Standards of nasal provocation tests

The nasal allergen provocation test (NAPT) plays an important role in diagnosis of allergy. It is based on the natural reaction of the nasal mucosa after application of tested substances on their surface. Nasal challenges are divided into specific (allergenic) and non-specific. Typical clinical symptoms depend on the immunological reaction: sneezing, itching, rhinorrhea and nasal blockage. Eosinophilic mucosal infiltration is observed in the late phase reaction. Typically the result of nasal challenge should be assessed by the physician and patient. The immunological reaction, especially the level of particular allergenic mediators, could also be investigated. Some objective methods for final assessment of the results are recommended. There is some information about non-specific nasal provocation with aspirin and occupational diseases in the pape

An Experimental Electronic Board ADF339 for Analog and FPGA-Based Digital Filtration of Measurement Signals

This work introduces and examines a new programmable electronic system, Board ADF339, designed for filtering analog measurement signals of low frequencies. The system operates in a mixed mode in collaboration with a digital controller implemented on the myRIO-1900 FPGA module. It enables the digital selection of the type and frequency settings of the UAF42 integrated circuit. In the technical implementation section, electronic filter and phase shifter circuit diagrams are presented, along with the digital counterpart of the analog filter. Tests of this system were conducted on signals generated using a function generator, which was followed by the filtration of signals occurring in real laboratory setups. A series of real responses from three different laboratory systems and a measurement system utilizing LabVIEW FPGA virtual instruments are demonstrated. After computing SNR indicators for noisy waveforms, the application scope and usability of the board are highlighted

Work-related symptoms among workers exposed to black tea dust

Background: Tea may be classified as unfermented green, semi-fermented oolong and fermented black. All of these types are derived from Camellia sinensis, the Tea Plant, which contains the low molecular weight (LMW) agent Epigallocatechin gallate (EGCg), probably responsible for allergic reactions. The aim of our study was to asses the work-related allergic symptoms and IgE-mediated sensitivity among black tea packers. Material and Methods: Study groups comprised 26 black tea packers (group 1) and 20 office workers (group 2). A questionnaire, skin prick tests (SPTs) to common allergens and black tea, evaluation of specific IgE (asIgE) to Camellia sinensis and moulds, pre- and post-work-shift spirometry were performed. Results: At least 1 symptom suggesting allergic disease was reported by 85% of the tea packers and 60% of the office workers. The most frequent positive results of SPTs were obtained with moulds (8%). A small decline in FEV1 (forced expiratory volume in 1 s) after the work shift was observed among tea packers sensitized to moulds. Conclusions: Although specific sensitization to black tea was not observed in our study groups, cough and skin symptoms were significantly more frequently among the tea packers than in office workers. The irritant impact on the airways and the skin of tea dust and/or sensitization to moulds contaminating tea leaves are being suspected. Med Pr 2015;66(1):11–1

Occupational allergy to Limonium sinuatum — a case report

Decorative flowers are known to be a cause of occupational allergy in the floral industry. The allergic manifestations induced by flowers include asthma, rhinoconjunctivitis and urticaria. We present a case of a 55-year-old woman, who has been working for the last 30 years as a gardener with various kinds of flowers, e.g., Limonium sinuatum (LS), chrysanthemum, sweet William (Dianthus barbatus) and Lilium. During the last 10 years she has developed nasal and eyes symptoms, dry cough, dyspnoea, chest tightness and wheezing. Clinical examination, routine laboratory testing, chest radiography, skin prick tests (SPT) involving common allergens, native plants pollens and leaves by the prick-prick technique, rest spirometry, methacholine challenge test and specific inhalation challenge test (SICT) were conducted. SPT results to common allergens were positive for grass pollens. SPT with native plants pollens and leaves showed a positive reaction only for LS. SICT induced an isolated early asthmatic reaction and significant increase in the number of eosinophils in the nasal lavage fluid. Additionally, significant increase in non-specific bronchial hyperreactivity was observed after SICT. To our knowledge, the presently described report is the first one of Limonium sinuatum induced occupational asthma and rhinitis in a Polish gardener

Occupational asthma caused by samba (Triplochiton scleroxylon) wood dust in a professional maker of wooden models of airplanes: A case study

