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J Ameille

Publications and source records attributed to J Ameille.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Occupational asthma in a teacher after repeated exposure to tear gas].

Acute exposure to tear gas causes generally reversible cutaneous and mucosal irritations. Lasting respiratory manifestations after exposure are exceptional. We report the case of a 26-year-old female teacher with no history of respiratory disease who developed asthma after repeated exposure to tear gas discharged in her class room. The disorders occurring during these repeated exposures to the irritating gas were consistent with the recently described low level reactive airway dysfunction syndrome (low level RADS).

Adult↗
PubMed1998

[Risk and clinical surveillance of workers exposed to asbestos].

The role of the family doctor in the medical surveillance of asbestos-exposed workers is important, mainly after retirement. The surveillance modalities should take into account the levels of exposure and the date of the beginning of exposure (long latency period of asbestos-related diseases). Due to the lack of evidence of improvement of lung cancer prognosis, and in the absence of effective treatment of mesothelioma, the interest of medical surveillance is at the present time medico-legal rather than strictly medical. Consequently, maximalist attitudes, costly and may be hazardous, should be avoided.

Asbestos↗
PubMed1998

[Rolled atelectasis and asbestosis. Apropos of 26 patients].

Round atelectasis (AE) is a benign form of respiratory problem which develops due to fixing of the visceral pleura. This lesion for which the principal cause is exposure to asbestos may pose problems of differential diagnosis with bronchopulmonary cancer. In a cohort of 286 patients suffering from benign asbestos related pleural disease the diagnosis of round atelectasis was made on computerized tomography in 26 patients (31 AE) on the following criteria: rounded opacities of less than 7 cm in diameter situated at the periphery of the lung in contact with a thickened pleura with an acute angle linking the pleura and the opacity, a reduction of lung volume on the side of the atelectasis and the presence of a "comet tail sign". These patients were investigated to specify the circumstances of the occurrence, including their symptomatology, the changes in lung function, the topography of the round atelectasis and the associated radiological signs. Intense exposure to asbestos either continuous or discontinuous was found in 19 patients; 20 patients presented with some respiratory symptoms (dyspnoea 15/26, cough 11/26 and chest pain 9/26) but the reduction in lung function was moderate (7 had restrictive ventilatory trouble, 4 obstructive problems and a mixed problem in 1). The preferred localisation for round atelectasis was in the inferior lobes in the posterior basal lateral vertebral area (26/31) which may explain their being frequently missed on the standard radiograph (only one case of round atelectasis was visible on the straight chest radiograph in our study). An understanding of the pathology and the computered tomographic characteristics are now well defined and should enable an unnecessary diagnostic thoracotomy to be avoided which besides has no justification from the functional point of view.

Asbestosis↗
PubMed1998

[Non-malignant asbestos-related diseases].

Non malignant asbestos diseases are dominated numerically by pleural plaques. This form of circumscribed fibrosis of the parietal pleural is generally asymptomatic and its potential for evolution is weak. More rarely diffuse pleural fibrosis results from disease of the visceral pleura with a secondary fusion of the two pleural layers. Usually it follows a pleural effusion which resolves spontaneously. Its functional effects are sometimes important. The generalised practice of computerized tomographic scanning as a work up for asbestos related disease has revealed the frequent association of this diffuse pleural fibrosis with a particular form of peripheral pulmonary collapse called round atelectasis. Asbestosis or pulmonary fibrosis induced by the inhalation of asbestos has become rarer due to the improvement in working conditions in the asbestos industry. It develops following heavy exposure. The frequency of bronchopulmonary cancer is increased when asbestosis exists although it is not currently possible to say if the two disorders are independent and each is only conditioned by exposure to asbestos or if the two diseases are inextricably linked by the same physiopathological process.

Asbestos↗
PubMed1997

Consequences of occupational asthma on employment and financial status: a follow-up study.

