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This document defines terms related to the structure and processing of inorganic, polymeric, and inorganic-organic hybrid materials from precursors, through gels to solid products. It is divided into four sections – precursors, gels, solids, and processes – and the terms have been restricted to those most commonly encountered. For the sake of completeness and where they are already satisfactorily defined for the scope of this document, terms from other IUPAC publications have been used. Otherwise, the terms and their definitions have been assembled in consultation with experts in the relevant fields. The definitions are intended to assist the reader who is unfamiliar with sol-gel processing, ceramization, and related technologies and materials, and to serve as a guide to the use of standard terminology by those researching in these areas.

The widespread use of thermal analysis (TA) by scientists as a laboratory technique carries with it a working vocabulary. This document is intended to provide those working in the field with a consistent set of definitions to permit clear and precise communication as well as understanding. Included in the document are the definitions of 13 techniques, 54 terms within the glossary, as well as symbols and units.

Perovskites are investigated as potential working materials in new technologies, such as solid oxide fuel cells, thermochemical energy storage, and magnetic refrigerators. They are interesting due to their application properties, such as electrical conductivity, ferromagnetic properties, and reducibility. Properties of perovskites can be improved by doping and the formation of structural defects. The aim of this work was to investigate the possibility of preparing Sr-doped lanthanum manganite with the chemical formula La0.5Sr0.5MnO3 by coprecipitation procedure, and to analyse the observed phase separation. The material was prepared by coprecipitation procedure in which sources of metal cations (La3+, Sr2+, Mn2+) were dissolved in 0.5 M HNO3. The nitrate solution was added dropwise in 10 wt% NH4HCO3 solution, both solutions being heated to 65 °C. To achieve coprecipitation of all present metal cations, the pH value was maintained at 8 by the addition of aqueous ammonia. The obtained precipitate was filtered and dried to obtain the precursor powder. One part of the prepared powder was calcined at 1200 °C/2 h (sample CL_Sr0.5_p), while the other part was pressed into a tablet and sintered in the same conditions (sample CL_Sr0.5_tab). Even though FTIR and PXRD analyses of the sample CL_Sr0.5_p (Figs. 1A-C) showed the formation of the pure phase, light and dark spots were observed during the SEM analysis of the tablet (CL_Sr0.5_tab) fracture surface (Fig. 2). These spots were analysed by energy-dispersive spectroscopy (EDS). EDS analysis (Table 1) showed that the light spots were SrMnO3 phase, while the dark spots were La0.76Sr0.24MnO3 phase. The tablet was then ground and FTIR and PXRD analyses were conducted. The obtained FTIR results (Figs. 1A and 1B) showed some bands characteristic for the SrMnO3 phase, and low-intensity maxima originating from the SrMnO3 phase were observed on the diffractogram (Fig. 1C) of CL_Sr0.5_tab sample, confirming the existence of separated phase. This was additionally investigated by the Rietveld refinement analysis (Table 1), and it was determined that Sr concentration was 0.24 instead of the targeted 0.5. Therefore, the La0.76Sr0.24MnO3 phase was formed, while the rest of added strontium during the synthesis crystallised in the SrMnO3 phase. Since successful preparation of La0.5Sr0.5MnO3 by hydrothermal synthesis was reported by multiple authors, it can be concluded that the coprecipitation procedure is not suitable for high concentration doping of LaMnO3 due to the separation of Sr into the secondary phase, especially when in tablet form. [ABSTRACT FROM AUTHOR]

