Respiratory symptoms among glass bottle workers--cough and airways irritancy syndrome?
Glass bottle workers have been shown to experience an excess of respiratory symptoms. This work describes in detail the symptoms reported by a cohort of 69 symptomatic glass bottle workers. Symptoms, employment history and clinical investigations including radiology, spirometry and serial peak expiratory flow rate records were retrospectively analyzed from clinical records. The results showed a consistent syndrome of work-related eye, nose and throat irritation followed after a variable period by shortness of breath. The latent interval between starting work and first developing symptoms was typically 4 years (median = 4 yrs; range = 0-28). The interval preceding the development of dysponea was longer and much more variable (median = 16 yrs; range = 3-40). Spirometry was not markedly abnormal in the group but 57% of workers had abnormal serial peak expiratory flow rate charts. Workers in this industry experience upper and lower respiratory tract symptoms consistent with irritant exposure. The long-term functional significance of these symptoms should be formally investigated. (+info)
Exhaled and nasal NO levels in allergic rhinitis: relation to sensitization, pollen season and bronchial hyperresponsiveness.
Exhaled nitric oxide is a potential marker of lower airway inflammation. Allergic rhinitis is associated with asthma and bronchial hyperresponsiveness. To determine whether or not nasal and exhaled NO concentrations are increased in allergic rhinitis and to assess the relation between hyperresponsiveness and exhaled NO, 46 rhinitic and 12 control subjects, all nonasthmatic nonsmokers without upper respiratory tract infection, were randomly selected from a large-scale epidemiological survey in Central Norway. All were investigated with flow-volume spirometry, methacholine provocation test, allergy testing and measurement of nasal and exhaled NO concentration in the nonpollen season. Eighteen rhinitic subjects completed an identical follow-up investigation during the following pollen season. Exhaled NO was significantly elevated in allergic rhinitis in the nonpollen season, especially in perennially sensitized subjects, as compared with controls (p=0.01), and increased further in the pollen season (p=0.04), mainly due to a two-fold increase in those with seasonal sensitization. Nasal NO was not significantly different from controls in the nonpollen season and did not increase significantly in the pollen season. Exhaled NO was increased in hyperresponsive subjects, and decreased significantly after methacholine-induced bronchoconstriction, suggesting that NO production occurs in the peripheral airways. In allergic rhinitis, an increase in exhaled nitric oxide on allergen exposure, particularly in hyperresponsive subjects, may be suggestive of airway inflammation and an increased risk for developing asthma. (+info)
Process and current status of the epidemiologic studies on cedar pollinosis in Japan.
This paper reviews the present situation and future aspects of epidemiologic studies on Japanese cedar pollinosis. Increase of allergic rhinitis patients is observed in both the Patient Survey and the Reports on the Surveys of Social Medical Care Insurance Services, however, these surveys are conducted when cedar pollens do not pollute the air. Many have reported on the prevalence of pollinosis in limited areas but only a few nationwide epidemiologic surveys have been conducted. Most of the studies were conducted at special medical facilities such as university hospitals. There is a high possibility that patients who visit the specific facilities do not exactly represent the actual number of patients and epidemiologic pictures of pollinosis in Japan. The rapid advances in laboratory test methods may change the diagnostic criteria and increase the number of reported patients. Therefore, the prevalence of Japanese cedar pollinosis in Japan has not been determined yet. Determination of the prevalence of cedar pollinosis and description of the epidemiologic pictures constitute the essential steps toward the control of this clinical entity. Thus it is necessary to conduct an epidemiologic survey on Japanese representative samples with a standardized survey form with clear and concise diagnostic criteria. (+info)
Comparison of intranasal triamcinolone acetonide with oral loratadine in the treatment of seasonal ragweed-induced allergic rhinitis.
A double-blind, randomized, multicenter, parallel-group controlled study compared the efficacy and safety of intranasal triamcinolone acetonide (220 micrograms/day) and oral loratadine (10 mg/day) in patients with at least two seasons of ragweed-induced seasonal allergic rhinitis. A 28-day screening period, including a 5-day baseline period, preceded a 4-week treatment period. Reduction in rhinitis symptom scores was evident in both groups as early as day 1, with no significant between-group differences during week 1. At weeks 2, 3, and 4, patients treated with triamcinolone acetonide were significantly (P < 0.05) more improved in total nasal score, nasal itch, nasal stuffiness, and sneezing than were patients treated with loratadine. At weeks 3 and 4, rhinorrhea and ocular symptoms were significantly (P < 0.05) more improved from baseline among triamcinolone acetonide patients compared with loratadine patients. There was no significant between-group difference in relief from postnasal drip at any time point. Physicians' global evaluations significantly (P = 0.002) favored triamcinolone acetonide at the final visit, with moderate to complete relief of symptoms attained by 68% of triamcinolone acetonide patients and 59% of loratadine patients. Over the 4-week treatment period, triamcinolone acetonide patients had significantly greater improvement in total nasal score, nasal itch, nasal stuffiness, sneezing, and ocular symptoms. Both treatments were well tolerated, with headache being the most frequently reported drug-related adverse effect in both the triamcinolone acetonide (15%) and loratadine (11%) groups. These results indicate that triamcinolone acetonide is more effective than oral loratadine in relieving the symptoms of ragweed-induced seasonal allergic rhinitis. (+info)
Treatment of allergic rhinitis: an evidence-based evaluation of nasal corticosteroids versus nonsedating antihistamines.
