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Biomedical subjects

S M Tarlo

Publications and source records attributed to S M Tarlo.

At least 55 records · Page 3Linked to original sources
PubMed1995

Anaphylaxis to carrageenan: a pseudo-latex allergy.

BACKGROUND: Anaphylactic reactions during a barium enema have been attributed to allergy to latex on the barium enema device. The observation of anaphylaxis during barium enema without latex exposure or latex allergy led to the performance of an allergy skin test to the barium enema solution. METHODS: Individual components of the barium enema solution were obtained for double-blind skin testing. A RAST to identify specific IgE antibodies to the skin test active agent was established. RESULTS: Carrageenan, a component of the barium enema solution, produced positive reactions to allergy skin test and RAST. Gastrointestinal symptoms for which the patient was being investigated by the barium enema subsequently disappeared with a diet free of carrageenan. CONCLUSIONS: Carrageenan is a previously unreported cause of anaphylaxis during barium enema. It is an allergen widely distributed in common foods and potentially could account for some symptoms related to milk products or baby formula.

Anaphylaxis↗
PubMed1995

Exposure characteristics and cutaneous problems in operating room staff.

Health care personnel have exposure to a variety of cutaneous irritants and allergens and a high prevalence of cutaneous problems. The objectives of this exploratory study were to characterize the exposures and determine the prevalence of cutaneous symptoms and findings in operating room personnel, and to examine relationships between exposure characteristics and cutaneous outcomes. A questionnaire and standardized hand examination were used to assess the exposures and cutaneous status of operating room personnel. 184 operating room staff (90% of the eligible population) were assessed. Current skin problems were reported by 26%. Hand examination revealed that 9% had findings consistent with eczema and 10% changes of moderate dryness. A variety of preventive practices were being used by those with symptoms or findings. Cutaneous problems are common in operating room personnel. The use of preventive strategies (changing the type of gloves worn or the type of soap used for scrubbing, the use of glove liners and emollients) varied between different groups. These workers might benefit from more education regarding cutaneous hazards, preventive stategies and the importance of appropriate investigation of these problems.

Adult↗
PubMed1995

A workers' compensation claim population for occupational asthma. Comparison of subgroups.

STUDY OBJECTIVE: (1) To compare patients with claims submitted to the Ontario Workers' Compensation Board (WCB) for occupational asthma, in relation to the WCB decisions reached of occupational asthma (OA); aggravation of asthma from irritant exposures (AA); unrelated asthma; no asthma; and (2) to assess determinants of outcome of WCB accepted claims at permanent disability assessments. DESIGN: A retrospective review of 609 claims submitted to the WCB 1984 to 1988. RESULTS: The WCB decision reached was OA in 39% of claims, mostly attributed to isocyanates (57% of these). A further 39% were accepted for AA. Exposure to a known sensitizer occurred in 91% with OA and to an irritant in 67% with AA. Forty percent with AA were attributed to a spill or accidental exposure and 68% had preceding asthma. Those with AA were more likely to have clearing of symptoms by the time of their main assessment (43% vs 20% with OA) and were more likely to have remained in the same work (35% vs 20% with OA). Of 200 OA accepted claims reviewed at a mean of 1.9 years later, clearing of asthma occurred in 19% and milder asthma in 47%. Outcome was best with early diagnosis (p < 0.05), and milder impairment of pulmonary function at initial assessment (p < 0.05). CONCLUSIONS: Patients with asthma induced by a workplace sensitizer demonstrate some differences from those related to workplace irritants. Accurate categorization and early removal of those with OA offers the best prognosis.

Adult↗
PubMed1994

Control of airborne latex by use of powder-free latex gloves.

OBJECTIVE: Our objective was to assess airborne latex allergen exposure in the workplace of a hospital laboratory technician with occupational latex sensitization and repeated anaphylactic episodes from this. Her allergic manifestations had cleared only when coworkers changed to powder-free latex gloves. Therefore a laboratory still using powdered latex gloves was selected for comparative airborne latex sampling. DESIGN: The design was a survey. SETTING: We used a hospital hematology laboratory, and a biochemistry laboratory was used for comparison. PARTICIPANTS: The index case with latex allergy is described. An average of 10 employees worked on the day shift in the same laboratory, and 10 employees worked in the biochemistry laboratory studied. MAIN OUTCOME MEASURE: Airborne latex allergen levels obtained by high airflow area sampling were compared in the laboratory using powder-free latex gloves and in the laboratory using powdered latex gloves. RESULTS: Levels were below the level of detection (< 0.02 ng/m3 of latex allergen) in the laboratory using powder-free latex gloves but ranged from 39 to 311 ng/m3 in the laboratory using powdered gloves. CONCLUSIONS: Airborne latex allergen is produced with use of powdered latex gloves. Such usage by coworkers may provoke respiratory and anaphylactic response to latex in sensitized subjects. Use of powder-free gloves by coworkers may enable such patients to continue work in their trained profession and may prevent measurable airborne latex exposure. Affected patients, however, still need to avoid direct latex contact.

