Odnos između azbestnih telašaca, serumskih imunoglobulina i rentgenografskih promena kod radnika u azbestnoj industriji

In this study 52 workers from an asbestos factory were examined. They were placed in three groups: Group 1, directly exposed to asbestos with X-ray changes of the lungs indicative of asbestosis, Group 2 also directly exposed to asbestos, but without X-ray changes, and Group 3 not directly exposed to asbestos. The lungs and pleura of all the examined workers were X-rayed in the anteroposterior projection. Sputum samples were taken to determine the presence of asbestos bodies, and the level of immunoglobulins (IgG, IgM and IgA) was determined in sera. In workers exposed to asbestos, a correlation between the number of asbestos bodies and X-ray changes was not found. The level of immunoglobulins in Group 1 workers was significantly higher than in Groups 2 and 3. In the former group, there were significantly more workers with increased IgG level than in the latter groups.Ispitivanja su obuhvatila 52 radnika azbestnog pogona podeljena u tri grupe (I grupa radnika, direktno izloženih azbestu, sa rendgenografskim promenama u smislu azbestoze, II grupa takođe direktno izloženih radnika bez RDG pramena i III grupa radnika koji nisu direktno izloženi azbestu). Svim ispitivanim radnicima napravljena je rendgenografija pluća i pleure, određivan je broj azbestnih telašaca u sputumu i nivo serumskih imunoglobulina (IgG, IgM i IgA). Kod ispitivane grupe azbestnih radnika izloženih azbestu nije utvrđena povezanost između broja azbestnih telašaca u sputumu sa RDG promenama i imunološkim statusom. Utvrđen je statistički značajno viši nivo imunoglobulina G kod I grupe radnika u odnosu na II i III grupu prethodno kategoriziranih radnika. Signifikantno je veći broj radnika I grupe sa povećanim nivoom IgG

The role of inflammation in the pathogenesis of occupational asthma

Posljednjih godina brojna istraživanja ukazuju na vezu između bronhijalne hiperreaktivnosti i inflamacije dišnih puteva. Istaknuti su najčešći mehanizmi nastanka bronhoopstrukcije sa uključivanjem inflamatornih procesa kao važne karike u nastanku i razvoju profesionalne bronhijalne astme (PBA). Naglasivši važnost inflamacije, autori navode klasifikaciju PBA Moire Chan-Yeung koja uzima u obzir i ovaj faktor. Određeni tipovi PBA po ovoj klasifikaciji postavljeni su u okvir radne sredine. Smatra se da bi prolongirana profilaksa inflamacije prevenirala ireverzibilnu opstrukciju dišnih puteva, što je od posebnog značaja za segment populacije na koji se problem PBA odnosi.Numerous recent studies point out a relationship between bronchial reactivity and the inflammation of the airways. The paper deals with the most frequent mechanisms of bronchoconstriction in occupational asthma combined with inflammatory process. The importance of inflammation in the Moira Chan-Yeung classification of occupational asthma is emphasized. According to this classification several types of occupational asthma are associated with the working environment. It is stressed that continuing prophylaxis of inflammation should protect the worker from irreversible airflow obstruction. This is of special interest to the population suffering from occupational asthma

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

Miliaria rubra as an occupational disease in special conditions of working environment

Prikazano je 87 slučajeva milijarije rubre kod rudara koji rade u rudniku za krom u čijoj su radnoj okolini registrovani veoma nepovoljni mikroklimatski faktori, ali kod kojih nema statistički signifikantne razlike između zimskog i ljetnog perioda. Dužina ekspozicije obično je iznosila 1-3 dana, dok srednje vrijeme trajanja oboljenja G-8 dana. Kožne promjene započinjale su se pojavljivati koncem svibnja, u srpnju su dostizale svoj maksimum, da bi se koncem kolovoza broj oboljelih rapidno smanjio. Fizički napor, visoka suha temperatura (iznad 31° C) i relativna vlaga (iznad 93%) jame, kao i nepovoljni klimatski uvjeti ljetnog perioda, su odlučujući momenti kod pojave milijarije rubre u uvjetima profesionalne ekspozicije. A čini se da i stanje neurovegetativnog sistema ima u tome izvjestan udio.Eighty seven cases of miliaria rubra are presented in the miners of a chromium mine in which unsuitable microclimatic factors were registered. There were no significant differences in these factors between the winter and the summer period. The average duration of the disease is from 6 to 8 days. The changes of the skin appeared at the end of May, they reached their maximum in July and by the end of August the number of the patients rapidly decreased. Physical effort, high dry temperature (over 31° C), high relative humidity in the mine (over 93%), and the unsuitable macroclimatic conditions in the summer period are the decisive moments causing the appearance of miliaria rubra. The neurovegetative nervous system disturbances seem to have certain effect on the occurrence of the skin changes observed

