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ABSTRACT: A lot of deficiencies in hygienic procedures had been observed in a medical practice on the occasion of a control visit by the Public Health services. Bloodborne infections for the patients could not be excluded. Therefore, this practice was closed by the authorities. After some improvements, the practice was reopened for conservative therapy, whereas operative therapy was still prohibited. Since this verdict was obviously neglected, the operation room was sealed. All these measures were approved by the Administrative Court. This case is reported and discussed with respect to the new infection control law with increased tasks in hygiene control for the Public Health services.
Das Gesundheitswesen 07/2003; 65(6):409-12. · 0.94 Impact Factor
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ABSTRACT: Good hygienic practice in hospitals and other medical institutions is mandatory to avoid or to minimise nosocomial infections. In Germany, official recommendations of the commission for hospital hygiene and infection control have been published as guidelines for hygiene management in hospitals as well as guidelines for control measures of the public health services who are obliged by law to control the hygienic situation in hospitals. In this paper the degree of implementation of these guidelines in the hospitals is studied in respect of the hygiene management in the operation theatre.
The constructive and functional situation and the personal hygienic management were documented in 22 community and private hospitals in Frankfurt am Main, including 40 operation suites with 111 operation theatres. Data of the layout of the rooms were obtained by questionnaire and the hygienic management was observed by means of standardised checklists.
Layout of rooms was not compatible with the recommendations of the Guidelines of 1990 and 2000 in many cases--especially with regard to the demand that doors to the operating theatres be closed. Automatic door closers were often either not available or defective. In some theatre areas correct hand disinfection while entering the suite was not possible for lack of disinfectant distributors at appropriate sites. Recommendations regarding surgical drapes and gowns were correctly observed in most cases, with the exception of changing gowns after having gone to the toilet room. Quite often, omission of hand disinfection after glove removal was observed. A discrepancy in hygienic procedures of nursing service and physicians was seen. In 40 % of the operation suites, powdered gloves were still in use. Though in all but one suite air conditioning systems were available, they were not correctly serviced in many cases. Cleaning and disinfection after single operations and at the end of the operating day were carried out correctly in most cases--except in operation theatres for ophthalmologic operations. Here too, manual preparation and disinfection/sterilisation of surgical instruments was common, and inappropriate use of sterilisers as well as the use of so-called "quick"-sterilisers.
The recommendations of the commission for hospital hygiene and infection prevention are generally accepted as guidelines, although the degree of translation into practice was often unsatisfactory.
Das Gesundheitswesen 06/2003; 65(5):312-20. · 0.94 Impact Factor
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ABSTRACT: In April 2002, a new draft regarding the quality of the water of public swimming pools in Germany was published. This draft was adapted to the new regulations for drinking water in respect of its structure and regulations. Microbiological tests for assessing the quality of bathing water are given priority. With regard to basic differences in facilities for drinking water and such for bath water and to legal aspects, many data (n = 14,425 data) on the practical experience of public health authorities are presented, obtained during the last few years. With regard to the data and in respect of the great delay between sampling and obtaining the results it is concluded that microbiological methods are inappropriate parameters for rapid assessment of the quality of bath water. Hence it is recommended to implement the evaluation of disinfection by chlorination including pH as an indicator for the quality of a bath water, parallel to the guidelines on technical standards. A high frequency of chlorination testing can markedly reduce the number of microbiological tests. Additionally, microbiological tests of the filtrate before disinfection by chlorination are recommended. This procedure has proved successful in legionella control.
