Background Recent studies have shown that airborne latex allergens cause allergic rhinitis and br... more Background Recent studies have shown that airborne latex allergens cause allergic rhinitis and bronchial asthma. Objective The aim of this study was to investigate the association between the development of rhinitis reactions during workplace-related inhalative challenge tests and nasal allergic in¯ammation. Methods Thirty-two health care workers (HCWs) with suspected respiratory hypersensitivity to latex allergens underwent an inhalative workplace-related challenge test with powdered latex gloves. Nasal lavage¯uid (NALF) and nasal brushing (NAB) material were collected before and after exposure (30 min, 2, 6 and 24 h) to determine mediator and cellular composition. In addition, lung function parameters and nasal¯ow were recorded. Furthermore, six healthy controls underwent nasal brushing and nasal lavage without latex allergen challenge at the same time intervals. Results Twenty-six HCWs showed acute rhinitis by contact to airborne latex allergen exposure and 10 of them had an additional asthma response. Only in responders, signi®cantly increased eosinophil levels were found 6 h (P < 0.00001) and 24 h (P < 0.0005) post-challenge when compared with the prechallenge values. The ECP levels measured 2, 6 and 24 h post-challenge in the responder group were signi®cantly elevated when compared with the prechallenge values as well as with the non-responders (6 h: P < 0.05, 24 h: P < 0.00001 afterwards). Only in some concentrated NALF samples of responders collected 30 min post-challenge (seven out of 15) tryptase concentration above the detection limit were found. The NO derivative concentrations in NALF were sig-ni®cantly increased 6 h post-challenge compared with the prechallenge values (P < 0.05) and were signi®cantly higher in responders than in non-responders and in controls (P < 0.002). IL-5 levels increased post-challenge in the responder group with a pronounced effect 6 h after challenge (P < 0.001). Overall, a variety of parameters was signi®cantly correlated (e.g. ECP with NO derivatives, r 0.792 P < 0.002). Conclusions Our data demonstrate for the ®rst time that nasal and bronchial hyperreactivity to airborne latex allergens are associated with an increase of eosinophils and mediators (e.g. ECP, NO derivatives, IL-5, tryptase) in nasal mucosa. The combined use of NAB (for cells) and NALF (for mediators) appears to be a useful model to monitor nasal in¯ammation during workplace-related challenge tests.
Background Welding, performed regularly by more than a million workers worldwide, is associated w... more Background Welding, performed regularly by more than a million workers worldwide, is associated with exposures to irritative, fibrogenic and carcinogenic fumes and gases. Methods and Results We present the case of a welder who had worked under extremely poor hygiene conditions for nearly 20 years and had developed end-stage lung fibrosis, finally requiring lung transplantation. Detailed histopathology and scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) analyses of his lungs showed advanced interstitial fibrosis and dust deposits in the lungs and in peribronchial lymph nodes containing welding type bodies, Fe, Si (silica), Ti (titanium), SiAl (aluminum silicates), Fe with Cr (Steel), and Zr (Zirkonium). Conclusion In the absence of a systemic disorder and the failure to meet the criteria for diagnosis of idiopathic pulmonary fibrosis (IPF), these findings suggest welder’s lung fibrosis as the most likely diagnosis.
Material and Methods The study population includes the total Danish working population of 5,478,6... more Material and Methods The study population includes the total Danish working population of 5,478,664 workers, followed 1979-2015. Annual individual exposure to respirable crystalline silica was estimated using a quantitative job exposure matrix. Cases of ILD were identified in the National Patient Register. We conducted adjusted analyses of exposure-response relations between cumulative silica exposure and different types of ILD. Register studies in Denmark without biological materials do not need approval from the National Committee of Health Research Ethics. This study is approved by the Danish Data Protection Agency. Results The risk of silicosis increased with increasing cumulative exposure with an incidence rate ratio (IRR) of 3.07 (95% confidence interval (CI) 2.40-3.93) in the highest exposure group (the highest tertile among the silica exposed) compared to the non-exposed group. The risk of other pneumoconioses was also increased with an IRR of 1.18 (95% CI 1.05-1.33) for the highest exposed compared to the non-exposed. For idiopathic ILD, ILD associated with connective tissue disease and other ILD the risks were increased in the highest exposure group compared to the non-exposed, but the analyses did not show clear exposure-response patterns. Conclusion This study confirms an exposure response relation for occupational silica exposure and silicosis and indicates increased risks for other types of ILD. This warrants further examination of the specific risk patterns for different types of ILD.
