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Biomedical subjects

A M Fletcher

Publications and source records attributed to A M Fletcher.

At least 37 records · Page 2Linked to original sources
PubMed1998

A comparison of performance of two personal sampling heads for cotton dust.

Cotton dust sampling for monitoring worker exposure was traditionally performed by work area sampling. A change to an exposure limit based on personal sampling has recently been agreed. The choice of sampling head for personal monitoring exposure was hampered by the use of two different sampling heads in the major epidemiological studies of textile workers which had incorporated personal sampling techniques. The purpose of this study was to compare the results of exposure measurements using these two sampling heads. This study has examined the performance of the two sampling heads, by performing dual sampling on cotton operatives during normal working activities. Each operative included wore two samplers randomly allocated to left or right side. A minimum of 200 minutes of sampling was accepted and the relative concentrations calculated. The IOM total dust sampler produced repeatedly higher measurements than the Manchester head. The ratio overall was 1.33 (95% C.I. 1.20-1.49). The performance was similar across the ranges of dust exposure from low (< 1 mg/m3-ratio 1.28), medium (1-3 mg/m3-ratio 1.43) to high exposure (> 3 mg/m3-ratio 1.24). The two heads give reproducibly proportionate dust measurements with approximately 30% greater results obtained with the IOM total dust sampler. Either dust sampling head could be used for worker monitoring and the results adjusted accordingly for reference to the Maximum Exposure Limit.

Dust↗
PubMed1998

Prevalence and predictors of work related respiratory symptoms in workers exposed to organic dusts.

OBJECTIVES: The aims of this study were to document the prevalence of work related upper and lower respiratory tract symptoms in workers exposed to organic dusts and to identify variables predictive of their occurrence. METHODS: A cross sectional survey with an administered questionnaire (a previously validated adaptation of the Medical Research Council (MRC) respiratory questionnaire) was performed. Symptoms were classified as work related by their periodicity. Demographic data, smoking habits, and occupational histories were recorded. Personal exposures to dust and endotoxin were measured and individual subjects ascribed an exposure value specific to occupation, site and industry. Cox's regression techniques were used to identify variables predictive of work related upper and lower respiratory tract symptoms. Information was stored using Dbase 3 and analysed with SPSS. RESULTS: 1032 Workers (93% of the target population) were studied in nine different industries. The highest prevalences of work related lower respiratory tract symptoms (38.1%), upper respiratory tract symptoms (45.2%), and chronic bronchitis (15.5%) were found among poultry handlers. White workers were significantly more likely to complain of upper and lower respiratory tract symptoms. An individual in the swine confinement industry had a symptom complex compatible with byssinosis. Increasing current personal exposures to dust or endotoxin were found to be predictive of upper and lower respiratory tract symptoms, chronic bronchitis, and byssinosis. In a univariate analysis a relation between current exposures and the organic dust toxic syndrome was found. Present smoking and previously documented respiratory tract illness were significantly predictive of work related lower respiratory tract symptoms. Women were more likely to report work related upper respiratory tract symptoms. CONCLUSIONS: People exposed to organic dusts may have a high prevalence of work related respiratory tract symptoms which are related to dust exposures and smoking habits. Action should be taken to reduce exposures to dust and endotoxin and stopping smoking should be promoted among workers exposed to organic dusts to reduce morbidity.

Adult↗
PubMed1997

Chronic bronchitis in textile workers.