Das Gesundheitswesen 05/2003; 65(4):255-62. · 0.94 Impact Factor
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ABSTRACT: In recent years problems with multiple resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) in hospitals have been increasing world-wide. Moreover, nursing home residents have also been found to be colonised with MRSA. In 1999, the Robert Koch Institute, Berlin inaugurated a multicenter study on the prevalence of MRSA colonisation in residents of old-age nursing homes in Germany. Here, the data from the city of Frankfurt will be reported. COLLECTIVES AND METHODS: With the informed consent of 359 residents from 7 old-age pensioners' homes and 42 patients of a geriatric rehabilitation unit, nasal and pharyngeal swaps were taken and tested for MRSA. Age, sex, duration of the stay in the home, former hospital admissions, acute and chronic diseases and medical devices such as urinary catheters were asked using a questionnaire. In addition including 150 employees (mainly nurses) of these institutions were tested for MRSA as well. RESULTS: None of the employees tested were MRSA-positive. MRSA was found in 10 out of 401 residents/patients (2.4 %), i. e. 4.8 % of the patients and 2.2 % of the residents. As risk factors for colonisation of the residents could be found: male sex (Odds ratio 4.7, 95 % confidence interval 95CI 1.3-16.9), stay in the institution for less than 1 year (OR = 17.4; 95CI: 2.2-141) and former MRSA-colonisation (OR = 24.2; 95CI: 3.9-152). In addition, we got hints that former hospital admission was a risk factor for colonisation with MRSA (OR = 3; 95CI: 0.6-14.4). Residents with ulcus, decubiti and peripheral circulatory disorder were at double risk for MRSA colonisation (not significant). DISCUSSION AND CONCLUSIONS: The prevalence of MRSA colonisation in the residents of the old-age pensioners homes in Frankfurt am Main, Germany, was 2.4 %, which is (still?) low. There were no hints available for the spread of MRSA within the homes, although in 7 of 8 MRSA-positive residents MRSA colonisation was not known previously, so that no special hygienic regime was applied. Therefore, US-American and British guidelines for the control of MRSA in nursing homes were confirmed: a good hygienic regime, especially correct hand hygiene is the most important measure to prevent the spread of MRSA within the nursing homes. In general, isolation of the colonised residents is not necessary, unless in very special individual cases.
Das Gesundheitswesen 08/2001; 63(7):447-54. · 0.94 Impact Factor
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ABSTRACT: Only few epidemiological data on legionella diseases are available in Germany and studies on the prevalence of legionella antibody response in the population are scarce. We report on an epidemiological study on immune response in residents of homes with heavy and with minor legionella contamination in their hot-water system. 53 inhabitants of houseblocks with central hot-water system and high legionella contamination (6,049 +/- 17,995 cfu/l; 40% > 1,000 cfu/l) were studied. 92 persons living in 1-2 family houses with decentral hot water systems (244 +/- 1,434 cfu/l; 3% > 1,000 cfu/l) served as controls. All persons filled in a questionnaire on bronchial and fever diseases etc; blood specimen were tested for legionella antibodies (different methods: immunofluorescence, and ELISA), and urine specimens were analysed for legionella antigen. During this investigation in the population exposed to Legionella no cases of legionellosis were reported. The prevalence of legionella antibodies was twice as high in the exposed versus the control persons. Significant correlation between cfu/l and legionella antibody titer in the inhabitants were found. One person with high antibody titer and with legionella-free hot-water system in his home had reported about pulmonary problems after having stayed in a hotel. The positive antibodies of the other persons are most likely the result of asymptomatic infections caused by permanent exposure in their home hot-water supply. In conclusion, with regard to the increased prevalence of antibody titers against legionellae in the exposed inhabitants and the significant correlation between antibody titers and cfu/l in hot-water samples, the necessity to control and redevelop hot-water systems in homes is confirmed--even though no cases of legionelloses in the exposed population were reported.
Das Gesundheitswesen 06/2001; 63(5):326-34. · 0.94 Impact Factor
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ABSTRACT: Internal polycyclic aromatic hydrocarbon (PAH) exposure is usually studied by determining 1-hydroxypyrene in urine. In many studies, increased urinary levels of 1-hydroxypyrene have been found in smokers compared with non-smokers. The disadvantage of this procedure, however, is that it is based on only one substance. Therefore, in our study, urine specimens from smokers and non-smokers were tested for four monohydroxylated phenanthrenes in addition to 1-hydroxypyrene.
Spot urine samples from 288 non-smokers and 100 smokers were analysed for 1-, 2-, 3- and 4-hydroxyphenanthrene and 1-hydroxypyrene by a very sensitive high performance liquid chromatography (HPLC) method with fluorescence detection. The detection limit of the method is 5 ng metabolite/l urine. The data were calculated on a creatinine basis (ng/g creatinine).