The aim of this study was to describe changes in employment and income following a diagnosis of occupational asthma, and to determine what factors might affect these changes. Two hundred and nine patients with occupational asthma were reviewed on average 3.1 yrs after the diagnosis had been made. They were contacted by telephone or were sent a self-administered questionnaire by post. Multiple logistic regression models were constructed to determine which variables were associated with loss of employment after the diagnosis. At the time of review, 44% of patients had left their previous job and 25% were currently unemployed. Remarkably, 32% remained exposed to the offending agents in the same job. Forty six percent of the patients had suffered a reduction of income (84% of those who had left their employer versus 19% of those still employed in the same company (p < 0.001)). Claims for compensation, size of the company, level of education, and age at the time of diagnosis were significantly associated with a risk for becoming unemployed or having a new employer after the diagnosis of occupational asthma. Occupational asthma results in severe socioeconomic consequences. The French compensation system for occupational asthma should be revised, as the criteria currently used to determine compensation for this disease largely underestimate the social and occupational damages.

Adolescent↗
PubMed1995

Respiratory symptoms, ventilatory impairment, and bronchial reactivity in oil mist-exposed automobile workers.

Studies concerning the respiratory effects of oil mists are sparse and contradictory. The aim of this study was to determine the respective effects of occupational exposure to straight cutting oils and soluble mineral oils on the prevalence of respiratory symptoms, ventilatory impairment, and bronchial reactivity. The population study consisted of 308 male workers of a large French car-making plant, including 40 subjects chronically exposed to straight cutting oils (group S), 51 subjects chronically exposed to soluble mineral oils (group E), 139 subjects with chronic dual exposure to straight cutting oils and soluble mineral oils (group D), and 78 unexposed assembly workers used as a control group (group C). Worker evaluation included a standardized questionnaire, measurement of pulmonary function, and a methacholine challenge. Oil mist concentration at the work place was determined by gravimetric analysis. The arithmetic mean concentration was 2.6 +/- 1.8 mg/m3. The geometric mean concentration was 2.2 +/- 1.9 mg/m3. The prevalence of respiratory symptoms did not differ significantly among the four groups. However, the subjects exposed to straight cutting oils (group S + group D) had a significantly higher prevalence of chronic cough and/or phlegm than the others (group E + group O): 25.7% vs. 16.3% (p = 0.048). Furthermore, the prevalence of cough and/or phlegm increased significantly (p = 0.03) with increasing duration of exposure to straight cutting oils after adjustment on smoking categories. Lung function tests did not differ significantly among the four groups but we observed a significant decrease of forced expiratory volume in 1 sec (FEV1), forced expiratory flow during the middle half of forced vital capacity (FEF25-75), and maximal flow rate at 50% and 25% of exhaled forced vital capacity (V50 and V25) according to duration of exposure among smokers exposed to straight cutting oils, suggesting a synergistic effect of tobacco and insoluble oils. No effect of exposure to mineral oils on bronchial reactivity was demonstrated. It is concluded that despite low levels of pollution by oil mists, the present study has shown tenuous adverse chronic effects of straight cutting oils on respiratory symptoms and lung function. However, no adverse effect of soluble mineral oils was demonstrated. These results suggest that threshold limit values for mineral oils should be reassessed.

Adult↗
PubMed1995

Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases.

A retrospective study was conducted in 23 subjects with previous occupational exposure to asbestos and exhibiting rounded atelectasis (RA) on high-resolution computed tomography scan (HRCT scan) to evaluate the retention of asbestos bodies (ABs) using light microscopy in the bronchoalveolar lavage (BAL) fluid or lung parenchyma in such patients. A total of 31 RAs were identified, usually located in the lower (25 RAs) and posterior (23 RAs) parts of the lung. Pleural thickening in contact with the RA was observed in 27 RAs and parenchymal bands were detected in 15 cases. Twelve of the 20 patients who underwent BAL or surgery exhibited significant retention of ABs in BAL fluid or lung tissue. Moreover, a significant retention of ABs was observed in five of nine patients with a history of asbestos exposure but no diffuse pleural thickening on chest radiograph or interstitial opacities on HRCT scan. Patients with RAs and coexisting diffuse pleural thickening and/or interstitial fibrosis should be considered at a higher risk for lung cancer in comparison to patients with isolated circumscribed pleural plaques based on increased AB counts. By contrast, the excess risk of lung cancer is more questionable in patients with only RAs and circumscribed pleural plaques as they may have AB counts either above or below that associated with pleural plaques alone. This emphasizes the need for further follow-up studies to define criteria indicating the need for thoracotomy in these subjects.

