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M Abramson

Publications and source records attributed to M Abramson.

At least 37 records · Page 2Linked to original sources
PubMed2000

A reliable and valid asthma general knowledge questionnaire useful in the training of asthma educators.

Using the responses of 115 adults attending an asthma educator training course, the Asthma General Knowledge Questionnaire for Adults (AGKQA) was found to be an acceptably valid and reliable measure for assessing knowledge related to the management of asthma by adults. Content and face validity: expert assessors considered the AGKQA to be a relevant and plausible test of the asthma general knowledge content of the programme. Criterion-related validity: the pretraining scores of educators were significantly higher (P < 0.001) than those of adults with no experience of asthma; total scores for the AGKQA and an asthma knowledge questionnaire developed for parents of children with asthma correlated strongly, 0.72. Test-retest reproducibility: the Spearman rank correlation for the test-retest score was 0.72 (P < 0.02), kappas for concordance of item responses were moderate to very good for two thirds of the items. Internal consistency for the total scale was also acceptable, KR20 0.66.

Adolescent↗
PubMed2000

Management and treatment perceptions among young adults with asthma in Melbourne: the Australian experience from the European Community Respiratory Health Survey.

OBJECTIVES: As part of the European Community Respiratory Health Survey (ECRHS) in 1992-1993 we assessed management practices and treatment perceptions among young asthmatic adults in Melbourne, Australia. METHODOLOGY: We conducted a postal questionnaire survey of 4500 randomly selected adults (aged 20-44 years), drawn from three electoral districts, of whom 3200 (71%) subjects responded. A randomly selected sample of 1642 respondents, 'enriched' by a further 433 symptomatic subjects, was invited to complete a second phase respiratory questionnaire. RESULTS: The questionnaire was completed by 757 subjects who underwent laboratory testing. A further 119 subjects who were unable to attend the laboratory completed an identical questionnaire by telephone interview (42% response rate). In the second phase, 16% of subjects reported 'current asthma' (group I) as defined by physician confirmation and a recent attack (within 1 year), 10% had confirmed asthma but reported no recent attack (group II) and 74% did not have asthma (group III). Inhaled corticosteroid use was significantly higher in group I than in group II subjects (45% vs 24%, P<0.01), but only 11% of asthmatic subjects overall reported daily prophylactic use. Regular treatment in any form was considered to be 'bad' by 65% of asthmatic subjects and only 43% took medication as prescribed all of the time. CONCLUSION: Despite national education campaigns, the majority of young asthmatic adults in Melbourne did not adhere to prescribed treatment, but continued to rely upon beta2-agonists alone with neglect of regular inhaled corticosteroid which has probably contributed to Australia's continued high asthma morbidity and mortality rates.

Adrenal Cortex Hormones↗
PubMed2000

Respiratory symptoms and lung function in alumina refinery employees.

OBJECTIVES: Employees in alumina refineries are known to be exposed to a number of potential respiratory irritants, particularly caustic mist and bauxite and alumina dusts. To examine the prevalence of work related respiratory symptoms and lung function in alumina refinery employees and relate these to their jobs. METHODS: 2964 current employees of three alumina refineries in Western Australia were invited to participate in a cross sectional study, and 89% responded. Subjects were given a questionnaire on respiratory symptoms, smoking, and occupations with additional questions on temporal relations between respiratory symptoms and work. Forced expiratory volume in 1 second (FEV(1)) and forced vital capacity (FVC) were measured with a rolling seal spirometer. Atopy was assessed with prick skin tests for common allergens. Associations between work and symptoms were assessed with Cox's regression to estimate prevalence ratios, and between work and lung function with linear regression. RESULTS: Work related wheeze, chest tightness, shortness of breath, and rhinitis were reported by 5.0%, 3.5%, 2.5%, and 9.5% of participants respectively. After adjustment for age, smoking, and atopy, most groups of production employees reported a greater prevalence of work related symptoms than did office employees. After adjustment for age, smoking, height, and atopy, subjects reporting work related wheeze, chest tightness, and shortness of breath had significantly lower mean levels of FEV(1) (186, 162, and 272 ml respectively) than subjects without these symptoms. Prevalence of most work related symptoms was higher at refinery 2 than at the other two refineries, but subjects at this refinery had an adjusted mean FEV(1) >60 ml higher than the others. Significant differences in FVC and FEV(1)/FVC ratio, but not FEV(1), were found between different process groups. CONCLUSIONS: There were significant differences in work related symptoms and lung function between process groups and refineries, but these were mostly not consistent. Undefined selection factors and underlying population differences may account for some of these findings but workplace exposures may also contribute. The differences identified between groups were unlikely to be clinically of note.