BACKGROUND: Exposure to cotton is known to produce a specific occupational disease known as byssinosis. A large population of textile workers was investigated to determine whether such exposure was also associated with chronic bronchitis once other possible aetiological factors had been accounted for. METHODS: A total of 2991 workers were investigated for the presence of symptoms compatible with chronic bronchitis. An MRC adapted respiratory questionnaire and MRC definition of chronic bronchitis were used for diagnostic labelling. Current and lifetime exposure to dust was estimated by personal and work area sampling, and the use of records of retrospective dust levels previously measured over the preceding 10 years. Airborne endotoxin exposure was measured using a quantitative turbidometric assay. Lung function tests were performed to measure forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). A control group of workers exposed to man-made fibre textiles was identified. The comparative prevalence of chronic bronchitis in the two populations was assessed, allowing for sex, age, smoking habit, and ethnic origin. Two case referent studies were also performed; cases of chronic bronchitis were separately matched with controls from the cotton and control populations to determine the effect of the symptomatic state on lung function. RESULTS: After controlling for smoking (pack years), workers in a cotton environment were significantly more likely to suffer from chronic bronchitis and this was most marked in workers over 45 years of age (odds ratio 2.51 (CI 1.3 to 4.9); p < 0.01). Regression analysis of all possible influencing parameters showed that cumulative exposure to cotton dust was significantly associated with chronic bronchitis after the effects of age, sex, smoking, and ethnic group were accounted for (p < 0.0005). In the intra-cotton population case control study a diagnosis of chronic bronchitis was associated with a small decrement in lung function compared with controls: percentage predicted FEV1 in cases 81.4% (95% CI 78.3 to 84.6), controls 86.7% (84.9 to 88.5); FVC in cases 89.9% (95% CI 87.0 to 92.9), controls 94.6% (92.8 to 96.4). After controlling for cumulative past exposure and pack years of smoking the effect of the diagnostic state remained significant for both FEV1 (p < 0.01) and FVC (p < 0.05). CONCLUSIONS: Chronic bronchitis is more prevalent in cotton workers than in those working with man-made fibre and exposure is additive to the effect of smoking. The diagnosis of chronic bronchitis is associated with a small but significant decrement in lung function.

Adult↗
PubMed1996

Reduction in humidity as a method of controlling mites and mite allergens: the use of mechanical ventilation in British domestic dwellings.

BACKGROUND: Low humidity is an important limiting factor for mite population growth. Reducing humidity can therefore be used as a method to control mites within the home. OBJECTIVE: This study investigated the effect of mechanical ventilation heat recovery (MVHR) units on house dust mites and mite allergen Der p 1 in typical homes in the North-West of England. METHODS: Mite counts and Der p 1 levels were measured at 3-monthly intervals over a period of 1 year in 18 houses (nine with MVHR units and nine architecturally matched control houses). Paired dust samples were collected using a vacuum cleaner with an air-flow rate 451/sec, adapted to collect the sample onto a preweighed filter paper. A 1 m2 area of bedroom carpet, living room carpet and mattress was sampled for 2 min. Indoor temperature and relative humidity (RH) levels were recorded for a period of 1 week before and after the winter period (November and February: 3 and 6 months data sets). The environmental questionnaire was completed at the beginning and at the end of the study. RESULTS: No difference in either Der p 1 concentrations or mite counts in any of the sampling sites at 3, 6, 9 and 12 months as compared with the baseline values was found, both within and between the groups (P > 0.01). The measured levels of RH performed in autumn and winter were found to be lower in the MVHR houses compared to the architectural controls. The indoor temperature during each period did not differ between the groups. Questionnaire data showed that the severity of condensation improved in the MVHR homes, whilst during the winter period, the severity of condensation had increased in the architectural control group. CONCLUSIONS: The MVHR unit does not reduce indoor humidity to levels capable of retarding the mite population growth and decreasing mite allergens in the type of houses predominantly found in the mild and humid climate of the North-West of England.

Allergens↗
PubMed1996

Lung function in Lancashire cotton and man made fibre spinning mill operatives.

OBJECTIVES: This survey was conducted to investigate current lung function levels in operatives working with cotton and man made fibres. Dust concentrations, smoking history, and occupational details were recorded so that factors influencing lung function could be identified. METHODS: A cross sectional study of respiratory symptoms and lung function was made in 1057 textile spinning operatives of white caucasian extraction. This represented 96.9% of the total available working population to be studied. Most (713) worked currently with cotton. The remainder worked with man made fibre. Lung function was assessed by measuring forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Exposure to cotton dust was measured in the work area and personal breathing zones, and retrospective exposure to cotton dust over a working life was estimated with accurate work history and best available hygiene data. RESULTS: 3.5% of all operatives had byssinosis, 55 (5.3%) chronic bronchitis, 36 (3.5%) work related persistent cough, 55 (5.3%) non-byssinotic work related chest tightness, and 56 (5.3%) work related wheeze. A total of 212 static work area dust samples (range 0.04-3.23 mg/m3) and 213 personal breathing zone samples (range 0.14-24.95 mg/m3) were collected. Percentage of predicted FEV1 was reduced in current smokers (mean 89.5, 95% confidence interval (95% CI) 88-91) in comparison with non-smokers (93.1, 90.5-94.1) and FVC was reduced in operatives currently working with man made fibre (95.3, 93.8-96.9) in comparison with cotton (97.8, 96.6-99.0). Regression analysis identified smoking (P < 0.01), increasing age (P < 0.01), increasing time worked in the waste room (P < 0.01), and male sex (P < 0.05) as being associated with a lower FEV1 and FVC. Current and retrospective cotton dust exposures did not appear as predictor variables in the regression analysis although in a univariate analysis, FEV1 was reduced in those operatives exposed to high dust concentrations assessed by personal and work area sampling. DISCUSSION: This study has documented loss of lung function in association with exposure to cotton dust. Those operatives with work related symptoms had significantly lower FEV1 and FVC than asymptomatic workers. Although lung function seemed to be affected by high dust exposures when operatives were stratified into high and low exposure groups, regression analysis did not identify current dust concentrations as an independent factor influencing loss. Smoking habit was found to explain most of the measured change in FEV1 and FVC. It is likely that smoking and dust exposure interact to cause loss of lung function in cotton textile workers.