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The aim of this review article is to point out to the danger for workers who, by the nature of their occupation, spend most of their working hours outdoor and are exposed to sunlight that increases their risk of skin cancer. Exposure to sunlight during outdoor work increases the average annual dose of UV radiation for 4-5 times compared to people who do not work in the sun, which in outdoor workers significantly increases the risk for the occurrence of actinic keratosis, basal-cell skin cancer and squamous-cell skin cancer. It is considered that the risk for the occurrence of these disorders is doubled if the total lifetime UV radiation dose for persons occupationally non exposed to sun (130 SED annually) is exceeded by 40%. In the EU countries, including Croatia, the introduction of UV radiation personal dosimetry for outdoors workers is in progress. In order to prevent skin cancer caused by occupational UV exposure, it is necessary to implement preventive measures for outdoor workers. Minimum standards for prevention at the EU level include the application of personal protection measures (sunglasses, headgear, clothing, creams with sun protective factor) and health and safety educational programs implemented in the curricula of secondary high schools, and provided to workers at risky workplaces. Skin cancers or multiple actinic keratosis can be recognized as an occupational disease if: 1) diagnosis of squamous-cell skin cancer or basal-cell skin cancer or multiple actinic keratosis (minimum 6 changes) is histologically confirmed; 2) the changes are expressed in occupationally exposed areas of the skin; 3) the history of the disease reveals sufficient occupational exposure to UV radiation. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the cases of diagnosed occupational disease (OD) in the Occupational Medicine of the Institute for Medical Research and Occupational Health Ltd. for a period 2010 to 2014. A review of archived data and voluntary telephone survey for collecting data about the employment status of patients after diagnosed OD were performed. In the period 2010 to 2014, OD was diagnosed in 55 patients. The most often diagnosed were skin OD (N=19), arm overuse syndromes (N=17), asthma and rhinitis (N=10). The most common skin OD was allergic contact dermatitis (N=15), most frequently found in hairdressers (N=5). Carpal tunnel sindrome was the most common overuse syndrome (N=15), most frequently found in textile workers (N=5). Respiratory disorders were most common in health care workers (N=3). Telephone survey was answered by 46 patients. After the diagnosed OD, 21 (46%) patients were employed by the same or another employer: the change of workplace occurred in 14 (30%) patients, in 1 case after retraining, while 7 (15%) patients are still working at the same workplace. Twelve (26%) patients were retired after diagnosed OD: 11 with disability pension or early retirement. Thirteen (28%) patients are unemployed: 11 got fired after diagnosed OD, and the retraining was done in 3 cases. The results indicate an inadequate rehabilitation of workers with diagnosed OD. The change of workplace occurred in only 30% of patients, and retraining in only 4 (9%) cases. The majority of patients are unemployed, retired early or employed at the same workplace that caused OD. [ABSTRACT FROM AUTHOR]

Rhinitis is defined as the inflammation of the nasal mucosa characterised by the presence of one or more of the following symptoms: nasal obstruction, rhinorrhea, sneezing and nasal itching. Occupational rhinitis occurs when nasal inflammation is caused only by substances or microclimatic conditions at the workplace that have irritative or aggravating effects on respiratory mucosa. Occupational rhinitis should be differentiated from rhinitis exacerbated at work which is defined as nasal mucosa inflammation where the cause is not occupational in origin, but the workplace is the source of exposure to conditions that aggravate nasal symptoms, including exposure to respiratory irritants and adverse microclimatic conditions. In the Republic of Croatia, from 2007 the List of Occupational Diseases (subsection 55) includes also allergic rhinitis caused by inhalation of substances with known allergenic properties specific to the workplace. In addition to the impact on the quality of life, work ability and socio-economic burden on the patient, occupational rhinitis poses a risk for the development of occupational asthma, a disorder with significantly greater impact on work ability and a financial burden on the employer and the community. Therefore, the importance of occupational rhinitis prevention and early detection of workers with the disease is emphasized. [ABSTRACT FROM AUTHOR]

