natgillin/translations-raw huggingface dataset:
at DBCP har vist sig at være mutagent (i stand til at ændre arveanlæg) og kræftfremkaldende i visse dyreeksperimentelle under søgelser.
By informally contacting some individuals at a local university they found out that DBCP had been shown to be a mutagenic and carcinogenic agent in some experimental studies, and that there were data on reproductive effects in animals as well.
Der var også dyreforsøg, der tydede på reproduk tionsskader.
Five men decided to have a sperm analysis.
5 mænd besluttede at få deres sæd analyseret og alle havde kun få sædceller (oligospermi) eller ingen sædceller overhovedet (azoospermi).
All of them had a low quantity of sperm (oligospermia) or no living sperm (azoospermia).
Nu forlangte de ansatte yderligere undersøgelse af samtlige på afdelingen, og hver af de 36 mænd blev bedt om at udfylde et medicinsk spørgeskema.
At this point the workers requested a further evaluation of all employees in the group. Each of the 36 male employees was asked to complete a medical history questionaire.
Fra 25 ikke-steriliserede mænd blev der indsamlet sædprøver, der blev undersøgt på det lokale laboratorium. torium.
Semen specimens were collected from the 25 non-vasectomized males and were taken to the laboratory for determination of sperm count, motility, and morphology.
14 af disse 25 mænd havde azoospermi eller oligospermi.
Of the 25 men, 14 had azoospermia or oligospermia.
11 havde normale sædcelletal, dvs. mere end 40 mill, sædceller per ml og 3 havde celletal mellem 10 og 30 mill/ml. Mændene med unormalt lave sædcelletal havde været ansat i gennemsnit 8 år og de andre i gennemsnit få måneder.
Eleven men had sperm counts of less than or equal to one million/ml; 11 men had normal counts of greater than 40 million/ml; (three men had counts between 10 and 30 million/ml). The men with abnormal sperm counts had a mean exposure time of eight years: for men with normal counts the mean exposure time was 0.1 years.
Alle mænd med celletal under 1 mill/ml havde været ansat i mindst 3 år, og alle med celletal på mere end 40 mill/ml havde været ansat i mindre end 3 måneder.
No worker with a sperm count of equal to or less than one million had been exposed less than three years, whereas all with a count above 40 million had been exposed less than three months.
Luftanalyser baseret på personbåren opsamling i 1977 viste DBCP-værdier på 0,4 ppm over en 8 timers opsamlingsperiode.
In the factory, the airborne concentration of DBCP measured with personal air-sampling devices in early 1977 was 0.4 ppm (average over an eight-hour day).
De igangsatte
Epidemiology in practice
endvidere en omfattende debat de ansatte imellem, inden for de ansvarlige myndigheder og i offentligheden generelt.
The results described led to a lowering of the threshold limit value (TLV) and to the instigation of further studies.
En ny undersøgelse blev påbegyndt på virksomheden for at undersøge alle mandlige ansattes testikelfunktion.
A second study at the same factory was conducted in which an attempt was made to study testicular function in all male employees.
Der var ialt 310 mandlige ansatte.
The total male population at risk was 310.
Af de mænd der ønskede at deltage i under søgelsen blev 107 klassificeret som eksponeret på et eller andet tidspunkt og 35 som aldrig eksponerede.
Of these only 142 provided semen samples, 107 were classified as 'ever' exposed and 35 were classified as 'never' exposed.
For den første gruppe var sædcelletallet i gennemsnit 46 mill/ml og for sidstnævnte 79 mill/ml. Blandt de eksponerede var 13% azoospermiske, 17% havde svær oligospermi og 16% mild oligospermi.
For the 'ever' exposed group the median sperm count was 46 million/ml: for the 'never' exposed group the median count was 79 million/ml.
Blandt de ikke-eksponerede var 3 % azoospermiske, ingen havde svær oligospermi og 6 % blev klassificeret med mild oligospermi.
Of the exposed workers 13 per cent were azoospermic, 17 per cent were severely Oligospermie, and 16 per cent mildly Oligospermie.
Herefter blev der iværksat flere undersøgelser på andre DBCP-producerende virksomheder.
As a result of these findings, several other studies were conducted of workers at other DBCP manufacturing facilities.
Landmænd der brugte stoffet blev også undersøgt og disse undersøgelser viste, at DBCP også i mindre koncentrationer påvirker sædcelleproduktionen.
These studies were important because they showed DBCP effects on spermatogenesis at levels of exposure potentially lower than those observed in the production process.
