Predictors of occupational sensitisation to grain dust allergens and changes in lung function among grain mill workers in Cape Town

Occupationally-related airway diseases, including asthma and chronic obstructive lung disease, have emerged as having substantial public health importance. The aim of this study was to identify the predictors of occupational sensitisation to grain dust allergens and changes in lung function among grain mill workers in Cape Town. There were two major objectives of the study. Firstly, to determine which of the following factors determine the distribution of serum ECP (eosinophilic cationic protein): age, gender, grain dust exposure, smoking status, atopy and sensitisation to workplace allergens. Secondly, to investigate the risk factors associated with the following outcomes: i) sensitisation to occupational allergens; ii) diagnosis of occupational asthma; iii) diagnosis of chronic obstructive airways disease; and iv) longitudinal changes in lung function. The risk factors studied included age, gender, smoking habits, occupational exposure, lung function status on baseline survey (1989), and allergic sensitisation assessed at follow up (1996). The methods employed involved a repeat measures cross-sectional design including a cohort followed up at different points over a seven year period. Survey instruments included a questionnaire, spirometry and allergy tests (phadiotop, RAST for wheat, rye, Lepidoglyphus destructor, Tyrophagus putrescentiae and Sitophilus granarius). The results indicated an association of grain dust with pulmonary function and allergic sensitisation to grain dust constituents. After adjusting for known confounders such as age, gender and smoking, significant associations were found between employment duration and both decrements in lung function and sensitisation to wheat grain. A decrement of 278 ml in FEY 1 and 328 ml in FYC was associated with occupational sensitisation to wheat (and rye). Increasing employment duration resulted in annual decrements of 18.3 ml in FEY1 and 23 ml in FYC for every year employed. The odds for developing occupational asthma was only mildly elevated (OR=l.35) with increasing employment duration. Age, however, was found to be protective (OR=0.85). Although we were unable to demonstrate a relationship between across-week changes in lung function, at inception, and rapid longitudinal lung function decline, our findings suggested that longitudinal change was related to the degree of airway obstruction at inception. Sensitisation to grain dust allergens was also found to be an independent predictor for FEY 1 and FYC. The prevalence of sensitisation was the highest for wheat (26.4%), followed by Tyrophagus putrescentiae (22.6%), rye (21.7%), Lepidoglyphus destructor (15.1 %) and Sitophilus granarius (15.1 %). Sensitisation to wheat was highly correlated with sensitisation to rye (r = 0.92) and so were Lepidoglyphus destructor and Tyrophagus putrescentiae (r = 0.85). Although a large proportion of the workforce ( 41.5 % ) were sensitised to occupational allergens, the prevalence of respiratory symptoms was between 15.6% and 23.9%. There were 16.7% of workers with health outcomes which fulfilled our criteria for occupational asthma. Atopic workers in our study had at least a nine-fold increased odds of becoming sensitised to grain dust allergens (OR: 8.9-74.7) and a two-fold increased odds of developing occupational asthma (OR= 1.9-84.9). Furthermore, the study found that smokers had a twofold increased odds of becoming atopic, thereby placing them at greater risk of developing respiratory health problems. The mean ECP in this population was 15.4 ug/1 (SD:2.5). Although 45.3% of the workers were atopic, it was not found to be predictor of elevated ECP levels. We were however able to demonstrate a significant association between ECP and sensitisation to grain allergens. Workers sensitised to wheat (positive RAST) had, on average, 1. 78 ug/1 higher ECP levels. The odds of having an elevated ECP (> 15 ug/1) increased by 2.9 for workers sensitised to wheat grain. In conclusion, the results of the study indicate that selection effects are in operation, demonstrating the health worker effect. The findings also suggest that across week reactions may be less sensitive than the across shift changes in predicting rapid longitudinal decline in lung function. While we were able to characterise the distribution of ECP according to exposure, we were however unable to define the temporal relationship between elevated between exposures, ECP and lung function outcomes due to limitations of the study design

Postgraduate Diploma in Occupational Health (DOH) - Module 3

Partly funded by Health OER Project (Hewlett Foundation)Chemistry bottles with liquid inside by zhouxuan12345678 shared under CC-BY-SA license.Designed to help teach doctors currently practising occupational health. The third module of a total of 8 modules for a two year part-time flexible distance learning course aimed primarily at medical doctors currently practising occupational health. It includes a residential block release component which consists of between 3 or 4 weeks over the two year cycle for practicum. While the course is aimed primarily at medical doctors currently practicing occupational health, it is also suited to selected graduates with appropriate University qualifications in relevant health sciences, as long as these individuals are currently practicing professionally in an occupational health setting. There are 8 modules (the two included here cover Occupational Hygiene and Epidemiology and Biostatistics). Each module has a theme around which the inputs are organised. Teaching inputs are intended to be non-didactic, and to allow student participation wherever possible. Candidates are expected to undertake substantial homework preparation and activities as well as self-directed learning. They will be expected to read widely and intensively around topics, and to provide teaching inputs themselves either directly or by way of specially structured interactive debates and role-play simulations. The content of these activities will include critical appraisal of the occupational health literature, project work, presentations by students as well as epidemiological, bio statistical, toxicological and occupational clinical assignments. Module 3 deals with basic occupational medicine and toxicology. Module 4 covers intermediate occupational medicine and toxicology, and Module 5 is advanced occupational medicine and toxicology

