BACKGROUND:The appropriate sequence of different imagings and indications of thoracic computed tomography (TCT) in evaluating chest trauma have not yet been clarified at present. The current study was undertaken to determine the value of chest X-ray (CXR) in detecting chest injuries in patients with blunt trauma. METHODS:A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department (ED) in the period of 2009–2013 were retrospectively reviewed. The patients met inclusion criteria (age>8 years, blunt injury to the chest, hemodynamically stable, and neurologically intact) and underwent both TCT and upright CXR in the ED. Radiological imagings were re-interpreted after they were collected from the hospital database by two skilled radiologists. RESULTS:Of the 447 patients, 309 (69.1％) were male. The mean age of the 447 patients was 39.5±19.2 (range 9 and 87 years). 158 (35.3％) patients were injured in motor vehicle accidents (MVA). CXR showed the highest sensitivity in detecting clavicle fractures [95％CI 78.3 (63.6–89)] but the lowest in pneuomediastinum [95％CI 11.8 (1.5–36.4)]. The specificity of CXR was close to 100％ in detecting a wide array of entities. CONCLUSION:CXR remains to be the first choice in hemodynamically unstable patients with blunt chest trauma. Moreover, stable patients with normal CXR are candidates who should undergo TCT if significant injury has not been ruled out.

INTRODUCTIONMethyl bromide is a toxic substance that has hazardous effects on human health with acute and chronic exposure. Our previous study showed that methyl bromide applicators frequently use large amounts of methyl bromide haphazardly in greenhouses in the prefectures of Narlidere and Balcova in the Aegean city of Izmir. This study aims to evaluate the health conditions of these workers.

MATERIALS AND METHODSOur previous study showed that there are 38 methyl bromide applicators in our study area. After the informed consent of methyl bromide applicators was obtained, a questionnaire was used for a survey of demography and symptoms. Each subject was examined before and after application of the compound. Blood and urine samples were collected and stored. Blood samples were analysed for methyl bromide and bromide ion, kidney and liver function tests and lipid profile.

RESULTSThe age range of subjects was 19 to 53 years (mean age: 41 +/- 8.57). This study showed that methyl bromide applicators use large amounts of methyl bromide disregarding legal regulations and that some of them had nonspecific complaints. Subjects had been working as methyl bromide applicators for approximately 9.7 +/- 4.15 years. A total of 69.7% of methyl bromide applicators reported that they did not use protective equipment while 33.3% of them had a history of acute methyl bromide intoxication. A statistically significant relationship was found between the usage of protective equipment and the level of blood bromide ion in the blood (P <0.05).

CONCLUSIONUsage of methyl bromide, training, screening and follow-up of applicators must be rigorously controlled in accordance with national legal arrangements and international protocols. Greater efforts are required in the implementation of controls to achieve the targets set by the legal regulations and to ensure continual improvement in the limitation of the risks of this environmental hazard.

Adult ; Case-Control Studies ; Female ; Gardening ; Health Surveys ; Humans ; Hydrocarbons, Brominated ; blood ; toxicity ; urine ; Inhalation Exposure ; adverse effects ; Male ; Middle Aged ; Noxae ; blood ; toxicity ; urine ; Occupational Diseases ; chemically induced ; epidemiology ; Occupational Exposure ; adverse effects ; Protective Clothing ; Surveys and Questionnaires ; Time Factors ; Turkey ; epidemiology