Lung function indices and anthropometric properties

U namjeri da ispitamo odnos između morfoloških dimenzija tijela i plućnih funkcija u našoj populaciji odabrali smo pet skupina. Ispitali smo 735 osoba, 411 žena i 324 muškarca u dobi od 30 do 55 godina. Primjenom koeficijenata korelacije i multiple linearne regresijske analize zaključili smo da je opravdano koristiti stojeću visinu, dob, a prema našim rezultatima i biakromijalni raspon u procjeni plućnih funkcija kao antropometrijske pokazatelje koji dobro koreliraju s nekim ventilacijskim funkcijama pluća (FVC i FEV1).The relationship between body dimensions and lung functions (FVC and FEV1) was investigated in five selected population groups including a total of 735 subjects, 324 men and 411 women aged 30-55 years. Our results show that: a) the association of lung function indices FVC and FEV1 is better with standing than with sitting height in terms of correlation coefficients, b) among examined predictors of lung function indices, age, standing height and biacromial width are constant and significant in most of our selected groups. We conclude that it is well justified to take age, standing height and biacromial width as reference values in assessing lung functions

A follow-up of bronchial reactivity in workers continuously and discontinuously exposed to respiratory irritants

Dinamika inducirane hiperreaktivnosti bronha ispitivana je na modelu radnika zaposlenih u elektrolizi aluminija. Koncentracija plinovitog fluorovodika te čestica fluorida i S02, kojima su radnici izloženi niže su od maksimalno dopuštenih u Jugoslaviji. Spirometrija i nespecifična reaktivnost bronha analizirana je kod 24 radnika kontinuirano izloženih respiratornim štetnostima i 9 radnika koji su prestali raditi u elektrolizi. U obje ispitivane skupine uočena je vrlo slaba promjenljivost reaktivnosti bronha. Kontinuirana ekspozicija nije rezultirala povećanjem reaktivnosti bronha čak ni kod ispitanika sa simptomima i izraženim opstruktivnim smetnjama ventilacije. Uklanjanje iz ekspozicije nije rezultiralo očekivanim poboljšanjem reaktivnosti bronha, nego je kod jednog od devet praćenih radnika došlo do blagog pogoršanja reaktivnosti. Zbog nekongruentnosti opstruktivnih smetnji ventilacije i reaktivnosti bronha predlaže se uz već ozakonjeno mjerenje funkcije pluća radnika kontinuirano eksponiranih iritansima i zdravstveni nadzor nad onima uklonjenim iz ekspozicije.Evolution of bronchial reactivity was examined in a sample of aluminium potroom workers exposed to a variety of respiratory irritants in concentrations below the MAC values for Yugoslavia (hydrogen fluoride, particulate fluorides, sulphur dioxide). Lung function indices and bronchial reactivity were measured in 24 workers continuously employed in an aluminium plant and in nine workers who had ceased to work in the plant measurements took place over a two-year interval. A sustained level of bronchial reactivity was recorded in both examined groups regardless of occupational practice. Even in workers with dyspnoea and airway obstruction bronchial reactivity did not worsen in spite of continuous exposure. Avoidance of exposure to potroom fumes did not bring about any significant improvement of reactivity, moreover, bronchial reactivity deteriorated in one worker. Owing to discordance between spirometric values and bronchial reactivity, a follow-up of workers removed from harmful occupational exposure is suggested

