Annoyance due to relatively high levels of sound and noise, above 50 dB, has been well documented in noise assessment literature. The potential for annoyance or disturbance from low amplitude sound, below 50 dB to the threshold of an individual’s hearing, is not as well documented. The thesis presents a new approach to the measurement and assessment of intrusive noise and low amplitude sound. Acoustical and sound quality measures are integrated with measures of loudness, pitch, dissonance and tonality to provide physical measures of sound. Individual amenity is assessed with respect to personal noise sensitivity and personal attitudes to sound in the environment, the environment itself and the perceived qualities of the audible sound. A decision-support methodology to integrate perceived noise with noise performance indicators, annoyance criteria, personal noise sensitivity and amenity is presented. A method for rating intrusive noise is derived. Designs for sound measurement and calibration instrumentation are described. Methods to measure and assess low amplitude sound are presented. Keywords annoyance, intrusive-noise, noise-sensitivity, sound-quality, soundscape

Cette thèse vise à répondre à trois questions fondamentales: 1) La diminution de l’excitabilité corticospinale et le manque d’inhibition intracorticale observés suite à la stimulation magnétique transcrânienne (SMT) du cortex moteur de la main atteinte de sujets hémiparétiques sont-ils aussi présents suite à la SMT du cortex moteur de la jambe atteinte? 2) Est-ce que les altérations dans l’excitabilité corticomotrice sont corrélées aux déficits et incapacités motrices des personnes ayant subi un accident vasculaire cérébral depuis plus de 6 mois? 3) La vibration musculaire, étant la source d’une forte afférence sensorielle, peut-elle moduler l’excitabilité corticomotrice et améliorer la performance motrice de ces personnes? Premièrement, afin d’appuyer notre choix d’intervention et d’évaluer le potentiel de la vibration mécanique locale pour favoriser la réadaptation des personnes ayant une atteinte neurologique, nous avons réalisé une révision en profondeur de ses applications et intérêts cliniques à partir d’informations trouvées dans la littérature scientifique (article 1). La quantité importante d’information sur les effets physiologiques de la vibration contraste avec la pauvreté des études qui ont évalué son effet thérapeutique. Nous avons trouvé que, malgré le manque d’études, les résultats sur son utilisation sont encourageants et positifs et aucun effet adverse n’a été rapporté. Dans les trois autres articles qui composent cette thèse, l’excitabilité des circuits corticospinaux et intracorticaux a été étudiée chez 27 sujets hémiparétiques et 20 sujets sains sans atteintes neurologiques. Les fonctions sensorimotrices ont aussi été évaluées par des tests cliniques valides et fidèles. Tel qu’observé à la main chez les sujets hémiparétiques, nous avons trouvé, par rapport aux sujets sains, une diminution de l’excitabilité corticospinale ainsi qu’un manque d’inhibition intracorticale suite à la SMT du cortex moteur de la jambe atteinte (article 2). Les sujets hémiparétiques ont également montré un manque de focus de la commande motrice lors de l’activation volontaire des fléchisseurs plantaires. Ceci était caractérisé par une augmentation de l’excitabilité nerveuse des muscles agonistes, mais aussi généralisée aux synergistes et même aux antagonistes. De plus, ces altérations ont été corrélées aux déficits moteurs au membre parétique. Le but principal de cette thèse était de tester les effets potentiels de la vibration des muscles de la main (article 3) et de la cuisse (article 4) sur les mécanismes neuronaux qui contrôlent ces muscles. Nous avons trouvé que la vibration augmente l’amplitude de la réponse motrice des muscles vibrés, même chez des personnes n’ayant pas de réponse motrice au repos ou lors d’une contraction volontaire. La vibration a également diminué l’inhibition intracorticale enregistrée au quadriceps parétique (muscle vibré). La diminution n’a cependant pas été significative au niveau de la main. Finalement, lors d’un devis d’investigation croisé, la vibration de la main ou de la jambe parétique a résulté en une amélioration spécifique de la dextérité manuelle ou de la coordination de la jambe, respectivement. Au membre inférieur, la vibration du quadriceps a également diminuée la spasticité des patients. Les résultats obtenus dans cette thèse sont très prometteurs pour la rééducation de la personne hémiparétique car avec une seule séance de vibration, nous avons obtenu des améliorations neurophysiologiques et cliniques. / This thesis aims to answer three basic questions: 1) Are the decrease in corticospinal excitability and the lack of intracortical inhibition observed following transcranial magnetic stimulation (TMS) of the affected hand motor cortex of stroke patients present after TMS of the affected leg motor cortex? 2) Are the alterations in corticomotor excitability correlated with motor impairments and disabilities of subjects who have suffered a stroke for over six months? 