1,720,999 research outputs found
Dermopatie professionali: analisi della casistica diagnosticata presso l’Istituto Scientifico di Pavia della Fondazione Maugeri nel periodo gennaio 1996 – aprile 2002
No full textLe dermopatie costituiscono una percentuale notevole (almeno il 10-30%) delle malattie professionali. I compiti della medicina del lavoro nei confronti di tali patologie vanno dalla definizione della diagnosi, alla identificazione degli agenti e delle modalità d’esposizione responsabili, all’adozione di misure terapeutiche e preventive, ad adempimenti di natura medico-legale. In tale contesto, abbiamo ritenuto utile svolgere un’indagine retrospettiva sulle dermopatie occupazionali diagnosticate presso il nostro Istituto negli ultimi anni.
I nostri dati indicano che, nonostante alcuni progressi compiuti negli ultimi anni in ambito preventivo, le dermopatie professionali continuano ad essere di frequente riscontro nella pratica clinica. Nella presente casistica, tali malattie sono state diagnosticate soprattutto nelle donne e in soggetti attorno ai 40 anni; nessuna età lavorativa è risultata tuttavia risparmiata.
La casistica conferma l’elevata frequenza in Italia di allergopatie cutanee professionali (DAC, orticaria da contatto, angioedema), già segnalata in passato. Queste malattie possono presentarsi in associazione tra loro e/o con asma bronchiale
Effect of salbutamol and inhaled sodium chromoglycate on the airway and neutrophil chemotactic activity in “fog”-induced bronchospasm
No full textRespiratory occupational allergies: the experience of the Hospital Operative Unit of Occupational Medicine in Lombardy from 1990 to 1998
No full textA retrospective study on occupational rhinitis and asthma diagnosed in 7 occupational health institutes in Lombardia (North-West Italy) was performed using a standardized card. 141 cases of rhinitis and 281 cases of asthma due to sensitization to occupational agents were analyzed and their clinical characteristics, aetiology, diagnostic methods and associated allergic diseases were determined. In this population the most frequent agents of occupational rhinitis were wheat flour and latex, whereas those of occupational asthma were latex and isocyanate. More than half of the subjects had more than one clinical manifestation of allergy. In 92 out of the 281 asthmatic patients rhinitis was the first clinical manifestation, particularly in subjects sensitized to high molecular weight substances, and preceded, asthma by 12 months as a mean. Specific bronchial provocation tests were useful for the diagnosis of asthma in 153 of the asthmatic patients and 45 of them had an isolated late bronchial reaction following the specific stimulus. At diagnosis 61 subjects (21.7%) had FEV1 < 80% of predicted; factors associated to ventilatory impairment were sensitization to high molecular weight substances, duration of exposure to the sensitizing agent, persistence of exposure after onset of symptoms
Espettorato indotto e patologie dell'apparato respiratorio
No full textInduced sputum is a nonivasive technique useful to assess airway inflammation. Sputum is induced through the inhalation of ultrasonic nebulized hypertonic saline solution and pre-treatment of the subject with b2 agonist is recommended to avoid bronchoconstriction. After the inhalation period the subject is invited to cough and to produce sputum. The sample is sent to the laboratory within 2 hours where it is solubilised in order to evaluate total cells and differential inflammatory cell count. Sputum of a healthy subject is mainly constituted by macrophages and neutrophils while eosinophils, lymphocytes and epithelial cells are only rarely present. Most asthmatic subjects have an increase of eosinophils in their sputum samples but neutrophilic or paucigranular patterns are also found in asthmatics' airways. Sputum eosinophils are usually predictors of a good response to inhaled or systemic corticosteroid therapy, whereas the presence of neutrophils in induced sputum, suggests a different therapeutic choice since neutrophils are not responsive to steroids. Furthermore, neutrophils are the most represented inflammatory cells in the sputum samples of subjects with chronic obstructive pulmonary disease (COPD). Total cells and sputum neutrophils increase during disease exacerbation. In the sputum of COPD subjects, the presence of eosinophils can precede an exacerbation and envisages a favourable response to steroids. Soluble mediators can be measured in the supernatant of processed induced sputum samples, particularly many cytokines, chemokines and other markers of inflammation and oxidative stress, but none of them seems to be particularly useful for the diagnosis or for the follow-up of patients with respiratory diseases. The majority of studies on induced sputum are conducted on asthmatic and COPD subjects but the scarce invasiveness of the procedure also allows its application in other pulmonary diseases such as eosinophilic bronchitis, cystic fibrosis, interstitial lung diseases
Usefulness of induced sputum in investigating occupational asthma with normal responsiveness to methacholine: a case report
No full textUsefulness of induced sputum in investigating occupational asthma with normal responsiveness to methacholine: a case report
[Fractional exhaled nitric oxide measurement during specific inhalation challenge tests]
