PURPOSE: The purpose of this study was to investigate the prevalence of diaper dermatitis (DD), knowledge of DD prevention and treatment, and diaper hygiene practices among mothers with diaper-wearing children. METHODS: The participants were 176 mothers who presented to an outpatient clinic at a children's hospital with diaper-wearing children. Data were collected using a structured self-administered questionnaire. RESULTS: The percent of correct answer for knowledge about DD was 59.7%. Almost half of the participants' children had experienced at least 1 episode of DD during the last 6 months. Inappropriate diaper hygiene practices, such as using talcum powder on DD and rubbing with a dry towel after cleansing, were reported. Moreover, only 37% of mothers used the recommended skin barrier to prevent DD. Although many children suffer from DD, levels of educational experience and perceived need for education on this topic were low. Almost 70% of mothers obtained DD-related information through internet sites. CONCLUSION: Educating parents about the etiology of DD and evidence-based diaper hygiene practices is an important aspect of effective DD prevention and treatment. Internet sites or smartphone apps may be effective methods for education on DD prevention and treatment considering parents' preferences for ways to obtain health information.
Ambulatory Care Facilities ; Child ; Dermatitis ; Diaper Rash ; Education ; Humans ; Hygiene ; Infant ; Internet ; Mothers ; Parents ; Prevalence ; Skin ; Smartphone ; Talc

The present review summarizes the results of several follow-up studies assessing an asbestos product manufacturing plant in Chongqing, China, and discusses three controversial issues related to the carcinogenicity of asbestos. The first issue is the amphibole hypothesis, which asserts that the carcinogenicity of asbestos is limited to amphiboles, such as crocidolite, but not serpentines, such as chrysotile. However, considering the possible multiple component of asbestos carcinogenicity in the presence of tobacco smoke or other carcinogens, chrysotile cannot be regarded as non-carcinogenic. Additionally, in a practical sense, it is not possible to assume "pure" chrysotile due to its ubiquitous contamination with tremolite, which is a type of amphibole. Thus, as the International Agency for Research on Cancer (IARC) assessed, all forms of asbestos including chrysotile should be regarded carcinogenic to humans (Group 1). The second issue is the chrysotile/tremolite paradox, which is a phenomenon involving predominant levels of tremolite in the lung tissues of individuals who worked in locations with negligible levels of tremolite due to the exclusive use of chrysotile. Four possible mechanisms to explain this paradox have been proposed but this phenomenon does not support the claim that amphibole is inert. The final issue discussed is the textile mystery, i.e., the higher incidence of cancer in asbestos textile plants compared to asbestos mines where the same asbestos was produced and the exposure levels were comparable. This phenomenon was first reported in North America followed by UK and then in the present observations from China. Previously, levels of fiber exposure were calculated using a universal converting coefficient to estimate the mass concentration versus fiber concentration. However, parallel measurements of fiber and mass concentrations in the workplace and exposed air indicated that there are wide variations in the fiber/mass ratio, which unjustifies the universal conversion. It is possible that contamination by airborne non-fibrous particles in mines with mass fiber conversion led to the overestimation of fiber concentrations and resulted in the textile mystery. Although the use and manufacturing of asbestos has been banned in Japan, more than 10 million tons of asbestos had been imported and the majority remains in existing buildings. Thus, efforts to control asbestos exposure should be continued.
Asbestos ; classification ; toxicity ; Asbestos, Amphibole ; toxicity ; Asbestos, Serpentine ; toxicity ; Carcinogens ; China ; Follow-Up Studies ; Humans ; Lung Neoplasms ; chemically induced ; epidemiology ; Manufacturing and Industrial Facilities ; statistics & numerical data ; Mining ; statistics & numerical data ; Occupational Diseases ; epidemiology ; Occupational Exposure ; adverse effects ; Textiles ; Tobacco Smoking ; epidemiology