Objectives: Wood dust is a known occupational allergen that may induce, in exposed workers, respiratory diseases including asthma and allergic rhinitis. Samba (obeche, Triplochiton scleroxylon) is a tropical tree, which grows in West Africa, therefore, Polish workers are rarely exposed to it. This paper describes a case of occupational asthma caused by samba wood dust. Material and Methods: The patient with suspicion of occupational asthma due to wood dust was examined at the Department of Occupational Diseases and Clinical Toxicology in the Nofer Institute of Occupational Medicine. Clinical evaluation included: analysis of occupational history, skin prick tests (SPT) to common and occupational allergens, determination of serum specific IgE to occupational allergens, serial spirometry measurements, metacholine challenge test and specific inhalation challenge test with samba dust. Results: SPT and specific serum IgE assessment revealed sensitization to common and occupational allergens including samba. Spirometry measurements showed mild obstruction. Metacholine challenge test revealed a high level of bronchial hyperactivity. Specific inhalation challenge test was positive and cellular changes in nasal lavage and induced sputum confirmed allergic reaction to samba. Conclusions: IgE mediated allergy to samba wood dust was confirmed. This case report presents the first documented occupational asthma and rhinitis due to samba wood dust in wooden airplanes model maker in Poland

Contact blepharoconjunctivitis due to black henna — A case report

Para-phenylenediamine (PPD) can induce immediate or – more often – delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid

Immunological determinants in a murine model of toluene diisocyanate-induced asthma

Objectives: Diisocyanates (DIC) are highly reactive, low-molecular-weight chemicals which are the leading cause of occupational asthma (OA). The aim of the study was to analyze certain aspects of the pathogenesis of allergic infl ammation in the airways induced by toluene diisocyanate (TDI) in an experimental model in mice. Materials and Methods: The experiment was carried out on 50 female BALB/cJ/Han/IMP mice, which were exposed by inhalation (intranasal and in the inhalation chamber) to toluene diisocyanate (2,4-TDI). After the experiment, the bronchoalveolar lavage fluid (BALF) was collected from the animals, and the composition of the induced infl ammatory cells, and the concentrations of certain cytokines (IL-4, IL-5, TNF-α) were evaluated. Results: The total number of cells in BALF of the examined group of mice was signifi cantly higher compared to the control mice. There was also a signifi cant increase in neutrophils and eosinophils in the study group compared to the controls. The number of lymphocytes and macrophages did not differ signifi cantly between the two groups. A statistically signifi cant increase in the level of TNF-α was shown to occur in the group exposed to toluene diisocyanate in comparison to the control group. The concentration of IL-4 increased in the study group, compared to the control one, but the differences did not reach the level of signifi cance, p > 0.05. Such difference was not observed for IL-5. Conclusions: We developed a murine model of TDI-induced asthma which caused the infl ux of infl ammatory cells like eosinophils and neutrophils in the bronchoalveolar lavage fl uid (BALF) in the TDI-treated mice. The increase of the concentration of some proinfl ammatory cytokines (TNF-α, IL-4) in BALF from the exposed mice was also observed

Metal-induced asthma and chest X-ray changes in welders

Objectives: The aim of this study was to evaluate the coexisting factors and usefulness of diagnostic methods in metal-induced asthma in Polish welders. Materials and Methods: Examination of 50 welders occupationally exposed to metals and with suspicion of metal-induced asthma (group A), 100 welders occupationally exposed to metals but without suspicion of metal-induced asthma (group B), and two control groups (10 patients with atopic asthma and 10 healthy subjects) was carried out. Questionnaire survey, clinical examination, skin prick tests to common aeroallergens and metal salts, rest spirometry tests, X-ray, metacholine challenge and a single-blind, placebo controlled specific inhalation challenge tests with metals (or work-like conditions challenge tests) were performed. Results: In group A – in 9 cases we obtained positive results of specific inhalation challenge tests with metals (in 3 cases with nickel, in 4 cases with chromium, in 1 case with cobalt and in 1 case with manganese). Nine cases of metal-induced occupational asthma were recognized. In group B – only in one case we obtained positive results of work-like conditions challenge test (clinical and spirometry changes, eosinophil influx in induced sputum), which confirmed the diagnosis of occupational asthma. In most of examined welders (62%), pulmonary changes in chest X-ray images were noted. The statistical analysis revealed that working as a welder for more than 10 years is the coexisting factor of presence of chest X-ray changes (p- or q-type nodular changes or interstitial changes). Positive results of skin prick tests with metal salts were the coexisting factors of occupational asthma due to metals among examined group of welders. Conclusions: Specific inhalation challenge plays the key role in diagnostics of metal-induced asthma in welders. Pulmonary changes in chest X-ray were found in a significant percentage of examined welders