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Studies the acceptability of the single breath N[sub 2] (SBN[sub 2]) test in a female population in a rural area of northeastern France. Low percentage of women able to produce two valid SBN[sub 2] tests in a series of six attempts; Age and higher prevalence of bronchial hyperresponsiveness in women who failed in the test; High rate of failure associated with higher age.

Application of a negative pressure has been utilized in experimental settings to demonstrate abnormal upper airways compliance. We hypothesized that a simple forced inspiratory maneuver could be used as a screening test for this abnormality in an epidemiological setting. 277 men and women, aged 30 years or more, who attended a Preventive Medicine Centre, volunteered for completing a sleep questionnaire, having standard anthropometric measurements, a non-invasive upper airways examination, and for performing an oronasal peak inspiratory maneuver. The peak inspiratory flow (PIF) of 127 females was significantly less compared to that of the 137 males (211±47 vs. 269±59 l.min-1). PIF was significantly inversely related to age in both sexes; a positive correlation with height was found in males only. Males with enlarged soft palates had a significantly lower PIF (256±54 vs. 277±62 l.min-1; p=0.04). No difference in PIF was found in subjects who stated that they experienced breathing pauses during sleep. Habitual snoring males had a significantly lower PIF as compared to the non-snorers (251±59 vs. 282±57 l.min-1; p=0.003); after adjustment for age, this difference was borderline significant (p=0.06). A forced inspiratory flow maneuver yielded a PIF which was different between genders, was age-dependent in both sexes, and related to height in males. PIF did not identify male subjects with breathing pauses during sleep, but was associated with a larger soft palate and was borderline decreased in habitual snoring males. The present results suggest that, with further validation, the PIF test could represent a simple means to indirectly explore upper airways compliance.

Background: Exposure to pollutants in bakeries and hairdressing salons can cause airway syndromes varying from bronchial irritation to asthma. Workplace respiratory health surveillance aims to identify possible cases requiring further investigation., Aims: To compare the performance of fractional exhaled nitric oxide (FE(NO)) and spirometry for health surveillance of apprentice bakers (ABs) and apprentice hairdressers (AHDs). Determinants of FE(NO) were also identified., Methods: Symptoms and physician-diagnosed asthma were evaluated by questionnaire. FE(NO) was measured and spirometry was carried out. Subjects with elevated FE(NO) (FE(NO) > upper limit normal), airway obstruction [forced expiratory volume in 1 s (FEV(1))/forced vital capacity (FVC) < 95th percentile] and atopy (history of allergies) were identified., Results: A total of 126 apprentices (59 ABs and 67 AHDs) participated. Twenty-nine (23%) apprentices had abnormal tests: 4 had associated high FE(NO) and airway obstruction, while 25 had either high FE(NO) (n = 15) or airway obstruction (n = 10) alone. Compared with ABs (n = 16), AHDs (n = 13) had more asthma (38 versus 0%; P < 0.05) and atopy (62 versus 6%; P < 0.05). There was no difference in symptoms, smoking FE(NO) or airways obstruction. Among 97 subjects with normal tests, no differences existed between ABs (n = 53) and AHDs (n = 44). Average FE(NO) was increased in atopic non-smokers compared with atopic smokers and non-atopic subjects (P < 0.05). Smoking, a history of allergies, FEV(1)/FVC % observed and respiratory symptoms were the main determinants of FE(NO)., Conclusions: FE(NO) and spirometry were not overlapping dimensions in ABs and hairdressers, each test contributing unique information on the physiological status of the respiratory system. FE(NO) may provide added information on airway inflammation not provided by spirometry.