Recent epidemiological studies indicate that occupational exposure to organic solvents may be an independent risk factor for the development of nonalcoholic fatty liver disease (NAFLD), particularly if occupational exposure limits are exceeded. Clinical assessment of hepatotoxicity of industrial solvents must take into account synergism with metabolic risk factors, but also other factors like medications, alcohol, viruses, age and nutrition. If occupational exposure to solvents remains within the permissible limits NAFLD may still develop as a work-related disease. It is essential that liver function testing is included in the periodic medical assessment of solvent-exposed workers, and that high risk individuals are identified and excluded from further exposure in order to prevent the development of irreversible liver damage. [ABSTRACT FROM AUTHOR]

In successful implementation of regulations governing occupational safety and health at work, it is essential to ensure a great degree of cooperation of all participants in the process including the employer, employees, occupational safety service and occupational medicine specialists. The paper gives an account of examples of good practise in protecting the workers handling dangerous substances in two companies, LUSH manufaktura d.o.o. and Genera d.d. In their efforts to implement and improve safety in handling dangerous substances, both companies opt for the recommended pyramidal approach, meaning that they primarily implement organisational and technical measures to reduce the exposure of workers to dangerous substances. In this, exchange of information among all participants is the key factor for improvements, which also helps to identify problems in risk assessment for different work places and supplements inadequate toxicology data on the technical lists that accompany dangerous substances. [ABSTRACT FROM AUTHOR]

Organic-inorganic hybrid materials are a sort of nanostructured material in which the organic and inorganic phases are mixed at molecular level. The inorganic phase in hybrid materials is formed by the sol-gel process, which consists of reactions of hydrolysis and condensation of metal (usually silicon) alkoxides. Flexibility of sol-gel process enables creation of hybrid materials with varying organic and inorganic phases in different ratios, and consequently fine-tuning of their properties. In order to obtain true hybrid materials, contact between the phases should be at molecular level, so phase separation between thermodynamically incompatible organic and inorganic phases has to be prevented. Phase interaction can be improved by formation of hydrogen or covalent bonds between them during preparation of hybrid materials. Covalent bond can be introduced by organically modified silicon alkoxides containing a reactive organic group (substituent) capable of reacting with the organic phase. In order to obtain hybrid materials with desired structures, a detailed knowledge of hydrolysis and condensation mechanism is necessary. The choice of catalyst, whether acid or base, has the most significant influence on the structure of the inorganic phase. Other important parameters are alkoxide concentration, water: alkoxide ratio, type of alkoxide groups, solvent used, temperature, purity of chemicals used, etc. Hydrolysis and condensation of organically modified silicon alkoxides are additionally influenced by nature and size of the organic supstituent.

Null-mutations which cause loss of function of the gene encoding filaggrin (FLG) have been strongly linked to the development of atopic disorders, predominantly atopic eczema/dermatitis syndrome (AEDS). Filaggrin plays a key role in epidermal barrier function by upholding epidermal structure and moisturization. Up to now, around 40 variants of FLG null-mutations have been genotyped among different world populations. FLG null-mutations are present in up to 10% of the Caucasian population in Western Europe and North America, with R05X and 2282del4 as the most common null-mutations. Epidemiological studies conducted in Europe indicate a latitude dependent distribution of common FLG null-mutations with a decreasing north-south gradient of R501X and 2282del4 mutation frequencies. FLG null-mutation carriers are prone to develop unspecific skin symptoms related to atopic and non-atopic skin disorders due to their defect of epidermal barrier function, which allows greater skin penetration of various hazards. Epidemiological studies indicate an association of FLG null-mutations with AEDS, whereas results regarding an association of FLG null-mutations with sensitization to common inhalant allergens and development of rhinitis and asthma are incoherent. A study conducted in Croatia found a low frequency of FLG null-mutations in general population (2.6%) and did not confirm FLG null-mutations as an etiological factor for atopy and atopic disease in the studied population.