Spontaneous regression of metastatic renal cell carcinoma (mRCC) was reported over the last century. However, there are no reports on spontaneous regression of mRCC by talc pleurodesis. A 43-year-old man who underwent left nephrectomy by RCC visited emergency room with headache and hallucination. Tumor was metastasized to brain, lung, and pleura accompanied by malignant pleural effusion. Talc pleurodesis by video-assisted thoracoscopic surgery was performed to treat malignant pleural effusion. After 7 months without specific chemotherapy, pulmonary lesions of mRCC gradually regressed. We thought that this phenomenon appears as an immunologic response of talc pleurodesis. We herein present a rare case of spontaneous regression of mRCC following talc pleurodesis. To the best of our knowledge, this is the first case of spontaneous regression in mRCC following talc pleurodesis.
Adult ; Brain ; Carcinoma, Renal Cell* ; Drug Therapy ; Emergency Service, Hospital ; Hallucinations ; Headache ; Humans ; Lung ; Nephrectomy ; Pleura ; Pleural Effusion, Malignant ; Pleurodesis* ; Talc* ; Thoracic Surgery, Video-Assisted

BACKGROUND: The goal of this study is to develop a general population job-exposure matrix (GPJEM) on asbestos to estimate occupational asbestos exposure levels in the Republic of Korea. METHODS: Three Korean domestic quantitative exposure datasets collected from 1984 to 2008 were used to build the GPJEM. Exposure groups in collected data were reclassified based on the current Korean Standard Industrial Classification (9th edition) and the Korean Standard Classification of Occupations code (6th edition) that is in accordance to international standards. All of the exposure levels were expressed by weighted arithmetic mean (WAM) and minimum and maximum concentrations. RESULTS: Based on the established GPJEM, the 112 exposure groups could be reclassified into 86 industries and 74 occupations. In the 1980s, the highest exposure levels were estimated in “knitting and weaving machine operators” with a WAM concentration of 7.48 fibers/mL (f/mL); in the 1990s, “plastic products production machine operators” with 5.12 f/mL, and in the 2000s “detergents production machine operators” handling talc containing asbestos with 2.45 f/mL. Of the 112 exposure groups, 44 groups had higher WAM concentrations than the Korean occupational exposure limit of 0.1 f/mL. CONCLUSION: The newly constructed GPJEM which is generated from actual domestic quantitative exposure data could be useful in evaluating historical exposure levels to asbestos and could contribute to improved prediction of asbestos-related diseases among Koreans.
Asbestos* ; Classification ; Dataset ; Mesothelioma ; Occupational Exposure ; Occupations* ; Republic of Korea* ; Talc

This study aimed to conduct measurement uncertainty assessment of a new method for determination of Sudan colorants (Sudan I, II, III and IV) in food by high performance liquid chromatography (HPLC). Samples were extracted with organic solvents (hexane, 20% acetone) and first purified by magnesium trisilicate (2MgO·3SiO2). The Sudan colorants (Sudan I-IV) were also initially separated on C8 by gradient elution using acetonitrile and 0.1% (v/v) formic acid aqueous solution as the mobile phases and detected with diode-array detector (DAD). The uncertainty of mathematical model of Sudan I, II, III and IV is based on EURACHEM guidelines. The sources and components of uncertainty were calculated. The experiment gave a good linear relationship over the concentration from 0.4 to 4.0 μg/mL and spiked recoveries were from 74.0% to 97.5%. The limits of determination (LOD) were 48, 61, 36, 58 μg/kg for the four analytes, respectively. The total uncertainty of Sudan colorants (Sudan I, II, III and IV) was 810±30.8, 790±28.4, 750±27.0, 730±50.0 μg/kg, respectively. The recovery uncertainty was the most significant factor contributing to the total uncertainty. The developed method is simple, rapid, and highly sensitive. It can be used for the determination of trace Sudan dyes in food samples. The sources of uncertainty have been identified and uncertainty components have been simplified and considered.
Azo Compounds ; chemistry ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Food Analysis ; methods ; Food Coloring Agents ; chemistry ; isolation & purification ; Humans ; Limit of Detection ; Magnesium Silicates ; chemistry ; Naphthols ; chemistry ; isolation & purification