Highly significant differences and dose-response relationships with regard to cigarettes smoked per day were found for 2-, 3- and 4-hydroxyphenanthrene and 1-hydroxypyrene, but not for 1-hydroxyphenanthrene. When the ratio of the sum of hydroxyphenanthrenes to 1-hydroxypyrene, and the ratio of 1- and 2-/3- and 4-hydroxyphenanthrene were taken into consideration, significant negative dose-response relationships to the numbers of cigarettes smoked per day, were found.
1-Hydroxypyrene as well as 2-, 3- and 4-monohydroxylated phenanthrenes in urine may be used as parameters to detect PAH exposure from cigarette smoking. Moreover, 3,4-oxidation of phenanthrenes was found to be enhanced in smokers, with a significant dose-response relationship. This phenomenon is thought to be caused by an induction of the CYP 1A2 (or CYP 3A4) monooxygenase system in smokers. Therefore, it may be recommended that monohydroxylated phenanthrenes be analysed in order to assess the balance between the PAH-metabolising cytochrome isoforms, and the activity or induction of cytochrome P450 isoforms, respectively.
Archiv für Gewerbepathologie und Gewerbehygiene 05/2001; 74(3):177-83. · 1.89 Impact Factor
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ABSTRACT: The most frequently used pesticide in U.S. homes, as well as in schools and day care centers, is chlorpyrifos. In 1998, this insecticide was detected in household dust from the former U.S. Forces housing estates in Frankfurt am Main, Germany, resulting from its earlier use up to 1993, i.e., at least 4 years ago. This led to great concern in the new inhabitants. To investigate their internal exposure to the substance, they were offered the opportunity of taking part in biomonitoring examinations. Children playing on the floor were assumed to be especially at risk due to increased exposure to chlorpyrifos via oral or dermal intake. A total of 1146 inhabitants took part in this voluntary investigation. All of them stated that they had never used chlorpyrifos in their homes. Spot urine samples of the study participants were analyzed for six metabolites of organophosphorous insecticides [dimethylphosphate (DMP), diethylphosphate (DEP), dimethylthiophosphate (DMTP), diethylthiophosphate (DETP), dimethyldithiophosphate (DMDTP), and diethyldithiophosphate (DEDTP)] using a very sensitive gas chromatographic method with mass-selective detection and a limit of detection of 1 microg/L. No evidence was found of increased internal exposure due to former chlorpyrifos application in these homes (>4 years ago), either in children or in adults. The median values and 95th percentiles of the urinary metabolite concentrations in 484 adults were (microg/g creatinine): DMP, 15.5 and 102.5; DMTP, 13.5 and 125.8; DMDTP, <1 and 13.1; DEP, 2.1 and 11.6; DETP, <1 and 6.4; DEDTP, both <1. The urinary metabolite concentrations in children <6 years of age were higher; this was caused mainly by lower creatinine concentrations. To conclude, no increase in internal exposure due to former indoor application of chlorpyrifos could be found, and the reference values published for internal organophosphate exposure in adults in Germany were confirmed. However, as shown in other environmental studies, the urinary excretion of organophosphorous metabolites exceeds dietary intake several fold; this has been estimated from the data in various duplicate dietary studies. This observation calls for further investigation.
