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Background: Occupational lung diseases remain common, and health surveillance is one approach used to assist identification of early cases., Aims: To identify areas of good practice within respiratory health surveillance and to formulate recommendations for practice., Methods: Published literature was searched since 1990 using a semi-systematic methodology., Results: A total of 561 documents were identified on Medline and Embase combined. Other search engines did not identify relevant documents that had not already been identified by these two main searches. Seventy-nine of these were assessed further and 36 documents were included for the full analysis., Conclusions: Respiratory health surveillance remains a disparate process, even within disease type. A standard validated questionnaire and associated guidance should be developed. Lung function testing was common and generally supported by the evidence. Cross-sectional interpretation of lung function in younger workers needs careful assessment in order to best identify early cases of disease. More informed interpretation of the forced expiratory volume in 1 s/forced vital capacity ratio, for example by using a lower limit of normal for each worker, and of longitudinal lung function information is advised. Immunological tests appear useful in small groups of workers exposed to common occupational allergens. Education, training and improved occupational health policies are likely to improve uptake of health surveillance, to ensure that those who fail health surveillance at any point are handled appropriately.

Objectives: To examine whether welding is a risk factor for an accelerated decline in pulmonary function., Methods: 2 Year follow up of pulmonary function and respiratory symptoms among 54 welders and 38 non-welders in eight New Zealand welding sites., Results: There were no significant differences in age, height, smoking habits, ethnicity, or total time in industrial work between welders and non-welders. No overall differences were noted in the changes of pulmonary function variables between the two study groups. However, when the comparison was restricted to smokers, welders had a significantly greater (p = 0.02) annual decline (88.8 ml) in FEV1 than non-welders, who had a slight non-significant annual increase (34.2 ml). Also, welders without respiratory protection or local exhaust ventilation while welding had a greater annual decline both in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) than welders with protection (p = 0.001 and 0.04, respectively). Among welders a significant association was found between the acute across shift change and the annual decline in FEV1. Chronic bronchitis was more common among welders (24%) than non-welders (5%). Only one welder (2%) but eight non-welders (21%) reported having asthma., Conclusions: Welders who smoked and welders working without local exhaust ventilation or respiratory protection have an increased risk of accelerated decline in FEV1.

Objectives: The possibility was investigated that exposure to welding fumes causes an acute decrease in pulmonary function., Methods: Changes in the pulmonary function of 62 current welders and 75 nonwelders at the same sites and the relationship with work-related symptoms were recorded., Results: Work-related cough was reported by 22.6% of the current welders and 6.7% of the nonwelders [odds ratio (OR) 4.1, 95% confidence interval (95% CI) 1.5-11.5], and the respective figures for at least 1 work-related symptom were 30.7% and 16.0% (OR 2.3, 95% CI 1.0-5.2). The groups' preshift lung function did not differ. The mean percentage change from the base-line value of the forced expiratory volume in 1 s (FEV1.0) after 15 minutes of work was -2.8% (range -29.3% to +20.9%) for the current welders and +1.0% (range -20.7% to +22.6%) for the nonwelders (P = 0.01). A multivariate analysis identified current welding as the most significant risk factor for a decrease of at least 5% in FEV1.0 after 15 minutes, the risk being greater for those with no local exhaust ventilation (OR 22.4, 95% CI 4.5-113.4) than for those with personal protection only (OR 16.0, 95% CI 2.1-122.9) and those with local exhaust ventilation (OR 2.8, 95% CI 0.2-41.2) or passive exposure only (OR 2.0, 95% CI 0.5-8.8)., Conclusions: An acute decrease in FEV1.0 in relation to work is more prevalent among welders than among nonwelders, and is more common among welders without local exhaust ventilation than among those with it.

A 25 year old man presented with dyspnoea and was found to have generalised, but predominantly pulmonary, lymphangiectasis without gastrointestinal symptoms. This is an unusual presentation of a disorder previously diagnosed only in childhood.