3) Can muscle vibration, as a source of strong sensory afference modulate corticomotor excitability and improve motor performance of these subjects? First of all, to support our choice of intervention and to assess the potential of local mechanical vibration to promote the recovery of persons with neurological impairment, we conducted a thorough review of its physiological effects and clinical applications in the scientific literature (article 1). The wealth of information on the physiological effects of vibration contrasts with the lack of studies that have evaluated its therapeutic effects. Nevertheless, we found that, despite the paucity of studies, the results on its clinical use are encouraging and positive and no adverse effects were reported. In the other three articles included in this thesis, the excitability of corticospinal and intracortical circuits has been studied in 27 hemiparetic patients and in 20 healthy subjects without neurological disease or injury. Sensorimotor functions were also evaluated with valid and reliable clinical tests. Similar to that observed in the hand of hemiparetic patients, we found, compared to the healthy subjects, a decrease of corticospinal excitability and a lack of intracortical inhibition following TMS of the affected leg motor cortex (Article 2). The hemiparetic patients also showed a lack of focus of the motor output during voluntary activation of plantar flexors. This was characterized by an increase in the neural excitability not only of the agonist muscles, but also of the synergists and even the antagonist muscles. The main goal of this thesis was to test the potential effects of vibrating hand (Article 3) and thigh (Article 4) muscles on the neural mechanisms that control these muscles. We found that vibration increases the amplitude of motor responses in the vibrated muscles and even produces a response in subjects with no motor response at rest or during a voluntary contraction. The vibration also decreased the intracortical inhibition recorded in the paretic quadriceps muscle (vibrated muscle). The decrease was however not significant at the hand. Finally, using a cross-over design study, the vibration of the paretic hand or leg resulted in specific improvements in hand dexterity or leg coordination, respectively. In the lower limb, quadriceps vibration also reduced the spasticity in patients. The results obtained in this thesis are very promising for stroke rehabilitation because with a single session of vibration, we obtained neurophysiological and clinical improvements.

De nombreuses études concluent que la charge mécanique supportée par le genou, qu’elle soit reliée à l’obésité, aux sports intenses, à une altération biomécanique des structures de l’articulation ou à une exposition à des charges lourdes durant les activités occupationnelles, est considérée comme un facteur de risque important au développement de la gonarthrose. La gonarthrose reliée au travail a été le sujet de nombreuses études et plusieurs d’entre elles ont rapporté une prévalence accrue de la gonarthrose chez les travailleurs de certains domaines en particulier, comme la construction, la pose de plancher, la peinture, l’exploitation minière, l’agriculture et le travail en atelier et en milieu de la santé. Les personnes qui travaillent dans ces métiers sont exposées à des positions ou des activités nuisibles, comme travailler à genoux ou accroupi, monter des escaliers ou des échelles, transporter des changes lourdes et marcher de façon prolongée. Ces gestes surchargent l’articulation du genou, ce qui cause des modifications aux structures de l’articulation du genou ou aux adaptations neuromusculaires de patron de mouvement du genou. Ces modifications structurelles et adaptations neuromusculaires peuvent apporter des changements cinématiques à la marche qui peuvent initier la gonarthrose ou contribuer à sa progression. L’objectif principal de la présente étude était d’analyser l’effet d’une surcharge mécanique sur l’articulation fémoro-tibiale (AF-T) subie au travail lors d’une tâche de marche et comparer le patron cinématique de l’articulation fémoro-tibiale des travailleurs exposés à une surcharge mécanique à celui des travailleurs non exposés. Vingt-quatre travailleurs exposés à une surcharge mécanique et neuf travailleurs non exposés ont participé à l’étude. Les données cinématiques de la marche ont été enregistrées au niveau du genou dans des conditions cliniques en utilisant un système de suivi du mouvement électromagnétique. Les paramètres suivant ont été extraits et utilisés pour la comparaison des groupes : l’angle maximum lors du contact initial, l’angle ii maximum de flexion durant la réponse à la charge, l’angle minimum au moment de l’appui unipodal et l’étendue max-min du cycle. La comparaison des groupes pour les variables cliniques et cinématiques a été effectué par l’utilisation de tests-t bilatéraux (« Student-t tests ») et de tests ANCOVA utilisant le poids et la vitesse comme covariables. Les travailleurs exposés à une surcharge mécanique présentaient un plus grand angle de flexion de l’articulation fémoro-tibiale au contact initial, durant la réponse au chargement et à la phase unipodale et ils ont démontré une étendue d’angle moindre que les travailleurs non exposés. Nous croyons que les données cinématiques de la marche peuvent donner des idées sur les facteurs biomécaniques qui pourraient prédisposer les travailleurs au développement ou à la progression de la gonarthrose. Une meilleure compréhension de ces facteurs pourrait être un premier pas vers le développement d’une intervention plus efficace pour cette population. / Many studies agree that mechanical knee loading, either related to obesity, intense sports, biomechanical alteration of the knee or exposition to heavy load occupational activities, is an important factor in knee OA development. Work related knee OA has been the focus of numerous studies, many of them reporting increased knee OA prevalence in workers involved in particular occupational fields such as construction, floor layer, painting, mining, agriculture, shop assistant and health care employees. Persons working in these occupations are exposed to noxious positions or activities such as kneeling, squatting, climbing stairs or ladders, carrying