Environmental Research 05/2001; 86(1):80-7. · 3.40 Impact Factor
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ABSTRACT: Pyrethroids are important insecticides used in agriculture, forestry, horticulture, and in the home. In humans, they are rapidly metabolized and renally eliminated. In numerous studies, pyrethroid metabolites have been detected in urine after occupational exposure to insecticides. In this study, we used a new, reliable, easy, and sensitive analytical method to assess the internal pyrethroid exposure of an urban population without exposure to pyrethoids at home or at work (children and adults). A total of 1,177 persons took part in this investigation, including 331 children under 6 years of age and 247 children between 6 and 12 years of age. None of them reported exposure to pyrethroids at home or at work. Accordingly, the levels of permethrin found in household dust from their homes were lower than expected (median < limit of detection; 95th percentile, 4.8 mg/kg; maximum value, 19 mg/kg). Urine specimens were analyzed for cis-3-(2,2-dibromo-vinyl)-2,2-dimethylcyclo-propanecarboxylic acid (Br(2)CA), cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-carboxylic acid (cis-Cl(2)CA and trans-Cl(2)CA), and 4-fluoro-3-phenoxybenzoic acid (F-PBA) using a gas chromatographic method with mass-selective detection. The limit of detection for pyrethroid metabolites was between 0.1 and 0.2 microg/L. trans-Cl(2)CA was detected in 65% of the urine specimens tested, cis-Cl(2)CA was detected in 30%, and Br(2)CA and F-PBA were found in 19% and 16%, respectively, of the urine specimens. The urinary metabolite levels in children did not differ from those in adults, and there was no correlation between the levels of metabolites and indoor exposure to permethrin in household dust. Moreover, no seasonal correlations could be found. The 95th percentile levels in urine specimens were as follows: Br(2)CA, 0.30 microg/L; cis-Cl(2)CA, 0.51 microg/L; trans-Cl(2)CA, 1.43 microg/L; F-PBA, 0.27 microg/L. Background exposure to pyrethroids was found in the general population; it seems to be caused by the uptake of pyrethroids with the diet. This hypothesis needs to be tested in duplicate diet studies combined with biomonitoring. As long as representative data are lacking, however, the rounded 95th percentile values obtained in our study may be used as reference values for pyrethroid metabolites in urine samples from the population in Germany; 95th percentile values for children and adults are as follows: Br(2)CA, 0.3 microg/L; cis-Cl(2)CA, 0.5 microg/L; trans-Cl(2)CA, 1.5 microg/L; and F-PBA, 0.3 microg/L.
Environmental Health Perspectives 04/2001; 109(3):213-7. · 7.04 Impact Factor
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ABSTRACT: PAHs form during the incomplete combustion of organic substances and hence they are distributed ubiquitously in the environment. PAHs in the diet are the main source of exposure in man. In 1997 a new source of potential PAH exposure was discovered: very high levels of polycyclic aromatic hydrocarbons (PAHs) and benzo-a-pyrene (BaP) were detected in household dust from former American Forces housing in Frankfurt am Main, Germany, built in 1955/1956. This contamination was caused by a parquet glue containing coal tar, the use of which was formerly standard building practice in Germany. Because the inhabitants of these flats were very concerned about the effects on their health, they were offered the opportunity to take part in biomonitoring examinations to assess individual internal PAH exposure.
1213 inhabitants from 511 flats/houses took part in the investigation; this corresponds to 12.7% of the total inhabitants of the former US housing estates in Frankfurt am Main. Spot urine samples were collected and frozen until analysis for 1-, 2-, 3- and 4-hydroxyphenanthrene and 1-hydroxypyrene, which was carried out using a very sensitive and practical high performance liquid chromatographic method with fluorescence detection, approved by the Deutsche Forschungsgemeinschaft.
The level of internal exposure to PAHs in study participants living in homes where parquet glue containing PAHs had been used did not differ from the levels found in participants in whose homes PAH-containing parquet glue was not used. This was true for the whole group as well as subgroups divided according to age and smoking behaviour. Internal exposure was not influenced by different levels of external exposure (BaP in parquet glue and in household dust). Spearman rank correlations between the level of BaP in parquet glue and in household dust were low and insignificant.
An increase in internal PAH exposure due to high levels of PAHs in parquet glue and household dust could not be detected. This confirms earlier results with small collectives, where only low and insignificant trends were found towards higher internal PAH exposure caused by contaminated homes. Therefore, the ad-hoc working group of the Commission for Indoor Air Quality of the German Federal Environmental Agency stated that a definitive threshold limit value cannot be defined for PAH contamination in parquet glue and household dust. For reasons of disease prevention, however, BaP contamination in household dust exceeding 10 mg/kg should be minimised.
Archiv für Gewerbepathologie und Gewerbehygiene 04/2001; 74(2):91-101. · 1.89 Impact Factor
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ABSTRACT: Hygiene conditions in residential homes for the aged must be surveyed by the Public Health services according to German legislation (Bundesseuchengesetz, Law for Protection against Infectious Diseases). We report here on the data of the routine controls of the public health department in Frankfurt am Main in all of the 31 residential homes for the aged of the city. RESULTS: In 1989, a special plan for cleaning and disinfection was available in one home only, whereas a hygiene plan was not available in any of the homes. Up to 1998, plans for cleaning and disinfection were established in 29 of the homes, and more than 50% of them had fulfilled their hygiene plan. The supply and maintenance of dispersers for disinfectants, the usage of disinfectants and the knowledge regarding proper disinfection and sterilisation procedures could be improved. The same was true of the kitchens: there, up to 1998 testing of samples set aside for later reassessment was properly done in most of the homes. CONCLUSION: Hygiene in the homes and the knowledge of the staff members were markedly improved during the last years. Some of the most relevant hygienic problems are today: wearing private clothing instead of special working clothes, or deficits in the knowledge of the management of MRSA-colonised residents.