Air Pollutants, Occupational↗
PubMed1999

Respiratory symptoms and lung function in two prebake aluminum smelters.

BACKGROUND: Respiratory symptoms are known to occur in some aluminum smelter employees working in the potroom department but little is known about the respiratory health of employees in other departments. METHODS: This cross-sectional study examined the prevalence of work-related respiratory symptoms and levels of lung function in different departments of two aluminum smelters compared to administration employees. Multiple logistic regression was performed with each of four work-related symptoms as outcomes and multiple linear regressions were performed with FEV1 and FVC as outcomes. RESULTS: There were 1,529 male participants in the two smelters representing a response rate of 89.6%. After adjusting for age and smoking, work-related respiratory symptoms were reported significantly more often among the ingot mill, anode, and potroom groups in Smelter A. In Smelter B, ingot employees were more likely to report work-related wheeze and potroom employees were more likely to report work-related rhinitis. Symptoms tended to increase with increasing time in the potrooms but were more likely to occur in new employees in the ingot mill and anode process groups. After adjusting for age, height, and smoking, there were no significant differences between the process groups for either FEV1 or FVC at Smelter A, and at Smelter B potroom employees had slightly greater FEV1 and FVC than the administration employees. CONCLUSIONS: Work-related respiratory symptoms among aluminum smelter workers are not reported only by potroom employees but also by ingot mill and anode employees.

Adult↗
PubMed1999

Residential characteristics influence Der p 1 levels in homes in Melbourne, Australia.

BACKGROUND: Exposure to house dust mite (HDM) allergens is an important risk factor for childhood asthma. Knowledge of environmental determinants of HDM allergen levels is essential before designing rational avoidance measures. AIM: To investigate the effect of domestic characteristics on HDM allergen (Der p 1) levels in Melbourne homes. METHODS: Dust was collected from bed and floor of the bedrooms in 485 houses over a period of one year. Dust was analysed for Der p 1 levels using an enzyme-linked immunosorbent assay. Temperature and relative humidity were measured at the visit. Details of residential characteristics were collected using a questionnaire. Statistically significant predictors of Der p 1 levels (P < 0.05) were identified using multiple linear regression. RESULTS: High levels of Der p 1 were observed in the floors (geometric mean 17.2 microg/g fine dust) as well as in the beds (geometric mean 20.3 microg/g fine dust). Der p 1 levels in the floor dust were significantly lower in winter and spring. They were higher in houses built before 1980 and those with central heating, weather board walls, damp bedrooms or fitted old wool carpets. Der p 1 levels in bed dust were significantly higher in houses built before 1980, with wooden floors built on stumps, with high relative humidity, with visible mould in the room, in beds with an old mattress or in beds without a quilt. CONCLUSIONS: We would encourage construction of homes without carpets, wooden floors on stumps or weather board walls.

Allergens↗
PubMed1999

Prevalence and residential determinants of fungi within homes in Melbourne, Australia.