Hairdressers are under a high occupational risk of developing various health disorders, particularly regarding the skin. The "SafeHair" project was implemented from 2010 to 2012, with the aim to develop health and safety standards for the prevention of occupational skin diseases in hairdressing. Croatian hairdressers participated in the project. The aim of this work was to establish the actual status of skin protection in Croatian hairdressers. Data were collected by the EvaHair questionnaire developed within the "SafeHair" project. A total of 213 questionnaires were analysed. The sample comprised 133 (64%) salon owners, 46 (22%) employees, and 31 (14%) trainees. Thirty-six (17%) subjects confirmed the presence of skin disorders in their salons in the last 3 years, and almost all of the subjects (98%) considered the prevention of occupational skin diseases important. We found a high proportion (from 40% to 50%) of non-answered questions about risk assessment. Protective gloves were mostly used when exposed to chemicals (88%), but rarely for hair washing (13%). They were available to the majority of subjects (95%), but 32% of subjects had trouble wearing them. Hairdressers with over 30 years of working experience used gloves for washing and cutting hair more frequently than those with less than 30 years of experience (p<0.05). Education on skin protection was more often provided (39%) than education on the protection of the respiratory (15%) and musculosceletal (18%) systems. A high proportion of subjects needed assistance with interpreting laws, regulations, and information about products (57%), as well as in the implementation of risk assessment methods (49%). The results indicate a need for further education on the health risks and the implementation of protective measures. This should be carried out during vocational education and later in the form of permanent education.

New regulations on the protection and rights of workers occupationally exposed to asbestos were introduced in Croatia in 2007 and 2008. They have been harmonised with the European Union (EU) and International Labour Organization (ILO) regulations, and make a step forward in safety at work, health protection, social rights, and pension schemes for Croatian workers occupationally exposed to asbestos. The 2007 Croatian regulation on the protection of workers from the risks related to exposure to asbestos at work defines and describes activities in which workers can be occupationally exposed to asbestos, defines the threshold value of asbestos in the air at work, defines valid methods for measurement of asbestos concentrations in the air, and establishes measures to reduce asbestos exposure at work or protect the exposed workers. Croatian law regulating obligatory health surveillance of workers occupationally exposed to asbestos from year 2007 defines activities and competent authorities to implement health surveillance of workers occupationally exposed to asbestos and to diagnose occupational diseases related to asbestos. This law also defines "occupational exposure to asbestos", and "occupational asbestos-related diseases", including asbestosis (pulmonary asbestos-related fibrosis), pleural asbestos-related disorders (plaques, pleural thickening, and benign effusion), lung and bronchial cancer, and malignant mesothelioma of serous membranes. These regulations have been harmonised with ILO, Directive 2003/18/EC amending Council Directive 83/477/EEC on the protection of workers from the risks related to exposure to asbestos at work, and with the Commission Recommendation 2003/670/EC concerning the European schedule of occupational diseases. The 2008 Croatian regulation on conditions of health surveillance, diagnostic procedures and criteria for confirmation of occupational asbestos-related diseases "defines the terms and the content of medical examination of workers exposed to asbestos, and criteria for the confirmation of occupational asbestos-related diseases which are harmonised with the Helsinki criteria acknowledged by ILO and EU, particularly concerning the level and length of exposure. Croatian law on compensation of workers occupationally exposed to asbestos from 2007 regulates compensation claims for workers with occupational asbestos-related disease, authorities competent to process these claims, and funds and coefficients for compensation payments. Accordingly, Croatia is responsible for compensation claims payment for workers with occupational asbestos-related disease. The 2007 law on conditions for entitlement to full pension for workers exposed to asbestos at work defines the conditions for fulfilling criteria for retirement pension for workers exposed to asbestos at work.

