Bulletin of the Institute of Maritime and Tropical Medicine in Gdynia最新文献

Changes in serum alpha 2-antyplasmin (alpha 2-AP) in rabbits exposed to hyperbaric environment (6 ATA, 40 min.) and 5-minute decompression (1 ATA/min) were estimated. 10 male New Zealand white rabbits consisted the studied group, and 10 the control group. Blood samples were collected in rabbits from the femoral artery: once before placing the rabbit in the hyperbaric chamber, and three times after opening the chamber: just after decompression, at 10 and 20 minutes after collecting the second sample. Serum alpha 2-AP activity was measured using chromogenic substrates. Rapid decompression in rabbits exposed to hyperbaric environment at 6 ATA caused decrease in serum alpha 2-AP activity. Significant decrease in serum alpha 2-AP activity was observed at 20 min. after decompression. Serum alpha 2-AP activity can be applied in diagnostics of DCS.

The present study was conducted to evaluate decompression, stress after heliox saturated dives on the basis of selected haemostatic parameters. Instantenously before and after each pressure exposure, the following examinations were performed: determination of blood platelets count, of aggregation and fibrinogen level, of several coagulation factors VII, XII and of hematocrit. After diving, a slight drop of blood platelet count and XII factor and fibrinogen was observed. Evaluation of haemostasis is a useful tool not only to verify decompression systems, but to correct them as well.

The ILO has sought to promote the health of workers since its founding in 1919. Concern for the special nature of life and work at sea has resulted in considerable work aimed at protecting and improving the health and safety of seafarers and fishermen. Much of the success of these efforts, however, rests with those involved in maritime medicine on a daily basis. It is therefore with great sincerity that the ILO applauds the founding of the IMHA and the initiation of training programmes aimed at improving the quality of maritime medicine and thus seafarers' health.

A group of harbour workers was examined: 127 operators of mechanic equipment, 74 cranemen, 55 container stevedores, 36 hoistmen. The control group consisted of 49 electricians. Mean age of the subjects was: 37.1 +/- 7.7 years, working experience averaged 15.5 +/- 7.4 years. All the examined workers were subjected to ecg, phonocardiographic examinations and to the physical analysis of circulation according to Wezler-Boerger and Braemser-Ranke. Heart beat rate at rest did not show statistically significant differences (p > 0.05). In the measurements of the diastolic and systolic pressure at rest statistically significant differences between the controls and the other groups were found. Arterial hypertension (160 mmHg and over the systolic pressure, and 95 mmHg and over diastolic pressure) was found in 21% mechanic equipment operators, 15% cranemen, 11% container stevedores, 8% hoistmen. 341 Ecg recordings were evaluated with the Minnesota Code, no pathologies in Q or QS were revealed. Features of the parasympathetic system effect were noted in 24% of the people examined. Alterations within ST-T segment were observed in the people showing arterial hypertension. Features of the sympathetic system impact were registered in 9% of cases. In phonocarcdiographic examinations 3 cases of compensated heart defects were revealed. The parameters obtained from the physical analysis were evaluated in the subjects with an appropriate weight, obesity and arterial hypertension. By comparison of mean rates of the central pulse, electric resistance, stroke and minute volume and air chamber volume statistically significant differences were found (p < 0.001). Evaluating the whole of the results a risk of the heart ischemic disease was found in 1/4 of the people examined. The changes observed were associated with individual factors, not with the job performed.

Following the ILO/WHO Consultation on Guidelines for Conducting Pre-sea and Periodic Medical Fitness Examinations for Seafarers (Geneva, 25-27 November 1987) held at the International Labour Office, this Course was conducted at the Institute of Maritime and Tropical Medicine and the WHO Collaborating Centre there on 14-28 June 1998. The Lecturers were scientists and experts in this field of medicine working at the Institute, and also invited Guest Lecturers from Belgium, Germany, Italy and Sweden. The WHO Representative from Geneva (Dr. M.I.Mikheev, Chief, Occupational Health, WHO HQ) participated during the last 3 days of the Course, lectured on the role of WHO in the health protection of maritime workers, took part in the field visits, and distributed Course Certificates to participants. The invited ILO Representative was not able to come, but ILO sent to Gdynia ILO publications for distribution to participants, and also a paper entitled "The International Labour Organization and the Health of Seafarers and Fishermen", text of which is published in this issue of the Bulletin.

Examinations on stevedores were performed in three series in the period from 1976 to 1997. Randomly selected were 286 of them in the first series of examinations, 224 in the second and 106 in the third one. In addition, the examinations enrolled also 106 stevedores who have lost their health qualifications, 55 retired workers, and 363 harbour workers whose jobs did not include direct loading of cargo, and they constituted the control group. Cardiographic examinations were performed in the morning, ECG was carried out with the use of Multiscriptor apparatus and the evaluation was made using the Minnesota code. Systolic blood pressure in stevedores averaged: 124.6 +/- 14.9 mm Hg in the first series, 123.8 +/- 18.9 mm Hg in the second, and 127.5 +/- 16.7 mm Hg in the third series; it was 125.9 +/- 14.0 mm Hg in the retired stevedores, and 134.0 +/- 17.0 mm Hg in the control group. Electrocardiographic sings of the left heart hypertrophy were found in: 32.2%, 30.3%, 29.2%, 23.1% and 11.0% of the examined groups, respectively. Traits of the effect of the parasympathetic system in the ECG according to clinical criteria were recorded in: 58.7% of subjects in the first series, 54.5% in the second, 51.9% in the third, 42.6% in the retired stevedores, and 6.9% in the control group. The systolic pressure of 120 mm Hg and less in the newly employed stevedores was recorded in less than 7.5% of examined subjects. In 9.2% cases a syndrome of early repolarization of heart ventricles was noted. Hypervagotony is characteristic for the stevedores with a long period of work. Evaluating their state of the circulatory system, a pronounced beneficial effect of an intense physical activity can be observed.

The objective of the study was to evaluate decompression stress after air and nitrox saturated divings on the basis of the parameters of haemostasis. Before and after each diving the following examinations were performed: blood platelet count, aggregation, fibrinogen level and coagulation factors VII, X and XII. After the air saturated dives a slight reduction of factor X and XII and of fibrinogen was observed. Evaluation of haemostatis may be one of the basic elements in the assessment of decompression sickness risk.