Dyreforsøg havde allerede i 1961 vist, at DBCP virkede toksisk på testikler fra rotter, marsvin og kaniner.
The chemical suspected to be the cause of infertility had in 1961 been shown to be toxic in the tests on rats, guinea pigs, and rabbits.
Stoffet havde vist sig carcinogent og mutagent i 1973 og 1975.
Furthermore, carcinogenicity and mutagenicity of DBCP in animals had been established in 1973 and 1975.
Alligevel måtte de ansatte selv gøre opmærksom på problemerne. Selv om forskningsverdenen kendte til stoffets virkninger, var de ansvarlige for produktionen ikke bekendt med denne viden.
Nevertheless the problem of infertility in humans was first identified by a group of concerned workers.
Selv efter fjernelsen af DBCP-eksponeringen forblev de azoosperme mænd uden sædceller.
After substitution of DBCP, workers who were azoospermic did not regain the ability to produce sperm.
For de fleste med oligospermi steg sædcelletallene dog-mod normale værdier.
However, the sperm counts of most^of those who were Oligospermie did improve considerably.
Nye kemiske produkter skal naturligvis afprøves i testsystemer og i dyreforsøg inden mennesker udsættes for dem. Dette hjælper dog kun lidt, hvis resultaterne ikke bruges eller ikke kendes af de ansvarlige. 3.
New chemicals should be tested in short-term tests and in animal studies before workers are exposed; but it is of little help if the test results are not used or known by the workers or the people in charge of their health.
De fleste af de nævnte undersøgelser blev gennemført af for skere, men lokale folk kunne være kommet langt med simple midler.
Most of the studies mentioned in the example were carried out by professional researchers, but those locally involved could have come far by using simple methods.
Ved at forfølge de problemer, de ansatte selv bragte frem, kunne man have indkredset fertilitetsproblemet.
By defining the problems the workers had discussed among themselves, fertility could have been identified as the issue to be examined.
En simpel spørgeskemaundersøgelse ville således have vist, at de udsatte arbejdere faktisk havde færre børn end de ikke-udsatte i samme aldersgrupper. Undersøgelsen, kunne også have vist, at flere af de udsatte var ufrivilligt barnløse.
A short questionnaire study would, for example, have shown that the workers exposed to DBCP had fewer children than the rest of the workers and that more of them were involuntarily childless.
Det ville også have været muligt at rekvirere sædanalyser på de ansatte og resultaterne kunne f.eks. tegnes op i et diagram over ansættelsestid og koncentration af sædceller.
It would also have been possible at the local level to get sperm counts from the 25 DBCP workers and recognize the dose-response pattern by plotting sperm counts versus exposure duration.
barnløshed ikke være blevet opklaret og forebyggelsen ikke blevet iværksat. 5.
All personal data (including those on fertility) must be considered confidential.
Sådanne non-responders vil ofte forvride undersøgelsens resultat - give bias - dvs. forkerte resultater. Bias' omfang afhænger dog af, hvilke grunde, der anføres til ikke at ville deltage.
Non-response will often introduce bias (a systematic error) in the results of the study, but the magnitude of the bias will depend upon the reasons for which people refuse to participate.
Hvis grundene er uden sammenhæng med eksponeringen og fertiliteten, så giver det ikke bias.
If these reasons are unrelated to both the exposure and the disease status no bias will occur.
I denne undersøgelse var sammenhængen så stærk, at det næppe kunne forklares ved bias alene.
In this study the effect of DBCP exposure on sperm production was so obvious that bias is hardly the only explanation.
Der er adskillige årsager til nedsat sædproduktion.
There are several causes of low sperm count which were considered in the study.
Disse andre årsager (mulige confounders), blev også inddraget i analyserne.
None of these differed between the diseased and the not diseased.
En ophobning af spontane aborter
A SMALL CLUSTER OF SPONTANEOUS ABORTIONS
I en lille virksomhed ude på landet arbejdede 40 kvinder bl.a. med at sy skjorter.
At a small factory close to a town in a rural area, about 40 women were mainly engaged in sewing men's shirts.
Arbejdet var monotont og dårligt betalt og tidligere var der et ganske stort gennemtræk af ansatte i virksomheden.
The work was monotonous and badly paid.
De fleste blev der kun i kort tid og forlod arbejdspladsen, når bedre arbejdsmuligheder tilbød sig.
Previously, most women only stayed in the job for a short period of time and left when other work opportunities presented.
Arbejdsløsheden i om rådet havde dog været stigende blandt ufaglærte og de 40 nu værende ansatte havde alle været der fra 2 til 10 år.
