Occupational and Environmental Medicine
Asthma/RADS
Nicholson PJ, Cullinan P, Taylor AJ, et al. Evidence-based guidelines for the prevention, identification, and management of occupational asthma. Occup Environ Med 2005;62:290-9. This comprehensive review gives strong evidence behind classic admonitions, including those to reduce asthmagens at the source and to provide ample surveillance.
PMID: 15837849
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Blanc PD, Toren K. How much adult asthma can be attributed to occupational factors? Am J Med 1999;107:580-7. Based on a critical review and synthesis of the published literature, the authors estimate occupational factors are associated with 10% of adult asthma cases.
PMID: 10625027
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Burge PS, O’Brien IM, Harries MG. Peak flow rate records in the diagnosis of occupational asthma due to isocyanates. Thorax 1979;34:317-24. Landmark study was the first to show peak flow is a suitable alternative to provocation testing in the diagnosis of OA.
PMID: 483205
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Chan-Yeung M. Fate of occupational asthma. A follow-up study of patients with occupational asthma due to Western Red Cedar (Thuja Plicata). Am Rev Respir Dis 1977;116:1023-6.This classic article demonstrated the frequent persistence of occupational asthma even months after removal from exposure to western red cedar. Subsequent studies found similar findings for other OA asthmagens, prompting heightened vigilance.
PMID: 931178
Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high-level irritant exposures. Chest 1985;88:376-84. Landmark article describing 10 patients in which the term “RADS” was coined. In the majority of cases respiratory symptoms and hyper reactivity persisted for greater than 1 year after a large exposure to vapor, fumes, or smoke.
PMID: 4028848
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Zock JP, Jarvis D, Luczynska C, et al. Housing characteristics, reported mold exposure, and asthma in European Community Respiratory Health Survey. J Allergy Clin Immunol 2002;110:285-92. Multicenter study looked at the association between mold exposure (based on questionnaire) and asthma (based on symptoms and methacholine challenge) and concluded that mold growth has an adverse effect on adult asthma.
PMID: 12170270
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Zock JP, Plana E, Jarvis D, et al. The use of household cleaning sprays and adult asthma. Am J Respir Crit Care Med 2007; 176:735-41. This longitudinal study of over 3,500 individuals free of asthma at baseline is noteworthy for finding regular, non-professional use of household cleaning sprays is associated with a RR of 2.1 of new physician-diagnosed asthma.
PMID: 17585104
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Tarlo SM, Balmes J, Balkissoon R, et al. Diagnosis and management of work-related asthma: American College of Chest Physicians consensus statement. Chest 2008;134:1S-41S. This update to the 1995 statement is derived primarily from consensus among a panel of experts, as there are no RCTs studying the diagnosis and treatment of work-related asthma. It provides practical guidance for clinicians that do not routinely see patients with work-related asthma.
PMID: 18779187
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Associations with interstitial lung disease and neoplasia
Selikoff IJ, Hammond EC, Churg J. Asbestos exposure, smoking, and neoplasia. JAMA 1968;204:106-12. Landmark study showing the synergistic effect of smoking and asbestos exposure on developing lung cancer.
PMID: 5694532
Wagner JC, Sleggs CA, Marchand P. Diffuse pleural mesothelioma and asbestos exposure in the NW Cape Province. Br J Ind Med 1960;17:260-71. Landmark study linking mesothelioma to asbestos exposure.
PMID: 13782506
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Adverse effects of crystalline silica exposure. American thoracic society committee of the scientific assembly on environmental occupational health. Am J Respir Crit Care Med 1997; 155:761-8. Reviews the epidemiology and prevention of silica-associated lung diseases including silicosis, asthma, tuberculosis, and extrapulmonary diseases. This document is also available in UpToDate™.
PMID: 9032226
Infante PF, Newman LS. Beryllium exposure and chronic beryllium disease. Lancet 2004;363:415-6. The authors highlight the lack of adequate protection for workers, the underdiagnosis of CBD by providers, and the growing number of industries in which exposure occurs.
PMID: 20458016
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Air pollution and cardiopulmonary disease
Dockery DW, Pope CA 3rd, Xu X, et al. An association between air pollution and mortality in six U.S. cities. N Engl J Med 1993; 329:1753-9. This seminal article linked fine particular air-pollution with lung cancer and cardiopulmonary mortality, associations that have been duplicated in subsequent studies and been highly influential in public health policy.
PMID: 8179653
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Banauch GI, Hall C, Weiden M, et al. Pulmonary function after exposure to the World Trade Center collapse in the New York City Fire Department. Am J Respir Crit Care Med 2006; 174:312-9. This study found a large average adjusted decline in FEV1 among firefighters in the year following 9 -11 (372 ml). Exposure intensity correlated linearly with exposure time.
PMID: 16645172
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McCreanor J, Cullinan P, Nieuwenhuijsen MJ, et al. Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med 2007; 357:2348-58. This randomized crossover study of patients with mild to moderate asthma found greater exposure to air pollution from road traffic resulted in greater decrements in lung function and greater inflammation, thus serving as confirmation of epidemiologic evidence linking traffic exposure to decrements in lung function among asthmatics.
PMID: 18057337
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Pope CA 3rd, Ezzati M, Dockery DW. Fine-particulate air pollution and life expectancy in the United States. N Engl J Med 2009; 360:376-86. Investigation compared air pollution exposure in the late 1970s and early 1980s to the late 1990s and early 2000s and found a reduction in ambient fine-particulate air pollution accounted for as much as 15% of the overall increase in life expectancy in the areas studied.
PMID: 19164188
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Künzli N, Bridevaux P-O, Liu L-J, et al. Traffic-related air pollution correlates with adult-onset asthma among never-smokers. Thorax 2009; 64:664-70. There is strong evidence that traffic-related air pollution places a causal role in childhood asthma, but less is known about risk in adults. This Swiss cohort study, which used particularly rigorous methodology, confirmed an association between adult-onset asthma and exposure to home outdoor traffic-related particulate matter in never smokers. Particulate matter concentrations improved during the 10-year study and there were only 41 new cases in a study population of 2,725.
PMID: 19359271
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Brook RD, Rajagopalan S, Pope A, et al. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the AHA. Circulation 2010;121:2331-78. This update of the 2004 AHA statement on the role of particulate matter in increasing cardiovascular morbidity and mortality is a bit daunting in size, but provides an excellent overview of new evidence linking particulate matter exposure to cardiovascular disease and discusses the implications for healthcare providers.
http://www.ncbi.nlm.nih.gov/pubmed/20458016
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Environmental tobacco smoke
The following 2 articles are good examples of research documenting the impact of legislation to limit secondhand smoke on the health of non-smoking bar workers. See also Smoking Cessation.
Eisner MD, Smith AK, Blanc PD. Bartenders’ respiratory health after establishment of smoke-free bars and taverns. JAMA 1998; 280:1909-14. This study of 53 bartenders found a substantial reduction in respiratory and nasopharyngeal irritation symptoms along with modest improvements in spirometry.
PMID: 9851475
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Menzies D, Nair A, Williamson PA, et al. Respiratory symptoms, pulmonary function, and markers of inflammation among bar workers before and after a legislative ban on smoking in public places. JAMA 2006; 296:1742-8. This study of 77 non-smoking, asthmatic and non-asthmatic, bar workers found a significant decline in respiratory symptoms and improvement in FEV1 (FEV1 % predicted improved by 5.1%) in the first 2 months following a smoking ban. Asthmatics experienced greater improvement in FEV1 than non-asthmatics and had a significant reduction in exhaled nitric oxide.
PMID: 17032987
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