Atopic dermatitis in a high-risk cohort: natural history, associated allergic outcomes, and risk factors.

Background: Atopic dermatitis (AD) is commonly associated with asthma and other atopic disorders in childhood.

Objective: To evaluate the natural history of AD and its association with other allergic outcomes in a high-risk cohort through the age of 7 years.

Methods: A total of 373 high-risk infants, who had undergone a randomized controlled trial with intervention measures for primary prevention of asthma applied during the first year of life, were assessed for asthma, AD, and allergic sensitization at 1, 2, and 7 years.

Cotinine versus questionnaire: early-life environmental tobacco smoke exposure and incident asthma.

Background: The use of biomarkers has expanded considerably, as an alternative to questionnaire-based metrics of environmental tobacco smoke (ETS); few studies have assessed the affect of such alternative metrics on diverse respiratory outcomes in children, and we aimed to do so.

Methods: We evaluated various measures of birth-year ETS, in association with multiple respiratory endpoints early years of life, in the novel context of a birth cohort at high risk for asthma. We administered questionnaires to parents, both at the end of pregnancy and at one year of life, and measured cotinine in cord blood (CCot; in 275 children) and in urine (UCot; obtained at 12 months in 365 children), each by radioimmunoassay.

Occupational exposure influences on gender differences in respiratory health.

Background: The aim of this study was to evaluate gender differences in the respiratory health of workers exposed to organic and inorganic dusts.

Methods: Meta-analysis techniques incorporating logistic regression were applied to a combined file of 12 occupational health studies.

Results: Meta-analysis of data on 1,367 women and 4,240 men showed that women had higher odds of shortness of breath whether exposed to inorganic dust or having no occupational exposure, with an overall odds ratio (OR) of 2.

Congenital anomalies in the offspring of nurses: association with area of employment during pregnancy.

The purpose of this study was to determine whether registered nurses in specific areas of employment during pregnancy had a higher risk for congenital anomalies in their offspring. An offspring cohort (n = 22,611) was created through linkage of the British Columbia Vital Statistics Agency live and stillbirth records from 1986 to 2000, to a female cohort database of registered nurses. Of these, 16,005 (70.

Association between endotoxin and mite allergen exposure with asthma and specific sensitization at age 7 in high-risk children.

The role of endotoxin and house dust mite allergen (HDM) in allergen sensitization and asthma is unclear. The timeframe of exposure and asthma assessment appears critical. We aimed to determine, in children at 7 yr of age, the association between current exposure to endotoxin and HDM and risks of recurrent wheeze, paediatric allergist diagnosed asthma and allergen sensitization.

Airway hyperresponsiveness to methacholine in 7-year-old children: sensitivity and specificity for pediatric allergist-diagnosed asthma.

Background: The operating characteristics of PC(20) values used as cut-offs to define airway hyperresponsiveness, as it informs the diagnosis of asthma in children, are poorly understood. We examine data from a unique cohort to inform this concern.

Objective: Determine the sensitivity and specificity of incremental PC(20) cut-offs for allergist-diagnosed asthma.

Respiratory health of two cohorts of terminal grain elevator workers studied 30 years apart.

Introduction: We evaluated the respiratory health of two cohorts of grain terminal elevator workers who participated in one of either respiratory health surveys undertaken in 1978 and 2008.

Methods: Questionnaire and spirometry data from 584 workers from the 1978 survey and 215 workers from the 2008 survey were compared using logistic regression and general linear modeling.

Results: The geometric means of area samples of grain dust averaged 8.

Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs.

Background: To determine the relationships of potential occupational exposure to antineoplastic drugs with cancer incidence and adverse pregnancy outcomes in a historical prospective cohort study of female registered nurses (RNs) from British Columbia, Canada (BC).

Methods: Female RNs registered with a professional regulatory body for at least one year between 1974 and 2000 formed the cohort (n = 56,213). The identifier file was linked to Canadian cancer registries.