However, because of a high rate of unemployment among unskilled women in the area, these 40 women had been at the factory from two to ten years.
32 af kvinderne var under 45 år.
Thirty-two of the women were under 45 years of age.
Fabrikssygeplejersken blev kontaktet af en af kvinderne, der fortalte at hun og manden havde forsøgt at få et barn i nogen tid. Da hun endelig blev gravid, aborterede hun efter 3 måneder.
One day the factory nurse was contacted personally by one of the women. She told her that she and her husband had been trying to have a child for some time.
Hun havde talt med nogle af de andre ansatte om dette problem, og tre andre fortalte, at de også havde aborteret inden for de sidste to år.
She had discussed the matter with some of the other women at the work place, and three others reported that they had also had a spontaneous abortion within the last two years.
Er der for mange spontane aborter?
Was there an excess of spontaneous abortion?
Det første sygeplejersken gør er at undersøge om der er flere aborter blandt de ansatte end man skulle forvente.
First, the nurse checked to see if the observed number of spontaneous abortions exceeded the expected number.
Det forvente de antal aborter beregner hun på basis af, hvad der gælder for andre kvinder. Først søger hun at få sikkerhed for, at hun har identificeret alle spontane aborter og at aborterne var spontane og ikke provokere-
This preliminary expected number was calculated on the assumption that the women in question had the same risk of spontaneous abortions as all other women.
de, det vil sige lægefremkaldte.
The nurse tried to verify that she had identified all abortions and that the abortions were in fact spontaneous and not induced.
Så undersøger hun om aborterne blev lægediagnosticerede og om de førte til hospitalsindlæggelse.
She asked if the abortions were diagnosed by a physician, or if they had led to hospitalization.
På dette stadium har hun desuden afgrænset studiebasen som alle ansatte kvinder, der har været gravide inden for de sidste 2 år.
Then she identified the study base which in this case is the number of women in the work area who had been pregnant in the last two years.
Det vil sige, alle kvinder der fødte et barn eller fik en abort -spontan eller provokeret.
That is, all women who gave birth to a child, and those who had had an abortion, spontaneous or provoked.
Ved denne efterforskning finder sygeplejersken ud af, at i de sidste 2 år har 12 af de ansatte været gravide.
Whilst making this inquiry, the factory nurse found that, in the past two years, 12 of the women currently employed had been pregnant.
4 har haft en spontan abort og 3 var hospitalsindlagt i denne forbindelse. Ingen for talte om provokerede aborter i perioden.
Four had had a spontaneous abortion, and three had been hospitalized for that reason.
Det betyder at 33 % af erkendte graviditeter endte med spontan abort og 25 % med en indlæggelse efter spontan abort.
This meant that 33 per cent of the recognized pregnancies ended as spontaneous abortions and 25 per cent ended as hospitalized spontaneous abortions.
Det er disse procentværdier, der nu kan sammenlignes med tilsvarende procenter for befolkningen som helhed.
It was then necessary to compare these percentages with the expected figure for the community at large.
I almindelige statiske rapporter fra Sundhedsstyrelsen ser sy geplejersken, at ca. 10% af erkendte graviditeter ender med spontan abort og hospitalsindlæggelse.
By checking statistical reports the nurse saw that an overall rate of hospitalized spontaneous abortions of 10 per cent was expected.
Ved at se den videnskabelige litteratur igennem, ser hun, at 12-14 % af normale gravide kvinder får en spontan abort. Der findes ikke tilsvarende tal for denne specifikke region og sociale gruppe, men virksomhedens ansatte i studiebasen har en aldersfordeling, der ligner befolkningsgennemsnittet.
By reading some of the literature in the field, she learned that the proportion of spontaneous abortions, based upon self-reported cases came to 12-14 percent, much less than the observed number.
Der er der for intet behov for at aldersjustere sammenUgningen.
The pregnant women had an age distribution similar to that of pregnant women in the country at large, so there was no need to adjust the expected number.
Står bedriftssygeplejersken med et arbejdsmedicinsk problem?
Was the factory nurse faced with a workrelated problem?
Der kan være tale om selektionsmekanismer eller confounding, det vil sige at årsagerne til de spontane aborter skal søges andetsteds.
Assessing the information, the nurse concluded that the observed number of spontaneous abortions exceeded the expected number,
Lader det sig gøre, taler det for, at problemerne er arbejdsbetingede.
If none of these explanations was likely, she could have been facing a workrelated problem.
Indtil nu er kvinderne på arbejdspladsen blot sammenlignet med alle andre kvinder.