Exposure to toxic gases which can induce serious health effects, can occur in the working as well as in general environment, including home. The severity of gas poisoning is determined by its physical and chemical characteristics, intensity and duration of exposure, and concomitant diseases and injuries in the poisoned person. Manifestations of gas toxic action involve simple asphyxia, local irritation of respiratory mucosa, systemic toxicity, and a combination of these mechanisms. This article describes the characteristics, modes of exposure and health effects of most common gases causing poisoning at home. These include gas fuels, carbon monoxide, ammonia, chlorine, and fire gases such as nitrogen and sulphur oxides, hydrogen cyanide and phosgene. First aid as well as preventive measures to avoid exposure to toxic gases and prevent fire at home are also given. The Croatian Poison Control Centre gathered data on toxic gas exposures in households between November 2005 and July 2006. During this period 30 persons (3 % of the total number of cases) were exposed to toxic gases at home, including carbon monoxide, irritating vapours from cleaning agents and disinfectants, gas fuels, septic tank gases, tear-gas, and chlorofluorocarbons from refrigerators.

Pyrethrins, natural extracts of Chrysanthemum cinerariaefolium and Chrysanthemum cocineum flowers, and pyrethroids, synthetic analogues and derivatives of pyrethrins, are powerful insecticides. They are widely used in households and insect control in pets or livestock, in textiles such as carpets, wallpapers, furniture and clothes, as well as in agriculture, forestry and public health services. This article brings a list of pyrethrin and pyrethroid insecticides registered for use in plant protection in Croatia. Pyrethrins and pyrethroids can enter the organism by ingestion (accidental or suicidal ingestion or in food), by inhalation and/or by skin contact. Although these pesticides pose a relatively low risk to mammals due to rapid metabolism with no significant accumulation, they can induce adverse health effects, more often in acute poisoning, but also due to chronic exposure. The primary target of pyrethrin and pyrethroid toxicity is the nervous system, since they act directly on the sodium channels of nerve cell axons, leading to hyperexcitation. Another important toxicological mechanism is allergenicity, which is more pronounced with pyrethrins than with synthetic pyrethroids. Because there is no antidote for pyrethrin and pyrethroid poisoning, treatment is symptomatic and supportive. The article discusses the measures for poisoning prevention and alleviation of exposure to pyrethrins and pyrethroids in occupational settings and in general population.

A 70-year old female patient was admitted to the hospital because of scheduled thoracotomy and biopsy of posterior mediastinal retrocardiac tumor of unrecognized etiology. The patient had no complaints regarding the tumor. Routine anesthesiological preoperative examination revealed status ASA III. Induction in anesthesia was usually stable. At the moment when the surgeon intraoperatively touched the tumor, hemodinamic instability started and arterial blood pressure and heart rate dramatically increased. Our first reaction was to deepen the anesthesia. Very soon it was obvious that blood pressure increased by the surgeon's manipulation of the tumor and we started to doubt on catecholamine-secreting tumor. During the course of the operation there were several hypertensive episodes and we managed them by alternately using atenolol, glyceroltrinitrate and anesthetic drug. The patient was extubated 5 hours after transfer to the intensive care unit. Postoperative period was hemodynamically stable. The level of catecholamines in 24-hour urine collection was significantly increased. Pathohistologic diagnosis was mediastinal paraganglioma.

This paper gives a review of the most important impacts of exposure to dust mites in general and working environment on human health. The Institute for Medical Research and Occupational Health in Zagreb, Croatia, has been investigating the frequency and exposure levels of allergies to pyroglyphid and non-pyroglyphid mites in Croatia for the last 10 years. Investigations were performed in general urban and rural population from the inland and coastal Croatia, and several industrial inland populations occupationally exposed to organic dusts. Mite species and levels of pyroglyphid mites allergens (Der p 1, Der f 1) were established in house dust samples taken from the floors of bedrooms and living rooms and in several industrial dust samples. The frequency of allergies to pyroglyphid mites in general urban population of inland Croatia is about 20%, with significant general indoor exposure to these mites (median value for Der p 1: 0.85 microg/g of dust). General adult population of the coastal region had a significantly higher exposure to pyroglyphid mites (median value for Der p 1: 4.5 microg/g of dust), yet showed a significantly lower frequency of allergies to these mites (about 5%). New studies are necessary to investigate possible genetic and environmental factors involved in the mechanisms which protect coastal population from the development of mite allergy. Acarological and statistical analyses have shown that the high frequency of sensitisation to non-pyroglyphid mites found in the general and working populations of the inland region is not related to environmental exposure to these mites, but to the cross-reactivity between pyroglyphid and non-pyroglyphid mites and to false positive skin reactions in prick testing, particularly to T. putrescentiae. So far, results do not indicate that pyroglyphid mites are occupational allergens in paper-recycling, fish-processing and tobacco-processing.