Rates of congenital anomalies and other adverse birth outcomes in an offspring cohort of registered nurses from British Columbia, Canada.

Objectives: Although there is concern that occupational exposures in some nursing professions may confer reproductive risks, there are few relevant studies. Our objective is to determine if a cohort of female registered nurses (RN) from British Columbia (BC), in comparison to BC women in general, have elevated rates of congenital anomalies, stillbirths, low birth weight, or prematurity in their offspring.

Methods: A cohort of RNs from BC was linked to Vital Statistics birth records and the BC Health Status Registry (HSR) between the years 1986 and 2000.

Exposure to anesthetic gases and congenital anomalies in offspring of female registered nurses.

Background: Studies of offspring of mothers exposed to anesthetic gases have shown associations with congenital anomalies reported by the mothers, but rarely in studies with objectively ascertained outcomes. We conducted a retrospective cohort study to examine associations between registry-ascertained congenital anomalies in offspring and anesthetic gas exposure of mothers employed as nurses.

Methods: A cohort of registered nurses in British Columbia, Canada, was linked to records of births and congenital anomalies from 1990 to 2000.

Indoor allergen exposure, sensitization, and development of asthma in a high-risk birth cohort.

Contradictory findings have been observed for the association of house dust mite (HDM), cat, and dog allergen exposure with sensitization and asthma. We sought to determine the relationship between exposures to these allergens, at various points during early childhood, and specific sensitization and asthma at age 7 in a high-risk birth cohort. As part of a multi-faceted Canadian intervention program for the primary prevention of asthma in high-risk infants, children were assessed by pediatric allergists at age 7 for asthma and underwent allergy skin prick testing.

Elevated cord blood IgE is associated with recurrent wheeze and atopy at 7 yrs in a high risk cohort.

There is considerable interest in identifying children at high risk for developing atopic diseases for primary prevention. This study evaluates risk factors for detectable cord blood IgE and assesses CB-IgE in predicting asthma and other IgE-mediated allergic diseases in children at high risk because of family history. Cord blood was obtained as part of a randomized controlled trial assessing the efficacy of an intervention program in the primary prevention of IgE-mediated allergic diseases.

Biomarkers of airway acidity and oxidative stress in exhaled breath condensate from grain workers.

Rationale: Grain workers report adverse respiratory symptoms due to exposures to grain dust and endotoxin. Studies have shown that biomarkers in exhaled breath condensate (EBC) vary with the severity of airway inflammation.

Objectives: The purpose of the study was to evaluate biomarkers of airway acidity (pH and ammonium [NH(4)(+)]) and oxidative stress (8-isoprostane) in the EBC of grain workers.

Early environmental determinants of asthma risk in a high-risk birth cohort.

Environmental exposures during early life have been suggested to have the greatest impact on childhood asthma. Our aim was to evaluate the risk factors associated with asthma at age 7 yr in a high-risk cohort that participated in a randomized controlled study on the primary prevention of asthma. Indoor exposures were characterized before birth and at 2 weeks, 4, 8, 12, 18, and 24 months after birth and again at 7 yr.

Environmental and occupational exposures: do they affect chronic obstructive pulmonary disease differently in women and men?

This workshop summary examines current research that addresses the question: Are women more susceptible than men to the effects of inhaled pollutants, namely those found in work or residential environments? A systematic literature review was performed in preparation for the workshop. A total of 73 recent (since 2000) articles were retrieved reporting on occupational and environmental exposures and their impact on chronic obstructive pulmonary disease, of which only nine provided gender-stratified results. In two mortality studies, results were contrary (one finding increased chronic obstructive pulmonary disease mortality in relation to traffic among elderly women compared with men, the other finding no gender difference).

Within- and between-person variability of exhaled breath condensate pH and NH4+ in never and current smokers.