Introduction: As there are important differences in the prevalence of snoring in the literature we have studied this prevalence and the risk factors in a sample of the active male population of Lorraine., Methods: 850 men, aged 22 to 66 tears, volunteered for the study and completed a questionnaire on the frequency of snoring, their lifestyle and their personal and family histories. The usual anthropomorphic measurements were made together with a non-invasive examination of the upper airways., Results: The prevalence of habitual snoring was 34.6%, increasing with age, weight and the derived indices. We identified, by logistic regression, the factors independently associated with habitual snoring in univariate analysis. These were age, weight, nocturnal nasal obstruction, a medical diagnosis of obstructive sleep apnoea, and hypertrophy of the soft palate and uvula. There was evidence that height had a protective effect but exercise activity did not appear to be significant., Conclusion: The 35% prevalence of habitual snoring in our sample of middle aged men is similar to other studies in the literature using the same methods. The present study confirmed that age, weight, girth, nasal obstruction and nasopharyngeal abnormalities are risk factors. The protective effect of height was a new finding not identified in previous studies.

Background: Most studies on habitual snoring have focused on its prevalence. However, from the clinical point of view, the intensity of snoring is of upmost importance, as it suggests the existence of sleep apnoeas., Objectives: The aim of the study was to assess the prevalence of loud snoring using a standard questionnaire and to evaluate the anthropometric and sleep characteristic differences between loud and light snorers in a sample of middle-aged males., Methods: The subjects were middle-aged active male employees. They completed a structured sleep questionnaire and had standard anthropometric measurements. Subjects reporting habitual snoring (> or =3 nights/week) were further classified as loud or light snorers., Results: Of the 850 male subjects volunteering, 149 (17.5%) were habitual loud snorers. Loud snorers were older and had a greater waist-to-hip ratio as compared with light snorers. In univariate analysis, loud snoring was associated with gasping/snorting during sleep, breathing stops during sleep, waking up too early, excessive daytime sleepiness and falling asleep while watching TV. Logistic regression identified four independent associates of loud snoring: gasping during sleep, excessive daytime sleepiness, falling asleep watching TV and age., Conclusions: Loud snoring is present in a significant proportion of middle-aged men and is associated with central obesity and age. It disturbs sleep and elicits significant daytime sleepiness. Its association with breathing pauses (univariate) and its independent association with gasping during sleep suggests that loud snoring could be considered a clinical correlate of obstructive sleep apnoeas., (Copyright 2006 S. Karger AG, Basel.)

The aim of the study was to evaluate the prevalence, the covariates and determinants of respiratory pauses during sleep in a sample of French middle-aged males. Study subjects were 850 active males, aged 22-66 years; 88.4% of them answered the question on breathing pauses during sleep from a structured, validated sleep questionnaire. Forty-one (=5.4%) subjects reported breathing pauses at least once a week; these "positive responders" were older, heavier and had larger neck- and waist girths as compared to subjects with negative answers. Loud habitual snoring, various sleep disturbances, excessive daytime sleepiness, a doctor diagnosis of sleep apnoea, history of stroke and hypertension were significantly more frequent among subjects with breathing pauses during sleep. The prevalence found in this survey was close to that reported from the UK (5.2%). However, by logistic regression, we identified novel determinants of breathing pauses i.e. habitual snoring, loud snoring, and excessive sleepiness, factors well known in clinical setting, but never previously reported in epidemiologic studies.

The aim of the present study was to test the hypothesis that unmarried (single) men have more sleep-disordered breathing symptoms due to a higher prevalence of obesity and a less healthy lifestyle than men living with a partner. Men (499) aged 23-66 years completed a structured questionnaire, had standard anthropometric measurements and a simple, noninvasive nose-throat examination. Of the 499,496 subjects answered the question concerning their marital status; 86% of them were married or lived with a partner (reference group) and the other 14% had never been married, divorced, or widowed ("single" group, considered at risk). Single subjects were younger, included slightly more smokers (30 vs. 23%) and more subjects with a history of chronic bronchitis, and less frequently had a large soft palate. The prevalence of sleep-disordered symptoms was not significantly different between the two groups. However, a study involving a larger number of subjects with information regarding alcoholic consumption may be needed to further evaluate this question.

