Rotifer Diversity in the Acidic Pyrite Mine Pit Lakes in the Sudety Mountains (Poland)

The diversity of rotifers was studied in three artificial water bodies (Azure Lake, Yellow Lake, and Purple Lake), which were once pyrite mines. The physicochemical parameters and the zooplankton composition of the water were determined. Azure Lake had a pH of 3.4–6.9, conductivity values of 165–194 µS cm− 1, and low concentrations of sulphate, calcium, magnesium, copper, and iron, while the other lakes had a pH of 2.6–2.9, a conductivity of 1636–3400 µS cm− 1, and high concentrations of sulphate (up to 2863 mg dm− 3), Cu (up to 2650 µg dm− 3), and Fe (up to 178.3 mg dm− 3). The rotifer community in the lakes comprised 27 taxa (15 in Azure Lake, 13 in Purple Lake and 14 in Yellow Lake). We also found two species that are rarely observed in Poland (Aspelta cincinator and Elosa spinifera), and three species commonly found in acidic water (E. worallii, Cephalodella delicata, and C. hoodi). The types of rotifers in Azure Lake differed from those in the other two lakes. The Shannon–Weaver biodiversity index (H′) was the highest in Purple Lake (H′ = 1.255) and lowest in Azure Lake (H′ = 0.455). The effect of some of the physicochemical parameters on rotifer diversity is discussed

The usefulness of bronchial challenge tests in the diagnosis of occupational asthma

Nadreaktywność oskrzeli (bronchial hyperresponsiveness – BHR) to osobnicza zdolność do ich reakcji skurczowej na różne bodźce swoiste i nieswoiste, które u zdrowej osoby nie wywołują takiej odpowiedzi. Nadreaktywność oskrzeli jest jedną z cech charakterystycznych astmy. Stopień nadreaktywności oskrzeli jest różny u osób z tą chorobą i koreluje z jej ciężkością (im cięższy przebieg astmy, tym większa nadreaktywność oskrzeli). Do wykrywania i pomiaru BHR służą wziewne testy prowokacyjne, w których wykorzystuje się czynniki fizyczne i chemiczne. Testy te podzielono – w zależności od ich mechanizmu działania – na bezpośrednie i pośrednie. Testy bezpośrednie są niezwykle czułe i mają zastosowanie głównie w diagnostyce wykluczającej astmę. Prowokacje z czynnikami pośrednimi są natomiast mniej precyzyjne, ale bardziej swoiste w porównaniu z testami bezpośrednimi. Wykorzystuje się je przede wszystkim do potwierdzenia rozpoznania astmy i lepszego wnioskowania o zmianach zapalnych u chorego. Testy nadreaktywności oskrzeli odgrywają ważną rolę w medycynie pracy. W określonych przypadkach powinny być wykonywane podczas badań wstępnych pracowników przed ich zatrudnieniem, w trakcie badań okresowych, w diagnostyce i monitorowaniu astmy zawodowej oraz astmy nasilającej się w pracy. W artykule opisano wybrane oskrzelowe testy prowokacyjne oraz ich zastosowanie w diagnostyce astmy związanej z pracą. Med. Pr. 2018;69(4):457–471Bronchial hyperresponsiveness (BHR) is the individual ability to respond with bronchoconstriction to a variety of specific and nonspecific stimuli which do not cause these symptoms among healthy subjects. Bronchial hyperresponsiveness is one of the hallmark features of asthma. The degree of bronchial hyperresponsiveness is variable among individuals with asthma and may correlate to its severity (the more severe asthma the higher bronchial hyperreactivity). Bronchial hyperresponsiveness is evaluated by performing bronchial provocation test (BPT). Provocation tests are classified – according to their mechanisms – into direct and indirect tests. Direct challenge tests are highly sensitive and they are used primarily to rule out asthma. In contrast, provocation tests with indirect stimuli are less sensitive but more specific to the direct tests; they are used generally to confirm the diagnosis of asthma and they allow for more accurate conclusions about inflammatory lesions in the case of a patient. Bronchial provocation tests play a significant role in occupational medicine. They are particularly relevant to be performed prior to employment, during periodic examinations, and to diagnose and monitor both occupational asthma and work-related asthma. This article presents selected bronchial provocation tests and their usefulness in the diagnosis of occupational asthma. Med Pr 2018;69(4):457–47

Application of recombinant latex allergens in diagnostics of occupational latex allergy

