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  • Allergy, asthma, Respiratory, Other exposures  (3)
  • Respiratory, Other exposures  (2)
  • 2010-2014  (5)
  • 1
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    Lactate dehydrogenase as a biomarker for silica exposure-induced toxicity in agate workers (2014)
    BMJ Publishing Group
    Details
    Publication Date: 2014-07-11
    Description: Objectives Agate workers are chronically exposed to silica dust generated from agate grinding, which makes them susceptible to silicosis. In the absence of diagnosis at an early stage, the workers continue to be exposed to silica dust until the development of silicosis. The present study was undertaken to investigate total lactate dehydrogenase (LDH) activity in blood samples of silica-exposed agate workers as a non-invasive way to measure silica-induced toxicity. Methods Blood samples were collected from agate workers and control subjects. Total LDH activity was measured in the blood plasma and blood cells of agate workers and non-exposed (control) subjects using sodium pyruvate as a substrate. The reduction of pyruvate to L-lactate with the concurrent oxidation of nicotinamide adenine dinucleotide (NADH) during the assay was monitored by change in absorbance (or optical density (OD)) at 340 nm at the fixed interval of 10 min. The ratio of LDH activity (blood plasma/blood cells) in the blood samples was calculated as a measure to detect cytotoxicity in exposed workers. Results The LDH activity in blood plasma samples of exposed workers was found to increase about 25 times, while the activity in the blood cells of silica-exposed agate workers was reduced to 10% of control subjects. The ratio of LDH activity (blood plasma/cells) was found to be 6.6 in the silica-exposed agate workers, while it was 0.02 in control (non-exposed) subjects. Conclusions This study proposes that total LDH activity and the LDH ratio (plasma/cells), along with occupational exposure history, are markers for silica exposure-induced toxicity in agate workers.
    Keywords: Respiratory, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
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    Work related asthma. A causal analysis controlling the healthy worker effect (2013)
    BMJ Publishing Group
    Details
    Publication Date: 2013-08-09
    Description: Objectives The healthy worker effect usually leads to underestimation of the association between occupational exposure and asthma. The role of irritants in work-related asthma is disputed. We estimated the effect of occupational exposure on asthma expression in a longitudinal study, using marginal structural modelling to control for the healthy worker effect. Methods Analyses included 1284 participants (17–79 years, 48% men) from the follow-up (2003–2007) of the French Epidemiological study on the Genetics and Environment of Asthma (case-control study). Age at asthma onset, periods with/without attacks over lifetime and occupational history were recorded retrospectively. Exposures to known asthmagens, irritants or low level of chemicals/allergens were evaluated through a job-exposure matrix. The job history was reconstructed into 5-year intervals. Results Thirty-one per cent of subjects had ever been exposed to occupational asthmagens. Among the 38% of subjects who had asthma (ever), presence of attacks was reported in 52% of all time periods. Using standard analyses, no association was observed between exposure to known asthmagens (OR (95% CI): 0.99 (0.72 to 1.36)) or to irritants/low level of chemicals/allergens (0.82 (0.56 to 1.20)) and asthma attacks. Using a marginal structural model, all associations increased with suggestive evidence for known asthmagens (1.26 (0.90 to 1.76)), and reaching statistical significance for irritants/low level of chemicals/allergens (1.56 (1.02 to 2.40)). Conclusions The healthy worker effect has an important impact in risk assessment in work-related asthma studies. Marginal structural models are useful to eliminate imbalances in exposure due to disease-driven selection. Results support the role of irritants in work-related asthma.
    Keywords: Allergy, asthma, Respiratory, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
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    Assessing the impact of national level interventions on workplace respiratory disease in the UK: part 1--changes in workplace exposure legislation and market forces (2013)
    BMJ Publishing Group
    Details
    Publication Date: 2013-06-11
    Description: Objective The 2004 amendment to the Control of Substances Hazardous to Health 2002 regulations (COSHH 2004) introducing workplace exposure limits (WELs) was enacted in the UK in 2005. This study aimed to determine whether introducing this legislation coincided with a reduction in the incidence of work-related short latency respiratory disease (SLRD) attributed to the agents with a WEL. The second objective was to determine whether changes in legislation, WELs and market forces coincided with a reduction in the incidence of SLRD attributed to glutaraldehyde and latex. Method Reports of SLRD made to the Surveillance of Work-related and Occupational Respiratory Disease scheme were used to estimate the change in incidence within reporters between two time periods (interrupted time series design) using a longitudinal, negative binomial regression model with β distributed random effects. A statistical interaction term was included in the model to make comparisons between the groups defined by suspected causal agent and/or occupation, essentially comparing two interrupted time series. Time periods were defined prospectively representing the changes in legislation or market forces. Results The introduction of the COSHH 2004 legislation in the UK coincided with a significant reduction in reports of SLRD attributed to agents with a WEL relative to those without a WEL (ratio of incidence rate ratios: 0.70; 95% CI 0.52 to 0.93) and a significant reduction in SLRD attributed to glutaraldehyde in healthcare workers (0.20; 0.07 to 0.57) and latex in all workers (0.37; 0.16 to 0.85). Conclusions These data are consistent with a beneficial effect of legislation aiming to reduce workplace exposures.