Bronchial reactivity after nasal provocation with histamine

Malo se zna o vezi između reaktivnosti gornjih i donjih dišnih putova. U 11 bolesnika s alergijskim rinitisom bez znakova bronhalne astme, u 11 radnika profesionalno eksponiranih iritansima dišnog sustava i u 11 zdravih osoba ispitali smo nespecifičnu nosnu reaktivnost i promjenu razine nespecifične bronhalne reaktivnosti nakon testa nespecifične nosne reaktivnosti. Prije i nakon nosnog testa učinjena je nespecifična bronhoprovokacija kumulativnorn metodom (prema Chai H. i sur, J Allergy Clin lmmunol 1975;56:323-7), inhalacijom otopine histamina od 0,125 mg/ml do 128 mg/ml. Nespecifična nosna provokacija izvedena je uštrcavanjem podvostručujućih koncentracija histamina (0,125-32 mg/ml) u obje nosnice svake tri minute. Reakcija je praćena mjerenjem parametara: nosni inspiratorni maksimalni protok, nosni otpor, nosni forsirani ekspiratorni volumen u prvoj sekundi i nosni srednji ekspiratorni protok. Utvrdili smo značajno nižu razinu nespecifične nosne reaktivnosti u osoba oboljelih od alergijskog rinitisa. Nespecifična bronhalna reaktivnost bila je značajno niža u njih, ali i u radnika izloženih respiratornim nadražljivcima u odnosu na kontrolnu skupinu. Spremnost bronhalnog stabla da reagira spazmom na inhalirani histamin statistički značajno je umanjena nakon nespecifične nosne provokacije u zdravih osoba i u radnika izloženih iritansima dišnog sustava.Data on the relationship between nasal and bronchial reactivities are scarce. This study aimed at investigating a possible influence of the nasal provocation test on bronchial reactivity. Three groups of eleven subjects each were examined: patients suffering from allergic rhinitis with no clinical evidence of asthma, workers exposed to respiratory irritants complaining of occupational rhinitis and asthma, and healthy subjects. Non-specific bronchoprovocation was performed before and after nasal challenge with histamine. The bronchial challenge with histamine solutions (0.125mg/ml and 128 mg/ml) was performed by the five-breath cumulative method (Chai H. et al. J Allergy Clin lmmunol 1975;56:323-7). Non-specific nasal provocation was performed by spraying doubling concentrations of histamine (0.125 mg/ml - 32 mg/ml) into both nostrils al three-minute intervals. The reaction was monitored by measurement of nasal inspiratory peak flow, nasal resistance, and nasal spirometry. The level of non-specific nasal reactivity was significantly lower in patients with allergic rhinitis than in the other two groups. The bronchial reactivity of the -rhinitis- group and of those occupationally exposed to irritants was significantly lower than among healthy subjects. An immediate and significant decrease in bronchial reactivity could be observed after nasal challenge in the group of healthy subjects as well as in workers exposed to irritants, but there was no significant change in bronchial reactivity among patients suffering from allergic rhinitis

Cutaneous reactivity to grass pollen and house dust mite in prick test with two types of allergen extracts

Upotrebljivost domaćih nestandardiziranih pripravaka za prick-test htjela se provjeriti usporedbom s internacionalno priznatim standardiziranim pripravcima aktivnosti 100 000 BU. Komparativna su upotrijebljeni alergeni grinje Dermatophagoides pteronyssinus kod 107 ispitanika te pojedinačni poleni trava, i to: Dactylis glomerata, Poa pratensis, Phleum pratense i Secale cereale kod 39 ispitanika. Klinička značajnost kožne reakcije određena je usporedbom veličine urtike izazvane alergenom s onom izazvanom negativnom kontrolom (puferom) te pozitivnom kontrolom (otopinom histamina koncentracije 1 mg/ml). Utvrđeno je da domaći preparat grinje od 3000 PNU/ml ne daje podjednake kožne reakcije kao standardizirani pripravak te ne daje klinički vjerodostojne rezultate, dok su pripravci polena trave, s izuzetkom trave Poa pratensis, vrlo dobri i usporedivi sa standardnim pripravcima, te se mogu pouzdano upotrebljavati u praksi. Na temelju rezultata ovog istraživanja zaključuje se da treba postrožiti kriterije za ocjenu klinički značajno pozitivne kožne reakcije na alergenske pripravke.The reliability of prick testing with allergen preparations produced in Yugoslavia was assessed by comparison to the internationally accepted ones (Pharmacia Diagnostica) of 100 000 BU activity. The following allergens were used: the mite Dermatophagoides pteronyssinus in 107 subjects, and grass pollens: Dactylis glomerata, Poa pratensis, Pbleum pratense and Secale cereale in 39 subjects. The clinical significance of the response was assessed in relation to the skin reaction to the negative control solution and positive histamine control (in concentration of 1 mg/ml). The results indicate that the allergen extract of Dermatophagoides pteronyssinus (3000 PNU/ml) produced in Yugoslavia does not provoke skin reactions comparable to those provoked by the standardized extract of 100 000 BU in contrast to the grass pollen allergens, with the exception of Poa pratensis, which evokes equivalent skin reactions. Thus grass pollen allergens are reliable extracts and can be applied with good confidence in routine work. The need to set more rigorous criteria for assessing skin prick reactions, when domestic, unstandardized products are used, emerged as a result of this study

