Predicting occupational asthma and rhinitis in bakery workers referred for clinical evaluation.

Background: Occupational allergic diseases are a major problem in some workplaces like in the baking industry. Diagnostic rules have been used in surveillance but not yet in the occupational respiratory clinic.

Objective: To develop diagnostic models predicting baker's asthma and rhinitis among bakery workers at high risk of sensitisation to bakery allergens referred to a specialised clinic.

What are the benefits of medical screening and surveillance?

Pre-employment examination is considered to be an important practice and is commonly performed in several countries within the European Union. The benefits of medical surveillance programmes are not generally accepted and their structure is often inconsistent. The aim of this review was to evaluate, on the basis of the available literature, the usefulness of medical screening and surveillance.

Increased Micronodule Counts Are More Common in Occupationally Silica Dust-Exposed Smokers Than in Control Smokers.

OBJECTIVE:: To determine the prevalence of increased micronodule counts in silica dust-exposed smokers. METHODS:: We evaluated 54 male smokers with severe silica dust exposure and 54 male control smokers. Both groups underwent low-dose chest computed tomography and lung function testing.

Guidelines for the management of work-related asthma.

Work-related asthma, which includes occupational asthma and work-aggravated asthma, has become one of the most prevalent occupational lung diseases. These guidelines aim to upgrade occupational health standards, contribute importantly to transnational legal harmonisation and reduce the high socio-economic burden caused by this disorder. A systematic literature search related to five key questions was performed: diagnostics; risk factors; outcome of management options; medical screening and surveillance; controlling exposure for primary prevention.

Acute respiratory effects in firefighters.

Background: Associations between acute respiratory inflammatory responses, changes in bronchial hyperresponsiveness, serum pneumoprotein levels, and exposure to fire smoke were studied.

Methods: The study comprised 51 firefighters. Blood samples were taken within 24 hr following exposure to fire smoke, and after a week and 3 months.

A cross-sectional study of exposures, lung function and respiratory symptoms among aluminium cast-house workers.

Unlabelled: OBJECTIVES To investigate exposures, respiratory symptoms, lung function and exposure-response relationships among aluminium cast-house workers.

Methods: A cross-sectional study was conducted among 182 workers. Exposure data were used to model exposure to irritants.

Lung function, bronchial hyperresponsiveness, and atopy among firefighters.

Objectives: The aim of this study was to determine associations between lung function, bronchial hyperresponsiveness (BHR), and atopy with exposure to fire smoke among firefighters.

Methods: The study was comprised of 402 firefighters, a randomly chosen subset of a previous survey among firefighters in the Netherlands. Subjects underwent spirometry and methacholine provocation, and blood samples were taken to assess atopy.

Respiratory symptoms in firefighters.

Background: The aim of the present study was to determine the prevalence and risk factors associated with respiratory symptoms in common firefighters in the Netherlands.

Methods: A total of 1,330 firefighters from the municipal fire brigades of three provinces of the Netherlands were included in the study. All subjects were administered a Dutch web-based version of the European Community Respiratory Health Survey questionnaire.

[Sleep disorders and the ability to drive, revision of legislation].

Professional truck drivers suffering from obstructive sleep apnoea syndrome (OSAS) are more often involved in traffic accidents. OSAS can be treated successfully and the effects of treatment are visible almost immediately. Treatment of OSAS has shown a significant reduction in the number of traffic accidents.

A cross-sectional study among detergent workers exposed to liquid detergent enzymes.

Objectives: To investigate sensitisation and respiratory health among workers who produce liquid detergent products and handle liquid detergent enzymes.

Methods: We performed a cross-sectional study among 109 eligible workers of a detergent products plant. 108 were interviewed for respiratory and allergic symptoms and 106 blood samples were taken from them to examine sensitisation to enzymes.

Hypersensitivity pneumonitis caused by occupational exposure to phytase.

A 43-yr-old male presented with a 6-month history of episodes of coughing, shortness of breath and fever. He suffered from dyspnoea on minor exertion. The patient worked in a cattle feed factory and noticed that he had more complaints after his working hours.

A cross-sectional study of lung function and respiratory symptoms among chemical workers producing diacetyl for food flavourings.

Objectives: Four diacetyl workers were found to have bronchiolitis obliterans syndrome. Exposures, respiratory symptoms, lung function and exposure-response relationships were investigated.