BACKGROUND: Recent epidemiological studies suggest that the adverse respiratory health effects caused by the inhalation of fungal propagules are substantial. Knowledge of the prevalence and environmental determinants of indoor fungal levels is essential in designing effective avoidance measures. AIM: To investigate the prevalence of fungi and the influence of residential characteristics on levels of fungi within homes in Melbourne, Australia. METHODS: Floor dust and air samples were collected from bedrooms in 485 houses over 1 year. The dust was analysed for ergosterol, a marker of cumulative fungal biomass exposure. Total and genera-specific fungal propagules were identified in air samples. Details of the relevant residential characteristics were documented using a questionnaire. Independent predictors (P < 0.05) of ergosterol and total fungal propagules were identified by multiple linear regression. RESULTS: Fifty-five percent of the houses had viable fungal propagules exceeding 500 CFU/m3. Cladosporium and Penicillium were identified as the most prevalent and abundant fungal genera in indoor air. The median ergosterol level in bedroom floor was 3.8 microg/g of dust. Multivariate analysis showed that total fungal propagules in indoor air were lower in bedrooms with a ceiling fan, without visible mould, and those that were more frequently vacuumed, had a solid fuel fire, had windows closed at the time of the sampling or lacked pets. The presence of more than one cat had the greatest effect on total fungal propagules. Ergosterol levels were significantly lower in homes without old fitted carpets, visible mould or pets and those with frequent airing and regular use of an extractor fan in the kitchen. Old wall-to-wall carpets had the greatest effect on ergosterol. CONCLUSIONS: High indoor fungal exposures were associated with infrequent ventilation or vacuuming, presence of pets, visible mould and old carpets.

Adult↗
PubMed1999

A reliable and valid home visit report for studies of asthma in young adults.

Validated instruments are not available to assess the residential characteristics. The aim of this study was to assess the reliability and validity of an interviewer-administered home visit report. The validity of 48 items in the Home Visit Report was examined against: observations made by a researcher, measurements of relative humidity, cat allergen, and ergosterol, a biomaker of fungal exposure and a biochemical test. Test-retest reliability of 10 fixed residential characteristics was assessed comparing the responses obtained in the main study with the pilot study, Kappa, ANOVA and Wilcoxon Rank Sum tests were applied to assess the agreement and P < 0.05 was considered as statistically significant. Among 44 items examined for the validity against observations, there was a perfect or almost perfect agreement in 21 (kappa = 0.9-1) and substantial agreement (kappa = 0.6-0.8) in 19. Higher cat allergen levels were observed with cat ownership and cat being allowed indoors. Observed condensation was associated with relative humidity and observed mould was associated with ergosterol levels. The agreement on the type of carpet and the test was substantial (kappa = 0.6). Among 10 items examined for reliability, there was a perfect or almost perfect agreement in 9 (kappa = 0.9-1) and substantial agreement (kappa = 0.7) in one. In conclusion, the Home Visit Report validated in this study provides reliable and valid data.

Adult↗
PubMed1999

Evaluation of a randomised controlled trial of adult asthma education in a hospital setting.

BACKGROUND: Although patient education is a key step in the Australian Asthma Management Plan, its impact has not been assessed in a hospital outpatient asthma clinic. METHODS: A controlled trial was undertaken in 125 adults with asthma recruited from the Alfred Hospital Asthma and Allergy Clinic and randomly allocated to an intervention (n = 64) or control (n = 61) group. Subjects in the intervention group attended three education sessions, each of 90 minutes duration, spread over three successive weeks. Asthma knowledge, quality of life, self-management skills, and attitudes and beliefs about asthma were assessed by questionnaires at baseline and after six months. The intervention group was also assessed immediately after the three education sessions. The control group was evaluated after six months of usual care. RESULTS: Asthma knowledge improved significantly in the intervention group after three education sessions (p = 0.0001) and this was retained six months later (p = 0.03). The impact of asthma on quality of life decreased significantly immediately after intervention (p = 0.03) but this was not maintained six months later (p = 0.35). On the other hand, the intervention had little impact on self-management skills or attitudes and beliefs about asthma. However, the control group had also improved their knowledge, quality of life and self-management skills after six months of usual care. The difference in mean change in knowledge score at six months between the intervention and control groups was not significant (p = 0.51). CONCLUSIONS: In contrast to some other studies, a limited asthma education programme in a hospital outpatient setting had a positive impact on patients' knowledge of asthma, but not on their quality of life, self-management skills, or attitudes and beliefs about asthma.