Розвиток поглядів про взаємозв'язок війни і миру, про «право народів» у елліністично-римській соціально-філософській думці

Античные мыслители лишь затронули вопрос об общем и вечном мире (в форме мечты, философского идеала идеального и гармонического государства), не находя способов примирения противоборствующих сторон, средств решения внутренних и внешних конфликтов.Античні мислителі лише порушили питання про загальний і вічний мир (у формі мрії, філософського ідеалу ідеальної і гармонічної держави), не знаходячи способів примирення протиборчих сторін, засобів вирішення внутрішніх і зовнішніх конфліктів

Health-Related Quality of Life (HRQoL) of Residents with Persistent Lower Respiratory Symptoms or Asthma Following a Sulphur Stockpile Fire Incident

Background: This study evaluated health-related quality of life (HRQoL) in residents with persistent lower respiratory symptoms (PLRS) or asthma six years after exposure to sulphur dioxide vapours emanating from an ignited sulphur stockpile. Methods:A cross-sectional study was carried out, using interview data collected at three time points (prior to, one- and six-years post incident), medical history, respiratory symptoms and HRQOL using the Medical Outcomes Study Form 36 (SF-36). Results: A total of 246 records, 74 with and 172 without PLRS or asthma, were analysed. The mean age was 42 (SD:12) years in the symptomatic group and 41 (SD:13) years in the asymptomatic group. Mean SF-36 scores were significantly lower for the symptomatic group in the Physical Functioning (24 vs. 39), Role—Physical (33 vs. 48) and General Health (GH) domains (24 vs. 37). Symptomatic residents experienced a significant decline in their Role—Physical (OR = 1.97; CI 1.09, 3.55) and GH (OR = 3.50; CI 1.39, 8.79) at year 6 compared to asymptomatic participants. Residents with co-morbid reactive upper airways dysfunction syndrome demonstrated stronger associations for GH (OR = 7.04; CI 1.61, 30.7) at year 1 and at year 6 (OR = 8.58; CI 1.10, 65.02). Conclusions:This study highlights the long-term adverse impact on HRQoL among residents with PLRS or asthma following a sulphur stockpile fire disaster

Allergenicity of latex rubber products used in South African dental schools

Background. Latex sensitisation is recognised as a health problem among health care workers (HCWs) using latex products. The aim of this study was to quantify specific latex allergens in latex devices used in South African academic dental schools. The current study also compared the total protein content and the levels of specific allergens in these products.Methods. Fourteen latex examination gloves (powdered and non-powdered) and five dental rubber dams, representing 6 brands, from five dental academic institutions were analysed for latex allergens and total protein. Total protein content was determined using the BioRad DC protein assay kit and natural rubber allergen levels using a capture enyme-linked immunosorbent assay (ELISA) specific for Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02.Results. Hev b 6.02 was found in higher concentrations thanother natural rubber latex (NRL) allergens in the products analysed. Hev b 5 content ranged from 0 to 9.2 ìg/g and Hev b 6.02 from 0.09 to 61.5 ìg/g of sample. Hev b 1 levels were below the detection limit (DL) for 79% of the samples (15/19). Dental dams showed higher allergen levels (median 80.91 ìg/ g) than latex gloves (median 11.34 ìg/g). Powdered rubber samples also showed higher allergen levels (median 40.54 ìg/g) than non-powdered samples (median 5.31 ìg/g). Astatistically significant correlation was observed between totalprotein and total allergen (r=0.74,

Relationship between serum omega-3 fatty acid and asthma endpoints

Recent studies have highlighted the potential protective role of omega-3 polyunsaturated fatty acids (n-3 PUFA) in asthma. This study aimed at determining the association between seafood intake, serum PUFA composition and clinical endpoints of asthma in adults. A cross-sectional study of 642 subjects used the European Committee Respiratory Health Survey (ECRHS) questionnaire, skin prick tests, spirometry and methacholine challenge tests following ATS guidelines. Sera was analysed for n-3 and n-6 PUFA composition. Subjects had a mean age of 34 years, were largely female (65%) and 51% were current smokers. While 99% reported fish consumption, rock lobster, mussels, squid and abalone were also consumed less frequently. The prevalence of asthma symptoms was 11%, current asthma (ECRHS definition) was 8% and non-specific bronchial hyperresponsiveness (NSBH) was much higher (26%) In adjusted models the n-3 PUFAs 20:5 (EPA) and 22:5 (DPA) were significantly associated with a decreased risk of having NSBH. Total n-3 PUFA composition was associated with decreased NSBH risk (OR = 0.92), while high n-6 PUFA composition was associated with an increased risk (OR = 1.14)