We evaluated the reliability of a French version of the Wisconsin Sleep Questionnaire designed to investigate snoring, obstructive apnoeas, and sleeping problems. The assessment of reliability included the study of internal consistency and the 3 months repeatability of the questionnaire. The questionnaire was first completed at a Center of Preventive Medicine by a random sample of 122 subjects from the community. Three months later the same form was mailed and 82 questionnaires were returned (67.2%). No significant differences existed between responders and nonresponders for anthropometric data or life habits. The internal consistency in each domain was good or satisfactory (Cronbach's alpha=0.67 to 0.81). The concordance between the answers at a 3-month interval was excellent for questions on ever snoring, frequency of snoring, gasping/choking during sleep, and breathing stops during sleep (Cohen kappa>0.60). The questions on snoring loudness, a history of sleep apnoea, and excessive daytime sleepiness were fairly reproducible (kappa 0.28 to 0.60). We found no difference in reproducibility by gender or age. In conclusion, this reliability assessment in a sample of middle-aged subjects from the community in northeastern France showed satisfactory internal consistency and 3-months reproducibility of the main questions of a French translation of the Wisconsin Sleep Questionnaire.

Background: No data on snoring prevalence obtained with a standard questionnaire exist for France. Major nose-throat abnormalities have been demonstrated in cases with obstructive sleep apnea; evidence of "minor" abnormalities in community studies is scarce., Objectives: The first objective of our study was to estimate the prevalence of habitual snoring in a sample of middle-aged active males in France. The second objective was to test the hypothesis that "minor" nose-throat abnormalities could be associated with habitual snoring in a field survey., Methods: Three hundred thirty-four male employees of a local university volunteered for the study (93.6% of those contacted by mail); 300 returned a sleep questionnaire. The protocol also included anthropometry and a noninvasive nose-throat examination., Results: Complete data were obtained in 299 subjects aged 23-63 years. When "habitual snorers" (= 32%) were compared with never-snorers, significant differences were found for all anthropometric variables, except height. In univariate analysis, habitual snoring was associated with a large number of variables, including a large soft palate, a large uvula, and altered nose patency. A logistic regression model retained 8 factors independently associated with snoring: age, neck circumference, tobacco consumption, breathing pauses during sleep, not feeling rested during the day, need for coffee to stay awake, blocked or running nose at night and a large soft palate., Conclusions: The prevalence of habitual snoring in this sample of middle-aged French males was 32%. We confirmed the significant association of habitual snoring with age, weight excess, and tobacco smoking, and identified two further factors: blocked nose at night and a large soft palate., (Copyright 2001 S. Karger AG, Basel)

Sleep-disordered breathing (SDB) and lower socio-professional status have in common a series of risk factors for ill health such as sedentary lifestyle, weight excess, heavy alcohol and tobacco consumption. We hypothesised that SDB will be more prevalent in lower socio-professional groups. A total of 496 male middle aged subjects (23-66 years) were tested with a protocol including a self-completed structured sleep questionnaire (translation of the Madison sleep cohort study form), anthropometry (including neck, waist and hip girth) and a simple, non-invasive nose-throat examination by a specialist physician. The subjects were classified according to the 10 major groups of the ISCO-88 classification (International Labour Office). Our sampling base did not contain subjects in the major groups 1 (senior officials, legislators), 6 (fishery and agricultural workers), and zero (armed forces), thus these groups were not represented in the analysis. To improve the power of the statistical analysis, groups 3 and 4, 5 and 7, 8 and 9 were merged, the analysis thus including four categories. The differences in demographic data were negligible; as expected, smoking was more prevalent in low socio-occupational groups (difference non-significant). A history of chronic bronchitis was more frequent in low socio-occupational groups, while a low physical job labour was more frequent in higher occupational groups. We did not find any differences in the prevalence of sleep-related respiratory disturbances (snoring, sleep apnoeas). This first study of the possible association between socio-occupational factors and sleep disordered breathing was negative, but we believe further studies, on larger samples, with a more homogeneous distribution of social groups are warranted.