Adult↗
PubMed1998

Exposures in the alumina and primary aluminium industry: an historical review.

We reviewed specific chemical exposures and exposure assessment methods relating to published and unpublished epidemiological studies in the alumina and primary aluminium industry. Our focus was to review limitations in the current literature and make recommendations for future research. Although some of the exposures in the smelting of aluminium have been well characterised, particularly in potrooms, little has been published regarding the exposures in bauxite mining and alumina refining. Past epidemiological studies in the industry have concentrated on the smelting of aluminium, with many limitations in the methodology used in their exposure assessment. We found that in aluminium smelting, exposures to fluorides, coal tar pitch volatiles (CTPV) and sulfur dioxide (SO2) have tended to decrease in recent years, but insufficient information exists for the other known exposures. Although excess cancers have been found among workers in the smelting of aluminium, the exposure assessment methods in future studies need to be improved to better characterise possible causative agents. The small number of cohort studies has been a factor in the failure to identify clear exposure-response relationships for respiratory diseases. A dose-response relationship has been recently described for fluoride exposure and bronchial hyper-responsiveness, but whether fluorides are the causative agent, co-agent or simply markers for the causative agent(s) for potroom asthma, remains to be determined. Published epidemiological studies and quantitative exposure data for bauxite mining and alumina refining are virtually non-existent. Determination of possible exposure-response relationships for this part of the industry through improved exposure assessment methods should be the focus of future studies.

Aluminum↗
PubMed1998

Do dairy products induce bronchoconstriction in adults with asthma?

BACKGROUND: Dairy products have often been implicated as a cause of exacerbation of asthma, but there is little scientific evidence to support this hypothesis. OBJECTIVE: We sought to determine whether dairy products induce bronchoconstriction in a group of adults with asthma. METHODS: Twenty subjects with asthma (13 women and 7 men) were recruited from respondents who had previously completed a food and asthma questionnaire. Ten subjects perceived that their asthma became worse with ingestion of dairy products (positive perceivers), whereas ten were negative perceivers. None of the subjects had positive skin prick test results with cow's milk. The study was a randomized, cross-over, double-blind, placebo-controlled trial. Subjects complied with a dairy-free diet throughout the study. The active challenge was a single-dose drink equivalent to 300 ml of cow's milk. A positive reaction was defined as a 15% reduction in both FEV1 and peak expiratory flow (PEF) on the active challenge day compared with results obtained at the same time on the placebo day. RESULTS: For both FEV1 and PEF there were no statistically significantly differences in group means between active challenge and placebo challenge, between sequence of administration, or between perceptions. Nine subjects showed FEV1 or PEF changes that were greater than 15% of baseline values: four patients showed changes after both active and placebo treatment; two after treatment with placebo only; and three after active treatment alone. Of the latter group, two subjects showed changes only in PEF, and when one of these subjects underwent a further detailed study, no asthmatic reaction could be demonstrated. CONCLUSION: It is unlikely that dairy products have a specific bronchoconstrictor effect in most patients with asthma, regardless of their perception.

Adolescent↗
PubMed1998

The effects of monosodium glutamate in adults with asthma who perceive themselves to be monosodium glutamate-intolerant.

