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The clinical evaluation of newly developed asthma in an adult should always include consideration of his occupational environment, since an abundance of different exposures, which are known causes of asthma, occur in workplaces. Two types of occupational asthma (OA) are distinguished, by whether they appear after a latency period: 1) Immunological OA, characterised by a latency period, caused by high and low-molecular-weight agents, with or without an IgE mechanism 2) Non-immunological, i.e. irritant induced asthma. The first step of the clinical evaluation is to confirm a diagnosis of asthma. Second step is to find out if there is a temporo-spatial distribution of symptoms and lung function that are indicative of OA. Third step is to determine if the disease at hand is an IgE or a non-IgE mediated disease. Last step is a challenge test that can be either unspecific, in order to assess the responsiveness of the lung, or specific challenge test, especially for the non-IgE mediated OA. The depth of clinical evaluation may vary from a situation in which a classical history confirms the clinical symptoms in e.g. a baker with confirmed allergy towards well-known allergens and a characteristic pattern in serial measurements of lung function, to more elaborate investigations in a situation with no or unknown allergen. In the latter situation, a specific challenge test might be necessary in order to find the offending agent. Finally, challenge tests are important in order to distinguish a causal relation from unspecific hyperresponsiveness in persons with pre-existing asthma. In these situations, extended sick leave and challenge tests can be the only way to find the answer.
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Respiratory effects of exposure to dust from herbs

63%
A group of 150 people occupationally exposed to dust from herbs were examined. As a reference group, 50 urban dwellers, not exposed to any kind of organic dust were examined. People were subjected to routine physical examination and to lung function examinations with the LUNGTEST 500 spirometer (MES, Krakow, Poland). The spirometric values of the forced expiratory volume in one second (FEV1), vital capacity (VC) and FEV1/VC were recorded before and after work. Physical chest examination revealed pathological crepitations in 10 people (6.7%). The mean baseline spirometric values in the study and reference groups did not show significant differences compared to the normal values. In the herb workers exposed to organic dust the post-shift decrease of all analysed spirometric values was noted. The post-shift decrease of some spirometric values (VC, VC% of normal values) was highly significant (p<0.01). There was evidenced of a significant positive correlation between the age of examined people and decrease of VC and FEV1 values. In 12 exposed workers the decrease of FEV1 or FEV1% of normal values higher than 15% was noted. 50% of these workers cultivated thyme (Thymus vulgaris L.). This may suggest that dust from herbs, especially thyme dust, may cause acute airway obstruction. In the group showing significant decrease of FEV1/FEV1% of normal values (>15%) the frequency of reported respiratory work-related symptoms (83.3%) was higher than in the rest of exposed group (61.5%). In conclusion, occupational exposure to dust from herbs may cause harmful effects on the respiratory system among herb processing workers. This indicates the need for use of prophylactic measures in this professional group, the more so as number of people occupationally exposed to dust from herbs is growing.
Air samples were collected on glass fi bre fi lters in 22 animal houses and 3 hay storage barns and examined for the presence of bacterial endotoxin with the Limulus (LAL) test and the gas chromatography – tandem mass spectrometry (GC-MSMS) technique, based on detection of 3-hydroxy fatty acids (3-OH-FAs) as chemical markers of the endotoxin lipopolysaccharide. The median concentrations of airborne endotoxin determined with LAL test in poultry houses, sheep sheds, piggeries, cow barns, and horse stables were respectively 62.49 μg/m3, 26.2 μg/m3, 3.8 μg/m3, 1.65 μg/m3, and 1.14 μg/m3, while those determined with the GC-MSMS technique were respectively 1.06 μg/m3, 7.91 μg/m3, 0.2 μg/m3, 0.31 μg/m3, and 1.42 μg/m3. The median concentrations of airborne endotoxin determined with LAL test and GC-MSMS technique in hay storage barns were much smaller, 0.09 μg/m3 and 0.03 μg/m3, respectively. The concentrations of airborne endotoxin (LPS) detected with GC-MSMS method in the air of sheep sheds were signifi cantly greater than in all other examined facilities, while those detected in hay storage barns were signifi cantly smaller than in all other examined facilities (p<0.05). The concentrations of airborne endotoxin determined with LAL test and GC-MSMS analysis exceeded in most of animal houses examined (91% by each method) the threshold limit value for airborne endotoxin of 0.1 μg/m3 proposed by various authors. A signifi cant correlation (p<0.05) between the concentrations of endotoxin determined with the LAL and GC-MSMS techniques was found in the air samples collected in poultry houses and sheep sheds, but not in other examined facilities. 3-OH FAs with C14-C18 chains were predominant in the air of the facilities under study. A signifi cant correlation (p<0.05) was found between the concentrations of endotoxin determined with LAL test and the amounts of 3-OH FAs with C14-C16 chains. In conclusion, endotoxin in the concentrations detected in this study may present a respiratory hazard to both humans and livestock animals.
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