No full textThe aim of the work is to evaluate the usefulness of the evaluation of the fractional exhaled nitric oxide (FeNO) in patients with suspected occupational asthma (OA) during the specific inhalation challenge (SIC). We evaluated 5 subjects with OA confirmed by SIC and 7 subjects with negative SIC result. In subjects with confirmed OA, but not in SIC negative subjects, a significant increase in FeNO values has been reported. In conclusion, FeNO measurement may be considered a useful tollfor the evaluation of bronchial inflammation during the SIC
A respiratory and allergy survey in textile workers employed in early stages of wool processing
No full textOBJECTIVES: To determine frequency and type of respiratory and allergic symptoms in textile workers employed in early stages of wool processing. METHODS: A cross-sectional study was carried out in four wool textile mills. 202 subjects (n. 148 males, 54 females, mean age 38.9 yrs, SD 9.5) employed in early stages (combing, n. 138, carding, n. 64) of wool processing were examined and an environmental survey was carried out to determine the level of wool dust exposure. All subjects were submitted to clinical interview, spirometry and measurement of serum specific IgE (s-IgE) against extracts of two wool lots (Australia and New Zealand) by means of RAST. In the subjects with a positive questionnaire for allergic symptoms serum specific IgE for common pneumoallergens were measured (PHADIATOP test). RESULTS: We found higher air dust concentrations during carding operations (inspirable fraction-IF-: range 1.6-20 mg/m3; respirable fraction (RF): 0.5-6.9 mg/m3) and lower concentrations during combing (IF 0.3-0.7 mg/m3, RF 0.1-0.3 mg/m3). 70 out of 202 subjects (34.7%, n. 26 employed in carding and n. 44 in combing operations) reported work-related symptoms. Cutaneous itching was reported by 30 subjects, upper airway irritation by 24, ocular irritation by 17 and dyspnoea by 5. Globally 27 subjects (13.4%) had respiratory work-related symptoms. 12 subjects reported only seasonal respiratory symptoms not related to work. Within the group of 82 symptomatic subjects, 62 (75.6%) had serum specific IgE for common pneumoallergens. In the whole group (n. 202) mean basal FEV-1 was L 3.6, SD 0.9 (103.6% of predicted values). No significant difference was found in basal FEV-1 between carding and combing workers. No s-IgE against the two wool extracts was detectable in any of the 202 examined subjects. CONCLUSIONS: Our data show that in early stages of wool processing: 1) the overall frequency of respiratory work-related symptoms is low and does not seem to be related to the stages of processing, 2) symptoms are mainly nasal and/or ocular; 3) serum s-IgE against wool extracts are not detectable. We conclude that respiratory allergy risk in wool textile mills is low
Occupational asthma due to styrene: two case reports
No full textTwo cases of occupational asthma due to styrene are described. The subjects complained of cough, breathlessness, and symptoms of asthma when coming into contact with styrene; in patient 1 the respiratory reaction was followed by a late cutaneous rash. The symptoms disappeared when the subjects were away from work on weekends or holidays. In both cases, inhalation challenge with styrene produced an immediate bronchospastic reaction which was followed by a late cutaneous rash in patient 1. Prior administration of disodium cromoglycate (40 mg from a spinhaler) prevented the respiratory reactions completely, but failed to prevent the late skin response in case 1. Styrene removal was followed by complete disappearance of the symptoms. We conclude that styrene can be a primary cause of occupational asthma
Toluene diisocyanate-induced asthma: clinical findings and bronchial responsiveness studies in 113 exposed subjects with work-related respiratory symptoms
No full textWe report the clinical findings and the results of inhalation challenge with toluene diisocyanate (TDI) and methacholine in 113 subjects with a history of exposure to TDI and work-related respiratory symptoms. Only some of the subjects (40.7%) had isocyanate asthma, diagnosed by a positive TDI inhalation challenge. Most reactors had a dual (30.4%) or a late (41.3%) response. The interval between the last occupational exposure and the specific challenge was significantly shorter in reactors, and among this group the number of immediate reactions to TDI decreased progressively with an increasing interval. The reactors had a significantly higher proportion of positive responses to methacholine and a significantly lower mean PD15 FEV-1 (provocative dose of methacholine which provoke a 15% decrease in forced expiratory volume in 1 second) (reactors: 557 micrograms, SEM 92.3; nonreactors: 1346 micrograms, SEM 128, P less than .01). Methacholine challenge could not identify subjects with isocyanate asthma
Occupational asthma and rhinitis caused by 1,2-benzisothiazolin-3-one in a chemical worker
No full textWe report a case of occupational asthma and rhinitis caused by inhalation of 1,2-benzisothiazolin-3-one, an additive used as a microbicidal in detergent production, in a 26-year-old man employed in a chemical factory producing detergents. The subject's task consisted of pouring raw materials into the recipient of a machine which mixed the substances. Two months after the beginning of this job the patient complained of rhinitis and asthma at the workplace. The specific challenge test with 1,2-benzisothiazolin-3-one, one of the raw materials to which the subject was exposed, provoked an immediate prolonged asthmatic response and nasal symptoms, whereas exposure to other agents (e.g., alpha-amylase, alcalase or bezalkonium chloride) to which the patient was also exposed at work did not. To our knowledge this is the first case of occupational asthma and rhinitis caused by this compound
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