Over many years, allergy to natural rubber latex has been a major problem among health care workers (HCW). The diagnosis of occupational allergy requires methods of high diagnostic accuracy in view of certification implications (e.g., a sick worker quits a job). With the development of molecular methods, the frequency of application of recombinant allergens in the diagnostics of allergic diseases continues to increase. This paper reviews the applicability of laboratory tests which use recombinant allergens in the diagnostics of occupational allergy. The diagnosis of latex allergy is based on the presence of clinical symptoms linked with exposure to latex allergens, positive skin prick tests and detection of specific IgE antibodies to latex in serum. Moreover, in some cases specific challenge tests are conducted. The analysis of literature indicates that applying the panel of recombinant latex allergens in diagnostic tests, cross-reactivity can very likely be excluded and/or sensitization can be confirmed without the need for specific challenge tests, which in case of latex allergens carries a potential risk of generalized reactions. Med Pr 2015;66(1):85–9

Etiological factors for developing carpal tunnel syndrome in people who work with computers

Background: Carpal tunnel syndrome (CTS) is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. Material and Methods: The study group comprised 60 patients (58 women and 2 men; mean age: 53.8±6.35 years) working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS) were performed in all the subjects. Results: The patients worked with use of computer for 6.43±1.71h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09±5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. Conclusion: The results of our study show that CTS is usually generated by different causes not related with using computers at work. Med Pr 2013;64(1):37–4

New occupational diseases legislation rules – Functioning evaluation

Background: On 3 July 2009, new law pertaining to occupational diseases (ODs) became effective in Poland. The article presents opinions of the representatives of the 1st degree ODs certification entities and sanitary inspectorates on the changes in OD law and the problems that may cause difficulties and/or certification errors. Material and Methods: A questionnaire study was performed covering representatives of 20 voivodeship occupational medicine centers and 40 national district sanitary inspectorates. We received 57 completed questionnaires which were analyzed. Results: Positive opinions were expressed on changes in procedures on reporting suspected occupational diseases (50%), keeping time limits for diagnosing ODs (89.2%), and changes pertaining to entities responsible for certifying infectious ODs (92.9%). A large group of respondents (66.7%) was in favor of conducting jointly an occupational exposure risk analysis by occupational medicine physicians and occupational health and safety practitioners and/or sanitary inspectors. One-third of the respondents declared that changes in the list of ODs had no influence on the certification procedure. Conclusions: New law has improved the existing procedure of ODs certification. There is a need to elaborate detailed diagnostic guidelines on and criteria for ODs identification and recognition. A panel of experts should be established by the Ministry of Health to track the latest advancements in medicine and to update the list of ODs. Conducting jointly an occupational exposure risk analysis by occupational medicine physicians and occupational health and safety practitioners and/or sanitary inspectors should become a standard. Med Pr 2014;65(4):473–48

Mannitol vs. methacholine in the evaluation of airway responsiveness in bakers’ asthma

ObjectivesVarious indirect or direct airway challenge tests are used to measure nonspecific bronchial hyper-responsiveness (NSBHR). The evaluation of NSBHR in diagnosing occupational asthma (OA) is performed, e.g., to monitor the specific inhalation challenge test (SICT). The aim of this study was to preliminarily compare the results of methacholine and mannitol inhalation challenge tests in SICT monitoring in bakers with work-related airway symptoms.Material and MethodsFour bakery workers with a suspicion of OA underwent single-blind placebo-controlled SICTs involving workplace allergens, accompanied by the evaluation of NSBHR with mannitol and methacholine, both before and after SICTs. Clinical examinations, spirometry tests, skin prick tests (SPTs) to common aeroallergens and occupational allergens, as well as tests to determine serum specific IgE antibodies to occupational aeroallergens were also performed.ResultsPositive SPTs results to occupational aeroallergens were found in all bakery workers, and specific IgE antibodies to flour were detected in 2 subjects. Three patients displayed positive SICT reactions. In all of these 3 patients, airway responsiveness to methacholine increased significantly. In 2 patients, airway reaction to mannitol was significant, whereas in 1 subject there was no increase in NSBHR after mannitol inhalation. The patient with a negative SICT result did not reveal any changes in NSBHR before and after the test, either to methacholine or mannitol.ConclusionsThe data obtained by the authors show that there is no clear correlation between the methacholine and mannitol inhalation challenge tests in SICT monitoring. Preliminary results indicate the need for further investigations to evaluate the usefulness of the mannitol challenge test in the diagnostics of OA

Identification of cross-reactive carbohydrate determinants in subjects reporting work-related respiratory symptoms