Adult↗
PubMed1995

Pharmacokinetics, oral bioavailability and tissue distribution of azithromycin in cats.

Azithromycin is the first of a class of antibiotics classified as azalides. In an initial experiment four cats were given a single dose of azithromycin 5 mg/kg orally (p.o.), followed 2 weeks later by a single intravenous bolus (i.v.) dose of 5 mg/kg. Subsequently, six cats were given [14C]azithromycin p.o. in a single dose of 5.4 mg/kg for the study of tissue distribution and metabolism. In both experiments, serial blood samples were collected and the plasma assayed for unchanged azithromycin to determine various pharmacokinetic parameters. After p.o. administration, bioavailability was 58% and absorption rapid with a tmax of 0.85 +/- 0.72 h and a Cmax of 0.97 +/- 0.65 microgram/mL. The harmonic mean terminal t1/2 after i.v. administration was 35 h. Tissue half-lives varied from 13 h in fat to 72 h in cardiac muscle. Three metabolites were identified in bile. Unchanged azithromycin accounted for 100% of the total radioactivity in lung and skin tissues when assayed. In comparison with other species, the bioavailability in cats is higher than in humans but lower than in dogs. As in the dog, > 50% of the azithromycin-related material in feline bile was unchanged azithromycin.

Absorption↗
PubMed1995

Effects of air pollution on symptoms and peak expiratory flow measurements in subjects with obstructive airways disease.

BACKGROUND: Evidence from laboratory studies suggests that air pollution can produce bronchoconstriction and respiratory symptoms in selected subjects, but the relevance of these findings to exposure to natural pollution is unclear. This study was performed to determine whether air pollution at typical levels found in the UK has demonstrable effects on respiratory function and symptoms in subjects with airways disease. METHODS: Seventy five adult patients with diagnoses of asthma or chronic obstructive pulmonary disease (COPD) were studied for a period of four weeks during which they kept records of their peak expiratory flow (PEF) rates, symptoms (wheeze, dyspnoea, cough, throat and eye irritation), and bronchodilator use. Thirty six patients in whom the provocative dose of methacholine causing a 20% fall in FEV1 was below 12.25 mumol were classified as reactors. Ambient air pollution was measured with absorption spectroscopy. RESULTS: There were modest but significant increases in PEF variability, bronchodilator use, and wheeze with increasing sulphur dioxide levels; bronchodilator use, dyspnoea, eye irritation, and minimum PEF readings were related to ozone levels. In the subgroup of reactors falls in mean and minimum peak flow and increases in wheeze, dyspnoea, and bronchodilator use were associated with increases in levels of both sulphur dioxide and ozone. Some associations were seen with pollution levels on the same day, but for others the pollution effects appeared to be delayed by 24 or 48 hours. Pollution levels did not breach the WHO guide levels during the course of the study. CONCLUSIONS: Increases in environmental levels of ozone and sulphur dioxide are associated with adverse changes in peak flow measurements and both ocular and respiratory symptoms in subjects with obstructive airways disease. Although the peak flow and symptom changes were modest, they occurred at pollution levels below current WHO guide levels.

Adult↗
PubMed1994

Domiciliary air filtration units, symptoms and lung function in atopic asthmatics.