Hipersenzitivnost i respiratorna funkcija kod radnika u drvnoj industriji

Ventilatory functions and skin hypersensitivity to allergens present in the wood industry were assessed in 47 workers with an average exposure of 12.8 years. On the basis of the MRC questionnaire for respiratory symptoms, each worker was submitted to the measurements of ventilatory lung function parameters for acute and chronic effects of exposure. Intradermal testing with five specific dust allergens was performed, and the level of serum immunoglobulins was determined. Fifty-five per cent of the workers were found to be hypersensitive to specific allergens. In those with positive skin tests, acute and chronic effects of wood dust on FEF75-85% and PVC were noted, which points to a possible constrictive effect of wood dust localized mostly in the small airways in sensitized persons.Kod 47 radnika drvne industrije sprovedena su ispitivanja u cilju procene senzibilizacije sa specifičnim alergenima i ventilatorne funkcije. Svim ispitivanim osobama popunjavan je MRC upitnik za respiratornu simptomatologiju, određivan je akutni i hronični efekt drvne prašine na ventilatornu funkciju (na njene pojedine parametre) izvršeno je intradermalno testiranje sa pet specifičnih alergena drvne industrije i određivan je nivo serumskih IgG, M i A. Ispitivanja su pokazala senzibilizaciju na specifične alergene kod 55,3% radnika intradermalnim testiranjem. Kod radnika sa pozitivnim intradermalnim testovima registrovan je i akutan i hroničan efekt drvne prašine na parametar FEF75-85% od FVK-a. Ovo ukazuje na eventualni mogući konstriktorni efekat drvne prašine, pretežno lokaliziran u malim disajnim putevima kod senzibiliziranih osoba

Odnos između azbestnih telašaca, serumskih imunoglobulina i rentgenografskih promena kod radnika u azbestnoj industriji

In this study 52 workers from an asbestos factory were examined. They were placed in three groups: Group 1, directly exposed to asbestos with X-ray changes of the lungs indicative of asbestosis, Group 2 also directly exposed to asbestos, but without X-ray changes, and Group 3 not directly exposed to asbestos. The lungs and pleura of all the examined workers were X-rayed in the anteroposterior projection. Sputum samples were taken to determine the presence of asbestos bodies, and the level of immunoglobulins (IgG, IgM and IgA) was determined in sera. In workers exposed to asbestos, a correlation between the number of asbestos bodies and X-ray changes was not found. The level of immunoglobulins in Group 1 workers was significantly higher than in Groups 2 and 3. In the former group, there were significantly more workers with increased IgG level than in the latter groups.Ispitivanja su obuhvatila 52 radnika azbestnog pogona podeljena u tri grupe (I grupa radnika, direktno izloženih azbestu, sa rendgenografskim promenama u smislu azbestoze, II grupa takođe direktno izloženih radnika bez RDG pramena i III grupa radnika koji nisu direktno izloženi azbestu). Svim ispitivanim radnicima napravljena je rendgenografija pluća i pleure, određivan je broj azbestnih telašaca u sputumu i nivo serumskih imunoglobulina (IgG, IgM i IgA). Kod ispitivane grupe azbestnih radnika izloženih azbestu nije utvrđena povezanost između broja azbestnih telašaca u sputumu sa RDG promenama i imunološkim statusom. Utvrđen je statistički značajno viši nivo imunoglobulina G kod I grupe radnika u odnosu na II i III grupu prethodno kategoriziranih radnika. Signifikantno je veći broj radnika I grupe sa povećanim nivoom IgG