Das Gesundheitswesen 01/2001; 62(12):670-7. · 0.94 Impact Factor
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ABSTRACT: The fungicidal substance pentachlorophenol (PCP) had been used commonly for wood protection and leather impregnation in Germany until 1989, when this substance was prohibited by law. Hence, the body burden in the general population in Germany has been steadily declining. The reference values (95th percentiles) in blood plasma decreased from 20 micrograms PCP/l in 1991 to 12 micrograms/l in 1996. In 1998 the current exposure in a large residential population was investigated. 623 persons with an average age of 34.6 years (0-62 years) were investigated. For all of them there was neither evidence of occupational contact with PCP nor of the presence of PCP in the residential indoor environment. The mean PCP concentration in the plasma samples was 2.4 +/- 3.9 micrograms/l, the median 1.7 micrograms/l, and the 95th percentile 6.1 micrograms/l, the maximum value was 59.3 micrograms/l. In children and adolescents higher median and 95th percentiles were obtained than in adults (median 2.5 vs. 1.5 micrograms/l and 95th percentile 7.7 vs. 5.9 micrograms/l). All values above 20 micrograms/l were checked again individually: relationships with the level of PCP in household dust could not be detected. In one family leather clothing containing PCP, however, was found to be the cause of unusually high PCP values in the blood. Our investigations confirm a trend observed in recent years: exposure to PCP in the population in Germany decreases steadily and leads to an actualized reference value of 6.1 micrograms PCP/l plasma. In individual cases, however, greatly increased PCP levels in blood can still occur today, for example due to leather clothing treated with PCP.
International Journal of Hygiene and Environmental Health 11/2000; 203(2):135-9. · 3.81 Impact Factor
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ABSTRACT: Tattooing and piercing have become increasingly popular in recent years. Both methods involve several medical risks, including transmission of infectious diseases. There are many reports on wound infections as well as transmission of hepatitis and human immunodeficiency viruses etc. According to these facts special hygiene regulations for tattooing and piercing have been published in Germany. Based on these regulations the public health department of the city of Frankfurt am Main, Germany, carried out special hygiene controls in such studios, one a year. Special tattoo or piercing exhibitions were also controlled. Results are reported here.
Studios for tattoos or piercing were informed about hygiene rules and annually controlled from 1995-1999, using a special check list on cleanliness in the studios, disinfection and sterilisation procedures etc. For permission of tattoo and piercing exhibitions special hygiene orders were made mandatory.
During 1995-1997 the absolute number of complaints decreased from 20 to 9, in spite of the increasing number of tattoo studios in Frankfurt am Main (from 6 to 10). This was true also of the tattoo and piercing exhibitions. After 1 year without control visits however, an increase of complaints was to be seen in 1999.
According to our experience tattooists and piercers are interested in good hygiene practice. But our data showing the worsening hygiene data in one year without control visits also demonstrate the necessity of regular controls by the authorities. According to the reports on infectious complications of tattooing and piercing and according to the data reported here hygienic advice and control is an important task of Public Health services.
Das Gesundheitswesen 05/2000; 62(4):219-24. · 0.94 Impact Factor
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U Heudorf
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ABSTRACT: In 1997 so far unknown indoor contaminations were detected in a flat of former American Forces living quarters in Frankfurt/Main, Germany. Household dust samples were found to be contaminated with polycyclic aromatic hydrocarbons (PAH), respectively with benzo(a)pyrene (BaP), due to the use of a coal tar pitch parquet glue that had been standard building practice in Germany up to the 'sixties. To assess the amount of exposure, the local Health Services department organised analyses of PAH metabolites in the urine of children below 6 years of age considered to be at risk for oral exposure to BaP in household dust while playing on the floor. In addition the local Health Services informed all ministeries concerned of the problem. During the following months several meetings on this topic were held by experts in the respective spheres and recommendations for redeveloping indoor sites were outlined. In almost 3,000 analyses of samples of household dust and parquet glue and about 1,200 urine analyses for PAH-metabolites in Frankfurt/Main no correlation was seen between the BaP levels in parquet glue and the BaP levels in household dust samples, as well as with interual exposure. Recommendations for further action were made in view of the importance of the composition of parquet flooring for possible indoor contamination.
Das Gesundheitswesen 12/1999; 61(11):567-72. · 0.94 Impact Factor
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ABSTRACT: Durch die am 3.11.1998 vom Europäischen Parlament verabschiedete Richtlinie des Rates der Europäischen Gemeinschaft über die
Qualität von Wasser für den menschlichen Gebrauch muß eine Absenkung des Bleigrenzwertes in Deutschland von derzeit 0,040
mg/l auf 0,025 mg/l bis spätestens zum Jahr 2003 und auf 0,010 mg/l bis spätestens zum Jahr 2013 erfolgen. Da in Frankfurt
a.M. bekannt war, daß noch ca. 7800 Liegenschaften mit bleihaltigen Hausinstallationen ausgestattet sind, wurde ab 1997 im
Stadtgesundheitsamt das „Blei-Projekt” gestartet, mit dem eine Untersuchung und ggf. erforderliche Sanierung aller betreffenden
Häuser binnen max. zehn Jahren ab 1996 unter dem Aspekt der Kostendeckung durchgesetzt werden soll. Pro untersuchtem Haus
wurden mehrere Proben entnommen, um das Stagnationsproblem adäquat zu berücksichtigen.
In 50% der von uns untersuchten Wohnungen, unter denen sich auch Hausinstallationen ohne Bleileitungen befanden, wurde der
ab dem Jahr 2013 geltende Grenzwert von 0,010 mg/l bereits erreicht. Bei einer nur aus bleihaltigen Hausinstallationen bestehenden
Stichprobe ist aufgrund unserer Daten zu erwarten, daß dieser Wert sogar deutlich überschritten würde. Der Mittelwert der
Leitungsproben nach 3 Stunden Stagnation überschreitet mit 0,034 mg/l den ab dem Jahr 2003 geltenden Grenzwert von 0,025 mg/l
klar. Aus der Fachdiskussion ist bekannt, daß sich die zukünftigen Grenzwerte nicht mit Aufbereitungsmaßnahmen wie Phosphatierung
u.ä. einhalten lassen werden, sondern daß der Austausch der Bleileitungen gegen Leitungen aus geeigneten Werkstoffen der einzig
in Frage kommende Sanierungsweg ist. Auch mit Innenbeschichtungen arbeitende Sanierungstechniken können derzeit nicht empfohlen
werden.
Schon die Festsetzung des Trinkwasser-Grenzwertes für Blei von zunächst 0,025 mg/l ab dem Jahr 2003 bedeutet daher, daß nahezu
jede bleihaltige Hausinstallation bis dahin durch vollständiges Austauschen der Bleirohre saniert werden muß. In jedem Fall
gilt dies für die Einführung des Parameterwertes von 0,010 mg/l ab dem Jahr 2013, was faktischen einem Verbot von Bleileitungen
gleichkommt.
Aus den gegebenen Fristen und den hier gemachten Erfahrungen hinsichtlich der benötigten Bearbeitungszeiten ist die Erkenntnis
abzuleiten, daß ein Vollzug der Trinkwasserverordnung ohne ein möglichst auf klare europaweite Rechtsvorschriften gegründetes
Verbot in den meisten betroffenen Bundesländern, Kreisen und kreisfreien Städten nicht möglich sein wird und somit die seitens
der die Bundesrepublik Deutschland als EG-Mitgliedsstaat eingegangenen Verpflichtung zur Einhaltung des Parameterwertes für
Blei nicht erfüllt werden kann. Ein Verbot für Bleileitungen würde die Einhaltung des Parameterwertes ermöglichen, Rechtsklarheit
sowohl für die Verbraucher als auch für die Eigentümer von Hausinstallationen bringen, erhebliche Mittel für Untersuchungs-
und Verwaltungskosten einsparen lassen, die ohnehin unumgängliche Sanierung von bleihaltigen Hausinstallationen für die Eigentümer
besser planbar machen sowie Rechtsstreitigkeiten über die Interpretation von Meßwerten vermeiden.