BACKGROUND: Many previous clinical studies of food-induced asthma suffer from inadequate baseline or control data. A statistically valid, randomized, double-blind, placebo-controlled, monosodium glutamate (MSG)-challenge protocol was developed for identifying early and late asthmatic reactions in an individual. OBJECTIVE: We sought to determine whether MSG would induce bronchoconstriction in a group of adults with asthma who perceived that they were MSG sensitive. METHODS: Twelve subjects (seven women, mean age 35.3 years) with clinically documented asthma and a perception of MSG-induced asthma were recruited. FEV1 and peak expiratory flow data were obtained for 3 whole control days, as well as time-matched data for 3 separate challenge days (1 gm MSG, 5 gm MSG, and 5 gm lactose [placebo]). Opaque capsule challenges were given as a single dose in the morning after an overnight fast. Subjects complied with an elimination diet throughout the study. Nonspecific bronchial hyperresponsiveness was measured at baseline, after the control days, and at the conclusion of the challenges. Venous blood samples were taken at baseline and on each challenge day to determine soluble inflammatory marker (eosinophil cationic protein and tryptase) activity. RESULTS: No immediate or definite late asthmatic reactions occurred. One subject's FEV1 declined more than 15% on MSG challenge, but 95% confidence limits for the control-day spirometry showed that this decline was within her daily variation, hence the challenge was deemed to be negative. No significant changes in bronchial hyperresponsiveness or soluble inflammatory markers were found. CONCLUSIONS: MSG-induced asthma was not demonstrated in this study. This study highlighted the importance of adequate baseline and control data and indicated that such a rigorous protocol for individual assessment is feasible.

Adult↗
PubMed1998

Air pollution in the Latrobe Valley and its impact upon respiratory morbidity.

OBJECTIVE: To assess the relationship between air pollution and respiratory morbidity. DESIGN: An ecological study of the daily hospital admissions abstracted for the 1988 calendar year. Air quality data, including nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3) and particulates, were obtained from the relevant authorities. SETTING: Latrobe Valley, Victoria. SUBJECTS: Hospital admissions for asthma and Chronic Obstructive Airways Disease. (COAD). RESULTS: There were significant associations (r = 0.11 to 0.17) between airborne particles, nitrogen dioxide and respiratory morbidity. There was no significant relationship between any of the pollutants and asthma admissions. However, multi-variate analysis confirmed that NO2 and particulates were associated with admissions for COAD. CONCLUSION: Respiratory morbidity appears to be affected even by the low air pollution levels in the Latrobe Valley.

Air Pollution↗
PubMed1998

Reported food intolerance and respiratory symptoms in young adults.

The aim of the study was to assess the ability of the European Community Respiratory Health Survey (ECRHS) questionnaire to provide data on the prevalence, type and reported symptoms associated with food intolerance from a group of young adults in Melbourne. Six hundred and sixty nine randomly selected subjects completed the questionnaire with 553 attending the laboratory for skin-prick tests, anthropometry, and ventilatory function tests. A further 207 symptomatic participants completed the questionnaire, with 204 of them attending the laboratory. Seventeen per cent of all respondents reported food intolerance or food allergy. A wide variety of food items was cited as being responsible for food-related illnesses. Those with current asthma did not report food-related illness more frequently than those without asthma. Respondents who reported respiratory symptoms following food ingestion were more likely to be atopic, to have used inhaled respiratory medications in the previous 12 months, reported less exposure to regular passive smoking over the past 12 months and weighed more. These associations between respiratory symptoms and food intolerance require further prospective investigation and verification. The importance of using appropriate dietary methodology in future studies for determining diet-disease relationships was highlighted by this study.

Adult↗
PubMed1998

Why do only some of the young adults with bronchial hyperreactivity wheeze?

