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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a persistent increase in nonspecific bronchial responsiveness following acute exposure to strong respiratory irritants in four subjects with no past history of asthma or atopy and in a subject with mild asthma. They were exposed either to a bleaching agent, sulfuric acid, hydrochloric acid, perchloroethylene, or toluene diisocyanate fumes. In all cases the inhalation of high concentrations of irritant fumes was brief (less than one hour) and induced acute symptoms of cough and dyspnea. The asthmatic subject developed a severe bronchospasm which required mechanical ventilation. In all subjects the exposure led to prolonged (more than one year) symptoms of variable airflow obstruction induced on contact with common respiratory irritants. In the previously normal subjects, a mild hyperresponsiveness to methacholine could be observed. The asthmatic subject became dependent on steroids. No change in the forced expiratory volume in one second was observed when the subject exposed to sulfuric acid was rechallenged in the laboratory, but her nonspecific bronchial responsiveness was then back to normal at this time. When those exposed to perchloroethylene or toluene diisocyanate fumes were reexposed to these agents, a late asthmatic response occurred, suggesting that the subjects developed occupational asthma after an intense short-term exposure to perchloroethylene or toluene diisocyanate. We conclude that airway hyperresponsiveness can develop or increase after the inhalation of high concentrations of irritants and that these changes may be prolonged. Occupational asthma following intense short-term exposure to sensitizing agents should be differentiated from airway hyperresponsiveness which results from a nonsensitizing mechanism, as in the reactive airway dysfunction syndrome.
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PMID:Increases in airway responsiveness following acute exposure to respiratory irritants. Reactive airway dysfunction syndrome or occupational asthma? 284 14

Occupational immunologic lung disease can be identified both in the individual patient under laboratory conditions and in a population of workers in industry. Occupational airways disorder is the most common occupational immunologic pulmonary process and is a disease of the airways caused by the inhalation of a substance or material that the worker manufactures or uses directly or that is incidentally present at the worksite. There are several occupational airways disorders, including industrial bronchitis, occupational asthma, and reactive airways disease syndrome, the latter two of which will be discussed more thoroughly. Occupational asthma can be appropriately identified when the following are present (1) typical symptoms, i.e., wheeze, cough, shortness of breath, and/or chest tightness; (2) specific identification of the offending agent; (3) documentation that the agent can cause asthma; (4) wheezes on physical examination; (5) pulmonary function changes; (6) immunologic abnormalities; (7) airway hyperreactivity; and (8) positive bronchial challenge with specific material. The diagnosis of occupational airways disorder requires a comprehensive approach, including clinical history, physiologic measurements, immunologic testing, and identification of airway hyperreactivity. By this approach both individual subjects and working populations can be studied.
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PMID:The evaluation of occupational airways disease in the laboratory and workplace. 708 3

Occupational asthma (OA) is a useful model for the study of asthma in humans. The possibility that inhaled corticosteroids, in addition to withdrawal from the workplace, could improve clinical and functional recovery from OA can be hypothesized. We assessed clinical, functional, and behavioral characteristics of 32 subjects (22 male, 10 female), in all but one of whom OA was confirmed by specific inhalation challenges induced by either high- (n=13) or low-molecular-weight (n=19) agents within 3 mo after cessation of exposure. In this randomized, crossover, double-blind study, subjects (paired for baseline PC20 and duration of symptoms after exposure) received either placebo or 1,000 micrograms of inhaled beclomethasone daily for 1 yr, followed by the alternate medication for 6 mo. Various clinical, functional, and behavioral parameters were examined at each 3-mo visit. Significant improvement in clinical (nocturnal symptoms, cough), functional (morning and evening peak expiratory flow rates), and behavioral (quality of life) parameters were detected in the active-treatment period, although the magnitude of the improvement was relatively small. Side effects (oropharyngeal, reduced cortisol) were similar in the placebo and treatment groups. Distinguishing subjects who started with the active preparation from those who were given placebo first showed that most clinical and behavioral parameters improved in the former instance, whereas there was no significant difference in the latter. We conclude that inhaled corticosteroids induce a small but significant overall improvement of the asthmatic condition in subjects with occupational asthma caused by high- and low-molecular-weight agents after withdrawal from exposure. The beneficial effect is, however, more pronounced if inhaled steroids are given early after diagnosis.
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PMID:Influence of inhaled steroids on recovery from occupational asthma after cessation of exposure: an 18-month double-blind crossover study. 863 May 79