Asbestos↗
PubMed1995

[Longitudinal study of radiologic anomalies in subjects working in asbestos-insulated buildings].

The respiratory effects of environmental pollution by asbestos was examined in a cohort of subjects working inside university buildings partly insulated with asbestos containing materials (University of Jussieu in Paris). The present study concerned 727 subjects having undergone two standard radiographic examinations (postero-anterior and oblique chest x-ray) in the period 1981-1992. The first examination was realized between 01/01/81 and 31/12/85 and the second examination took place between 01/01/86 and 31/12/92. The subjects were classified into three groups according to their exposure status: the group G1 consisted of 161 workers occupationally exposed to asbestos; the group G2 comprised 416 subjects working for at least 15 yr in asbestos-insulated buildings without known occupational exposure to asbestos; the group G3 consisted of 150 workers working for at least 15 yr in the university with no known exposure to asbestos. Whatever the radiological abnormalities considered, no significant difference was observed between G2 and G3 in cross-sectional analyses of the two phases. The group G1 exhibited a significantly higher prevalence of pleural thickening compared to the other exposure groups after adjustment for confounding variables. Detailed examination of oblique x-ray allowed to confirm that pleural thickening were largely due to extrapleural fat. Concerning the changes in pleural abnormalities between the two phases of the study, no difference was observed between G2 and G3. This study was unable to show any excess of radiographic chest abnormalities among subjects working in asbestos-insulated buildings compared to non-exposed subjects. However, the participation in the second phase of examination was 51.2%. The study is still on-going. Therefore, it would be necessary to continue to follow-up the subjects because respiratory disorders could occur after a long latent period.

Adult↗
PubMed1994

[Magnetic resonance imaging in thoracic diseases].

Most all the thoracic structures are visible with magnetic resonance imaging: the mediastin, the myocardium including the endocardium and the pericardium, the pulmonary parenchyma and hile and the pleural walls. In cases of mediastrinal masses, T1 images clearly delimit their relations with neighbouring organs and vessels. The intensity of the signal is compared with that of the muscles on T1 weighted images of the preceding sections and T2 weighted images of fat. Images of aneurysms and chronic dissections can be synchronized with the ECG allowing three-dimensional measurement of the size and thickness of the vessel walls. Thrombi or extension to other vessels can also be recognized. Small hilar tumours can be differentiated from vessels but the scanner is better for analyzing systematization and bronchial lesions. For lung tissue itself, magnetic resonance imaging can detect nodules greater than one centimeter in diameter, but the low proton density and respiratory movements hinder spatial resolution. MRI is indicated for localizing tumours situated anteriorly or posteriorly or at the apex and to identify parietal extension of peripheral cancers. Spinal, vascular, pericardial, diaphragmatic and lymph node metastases can be recognized. MRI is the noninvasive method of choice for evaluating left ventricular masse, intra and paracardiac mass studies and for investigating congenital and acquired cardiomyopathies. Technical advances have made it possible to evaluate myocardial perfusion and heart function.

Aortic Diseases↗
PubMed1994

Pleural plaques, asbestos exposure, and asbestos bodies in bronchoalveolar lavage fluid.

The profiles of occupational asbestos exposure were investigated in a series of 66 hospital patients in whom pleural plaques constituted the only asbestos-induced abnormality. The relationship between a radiological semiquantitative score of pleural plaques and indices of asbestos exposure was also examined. On the basis of a standardized occupational questionnaire, four classes of asbestos exposure were distinguished in our study population: no evidence of exposure, low-level exposure, sporadic exposure at higher levels, and a remaining group of individuals with substantial exposure. Asbestos body count in bronchoalveolar lavage fluid (BALF) was used as an objective indicator of cumulative lung retention of asbestos. Our results support the data indicating that pleural plaques may occur in subjects with low-level or sporadic asbestos exposure. Although it is admitted that pleural plaques are strongly associated with past asbestos exposure, our data suggest that the stage of pleural plaques was not correlated to the level, frequency, duration of exposure nor to the amount of asbestos bodies in the BALF in subjects free of any lung parenchymal abnormalities on high resolution computerized tomography.

