Diseases of the upper respiratory tract are wide spread in the workers exposed to dust and closely correlate with the length of service. Pathologic process grows severe and disseminates the upper respiratory tract according to prolongation of the exposure to dust. The main pathologic mechanisms of process in the upper respiratory tract mucosa are: disorder of mucociliary clearance, disturbance of the regional immunity and the acid-base balance of tissues. Criteria of occupational connection of the nose, throat and larynx dystrophic diseases in workers exposed to dust are given.
In 1967, 240 workers in the Kiruna, Sweden, mine were examined with regard to lung function and respiratory symptoms. Seventeen years later, 167 of these workers were reexamined using a structured interview which covered respiratory symptoms, smoking habits, and workplace, and lung function tests, including dynamic spirometry and closing volume. The prevalence of chronic bronchitis in the present study was 9.6%. There was a strong relationship between chronic bronchitis and smoking but no relationship between chronic bronchitis and working underground in the mine. Only three persons had chronic obstructive lung disease. In the still active mine workers, dynamic spirometry results showed no difference between smokers or nonsmokers or between underground and surface workers. Thus, we found no excess of chronic obstructive lung disease or lung function disturbances in the mine workers studied. This probably reflects a self-selection process whereby the workers with airway obstruction due to smoking or underground exposure have left underground work and also the company. Underground workers with chronic mucous hypersecretion, on the other hand, have not felt motivated, because of this, to leave underground work. Some, however, may have stopped smoking but not necessarily because of the hypersecretion.
OBJECTIVES: The purpose of this study was to investigate nasal symptoms and function among workers exposed to lime dust and to determine if a reconstruction of the workplace improved the worker's nasal health. METHODS: In 1992, pulp-mill workers (N = 15) exposed to lime dust and an equal number of matched unexposed referents were examined by questionnaires, nasal peak expiratory flow, the saccharin test, nasal lavage, and a clinical examination of the upper airways. The study was repeated one year later, after the pulp mill had been rebuilt. Dust levels were measured on both occasions with stationary and personal samplings. RESULTS: In 1992 the total dust level was 1.2 mg.m-3. The saccharin test showed a significantly increased nasal transit time for the exposed workers in comparison with that of the unexposed referents (difference 3.5 min, 95% confidence interval 0.1-6.9 min). One year later the dust levels had decreased to 0.1 mg. m-3, and the difference in nasal transit time had decreased (difference- 0.8 min, 95% confidence interval -4.8-3.3 min). CONCLUSIONS: Workers exposed to lime dust have an impaired mucociliary function. This impairment is probably due to the alkalinity of the lime. When dust levels are reduced, mucociliary function improves; therefore renovating a workplace to reduce dust levels has a positive effect.
OBJECTIVE: This study investigated the role of late-phase allergy in the development of otitis media with effusion. METHODS: Brown Norway rats were sensitized to ovalbumin and later challenged transtympanically. Eustachian tube ventilatory function was assessed 2, 4, 8, 24, 28, and 32 hours postchallenge by measuring passive opening and closing pressures, active clearance of positive and negative middle ear pressure, and mucociliary clearance. RESULTS: The results demonstrate that exposure to transtympanic allergen induces eustachian tube dysfunction and subsequent formation of effusion. Allergic animals showed significant increases in passive and active opening pressures, as well as a decreased ability to actively clear middle ear pressure. Finally, the mucociliary was significantly impaired in all sensitized rats exposed to transtympanic allergen. CONCLUSION: These findings demonstrate that late-phase allergy leads to significant eustachian tube dysfunction and subsequent formation of effusion by impairing the ventilatory and clearance functions of the eustachian tube.
Childhood idiopathic bronchiectasis (IB) unrelated to cystic fibrosis (CF) or known immunodeficiency remains a common problem among indigenous populations in developed and developing countries. The physical and transport properties of sputum among children with IB have not been described, and these properties may suggest therapies that would be particularly effective for this group of children.