Physical load and bronchial hyperreactivity among the aluminium electrolysis workers

Utjecaj fizičkog opterećenja na stupanj bronhijalne hiperreaktivnosti uz istodobnu izloženost respiratornim nadražljivcima iz radne atmosfere ispitan je u tvornici aluminija, u stvarnim uvjetima rada u pogonu elektrolize, na dvije skupine radnika: skupini s respiratornim simptomima (n = 34) i kontrolnoj skupini, bez simptoma (n-19). Skupine su se podudarale u godinama radnog staža i starosti te u tjelesnoj visini i težini. Primijenjen je progresivni submaksimalni test opterećenja s 300-600-900 kpm/min s pomoću biciklergometra uz kontinuirano praćenje rada srca i mjerenje pulsa i tlaka. Plućni parametri (FVK, FEV1, PEF, MEF75, MEF50, MEF25 i omjer FEV1/FVK%) mjereni su prije testa opterećenja i u zadnjem trenutku nakon završetka testa opterećenja, uz snimanje EKG i mjerenje tlaka nakon isteka 18 minuta. Dobiveni rezultati pokazali su da fizičko opterećenje uz izloženost respiratornim nadražljivcima nije povećalo bronhijalnu hiperreaktivnost skupine sa simptomima, kao ni kontrolne skupine radnika. Unutar uspoređenih skupina radnika zabilježene su, međutim, dosta izražene individualne razlike u reakciji na test opterećenja.A possible impact of physical load on the degree of bronchial hyperreactivity was studied in actual working conditions among the workers in an aluminium electrolysis plant. Respiratory irritants present in the working environment were also determined. The study was conducted in two groups of workers: one, of 34 workers who had been previously categorized as having respiratory symptoms and the other, of 19 control workers without symptoms. Both groups were matched by age, height, weight and years of service in the plant. All workers underwent a progressive submaximum exercise test of 300 - 600 - 900 kpm/min load on a bicycle ergometer. Simultaneously a continuous monitoring of heart function was performed. Heart rate, blood presure and lung function parameters: FVC, FEV1, PEP, MEF25, MEF50, MEF75 and FEV1/FVC% ratio were measured before and 18 minutes after exercise. The results of the study showed that physical load and concurrent exposure to respiratory irritants had no impact on bronchial hyperreactivity in either group of workers. However, the exercise test demonstrated the existence of appreciable individual differences within the two groups