Stress is one of the components in the complex interaction of environmental, genetic, physiological, psychological, behavioural and social factors that can influence the body's ability to remain healthy or become healthy, to resist or overcome a disease. Stress can alter neuroendocrine and immune mechanisms of health and disease through various psychosocial processes. In addition, it can affect health through the impact on health-impairing behaviours and on compliance with medical regimens. At the same time, the relationship between stress and health is not unidirectional but bi-directional. Current views on the relation between stress and allergy vary from the denial of any relationship that could fundamentally help in allergy treatment to the widespread opinion that psychological stress can exacerbate some skin symptoms and precipitate asthma. The role of stress in the genesis, incidence and symptomatology of allergy still remains a controversial issue since the mechanisms of that relationship are not well understood. Starting from the biopsychosocial model of disease, we introduced the Social Readjustment Rating Scale which measures stressful life events, and the WHOQOL-BREF which measures subjective quality of life, into an extensive multidisciplinary study of immunotoxic effects of indoor bioaerosols and lifestyle. This paper describes the characteristics of those two questionnaires and discusses the relationship between stress and various domains of the quality of life. The Social Readjustment Rating Scale proved to be a reliable predictor for quality of life in the domains of physical health and environment. Future analyses will examine the role of stress and subjective quality of life in allergy.

The prevalence of allergic diseases is rapidly increasing over the last 40 years, especially in most industrialized countries of the world. Manifestations of allergic diseases are observed in about 35% of the general population. In this paper, the most frequent allergic respiratory and skin diseases are described (rhinitis, asthma, atopic eczema/dermatitis syndrome, contact eczema/dermatitis, urticaria). The most important individual and environmental factors involved in the occurrence of allergic diseases are described: genetic predisposition, exposure to allergens, environmental pollution and modern life style are discussed. The results of our investigations related to the prevalence of allergy markers in general and working population are presented. The preventive measures concerning allergic diseases are considered.

Exercise-induced bronchospasm (EIB) is a type of nonspecific bronchial hyperreactivity. It affects mostly children and younger adults with asthma (75%-95%) and allergic rhinitis (40%), but it is also found in 3-11% of the nonasthmatic and nonatopic younger population. Pathophysiology of this phenomenon is not clear and there are some attempts to explain it with hyperosmolality of bronchial epithelia, exchange of heat and water (reactive hyperemia) in airways and reflex vagal bronchospasm. Unrecognized and uncontrolled symptoms of EIB can lead patients to avoid general and occupational physical activities and sports. Diagnosis of EIB is focused on medical history and on pulmonary function testing after standardized exercise testing protocols on treadmill, cycle ergometer or by free running. Non-pharmacological and pharmacological prophylactic measures are the most important approach in the therapy of EIB. Inhalation of beta 2-agonists or cromolyns is the first choice in pharmacological prevention of EIB. With adequate therapy, symptoms of EIB can be controlled enough to maintain everyday as well as sports activities.