There is only limited information on the factors associated with nonspecific bronchial hyperresponsiveness (BHR) in farmers. Our purpose was to examine the relationship between BHR and respiratory symptoms, atopy, and abnormalities of lung function in a sample of French farmers. Farmers scheduled for a preventive medicine check-up in northeastern France were examined. Occupational exposure, respiratory symptoms, and work-related symptoms were assessed by questionnaire, sensitization to 34 common and agricultural allergens by skin prick tests, and BHR by the single-dose (1,200 microg) acetylcholine (ACh) challenge test. Data were obtained from 741 farmers (95% of those invited). Seventy-seven subjects (10.3%) had BHR defined as a fall in forced expiratory volume in 1 s (FEV1) >/= 10% after the inhalation of ACh or, for those with a poor lung function, an increase in FEV1 > 10% and > 200 ml after the inhalation of 200 microg of salbutamol. The proportion of asthmalike symptoms, especially wheeze during work, positive skin tests to acarian (storage mites) and cereal dust allergens, and low levels of lung function was significantly greater among reactors than among nonreactors. Stepwise logistic regression analysis showed a significant and independent association between BHR and wheezing during work (OR = 4.99; 95% CI = 2.29-10.89; p = 0.0001) and baseline FEV1 (OR = 1.49; 95% CI = 1.05-2.20; p = 0.026). In conclusion, hyperreactive farmers had significantly more asthmalike symptoms, positive skin tests, and abnormal lung function than normoreactive farmers. Work-related wheeze and low baseline FEV1 were significantly and independently associated with BHR.

Study Objectives: To verify that sick building symptoms are present in north-eastern France office workers; to try to identify new confounding factors., Methods: The design was that of a cross-sectional study with control group. We studied with the same methods the personnel of an air-conditioned building (n=425), and of a naturally ventilated building (n=351). Air temperature and humidity, bacterial and fungal densities were measured by the same technical staff in the two buildings. A standard questionnaire on irritative and respiratory symptoms, personal and family history, and lifestyle was completed by the participants., Results: In univariate analysis, exposure to air-conditioning was associated with an increased prevalence of symptoms (odds ratios-OR-between 1.54 and 2.84). A significant increase in sickness absence was also found among subjects working in air-conditioned offices. As a series of factors were suspected to interfere with these associations, logistic regression was applied. This method confirmed exposure to be an independent determinant of 7 symptoms, and also identified two determinants not previously described: a family history of respiratory diseases and "do-it-yourself' activities., In Conclusion: we found the sick building symptoms to be present in a group of French office workers exposed to air-conditioning. We confirmed the influence of a number of confounding factors and described two further confounders - do-it-yourself activities at home and a history of familial respiratory disease.

The prevalence of sleep-disordered breathing (SDB) was evaluated in a male population sample of Lorraine (university staff), with a protocol including a self-completed standardized questionnaire, anthropometry (including neck, waist and hip circumferences) and non-invasive ear, nose, and throat examination. Among 357 subjects present in the institution at the moment of the survey, 334 (93.6%) accepted to participate, and 300 (84%) returned the questionnaires. The anthropometric results corresponded to the French normative values according to gender and age. We chose a value of 32 as limit of the body mass index (BMI) between weight excess and obesity; this limit was exceeded by 7.2% of the subjects. The mean age of the sample was 44.8 (SD 10.1) years; the waist-to-hip ratio was of 0.907 +/- 0.053. The ENT examination found a high prevalence of nasal septum deviations (52.6%), of soft palate (25.2%), and uvula (42%) abnormalities; 32.1% of the subjects had experienced amygdalectomy. The non-responses to the questionnaire were infrequent (less than 2%), except for the questions regarding a history of hypertension (2.6%), weight fluctuations the last 5 years (7.6%), and the number of years in school (12%). The questionnaire included, for each question, the optional answer "don't know"; this answer was chosen for the questions concerning the duration of snoring (37.1%), stopping breathing during sleep (12.7%) and the parental history of narcolepsy (18.7 and 20.7%) and sleep apnoea (33.7 and 36.4%). 5.7% of the subjects declared sleep apnoeas at least once per week: 16.1% had unrefreshing sleep; 10.6% admitted to excessive daytime sleepiness; 41.9% were habitual snorers. These results indicate a prevalence of SDB in our sample which is comparable to the figures obtained in other European studies. Further analysis of our data will indicate if, besides weight excess and its troncular distribution, cigarette smoking and respiratory symptoms, the "minor" ENT abnormalities play a role in the pathogenesis of SDB.