heavy load and prolonged walking. These gestures overload the knee joint, resulting in modifications of the knee joint structures or in neuromuscular adaptations of the knee movement pattern. These structural modifications and neuromuscular adaptations can bring about gait kinematic changes that can either initiate knee OA or contribute to its progression. The main objective of this study was to analyze the effect of mechanical overloading on the tibial-femoral joint suffered during walking tasks at work and compare the kinematics gait tibial femoral joint of workers exposed to knee overloading (KO workers) to that of non-knee overloaded workers (non-KO workers). Twenty four KO workers and 9 non-KO workers participated to the study. Gait kinematic data were recorded at the knee in a clinical setting using an electromagnetic motion tracking system. The following parameters were extracted and used for group comparison: knee angle at initial contact, peak knee flexion angle during loading response and angle range. Group comparison for clinical and kinematic variables of interest was performed with Student-t and ANCOVA tests. KO workers had greater knee flexion angle at initial contact, during loading response and single limb support, and they demonstrated a lower angle range than non-KO workers. iv We believe that gait kinematic data can suggest biomechanical factors that could predispose workers to the development or progression of knee OA. A better understanding of these factors could be a first step toward more efficient intervention within the population.

L'étude vise à évaluer l'exposition professionnelle au bruit des travailleurs d'une plateforme gazière en Algérie et à mettre en évidence des déterminants influençant cette exposition. Des groupes d'exposition homogène (GEH) ont été constitués sur la base de ressemblances quant à l'exposition au bruit, aux titres d'emploi et aux lieux de travail. Deux stratégies d'échantillonnage ont été suivies, la première selon la norme internationale ISO 9612 : 2009 et la seconde selon la stratégie aléatoire de l'AIHA. Pour les deux approches, les niveaux de bruit (Lex, 8h, niveaux d'exposition au bruit pondéré (A) ajustés à une journée de travail de 8 heures) des opérateurs et des superviseurs étaient généralement > 85 dB(A) alors que pour les techniciens-tableau, les niveaux de bruit (Lex, 8h) étaient en tout temps < 85 dB(A). Pour les trois GEH du titre d'emploi des maintenanciers, il y a eu régulièrement des dépassements de la valeur de référence. Plusieurs travailleurs oeuvrant sur les plateformes gazières sont exposés à des niveaux importants de bruit et sont à risque de développer des problèmes auditifs. / The study aims to evaluate workers'noise exposure from an onshore gas platform in Algeria, and to emphasize the determinants influencing the exposure. Exposure groups were formed based on their work category and job location. Two sampling strategies were followed. The first was according to the international standard ISO 9612: 2009, and the second, according to the AIHA random strategy. For both strategies, the noise level (Lex, 8h, levels of exposure to noise ratio (A) for a working day of 8-hour) for operators and supervisors was usually > 85 dB(A) whereas the noise level for the technicians exposed in the distributed control system (DCS) was < 85 dB(A) at all times. The three HEG belonging to the maintenance technician group regularly exceeded the reference value of 85 dB(A). We concluded that employees working on the gas platform are exposed to significant noise level, and are at risk of developing hearing problems

Introduction La santé est considérée comme un idéal, un objectif et un but à atteindre; pour l'améliorer, certains ergothérapeutes utilisent les approches habilitantes. Ces dernières démontrent des résultats positifs pour la prévention des troubles musculosquelettiques (TMS). Objectif L’objectif de cette recherche est de mesurer les effets d'un programme en partenariat pour la prévention des TMS dans une pharmacie communautaire. Méthodologie Un devis mixte (quantitatif, qualitatif et descriptif) avant-après avec un groupe témoin non équivalent est utilisé. Le recrutement des participants se fait sur une base volontaire. Ceux-ci sont âgés de 18 ans et plus (groupe expérimental (n = 18) et témoin (n = 17)) et occupent trois titres d'emplois distincts. Différentes mesures via des questionnaires et des entrevues sont prises avant et après l’intervention. L’intervention, quant à elle, comprend trois rencontres élaborées à partir des concepts de l’ergonomie. Résultats En lien avec les connaissances acquises et la mobilisation, une diminution des sensations douloureuses est constatée chez les participants du groupe expérimental. De même, pour ceux-ci, une tendance à la généralisation des connaissances est notée. Conclusion Inspirée des principes de la prévention, de l’ergonomie et de l’habilitation, cette recherche, malgré ses limites, permet de mieux documenter les effets d'un programme en partenariat en entreprise de services pour la prévention des TMS. / Introduction Health is regarded as an ideal, a goal to improve and to achieve; in order to enhance it some therapists using enabling approaches. The latter show positive results for the prevention of musculoskeletal disorders (MSD's). Objective The objective of this research is to measure the effects of a partnership program in a community pharmacy for the prevention of MSD's. Methodology A mixed design (quantitative, qualitative and descriptive) before and after with a non-equivalent control group is used. Participant recruitment is done on a voluntary basis. They are aged 18 years and over (experimental group (n = 18) and control (n = 17)) and occupy three distinct job titles. Different measures through questionnaires and interviews are taken before and after the intervention. The intervention, meanwhile, includes three session developed from the concepts of ergonomics. Results Results are related to the acquired knowledge and mobilization, and there is a decreased of pain sensation is measured among the participants of the experimental group. Similarly, for these participants, a disposition or proneness to generalize knowledge is observed. Conclusion Inspired by the principles of prevention, ergonomics and empowerment, this study, despite its limitations, allows to better document the effects of a program in partnership with business services for MSD's prevention.