Background Welding which as performed regularly by more than a million workers worldwide is assoc... more Background Welding which as performed regularly by more than a million workers worldwide is associated with exposures to irritative, fibrogenic and carcinogenic fumes and gases. Methods and Results We present the case of a welder who had worked under extremely poor hygiene conditions for nearly 20 years and had developed end-stage lung fibrosis, finally requiring lung transplantation. Detailed histopathology and Scanning Electron Microscopy/Energy dispersive x-ray spectroscopy (SEM/EDS) analysis of his lungs showed advanced interstitial fibrosis and dust deposits in the lungs and in peribronchial lymph nodes containing welding type bodies, Fe, Si (silica), Ti (titanium), SiAl (aluminum silicates), Fe with Cr (Steel), Zr (Zirkonium). Conclusion Due to these severe findings, the absence of a systemic disorder and the failure to meet the criteria for diagnosis of idiopathic pulmonary fibrosis (IPF), the most likely diagnosis of this case is welder’s lung fibrosis.
Die gesetzlichen Rahmenbedingungen des Gesundheitsschutzes bei der Arbeit werden heute auf EU-Ebe... more Die gesetzlichen Rahmenbedingungen des Gesundheitsschutzes bei der Arbeit werden heute auf EU-Ebene festgelegt. Die Konkretisierung erfolgt in nationalen Gesetzen und einer Reihe nachgeordneter Regularien. Verantwortung tragen insbesondere der Arbeitgeber und die gesetzliche Unfallversicherung (Berufsgenossenschaften).
Mit der Atemluft werden partikulare und tropfchenformige Fremdstoffe inhalativ aufgenommen. Ihre ... more Mit der Atemluft werden partikulare und tropfchenformige Fremdstoffe inhalativ aufgenommen. Ihre Deponierbarkeit innerhalb des Atemtrakts ist abhangig von deren aerodynamischen Durchmesser und Loslichkeit sowie von der Atemtiefe und dem Atemminutenvolumen. Nanopartikel werden grosteils systemisch wirksam.
Hierzu gehort nur das Augenzittern der Bergleute (BK Nr. 6101). Die Erkrankung, bedingt durch lan... more Hierzu gehort nur das Augenzittern der Bergleute (BK Nr. 6101). Die Erkrankung, bedingt durch langjahrige Untertage- Tatigkeit bei schlechten Lichtverhaltnissen, wird seit Jahrzehnten in Deutschland nicht mehr beobachtet.
Um Sicherheit und Gesundheit der Beschaftigten bei der Arbeit zu erhalten und zu verbessern sowie... more Um Sicherheit und Gesundheit der Beschaftigten bei der Arbeit zu erhalten und zu verbessern sowie Arbeit menschengerecht zu gestalten, ist eine Analyse und Bewertung der Chancen und Risiken, die in den betrieblichen Arbeitsbedingungen enthalten sein konnen, eine wichtige Voraussetzung.
Nach den Feinstaeuben rueckt aufgrund der aktuellen EU-Grenzwerte fuer 2010 ein weiterer Luftscha... more Nach den Feinstaeuben rueckt aufgrund der aktuellen EU-Grenzwerte fuer 2010 ein weiterer Luftschadstoff in den Interessenmittelpunkt. Es handelt sich dabei um NO2, fuer das zukuenftig ein Jahresmittelwert von 40 Mikrogramm/m3 Luft und ein 1-Stundenwert von 200 Mikrogramm/m3 Luft einzuhalten ist. Diese EU-Grenzwerte stehen in guter Uebereinstimmung mit den Empfehlungen einer wissenschaftlichen Arbeitsgruppe der Weltgesundheitsorganisation (WHO) zum Schutz der menschlichen Gesundheit. Das Wissen um gesundheitliche Wirkungen von NO2 im Niedrigdosisbereich ist trotz jahrzehntelanger Forschung nach wie vor begrenzt. Ausloeser fuer die hier vorgestellte umfangreiche Qualitaetsbewertung der verfuegbaren Literatur war die Empfehlung einer Arbeitsgruppe in der Kommission Reinhaltung der Luft beim Verein Deutscher Ingenieure (VDI), die WHO Grenzwerte nochmals deutlich abzusenken. Da davon auszugehen ist, dass beide Arbeitsgruppen sich nur auf die Bewertung der international verfuegbaren Daten...