Adult↗
PubMed1993

Pleural thickening: a comparison of oblique chest radiographs and high-resolution computed tomography in subjects exposed to low levels of asbestos pollution.

The present study was conducted to investigate the value of oblique chest radiographs, compared with high-resolution computed tomography (HRCT), in the assessment of pleural asbestosis in a group of subjects exposed to low levels of asbestos pollution. The study population consisted of 23 people derived from a previously reported cohort of subjects working in university buildings insulated with asbestos-containing material. Subjects were selected on a voluntary basis from among patients whose initial oblique chest X-rays showed pleural thickening. Sixteen patients were maintenance workers occupationally exposed to asbestos; the remaining seven were environmentally exposed to asbestos. For each subject, two standard chest radiographs [posteroanterior (PA) and right anterior oblique (RAO) views] were taken and HRCT was performed. Films were interpreted after agreement by three chest physicians and a radiologist. Pleural thickening was considered present in all 23 patients on RAO films and in six patients on PA films. HRCT revealed unequivocal pleural plaques in three maintenance workers and doubtful pleural abnormalities in three other maintenance workers. Considering HRCT as the "gold standard," the positive predictive value of RAO film was only 13%-26%. Most of the 17 false-positive diagnoses of pleural fibrosis were due to significant subpleural fat. These results suggest that the routine use of oblique radiographs as a screening test in cohorts of subjects exposed to low levels of pollution by asbestos should be reevaluated.

Air Pollutants, Occupational↗
PubMed1993

Respiratory symptoms, lung function, and pneumoconiosis among self employed dental technicians.

From the registry of self employed workers living in Paris, a group of 105 dental technicians was studied to evaluate occupational exposure, to determine respiratory manifestations, and to investigate immune disturbances. Seventy one dental technicians (age range 43-68: group D), 34 dental technicians younger than 43 or older than 68 (group d), and 68 control workers (age range 43-66: group C) were investigated. The demographic characteristics and the smoking habits of the groups D and C did not differ significantly. The dental technicians often worked alone (43.7%) or in small laboratories without adequate dust control. The mean duration of their exposure was long (group D 34.0 (SD 8.4) years). The prevalence of respiratory symptoms did not differ between groups D and C except for the occurrence of increased cough and phlegm lasting for three weeks or more over the past three years (group D 16.9%, group C 2.9%, p < 0.007). The effect of cigarette smoking on respiratory symptoms and lung function was obvious. All mean values of lung function for dental technicians and controls were within normal limits. Significant decreases in all mean lung function values were found among smokers by comparison with non-smokers, however, and a positive interaction with occupational exposure was established. The x ray films of dental technicians (n = 102, groups D and d) were read independently by four readers and recorded according to the International Labour Office classification of pneumoconioses. The prevalence of small opacities greater than 1/0 was 11.8% with a significant increase with duration of exposure. The prevalence among dental technicians with 30 years or exposure or more was significantly higher (22.2%) than those with less than 30 years (3.5, p < 0.004). The prevalence of autoantibodies (rheumatoid factors, antinuclear antibodies, and antihistone antibodies) was not significantly different in the groups D and C. When positive, autoantibodies only occurred at low concentrations. This finding contrasts with previous reports on the occurrence of autoantibodies and even of connective tissue diseases in dental technicians. In conclusion, the study confirms an increased risk of pneumoconiosis among dental technicians. Moreover, there may be other lung disorders such as impairment of lung function especially in association with cigarette smoking.

Adult↗
PubMed1992

Occupational hypersensitivity pneumonitis in a smelter exposed to zinc fumes.

A smelter exposed to zinc fumes reported severe recurrent episodes of cough, dyspnea and fever. Bronchoalveolar lavage showed a marked increase in lymphocytes count with predominance of CD8 T-lymphocytes. Presence of zinc in alveolar macrophages was assessed by analytic transmission electron microscopy. This is the first case of recurrent bronchoalveolitis related to zinc exposure in which the clinical picture and BAL results indicate a probable hypersensitivity pneumonitis.

Adult↗