Characterization of Seafood Proteins Causing Allergic Diseases

[Extract] Food allergy is increasing at a faster rate than any other allergic disorder (Gupta et al., 2007). In the last few decades, a large movement toward healthier eating makes seafood one of the major foods consumed worldwide (Wild & Lehrer, 2005). Consequently, the international trade of seafood has been growing rapidly, which reflects the popularity and frequency of consumption worldwide. The United States has become the third largest consumer of seafood in the world, with 1.86 billion kg of crustaceans in 2007 (6.04 kg/capita/year)(Food and Agriculture Organisation, 2007). Since seafood ingestion can cause severe acute hypersensitivity reactions and is recognized as one of the most common food allergies, the increased production and consumption of seafood has resulted in more frequent health problems (Lopata & Lehrer, 2009; Lopata et al., 2010). Exposure to seafood can cause a variety of health problems, including gastrointestinal disorders, urticaria, immunoglobulin E (IgE)-mediated asthma and anaphylaxis (Bang et al., 2005; Lopata & Lehrer, 2009; Malo & Cartier, 1993; Sicherer et al., 2004; Wild & Lehrer, 2005)

Allergenicity of latex rubber products used in South African dental schools

Background: Allergens from latex products in healthcare settings have been known to trigger latex induced allergic reactions in healthcare workers (HCWs). There is a need to quantify individual latex allergens in products in order to assess the allergenicity of latex products used in health care settings, so as to minimize the risk of sensitisation to these proteins. Methods: Fourteen latex examination gloves representing six brands (powdered and non-powdered) and five dental rubber dams from five dental academic institutions were analysed for latex allergens and total protein. Total protein content was determined using the BIORAD DC protein assay kit and natural rubber allergen levels using a capture ELISA assay specific for hev b 1, hev b 3, hev b 5 and hev b 6.02. Results: Hev b 6.02 was found in higher concentrations than other NRL allergens in the products analysed. Hev b 5 content ranged from 0 to 9.2µg/g and hev b 6.02 from 0.09 to 61.5µg/g of sample. Hev b 1 levels were below the detection limit (DL) for 79% of the samples (15/19). Dental dams showed higher allergen levels (median: 80.91µg/g) in comparison to latex gloves (median: 11.34µg/g). Powdered rubber samples also showed higher allergen levels (median: 40.54µg/g) compared to non-powdered samples (median: 5.31µg/g). A statistically significant correlation was observed between total protein and total allergen (r=0.74, p<0.001) concentrations. Conclusion Natural rubber latex (NRL) allergen concentrations differ significantly by product and brand. This study has demonstrated that NRL allergens in latex containing products used in South African dental institutions are present at sufficiently high levels to pose an allergic health risk

Occupational allergy and asthma among salt water fish processing workers

Background Fish processing is a common economic activity in Southern Africa. The aim of this study was to determine the prevalence and host determinants of allergic symptoms, allergic sensitization, bronchial hyper-responsiveness and asthma among workers processing saltwater fish. Methods A cross-sectional study was conducted on 594 currently employed workers in two processing plants involved in pilchard canning and fishmeal processing. A modified European Community Respiratory Health Survey (ECRHS) questionnaire was used. Skin prick tests (SPT) used extracts of common airborne allergens, fresh fish (pilchard, anchovy, maasbanker, mackerel, red eye) and fishmeal. Spirometry and methacholine challenge tests (MCTs; tidal breathing method) used ATS guidelines. Results Work-related ocular-nasal symptoms (26%) were more common than asthma symptoms (16%). The prevalence of atopy was 36%, while 7% were sensitized to fish species and 26% had NSBH (PC 20  ≤ 8 mg/ml or ≥12% increase in FEV 1 post-bronchodilator). The prevalence of probable occupational asthma was 1.8% and fish allergic rhino-conjunctivitis 2.6%. Women were more likely to report work-related asthma symptoms (OR = 1.94) and have NSBH (OR = 3.09), while men were more likely to be sensitized to fish (OR = 2.06) and have airway obstruction (OR = 4.17). Atopy (OR = 3.16) and current smoking (OR = 2.37), but not habitual seafood consumption were associated with sensitization to fish. Conclusions Based on comparison with previous published studies, the prevalence of occupational asthma to salt water fish is lower than due to shellfish. The gendered distribution of work and exposures in fish processing operations together with atopy and cigarette smoking are important determinants of occupational allergy and asthma. Am. J. Ind. Med. 51:899–910, 2008. © 2008 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/61335/1/20635_ftp.pd

Allergic Disorders in Africa and Africans: Is it Primarily a Priority?

In Africa, the burden of some diseases has been a problem for centuries. The spectrum of African diseases includes allergies, infections, nutritional deficiencies, and natural disasters. Efforts made by scientists to search for possible means of disease control have been outstanding; however, in some infections, solutions are still out of reach. In disease control programs, it might be worthwhile to pay attention to the most striking diseases than merely follow a holistic approach. This short review tackles the problems of allergy and allergens in Africa as compared with other disease burdens that may suggest the need for a more balanced approach based on priority