Patients with an implantable cardioverter defibrillator (ICD) have an ongoing risk of sudden incapacitation that might cause harm to others while driving a car. Driving restrictions vary across different countries in Europe. The most recent recommendations for driving of ICD patients in Europe were published in 1997 and focused mainly on patients implanted for secondary prevention. In recent years there has been a vast increase in the number of patients with an ICD and in the percentage of patients implanted for primary prevention. The EHRA task force on ICD and driving was formed to reassess the risk of driving for ICD patients based on the literature available. The recommendations are summarized in the following table and are further explained in the document. [table: see text] Driving restrictions are perceived as difficult for patients and their families, and have an immediate consequence for their lifestyle. To increase the adherence to the driving restrictions, adequate discharge of education and follow-up of patients and family are pivotal. The task force members hope this document may serve as an instrument for European and national regulatory authorities to formulate uniform driving regulations.

/pdf/consensus-statement-of-the-european-heart-rhythm-association-1zqgy0kwt8.pdf

Consensus statement of the European Heart Rhythm Association: updated recommendations for driving by patients with implantable cardioverter defibrillators

/pdf/draft-toxicological-profile-for-perfluoroalkyls-2b8vk9ipio.pdf

Draft toxicological profile for perfluoroalkyls

Vaccinia virus, the prototype Orthopoxvirus, is widely used in the laboratory as a model system to study various aspects of viral biology and virus-host interactions, as a protein expression system, as a vaccine vector, and as an oncolytic agent. The ubiquitous use of vaccinia viruses in laboratories around the world raises certain safety concerns because the virus can be a pathogen in individuals with immunological and dermatological abnormalities, and on occasion can cause serious problems in normal hosts. This chapter reviews standard operating procedures when working with vaccinia virus and reviews published cases of accidental laboratory infections with poxviruses.

by vaccinia virus

Vaccinia Virus

OBJECTIVES : Welding operations expose to metal fume. We investigated the inflammatory responses and oxidative stress from metal fume exposure in an automobile plant. METHODS : We recruited 258 automobile workers and measured the urine zinc, copper, and nickel to determine the exposure level, and examined the white blood cells, and IL-6 as inflammatory responses to the metal fume exposure. We also examined the relationship between glutathione (GSH) and metals exposure. RESULTS : There were significant association between urine metals levels and welding hours. Zinc was significantly associated with blood white cells, interleukin-6, and GSH. Copper was significantly associated with GSH, but nickel was significantly inversely associated with GSH. CONCLUSIONS : Automobile welders appear to have significant metals exposure. White blood cells and IL-6 might be involved in inflammatory process of zinc fume exposure with zinc and copper increasing GSH, but nickel depleting it.

Inflammatory responses and oxidative stress from metal fume exposure in automobile welders.

Limitations on Employees with Pacemakers

The Occupational Medicine Forum is prepared by the ACOEM Occupational and Environmental Medical Practice Committee and does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney. Inquiries and contributions to the Forum should be forwarded to Joseph J. Schwerha, MD, MPH by e-mail at schwer@pitt.edu

Occupational Medicine Forum

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Occupational Medicine Forum