    Keywords: Respiratory, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
    Location Call Number Limitation Availability
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  • 4
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    Occupational risk factors associated with work-exacerbated asthma in Quebec (2012)
    BMJ Publishing Group
    Details
    Publication Date: 2012-11-15
    Description: Background There is limited information regarding the occupational exposures of subjects with a diagnosis of work-exacerbated asthma (WEA). Objectives To: (1) identify potential specific occupational, chemical, biological and physical agents associated with incident cases of WEA and (2) compare these agents with occupational exposures of occupational asthma (OA) and non-work-related asthma (NWRA) cases. Methods Subjects were workers with work-related asthma (WRA) or NWRA referred between 2005 and 2008 to two Quebec clinics specialised in the field of WRA. Specific inhalation challenges were performed to differentiate OA from WEA. Work exposures were assessed using a detailed occupational questionnaire. Exposures to 41 chemical and biological agents were coded in a semiquantitative way according to a combination of indices for concentration in workplace air, frequency and confidence of exposure by an occupational hygienist expert in occupational exposure coding. This expert was blind to the medical status of WEA, OA or NWRA. Five physical agents were coded on a yes/no scale. Results 153 subjects were enrolled (53 WEA, 67 OA and 33 NWRA). WEA cases were significantly more exposed to ammonia, engine exhaust fumes, silica, mineral fibres, aerosol propellants and solvents, and significantly less exposed to animal derived dust and enzymes than were OA cases. Exposure to physical conditions did not differ between WEA and OA. Conclusions Exposures associated with WEA differ from those associated with OA in this study. A proportion of subjects with WEA may suffer from low-dose irritant asthma, which remains a hypothesis to be tested.
    Keywords: Allergy, asthma, Respiratory, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 5
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    Occupational exposure to cleaning products and asthma in hospital workers (2012)
    BMJ Publishing Group
    Details
    Publication Date: 2012-11-15
    Description: Objective Cleaning products may cause work-related asthma, but information regarding the specific exposures involved is scarce. We aimed to determine the associations between asthma and occupational exposure to cleaning agents in hospital workers. Methods Analyses were conducted in 179 (136 women) hospital workers and a reference population of 545 subjects (18–79 years) from the French case-control and familial Epidemiological study on the Genetics and Environment of Asthma (2003–2007). Exposures to cleaning agents were estimated using three methods: self-report, expert assessment and an asthma-specific job-exposure matrix (JEM). Associations between cleaning products and current asthma were evaluated by logistic regressions, stratified by sex and adjusted for age and smoking status. Results According to expert assessment, 55% of male and 81% of female hospital workers were exposed to cleaning/disinfecting tasks weekly (p〈0.001). No association was observed between cleaning/disinfecting tasks and current asthma in men or in women whatever the assessment method used. In women, exposure to decalcifiers (expert assessment) was associated with current asthma (OR (95% CI):2.38 (1.06 to 5.33)). In hospital workers classified as exposed according to both the expert assessment and the JEM, additional associations were observed for exposure to ammonia (3.05 (1.19 to 7.82)) and to sprays with moderate/high intensity (2.87 (1.02 to 8.11)). Conclusions Female hospital workers are often exposed to numerous cleaning products, some of which were markedly associated with current asthma. Low numbers prevented a meaningful analysis in men. Objective and more accurate estimates of occupational exposure to cleaning products are needed to better understand the adverse effects of cleaning products.
    Keywords: Allergy, asthma, Respiratory, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
    Location Call Number Limitation Availability
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    PAPER CURRENT
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