[Chronic cough: clinical symptoms].
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A previous retrospective mortality study of 292 U.S. cadmium production workers employed for a minimum of 2 years showed increased mortality from respiratory and prostate cancer and from nonmalignant lung disease. To examine further the mortality experience of these workers, investigators from the National Institute for Occupational Safety and Health extended the study to include 602 white males with at least 6 months of production work in the same plant between 1940 and 1969. Vital status was determined through 1978, which included the addition of 5 years to the original follow-up. Cause-specific mortality rates for seven causes of death potentially related to cadmium exposure were compared between the overall cohort and U.S. white males and between subgroups. Mortality from respiratory cancer and from nonmalignant gastrointestinal disease was significantly greater among the cadmium workers than would have been expected from U.S. rates. All deaths from lung cancer occurred among workers employed for 2 or more years. A statistically significant dose-response relationship was observed between lung cancer mortality and cumulative exposure to cadmium. A 50% increase in lung cancer mortality, which was not statistically significant, was observed even among workers whose cumulative exposure to cadmium was between 41 and 200 micrograms/m3 over 40 years. Since the previous investigation, no new deaths from prostate cancer and no excess of deaths from nonmalignant respiratory disease have been observed.
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The results of a survey conducted in a company employing 1850 persons working in air-conditioned premises are reported. One hundred and five persons were examined, including 790 who mostly complained of respiratory disorders and 20 controls. Regular check-ups during the last two years have failed to reveal any serious disease. The most frequent complaints were rhinitis and tracheitis, especially among female employees. No alveolitis was observed. The finding of Bacillus subtilis in samples of ambient air and air-conditioner filters in conjunction with the presence of precipitating antibodies against crude extracts from these samples, suggested that the respiratory disorders might have been due to this microorganism. A multifactorial analysis demonstrated a statistically significant correlation between clinical symptoms and immunological disorders. The air-conditioner disease, therefore, may present as a benign condition.
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Group pens equipped with automatic milk-feeding systems are increasingly being used for young dairy calves in Sweden. The system is, however, associated with an increased risk of clinical respiratory-tract disease and a reduced growth rate. In an experimental study we compared the health and growth rate of two different group sizes of calves (6-9 versus 12-18) kept in pens with automatic milk-feeders. The experiment was performed from September 2002 to February 2004, in nine commercial dairy farms in south-west Sweden. Each farm was equipped with two pens with automatic milk-feeders and no possibility of direct contact between calves from different pens. The calves were housed individually until 3-35 (median, 12) days of age, and then were allocated to one of the two group pens by random-number lists. Altogether 892 calves were studied: 297 in the small- and 595 in the large-sized groups. The calves' heart girths were measured at birth and at 56 days of age. Blood samples for analysis of serum haptoglobin concentration (S-Hp) were collected once for each calf, at four to eight weeks of age. Diseases were recorded by the farmers and by a veterinarian, who visited the farms every third week and physically examined all the calves. The effects of group size on the risks of diarrhoea, clinical respiratory-tract disease and increased respiratory sounds, and on the growth rate and S-Hp were evaluated using multiple logistic- and linear-regression models with herd as fixed effect. Age at transfer to group pen, breed, immunoglobulin concentration of colostrum received, parity of the dam and presence of diarrhoea before transfer to the group pen, season, sex, year, and, in the analysis of growth rate, birth heart girth were extra explanatory variables. Calves in pens for 12-18 calves had a higher incidence of respiratory illness (OR: 1.4) and grew 0.022 cm/day less than calves housed in groups of 6-9 animals (equivalent to approximately 40 g/day). We detected no differences between calves kept in the small-sized versus the large-sized groups in terms of risk of diarrhoea or mean S-Hp. We concluded that housing calves in groups of under 10 calves is preferable from a health and growth perspective.
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Multiple factors, including cardiopulmonary anatomy, direct viral effects and the immune response can affect the severity of lower respiratory tract disease caused by respiratory syncytial virus (RSV). RSV is the most frequent viral respiratory cause of hospitalization in infants and young children in the world. In this review, we discuss the mechanisms of illness associated with severe RSV lower respiratory tract disease. A better understanding of the factors affecting the course of illness and their interplay should allow development of effective therapies in the future.
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