Background: Prostitution has been documented in most societies, although the context in which it occurs may vary greatly. In Queensland, Australia, sex workers can operate from legal brothels or privately but all other sectors of the sex industry are prohibited. It is assumed that regulation of the sex industry through legalization leads to better health and social outcomes for sex workers and their clients. However, this assumption has rarely been subjected to empirical scrutiny. Aims: This research examined the occupational health and safety of female sex workers in Queensland and explored the relationship between legislative change, workplace violence, mental health and job satisfaction. Sex workers interviewed in 2003 (after legalisation) were compared to a prior study of this population conducted in 1991 (before official regulation of the sex industry). Further, in-depth analysis of the 2003 cohort compared sex workers employed in legal and illegal sectors, to assess violence, health status and job satisfaction. Methods: Cross-sectional, convenience sampling was used to collect data from female sex workers in 2003. This data was compared with data collected earlier (in 1991) and explored differences in the two samples using bivariate analysis. Similar recruitment strategies on both occasions were used to recruit women from all known sectors of the Queensland sex industry. The 1991 comparison sample (Boyle et al. 1997) included 200 women (aged between 16 and 46 years), and in 2003, 247 women (aged 18 to 57) participated. The 2003 sample included workers from legal brothels (n=102), private sole-operators (n=103) and illegal street-based sex workers (n=42). Using data collected in 2003, this study assessed the relationship between physical and mental health and job satisfaction and two main independent variables, i.e., current work sector and recent workplace violence. Bivariate analysis of physical health and independent variables showed no significant relationships and therefore further analysis was not undertaken. However, analysis of mental health and job satisfaction showed complex interactions between multiple variables and therefore linear modeling was performed to adjust for confounding. Results: Analysis of the 1991 and 2003 samples showed little apparent change over time in self-reported sexually transmitted infections (STIs). There were substantial changes over time in the types of sexual services being provided to clients, with the 2003 sample more likely to provide 'exotic' services. Violence experienced ever in their lifetime differed; in 1991, 29% reported having ever been raped compared with 42% in 2003 (p= &lt0.01). In 2003, 50% of illegal sex workers reported having ever been raped by a client compared with 12% of private sex workers and 3% of brothel-based sex workers (p=&lt0.01). Overall, the sex workers reported roughly equivalent job satisfaction to Australian women. A desire to leave the sex industry was most strongly correlated with reduced job satisfaction (p=&lt0.01). Satisfaction was also relatively low among those whose family was not aware of their sex work (p=&lt0.01). Similarly, the mental and physical health of this sample was comparable to age-matched women from the general population. Wanting to leave the sex industry was most strongly associated with poor mental health (p=&lt0.01), as was recent sexual or physical assault by a client (p=0.06) and the woman's main work sector (p=0.05). Illegal sex workers reported substantially lower mental health scores than their counterparts in legal sex work. Conclusions: Self-reported STI diagnosis was high in these samples but the prevalence appears not to have changed over time. Comparing 2003 to 1991, there were trends towards safer and more diverse sexual practices. It is likely the sex industry has 'professionalized' and now includes more sex workers providing specialist, 'exotic' services. This sample of female sex workers reported high rates of violence, with those working illegally at greatest risk. Analysis suggests a complex interaction between variables contributing to mental health and job satisfaction. In general, it appears that the majority of sex workers enjoyed at least as much job satisfaction as women working in other occupations. It also appears that this sample had equivalent mental health to women from the general population, although the sub-group of illegal workers generally had poorer health. Job satisfaction and the extent of workplace hazards (especially risk of violence) were also strongly associated with different sectors of the sex industry. It is probable that legalisation has benefited some (perhaps most) but there are health and safety concerns for those outside the legal framework. Legislative reform should focus on violence prevention, promoting reporting of violent events to police, and further exploration of the impact of legislation on the health of workers in the sex industry.