Respiratory function and immunological status were studied in 40 cocoa and 53 flour processing workers employed as packers in a confectionery industry and in 65 unexposed control workers in the same industry. A high prevalence of chronic respiratory symptoms was recorded in exposed workers, varying from 5.0% to 30.0% in cocoa workers and from 5.7% to 28.3% in flour workers. Occupational asthma was diagnosed in 2 (5%) of the cocoa workers and in 3 (5.7%) of the flour workers. None of the control workers suffered from occupational asthma. The prevalence of almost all chronic respiratory symptoms was significantly greater in cocoa and flour workers than in control workers. There was also a high prevalence of acute symptoms that developed during the work shift, being highest for cough (cocoa: 57.5%; flour: 50.9%) and eye irritation (cocoa: 50.0%; flour: 54.7%). Significant across-shift reductions of ventilatory capacity were recorded in exposed workers, being largest for flow rates at 50% and the last 25% of the vital capacity on maximum expiratory flow-volume (MEFV) curves (FEF50, FEF75). The prevalence of positive skin tests for cocoa (60.2%) was significantly higher than the prevalence of positive skin tests for flour (25.8%) among the 93 exposed workers (p < 0.05). Control workers had significantly lower prevalences of positive skin tests to cocoa (4.6%) and flour (12.3%) than exposed workers (p < 0.01). Increased total serum IgE levels were found in 17.5% of cocoa and in 18.7% of flour workers; none of the control workers had increased IgE levels. Bronchoprovocation testing demonstrated significant decreases in lung function following inhalation of cocoa dust extract and flour dust in workers with respiratory symptoms and large across-shift reductions in lung function. Dust concentrations in the working environment were higher than those recommended by Croatian standards. These data suggest that workers employed in the processing of cocoa and flour may be at a high risk for the development of allergic sensitization and respiratory impairment.
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PMID:Respiratory function and immunological status in cocoa and flour processing workers. 940 26

We studied 308 female and 92 male textile workers employed in a factory that produced synthetic fiber hosiery. The mean age of the women was 38 years, their mean duration of employment 16 years. The mean age of the men was 39 years with a mean duration of employment of 16 years. A control group of 160 female and 78 male nonexposed workers was also studied. Chronic and acute work related symptoms were recorded for all workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves from which the forced vital capacity (FVC), the 1-sec forced expiratory volume (FEV1) and maximum expiratory flow rates at 50% and the last 25% (FEF50, FEF75) were read. There was a higher prevalence of all chronic respiratory symptoms in exposed than in control workers, although the differences were statistically significant only for dyspnea, sinusitis, and nasal catarrh (P < 0.01) in female synthetic textile workers, and for nasal catarrh (P < 0.01) in male synthetic textile workers. Occupational asthma was recorded in 3 (0.9%) of the women textile workers, and in 1 (1.1%) of male textile workers. There was a high prevalence of acute symptoms during the work shift, which was greatest for cough (female: 46%; male: 59%), dryness of the throat (female: 49%; male: 40%), dryness of the nose (female: 53%; male: 43%) and eye irritation (female: 46%; male: 36%). Ventilatory capacity data among the synthetic textile workers demonstrated significantly decreased FEF75 compared to predicted (P < 0.05). Our data suggest that inhalation of dust in synthetic textile plants causes the respiratory impairment.
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PMID:Respiratory findings in synthetic textile workers. 948 25

The study included 308 female workers employed in processing synthetic stockings and 160 controls. The mean age of the exposed workers was 38 years with the mean exposure of 16 years. Most workers did not smoke while 41% of smokers consumed about 10 cigarettes a day. The data on acute and chronic respiratory symptoms were taken from all workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves with readings on forced vital capacity (FVC), one-second forced expiratory volume (FEV1), and maximum expiratory flows at 50% and the last 25% (FEF50, and FEF25, respectively). Textile workers manifested a higher prevalence of chronic respiratory symptoms than did the controls, although the differences were statistically significant only for sinusitis, dyspnoea, and nasal catarrh. Occupational asthma was found in 3 (0.9%) textile workers. The prevalence of acute symptoms in the exposed workers was particularly high during shift, especially with regard to dryness of the nose (53%), dryness of the throat (49%), headache (47%), cough (47%), and the eye irritation (46%). Textile workers showed a significantly lower FEF25 than predicted. Our study on textile workers indicates that inhalation of synthetic fiber dust may impair the respiratory function.
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PMID:[Respiratory function in textile workers involved in the processing of synthetic fibers]. 981 Jul 61