Allergic rhinitis is a high-cost, high-prevalence disease. In the 12 months ending March 31, 1997 $3.1 billion was spent in the United States for medications to manage this illness. Allergic rhinitis affects quality of life and interferes with work productivity. Nonsedating antihistamines are the most common and most expensive therapy for this condition. This study reviewed 13 randomized studies in which blinded investigators compared management of allergic rhinitis by means of intranasal steroids to management by means of nonsedating antihistamine. Evidence tables demonstrated that in all studies in which total nasal symptoms and nasal obstruction were recorded, the nasal steroid was statistically superior to the nonsedating antihistamine. For nasal blockage the nonsedating antihistamines did not perform better than placebo. For all other nasal symptoms the intranasal steroid was statistically superior in most reports and equal or numerically better in the remaining papers. When these data are linked to those from cost analysis and quality-of-life studies, the evidence strongly suggests that nasal steroids should be first-line therapy for allergic rhinitis. In four reports on the combination of a nonsedating antihistamine compared to a nasal steroid alone, there was no significant difference between these two treatments. Like asthma, allergic rhinitis is an inflammatory disease and should be managed with anti-inflammatory medication. Making such a change in the management of allergic rhinitis should increase efficacy and decrease costs. (+info)
(1-->3)-beta-D-glucan may contribute to pollen sensitivity.
The amount of (1-->3)-beta-D-glucan in pollen from different plants was evaluated using the Limulus assay with a specific lysate. The amount ranged from 79 to 1800 ng/10(6) pollen. A calculation of the inhaled dose suggests that the amount of (1-->3)-beta-D-glucan present during periods with a high pollen content in the air exceeds levels that cause airways inflammation. (+info)
Birth weight, body mass index and asthma in young adults.
BACKGROUND: Impaired fetal growth may be a risk factor for asthma although evidence in children is conflicting and there are few data in adults. Little is known about risk factors which may influence asthma in late childhood or early adult life. Whilst there are clues that fatness may be important, this has been little studied in young adults. The relations between birth weight and childhood and adult anthropometry and asthma, wheeze, hayfever, and eczema were investigated in a nationally representative sample of young British adults. METHODS: A total of 8960 individuals from the 1970 British Cohort Study (BCS70) were studied. They had recently responded to a questionnaire at 26 years of age in which they were asked whether they had suffered from asthma, wheeze, hayfever, and eczema in the previous 12 months. Adult body mass index (BMI) was calculated from reported height and weight. RESULTS: The prevalence of asthma at 26 years fell with increasing birth weight. After controlling for potential confounding factors, the odds ratio comparing the lowest birth weight group (<2 kg) with the modal group (3-3.5 kg) was 1.99 (95% CI 0.96 to 4.12). The prevalence of asthma increased with increasing adult BMI. After controlling for birth weight and other confounders, the odds ratio comparing highest with lowest quintile was 1.72 (95% CI 1.29 to 2.29). The association between fatness and asthma was stronger in women; odds ratios comparing overweight women (BMI 25-29.99) and obese women (BMI >/=30) with those of normal weight (BMI <25) were 1.51 (95% CI 1.11 to 2.06) and 1.84 (95% CI 1. 19 to 2.84), respectively. The BMI at 10 years was not related to adult asthma. Similar associations with birth weight and adult BMI were present for wheeze but not for hayfever or eczema. CONCLUSIONS: Impaired fetal growth and adult fatness are risk factors for adult asthma. (+info)
Bakery work, atopy and the incidence of self-reported hay fever and rhinitis.
The aims of this study were to estimate the risk to bakers of developing hay fever and rhinitis, to assess the modifying effect of atopy and to estimate the occurrence of job change due to nasal symptoms. A retrospective cohort study was performed among bakers trained in Swedish trade schools from 1961 to 1989 (n=2,923). School control subjects (n=1,258) comprised students in other programmes in the trade schools and population controls (n=1,258) were randomly selected from the general population. A questionnaire on hay fever, rhinitis, the year of onset of these diseases, change of work due to nasal symptoms and work history was mailed to all participants. The atopic state of the responders was assessed by questions on allergic diseases in childhood and among next of kin. Incidence rates for hay fever and other rhinitis were calculated. The relative risk (RR) for hay fever when working as a baker compared with all control subjects combined was increased in males (RR=1.9, 95% confidence interval (CI) 1.2-2.9). The RR for rhinitis in male bakers compared with combined control subjects was 2.8 (95% CI 2.3-3.4) and for female bakers 2.0 (1.6-2.7). Of the bakers, 6.1% had changed job due to nasal symptoms, significantly more than the controls. A history of respiratory atopy increased the incidence rates of hay fever and rhinitis, with a synergistic effect between atopy and bakery work in males. In conclusion, Swedish bakers, mainly working in the 1970s and 1980s, had an approximately doubled risk of developing rhinitis. Male bakers also had an increased risk for hay fever. There was a synergistic effect of bakery work and atopy such as a family history of hay fever. Bakers also changed job due to nasal symptoms more often than control subjects. (+info)