Air infiltration units (AFUs) incorporating a high efficiency particulate air filter are theoretically able to remove almost all potential airborne allergens. This may have implications for subjects with allergic lower respiratory disease. AFUs were placed in the living room of 12 atopic asthmatics, and the internal filters were inserted and removed in a double-blind fashion. No difference in subjective symptom scoring, spirometry or bronchial reactivity was demonstrated. Peak expiratory flow rate (PEFR) variability was significantly improved from baseline readings, and there was a trend towards higher mean PEFRs when the filters were present in the AFU. Trends towards lower levels of airborne micro-organisms were also demonstrated when the filters were present, however no effect upon total airborne dust and airborne Der pI could be demonstrated.

Air Conditioning↗
PubMed1994

Ocular and nasal irritation in operatives in Lancashire cotton and synthetic fibre mills.

OBJECTIVES: To document the prevalence of work related ocular (eyeWRI) and nasal (noseWRI) irritation in workers in spinning mills of cotton and synthetic textile fibres and to relate the prevalence of symptoms to atopy, byssinotic symptoms, work history, and measured dust concentrations in the personal breathing zone and work area. METHODS: A cross sectional study of 1048 cotton workers and 404 synthetic fibre workers was performed. A respiratory questionnaire was given to 1452 workers (95% of the total available population). Atopy was judged by skin prick tests to three common allergens. Work area cotton dust sampling (WAdust) was carried out according to EH25 guidelines in nine of the 11 spinning mills included in the study. Personal breathing zone dust concentrations were assessed with the IOM sampler to derive total dust exposure (PTdust) and a concentration calculated after the removal of fly (Pless). RESULTS: 3.7% of all operatives complained of symptoms of byssinosis, 253 (17.5%) complained of eyeWRI and 165 (11%) of noseWRI. These symptoms did not relate to atopy or byssinosis, or correlate univariately with any measure of cotton dust exposure (noseWRI v WAdust r = 0.153, PTdust r = 0.118, eyeWRI v WAdust r = 0.029, PTdust r = 0.052). Both of these symptoms on logistic regression analysis were related to being of white origin (P < 0.001), female sex (P < 0.001), and younger age (P < 0.001). With regression analysis, there was a negative relation between dust concentration and prevalence of symptoms. CONCLUSION: Work related ocular and nasal irritation are the most common symptoms complained of by cotton textile workers. There was no relation between these symptoms and atopy, byssinosis, or dust concentration. It is likely that they relate to as yet unidentified agents unrelated to concentration of cotton dust.

Adult↗
PubMed1994

Respiratory symptoms and dust exposure in Lancashire cotton and man-made fiber mill operatives.

A cross-sectional study of work-related symptoms and cotton dust exposure was made in 404 man-made fiber and 1,048 cotton operatives in Lancashire spinning mills; 39 cotton-exposed operatives (3.7%) had symptoms of byssinosis. This was associated on regression analysis with cumulative lifetime cotton dust exposure (p < 0.001), total years spent carding (p < 0.001), and currently working in the carding area (p = 0.0041). Smoking habit did not differ significantly between byssinotic and nonbyssinotic workers. Other work-related symptoms were common: chronic bronchitis (CB) and persistent cough. The prevalence of CB correlated positively with dust exposure (r = 0.59). Cotton dust sampling was performed in the work area (SDPRES) and personal breathing zone (PD1). A retrospective estimate of lifetime cotton dust exposure based on SDPRES correlated best with the prevalence of byssinosis (r = 0.797), although correlations with PD1 (r = 0.709) and SDPRES (r = 0.594) were also significant.

Adult↗
PubMed1993

A phase I study of the toxicity of regional hyperthermia with systemic warming.

This study examines the consequences of allowing moderate systemic hyperthermia during regional heating of the abdomen and pelvis in 29 patients participating in Phase I studies of hyperthermia combined with chemotherapy or radiation therapy. In Group 1 (20 patients, 42 treatments), systemic temperatures were limited by employing surface cooling, while in Group 2 (9 patients, 24 treatments), surface warming and insulation were used so that systemic temperature would rise. Mean time-averaged oral temperatures were 38.4 degrees C and 39.9 degrees C for Groups 1 and 2, respectively. Time-averaged mean regional temperatures were 40.2 +/- 0.7 degrees C and 41.5 +/- 0.2 degrees C for Groups 1 and 2, respectively (p < .001). Regional temperatures > or = 41.0 degrees C were achieved by 64% of Group 1 and all Group 2 patients. The mean time-averaged power required was significantly lower for Group 2 (453 W vs 740 W; p = .032), as was the incidence of pain. Mean maximum pulse rate was significantly higher in Group 2, although this was not associated with symptoms. Allowing systemic temperature to rise decreased power requirements and treatment-related pain, at the cost of an asymptomatic increase in heart rate. The results suggest that regional heating may be more readily achieved in the setting of elevated systemic temperature.