Cyanobacteria are common inhabitants of freshwater lakes and reservoirs throughout the world. Under favourable conditions, certain cyanobacteria can dominate the phytoplankton within a waterbody and form nuisance blooms. Case reports and anecdotal references dating from 1949 describe a range of illnesses associated with recreational exposure to cyanobacteria: hay fever-like symptoms, pruritic skin rashes and gastro-intestinal symptoms (the latter probably related to ingestion of water) are most frequently reported. Some papers give convincing descriptions of allergic responses to cyanobacteria; others describe more serious acute illnesses, with symptoms such as severe headache, pneumonia, fever, myalgia, vertigo and blistering in the mouth. A U.S. coroner recently found that a teenage boy died as a result of accidentally ingesting a neurotoxic cyanotoxin from a golf course pond; this is the first recorded human fatality attributed to recreational exposure to cyanobacteria. One of the main public health concerns with exposure to freshwater cyanobacteria relates to the understanding that some blooms produce toxins that specifically affect the liver or the central nervous system. The route of exposure for these toxins is oral, from accidental or deliberate ingestion of recreational water, and possibly by inhalation. Cyanobacterial lipopolysaccharides (LPS) are also reported to be putative cutaneous, gastrointestinal, respiratory and pyrogenic toxins. The aims of this project were to enhance the understanding of public health issues relating to recreational exposure to cyanobacteria by conducting epidemiological and laboratory-based toxicology studies. A prospective cohort study of 1,331 recreational water users was conducted at various sites in southern Queensland, the Myall Lakes area of New South Wales, and central Florida. The study design sought to make improvements over previously published epidemiological studies, in that an unexposed group was recruited from cyanobacteria-free waters, cyanobacterial toxins were measured in site water samples, and respondents were asked to rate the severity of reported symptoms. This study has shown an increased likelihood of symptom reporting amongst bathers exposed to high cyanobacterial cell density (measured by total cell surface area) compared to those exposed to low cyanobacteria-affected waters. Mild respiratory symptoms appear to be the predominant symptom category. A clinical dermatology study to examine delayed-contact hypersensitivity reactions to cyanobacterial extracts was conducted. The study groups were 20 patients presenting for diagnostic skin patch testing at the Royal Brisbane Hospital's dermatology outpatient clinic; a convenience sample of 20 individuals was recruited from outside the hospital as a control group. One patient developed unequivocal reactions to several cyanobacteria extracts, with no dose-response pattern seen, indicating that the reactions were allergic in nature. A mouse model of delayed-contact hypersensitivity, the mouse ear swelling test, has demonstrated that the purified toxin cylindrospermopsin, a highly water-soluble compound, is capable of producing cutaneous injury. Encrusting lesions were seen on abdominal skin during the induction phase of these experiments. Delayed-contact hypersensitivity reactions were also demonstrated with this toxin. LPS from two non-axenic cyanobacterial samples - Cylindrospermopsis raciborskii and Microcystis aeruginosa - were extracted and purified. Thermoregulation studies were performed using a mouse model of rectal temperature measurement. Separate groups of mice were injected with these LPS extracts at two dose levels. Thermoregulation studies were also conducted with purified cyanobacterial toxins: microcystin-LR and cylindrospermopsin and anatoxin-a; cyanobacterial LPS samples purified by collaborators in Adelaide were also investigated for thermoregulation potential. These experiments have shown that the LPS extracts are weakly active when compared with responses to much lower doses of Escherichia coli LPS. Cylindrospermopsin also produces hypothermic responses in mice - comparable to pyrexia in larger mammals - although at a later stage than was seen with LPS extracts. Supplementing the experimental observations of the toxicology and immunotoxicology of cyanobacterial LPS are insights gained from beyond the cyanobacteria literature on the mechanisms of toxicity of different LPS structures. Cyanobacterial LPS was initially suggested to be toxic in the 1970s, at a time when lipid A, the active moiety of LPS, was thought to be identical across all Gram-negative bacteria. More recent work raises questions about the attribution of cutaneous and gastrointestinal illness to cyanobacterial LPS, with the understanding that some bacterial lipid A structures are LPS antagonists, LPS is not toxic by the oral route, and LPS is not reported as a toxin in the clinical dermatology literature. Gut-derived lipopolysaccharides, however, exert potent synergistic effects with a variety of xenobiotic hepatotoxins, and the well-known shock-like syndromes associated with severe cylindrospermopsin and microcystin poisoning deserve further scrutiny from the perspective of immunotoxicology.