Introduction The role of cross-reactive carbohydrate determinants (CCDs) in diagnostics of occupational allergy remains unclarified and its clinical relevance is still questioned. The aim of the study was to assess the frequency of positive response to CCDs in the subjects with suspected occupational allergy and the relationship between other diagnostic test results and final diagnosis. Material and methods The study group included 201 patients. They underwent clinical examination, skin prick test (SPT) to common and occupational allergens, specific serum immunoglobulin (sIgE) determinations, spirometry and specific inhalation challenge test. Moreover, sIgE to CCDs from bromelain was assessed in all subjects. Results Occupational respiratory allergy was recognized in 64.3% of CCD-positive and 52.4% of CCD-negative patients. Positive SPT results to common and occupational allergens were found in 64.3% and 35.7% of CCD-positive subjects, respectively. In all subjects with CCDs, the sIgE to grass pollens as well as to occupational allergens were detected. The total IgE level > 100 kU/l was significantly associated with the presence of sIgE to CCDs. Conclusions sIgE to CCDs were found in 7% of subjects suspected to suffer from occupational respiratory allergy. The presence of CCDs is not significantly associated with occupational respiratory allergy. It is also not more frequent in subjects reporting work-related respiratory symptoms in whom occupational allergy was not confirmed. The elevated total IgE level was related with CCD positivity. In patients with suspected occupational allergy, the presence of sIgE to CCDs in serum did not indicate the irrelevance of positive sIgE to occupational allergens

NEW OCCUPATIONAL DISEASES LEGISLATION RULES – FUNCTIONING EVALUATION

Background: On 3 July 2009, new law pertaining to occupational diseases (ODs) became effective in Poland. The article presents opinions of the representatives of the 1st degree ODs certification entities and sanitary inspectorates on the changes in OD law and the problems that may cause difficulties and/or certification errors. Material and Methods: A questionnaire study was performed covering representatives of 20 voivodeship occupational medicine centers and 40 national district sanitary inspectorates. We received 57 completed questionnaires which were analyzed. Results: Positive opinions were expressed on changes in procedures on reporting suspected occupational diseases (50%), keeping time limits for diagnosing ODs (89.2%), and changes pertaining to entities responsible for certifying infectious ODs (92.9%). A large group of respondents (66.7%) was in favor of conducting jointly an occupational exposure risk analysis by occupational medicine physicians and occupational health and safety practitioners and/or sanitary inspectors. One-third of the respondents declared that changes in the list of ODs had no influence on the certification procedure. Conclusions: New law has improved the existing procedure of ODs certification. There is a need to elaborate detailed diagnostic guidelines on and criteria for ODs identification and recognition. A panel of experts should be established by the Ministry of Health to track the latest advancements in medicine and to update the list of ODs. Conducting jointly an occupational exposure risk analysis by occupational medicine physicians and occupational health and safety practitioners and/or sanitary inspectors should become a standard. Med Pr 2014;65(4):473–48

Identification of cross-reactive carbohydrate determinants in subjects reporting work-related respiratory symptoms

Introduction The role of cross-reactive carbohydrate determinants (CCDs) in diagnostics of occupational allergy remains unclarified and its clinical relevance is still questioned. The aim of the study was to assess the frequency of positive response to CCDs in the subjects with suspected occupational allergy and the relationship between other diagnostic test results and final diagnosis. Material and methods The study group included 201 patients. They underwent clinical examination, skin prick test (SPT) to common and occupational allergens, specific serum immunoglobulin (sIgE) determinations, spirometry and specific inhalation challenge test. Moreover, sIgE to CCDs from bromelain was assessed in all subjects. Results Occupational respiratory allergy was recognized in 64.3% of CCD-positive and 52.4% of CCD-negative patients. Positive SPT results to common and occupational allergens were found in 64.3% and 35.7% of CCD-positive subjects, respectively. In all subjects with CCDs, the sIgE to grass pollens as well as to occupational allergens were detected. The total IgE level > 100 kU/l was significantly associated with the presence of sIgE to CCDs. Conclusions sIgE to CCDs were found in 7% of subjects suspected to suffer from occupational respiratory allergy. The presence of CCDs is not significantly associated with occupational respiratory allergy. It is also not more frequent in subjects reporting work-related respiratory symptoms in whom occupational allergy was not confirmed. The elevated total IgE level was related with CCD positivity. In patients with suspected occupational allergy, the presence of sIgE to CCDs in serum did not indicate the irrelevance of positive sIgE to occupational allergens