Adolescent↗
PubMed1992

A study of the performance and comparability of the sampling response to cotton dust of work area and personal sampling techniques.

In order to compare and contrast the sampling response to cotton dust of two forms of dust sampling 85 work areas were identified over a 2-year period for investigation in eight Lancashire spinning mills. Three hundred and five work area dust samples were undertaken and 252 personal dust samples were performed. Operatives who spent a minimum of 80% of their working shift in the area in which work area sampling was also performed were selected for personal sampling. Work area dust exposures have recently shown an upward trend, with highest concentrations occurring in the ring spinning room (median 1.15 mg m-3, range 0.82-2.06). Personal dust samples showed a reduction in dust exposures as cotton processing progressed, from a high in the opening room (median value of 6.24 mg m-3, range 1.0-41.5) to a minimum of 1.02 mg m-3 (range 0.30-0.93) in the winding room. The ratio of measured personal sampling dust exposure to work area sampling exposure was used to compare the relative performance of the two techniques. This ratio was highest in the early processes. There was a 7.8-fold difference in measurement between the two techniques in the opening processes, falling to 4.9 in carding and 4.2 in the other card-room processes. However in ring spinning the ratio was only 1.4, suggesting a degree of comparability in the methods at this stage of processing. The value rose to 2.5 for the last stage (winding). Respiratory disease is known to occur predominantly in the early stages of processing (opening and carding) where high dust concentrations are found using the personal technique. These data support the use of personal sampling for setting exposure limits to cotton dust in preference to the current recommended method using work area sampling techniques, which may significantly underestimate dust exposure in the high risk work areas and is outdated.

Dust↗
PubMed1992

Lung function, bronchial reactivity, atopic status, and dust exposure in Lancashire cotton mill operatives.

A total of 645 cotton mill operatives were administered a respiratory questionnaire. Of these, 85 (13.2%) complained of one or more work-related respiratory symptoms: 23 (3.6%) had byssinosis and the remaining 62 had symptoms not conforming to byssinosis (nonbyssinotic symptomatics, NBS). All byssinotic, 56 NBS, and 84 matched asymptomatic operatives underwent pulmonary function testing (FEV1 and FVC), skin testing to common allergens, and histamine bronchial challenge. Work area and personal breathing zone cotton dust concentrations were assessed, and a cumulative cotton dust exposure index was calculated for each individual. Byssinotic, NBS, and asymptomatic operatives all had reduced FEV1; observed mean liters (95% CI); predicted mean: byssinosis, 2.36 (2.09 to 2.63), 3.02; NBS, 2.94 (2.71 to 3.17), 3.29; and asymptomatic, 3.12 (2.95 to 3.29), 3.31. Only byssinotic subjects had evidence of impaired FVC: 3.31 (2.97 to 3.65), 3.69. The majority of byssinotic operatives (18 of 23) had bronchial hyperreactivity (BHR) in comparison with 21 of 56 NBS and 14 of 84 asymptomatic operatives. Mean log PD20 (95% CI) values were significantly lower in the byssinotic group -0.72 (-1.42, -0.02) than in NBS 0.57 (0.08, 1.06) and asymptomatic subjects 0.57 (-0.26, 1.39). The distribution of atopy did not differ significantly between groups, and lung function did not differ significantly between atopic and nonatopic subjects. The cumulative cotton dust exposure index was the only dust parameter to be significantly greater in those with BHR (mean mg-yr/m3 [95% CI] 14.13 [13.1 to 15.1]) than those with normal reactivity [5.35 (3.9 to 6.8)].

Adult↗
PubMed1991

Germfree technique for the rearing of kittens--a research tool.

Techniques to derive and rear germfree kittens (Felis catus) for biomedical research were explored and refined. The isolator units, equipment, sterilization procedures, husbandry techniques, and safety issues are discussed. This method proved to be successful for the surgical derivation and hand-rearing of germfree kittens.

Animal Feed↗