Cyanobacteria are common inhabitants of freshwater lakes and reservoirs throughout the world. Under favourable conditions, certain cyanobacteria can dominate the phytoplankton within a waterbody and form nuisance blooms. Case reports and anecdotal references dating from 1949 describe a range of illnesses associated with recreational exposure to cyanobacteria: hay fever-like symptoms, pruritic skin rashes and gastro-intestinal symptoms (the latter probably related to ingestion of water) are most frequently reported. Some papers give convincing descriptions of allergic responses to cyanobacteria; others describe more serious acute illnesses, with symptoms such as severe headache, pneumonia, fever, myalgia, vertigo and blistering in the mouth. A U.S. coroner recently found that a teenage boy died as a result of accidentally ingesting a neurotoxic cyanotoxin from a golf course pond; this is the first recorded human fatality attributed to recreational exposure to cyanobacteria. One of the main public health concerns with exposure to freshwater cyanobacteria relates to the understanding that some blooms produce toxins that specifically affect the liver or the central nervous system. The route of exposure for these toxins is oral, from accidental or deliberate ingestion of recreational water, and possibly by inhalation. Cyanobacterial lipopolysaccharides (LPS) are also reported to be putative cutaneous, gastrointestinal, respiratory and pyrogenic toxins. The aims of this project were to enhance the understanding of public health issues relating to recreational exposure to cyanobacteria by conducting epidemiological and laboratory-based toxicology studies. A prospective cohort study of 1,331 recreational water users was conducted at various sites in southern Queensland, the Myall Lakes area of New South Wales, and central Florida. The study design sought to make improvements over previously published epidemiological studies, in that an unexposed group was recruited from cyanobacteria-free waters, cyanobacterial toxins were measured in site water samples, and respondents were asked to rate the severity of reported symptoms. This study has shown an increased likelihood of symptom reporting amongst bathers exposed to high cyanobacterial cell density (measured by total cell surface area) compared to those exposed to low cyanobacteria-affected waters. Mild respiratory symptoms appear to be the predominant symptom category. A clinical dermatology study to examine delayed-contact hypersensitivity reactions to cyanobacterial extracts was conducted. The study groups were 20 patients presenting for diagnostic skin patch testing at the Royal Brisbane Hospital's dermatology outpatient clinic; a convenience sample of 20 individuals was recruited from outside the hospital as a control group. One patient developed unequivocal reactions to several cyanobacteria extracts, with no dose-response pattern seen, indicating that the reactions were allergic in nature. A mouse model of delayed-contact hypersensitivity, the mouse ear swelling test, has demonstrated that the purified toxin cylindrospermopsin, a highly water-soluble compound, is capable of producing cutaneous injury. Encrusting lesions were seen on abdominal skin during the induction phase of these experiments. Delayed-contact hypersensitivity reactions were also demonstrated with this toxin. LPS from two non-axenic cyanobacterial samples - Cylindrospermopsis raciborskii and Microcystis aeruginosa - were extracted and purified. Thermoregulation studies were performed using a mouse model of rectal temperature measurement. Separate groups of mice were injected with these LPS extracts at two dose levels. Thermoregulation studies were also conducted with purified cyanobacterial toxins: microcystin-LR and cylindrospermopsin and anatoxin-a; cyanobacterial LPS samples purified by collaborators in Adelaide were also investigated for thermoregulation potential. These experiments have shown that the LPS extracts are weakly active when compared with responses to much lower doses of Escherichia coli LPS. Cylindrospermopsin also produces hypothermic responses in mice - comparable to pyrexia in larger mammals - although at a later stage than was seen with LPS extracts. Supplementing the experimental observations of the toxicology and immunotoxicology of cyanobacterial LPS are insights gained from beyond the cyanobacteria literature on the mechanisms of toxicity of different LPS structures. Cyanobacterial LPS was initially suggested to be toxic in the 1970s, at a time when lipid A, the active moiety of LPS, was thought to be identical across all Gram-negative bacteria. More recent work raises questions about the attribution of cutaneous and gastrointestinal illness to cyanobacterial LPS, with the understanding that some bacterial lipid A structures are LPS antagonists, LPS is not toxic by the oral route, and LPS is not reported as a toxin in the clinical dermatology literature. Gut-derived lipopolysaccharides, however, exert potent synergistic effects with a variety of xenobiotic hepatotoxins, and the well-known shock-like syndromes associated with severe cylindrospermopsin and microcystin poisoning deserve further scrutiny from the perspective of immunotoxicology.