Malignant mesothelioma (MM) is one of the most aggressive cancers with the poorest of outcomes. T... more Malignant mesothelioma (MM) is one of the most aggressive cancers with the poorest of outcomes. There is no doubt that mesothelioma in males is related to asbestos exposure, but some authors suggest that most of the cases diagnosed in females are “idiopathic.” In our assessment of the science, the “low risk” of mesothelioma in females is because of the nonsystematic recording of exposure histories among females. Indeed, asbestos exposure is mentioned in only some of the studies that include females. We estimate the risk of MM among females to be close to that in males. The absence of detailed exposure histories should be rectified in future studies involving women. As a matter of social justice, the ongoing failure to recognize asbestos as the cause of a majority of cases of MM in females does them, and their kin, a profound disservice.
Verhandlungen der Deutschen Gesellschaft für innere Medizin, 1979
Papain (MW 23 000) ist eine aus der sudamerikanischen Frucht Carica papaya isolierte Sulphydrylpr... more Papain (MW 23 000) ist eine aus der sudamerikanischen Frucht Carica papaya isolierte Sulphydrylprotease mit einer breiten Substratspezifitat. Bromelin (MW 32 000) stellt ein Gemisch sehr ahnlicher Sulphydrylproteasen der Ananasfrucht und -strunke dar.
Manuscripts, figures and tables published in Tuberculosis and Thorax may not be reproduced, archi... more Manuscripts, figures and tables published in Tuberculosis and Thorax may not be reproduced, archieved in a retrieval system, or used for advertising purposes without a prior written permission from Turkish Association of Tuberculosis and Thorax. Quotations may be used in scientific articles with proper referral. The responsibilities of the content of the advertisements published belong to the related company.
Background Recent studies have shown that airborne latex allergens cause allergic rhinitis and br... more Background Recent studies have shown that airborne latex allergens cause allergic rhinitis and bronchial asthma. Objective The aim of this study was to investigate the association between the development of rhinitis reactions during workplace-related inhalative challenge tests and nasal allergic in¯ammation. Methods Thirty-two health care workers (HCWs) with suspected respiratory hypersensitivity to latex allergens underwent an inhalative workplace-related challenge test with powdered latex gloves. Nasal lavage¯uid (NALF) and nasal brushing (NAB) material were collected before and after exposure (30 min, 2, 6 and 24 h) to determine mediator and cellular composition. In addition, lung function parameters and nasal¯ow were recorded. Furthermore, six healthy controls underwent nasal brushing and nasal lavage without latex allergen challenge at the same time intervals. Results Twenty-six HCWs showed acute rhinitis by contact to airborne latex allergen exposure and 10 of them had an additional asthma response. Only in responders, signi®cantly increased eosinophil levels were found 6 h (P < 0.00001) and 24 h (P < 0.0005) post-challenge when compared with the prechallenge values. The ECP levels measured 2, 6 and 24 h post-challenge in the responder group were signi®cantly elevated when compared with the prechallenge values as well as with the non-responders (6 h: P < 0.05, 24 h: P < 0.00001 afterwards). Only in some concentrated NALF samples of responders collected 30 min post-challenge (seven out of 15) tryptase concentration above the detection limit were found. The NO derivative concentrations in NALF were sig-ni®cantly increased 6 h post-challenge compared with the prechallenge values (P < 0.05) and were signi®cantly higher in responders than in non-responders and in controls (P < 0.002). IL-5 levels increased post-challenge in the responder group with a pronounced effect 6 h after challenge (P < 0.001). Overall, a variety of parameters was signi®cantly correlated (e.g. ECP with NO derivatives, r 0.792 P < 0.002). Conclusions Our data demonstrate for the ®rst time that nasal and bronchial hyperreactivity to airborne latex allergens are associated with an increase of eosinophils and mediators (e.g. ECP, NO derivatives, IL-5, tryptase) in nasal mucosa. The combined use of NAB (for cells) and NALF (for mediators) appears to be a useful model to monitor nasal in¯ammation during workplace-related challenge tests.