On 3.11.1998 the Drinking Water Directive passed the European Parliament. This new directive will lower the current limit
value for lead in Germany from 0,040 mg/l to 0,025 mg/l in 2003 and to 0,010 mg/l in 2013. Since there are still around 7800
premises with plumbing-systems containing lead-pipes in Frankfurt, the Stadtgesundheitsamt started the „Frankfurt Lead-Project”
in 1997. Aim of the project was the investigation and, if necessary, the order to exchange all concerned plumbing systems.
The owners of the buildings are liable to a fee for these measures of the local public health service, thus covering of the
costs should be attainable. Within the project 3 to 5 water probes from each concerned building were sampled, to take the
stagnation-problem into account.
The drinking water of 50% of the investigated flats reached the EG-parametric value of 0,01 mg/l, which has to be transferred
into national law from 2013 on the latest. Houses with plumbing-systems not containing lead were part of this sample. A sample
of houses with only lead containing plumbing systems would result in considerably higher values. The mean lead-concentration
after a stagnation-period of 3 hours was 0,034 mg/l and therefore significantly exceeded the EG-parametric value of 0,025
mg/l. Experts agree that the future EG-parametric values can not be met with special water treatments, but only by replacement
of lead pipes by pipes composed of other suitable materials. Even pipe-coating techniques can not be recommended at this time.
To our experience the new EG-parametric-value for lead of 0,025 mg/l, which has to be transferred into national law by the
european member states from 2003 on, will require the sanitation of nearly every house with a lead-containing plumbing system.
All the more so because the EG-parametric-value of 0,10 mg/l will become effective from 2013 on, what factually equals a prohibition
of lead-pipes.
Considering the time given by the EG-Drinking Water Guideline and the experience reported here we conclude that compliance
with the new EG-parametric values would not be possible for most of the German cities and communities having a lead-pipe problem.
It is foreseeable therefore, that the Federal Republic of Germany will have to face complaints for non-compliance with the
parametric value from the European Commission. Based on the experiences with the lead-project we would recommend the prohibition
of lead pipes whithin domestic distribution systems as an appropriate measure to achieve compliance with the parametric value
for lead. Such a prohibition would make it possible to meet the parametric value for lead, create a reliable legal situation
for both consumers and owners of the concerned plumbing systems, save considerable expenses for staff and laboratory tests,
make the exchange of lead-containing installations easy to plan and would avoid conflicts about the interpretation of monitoring
results.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 11/1999; 42(12):902-910. · 0.66 Impact Factor
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U Heudorf
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ABSTRACT: According to the current law of preventing infectious diseases in Germany, bacterial as well as aseptic meningitis have to be reported to the health authorities, whereas according to the amendment aseptic meningitis will no longer be notifiable. In Summer 1997, 63 children with aseptic meningitis were reported to the local health authorities of Frankfurt compared with 4 or 5 per year during the preceding years. In 40% enterovirus, resp. ECHO-30 virus could be detected. The local health authorities gave detailed information on the medical relevance as well as necessary hygienic measures to the families and kindergartens. During the same time reports on aseptic meningitis increased to double compared with 1996, with hot spots in 4 defined regions in Bavaria, Hesse and in Northern Germany. According to these data the duty of notification of aseptic meningitis should be maintained, so that health authorities can inform the population and ensure good hygiene methods.
Das Gesundheitswesen 06/1998; 60(5):307-10. · 0.94 Impact Factor
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U Heudorf
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ABSTRACT: The Public Health office of the city of Frankfurt am Main processed from 1994 to 1995 to total of 13,434 applications for health certificates in accordance with section 18 of the Federal Epidemics law. In 78 applicants (= 0.56%) the certificate was refused or the applicants barred from exercising their profession because of positive findings in their faeces (usually salmonellae). Other examining offices had also arrived at clearly less than 1% (0.3-0.6%) positive findings. These results support the projected change in the revision of the Federal Epidemics law (Law of Protection against Infections) providing for omission of the once-only performed examination of faeces, in favour, of an intensive and annually repeated training of personnel in matters of hygiene. Infection epidemiology data also show that hygiene in the processing of foods of animal origin is of prime importance for the incidence of infections caused by foods, the other important factor being the ways and means of keeping, breeding and producing the animals concerned.