OBJECTIVE: This study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups. MATERIALS AND METHODS: This study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups. RESULTS: Concerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, 5.4 +/- 2.7 mm) and lengths (5-310 mm; 72.6 +/- 54.8 mm). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05). CONCLUSION: Pleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals.
Adult ; Aged ; Aged, 80 and over ; Asbestos, Serpentine/*toxicity ; Asbestosis/*etiology/radiography ; Asian Continental Ancestry Group ; Environmental Pollutants/toxicity ; Female ; Humans ; Male ; Middle Aged ; Mining ; Occupational Exposure ; Pleural Diseases/*etiology/radiography ; Republic of Korea ; Tomography, X-Ray Computed

INTRODUCTIONThis study aimed to assess the effectiveness of medical thoracoscopy (MT) and thoracoscopic talc poudrage (TTP) in patients with exudative pleural effusion.

METHODSWe evaluated the diagnostic yields, complications and outcomes of MT and TTP in 41 consecutive patients with symptomatic pleural effusions who were planned to undergo both procedures from 1 December 2011 to 30 November 2012. Data was reviewed retrospectively and prospectively up to March 2013.

RESULTSAmong the 41 patients, 36 underwent MT with the intent of biopsy and talc pleurodesis, 2 underwent MT for pleurodesis only and 3 had failed MT. Aetiologies of pleural effusion included lung cancer (n = 14), tuberculosis (n = 9), breast cancer (n = 7), ovarian cancer (n = 2), malignant mesothelioma (n = 1), congestive cardiac failure (n = 1), peritoneal dialysis (n = 1) and hepatic hydrothorax (n = 1); pleural effusion was undiagnosed in five patients. The overall diagnostic yield of MT, and the yield in tubercular and malignant pleural effusions were 77.8%, 100.0% and 82.6%, respectively; it was inconclusive in 22.2%. Complications that occurred were self-limiting, with no procedure-related mortality. The 30-day mortality rate was 17.1%. A total of 15 patients underwent TTP. The 30-, 60- and 90-day success rates were 77.8%, 80.0% and 80.0%, respectively, with one patient having complications (i.e. empyema). The 30-day mortality was 40.0%.

CONCLUSIONMT is a safe procedure with high diagnostic yields in undiagnosed pleural effusions. TTP is an effective method to stop recurrence of pleural effusions.

Aged ; Aged, 80 and over ; Biopsy ; Exudates and Transudates ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; complications ; diagnosis ; Pleural Effusion ; diagnosis ; therapy ; Pleural Effusion, Malignant ; diagnosis ; Pleurodesis ; methods ; Prospective Studies ; Recurrence ; Retrospective Studies ; Talc ; administration & dosage ; Thoracoscopy ; methods ; mortality ; Treatment Outcome ; Tuberculosis ; complications ; diagnosis

OBJECTIVETo analyze asbestos exposure level between 1984 and 2010 in a district of malignant mesothelioma with clustering incidence in Zhejiang Province, in order to improve the recognizing and early diagnosis of malignant mesothelioma, protect the health of workers.

METHODSMonitoring data of total asbestos dust concentration in the air of workplace from 1984 to 2010 in asbestos textile enterprises, family hand spinning operation, brake production, and asbestos board production in Zhejiang Province were collected in the local CDC. A total of 766 TWA copies of mass concentration were collected, and 1233 copies of MAC data. Asbestos mass concentration and fibre counting concentration of 29 points of family hand spinning operation were parallel determinated in the same time and the same sampling point. Raw asesbtos materials and dust composition of local asbestos processing corporations were collected and analyzed using X-ray diffraction method.

RESULTSRaw materials of asbestos used between 1984 and 2010 in this area were chrysotile from Sichuan, Qinghai, Xinjiang, Russia, Zimbabwe, and some were mixed with SiO2, CaCO3 and other impurities. Raw materials used in asbestos board production were blue asbestos. Dust concentration between 1960s and 1980s in asbestos processing plants far exceeded the national standard. After then the dust concentration decreased significantly, but still higher than the national standard. 95.2% of air dust concentrations in the workplaces of asbestos factories exceeded the standard, and dust concentrations of workplaces of raw material, spinning, weaving, carding and labor insurance were above 90% in which carding work had the highest median concentration. 37.9% of dust mass concentrations in hand spinning work exceeded the standard where textile machinery side had the highest value. Beating job in asbestos board manufacturing and grinding job in brake production had higher concentrations.