Background Welding, performed regularly by more than a million workers worldwide, is associated w... more Background Welding, performed regularly by more than a million workers worldwide, is associated with exposures to irritative, fibrogenic and carcinogenic fumes and gases. Methods and Results We present the case of a welder who had worked under extremely poor hygiene conditions for nearly 20 years and had developed end-stage lung fibrosis, finally requiring lung transplantation. Detailed histopathology and scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) analyses of his lungs showed advanced interstitial fibrosis and dust deposits in the lungs and in peribronchial lymph nodes containing welding type bodies, Fe, Si (silica), Ti (titanium), SiAl (aluminum silicates), Fe with Cr (Steel), and Zr (Zirkonium). Conclusion In the absence of a systemic disorder and the failure to meet the criteria for diagnosis of idiopathic pulmonary fibrosis (IPF), these findings suggest welder’s lung fibrosis as the most likely diagnosis.
Material and Methods The study population includes the total Danish working population of 5,478,6... more Material and Methods The study population includes the total Danish working population of 5,478,664 workers, followed 1979-2015. Annual individual exposure to respirable crystalline silica was estimated using a quantitative job exposure matrix. Cases of ILD were identified in the National Patient Register. We conducted adjusted analyses of exposure-response relations between cumulative silica exposure and different types of ILD. Register studies in Denmark without biological materials do not need approval from the National Committee of Health Research Ethics. This study is approved by the Danish Data Protection Agency. Results The risk of silicosis increased with increasing cumulative exposure with an incidence rate ratio (IRR) of 3.07 (95% confidence interval (CI) 2.40-3.93) in the highest exposure group (the highest tertile among the silica exposed) compared to the non-exposed group. The risk of other pneumoconioses was also increased with an IRR of 1.18 (95% CI 1.05-1.33) for the highest exposed compared to the non-exposed. For idiopathic ILD, ILD associated with connective tissue disease and other ILD the risks were increased in the highest exposure group compared to the non-exposed, but the analyses did not show clear exposure-response patterns. Conclusion This study confirms an exposure response relation for occupational silica exposure and silicosis and indicates increased risks for other types of ILD. This warrants further examination of the specific risk patterns for different types of ILD.
Background Welding which as performed regularly by more than a million workers worldwide is assoc... more Background Welding which as performed regularly by more than a million workers worldwide is associated with exposures to irritative, fibrogenic and carcinogenic fumes and gases. Methods and Results We present the case of a welder who had worked under extremely poor hygiene conditions for nearly 20 years and had developed end-stage lung fibrosis, finally requiring lung transplantation. Detailed histopathology and Scanning Electron Microscopy/Energy dispersive x-ray spectroscopy (SEM/EDS) analysis of his lungs showed advanced interstitial fibrosis and dust deposits in the lungs and in peribronchial lymph nodes containing welding type bodies, Fe, Si (silica), Ti (titanium), SiAl (aluminum silicates), Fe with Cr (Steel), Zr (Zirkonium). Conclusion Due to these severe findings, the absence of a systemic disorder and the failure to meet the criteria for diagnosis of idiopathic pulmonary fibrosis (IPF), the most likely diagnosis of this case is welder’s lung fibrosis.
Die gesetzlichen Rahmenbedingungen des Gesundheitsschutzes bei der Arbeit werden heute auf EU-Ebe... more Die gesetzlichen Rahmenbedingungen des Gesundheitsschutzes bei der Arbeit werden heute auf EU-Ebene festgelegt. Die Konkretisierung erfolgt in nationalen Gesetzen und einer Reihe nachgeordneter Regularien. Verantwortung tragen insbesondere der Arbeitgeber und die gesetzliche Unfallversicherung (Berufsgenossenschaften).
Mit der Atemluft werden partikulare und tropfchenformige Fremdstoffe inhalativ aufgenommen. Ihre ... more Mit der Atemluft werden partikulare und tropfchenformige Fremdstoffe inhalativ aufgenommen. Ihre Deponierbarkeit innerhalb des Atemtrakts ist abhangig von deren aerodynamischen Durchmesser und Loslichkeit sowie von der Atemtiefe und dem Atemminutenvolumen. Nanopartikel werden grosteils systemisch wirksam.
