Is maternal alpha-fetoprotein screening still of value in a low-risk area for neural tube defects?

Estimation of maternal serum alpha-fetoprotein (AFP) was used as a screening method for the detection of neural tube defects (NTDs) in 6344 women over three years. Of 88 (1.4 per cent) who had one or more serum AFP levels equal to, or greater than, 2.5 multiples of the median (MoM) for the relevant gestational age, 43 (0.68 per cent) underwent amniocentesis. There were eight NTDs. Four of these were screened by serum AFP, and all cases of spina bifida had serum AFP levels greater than 3.0 MoM, including one small open defect which was not seen on ultrasound. The other four cases of NTD, which were not screened, were identified by ultrasound. Of 64 singleton pregnancies 32 (50 per cent) had serum AFP levels between 2.5 and 3.0 MoM, and low birthweight (⪕2500 g) occurred in 29 per cent. Because of improvements in ultrasound techniques and the apparent falling incidence of NTD, the role of serum AFP as the primary screening procedure should be regularly reviewed. Effective screening is dependent on mothers booking early.     

Prenatal diagnosis of the hurler syndrome: Report on 40 pregnancies at risk

In 40 pregnancies at risk for the Hurler syndrome 13 affected fetuses were detected by the demonstration of an α-L -iduronidase deficiency and an increased level of ³⁵S-sulphate incorporation. The diagnoses were confirmed by the analysis of fetal tissues and/or cultured fetal skin fibroblasts. Microassays for α-L -iduronidase, using phenyl α-L -iduronide and more recently 4–methyl-umbelliferyl α-L -iduronide, enabled a reliable diagnosis to be made within 15 to 18 days after amniocentesis. ³⁵S-sulphate incorporation has been a valuable adjunct in cases with a low (heterozygote) enzyme activity.     

Erratum

Naturwissenschaften Aktuell     

CLIMATE CHANGE AND NATURAL HAZARDS IN NORTHERN CANADA: INTEGRATING INDIGENOUS PERSPECTIVES WITH GOVERNMENT POLICY

A study of the relationship between natural hazards and climate change in the international context provides the background for a discussion of the expected changes. In the context of this global discussion, this paper reviews the current perspectives of those natural hazards that are likely to be influenced by climate change, using northern Canada as a regional case study. The northern implications of the United Nations Framework Convention on Climate Change are examined, including the status of climate change action by the northern territorial governments, the evolving role of indigenous people, and the responsibility for climate change impacts. The difficulties surrounding natural hazards research in remote locations, and the approaches of indigenous people to natural hazards are then presented. The paper concludes with a suggested policy approach for climate change and natural hazards in northern Canada, underscoring the need for more comprehensive adaptive strategies to complement the current tendency to focus on the mitigation of greenhouse gases produced in this region.     

Specific Contributions of Politics,Economics, and Toxicology in Setting Socially Consensual Limit Values

/ Limit values are legal limits for the concentrations of substances in the environment. They must be agreed upon in a consensual procedure between science, economics/technology, and political forces. This is a crucial political precondition for their social acceptance. The arguments put forward to justify their expediency and numerical level are based not only on risk-benefit considerations but also on the aspect of the technical avoidability of direct and indirect exposure. The critical assessment of the direct benefit of specified exposures falls within the responsibility of economics/technology, whereas criteria for their potential adverse effects (direct and indirect) are provided by medicine/biochemistry and/or ecology. Within this concept, the avoidance of nonbeneficial-even if not openly adverse-exposure is the essential aim of environmental hygiene and should be promoted by politics/science. In general, society or segments thereof reject adverse, accept beneficial, and tolerate unavoidable exposure. Conflicts of interest arise when different groups of society simultaneously define a given exposure as being adverse, beneficial, and unavoidable. Therefore, from the viewpoint of society as a whole, an optimal exposure lies as far as reasonably achievable at a level lower than known or plausible adverse effect thresholds (as defined by toxicology or ecology). This optimal level of exposure must be determined using a transparent and, hence, public procedure.KEY WORDS: Legal limit values; Benefit threshold; Social acceptance; Social tolerability; Adverse effect threshold; Avoidable exposure; Tolerance threshold; Environmental hygiene     

Electromagnetic fields in offices.

With the increased use of electric and electronic equipment in our offices, our daily exposure to electromagnetic fields has become increasingly complex due to the great variety of the frequency content of the fields. Today focus has shifted from monitors as the dominating sources of electromagnetic fields to other electronic equipment, cabling, nearby substations, power lines and stray currents in buildings. In the last 5 years wireless communication has become common in our offices. These devices use radio frequency waves to communicate and are therefore sources of radio frequency fields in our offices. To a certain degree, they all add to the complicated issue of the extensive field frequencies found in offices. The exposure of office workers is generally considered to be low and not in conflict with the existing guidelines, but if a precaution approach is applied there are a number of measures that can be taken to reduce the electromagnetic fields in offices in order to obtain a good electrical environment.     

Leachability testing of metallic wastes.

The performance of two tests, a batch test and a percolation test for the characterization of waste as suggested in the EU council decision 2003/33/EC was investigated. The tests were carried out on two solid waste streams from a metal recycling industry. The concentrations of heavy metals such as Cu, Zn and Pb were more than one order of magnitude lower than the proposed limit values. Generally, batch test values were equal or higher than percolation test values. With the proposed test procedures both materials could be considered as non-dangerous wastes. The test performance was also investigated using a leachant with higher ionic strength instead of demineralized water as prescribed. The results clearly show a significant increase in the concentration of some heavy metals. Total concentrations of phenolic compounds and polychlorinated biphenyls were less than 1 p.p.m. and 2 p.p.b., respectively. The precision of the batch and the percolation tests were on average 48 and 35%, respectively.     

The effect of an ergonomic intervention on musculoskeletal, psychosocial, and visual strain of VDT data entry work: the Polish part of the international study.

A group of routine data entry operators (female) was included in the Polish MEPS (musculoskeletal--eyestrain--psychosocial--stress) study. Before the intervention, ergonomic assessment revealed improper working conditions such as inadequate lighting, uncomfortable chairs, and lack of forearm and wrist support while medical examination revealed that trapezius muscle load along with upper arm, head and back angles were higher than advisable. Subjects complained about neck and shoulder pain, visual problems, and psychosocial conditions. The ergonomic intervention included installation of new luminaires and Venetian blinds, new chairs, repair of ventilators, and optometric corrections. The results after the intervention showed mainly improvement in chair comfort, lighting conditions, visual strain, and sitting posture. However, financial limitations did not allow satisfactory completion of the intervention leading to a mixed interpretation of the results.