Cases reported "Occupational Diseases"

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1/37. mercury toxicity due to the smelting of placer gold recovered by mercury amalgam.

    A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.
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ranking = 1
keywords = fatigue
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2/37. Cerebral arterial gas embolism in air force ground maintenance crew--a report of two cases.

    Two cases of cerebral arterial gas embolism (CAGE) occurred after a decompression incident involving five maintenance crew during a cabin leakage system test of a Hercules C-130 aircraft. During the incident, the cabin pressure increased to 8 in Hg (203.2 mm Hg, 27 kPa) above atmospheric pressure causing intense pain in the ears of all the crew inside. The system was rapidly depressurized to ground level. After the incident, one of the crew reported chest discomfort and fatigue. The next morning, he developed a sensation of numbness in the left hand, with persistence of the earlier symptoms. A second crewmember, who only experienced earache and heaviness in the head after the incident, developed retrosternal chest discomfort, restlessness, fatigue and numbness in his left hand the next morning. Both were subsequently referred to a recompression facility 4 d after the incident. Examination by the diving Medical Officer on duty recorded left-sided hemianesthesia and Grade II middle ear barotrauma as the only abnormalities in both cases. Chest x-rays did not reveal any extra-alveolar gas. Diagnoses of Static Neurological decompression Illness were made and both patients recompressed on a RN 62 table. The first case recovered fully after two treatments, and the second case after one treatment. magnetic resonance imaging (MRI) of the brain and bubble contrast echocardiography performed on the first case 6 mo after the incident were reported to be normal. The second case was lost to follow-up. decompression illness (DCI) generally occurs in occupational groups such as compressed air workers, divers, aviators, and astronauts. This is believed to be the first report of DCI occurring among aircraft's ground maintenance crew.
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ranking = 2
keywords = fatigue
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3/37. Aerobiological analysis in a salami factory: a possible case of extrinsic allergic alveolitis by penicillium camembertii.

    A 39-year-old man was hospitalized with a history of fatigue, dyspnoea and low grade fever which seemed to be related to his working environment. The patient was employed in a salami factory, working near the area where the salami are seasoned with fungal inocula. Chest X-ray showed diffuse initial changes of reticulonodular pattern that disappeared after a brief course of steroids therapy. Precipitating antibodies to penicillium notatum and aspergillus fumigatus were found both in plasma and bronchoalveolar lavage fluid. This, together with the finding of a lymphocytic alveolitis with CD4 depletion and CD8 increase, suggested the possibility of extrinsic allergic alveolitis of fungal aetiology. Qualitative and quantitative monitoring with an impinger of both the working and outside environment for aerial fungal concentration demonstrated a very high level of contamination (up to 1.14x10(9) fungal propagules m-3 of air) and an inside/outside ratio from 21 to about 2000. penicillium camembertii was the most common species found in all the indoor sites (60-100% of the fungal load). The patient's BALF and serum both displayed precipitating antibodies to P. camembertii from the powder used for the inoculum and the air samples. These results together with the patient's working history gave some evidence of relationship between the indoor P. camembertii concentration and the patient's symptoms.
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ranking = 1
keywords = fatigue
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4/37. 'Cable-maker's clavicle': stress fracture of the medial clavicle.

    A 50-year-old man presented with a non-traumatic painful swelling over the medial clavicle. Radiographs showed a poorly defined fracture and the possibility of an underlying pathology was raised. Computed tomography suggested a stress fracture. This prompted a further, more detailed occupational history to be obtained from the patient, which revealed a hitherto undescribed cause of clavicular stress fracture and obviated the need for further imaging or biopsy.
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ranking = 82.221389702526
keywords = stress fracture, fracture
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5/37. Chronic fatigue syndrome (CFS) associated with staphylococcus spp. bacteremia, responsive to potassium arsenite 0.5% in a veterinary surgeon and his coworking wife, handling with CFS animal cases.

    Chronic fatigue syndrome (CFS) in human patients remain a controversial and perplexing condition with emerging zoonotic aspects. Recent advances in human medicine seem to indicate a bacterial etiology and the condition has already been described in horses, dogs, cats and birds of prey in association with micrococci-like organisms in the blood. To evaluate the possibility of a chronic bacteremia, a veterinary surgeon (the author) and his coworking wife, both diagnosed with CFS and meeting the CDC working case definition, were submitted to rapid blood cultures and fresh blood smears investigations. blood cultures proved Staph-positive and micrococci-like organisms in the blood were repeatedly observed in the 3-year period preceding the arsenical therapy, during which several medicaments, including antibiotics, proved unsuccessful. Following treatment with a low dosage arsenical drug (potassium arsenite 0.5%, im., 1 ml/12 h, for 10 days) both patients experienced complete remission. At the post-treatment control made 1 month later, micrococci had disappeared from the blood, and the CD4/CD8 ratio was raising.
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ranking = 5
keywords = fatigue
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6/37. Respiratory illness in workers exposed to metalworking fluid contaminated with nontuberculous mycobacteria--ohio, 2001.