CONCLUSIONSMost of production technologies in asbestos processing industry exceed the standard level, indicating that the workers were at risk for malignant mesothelioma and other asbestos related diseases, which should draw high attention.

Asbestos ; analysis ; Asbestos, Crocidolite ; analysis ; Asbestos, Serpentine ; analysis ; China ; epidemiology ; Dust ; analysis ; Humans ; Lung Neoplasms ; epidemiology ; Mesothelioma ; epidemiology ; Occupational Diseases ; epidemiology ; Silicon Dioxide ; analysis ; Workplace

OBJECTIVES: Asbestos is a carcinogenic mineral substance formerly used widely in the construction industry, all forms of which, except for chrysotile asbestos, have been banned in the Philippines. This article aims to propose policy alternatives to reduce the health and economic effects of continued asbestos use in the country.
METHODS: Records of asbestos-related diseases, and asbestos industry-related data in the country were consolidated. The impact of continued asbestos use on the national economy were estimated incorporating natural mortality, regulations of the Department of Labor and Employment (DOLE), and concepts of multiplier effect and net present value. Round table discussions validated data and generated policy recommendations.
RESULTS: Filipinos directly and indirectly exposed to asbestos-containing materials (ACMs) are 5,289 and 30,000, respectively. The contributions of these groups to the national economy were estimated at PhP 1.08 Billion annually for workers directly exposed to ACMs and PhP 6.83 Billion annually for workers indirectly exposed. Two policy options--adjustment of threshold limit values, and a total ban--are presented.
CONCLUSION: A total ban on all forms of asbestos is shown to be the more cost-effective policy option for the country. It is recommended that government agencies, stakeholders in the asbestos industry, and the general public be involved in strategies for improving surveillance on asbestos exposure, increasing public awareness, and promoting the use of asbestos alternatives.

Asbestos, Serpentine ; Threshold Limit Values ; Construction Industry ; Philippines ; Asbestos ; Carcinogens ; Policy ; Government Agencies ; Employment

OBJECTIVETo clarify the dose-response relationship between asbestos dust exposure and lung cancer incidence in chrysotile asbestos miners by fixed cohort study and to investigate the incidence rates of lung cancer in exposure to different concentrations of asbestos dust.

METHODSA retrospective cohort study was conducted in 1932 asbestos miners who registered from January 1, 1981 to December 31, 1988, had worked for at least 1 year, and had no obvious cardiopulmonary diseases; the cohort study began in July 2009 and covered a time span of 29 years (1981 - 2009). The personal information, occupational history, disease history, and health data of these miners were recorded, and the monitoring data on dust concentrations in the mine over the years were collected. The dose-response relationship between asbestos dust concentration and lung cancer incidence was established by the method of life table; a regression equation was fitted to predict the excess incidence rates of lung cancer under the conditions of different working years and dust concentrations.

RESULTSA significant dose-response relationship was observed between cumulative exposure (Ce) and cumulative probability (Px) of lung cancer incidence, and the smokers hada higher Px than nonsmokers. When Ce was less than 2000 mg/m(3)·each year, Px reached 6.58/10000; when Ce was not less than 2000 mg/m(3)·and less than 3000 mg/m(3)·each year, Px reached 91.72/10000; when Ce was more than 5000 mg/m(3)·each year, Px was as high as 141.02/10000. The three models were fitted to obtain the optimal regression equation: Px = -0.0004Ce(2) + 0.0052Ce - 0.0011 (r(2) = 0.9387). In the workshop of asbestos mine in this study, the average dust concentration was 85 times higher than the limit in 2009, so the excess incidence rate of lung cancer was 112.598/10000 if the miners worked under this condition for 40 years, according to the equation.

CONCLUSIONThere is a significant dose-response relationship between cumulative asbestos exposure and lung cancer incidence in chrysotile asbestos miners. The risk for lung cancer rises as asbestos exposure increases.

Asbestos, Serpentine ; toxicity ; Dust ; Female ; Humans ; Lung Neoplasms ; etiology ; Male ; Mining ; Occupational Exposure ; Retrospective Studies