Immunological status and respiratory function in swine workers

Prevalencija respiratornih simptoma i ventilacijski kapacitet u odnosu na imunološki status ispitivani su u 32 radnika u svinjogojstvu i u 39 radnika kontrolne skupine. Velik broj radnika u svinjogojstvu reagirao je na alergen svinjske dlake (31%) i na alergen pripremljen od materijala sakupljenog u svinjogojskim farmama (28%), ali i na ostale alergene kao što su stočna hrana (76%) i kukuruzno brašno (37%). Radnici kontrolne skupine reagirali su na iste alergene u sličnoj prevalenciji (17%, 25%, 51%, 25%). Povišen IgE u serumu utvrđen je u tri radnika u svinjogojstvu (9,4%) i u jednog radnika kontrolne skupine (2,6%). Radnici u svinjogojstvu s pozitivnim kožnim reakcijama pokazivali su značajno veće akutne redukcije tijekom radne smjene za FEF50 i FEF25 nego oni s negativnim kožnim testovima (P<0,01). Izmjerene vrijednosti ventilacijskog kapaciteta prije radne smjene u radnika u svinjogojstvu s pozitivnim kožnim testovima bile su značajno niže nego predviđene normalne vrijednosti. Alergen pripremljen od materijala sakupljenog u svinjogojskim farmama uzrokuje kontrakciju glatke muskulature bronha u ispitivanjima in vitro. Naši podaci upućuju na to da neimunološke reakcije mogu djelomično objasniti akutne i/ili kronične promjene u respiratornoj funkciji radnika u svinjogojstvu.The prevalence of respiratory symptoms and ventilatory capacity in relation to immunological status were studied in 32 swine workers and in 39 controls. A large number of swine workers reacted to antigen of swine hair (34%) and to swine confinement antigen (28%) but also to other antigens such as animal food (78%), and corn flour (37%). Control workers showed comparable prevalence in their reaction to the antigens (17%, 25%, 51 %, 25%). Increased IgE serum level was determined in three swine workers (9.4%) and in one control worker (2,6%). Swine workers with positive skin tests demonstrated significantly larger acute reductions in FEF50 and FEF25 than those with negative skin tests (P < 0.01). The ventilatory capacity data measured before shift in swine workers with positive skin tests were significantly lower than the predicted normal values. Swine confinement antigen caused a dose-related contraction of guinea pig smooth muscle in vitro. Our data indicate that non-immunological reactions may be partly responsible for the acute and/or chronic changes in respiratory function

Učestalost dišnih tegoba kod radnika u elektrolizi aluminija i njihova povezanost s promjenama spirometrijskih vrijednosti

The goal of this study was to examine the prevalence of chronic respiratory symptoms in potroom workers and to compare these results with changes in spirometric parameters. A modified questionnaire on respiratory symptoms from the British Medical Research Council was used to take the medical history data about respiratory symptoms. Spirometric parameters were determined on the same day (as a part of regular checkups) using the Jaeger spirometer. The study included 215 potroom workers from the aluminium factory in Podgorica, Montenegro. All subjects were men, but they differed in age and duration of work. The group used for comparison consisted of 81 unemployed male applicants for jobs in the factory who had never been exposed to this kind of air pollution before. Potroom workers mostly complained of breathlessness associated with the workplace (56.7 %) or weather changes (rain, cold wind, and humidity) (41.9%) and of dyspnoea when climbing stairs (51.2 %), but only 22.3 % reported using medication to treat these episodes. Most workers reported to have been smoking at the time of the study (62.4 %). Spirometric data showed only insignificant variations compared to the expected values (CECA standards). Chronic obstructive pulmonary disease (COPD), characterised by FEV1/ VC % <88 % was found in only 17 (7.9 %) potroom workers, while asthma was identified in 9 (4.2 %). Although the prevalence of chronic respiratory symptoms reported by the examined potroom workers was quite high at the group level, they were not associated with ventilatory impairments.Cilj rada bio je da se kod radnika u pogonu elektrolize aluminija ispita učestalost respiratornih simptoma koji imaju kroničan karakter i da se usporedi s učestalošću promjena spirometrijskih parametara kod istih osoba. Anamnestički podaci o respiratornim simptomima uzimani su s pomoću modificiranog upitnika o respiratornim simptomima Britanskog savjeta za medicinska istraživanja. Spirometrijski parametri određivani su ispitanicima istoga dana (u sklopu njihova periodičnog pregleda) s pomoću spirometra marke Jaeger. Skupinu ispitanika činilo je 215 radnika pogona elektrolize Kombinata aluminijuma u Podgorici. Svi ispitanici bili su muškog spola, a različite dobi i dužine ekspozicije u elektrolizi. Istodobno je na jednak način ispitana skupina od 81 radnika također muškog spola, svi kandidati za radno mjesto u istoj tvornici, koji do tada nisu bili izloženi toj vrsti aeroonečišćenja. Najčešći respiratorni simptomi kod radnika u elektrolizi bili su napadaji gušenja na radnome mjestu (56,7 %), dispneja pri usponu (51,2 %) i utjecaj vremenskih prilika (kiša, hladan vjetar, povišena vlažnost zraka) na disanje (41,9 %). Međutim, tek je četvrtina (22,3 %) navela da pri napadu gušenja uzima neki od medikamenata. Među pregledanim radnicima bilo je najviše aktivnih pušača (62,3 %). Istodobno, vrijednosti ventilacijskih volumena pokazale su samo neznatna odstupanja od očekivanih (po standardima CECA), a prevalencija kronične opstruktivne plućne bolesti (KOPB) definirana kriterijem FEV1/VC % < 88 % nađena je samo kod 17 (7,9 %) radnika. Na osnovi ovog istraživanja zaključili smo da je učestalost respiratornih simptoma koje prijavljuju radnici elektrolize aluminija visoka, ali da nju ne prate adekvatni pomaci objektivnih pokazatelja kakvi su spirometrijski