    In January 2001, three machinists at an automobile brake manufacturing facility in ohio (plant A) were hospitalized with respiratory illness characterized by dyspnea, cough, fatigue, weight loss, hypoxia, and pulmonary infiltrates. hypersensitivity pneumonitis (HP) was diagnosed in all three workers. In March 2001, additional employees began seeking medical attention for respiratory and systemic symptoms. In May 2001, union and management representatives requested assistance from CDC's National Institute for Occupational safety and Health (NIOSH) in determining the cause of the illnesses and preventing further illness in employees. This report describes two case reports and the preliminary results of the ongoing investigation, which found that exposure to aerosolized nontuberculous mycobacteria (NTM) might be contributing to the observed respiratory illnesses in this manufacturing facility. Clinicians and public health professionals should be alert to the variable presentation of occupational respiratory disease that might occur in workers in the machining industry.
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ranking = 1
keywords = fatigue
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7/37. Injuries of the sterno-clavicular joint in backpackers.

    Anterior sterno-clavicular dislocation, or fracture dislocation, as a result of carrying a backpack has not previously been described. We describe two cases, and reflect on the factors that may have led to the injuries, noting that the current PLCE (personal load carrying equipment) may also increase the risk of this condition. The condition is one that carries a grading of U8 (unfit for service), and is one that Medical Officers should be aware of, as it has serious implications for a continuing military career.
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ranking = 2.0508248319343
keywords = fracture
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8/37. Hot on the inside.

    When a disease process becomes life-threatening, it is termed to be malignant. Hyperthermia is a heat illness that arises from one of two basic causes: 1) the body's normal thermoregulatory mechanisms are overwhelmed by the environment (an exogenous heat load) or, more commonly, by excessive exercise in a moderate-to-extreme environment (an endogenous heat load); or 2) failure of the thermoregulatory mechanisms, such as those encountered in the elderly or debilitated patient. Either cause can lead to heat illnesses such as heat cramps, heat exhaustion or heatstroke. Heat cramps are brief, intermittent and often severe muscular cramps that frequently occur in muscles fatigued by heavy work or exercise. They are believed to be caused by a rapid change in the extracellular fluid osmolarity resulting from sodium and water loss. heat exhaustion is a more severe form of heat illness characterized by minor changes in mental status (poor judgment, irritability), dizziness, nausea and headache. In severe cases, the patient may have an altered LOC. Just as with heat cramps, profuse sweating is present. Removing the patient from the hot environment and administering fluids will usually result in a rapid recovery. [table: see text] Left untreated, heat exhaustion may progress to heatstroke. Heatstroke results when there is a complete collapse of thermoregulatory mechanisms. This will lead to a rise in body core temperature in excess of 105.8 degrees F (41 degrees C), which will produce multisystem tissue damage and physiological collapse. Severe cases can cause death. The patient in this case had an axillary temperature taken and recorded at 101.4 degrees F. Typically, axillary temperatures are one degree cooler than oral temperatures, which are one degree cooler than core temperatures. This patient, then, had a core temperature of 103 degrees F or higher. There are two types of heatstroke: classic and exertional. Classic heatstroke occurs during periods of sustained high ambient temperatures and humidity. Exertional heatstroke more often occurs in athletes, military personnel and people who work strenuosly in the environment. In these situations, endogenous heat accumulates more rapidly than the body can dissipate it in the environment. Although sweating is usually absent in the classic form of heatstroke, 50% of exertional heatstroke cases have persistent sweating as a result of catecholamine release. The presence of sweating does not preclude the diagnosis of heatstroke, and cessation of sweating is not the cause of it. As the illness progresses, peripheral vasodilation occurs, resulting in hypotension and shunting. As internal temperatures rise, myocardial contractility begins to decrease, manifested by bradycardia and irritability of the myocardium. No matter the age group, the presence of hypotension and decreased cardiac output indicates a poor prognosis for the patient.
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ranking = 1
keywords = fatigue
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9/37. Transmission of hepatitis c by blood splash into conjunctiva in a nurse.

    The risk of transmission of hepatitis c virus (HCV) infection is an important problem for the health care worker. HCV transmission by blood splashing into eyes is very rare. In a hemodialyses department, a 23-year-old female nurse splashed blood from a patient who was anti-HCV positive into her eyes. She washed her eyes with water immediately and reported to the infection control department. She had never used intravenous drugs nor received transfusions. At the time of exposure, there was no abnormality in her laboratory tests. Her anti-HCV and HCV-rna tests produced negative results. She was followed up for anti-HCV and alanine aminotransferase activity. After 6 months, she presented with sore throat, nausea, vomiting, fatigue, and weight loss. She had icterus and hepatomegalia. In laboratory tests, alanine aminotransferase level was 504 U/L, aspartate aminotransferase level was 388 U/L, and anti-HCV and HCV-rna tests produced positive findings. She was treated with interferon alfa-2a for a 1-year period. After treatment, an HCV-rna test produced negative results and transaminase levels were normal. In conclusion, splashing blood from patients who are HCV positive into the face or eyes is a risk for health care workers. They should be educated to prevent a nosocomial acquisition of bloodborne infection and they should observe protective precautions.
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ranking = 1
keywords = fatigue
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10/37. Femoral neck stress fracture in a sanitary worker.

    Stress fractures of the femoral neck are uncommon, it is important to have a high index of suspicion in young active people who perform repetitive vigorous activity or have recently had an increase in frequency of such activity. We report a case of femoral neck stress fracture in a sanitary worker which was treated successfully with a dynamic hip screw.
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ranking = 68.85962889076
keywords = stress fracture, fracture
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