Comparative manual and computer measurements of the alveolar N2 slope and closing volumes have indicated systematic differences. When a computerized system is used in field surveys, predicted values are to be obtained under the same conditions. Therefore, we measured the alveolar nitrogen slope (phase III, PIII), closing volume (CV), and closing capacity (CC) from single-breath N2 washout maneuvers in 158 healthy subjects (68 females), ages 21 to 64 years, from a rural community living in a nonpolluted area of northeast France. PIII, the CV to vital capacity ratio (CV:VC, %), and the CC to the total lung capacity ratio (CC:TLC, %) were regressed against age, height, weight, and the body mass index (BMI, kg/m2) and prediction equations with 95% confidence intervals were computed. PIII increased with age in both sexes and tended to decrease with height in males (r = -0.19, p = .08). The CV:VC and CC:TLC ratios depended on age and, in males, increased with the BMI. Despite accepting a 15% difference between the test VC and the spirometric VC, only 46.3% of asymptomatic nonsmokers produced a valid single-breath nitrogen washout (SBN2) test. This high failure rate limits the usefulness of the test for epidemiologic purposes when older populations "naive" to pulmonary function testing are studied under field-survey conditions.

Total lung capacity (TLC) and residual volume (RV) estimations were obtained from single-breath nitrogen washouts in 96 male and 77 female healthy never-smokers with normal spirometry from a non-polluted rural area in north-east France. TLC depended on height (both sexes) and diminished slightly with age in males, with the body-mass index (kg/m2) in females. RV increased with age in both sexes and with weight in males. The RV/TLC ratio was related only to age. When compared with values obtained using multiple-breath helium dilution, our results yielded lower predicted values. The test depends heavily on the subject's co-operation, and errors are frequent if a standard procedure is not observed. This method cannot thus be recommended for routine use in patients with respiratory diseases.

An increased mortality from lung and stomach cancer was found in previous studies on Lorraine iron miners. A detailed analysis, however, was not possible due to the lack of data for survivors. In this study the cohort included 1178 workers selected at random from all the 5300 working miners aged between 35 and 55 at the start of the follow up period, which ranged from 1975 to 1985. Occupational exposures and tobacco consumption, lung function tests, and respiratory symptoms were assessed for each subject in 1975, 1980, and 1985. This study confirmed the excess of lung cancer (standardised mortality ratio (SMR) = 389, p < 0.001) and of stomach cancer (SMR = 273, p < 0.05). There was no excess of lung cancer in non-smokers and moderate smokers (< 20 pack-years) or the miners who worked only at the surface or underground for less than 20 years. A significant excess (SMR = 349, p < 0.001) was found in moderate smokers when they worked underground for between 20 and 29 years. Heavy smokers (over 30 pack-years) or subjects who worked underground for more than 30 years experienced a high risk: SMR = 478 (p < 0.001) for moderate smokers who worked underground for over 30 years; 588 (p < 0.001) for heavy smokers who worked underground for between 20 and 29 years; and 877 (p < 0.001) for heavy smokers who worked underground for over 30 years. This showed an interaction between smoking and occupational exposure. The excess mortality from lung cancer was because there were some subjects who died young (from 45 years old). Comparison with the results of a previous study showed that additional hazards produced by diesel engines and explosives increased the mortality from lung cancer. The SMR was higher than 400 (p < 0.001) from 45 years old instead of from 56 years. A relation was found between a decrease in vital capacity (VC), forced expiratory volume in one second (FEV1) and of FEV1/VC and mortality from all causes and from lung cancer in heavy smokers or men who had worked underground for more than 20 years. Respiratory symptoms were related to mortality from lung cancer among smokers (moderate and heavy) who worked underground for more than 20 years. It is considered that the risk of lung cancer in the Lorraine iron miners was mainly due to dust, diesel engines, and explosives although the role of low exposure to radon daughters could not be totally excluded.