Adult↗
PubMed1993

Seasonal variations of nasal resistance in allergic rhinitis and environmental pollen counts.

We made measurements of nasal airway resistance in a patient with Japanese cedar pollinosis and also measured the environmental pollen counts under different exposure conditions. In the season of high Japanese cedar pollen counts in Japan values of mean nasal airway resistance were significantly increased, remained elevated for 2 months after the season, and eventually decreased. In the season of low pollen counts, the mean values of nasal airway resistance measurements were increased during the season but decreased more rapidly after the season. In a year with no exposure to the environmental allergen because the subject lived out of Japan, the mean nasal airway resistances were relatively increased closely in phase with the Japanese cedar pollen season.

Adult↗
PubMed1993

Hypersensitivity pneumonitis and airways hyperreactivity induced by occupational exposure to penicillin.

A patient with penicillin-induced hyperreactive airways in association with hypersensitivity pneumonitis is described. Patch tests and intradermal tests to penicillin were positive. Bronchoalveolar lavage demonstrated a relative lymphocytosis and mild neutrophilia. Symptoms and physiologic abnormalities of pulmonary function and gas exchange resolved on cessation of exposure to penicillin.

Alveolitis, Extrinsic Allergic↗
PubMed1993

Occupational asthma caused by pectin inhalation during the manufacture of jam.

We report a case of pectin-induced occupational asthma in a 35-year-old man. His job involved mixing powdered pectin into a fruit puree during the manufacture of jam. Within minutes of adding pectin, he developed coryza, rhinorrhea, coughing, and wheezing. His symptoms cleared during weekends while away from work and improved with the use of a protective face mask at work. Peak flow rates were significantly lower while at work compared with those at home, and a prick skin test with the pectin powder was positive. We conclude that pectin should be added to the list of the substances known to induce occupational asthma.

Adult↗
PubMed1993

Asthma and anaphylactoid reactions to food additives.

Presumed allergic reactions to hidden food additives are both controversial and important. Clinical manifestations include asthma, urticaria, angioedema, and anaphylactic-anaphylactoid events. Most adverse reactions are caused by just a few additives, such as sulfites and monosodium glutamate. Diagnosis is suspected from the history and confirmed by specific challenge. The treatment is specific avoidance.

Anaphylaxis↗
PubMed1992

Occupational asthma induced by tall oil in the rubber tyre industry.

A worker in the rubber tyre industry is described with occupational asthma from exposure to a solution of tall oil, a pine resin, confirmed by specific inhalation challenge. This supports studies of contact dermatitis which have suggested abietic and dehydroabietic acid oxidants to be the cause of colophony induced allergic reactions.

Asthma↗
PubMed1991

Peak expiratory flow rates in possible occupational asthma.

Objective criteria for interpretation of peak expiratory flow rate readings were assessed in 50 patients evaluated for suspected occupational asthma who had at least two weeks of PEFR readings and an objective diagnosis based on other investigations. The prevalence of OA was 36 percent. Peak flows were interpreted by two observers blinded to other results. Criteria for a PEFR interpretation of OA were as follow: diurnal variation greater than or equal to 20 percent relatively more frequently or with greater variation on working days than days off work. With the objective diagnoses as the gold standard, the sensitivity of the PEFR interpretations was 72 percent for OA; specificity for no asthma was 53 percent. Excluding those with greater than or equal to 20 percent variation on only one day sensitivity improved to 93 percent for OA, and specificity to 77 percent. There was an acceptable level of interobserver variation (kappa 62 to 83 percent). We conclude that simple objective criteria for PEFR interpretation can be developed with acceptable interobserver variation.

Adult↗
PubMed1991

Outcome of assessments for occupational asthma.

Among 154 referrals to a university hospital clinic for assessment of possible occupational asthma, the feasibility and results of different investigations were assessed using a consistent approach to all patients. A positive skin test to a workplace allergen (14 percent of all subjects), positive peak flow workplace changes (12 percent), improvement in methacholine response on holiday (9 percent), and/or positive specific challenge testing (14 percent) supported the diagnosis of occupational asthma in 61 subjects (39 percent of the total referrals). Fifty-one of these were related to a workplace sensitizer and ten to a presumed irritant. Occupational asthma was excluded in 48 subjects (31 percent) who had normal methacholine responsiveness within 24 hours of work (22 percent of the 154 subjects), peak flow readings no worse at work than on holidays (14 percent of the total referrals) and/or negative specific challenge testing (10 percent of the total referrals). Insufficient information could be obtained for a diagnosis in the remaining 45 subjects (28 percent). No single investigation was considered diagnostic in this study, as each could be positive or negative for other reasons.