The significance of nonspecific bronchial hyperreactivity (BHR) is a controversial issue in asthma. The natural history of BHR has not been investigated adequately although its importance as a cross-sectional risk factor for asthma is widely accepted. This paper investigates the risk factors for wheeze among people with BHR. Subjects were young adults who had participated in the second phase of the European Community Respiratory Health Survey in Melbourne, Australia. We compared the participants with wheeze and BHR (n=186) to those with asymptomatic BHR (n=66). Information was collected on sociodemographic factors, family history of asthma, and relevant environmental factors using an interviewer-administered questionnaire. Atopy to a range of aeroallergens was examined by skin prick tests. Risk factors were examined by adjusting the odds ratios (OR) by a logistic regression to control for confounding effects. Parental asthma (OR=4.2), keeping pets during childhood (OR=3.3), allergy to house dust mite (OR=2.7), allergic rhinitis (OR=2.6), and having ever smoked (OR=2.4) were associated with an increased risk of wheeze, independent of the other factors examined. When allergic rhinitis was not included as an explanatory variable, being atopic to any of the allergens assessed was found to increase the risk of current wheeze (OR=4.8). Allergic rhinitis may represent an intermediate stage in the natural history of BHR. Avoidance of pets during childhood, not smoking, and taking steps to minimize dust exposure are likely to prevent the progression from asymptomatic BHR to asthma.

Adult↗
PubMed1997

Attendance at an asthma educational intervention: characteristics of participants and non-participants.

As part of an evaluation of the patient education component of the Australian Asthma Management plan, a randomized, controlled trial of asthma education was conducted in 1994/95 at the outpatient asthma and allergy clinic of The Alfred Hospital, a tertiary referral hospital in Melbourne, Australia. The objective of the study was to investigate which demographic and clinical characteristics were associated with attendance at asthma educational session. A total of 125 asthmatics aged over 16 years agreed to participate in the programme, and full compliance with the programme was 43.2%. Allocation to immediate, rather than delayed, education and age were the only significant predictors of attendance. Subjects randomized to the intervention were approximately three times more likely to attend than control subjects (OR = 3.3, 95% CI 1.5-7.3). Asthmatics over 60 years old were approximately six times more likely to attend (OR = 6.6, 95% CI 2.2-19.8) than the age group 16-30 years. The increasing trend in attendance across age categories was highly significant (P < 0.001). There was no relationship between attendance and gender, medication, atopy, smoking status or the physical accessibility of the hospital. Despite offering incentives and conducting the education sessions at subjects' preferred times, their compliance in attending sessions was poor. Over half of the asthmatics, who had expressed interest, failed to attend for their educational sessions. An alternative strategy is required to improve participation by young and employed asthmatics at hospital-based asthma education programmes.

Adolescent↗
PubMed1997

Does occupational exposure to brown coal dust cause a decline in lung function?

OBJECTIVES: To determine if the rate of change in forced expiratory volume in one second (FEV1) in subjects with high exposure to Latrobe Valley brown coal dust was significantly greater than the rate of change among subjects with low exposure. METHODS: A retrospective dynamic cohort design with variable time windows. This study was conducted over a period of 14 years from 1980 to 1994 and used data collected by the State Electricity Commission (SEC) Lung Function Unit for an asbestos surveillance programme. The subjects were exposed to low, medium, or high levels of coal dust. Basic spirometry with wedge bellows spirometers was used to assess lung function. A general linear model (GLM) was used to assess the effects of smoking and exposure to coal dust upon the change in forced expiratory volume in one second (FEV1) while adjusting for age and height. RESULTS: The mean (95% confidence interval (95% CI) rate of decline in FEV1 was 40 (36 to 44) ml/year. Age was a significant predictor of change. A significant effect was found for smoking (P = 0.02) and for exposure to coal dust (P = 0.008). The only significant difference with exposure to coal dust was between the high and mixed exposure categories. CONCLUSION: There is no convincing evidence of excessive decline in FEV1 with exposure to coal dust > 0.75 mg/m3. The absence of a dose response relation provides some evidence against a causal relation. On the basis of this study, reduction of the exposure standards currently applied to brown coal dust in the Victorian electricity industry is not warranted to prevent respiratory disease.

Age Factors↗