Cyanobacteria are common inhabitants of freshwater lakes and reservoirs throughout the world. Under favourable conditions, certain cyanobacteria can dominate the phytoplankton within a waterbody and form nuisance blooms. Case reports and anecdotal references dating from 1949 describe a range of illnesses associated with recreational exposure to cyanobacteria: hay fever-like symptoms, pruritic skin rashes and gastro-intestinal symptoms (the latter probably related to ingestion of water) are most frequently reported. Some papers give convincing descriptions of allergic responses to cyanobacteria; others describe more serious acute illnesses, with symptoms such as severe headache, pneumonia, fever, myalgia, vertigo and blistering in the mouth. A U.S. coroner recently found that a teenage boy died as a result of accidentally ingesting a neurotoxic cyanotoxin from a golf course pond; this is the first recorded human fatality attributed to recreational exposure to cyanobacteria. One of the main public health concerns with exposure to freshwater cyanobacteria relates to the understanding that some blooms produce toxins that specifically affect the liver or the central nervous system. The route of exposure for these toxins is oral, from accidental or deliberate ingestion of recreational water, and possibly by inhalation. Cyanobacterial lipopolysaccharides (LPS) are also reported to be putative cutaneous, gastrointestinal, respiratory and pyrogenic toxins. The aims of this project were to enhance the understanding of public health issues relating to recreational exposure to cyanobacteria by conducting epidemiological and laboratory-based toxicology studies. A prospective cohort study of 1,331 recreational water users was conducted at various sites in southern Queensland, the Myall Lakes area of New South Wales, and central Florida. The study design sought to make improvements over previously published epidemiological studies, in that an unexposed group was recruited from cyanobacteria-free waters, cyanobacterial toxins were measured in site water samples, and respondents were asked to rate the severity of reported symptoms. This study has shown an increased likelihood of symptom reporting amongst bathers exposed to high cyanobacterial cell density (measured by total cell surface area) compared to those exposed to low cyanobacteria-affected waters. Mild respiratory symptoms appear to be the predominant symptom category. A clinical dermatology study to examine delayed-contact hypersensitivity reactions to cyanobacterial extracts was conducted. The study groups were 20 patients presenting for diagnostic skin patch testing at the Royal Brisbane Hospital's dermatology outpatient clinic; a convenience sample of 20 individuals was recruited from outside the hospital as a control group. One patient developed unequivocal reactions to several cyanobacteria extracts, with no dose-response pattern seen, indicating that the reactions were allergic in nature. A mouse model of delayed-contact hypersensitivity, the mouse ear swelling test, has demonstrated that the purified toxin cylindrospermopsin, a highly water-soluble compound, is capable of producing cutaneous injury. Encrusting lesions were seen on abdominal skin during the induction phase of these experiments. Delayed-contact hypersensitivity reactions were also demonstrated with this toxin. LPS from two non-axenic cyanobacterial samples - Cylindrospermopsis raciborskii and Microcystis aeruginosa - were extracted and purified. Thermoregulation studies were performed using a mouse model of rectal temperature measurement. Separate groups of mice were injected with these LPS extracts at two dose levels. Thermoregulation studies were also conducted with purified cyanobacterial toxins: microcystin-LR and cylindrospermopsin and anatoxin-a; cyanobacterial LPS samples purified by collaborators in Adelaide were also investigated for thermoregulation potential. These experiments have shown that the LPS extracts are weakly active when compared with responses to much lower doses of Escherichia coli LPS. Cylindrospermopsin also produces hypothermic responses in mice - comparable to pyrexia in larger mammals - although at a later stage than was seen with LPS extracts. Supplementing the experimental observations of the toxicology and immunotoxicology of cyanobacterial LPS are insights gained from beyond the cyanobacteria literature on the mechanisms of toxicity of different LPS structures. Cyanobacterial LPS was initially suggested to be toxic in the 1970s, at a time when lipid A, the active moiety of LPS, was thought to be identical across all Gram-negative bacteria. More recent work raises questions about the attribution of cutaneous and gastrointestinal illness to cyanobacterial LPS, with the understanding that some bacterial lipid A structures are LPS antagonists, LPS is not toxic by the oral route, and LPS is not reported as a toxin in the clinical dermatology literature. Gut-derived lipopolysaccharides, however, exert potent synergistic effects with a variety of xenobiotic hepatotoxins, and the well-known shock-like syndromes associated with severe cylindrospermopsin and microcystin poisoning deserve further scrutiny from the perspective of immunotoxicology.