Adult↗
PubMed1990

Occupational asthma caused by latex in a surgical glove manufacturing plant.

A 33-year-old latex glove inspector was diagnosed as having occupational asthma on the basis of peak flow and methacholine-responsiveness changes related to workplace exposure. She had latex sensitivity by skin prick testing. This finding led to a survey of her workplace. Of the 81 workers, 84% completed a questionnaire to assess work-related respiratory symptoms, 79% underwent skin prick testing to latex and six other workplace chemicals, and 62% performed workshift spirometry. Seven workers had spirometric changes consistent with asthma, of whom five had greater than or equal to 15% fall in FEV1 during the workshift. Six of these workers underwent methacholine-challenge testing, and three were found to have a significant improvement in responsiveness to methacholine away from work, suggestive of occupational asthma. Two of these workers had positive skin test responses to latex. Including the index case, 6% of workers who had pulmonary function testing had findings of latex-related occupational asthma. Skin test responses to latex occurred in 11% of workers tested. Our findings suggest that latex should be considered among the causes of occupational asthma.

Adult↗
PubMed1990

Characteristics of patients with food-related complaints.

Forty-five patients with classic food-allergic symptoms and/or subjective food-related complaints not traditionally associated with food allergy underwent evaluation. On the basis of a comprehensive clinical history, skin testing, and placebo-controlled, double-blind food challenges, patients were assigned to one of two groups: patients with reactions highly suggestive of IgE-mediated food hypersensitivity (group A, N = 22) and patients with atypical adverse food reactions that could not be confirmed by double-blind food challenge (group B, N = 23). Most patients in both groups were female, 77.3% and 91.3% of patients in group A and B, respectively. In group B, onset of symptoms occurred at an older age than in group A, 28.9 years +/- 17.2 versus 17.1 +/- 12.1 (p = 0.0015), respectively, and involved more foods, 25.6 +/- 22.1 versus 5.2 +/- 5.5 (p = 0.0002). Foods causing most prominent symptoms among patients in group A included legumes, tree nuts, crustaceans, and fish. In group B, milk, white sugar, wheat, egg, smoked/cured meat, and yeast were among the most troublesome foods. All but one patient in group A gave a positive skin test response to food; only four patients in group B had a positive response. We conclude that a subset of patients with food-related complaints can be accurately predicted to have a negative double-blind challenge with suspected foods on the basis of information obtained by history and skin testing.

Adolescent↗
PubMed1989

Irritant-induced occupational asthma.

A retrospective review was performed on the files of 154 consecutive workers assessed for occupational asthma to clarify the relative frequency of asthma induced by irritants in the workplace and to determine whether such asthma was clearly distinguishable from other forms of occupational asthma. Fifty-nine workers were considered to have occupational asthma. A subset of ten had a history consistent with asthma initiated by exposure to high concentrations of an irritant, had persistent symptoms for an average of five years when seen, demonstrated increased reactivity to methacholine, and gave no prior history of pulmonary complaints. These ten had a lower incidence of atopy (20 percent vs 58 percent) and a more frequent history of smoking (80 percent vs 38 percent) than the other subjects with occupational asthma but did not differ in average latency (5.9 years vs 5.7 years). Our findings suggest that irritant-induced asthma is not uncommon, and those affected may have different baseline characteristics from others with occupational asthma.

Adult↗
PubMed1988

Skin testing with extracts of fungal species derived from the homes of allergy clinic patients in Toronto, Canada.

Airborne fungi in the homes of patients with allergic rhinitis or asthma, from a Toronto Allergy Clinic population, were isolated, quantified and identified to species. Allergen extracts were prepared from sixteen of these isolated species and used for skin-prick testing of twenty-six patients. Fourteen of the total patients reacted to one or more of these extracts at 1:10 (w/v) concentrations. The most common positive skin responses (8/14 to 6/14) were found for Cladosporium cladosporioides, Alternaria tenuis, C. sphaerospermum, and Fusarium sp. The two Cladosporium species were also most commonly isolated in homes, but A. tenuis and Fusarium sp. were found only in 4% and less than 1% of the air samples, respectively. Epicoccum purpurascens and C. herbarum, which were isolated on approximately 10% of the plates, showed fewer skin reactions compared with the above. Positive skin-test response to the other ten study extracts ranged from 5/14 for two species of Aspergillus and Phoma glomerata, to 1/14 for Penicillium viridicatum; of these species, Aspergillus fumigatus was isolated in 3% of the home samples, the others were less than 1%. The findings suggest that fungal antigens from species found in homes are commonly associated with skin sensitization in an allergy clinic population with upper or lower respiratory allergy. No specific relationships were found, however, between the prevalence of fungal species in the home environment and their prevalence as skin-test allergens.

Adult↗