Publications by authors named "Susan Tarlo"

Occupational lung disease remains one of the most common work-related illnesses and accounts for most deaths from occupational illness. Occupational lung diseases often have delayed manifestation over decades and nonspecific clinical presentations, making it challenging for clinicians to promptly identify the disease and implement preventive measures. Radiologists play a crucial role in identifying and diagnosing occupational lung diseases, allowing for removal of the exposure and early medical intervention.

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Wildfires, including forest fires, bushfires, and landscape fires, have become increasingly prevalent, fueled by climate change and environmental factors and posing significant challenges to both ecosystems and public health. This review article examines the relationship between wildfires and respiratory diseases in outdoor workers, with a main focus on airway disease. In addition to the expected effects of direct thermal respiratory injuries and possible carbon monoxide poisoning, there are associations between wildfires and upper and lower respiratory effects, including infections as well as exacerbations of asthma and chronic obstructive pulmonary disease.

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Background: Persons with asthma may experience excessive airway narrowing due to exercise or exposure to cold air, worsening their daily functionality. Exercise has several benefits for asthma control, but it may induce airway narrowing in some persons with asthma. When combined with cold temperatures, it introduces another layer of challenges.

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Increased negative intrathoracic pressure that occurs during pharyngeal obstruction can increase thoracic fluid volume that may contribute to lower airway narrowing in individuals with obstructive sleep apnea (OSA) and asthma. Our previous study showed that fluid accumulation in the thorax induced by simulated OSA can increase total respiratory resistance. However, the effect of fluid shift on lower airway narrowing has not been investigated.

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Purpose: Nocturnal asthma is a sign of asthma worsening and could be partially due to more fluid drawn into the thorax during sleep by gravitational force and/or pharyngeal collapse in those with obstructive sleep apnea. Wearing compression stockings during the day reduces fluid shift from the legs to the neck overnight. However, the potential effect of wearing compression stockings to reduce fluid accumulation in the leg and to improve nocturnal small airway narrowing in patients with asthma has not been investigated.

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Background: Silicosis is a fibrotic lung disease caused by exposure to respirable crystalline silica. Historically, silicosis was common among miners and other professions in the 20th century, and in recent decades has re-emerged in coal mining and appeared in new workplaces, including the manufacture of distressed jeans and artificial stone countertops.

Methods: Physician billing data for the province of Ontario between 1992 and 2019 were analyzed across six time-periods (1993-1995, 1996-2000, 2001-2005, 2006-2010, 2011-2015, and 2016-2019).

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Rationale: Obstructive sleep apnea (OSA) is highly prevalent among patients with asthma, suggesting a pathophysiological link between the two, but a mechanism for this has not been identified.

Hypothesis: Among patients with asthma, those with OSA will have greater overnight increases in thoracic fluid volume and small airways narrowing than those without OSA.

Methods: We enrolled 19 participants with asthma: 9 with OSA (apnea-hypopnea index (AHI) ≥10) and 10 without OSA (AHI <10).

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Background And Aims: Several studies from multiple work settings have reported an increase in asthma and asthma-like respiratory symptoms in workers exposed to cleaning or disinfecting agents. Hospital workers perform many cleaning and disinfecting activities and may be vulnerable to respiratory and skin symptoms caused by these agents. This systematic review and meta-analysis aim to quantify the risk of asthma and asthma-like symptoms in hospital workers exposed to cleaning/disinfecting agents.

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Article Synopsis
  • Allergic asthma (AA) is a type of asthma that requires proof of IgE-sensitization to allergens and its role in causing symptoms; bronchial allergen challenge (BAC) may help identify AA cases among atopic asthmatics.
  • Current BAC methods are mainly used in research settings focused on mild asthma, which limits their application for moderate-to-severe cases in clinical practice.
  • The EAACI Task Force suggests a new BAC methodology aimed at improving patient identification for effective treatments like immunotherapy, ultimately enhancing asthma management in real-world scenarios.
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The impact of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID-19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide.

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Background And Objectives: Healthcare workers have an increased risk of respiratory symptoms and dermatitis, likely related to cleaning/disinfecting agents. The aim of this study was to identify work tasks and cleaning/disinfecting agents associated with respiratory symptoms and hand dermatitis among healthcare workers in a tertiary hospital.

Methods: Cleaning agent usage, respiratory symptoms and skin symptoms were recorded by participants using a questionnaire in a cross-sectional study.

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Background: The objective was to update the 2011 Cochrane systematic review on the effectiveness of workplace interventions for the treatment of occupational asthma.

Methods: A systematic review was conducted with the selection of articles and reports through 2019. The quality of extracted data was evaluated, and meta-analyses were conducted using techniques recommended by the Cochrane Handbook for Systematic Reviews of Interventions.

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Work-related rhinitis and laryngeal disorders are common and can significantly contribute to work absences and presenteeism. Each can cause respiratory symptoms that may be misdiagnosed as asthma symptoms, and each may occur as an isolated disorder or may also accompany asthma. Suspicion of these disorders and correct management require a careful medical and occupational history.

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To reduce the spread of the severe acute respiratory syndrome coronavirus 2, many pulmonary function testing (PFT) laboratories have been closed or have significantly reduced their testing capacity. Because these mitigation strategies may be necessary for the next 6 to 18 months to prevent recurrent peaks in disease prevalence, fewer objective measurements of lung function will alter the diagnosis and care of patients with chronic respiratory diseases. PFT, which includes spirometry, lung volume, and diffusion capacity measurement, is essential to the diagnosis and management of patients with asthma, COPD, and other chronic lung conditions.

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Work-related asthma (WRA) includes heterogeneous conditions, which have in common (i) symptoms and signs compatible with asthma and (ii) a relationship with exposures in the workplace. The types of WRA described in this review are distinguished by their etiology, comprising of work-exacerbated asthma (WEA), irritant-induced asthma (IIA), and immunologic occupational asthma (OA). There have been significant advances in the definition and characterization of the different forms of WRA by international panels of experts.

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Phenotypic differences and similarities in the spectrum of occupational asthma (OA) subtypes reflect the underlying mechanisms of the diverse forms of the disease, and these phenotypes provide information as to diagnostic steps and approaches to management. In large part, the phenotype reflects the existence of immunologic mechanisms and the presence or absence of a specific IgE-antibody response to a work sensitizer. However, further differences occur between OA from high- and low-molecular-weight sensitizers (chemical sensitizers), which potentially might be relevant for nonoccupational asthma.

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The aim of this study was to determine concentrations of particulates and volatile organic compounds (VOCs) emitted from 3D printers using polylactic acid (PLA) filaments at a university workroom to assess exposure and health risks in an occupational setting. Under typical-case (one printer) and worst-case (three printers operating simultaneously) scenarios, particulate concentration (total and respirable), VOCs and formaldehyde were measured. Air samples were collected in the printing room and adjacent hallway.

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Women's work has traditionally been considered less hazardous to health in comparison with men's work. The increased women's participation in the workforce has led to an increased attention to women's working conditions. Women and men are unequally represented in individual professions or sectors (horizontal segregation), with women also under-represented in leadership positions (vertical segregation).

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