the high-frequency noise of dental drills; X-rays; mercury vapours and anaesthetic substances; infectious diseases (chiefly hepatitis B); head lice.
Revista brasileira de saúde ocupacional, 1983, Vol.11, No.41, p.16-24. 59 ref.

CIS 83-542 Neukirch F., Perdrizet S., Bouvier-Colle M.H., Pariente R.
Respiratory deaths in agricultural and non-agricultural workers in France from 1970 to 1974
Mortalité par maladies respiratoires chez les travailleurs en milieu agricole et non agricole en France de 1970 à 1974 [en francés]
Analysis of respiratory mortality data in France collected by a European Community working group and comparison of findings in urban and rural communities. There was excess acute respiratory mortality among male and female agricultural workers; this confirmed the existence of this specific risk among agricultural workers. Further studies will be needed to precisely identify the environmental factors specific to farmwork to which these agricultural workers are exposed.
Revue française des maladies respiratoires, 1983, Vol.11, No.1, p.47-55. 17 ref.


CIS 84-1086 Hepatocarcinogenesis in laboratory rodents: relevance for man
2 broad mechanisms are considered: in the genotoxic model, chemicals are thought to act by altering the structure of the genetic material of the cell, thus converting it to a cancerous cell; in the non-genotoxic model, the cancer develops from a non-cancerous lesion - involving necrosis, at the subcellular level, or involving hyperplasia. A recommended sequence of steps is given for establishing the hepatocarcinogenic potential of a chemical to laboratory animals and man.
European Chemical Industry, Ecology and Toxicology Centre, Avenue Louise 250, Boîte 63, 1050 Bruxelles, Belgium, Oct. 1982. 77p. Illus. 253 ref.

CIS 83-1396 Bacterial and viral zoonoses
Report of an expert committee (Geneva, Switzerland, 22-30 Sep. 1981): impact of zoonoses and general preventive measures; factors affecting the spread of zoonoses; diagnosis and surveillance; prevention and control of zoonoses; contributions of zoonoses control to national and international programmes; conclusions and recommendations. Appendices.
World Health Organization, Avenue Appia, 1211 Genève 27, Switzerland, 1982. 146p. Bibl. Price: SF.11.00.

CIS 83-1065 Holdener F., Grob P.J., Joller-Jemelka H.I.
Hepatitis virus infection in flying airline personnel
Sera of 1126 flying personnel were tested for present or past infection with hepatitis B virus (HBV) or A virus (HAV). The prevalence of anti-HA antibodies was similar to that of controls. HBV immunity was similar in pilots, flight engineers, and female flight attendants, but more prevalent in male flight attendants. Within 1 year, 13 of 2624 personnel had acute hepatitis, mainly due to hepatitis B among male flight attendants. It is suggested that life style may be responsible for these findings.
Aviation, Space, and Environmental Medicine, June 1982, Vol.53, No.6, p.587-590. Illus. 6 ref.

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