Sputum from children in stable condition with IB and chronic daily productive cough was collected to measure viscosity, elasticity, cohesivity, adhesivity, and mucociliary and cough transportability in vitro. The results were compared to banked data from the sputa of children with CF and adults with chronic bronchitis (CB) measured by the same methods.
Sputa from children with CF and adults with CB had similar values for viscosity, elasticity, frictional adhesion, cough transportability, and mucociliary transportability. The elasticity of sputum from children with IB was 12 to 20%, respectively, of the value of CB and CF sputum (p 0.05).
The physical and transport properties of sputum from children with IB who are stable in the outpatient setting are substantially different and lead to improved cough transportability compared to sputum from children with CF or adults with CB. Therapies that focus on cough may be sufficient to improve airway mucus clearance in children with IB. Sputum properties may explain in part the different clinical course of children with IB compared to children with CF.
OBJECTIVES: We investigated the role of soluble interleukin (IL)-4 receptors (sIL-4R) and IL-5 antibodies (IL-5Ab) in preventing allergic eustachian tube dysfunction (ETD) and middle ear effusion (MEE). STUDY DESIGN: Brown-Norway rats were sensitized to ovalbumin (OVA) and challenged transtympanically. Two groups of rats received either IL-4R or IL-5Ab transtympanically 1 hour before challenge. Three additional groups were used as controls. Following the second transtympanic challenge, the ventilatory and clearance functions of the eustachian tube (ET) were assessed at 0, 2, and 8 hours. Histology was prepared using cut paraffin sections stained with hematoxylin and eosin. RESULTS: sIL-4R-pretreated rats showed no significant changes in ventilatory or clearance functions of the ET or inflammatory changes in ET mucosa, whereas IL-5Ab pretreatment showed significant late ventilatory and clearance dysfunction as well as inflammatory mucosal changes. CONCLUSION: These data demonstrate that the late-phase allergic inflammatory response that leads to subsequent formation of ETD and MEE is prevented by pretreatment with sIL-4R and, more modestly, with IL-5Ab.
We have investigated the functional state of the mucous membrane of the nasal cavity and maxillary sinus after radical and minimally invasive surgical procedures during the log-term postoperative period, i.e. three and more months after the intervention. The materials for the study were brushings and histological biopsies; in addition, the functional parameters of the mucous membranes of the nose and maxillary sinuses were estimated before and after surgery. It has been found that the type of the surgical intervention on the inferior turbinate bones for the treatment of chronic rhinitis, such as gentle turbinotomy, has no significant influence on the state of the mucous membrane. The study has demonstrated that 48% of the patients presenting with the chronic maxilloethmoidal mixed form of sinusitis experience epithelial metaplasia resulting in atrophic scarring of the mucosa whereas in the remaining 52% the ciliary epithelium becomes either damaged or detached and the ciliary beat frequency (CBF) decreases. In the exudative form of the disease, CBF and some other functional characteristics are improved but the stromal oedema persists and ciliated epithelium integrity gets compromised.
To study the relation between exposure and nasal function in woodwork teachers.
39 selected woodwork teachers employed full time and 32 control subjects (other school personnel) were examined at the beginning and at the end of a working week with symptom rating, nose and throat inspection, rhinomanometry, nasal mucociliary clearance test, and a smell identification test. During one working day of the same week climate, dust and terpene concentrations were measured in all 39 schools.
The ventilation rate was highest in rooms with mechanical ventilation. Range of total dust (personally sampled) was 0.12-1.18 mg/m3, respirable dust 0.02-0.21 mg/m3, and terpenes (area sampled) 0.02-6.8 mg/m3. In contrast to the control subjects, the woodwork teachers had more nasal symptoms on the Thursday afternoon than on the Monday morning, especially those working in rooms without mechanical ventilation. Their mucociliary clearance worsened during the week (mean increase 4 min, P
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