Cyanobacteria are common inhabitants of freshwater lakes and reservoirs throughout the world. Under favourable conditions, certain cyanobacteria can dominate the phytoplankton within a waterbody and form nuisance blooms. Case reports and anecdotal references dating from 1949 describe a range of illnesses associated with recreational exposure to cyanobacteria: hay fever-like symptoms, pruritic skin rashes and gastro-intestinal symptoms (the latter probably related to ingestion of water) are most frequently reported. Some papers give convincing descriptions of allergic responses to cyanobacteria; others describe more serious acute illnesses, with symptoms such as severe headache, pneumonia, fever, myalgia, vertigo and blistering in the mouth. A U.S. coroner recently found that a teenage boy died as a result of accidentally ingesting a neurotoxic cyanotoxin from a golf course pond; this is the first recorded human fatality attributed to recreational exposure to cyanobacteria. One of the main public health concerns with exposure to freshwater cyanobacteria relates to the understanding that some blooms produce toxins that specifically affect the liver or the central nervous system. The route of exposure for these toxins is oral, from accidental or deliberate ingestion of recreational water, and possibly by inhalation. Cyanobacterial lipopolysaccharides (LPS) are also reported to be putative cutaneous, gastrointestinal, respiratory and pyrogenic toxins. The aims of this project were to enhance the understanding of public health issues relating to recreational exposure to cyanobacteria by conducting epidemiological and laboratory-based toxicology studies. A prospective cohort study of 1,331 recreational water users was conducted at various sites in southern Queensland, the Myall Lakes area of New South Wales, and central Florida. The study design sought to make improvements over previously published epidemiological studies, in that an unexposed group was recruited from cyanobacteria-free waters, cyanobacterial toxins were measured in site water samples, and respondents were asked to rate the severity of reported symptoms. This study has shown an increased likelihood of symptom reporting amongst bathers exposed to high cyanobacterial cell density (measured by total cell surface area) compared to those exposed to low cyanobacteria-affected waters. Mild respiratory symptoms appear to be the predominant symptom category. A clinical dermatology study to examine delayed-contact hypersensitivity reactions to cyanobacterial extracts was conducted. The study groups were 20 patients presenting for diagnostic skin patch testing at the Royal Brisbane Hospital's dermatology outpatient clinic; a convenience sample of 20 individuals was recruited from outside the hospital as a control group. One patient developed unequivocal reactions to several cyanobacteria extracts, with no dose-response pattern seen, indicating that the reactions were allergic in nature. A mouse model of delayed-contact hypersensitivity, the mouse ear swelling test, has demonstrated that the purified toxin cylindrospermopsin, a highly water-soluble compound, is capable of producing cutaneous injury. Encrusting lesions were seen on abdominal skin during the induction phase of these experiments. Delayed-contact hypersensitivity reactions were also demonstrated with this toxin. LPS from two non-axenic cyanobacterial samples - Cylindrospermopsis raciborskii and Microcystis aeruginosa - were extracted and purified. Thermoregulation studies were performed using a mouse model of rectal temperature measurement. Separate groups of mice were injected with these LPS extracts at two dose levels. Thermoregulation studies were also conducted with purified cyanobacterial toxins: microcystin-LR and cylindrospermopsin and anatoxin-a; cyanobacterial LPS samples purified by collaborators in Adelaide were also investigated for thermoregulation potential. These experiments have shown that the LPS extracts are weakly active when compared with responses to much lower doses of Escherichia coli LPS. Cylindrospermopsin also produces hypothermic responses in mice - comparable to pyrexia in larger mammals - although at a later stage than was seen with LPS extracts. Supplementing the experimental observations of the toxicology and immunotoxicology of cyanobacterial LPS are insights gained from beyond the cyanobacteria literature on the mechanisms of toxicity of different LPS structures. Cyanobacterial LPS was initially suggested to be toxic in the 1970s, at a time when lipid A, the active moiety of LPS, was thought to be identical across all Gram-negative bacteria. More recent work raises questions about the attribution of cutaneous and gastrointestinal illness to cyanobacterial LPS, with the understanding that some bacterial lipid A structures are LPS antagonists, LPS is not toxic by the oral route, and LPS is not reported as a toxin in the clinical dermatology literature. Gut-derived lipopolysaccharides, however, exert potent synergistic effects with a variety of xenobiotic hepatotoxins, and the well-known shock-like syndromes associated with severe cylindrospermopsin and microcystin poisoning deserve further scrutiny from the perspective of immunotoxicology.