Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>Occupational exposures are thought to be responsible for 10-15% of new-onset asthma cases in adults, with disparities across sectors. Because most of the data are derived from registries and cross-sectional studies, little is known about incidence of occupational asthma (OA) during the first years after inception of exposure. This paper describes the design of a study that focuses on this early asthma onset period among young workers in the bakery, pastry making and hairdressing sectors in order to assess early incidence of OA in these "at risk" occupations according to exposure duration, and to identify risk factors of OA incidence.</p> <p>Methods/Design</p> <p>The study population is composed of subjects who graduated between 2001 and 2006 in these sectors where they experience exposure to organic or inorganic allergenic or irritant compounds (with an objective of 150 subjects by year) and 250 young workers with no specific occupational exposure. A phone interview focusing on respiratory and 'Ear-Nose-Throat' (ENT) work-related symptoms screen subjects considered as "possibly OA cases". Subjects are invited to participate in a medical visit to complete clinical and lung function investigations, including fractional exhaled nitric oxide (FE_NO) and carbon monoxide (CO) measurements, and to collect blood samples for IgE (Immunoglobulin E) measurements (total IgE and IgE for work-related and common allergens). Markers of oxidative stress and genetic polymorphisms exploration are also assessed. A random sample of 200 "non-cases" (controls) is also visited, following a nested case-control design.</p> <p>Discussion</p> <p>This study may allow to describ a latent period between inception of exposure and the rise of the prevalence of asthma symptoms, an information that would be useful for the prevention of OA. Such a time frame would be suited for conducting screening campaigns of this emergent asthma at a stage when occupational hygiene measures and adapted therapeutic interventions might be effective.</p> <p>Trial registration</p> <p>Clinical trial registration number is NCT01096537.</p

Guidance document on leptospirosis in relation to swimming in surface waters

Leptospirose is een verzamelnaam voor verschillende ziekten die worden veroorzaakt door Leptospira-bacteriën, zoals modderkoorts of de ziekte van Weil. Deze bacteriën kunnen met de urine van de bruine rat in het oppervlaktewater terechtkomen. Mensen kunnen hier ziek van worden door bijvoorbeeld in of rond oppervlaktewater te recreëren. In Nederland komt het erg weinig voor dat mensen leptospirose krijgen door te zwemmen in oppervlaktewater. Áls het gebeurt, is het niet altijd duidelijk wie waarvoor verantwoordelijk is en actie moet ondernemen. Ook hebben de betrokken overheden vaak vragen over te nemen maatregelen en de wetten en regels. Daarom heeft het RIVM met betrokken partijen een handreiking gemaakt die informatie geeft over leptospirose, wetgeving en welke acties en maatregelen mogelijk zijn. Het is niet bekend van welke hoeveelheid Leptospira-bacteriën in zwemwater mensen ziek kunnen worden. De handreiking beschrijft daarom drie scenario’s om maatregelen te nemen na (mogelijke) besmettingen: als het gerucht gaat dat er iemand op een zwemlocatie is besmet, als er één persoon is besmet, en als er meerdere personen zijn besmet. Zwemwaterbeheerders kunnen uitzoeken of op een zwemlocatie risico’s door ratten te verwachten zijn. Zij kunnen hiervoor, naast het verplichte zwemwaterprofiel, een zogeheten plaagdier risico-inventarisatie laten opstellen. Zo kunnen ze te weten komen of maatregelen nodig zijn. Er zijn twee soorten maatregelen mogelijk om besmettingen op een zwemlocatie te voorkomen: ratten bestrijden en zwemmers informeren. Goede informatie voor de zwemmers kan ervoor zorgen dat er geen besmettingen optreden. Zwemmers moeten op hun gedrag worden gewezen. Ze moeten bijvoorbeeld geen afval achterlaten op een zwemlocatie, want dat trekt ratten aan. En als ze een wondje hebben, kunnen ze beter niet in het water gaan. Ze kunnen namelijk besmet raken doordat hun slijmvliezen of wondjes in de huid in contact komen met oppervlaktewater waarin Leptospira-bacteriën zitten.Leptospirosis is an umbrella term for a variety of conditions caused by Leptospira bacteria, such as fever and Weil's disease. These bacteria can end up in surface water with the urine of brown rats. People can contract the disease during recreational activities in or around surface water. In the Netherlands, very few people get leptospirosis from swimming in surface water. If this does happen, it is not always clear who is responsible and who should take action. In addition, the authorities involved are often uncertain about what the rules are and what measures to take. This is why RIVM and a number of parties involved have drawn up a guidance document with information about leptospirosis, the relevant laws and regulations and possible measures. It is not known how much Leptospira bacteria in bathing water can make people ill. For that reason, the guidance document describes three scenarios for measures following a (possible) infection: when a person is thought to have been infected at a particular bathing site, when one person has been infected and when several persons have been infected. Bathing water managers can then find out whether a particular bathing site poses a risk of infection by rats. They can commission a pest risk inventory for that site, in addition to the obligatory bathing water profile. This will tell them whether any measures are required. Infections at bathing sites can be prevented in two ways: by controlling rat populations and by informing swimmers. Good information for swimmers can help to prevent infections. Swimmers need to be made aware of their own behaviour. For example, they should not leave any litter at bathing sites, to avoid attracting rats. And even with a small wound it is better not to go into the water. Swimmers can get infected when mucous membranes or small cuts in the skin come into contact with surface water that contains Leptospira bacteria

Christian Economic Thought in The Netherlands

Christian economic thought, Christian ethics, Netherlands, Civil society organizations,