Recent studies have suggested that the collection of exhaled breath condensate (EBC) may be a viable method in occupational field studies to sample secretions of the lower airway because it is simple to perform and non-invasive. However, there are unresolved questions about whether certain laboratory conditions may influence the analysis of EBC biomarker measurements. A total of 12 subjects performed 116 EBC tests.

Mortality and cancer incidence in a cohort of registered nurses from British Columbia, Canada.

Background: A retrospective cohort study of provincial registered nurses (RNs) from British Columbia, Canada was undertaken to determine risks of mortality and cancer incidence; in particular for breast cancer and leukemia.

Methods: Cohort records of RNs from 1974 to 2000 were linked to Canadian death and cancer registries. Analyses included standardized mortality (SMR) and incidence ratios (SIR) as well as relative risks for internal comparisons.

Quality of life and employment status of workers with Western red cedar asthma.

Objective: The impact of current employment status and other factors on quality of life was evaluated for workers diagnosed with western red cedar asthma in British Columbia, Canada.

Methods: Telephone interviews by questionnaire included the Short Form 36 (SF-36) and Marks Asthma quality-of-life instruments.

Results: Of the 302 subjects contacted, 70.

Airflow obstruction in young adults in Canada.

Objective: Airflow obstruction is relatively uncommon in young adults, and may indicate potential for the development of progressive disease. The objective of the present study was to enumerate and characterize airflow obstruction in a random sample of Canadians aged 20 to 44 years.

Setting: The sample (n=2962) was drawn from six Canadian sites.

Relationship of early childhood viral exposures to respiratory symptoms, onset of possible asthma and atopy in high risk children: the Canadian Asthma Primary Prevention Study.

The contribution of respiratory viral infections to the onset of asthma and atopy is controversial. In "high risk" children (n = 455) born into asthmatic/atopic families, we determined the relationship of exposures to common respiratory viruses and concomitant respiratory symptoms, and to subsequent possible asthma and atopy at ages 1 and 2 years. Frozen nasal specimens, obtained when children were 2 weeks, 4, 8, and 12 months old, underwent reverse transcription-polymerase chain reaction (RT-PCR) testing for parainfluenza virus (PIV), respiratory syncytial virus (RSV), and picornavirus (rhinovirus/enterovirus).

Gender differences in respiratory symptoms-does occupation matter?

Little attention has been given to gender differences in respiratory health, particularly in occupational settings. The purpose of this paper was to evaluate gender differences in respiratory morbidity based on surveys of hospitality workers, radiographers, and respiratory therapists. Data were available from mail surveys of 850 hospitality industry workers (participation rate 73.

Farm injuries and fatalities in British Columbia, 1990-2000.

Background: Farming is considered to be one of the most dangerous occupations in Canada and internationally, as it often involves work in a high-risk environment due to exposure to such hazards as machinery, large animals and noxious chemicals. The objective of this study was to describe the incidence and nature of farm-related deaths and injuries on British Columbian farms from 1990-2000, with reference to Canadian averages.

Methods: British Columbian farm fatalities and farm injury hospitalizations data from Canadian Agricultural Injury Surveillance Program for 1990-2000 were analyzed in conjunction with the 1996 and 2001 Canada Census of Agriculture.

The Canadian Childhood Asthma Primary Prevention Study: outcomes at 7 years of age.

Background: Avoidance of any one of the individual risk factors associated with childhood asthma has not been successful in preventing its development.

Objective: The purpose of this study is to determine the effectiveness of a multifaceted intervention program for the primary prevention of asthma in high-risk infants at 7 years of age.

Methods: Five hundred forty-five high-risk infants with an immediate family history of asthma and allergies were prospectively randomized into intervention or control groups prenatally.

Impact of smoking policy on the respiratory health of food and beverage servers.

Objectives: The purpose of this study was to determine whether workplace smoking policy was associated with respiratory health effects among food and beverage servers.

Methods: Data were obtained from a postal survey of hospitality workers. The participation rate for the questionnaire was 73.