Occupational medicine: Research, Teaching, ethics, clinical practise/expert opinion

Prof. Dr. Xaver BaurXaver Baur, MD, has devoted much of his academic career to broad questions of occupational and environmental medicine.

His career research contributions have been mainly in the areas of lung function measurements, allergic disorders, including occupational asthma, hazardous exposures to inorganic dust, allergens, pollution, chemicals such as isocyanates. In focusing on research and policy he has been addressing questions of relevance to public health and ethics in occupational and environmental health. Xaver Baur has being consulted from around the world as an independent expert witness and speaker. He is president of the charity European Society for Environmental and Occupational Medicine which fosters independent research in occupational, public and environmental health, open EOM WebsiteEOM e.V.

 Alles Fake? Wissenschaft im Zeitalter der vielen Wahrheiten

Most interesting presentations at the 7. BfR-Stakeholderkonferenz on15. November 2018 (German). Topic:  „Fake news“ - which increasingly meets science

Occupational health: a world of false promises

United Nations agencies, WHO and the International Labor Organization (ILO), are faced with the global problem of inadequate worker protections and a growing crisis in occupational health

By Joseph LaDou, Leslie London and Andrew Watterson:

“The United Nations currently has limited ability to take on the problems of a globalized world and has limited capacity to affect major issues within member states. But it can have a useful influence in facilitating stronger oversight by broader civil society. It can do this by strengthening the national and global civil society voice in WHO and ILO structures, and by keeping conflict of interest out of policy decisions. Corporate influence on international organisations is not a new problem. It goes on in all member states and is evidenced in the neglect of occupational health and safety, and the weakness of workers’ compensation laws, in all developing countries.

UN agencies should develop stronger and unambiguous processes to manage conflict of interest in ways that equalize the influence of powerful interests with those of communities, Non-Governmental Organizations, Civil Society Organizations and Social Movements. More support should be given to protect the WHO from industry attacks and to help it increase its supply of information on occupational health and safety to developing countries, free of industry influence.”

On the other hand, the authors suggest that “the staff assigned to WHO and ILO agencies responsible for occupational health and safety should have appropriate credentials and backgrounds. The selection

process is currently removed from public view, and not subject to approval by relevant international authorities.

There is no current method of finding conflicts of interest in staff assignments. An international organization with no industry bias exists in the Collegium Ramazzini, headquartered in Bologna, Italy. The Collegium should be considered as an independent approval authority for WHO and ILO staff positions, and for technical review of publications“.

in: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-018-0422-x

Diagnostic limitations of lung fiber counts in asbestos-related diseases

https://www.jospi.org/article/70352-diagnostic-limitations-of-lung-fiber-counts-in-asbestos-related-diseases?auth_token=takLDrUb9Z7U6VDczUEu

Background
Lung dust fibre analyses have been used by some pathologists to estimate past asbestos
exposure in the workplace and its related health risks. Asbestos, however, especially the
predominately applied chrysotile asbestos type, undergoes translocation, clearance and
degradation in the lungs.
Objectives
We quantified the asbestos fibre and ferruginous (asbestos) body (FB) content in human
tissue with respect to the German asbestos ban in 1993 and the interim period of more
than 20 years in order to evaluate the diagnostic evidence of these analyses for
asbestos-related diseases (ARD).
Methods
Lung dust analyses have been used in empirical assessments of ARD since 1982. Tissue
samples of about 2 cm3 were used and processed in standardized manner. FB was
analysed by light microscopy and asbestos fibres by scanning transmission electron
microscopy (STEM).
Results
Chrysotile and amphibole fibre concentrations in the lung tissue depend roughly on the
cumulative asbestos exposure levels in the workplace.
However, the concentration of lung asbestos fibre and FB depends on the year of
examination and especially on the interim period. As the interim period increases, the
asbestos fibre burden decreases. There is no relationship between FB and chrysotile
asbestos fibre concentrations and only a weak correlation between FB and crocidolite
fibre concentrations.
There was no significant difference in chrysotile and amphibole fibre concentrations as
well as in FB counts between the different ARD.
Conclusions
Due to the length of interim periods, a past exposure to chrysotile or amphibole asbestos
can no longer be detected with FB or asbestos fibre measurement in lung tissue. This
means that negative results of such measurements cannot disprove a qualified
occupational case history of asbestos exposures and the related health risks due to the
fibrogenic and carcinogenic potential of asbestos

Aerotoxic syndrome after fume events

Health consequences of exposure to aircraft contaminated air and fume events: a narrative review and medical protocol for the investigation of exposed aircrew and passengers
by Burdon J, Budnik LT, Baur X, et al. Health consequences of exposure to aircraft contaminated air and fume events: a narrative review and medical protocol for the investigation of exposed aircrew and passengers. Environmental Health. 2023;22(1):22-43.

Thermally degraded engine oil and hydraulic fluid fumes contaminating aircraft cabin air conditioning systems have been well documented since the 1950s. Whilst organophosphates have been the main subject of interest, oil and hydraulic fumes in the air supply also contain ultrafine particles, numerous volatile organic hydrocarbons and thermally degraded products. We review the literature on the effects of fume events on aircrew health. Inhalation of these potentially toxic fumes is increasingly recognised to cause acute and long-term neurological, respiratory, cardiological and other symptoms. Cumulative exposure to regular small doses of toxic fumes is potentially damaging to health and may be exacerbated by a single higher-level exposure. Assessment is complex because of the limitations of considering the toxicity of individual substances in complex heated mixtures.
https://ehjournal.biomedcentral.com/articles/10.1186/s12940-023-00987-8

There is a need for a systematic and consistent approach to diagnosis and treatment of persons who have been exposed to toxic fumes in aircraft cabins. The medical protocol presented in this paper has been written by internationally recognised experts and presents a consensus approach to the recognition, investigation and management of persons suffering from the toxic effects of inhaling thermally degraded engine oil and other fluids contaminating the air conditioning systems in aircraft, and includes actions and investigations for in-flight, immediately post-flight and late subsequent follow up.