At this preliminary stage, the women at this particular work site were compared with women of the same age in the same country.
Det er en lidt primitiv sammenligning, der kan være misvisende.
This is a crude comparison and the two groups may not be comparable for several reasons.
Hvis det f.eks. er sådan, at de ansatte kvinder ofte forlader virksomheden sidst i graviditeten, så ville aborthyppigheden blive vurderet alt for højt, hvis ikke også disse kvinder indgik i undersøgelsen.
For instance, if pregnant women leave work late in pregnancy, this would of course overestimate the abortion rate among workers, if such women were not included in the study.
Tælleren ville være den samme, da spontane aborter optræder tidligt, men nævneren ville blive mindre end den burde være. Selektion kunne have gjort de ansatte usammenlignelige med andre kvinder, men det var dog ikke til fældet her.
The numerator would be the same since spontaneous abortions occur early in pregnancy, but the denominator would be less than it should be.
Mere komplicerede former for selektion er dog formentlig til stede.
More subtle forces of selection are likely to distort the comparability of the two groups.
Kvinder med små børn er ikke så hyppigt erhvervsaktive som andre kvinder, og disse kvinder har formentlig lavere abort risiko end andre.
Women with small children at home would be less likely to have work outside the home. These women might be in a low risk group, since they had recently demonstrated their reproductive capability.
Det vil dog være en mere professionel opgave at kontrollere sådanne selektionsmekanismer.
Controlling factors of this sort is beyond the scope of a study at the work site level.
Det må overlades til fagepidemiologerne.
This should be left to the professional epidemiologists.
Før sygeplejersken overdrager de videre studier til andre er der dog flere andre ting hun kan og bør gøre.
Before the nurse handed over the investigation to the researchers, there were several other things to be done.
De videre undersøgelser kræver lidt medicinsk viden og her er der hjælp at få på biblioteket.
Some information on the aetiology of spontaneous abortion was required from the medical library.
På biblioteket vil sygeplejersken opdage, at vi stadig ved forbløffende lidt om årsagerne til spontane aborter.
The nurse found out that surprisingly little was known about the aetiology of spontaneous abortion.
De fleste tidlige aborter skyldes fejl i arveanlæggene, og eksponeringsforhold, der
Most of the early spontaneous abortions have chromosomal abnormalities; therefore exposures which could damage the genetic structures—either directly in the fetus or indirectly through the germ-cells of the father or mother— could lead to spontaneous abortions. Which exposures, other than
kan skade generne - enten direkte ved at skade fosterets gener eller indirekte ved at skade forældrenes kønsceller - kan derfor måske føre til spontane aborter.
Searching for Causes of Work-Related Diseases the ones at the work site, or what alternative explanation could explain the excess of spontaneous abortions?
Men hvilke eksponeringer inden for arbejdspladsen kan være ansvarlige for dette overskud af aborter?
Did the women have any exposure in common which should be taken into consideration?
Har de f.eks. samme drikkevandsforsyning?
Did they live close to each other and if so, was there any risk of, for example, air pollution in the area?
Bor de tæt op ad en forurenende virksomhed?
Had they had any similar contagious disease early in pregnancy?
Havde de smitsomme sygdomme tidligt i graviditeten?
Had they received any medical treatment?
Fik de medicinsk behandling?
Were they all heavy smokers?
Er de alle storrygere?
Did they consume large quantities of alcohol?
Hvad med deres alkoholforbrug og mandens arbejde?
What occupations did their husband have? etc.
I dette tilfælde havde ingen af de fire kvinder med spontane aborter andre mulige eller kendte årsager tilfælles.
In this case none of the four women, who had the spontaneous abortions, had had any of the above exposures in common.
To af kvinder ne var førstegangsgravide.
Two of the women were pregnant for the first time.
Ingen af de andre havde aborteret før.
None had any serious diseases, neither did their husbands have any particular exposures in common.
Ingen led af særlige sygdomme og deres mænd havde heller ikke særlige eksponeringsforhold tilfælles.
The nurse therefore had to conclude that there was no obvious explnation.
Problemerne blev således ikke løst i efterforskningens indledende fase og det var på tide at se nærmere på kvindernes arbejdsforhold. bejdsforhold.
Having considered alternative explanations, the nurse focused on possible causes at the work site.
Arbejdspladsundersøgelsen
Studies at the work site
Alle 4 arbejdede med syning i samme arbejdslokale, dog ikke Uge ved siden af hinanden.
However, most of the other women who had been pregnant also worked in the same room.
