17 research outputs found
Pušenje među makedonskim radnicima pet godina nakon kampanje protiv pušenja
To assess the efficacy of a nationwide anti-smoking campaign, we compared the findings of a study on worker smoking performed in 2005 with our latest cross-sectional study completed in 2010. It included 753 randomly selected workers, of whom 126 office, 108 construction, 93 agricultural, 97 petroleum refinery, 114 textile, 117 food processing workers, and 98 cleaners. Information was collected with a selfadministered questionnaire. The prevalence of current smokers among all workers was 35.4 %, ranging from 30.2 % in office workers to 43.5 % in construction workers. It did not significantly differ from the prevalence recorded in 2005 (35.4 % vs. 36.8 %, respectively; P=0.441). Mean pack-years smoked among all smokers was 12.4±2.3, ranging from 10.9 in administrative workers to 13.7 in agricultural workers. We did not find any significant difference in the prevalence of current smokers between male and female workers and between workers aged less or more than 40 years, as well as between workers of higher and lower education. The prevalence of ex-smokers was 10.5 %, ranging from 8.4 % in construction workers to 12.1 % in administrative workers, whereas the prevalence of passive smokers was 29.1 %, ranging from 26.2 % in food processing workers to 32.9 % in agricultural workers. Our findings indicate that the prevalence of current and passive smokers has remained high regardless of the anti-smoking campaign and call for stricter implementation of anti-smoking regulations.Želeći utvrditi djelotvornost kampanje protiv pušenja u Makedoniji, usporedili smo rezultate istraživanja o pušenju u radničkoj populaciji provedenog 2005. s rezultatima našega najnovijega presječnoga randomiziranog ispitivanja koje je dovršeno 2010. Ispitivanje je obuhvatilo 753 radnika, od kojih je 126 uredskih, 108 građevinskih, 93 poljoprivrednih, 97 u rafineriji nafte, 114 tekstilnih, 117 prehrambenih te 98 čistač(ic)a. Podaci su prikupljeni s pomoću upitnika koji su ispunjavali ispitanici. Prevalencija aktivnih pušača među svim radnicima bila je 35,4 %, od 30,2 % u uredskih radnika do 43,5 % u građevinskih. Nije se značajno razlikovala od prevalencije zabilježene 2005. (35,4 % odnosno 36,8 %, P=0,441). Srednja vrijednost kutija/godina u pušača bila je 12,4±2,3, od 10,9 u uredskih do 13,7 u poljoprivrednih radnika. Značajnih razlika u aktivnome pušenju nije bilo među ženama i muškarcima, radnicima starijim i mlađima od 40 godina, niti među radnicima višeg i nižeg obrazovanja. Prevalencija bivših pušača bila je 10,5 %, od 8,4 % u građevinskih do 12,1 % u uredskih radnika, dok je prevalencija pasivnih pušača bila 29,1 %, od 26,2 % u radnika u preradi hrane do 32,9 % u poljoprivrednih radnika. Naši rezultati pokazuju da je prevalencija aktivnih i pasivnih pušača ostala visoka bez obzira na kampanju protiv pušenja te pozivaju na strožu provedbu propisa koji ograničavaju pušenje
Izloženost ambijentalnomu duhanskomu dimu na radnome mjestu u Makedoniji: kako sada stojimo?
To assess the prevalence and the level of exposure to environmental tobacco smoke (ETS) in the workplace after the enactment of the law restricting indoor smoking in Macedonia, we performed a cross-sectional, self-administered questionnaire study including 372 never-smoking workers recruited from six workplaces. We found a high prevalence of workers exposed to ETS in the workplace (27.4 %) with no significant difference between particular occupation groups. We found no significant difference in the prevalence of passive smokers in the workplace between this study and our study conducted before the law was enacted (31.5 % vs. 27.4 %, P=0.324). The prevalence of workers exposed to ETS for less than three hours a day was significantly lower than of passive smokers with longer exposure (28.4 % vs. 71.6 %, P=0.038). The prevalence of workers exposed to ETS from less than 10 cigarettes smoked by coworkers per day was lower than the prevalence of workers with higher exposure, but statistical significance was not reached (37.9 % vs. 62.1 %, P=0.087). Our findings indicate a high prevalence and a high level of exposure to ETS in the workplace, which calls for stricter adherence to smoking-free legislation or even the total ban of smoking in the workplace.Ovo je ispitivanje obuhvatilo 372 radnika na šest različitih radnih mjesta koji nikad nisu pušili kako bi se procijenila zastupljenost osoba izloženih duhanskomu dimu na radnome mjestu i razina njihove izloženosti nakon zakonskih ograničenja pušenja u zatvorenim prostorijama u Makedoniji. Ispitivanje je provedeno s pomoću upitnika koji su radnici ispunjavali sami. Utvrdili smo visoku zastupljenost radnika izloženih ambijentalnomu duhanskomu dimu na radnome mjestu (27,4 %) te nisu zamijećene statistički značajne razlike među zanimanjima. Nisu uočene značajne razlike između zastupljenosti pasivnih pušača na radnome mjestu u ovome ispitivanju i u našem ranijem ispitivanju, kada još nije na snagu stupio zakon o ograničenju pušenja (31,5 % naprema 27,4 %, P=0,324). Zastupljenost radnika izloženih ambijentalnomu duhanskomu dimu ne dulje od tri sata na dan bila je statistički značajno niža negoli onih čija je izloženost trajala duže (28,4 % naprema 71,6 %, P=0,038). Zastupljenost radnika koji su bili izloženi dimu kolega koji su pušili manje od 10 cigareta na dan bila je niža negoli onih s većom izloženosti, ali razlika nije bila statistički značajna (37,9 % naprema 62,1 %, P=0,087). Naši rezultati potvrđuju da i dalje postoje visoka zastupljenost izloženih radnika i visoke razine izloženosti ambijentalnomu duhanskomu dimu na radnome mjestu, što upućuje na potrebu uvođenja strožih zakona o zabrani pušenja
Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy
IgE-mediated food allergies are caused by adverse immunologic responses to food proteins. Allergic reactions may present locally in different tissues such as skin, gastrointestinal and respiratory tract and may result is systemic life-threatening reactions. During the last decades, the prevalence of food allergies has significantly increased throughout the world, and considerable efforts have been made to develop curative therapies. Food allergen immunotherapy is a promising therapeutic approach for food allergies that is based on the administration of increasing doses of culprit food extracts, or purified, and sometime modified food allergens. Different routes of administration for food allergen immunotherapy including oral, sublingual, epicutaneous and subcutaneous regimens are being evaluated. Although a wealth of data from clinical food allergen immunotherapy trials has been obtained, a lack of consistency in assessed clinical and immunological outcome measures presents a major hurdle for evaluating these new treatments. Coordinated efforts are needed to establish standardized outcome measures to be applied in food allergy immunotherapy studies, allowing for better harmonization of data and setting the standards for the future research. Several immunological parameters have been measured in food allergen immunotherapy, including allergen-specific immunoglobulin levels, basophil activation, cytokines, and other soluble biomarkers, T cell and B cell responses and skin prick tests. In this review we discuss different immunological parameters and assess their applicability as potential outcome measures for food allergen immunotherapy that may be included in such a standardized set of outcome measures
Recognition of COVID-19 with occupational origin: a comparison between European countries
Objectives This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe.
Methods A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022.
Results The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries.
Conclusions COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.This publication is based on work from COST Action CA16216 (OMEGA-NET), supported by COST (European Cooperation in Science and Technology)
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
Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food—A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper
Background
Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin.
Methods
MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results.
Results
In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds.
Conclusion
Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement “this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product” for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged