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C A Pickering

Publications and source records attributed to C A Pickering.

At least 19 recordsLinked to original sources
PubMed2000

Environmental exposure to air pollution and allergens and peak flow changes.

Laboratory-based studies have shown that ozone and nitrogen dioxide can potentiate the effect of allergen in sensitized asthmatic subjects, but it is not known whether this interaction is important under natural exposure conditions. Thirty-five subjects with clinical diagnoses of asthma or chronic obstructive pulmonary disease and with a provocative dose causing a 20% fall in forced expiratory volume in one second methacholine <12.25 micromol (using the Yan method) kept peak expiratory flow (PEF) records for a 4-week period during late summer, with concurrent measurement of spore and pollen counts and pollution levels. Multiple regression analysis was then used to determine the effect on PEF of aeroallergen, and of the interaction between aeroallergen and pollutant levels. A statistically significant interaction was demonstrated between total spore count and ozone, but not nitrogen dioxide. Mean PEF fell in association with increasing spore count (same-day and 24-h lag level) and PEF variability increased with increasing spore count (24-h lag level only); both changes were greater the higher the prior ozone level. These results suggest that ozone can potentiate the effect of aeroallergens in subjects with bronchial hyperreactivity under natural exposure conditions. However, the effect was small, and the clinical significance of the interaction requires further study.

Adult↗
PubMed2000

Survey of symptoms, respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy nursing staff.

OBJECTIVES: To find the nature and incidence of symptoms experienced by a large sample of hospital endoscopy nurses. To find whether nurses in endoscopy units develop asthma under current working conditions in endoscopy units. To obtain analytically reliable data on exposure concentrations of glutaraldehyde (GA) vapour in endoscopy units, and to relate them to individual hygiene and work practices. To characterise any exposure-response relations between airborne GA and the occurrence of work related symptoms (WRSs). Due to the growing concern about the perceived increase in WRSs among workers regularly exposed to biocides, all of whom work within a complex multiexposure environment, a cross sectional study was designed. METHODS: Current endoscopy nurses (n=348) from 59 endoscopy units within the United Kingdom and ex-employees (who had left their job for health reasons (n=18) were surveyed. Symptom questionnaires, end of session spirometry, peak flow diaries, skin prick tests (SPTs) to latex and common aeroallergens, and measurements of total immunoglobulin E (IgE) and IgE specific to GA and latex were performed. Exposure measurements included personal airborne biocide sampling for peak (during biocide changeover) and background (endoscopy room, excluding biocide changeover) concentrations. RESULTS: All 18 ex-employees and 91.4% of the current nurses were primarily exposed to GA, the rest were exposed to a succinaldehyde-formaldehyde (SF) composite. Work related contact dermatitis was reported by 44% of current workers exposed to GA, 56.7% of those exposed to SF composite, and 44.4% of ex-employees. The prevalence of WRSs of the eyes, nose, and lower respiratory tract in current workers exposed to GA was 13.5%, 19.8%, and 8.5% respectively and 50%, 61.1%, and 66.6% in the ex-employees. The mean percentage predicted forced expired volume in 1 second (ppFEV(1)) for ex-employees (93.82, 95% confidence interval (95% CI) 88.53 to 99.11) was significantly lower (p<0.01) than that of current workers exposed to GA (104.08, 95% CI 102.35 to 105.73). Occupational peak flow diaries completed by current workers with WRSs of the lower respiratory tract showed no evidence of bronchial asthma (<15% variation). Six per cent of the population had positive latex SPTs. Positive indications of one GA specific IgE and 4.1% latex specific IgE occurred. There was no conformity between the latex specific IgE and positive SPTs. Positive SPTs to latex were associated with WRSs of dermatitis and ocular WRSs, but no other WRSs. Exposures were above the current maximum exposure limit (MEL) of 0.2 mg/m(3) (0.05 ppm) in eight of the units investigated. A significant relation existed between peak GA concentrations and work related chronic bronchitis and nasal symptoms (after adjustment for types of local ventilation) but not to other WRSs. Peak GA concentrations were significantly higher in units that used both negative pressure room and decontaminating unit ventilation. CONCLUSION: This study documents a significant level of symptoms reported in the absence of objective evidence of the physiological changes associated with asthma. Ex-employees and current workers with WRSs warrant further study to elucidate the cause and mechanisms for their symptoms. Ventilation systems used for the extraction of aldehydes from the work area may be less effective than expected and due to poor design may even contribute to high peak exposures.

Air Pollutants, Occupational↗
PubMed2000

Building sickness syndrome in healthy and unhealthy buildings: an epidemiological and environmental assessment with cluster analysis.

OBJECTIVES: Building sickness syndrome remains poorly understood. Aetiological factors range from temperature, humidity, and air movement to internal pollutants, dust, lighting, and noise factors. The reported study was designed to investigate whether relations between symptoms of sick building syndrome and measured environmental factors existed within state of the art air conditioned buildings with satisfactory maintenance programmes expected to provide a healthy indoor environment. METHODS: Five buildings were studied, three of which were state of the art air conditioned buildings. One was a naturally ventilated control building and one a previously studied and known sick building. A questionnaire was administered to the study population to measure the presence of building related symptoms. This was followed by a detailed environmental survey in identified high and low symptom areas within each building. These areas were compared for their environmental performance. RESULTS: Two of the air conditioned buildings performed well with a low prevalence of building related symptoms. Both of these buildings out performed the naturally ventilated building for the low number of symptoms and in many of the environmental measures. One building (C), expected to perform well from a design viewpoint had a high prevalence of symptoms and behaved in a similar manner to the known sick building. Environmental indices associated with symptoms varied from building to building. Consistent associations between environmental variables were found for particulates (itchy eyes, dry throat, headache, and lethargy) across all buildings. There were persisting relations between particulates and symptoms (headache, lethargy, and dry skin) even in the building with the lowest level of symptoms and of measured airborne particulates (building B). There were also consistent findings for noise variables with low frequency noise being directly associated with symptoms (stuffy nose, itchy eyes, and dry skin) and higher frequency noise being relatively protective across all buildings. CONCLUSIONS: This is the first epidemiological study of expected state of the art, air conditioned buildings. These buildings can produce an internal environment better than that of naturally ventilated buildings for both reported symptoms and environmental variables. The factors associated with symptoms varied widely across the different buildings studied although consistent associations for symptoms were found with increased exposure to particulates and low frequency noise.

Adult↗
PubMed1999

Is atopy and smoking important in the workplace?

The relationship between the respiratory system and the environment involves a complex dynamic interaction of genetic susceptibility, host defence and toxicity. The chance of an individual developing a respiratory disease is dependent on genetic susceptibility and subsequent hereditary risk factors, life-style risk factors and the amount and nature of the exposure that may be encountered in the working environment. Atopic status is an important pre-existing risk that a worker may bring to the workplace (occupational asthma/rhinitis to high molecular weight agents). Smoking is an avoidable additional risk for certain occupational diseases (occupational asthma/bronchitis/cancer) while it can be protective in other circumstances (allergic alvcolitis). More controversially, smoking in some workers may put at increased risk the health of colleagues (passive smoking). This article attempts to clarify the issues surrounding the interaction of atopy, smoking and the workplace.

Asthma↗
PubMed1999

Respiratory symptoms in Lancashire textile weavers.

OBJECTIVES: To investigate a large population of cotton textile weavers for reported respiratory symptoms relative to occupational factors, smoking, and exposure to dust. Cotton processing is known to produce a respiratory disease known as byssinosis particularly in the early processes of cotton spinning. Relatively little is known about the respiratory health of the cotton weavers who produce cloth from spun cotton. By the time cotton is woven many of the original contaminants have been removed. METHODS: 1295 operatives from a target population of 1428 were given an interviewer led respiratory questionnaire. The presence of upper and lower respiratory tract symptoms were sought and the work relatedness of these symptoms determined by a stem questionnaire design. Also occupational and demographic details were obtained and spirometry and personal dust sampling performed. RESULTS: Byssinosis was present in only four people (0.3%). Chronic bronchitis had a moderate overall prevalence of about 6% and was related predominantly to smoking. There were several other work related respiratory symptoms (persistent cough 3.9%, chronic production of phlegm 3.6%, chest tightness 4.8%, wheezing 5.4%, and breathlessness 2.3%). All of these were predicted predominantly by smoking (either past or present), with no consistent independent effect of exposure to dust. Work related eye and nasal symptoms were more common (10.4% and 16.9% respectively). CONCLUSION: Byssinosis is a rare respiratory symptom in cotton weaving. Other work related respiratory symptoms were reported but their presence was predominantly related to smoking with no consistent effects of exposure to dust.

Adult↗
PubMed1999

Ventilatory function and personal breathing zone dust concentrations in Lancashire textile weavers.

BACKGROUND: To report findings on ventilatory function and estimations of concentrations of personal breathing zone dust in Lancashire textile weavers. Weaving room dust is considered to be less harmful than that encountered in the cardroom or spinning room and weavers are generally thought to have less respiratory disability than carders or spinners. However, this occupational group has not been extensively studied. METHODS: Each person was given a respiratory symptom questionnaire (modified Medical Research Council, UK, questionnaire on respiratory diseases). Ventilatory function tests, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were performed on each person. A representative sample of workers from each occupational group underwent dust sampling in their personal breathing zone. Dust concentrations and ventilatory tests were analysed statistically with the Student's t test, Pearson's correlation coefficient, and forward step regression for relations with symptoms and environmental factors. Significance was p > or = 0.05. RESULTS: The FEV1 and FVC were reduced in workers with respiratory symptoms (non-specific chest tightness, shortness of breath, persistent cough, and wheezing) as well as in preparation room workers, current and former smokers, Asians, those working with predominantly cotton fibre (> 50% cotton) and starch size. Mean total dust concentration (pd1) in the personal breathing zone was 1.98 mg/m3. The corresponding value for total dust with large fibres lifted off the filter paper (pd2) was 1.55 mg/m3. There was a strong correlation (r = 0.94, p < 0.0001) between pd1 and pd2. Non-specific chest tightness was predicted by low dust concentrations and persistent cough by high dust concentrations. On regression analysis, impairment of ventilatory function (FEV1, FVC) was predicted by smoking, male sex, age, not working in the weaving shed, not being white, and personal dust concentrations. CONCLUSIONS: The FEV1 and FVC were impaired in smokers and those exposed to high dust concentrations in the personal breathing zone. Symptoms were inconsistently related to dust concentrations in the personal breathing zone.

Dust↗
PubMed1999

Assessment of a simple scoring system applied to a screening questionnaire of asthma in children aged 5-15 yrs.

The aim of the present study was to validate a simple scoring system using a parent-completed screening questionnaire to identify children aged 5-15 yrs who may have asthma. A stratified random sample of 157 children of 1,808 whose parents had answered a postal respiratory questionnaire underwent detailed clinical evaluation. The results were reviewed by three independent paediatricians whose opinions were combined to reach, for each child, decisions regarding three standards: 1) "possible asthma" defined as >50% likelihood of having asthma; 2) "possible asthma" defined as meriting a clinical trial of asthma medication; and 3) "probable asthma" defined as >90% likelihood of having asthma. The combined decisions were compared to three sets of questionnaire scores, in order to determine the positive predictive value, sensitivity and specificity of each set in identifying children with probable/possible asthma. The three sets of chosen questionnaire scores all had positive predictive values of 79-96% for predicting possible asthma, using either the combined expert opinion ">50% likelihood of asthma" or that of "warrants a trial of treatment" as the definition. This suggests that a low proportion of false positives would be obtained were this scoring system to be used for a screening programme. The combined decision >90% chance of asthma could be used as a means of estimating prevalence of asthma in the survey. When used for this, the prevalence of asthma in the surveyed population was 18.8% (95% confidence interval 13.1-26.3). In conclusion, the present scoring system, based on a simple respiratory questionnaire, provides a valid method of identifying children likely to have asthma, and who, if unknown to the medical services, would benefit from clinical review.

Adolescent↗
PubMed1999

Pulmonary Langerhans' cell histiocytosis: radiologic resolution following smoking cessation.

We describe two patients with histologically proven pulmonary Langerhans' cell histiocytosis in whom radiologic improvement occurred following smoking cessation. The patients had 23- and 25-pack-year smoking histories, respectively. High-resolution CT revealed multiple small nodules, located predominantly in the upper and middle lung fields. There was a close temporal relationship between smoking cessation and radiologic improvement.

Adult↗
PubMed1999

Comparative personal exposures to organic dusts and endotoxin.

The aims of the study were to provide valid comparative data for personal exposures to dust and endotoxins for different occupations and to calculate comparative data for the contamination of organic dusts with endotoxin. Nine different occupational settings were studied, drawn from the textile, agricultural and animal handling industries. Samples were collected by personal sampling techniques, using the Institute of Occupational Medicine (IOM) sampling head, glass fibre filters and rechargeable sampling pumps. The dust exposures were calculated by gravimetric analysis and using the calculated volume of air sampled were expressed as mg/m3. Endotoxin exposures were measured using a simple water extraction from the collected dusts, followed by a quantitative turbidimetric assay. Results were expressed as ng/m3, using the calculated volume of air sampled. In addition, the levels of the contamination of dusts with endotoxin for individual industries were expressed as ng/mg of collected dust. Two hundred and fifty-nine samples, collected from 9 different industries and across 36 different sites were analysed. This represented a sampling rate of 25% for the total work force. The average sampling time was 4.62 h. For all the dusts collected, a significant correlation between the collected dust and endotoxin was seen (r = 0.7 and p < 0.001). The highest dust exposures occurred during cleaning activities (grain handling: 72.5 mg/m3). The individuals exposed to the highest median level of dust and endotoxin were the animal handlers (poultry handlers, dust: 11.53 mg/m3, endotoxin: 71,995 ng/m3). Weaving and mushroom cultivation had the lowest exposures for dust and endotoxins. The mostly highly contaminated dusts (median values expressed as ng of endotoxin per mg of collected dust) were found in the animal handling (poultry: 1,030 ng/mg, swine: 152 ng/mg) and cotton spinning (522 ng/mg) industries. Processing of cotton and wool fibres was found to reduce the levels of contamination of dusts with endotoxin. In the study, valid comparative data for personal exposures to organic dusts and endotoxins have been presented. The highest exposures were found amongst animal handlers and during cleaning activities. The results highlight that dust exposures are greater in a number of industries than the set exposure standards. In addition, endotoxin exposures are found to be greater than levels at which harmful effects have been demonstrated.

Agriculture↗
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

Domestic allergens in public places III: house dust mite, cat, dog and cockroach allergens in British hospitals.

BACKGROUND: Exposure and sensitization to indoor allergens is a major cause of asthma. OBJECTIVES: This study investigated the levels of house dust mite, cat, dog and cockroach allergens in the dust and air in hospitals and the effects of regular vacuum cleaning on allergen levels in hospital chairs. METHODS: Der p 1, Fel d 1, Can f 1 and Bla g 2 were measured in the dust collected by vacuuming upholstered chairs and a 1 m2 area of carpet and mattress in 14 hospitals. Air samples were collected using an air sampler (flow rate 60 L/min) on 10 separate days for 4 h in the outpatient department in one of the hospitals during busy clinics when patients were waiting for their appointments. In addition, dust samples were collected on four occasions, at 4-weekly intervals, from 36 fabric covered chairs in the outpatient area of a busy chest clinic by vacuuming each chair for 2 min. During the intervening weeks, 18 of the chairs (active group) were each cleaned by vacuuming for 1 min, three times per week. Der p 1, Fel d 1, Can f 1 and Bla g 2 were assayed using monoclonal antibody-based ELISA. RESULTS: In total, 83 carpets, 69 mattresses and 42 upholstered chairs were sampled. The levels of dust mite allergen Der p 1 and cockroach allergen Bla g 2 found in the hospital setting were low. High levels of Fel d 1 (GM 22.9 microg/g, range 4.5-58) and Can f 1 (GM 21.6 microg/g, range 4-63) were found in upholstered chairs. Airborne Can f 1 was detected on every occasion (range 0.12-0.56 ng/m3), whilst detectable airborne Fel d 1 was found on 7 out of the 10 sampling days (range 0.09-0.22 ng/m3). Der p 1 and Bla g 2 were below the detection limit in all airborne samples. Following repeated vacuuming the mean cat and dog allergen levels decreased significantly (P<0.001) and were almost fivefold lower in the vacuumed chairs compared with the control group. CONCLUSIONS: Low levels of mite allergen are unlikely to be of any clinical significance to mite-sensitive asthmatic patients. However, upholstered chairs in hospitals constitute a significant reservoir of cat and dog allergen. Inhalation of airborne allergen in patients attending their hospital appointment may exacerbate asthma in those highly allergic to cats or dogs. These results question the wisdom of introducing soft furnishings and carpets into hospitals. Three-times weekly vacuuming significantly reduces allergen levels in upholstered chairs.

Air Pollution, Indoor↗
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↗
PubMed1997

Aerodynamic properties of the major dog allergen Can f 1: distribution in homes, concentration, and particle size of allergen in the air.

Exposure and sensitization to dog allergen is a significant cause of asthma. In this study we investigated the distribution, aerodynamic characteristics, and particle-size distribution of the major dog allergen Can f 1. Dust samples were collected in 50 homes with a dog and 50 homes without dogs. Airborne Can f 1 concentration was measured in 28 homes with dogs and 36 homes without a dog. Particle-size distribution was determined by using 10 separate Andersen sampler measurements in a dog-handling facility, and in 10 homes with dogs, and by repeated measurements in a home with one dog. High levels of Can f 1 (> 10 microg/g) were found in dust in all but one home with a dog and in eight of 50 homes without dogs. Airborne Can f 1 levels varied greatly between the homes with dogs (range: 0.3 to 99 ng/m3). Low levels of airborne Can f 1 (range: 0.4 to 1.1 ng/m3) were detected in 11 of 36 homes without a dog. Can f 1 was predominantly associated with large particles collected on the first stage of the Andersen sampler (> 9 microm), which averaged 42 to 49% of the total allergen recovered in the dog-handling facility and in homes with dogs. Small particles (< 5 microm diameter) also carried Can f 1, and these particles comprised approximately 20% of the total airborne allergen load. There was an excellent concordance between the results obtained in different sampling areas, and between the total Can f 1 recovered on the Andersen sampler and on the parallel filter. In conclusion, airborne Can f 1 was detectable in undisturbed conditions in all homes with dogs and in almost one third of the homes without dogs. In houses with dogs, a significant proportion (approximately 20%) of airborne Can f 1 was associated with small particles (< 5 microm diameter). Owing to their aerodynamic characteristics, these particles would be expected to remain airborne for a long period and, when inhaled, could penetrate into the lower airways and initiate asthma attacks.

Air Pollution, Indoor↗
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↗
PubMed1996

Functional upper airways obstruction: two patients with persistent symptoms.

Functional upper airways obstruction is caused by vocal cord dysfunction and classically occurs in paroxysms closely resembling acute asthmatic attacks. We present two cases in which the symptoms and signs of the vocal cord dysfunction demonstrate very little variability with time. We suggest that as part of this disorder, a syndrome of chronic unremitting symptoms may occur.

Adolescent↗