De fleste af de andre kvinder der havde født i perioden, arbejdede imidlertid også i dette lokale.
Three of the four women had worked on shift work during pregnancy, compared with 40 per cent of the other women who had a child during the study period.
3 af de 4 arbejdede på skift under graviditeten, sammenlignet med 40 % blandt de andre gravide.
All had been engaged in welding of a PVC raincoat material.
Alle 4 havde desuden arbejdet med kort bølgesvejsning i plasticmaterialer (til regnfrakker) mod kun 2 af de øvrige gravide.
Only two of the other pregnant women had been in the same work process.
Denne arbejdsproces havde virksomheden net op startet for halvandet år siden.
None had been pregnant within the last two years. Production of raincoats only began a year and a half ago.
Ingen i arbejdslokalet blev udsat for organiske opløsningsmidler, tungmetaller eller andre kendte toksiske materialer.
None of those in the area were exposed to organic solvents, heavy metals, or any other harmful substance.
Der var ingen eksponering fra andre afdelinger via virksomhedens ventilationsanlæg. lationsanlæg.
No other chemical substance could leak from any other area of the factory to the sewing area through the ventilation system.
Tilfældighedernes spil
Epidemiology in practice
Selv om de ansatte kvinder skulle have en helt normal abortrisiko, så vil aborthyppigheden fra tid til anden variere.
57 rate would sometimes be above average, sometimes less than average.
Spontane aborter er ikke en"fast andel af alle graviditeter.
The number of spontaneous abortions is not a fixed proportion of all pregnancies.
De udebliver sommetider og optræder i klynger til andre tider, af grunde vi ikke kender og derfor kalder tilfældige for at skjule vor uvidenhed. hed.
It fluctuates, as do most biological phenomena, for unknown reasons which we often call 'chance'.
Hvis andelen af aborter forbliver høj taler det dog imod,tilfældighedernes spil som forklaring, f.eks. hvis aborthyppigheden har været høj igennem en årrække på virksomheden.
If the nurse had access to data from previous time periods, and if these data showed a high number of spontaneous abortions compared with the expected number, it would suggest an association not rooted in chance.
Var det sidste tilfældet, ville det desuden tale imod kortbølge svejsning som en mulig forklaring.
However, a previously normal rate is of course no proof that the clustering of spontaneous abortions is the result of chance.
Tilfældighedsforklaringen bliver altid tilbage, når andre forklaringsmuligheder er udelukket, men det er indlysende, at sandsynligheden for denne forklaring afhænger af undersøgelsens størrelse.
It would indicate rather that the nurse should be aware of any changes in the work process, which had taken place within recent years.
Er det en stor undersøgelse, så svinger aborthyppigheden ikke meget fra tid til anden (som det f.eks. ses i befolkningsstatistikken), men på en lille virksomhed er situationen en helt anden.
The chance possibility is one which always remains when other possibilities have been ruled out.
Alligevel må man være forsigtig med blot at slå alle fund hen som „tilfældighedernes spil".
Obviously the larger the study the less likely it is that chance will distort the results to a large extent.
Sygeplejersken har nu afprøvet flere epidemiologiske teknikker og har anvendt adskillige epidemiologiske begreber.
The nurse had now used a number of epidemiological techniques, and had practised a good deal of epidemiological thinking; she had not proved anything.
Hun har ikke bevist noget og de fire spontane aborter kan have været en tilfældig ophobning.
The four spontaneous abortions could easily have been a chance phenomenon.
Alligevel må man være på vagt, og det synes fornuftigt at undersøge regnfrakkeproduktionen med plasticsvejningen nærmere.
Nevertheless she had identified a situation where an excess of spontaneous abortions, whether due to chance or not, had occurred.
Efter disse indledende øvelser skulle det være muligt at overtale en epidemiolog til en større undersøgelse med fokus på dette problem.
The production of plastic raincoats needed to be checked carefully.
Den professionelle epidemiolog vil sandsynligvis skaffe en
A larger study should be designed and she should be able to convince an epidemiologist that such a study was worth while and necessary.
større studiebase ved at inddrage andre kvinder med lignende erhverv.
The professional epidemiologist would probably not only expand the study base to other women with similar exposure, but also expand the outcomes to be measured.
Epidemiologen vil sandsynligvis også undersøge andre reproduktionsskader end aborter, såsom infertilitet, væksthæmning, for tidlig fødsel og medfødte misdannelser.
If possible infertility, spontaneous abortions, low birthweight, premature births, and congenital malformations should be included in further studies.