This paper gives an overview of common outdoor and indoor allergens which cause sensitisation of the respiratory tract and considers relevant biological and ecological hallmarks and symptoms of allergies. Grass, tree, and weed pollens as well as moulds (Cladosporium and Alternaria species) are a major source of allergens in the outdoor environment whereas mites (Pyroglyphidae, Acaridae, and Glycyphagidae), animals (pets, rodents, and insects), and moulds (Aspergillus, Penicillium, and Mucor species) are a major source in the indoor environment. The paper pays attention to the seasonal, geographical, and climatic influence on the concentration of allergen in the environment. The authors discuss differences between exposure to outdoor and indoor allergens, as well as the impact of pollutants on sensitisation of the respiratory tract. The paper proceeds with a short description of the primary prevention measures such as avoidance of the allergens and the secondary measures which are intended to prevent the occurrence or deterioration of respiratory symptoms in sensitised persons.

Sensitization to dust mites is in significant increase in the world and is known as independent risk factor for development of bronchial asthma. In this paper, important biological markers and environmental spread of dust mites are described as well as the epidemiology, the most frequent clinical patterns and standard diagnostic procedures of sensitization to dust mites. The importance of the environmental dust mites control is emphasized, particularly as a part of primary and secundary prevention of sensitization to dust mites.

The study included 17 female workers employed in latex glove rubber manufacturing plants. The mean age was 42 years and the mean duration of employment 19 years. Subjects were predominantly nonsmokers. A control group of 17 nonexposed workers was also studied. Chronic respiratory symptoms and diseases as well as acute work-related symptoms were recorded for these workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves on which forced vital capacity (FVC), one second forced expiratory volume (FEV1) and maximum expiratory flow at 50% and the last 25% of the vital capacity (FEF50, FEF25) were read. Skin prick tests were performed with three types of latex (original material-latex 1, extract from gloves-latex 2, and extract of latex company Epypharm-latex 3). The prevalence of chronic respiratory symptoms was greater among latex workers (varying from 5.9% for occupational asthma to 58.8% for dyspnea) than among control workers (0%). There was a high prevalence of acute work-related symptoms, particularly for eye irritation (76.5%), dryness of the nose (70.6%), throat burning (70.6%), dryness of the throat (64.7%) and cough (58.8%). Measured ventilatory capacity data in latex workers were significantly lower in comparison to control, particularly for FEF25 (75.1 +/- 19.5%). Among latex gloves making workers one had positive skin reaction to latex 3 along with the symptoms of occupational asthma. Our data indicate that employment in latex making gloves may be associated with the development of occupational asthma, in addition to frequent nonspecific respiratory findings.

Sensitization to latex and rubber additives has been acknowledged during the last 10 years as a major occupational health problem among health-care workers. In sensitized persons, respiratory and/or skin symptoms may be present. Pathophysiologic mechanisms of senzitisation involve allergic reactions types I and IV (Coombs and Gell). In this case report we described a female health-care worker with sensitization to latex and rubber additives simultaneously present on the skin and in the respiratory system, caused by wearing protective rubber gloves. The complex diagnostic procedure involved in determination of occupational allergic diseases is discussed.

Respiratory function and allergic reactions were studied in 101 male workers in paper recycling and in 87 nonexposed male control 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). Skin prick test with paper dust allergens, some nonoccupational allergens, and total immunoglobulin IgE analysis were used to assess immunological status. Significantly higher prevalences of all chronic respiratory symptoms were recorded in the exposed workers than in controls. The highest prevalence was recorded for chronic cough (36.6%), followed by chronic phlegm (34.7%), chronic bronchitis (33.7%), sinusitis (31.7%), nasal catarrh (29.7%), and dyspnea (16.8%). Occupational asthma was diagnosed in four paper recycling workers only (4.0%). Values of FEF50 and FEF25 were significantly lower than predicted, indicating obstructive changes located mostly in the smaller airways. Skin tests to paper allergens were found positive in 16 (15.8%) paper recycling workers and none in controls. An increase in total immunoglobulin IgE was found in 21 of 101 paper recycling workers and in two of 37 of controls (P < 0.05). Our data indicate that exposure to air pollutants in paper recycling industry may lead to the development of respiratory symptoms accompanied by lung function and immunological impairment.