Hierzu gehort nur das Augenzittern der Bergleute (BK Nr. 6101). Die Erkrankung, bedingt durch lan... more Hierzu gehort nur das Augenzittern der Bergleute (BK Nr. 6101). Die Erkrankung, bedingt durch langjahrige Untertage- Tatigkeit bei schlechten Lichtverhaltnissen, wird seit Jahrzehnten in Deutschland nicht mehr beobachtet.
Um Sicherheit und Gesundheit der Beschaftigten bei der Arbeit zu erhalten und zu verbessern sowie... more Um Sicherheit und Gesundheit der Beschaftigten bei der Arbeit zu erhalten und zu verbessern sowie Arbeit menschengerecht zu gestalten, ist eine Analyse und Bewertung der Chancen und Risiken, die in den betrieblichen Arbeitsbedingungen enthalten sein konnen, eine wichtige Voraussetzung.
Nach den Feinstaeuben rueckt aufgrund der aktuellen EU-Grenzwerte fuer 2010 ein weiterer Luftscha... more Nach den Feinstaeuben rueckt aufgrund der aktuellen EU-Grenzwerte fuer 2010 ein weiterer Luftschadstoff in den Interessenmittelpunkt. Es handelt sich dabei um NO2, fuer das zukuenftig ein Jahresmittelwert von 40 Mikrogramm/m3 Luft und ein 1-Stundenwert von 200 Mikrogramm/m3 Luft einzuhalten ist. Diese EU-Grenzwerte stehen in guter Uebereinstimmung mit den Empfehlungen einer wissenschaftlichen Arbeitsgruppe der Weltgesundheitsorganisation (WHO) zum Schutz der menschlichen Gesundheit. Das Wissen um gesundheitliche Wirkungen von NO2 im Niedrigdosisbereich ist trotz jahrzehntelanger Forschung nach wie vor begrenzt. Ausloeser fuer die hier vorgestellte umfangreiche Qualitaetsbewertung der verfuegbaren Literatur war die Empfehlung einer Arbeitsgruppe in der Kommission Reinhaltung der Luft beim Verein Deutscher Ingenieure (VDI), die WHO Grenzwerte nochmals deutlich abzusenken. Da davon auszugehen ist, dass beide Arbeitsgruppen sich nur auf die Bewertung der international verfuegbaren Daten...
Malignant mesothelioma (MM) is one of the most aggressive cancers with the poorest of outcomes. T... more Malignant mesothelioma (MM) is one of the most aggressive cancers with the poorest of outcomes. There is no doubt that mesothelioma in males is related to asbestos exposure, but some authors suggest that most of the cases diagnosed in females are “idiopathic.” In our assessment of the science, the “low risk” of mesothelioma in females is because of the nonsystematic recording of exposure histories among females. Indeed, asbestos exposure is mentioned in only some of the studies that include females. We estimate the risk of MM among females to be close to that in males. The absence of detailed exposure histories should be rectified in future studies involving women. As a matter of social justice, the ongoing failure to recognize asbestos as the cause of a majority of cases of MM in females does them, and their kin, a profound disservice.
Verhandlungen der Deutschen Gesellschaft für innere Medizin, 1979
Papain (MW 23 000) ist eine aus der sudamerikanischen Frucht Carica papaya isolierte Sulphydrylpr... more Papain (MW 23 000) ist eine aus der sudamerikanischen Frucht Carica papaya isolierte Sulphydrylprotease mit einer breiten Substratspezifitat. Bromelin (MW 32 000) stellt ein Gemisch sehr ahnlicher Sulphydrylproteasen der Ananasfrucht und -strunke dar.
Manuscripts, figures and tables published in Tuberculosis and Thorax may not be reproduced, archi... more Manuscripts, figures and tables published in Tuberculosis and Thorax may not be reproduced, archieved in a retrieval system, or used for advertising purposes without a prior written permission from Turkish Association of Tuberculosis and Thorax. Quotations may be used in scientific articles with proper referral. The responsibilities of the content of the advertisements published belong to the related company.
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