Objectives-This study was carried out to investigate possible immunological changes in workers with prolonged low exposure to inorganic mercury in a fluorescent light bulb factory. Methods-29 immunological variables were examined in 34 workers with prolonged low level exposure to inorganic mercury (exposed workers) and 35 unexposed workers as the controls. The selected indicator of mercury exposure was concentration of mercury in the urine (U-Hg), which declined progressively from 36.0 pg/l in 1978 to 6.0 igIl in the study year 1994. Results-None ofthe exposed workers had ever shown signs ofeither acute or chronic inorganic mercury toxicity or had shown any form of hypersensitivity. The only changes found in the exposed workers, compared with the controls, were a reduction of the cells that express cluster differentiation (CD25,(T activation antigen (Tac antigen))) and concentrations of tumour necrosis factor-a (TNF-a) in serum. However, the decrease of cells that express CD25 was unrelated to occupational exposure and was, in all likelihood, a chance finding. Conversely, the decline in serum TNF-a was closely associated with occupational exposure. However, no dose-response relation was found between U-Hg and TNF-a concentrations; nor were TNF-a concentrations affected by cumulative occupational exposure to inorganic mercury in over 20 years. Conclusions-Tentatively, we suggest that reduced serum TNF-a concentrations might be indicative ofan in vivo functional defect of the monocyte macrophage system in this particular group of workers even though they were clinically asymptomatic. (Occup Environ Med 1997;54:437-442)

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Citation analysis is widely used to evaluate the performance of individual researchers, journals, and universities. Its outcome plays a crucial role in the decision-making process of ranking applicants for an academic position. A number of indicators, including the h-index reflecting both scientific productivity and its relevance in medical fields, are available through the Web of Knowledge( sm ) and Scopus®. In the field of occupational medicine, the adoption of the h-index in assessing the value of core journals shows some advantages compared with traditional bibliometrics and may encourage researchers to submit their papers. Although evaluation of the overall individual performance for academic positions should assess several aspects, scientific performance is usually based on citation analysis indicators. Younger researchers should be aware of the new approach based on transparent threshold rules for career promotion and need to understand the new evaluation systems based on metrics.

The study shows that the factors affecting airborne mycobacterial dose (patient infectiousness, low sized confined rooms) were the major determinants for MTB transmission after a brief exposure to a highly infectious TB case.

Liver injury has long been associated with occupational exposure to a wide variety of chemicals. The controversial data existing in relation to hepatotoxicity of organic solvents might be explained as a consequence of the different exposures or it may well be that the tests used for evaluating liver function might not be sensitive enough to detect any mild changes at an early stage. To study liver function during exposure to solvent mixtures, we determined serum bile acid (SBA) concentrations as compared with conventional liver function tests in a selected group of workers (n = 30) occupationally exposed to a mixture of organic solvents (mostly toluene, xylene, acetone, n-butylacetate, n-butanol, ethylacetate) and in a reference group (n = 20). The mean levels of liver enzyme activities and bilirubin concentrations in the two groups were similar, whereas mean SBA levels increased in the exposed group (8.0 +/- 6.0 mumol/l vs 2.8 +/- 1.4 mumol/l) and the difference as compared with the controls was significant (P less than 0.01). In 73% of the exposed workers, SBA levels were higher than 5.6 mumol/l (the cut-off value) as compared with 5% of the controls. These results demonstrate the higher sensitivity in detecting liver dysfunction achieved with the SBA test as compared with conventional hepatic function tests. As increased SBA concentrations are considered to reflect an impairment of anion transport across the liver, higher SBA levels in the group of workers exposed to organic solvents might be explained as a slight and early sign of liver dysfunction. Therefore, SBA determination in biological monitoring of workers exposed to potentially hepatotoxic chemicals might be proposed.