Objectives: This survey was conducted to investigate current lung function levels in operatives working with cotton and man made fibres. Dust concentrations, smoking history, and occupational details were recorded so that factors influencing lung function could be identified., Methods: A cross sectional study of respiratory symptoms and lung function was made in 1057 textile spinning operatives of white caucasian extraction. This represented 96.9% of the total available working population to be studied. Most (713) worked currently with cotton. The remainder worked with man made fibre. Lung function was assessed by measuring forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Exposure to cotton dust was measured in the work area and personal breathing zones, and retrospective exposure to cotton dust over a working life was estimated with accurate work history and best available hygiene data., Results: 3.5% of all operatives had byssinosis, 55 (5.3%) chronic bronchitis, 36 (3.5%) work related persistent cough, 55 (5.3%) non-byssinotic work related chest tightness, and 56 (5.3%) work related wheeze. A total of 212 static work area dust samples (range 0.04-3.23 mg/m3) and 213 personal breathing zone samples (range 0.14-24.95 mg/m3) were collected. Percentage of predicted FEV1 was reduced in current smokers (mean 89.5, 95% confidence interval (95% CI) 88-91) in comparison with non-smokers (93.1, 90.5-94.1) and FVC was reduced in operatives currently working with man made fibre (95.3, 93.8-96.9) in comparison with cotton (97.8, 96.6-99.0). Regression analysis identified smoking (P < 0.01), increasing age (P < 0.01), increasing time worked in the waste room (P < 0.01), and male sex (P < 0.05) as being associated with a lower FEV1 and FVC. Current and retrospective cotton dust exposures did not appear as predictor variables in the regression analysis although in a univariate analysis, FEV1 was reduced in those operatives exposed to high dust concentrations assessed by personal and work area sampling., Discussion: This study has documented loss of lung function in association with exposure to cotton dust. Those operatives with work related symptoms had significantly lower FEV1 and FVC than asymptomatic workers. Although lung function seemed to be affected by high dust exposures when operatives were stratified into high and low exposure groups, regression analysis did not identify current dust concentrations as an independent factor influencing loss. Smoking habit was found to explain most of the measured change in FEV1 and FVC. It is likely that smoking and dust exposure interact to cause loss of lung function in cotton textile workers.

Background Consistent evidence from population studies report that 10-15% of the total burden of chronic obstructive pulmonary disease (COPD) is associated with workplace exposures. This proportion of COPD could be eliminated if harmful workplace exposures were controlled adequately. Aims To produce a standard of care for clinicians, occupational health professionals, employers and employees on the identification and management of occupational COPD. Methods A systematic literature review was used to identify published data on the prevention, identification and management of occupational COPD. Scottish Intercollegiate Guidance Network grading and the Royal College of General Practitioner three star grading system were used to grade the evidence. Results There are a number of specific workplace exposures that are established causes of COPD. Taking an occupational history in patients or workers with possible or established COPD will identify these. Reduction in exposure to vapours, gases, dusts and fumes at work is likely to be the most effective method for reducing occupational COPD. Identification of workers with rapidly declining lung function, irrespective of their specific exposure, is important. Individuals can be identified at work by accurate annual measures of lung function. Conclusions Early identification of cases with COPD is important so that causality can be considered and action taken to reduce causative exposures thereby preventing further harm to the individual and other workers who may be similarly exposed. This can be achieved using a combination of a respiratory questionnaire, accurate lung function measurements and control of exposures in the workplace. [ABSTRACT FROM AUTHOR]

The article provides information about standards of medical care for occupational asthma recommended by the British Occupational Health Research Foundation (BOHRF) in Great Britain. The recommendations include reported incidence of occupational asthma, the risk of developing the disease, and the likelihood of improvement or resolution of symptoms. Furthermore, the article provides guidance to all healthcare professionals dealing with workers exposed to agents that potentially cause asthma.

Background A study of occupational respiratory symptoms in hairdressers was carried out in 26 salons in New Zealand. Methods A questionnaire was administered to 100 hairdressers and 106 office and shop workers, recording respiratory symptoms, demographic data, and smoking habits. Pulmonary function was measured before each shift. Results Hairdressers had a higher prevalence of asthma symptoms, diagnosed asthma, and asthma attacks in the previous 12 months, but these differences reduced markedly when adjusted for age, gender and smoking. Hairdressers had a significantly lower pulmonary function, even after adjustment for smoking, but this difference was entirely due to differences between hairdressers and office workers and there were no such differences between hairdressers and shop workers. Conclusions The excess symptom prevalence in hairdressers was largely due to the high smoking rates. Mean pulmonary function was lower in hairdressers but this finding requires further study. [ABSTRACT FROM PUBLISHER]