Asthma is common among older persons, affecting approximately 4 to 8% of those above the age of 65 years. Despite its prevalence, late onset asthma may be misdiagnosed and inadequately treated, with important negative consequences for the patient's health. The histopathology of late onset disease appears to be similar to that of asthma in general, with persistent airway inflammation a characteristic feature. It is less clear, however, that allergic exposure and sensitisation play the same role in the development of disease in adults as they do in children. Atopy is less common among those with late onset asthma, and the prevalence of elevated immunoglobulin E levels is lower among those aged over 55 years of age than younger patients. Occupational asthma is an aetiological consideration unique to adult onset disease, with important implications for treatment. The differential diagnosis for cough, wheeze, and dyspnoea in the elderly is broad, and includes chronic obstructive bronchitis, bronchiectasis, congestive heart failure, lung cancer with endobronchial lesion and vocal cord dysfunction. Keys to accurate diagnosis include a good history and physical examination, the demonstration of reversible airways obstruction on pulmonary function tests and a favorable response to treatment. Inhaled corticosteroid therapy is recommended for patients with persistent disease, and careful instruction in the use of metered-dose inhalers is particularly important for the elderly.
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PMID:Late onset asthma: epidemiology, diagnosis and treatment. 1119 Apr 18

48 woodworkers employed in the furniture factory were examined. The control group consisted of 41 office workers with no exposure to organic dust. The examination included: interview on work-related symptoms, physical examination, and lung function test performed before and after the working-day. 38 out of 48 (79.2%) woodworkers reported work-related symptoms. The most common complaint was dry cough reported by 25 workers (52.1%), followed by general malaise -- reported by 17 (35.45%), conjunctivitis -- by 16 (33.3%), rhinitis - by 16 (33.3%), and skin symptoms by 16 (33.3%). Other symptoms such as headache, shortness of breath and chest pain occurred less frequently. Subjects working in initial processing and board processing departments had a higher prevalence of cough compared to workers employed in the varnishing department (p < 0.01). The prevalence of skin symptoms was significantly higher in board processing and varnishing departments compared to initial processing department (p < 0.05). Occupational asthma and allergic alveolitis were recorded in 3 out of 48 (6.2%) and 2 out of 48 (4.2%) workers, respectively. Baseline FVC and FEV(1) values were lower in woodworkers compared to controls (p < 0.01). The increased lung function parameters (FVC, FEV(1)) were observed in woodworkers who smoked compared to non-smokers. The difference was not statistically significant. There was a significant over-shift decrease of all measured spirometric values: FVC, FEV(1)), FEV(1)) /VC, PEF among woodworkers (p < 0.001). There was a significant pre-shift, post-shift decline in FVC, FEV(1)), FVC/FEV(1)), and PEF among workers under 30 years of age (p < 0.001). The same tendency was seen for FVC and FEV(1)) in subjects over 30. The percentage changes in FVC and FEV(1)) were greater in the group of younger workers (15.1% and 17.6%) respectively, than in the group of older subject (6.2%, 7.1%). The difference was not statistically significant.
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PMID:Work-related symptoms among furniture factory workers in Lublin region (eastern Poland). 1208 5

A 58-year-old man, a carpenter, had been suffering from cough, rhinorrhea, wheezing, dyspnea and ocular itching a few minutes after each exposure to the sawdust of "Ayous" wood (Obeche, Triplochiton scleroxylon) since starting to work on this imported wood in 1998. Although his symptoms improved soon after exposure, he had a secondary response several hours later. He had no symptoms when working with any other woods. In January, 2001, he came to our hospital, and occupational asthma was suspected. Peak flow monitoring revealed immediate- and late-type responses when he was exposed to Ayous wood dust. Non-specific bronchial hyperresponsiveness to acetylcholine was positive. An immediate skin test with Ayous wood extract was positive. In the RAST inhibition test, his serum revealed specific IgE antibody to Ayous extract. Bronchoprovocation with Ayous wood extract demonstrated immediate and later type responses (dual response). Occupational asthma caused by Ayous wood dust was confirmed. This is the first case report of occupational asthma caused by Ayous wood in Japan.
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PMID:[A case of occupational asthma caused by Ayous wood (Triplochiton scleroxylon)]. 1216 61

Occupational asthma could be defined as a reversible lung disorder characterized by attacks of breathing difficulty, wheezing, and cough, which are caused by various agents found in the workplace. Incidence varies from 2 to 15% in adult work population; actually there is no data for the child population. Allergic occupational asthma is due to allergic sensitization to a specific substance or material present at the workplace; non-allergic occupational asthma occurs because of the high exposure to an irritant also at the workplace. Over the past few years, more people have been diagnosed as having asthma because of some workplace exposure. The identification of occupational asthma in workers is important because early detection may lead to the control of the worker's symptoms and control of the chemicals in the workplace. In Latin America there is no data about occupational asthma, maybe for the scarce information about it or for its difficult diagnosis.
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PMID:[Occupational asthma and reactive airway dysfunction syndrome]. 1656 10


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