Immunological reactions and ventilatory capacity in hemp workers

Odnos imunološkog statusa i respiratornih nalaza ispitivan je u 42 radnice profesionalno izložene prašini konoplje i u 49 radnica kontrolne skupine. Najviša prevalencija pozitivnih kožnih prick testova u radnica na preradi konoplje utvrđena je za mješavinu konoplje i lana (64% ), zatim za lan (48% ), konoplju s češljara (41%), konoplju s karda (38%), konoplju s predilica i tkalačkih strojeva (33%) i konoplju s omekšivača (20%). Prevalencija pozitivnih kožnih tekstova u radnica kontrolne skupine bila je znatno niža i varirala je od 21% do 5%. Povišen ukupni IgE utvrđen je u 35,7% radnica na preradi konoplje i u 4,1% radnica kontrolne skupine (P<0,05). U radnica na preradi konoplje s pozitivnim kožnim testovima utvrđena je značajno viša prevalencija kroničnih respirator-nih simptoma nego u onih s negativnim kožnim testovima. Akutne promjene ventilacijske funkcije pluća nisu se razlikovale prema imunološkom statusu. Vodeni ekstrakt prašine konoplje uzrokovao je kontrakciju glatke muskulature traheje u eksperimentu in vitro na nesenzibiliziranoj zamorčadi. Naši rezultati upućuju na to da prašina konoplje osim imunološkim mehanizmom može djelovati i iritativno na respiratorni sustav izloženih radnika.The relationship between immunological status and respiratory function was studied in 42 hemp workers and in 49 control workers. The highest prevalence of positive skin tests was recorded for a mixture of hemp and flax (64%), followed by flax (48%), hemp on a combing machine (41%), hemp on a carding machine (38% ), hemp on spinnin~ and weaving machines (33% ), and hemp on a softening machine (20%). The prevalence of positive skin tests in control workers was smaller and varied from 21 to 5%. Increased lgE was found in 35.7% of the hemp workers and in 5.0% of the controls (P<0.05). Hemp workers with positive skin tests had a significantly higher prevalence of chronic respiratory symptoms than those with negative skin tests. Acute ventilatory capacity reductions did not differ in respect to the immunological status. An extract of hemp dust caused a constriction of an isolated guinea pig tracheal smooth muscle in vitro. Our data suggest that hemp dust as well as producing an immunological effect may exert an irritant effect on the respiratory system in exposed textile workers