Methods: 175 workers from a plant producing diacetyl between 1960 and 2003 were investigated.

Bronchiolitis obliterans syndrome in chemical workers producing diacetyl for food flavorings.

Rationale: Workers in microwave popcorn plants are at risk of developing bronchiolitis obliterans associated with exposure to butter flavoring volatiles, including diacetyl.

Objectives: To investigate the risk of bronchiolitis obliterans for chemical workers producing diacetyl, with exposure to less complex mixtures of chemicals.

Methods: We interviewed and conducted spirometry on 175 of 196 workers from a chemical production plant that produced diacetyl between 1960 and 2003.

Exposure to trichloramine and respiratory symptoms in indoor swimming pool workers.

The association between swimming pool characteristics and activities of employees and respiratory symptoms in employees was studied. Trichloramine levels were measured to evaluate relationships with pool characteristics and to estimate long-term exposure levels. Questionnaires were available from 624 pool workers and 38 swimming facilities.

[The Netherlands Expertise Center for Occupational and Respiratory Disorders].

In 2000 the Netherlands Expertise Centre for Occupational Respiratory Disorders (NECORD) was started as a centre of expertise in occupational health. The centre received a grant from the ministry of Health Welfare and Sport for a period of 5 years. Their mission was to collect, develop and implement knowledge in the fields of diagnosis, treatment, reintegration and prevention of work-related health- and occupational disorders.

Eccentric exercise training in patients with chronic obstructive pulmonary disease.

The oxygen cost of eccentric exercise is lower than that of concentric exercise at similar work-loads. In this study, the response to eccentric cycle exercise training (EET) in addition to general exercise training (GET) on exercise performance and quality of life was investigated in 24 patients with severe chronic obstructive pulmonary disease (COPD). All patients had a normal resting PaO2 and an arterial oxygen saturation (SaO2) below 90% at Wmax, achieved during a maximal incremental concentric cycle exercise test.

[CBO guideline 'Oxygen therapy at home'].

In the Netherlands, domiciliary oxygen therapy is regularly prescribed incorrectly and thus inefficiently, and the policies surrounding this therapy are inconsistent. This applies particularly to patients with chronic hypoxaemia due to chronic obstructive pulmonary disease (COPD). In order to establish a scientific basis for a uniform prescription policy, guidelines have been developed under the auspices of the Dutch Thoracic Society with the support of the Dutch Institute for Health Care Improvement.

Risk of overtreatment with current peak flow criteria in self-management plans. Dutch CNSLD Study Group. Chronic Non-Specific Lung Disease.

Home peak expiratory flow (PEF) measurements have become the cornerstone of asthma self-management plans. However, the cut-off values for changing treatment have not been formally tested. This study focusses on the possible overtreatment brought about by the different cut-off values and denominators currently employed.

Cardio-respiratory load of exercise training in patients with severe COPD.

The effect of physical training depends on the intensity at which exercise is performed. Patients with chronic obstructive pulmonary disease (COPD) may not tolerate high exercise intensities during training due to breathlessness. The purpose of the present study was to investigate the cardiorespiratory load of exercise training, during pulmonary rehabilitation, in patients with severe COPD.

[Subnormal vitamin B6 levels in theophylline users].

Objective: To study the effect of theophylline use on the vitamin B-6 status.

Design: Descriptive.

Setting: Department of Geriatric Medicine of Nijmegen Academic Hospital and Department of Pulmonary Diseases, University of Nijmegen, the Netherlands.

Potassium and ventilation during positive and negative work in patients with chronic obstructive pulmonary disease.

In patients with chronic obstructive pulmonary disease (COPD), reduced ventilatory reserves limit exercise tolerance. In these patients, the ventilatory requirements of eccentric exercise (negative work, Wneg) are lower than those of concentric exercise (positive work, Wpos) at similar workloads. In this study, we investigated the relationship between plasma potassium levels and ventilation during Wpos and Wneg in these patients.

Training with supplemental oxygen in patients with COPD and hypoxaemia at peak exercise.

Supplemental oxygen has acute beneficial effects on exercise performance in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate whether oxygen-supplemented training enhances the effects of training while breathing room air in patients with severe COPD. A randomized controlled trial was performed in 24 patients with severe COPD who developed hypoxaemia during incremental cycle exercise (arterial oxygen saturation (Sa,O2) <90% at peak exercise).