Profesionalna astma u radnika izloženih prašinama iz biljnih i voćnih čajeva

We performed a cross-sectional study to detect occupational asthma (OA) in 63 subjects occupationally exposed to herbal and fruit tea dust and in 63 corresponding controls. The evaluation included a questionnaire, skin prick tests to workplace and common inhalant allergens, spirometry, and histamine challenge test. The evaluation of the work-relatedness of asthma in the exposed workers was based on serial peak expiratory flow rate (PEFR) measurements and bronchoprovocation tests. We found a higher prevalence of respiratory symptoms in the exposed workers, whereas spirometric parameters were significantly lower. The prevalence of sensitisation to allergens and of bronchial hyperresponsivenss (BHR) did not differ significantly between the groups. The prevalence of asthma was also similar in both groups (8.0 % vs. 6.4 %; P=0.540). Work-relatedness of symptoms was reported by all asthmatic tea workers and by no control with asthma. Significant work-related changes in PEFR diurnal variations and in non-specific BHR, suggesting allergic OA, were found in one tea worker with asthma (1.6 %). No specific workplace agent causing OA in the affected subject was identified. None of the tea workers with asthma met the criteria for medical case definition of the reactive airway dysfunction syndrome (RADS). Our data confirm workplace exposure to herbal and fruit tea dust as a risk factor for OA.Svrha je ovoga presječnog ispitivanja bila otkriti profesionalnu astmu u skupini od 63 ispitanika koji su na radnome mjestu bili izloženi prašinama biljnih i voćnih čajeva. Kao kontrola uzet je jednak broj uredskih radnika koji nisu bili izloženi ovim prašinama. Ocjena izloženih i kontrolnih ispitanika obuhvatila je upitnik, skin prick testove na uobičajene i profesionalne inhalacijske alergene, spirometriju te histaminski test. Povezanost astme s profesionalnom izloženosti u radnika utvrđena je prema kriterijima Američkog kolegija pulmologa (American College of Chest Physicians, krat. ACCP), a na temelju mjerenja niza vršnih ekspiratornih protoka (engl. peak expiratory flow rate, PEFR) i niza bronhoprovokativnih testova. Izloženi su radnici iskazali veću prevalenciju respiratornih simptoma odnosno niže spirometrijske vrijednosti od kontrole. Izloženi ispitanici nisu se značajno razlikovali od kontrole u prevalenciji senzibilizacije na profesionalne i uobičajene inhalacijske alergene te prevalenciji pretjerane bronhalne reaktivnosti (engl. bronchial hyperresponsiveness, krat. BHR). Isto vrijedi i za prevalenciju astme (8,0 % u izloženih radnika prema 6,4 % u kontrola; P=0,540). Povezanost simptoma s poslom prijavili su svi radnici u obradi čaja oboljeli od astme te ni jedan kontrolni ispitanik s astmom. U jednoga astmatičnog radnika na čaju utvrđene su značajne promjene u dnevnim varijacijama PEFR-a te u nespecifičnom BHR-u koji upućuju na profesionalnu astmu (1.6 %). Nije utvrđeno koja je to tvar uzrokovala profesionalnu astmu u ovog ispitanika. Nitko od izloženih radnika s astmom nije zadovoljio sve medicinske kriterije za dijagnozu sindroma reaktivne disfunkcije dišnih putova (engl. reactive airway dysfunction syndrome, RADS). Naši podaci potvrđuju da je profesionalna izloženost prašinama iz biljnih i voćnih čajeva čimbenik rizika od profesionalne astme

Pretjerana bronhalna reaktivnost u kuharica i čistača

The aim of this cross-sectional study was to assess the prevalence and characteristics of bronchial hyperresponsiveness (BHR) in 43 women cleaners (aged 26 to 57) and 37 women cooks (aged 29 to 55) and compare them with 45 controls (women office workers aged 27 to 58). The evaluation of all subjects included a questionnaire, skin prick tests to common aeroallergens, spirometry, and histamine challenge (PC20≤8 mg mL-1). We found higher BHR prevalence in cleaners and cooks than in office workers (30.2 % and 29.7 %, vs. 17.7 %, respectively), but statistical significance was not reached. The prevalence of mild and moderate to severe BHR was similar in all groups. Borderline BHR prevalence was significantly higher in cleaners than in controls (16.2 % vs. 6.6 %, P=0.032) whereas the difference was on the verge of significance in cooks (13.5 % vs. 6.6 %, P=0.081). Moderate to severe BHR was strongly associated with positive family history of asthma and atopy in all groups. Mild BHR was significantly associated with daily smoking in cleaners (P=0.031) and cooks (P=0.021), as well as with the duration of exposure in cleaners (P=0.038). Borderline BHR was closely related to daily smoking and duration of exposure in both cleaners and cooks. Our findings indicate an important role of workplace exposure in borderline BHR development, as well as the significant effect of smoking on mild BHR development in women cleaners and cooks.Svrha je ovoga presječnog ispitivanja bila utvrditi prevalenciju i značajke pretjerane bronhalne reaktivnosti (engl. bronchial hyperresponsiveness, krat. BHR) u profesionalnih čistačica (43 ispitanice u dobi od 26 do 57 godina) i kuharica (37 ispitanica u dobi od 29 do 55 godina). Kontrolna skupina obuhvatila je 45 uredskih radnica u dobi od 27 do 58 godina. Ocjena izloženih i kontrolnih ispitanica obuhvatila je upitnik, skin prick testove na uobičajene inhalacijske alergene, spirometriju te histaminski test (PC20 ≤8 mg mL-1). ^istačice odnosno kuharice iskazale su veću prevalenciju BHR-a od kontrolnih uredskih radnica (30,2 % odnosno 29,7 % prema 17,7 %), ali ona nije bila statistički značajna. Sve su skupine iskazale podjednaku prevalenciju umjerenog i snažnog BHR-a. Prevalencija graničnoga BHR-a bila je značajno viša u čistačica negoli u kontrole (16,2 % naprema 6,6 %, P=0,032), a na rubu statističke značajnosti bila je i razlika između kuharica i kontrole (13,5 % prema 6,6 %, P=0,081). Umjeren odnosno snažan BHR u svih je skupina bio značajno povezan s obiteljskom povijesti astme i atopija. Blagi BHR značajno je povezan sa svakodnevnim pušenjem u čistačica (P=0,031) i kuharica (P=0,021), a u čistačica i s trajanjem izloženosti (P=0,038). Granični BHR je i u čistačica i u kuharica povezan sa svakodnevnim pušenjem i trajanjem profesionalne izloženosti. Naši podaci upućuju na važnu ulogu profesionalne izloženosti u nastanku graničnoga BHR-a te na značajan utjecaj pušenja na nastanak blagoga BHR-a u profesionalnih čistačica i kuharica