Das Gesundheitswesen 04/1998; 60(3):166-9. · 0.94 Impact Factor
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ABSTRACT: On 27 January 1996, about 1 ton of Isoproturone was released into the atmosphere due to an accident in a chemical plant located at Frankfurt-Griesheim, Germany. A nearby residential area was contaminated by up to 500 mg Isoproturon/m2. According to the published toxicological data and the contamination data, model calculations were performed demonstrating that the individual exposure remained below the LOEL. For better exposure and risk assessment urine biomonitoring was offered to the residents. HMEPMH, the main metabolite of Isoproturon was detected in 12% (19/154) of the participants in the test, with a maximum value of 14.2 micrograms/l, i.e. the internal exposure remained even below ADI. Control tests demonstrated the decrease of the soil contamination after some weeks, and by June 1996 Isoproturone was no longer detectable, neither in soil nor in vegetables.
Das Gesundheitswesen 12/1997; 59(11):661-6. · 0.94 Impact Factor
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ABSTRACT: Public Health authorities in Germany are obliged to check on the hygienic situation in hospitals, homes for the elderly, etc., but are not permitted to perform routine hygiene controls in physician's practices--with the exception of those that are licensed for termination of pregnancy (the latter exception applies to the Federal Land of Hesse). Public Health authorities in Frankfurt/Main have been checking on hygienic conditions in 16 medical practices in Frankfurt since 1990. Initially, severe hygienic defects were found. For example, in only one practice did they find a plan for safeguarding hygienic conditions, or a dispenser for disinfectants. Severe faults in disinfection and sterilisation methods or in handling medicaments, ampoules etc. were seen in many practices. However, in the course of years remarkable improvements have been achieved. These data support the official plan according to which Public Health authorities will be obliged to check on hygienic conditions prevailing also in the consulting rooms of practising specialists.
Das Gesundheitswesen 11/1997; 59(10):569-72. · 0.94 Impact Factor
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ABSTRACT: BTXE-Immissions (benzene, toluene, ethylbenzene, xylene) were measured in 32 flats in the neighbourhood of 12 filling stations in Frankfurt on the Main. Mean benzene-concentration in the indoor air nearby filling stations was 10.2 micrograms/m3, whereas in reference flats 5.6 micrograms/m3 were measured. Maximum levels were 22.4 micrograms/m3 and 8.0 micrograms/m3. Indoor air levels were slightly higher than outdoor air contaminations. High Toluene-concentrations were not caused by the filling stations but by other commercial enterprises, such as paint shops. Mean ethylbenzene or xylene-concentrations in the neighbourhood of filling stations did not differ from the concentrations measured in the reference flats. Because of the cancerogenicity of benzene the benzene-contaminations in the neighbourhood of filling stations have to be lowered. The newly established German law to prevent gas leakage in filling stations will lead to some improvement in the future.
Zentralblatt für Hygiene und Umweltmedizin = International journal of hygiene and environmental medicine 02/1995; 196(5):416-24.
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ABSTRACT: A major industrial chemical accident occurred on 22 February 1993 at Hoechst AG Frankfurt/Germany. Approximately 11.8 tons of a chemical mixture (mostly chlorinated nitroarenes) were emitted, resulting in heavy contamination of Schwanheim, a nearby housing area. Urine samples were collected from the inhabitants of the affected area a few days after the accident and were analyzed for o-nitrophenol (ONP) as a representative metabolite to assess the actual uptake of the pollutants. As a result, ONP was found in urines of control subjects from elsewhere, an observation hitherto not described in the literature. Mean ONP excretion was about three times higher in the Schwanheim population than in the controls. The results show not only a higher accident-related but also a higher permanent ONP-excretion of the population of Schwanheim, pointing to a permanent environmental pollution in Schwanheim. Both results, the hitherto unknown ONP excretion in controls and regional differences in ONP excretion, require further investigation.
Das Gesundheitswesen 11/1994; 56(10):558-62. · 0.94 Impact Factor