Immunological and respiratory changes in soy-bean workers

Imunološki status i respiratorna funkcija ispitivani su u skupini od 19 radnika na preradi soje i u 31 radnika kontrolne skupine. Svi radnici u preradi soje imali su pozitivne kožne reakcije na prašinu soje, 18 radnika na antigen soje nakon ekstrakcije ulja, tri na sojin lecitin i samo jedan na sojino ulje. U tri radnika na preradi soje utvrđeni su povišeni specifični imunoglobulini lgE. Među radnicima kontrolne skupine 19 je reagiralo pozitivnim kožnim testovima na alergen soje, 20 na soju nakon ekstrakcije ulja, a niti jedan na sojino ulje. U jednog radnika utvrđen je povišeni specifični IgE. Prevalencija kroničnih respiratornih simptoma bila je viša u eksponiranih nego u kontrolnih radnika (statistički značajno samo za dispneju, P<0,01). Radnici na preradi soje s povećanim IgE, kao i oni s pozitivnim kožnim testovima na kućnu prašinu nisu pokazivali veću prevalenciju kroničnih respiratornih simptoma nego oni s negativnim testovima. Snižene vrijednosti ventilacijskog kapaciteta utvrđene su u relativno velikog broja radnika. Radnici s pozitivnim kožnim testovima na kućnu prašinu imali su slične akutne redukcije kao i oni s negativnim kožnim testovima. Osim toga utvrđivali smo djelovanje ekstrakta soje na izoliranoj traheji zamorčeta, Rezultati su pokazali da je ekstrakt vrlo aktivan uzrokujući direktno konstrikciju glatke muskulature bronha. Rezultati upućuju na to da je senzibilizacija na soju vrlo česta, premda na temelju ovih podataka ne možemo zaključiti o ulozi atopije u razvoju respiratornih bolesti i promjena plućne funkcije.Immunological and respiratory findings were studied in a group of 19 male soy-bean workers. A group of 31 control workers were examined for the prevalence of respiratory symptoms and 20 control workers were included in the immunological study. All soy-bean workers had positive immediate skin reaction to soy-bean dust, IR to soy antigen after separation from oil, three to lecithin antigen and only one to soy oil. Only three soy-bean workers had increased levels of specific IgE. Among 20 control workers, 19 reacted to soy-bean dust, 20 to soy after separation of oil and none to soy oil. One demonstrated increased specific IgE. The prevalence of chronic respiratory symptoms was considerably higher in exposed than in control workers, being statistically different for dyspnea (P < 0.01). The statistically significant acute reductions in ventilatory capacity were particularly pronounced for FEF50 (- 4.7%) and FEF25 (- 9.4%). The mean ventilatory capacity values before shift on monday were significantly lower than those on the following Friday for FVC, FEF50 and FEF25. There was no difference in ventilatory capacity between soy-bean workers with positive and those with negative skin tests to house dust or between those with increased and those with normal IgE serum levels. A water soluble extract of soy-bean dust was also assayed in organ bath containing guinea pig trachea. This model showed the extract to be highly reactive causing a dose-related constriction of airway smooth muscle. Our data suggest that immunologic sensitization to soy-bean products is very frequent. In addition to possible humoral contribution to respiratory disorders, soy dust seems to directly affect airway smooth muscle

Respiratory symptoms and ventilatory capacity in hemp workers

Prevalencija respiratornih simptoma i ventilacijski kapacitet pluća ispitivani su u 84 radnice (tvornice A i B) i u 27 radnika zaposlenih na preradi konoplje. Skupina neeksponiranih 49 radnica i 30 radnika ispitivana je kao kontrola. Značajno viša prevalencija gotovo svih kroničnih respiratornih simptoma utvrđena je u žena u usporedbi s radnicama kontrolne skupine. Za muškarce značajna razlika u odnosu na kontrolnu skupinu utvrđena je za katar nosa i sinusitis. Visoka prevalencija bisinoze utvrđena je u žena (A=47,8%, B=57,9%), kao i u muškaraca (66,7%). Statistički značajne akutne redukcije ventilacijskog kapaciteta tijekom radne smjene utvrđene su za sve testove u muškaraca i žena, varirajući od 7,1 % za FEV1 do 15,1 % za FEF50 (P 0.01) varying from 7.1 % for FEV1 to 15.1 % for FEF50. Measured Monday baseline values before the work shift were significantly lower than expected hemp workers being particularly reduced for FEF25 and FEF50. The data suggest that exposure to hemp dust is a major risk factor for the development of occupational lung disease