Within-subject (difference between paired tests, or coefficient of variation [c. var.] of three consecutive measurements) and between-subjects (standard deviation of the mean group) variability were assessed for the variables derived from the single-breath nitrogen (SBN2) test in a group of healthy, asymptomatic subjects (n = 289) aged 20-64 years, from a rural area in North-East France. Duplicate measurements in 99 subjects showed excellent agreement between the two attempts (correlation coefficients between 0.94 and 0.98) for static lung volumes and the alveolar N2 slope (PIII); closing volumes (CV) were more variable (r = 0.77 for absolute value, 0.79 for % VC) while closing capacities (CC) were in intermediate position (r = 0.86 for absolute value, and 0.88 for % TLC). The variability of three consecutive measures in 190 subjects showed the coefficients of variation to be low for static volumes and closing capacity (2.4-7.4%) and higher for PIII (15.1%) and CV or CV/VC (18.2 and 17.8%). The analysis of variance did not detect significant differences between the three sets of measurements, with the exception of a progressive increase of vital capacity (VC), and decrease in residual volume (RV) from test 1 to test 3, the total lung capacity being the same. Variability was uninfluenced by age or sex, except a higher c. var. for female VC as compared to males (2.8 vs. 2.2%, P = 0.02) and a higher variability of TLC (2.9 vs. 2.3%, P = 0.03) and VC (2.8 vs. 1.9%, P = 0.003) in people older than 40 years as opposed to those younger than 40 years.

The prevalence of habitual snoring and its associations with respiratory symptoms, personal and familial risk factors, ear, nose, and throat (ENT) abnormalities, and its influence on ventilatory function were studied in a sample of 190 children aged 5 to 6 years from nine kindergartens in Nancy (northeastern France). Nineteen (10%; 95% CI 5.7-14.3%) of the children were habitual snorers; the prevalence was the same in boys and girls. In univariate analysis habitual snoring was significantly associated with a personal history of exercise-induced bronchospasm [relative risk (RR) 4.50]; a history of adenotonsillectomy (RR, 2.56); a personal history of allergy (RR, 2.83); a sibling history of atopy (RR, 2.39); and doctor-assessed tonsillar hypertrophy (RR, 2.51). These factors were entered into a logistic regression model that retained as independent determinants exercise-induced asthma, personal history of allergy, sibling history of allergy, and tonsillar hypertrophy. The height-adjusted peak expiratory flow rate was slightly, non-significantly lower in habitual snorers as compared to non-snorers (2.01 +/- 0.32 vs 2.10 +/- 0.38 L/s/m2). Due to the limited numbers in the sample, the increased risk for paternal (RR, 1.8) and maternal (RR, 1.6) smoking at home remained nonsignificant.

1167 workers of Lorraine (France) iron mines, a random sample of 5600 workers aged 35 to 55 years, at work in 1975 constituted the initial cohort that was examined twice at 5-year intervals after the first examination. A questionnaire on respiratory symptoms and smoking habits (MRC questionnaire) plus questions on the work history of each participant was completed, vital capacity (VC), forced expiratory volume in one second (FEV1.0), residual volume (RV) and fractional uptake of CO (FuCO) were measured at the first examination and repeated five and ten years later. At the end of the ten year follow-up, 522 subjects were re-examined, 186 were lost to follow-up, 328 answered a mail questionnaire, and 111 had died. The total number of deaths was not different from that of the general population, but for lung cancer the standardized mortality ratio (SMR) was significantly increased (SMR = 3.7). For the miners re-examined, frequency of bronchitis and decrease of functional tests were more related to age and smoking habits than to occupation.

A prospective mortality study was conducted over a period of 5 years on a group of 13,801 iron miners, who were alive on January 1, 1982. During this 5-year period, 1813 deaths were registered. For 1222 (67.4%), the cause of death and work history are known. For 135 (7.4%), the cause of death is known, but not the work history. For 455 (25.1%), the cause of death is unknown. Proportional mortality ratio (PMR) is significantly higher than 1 for lung cancer (PMR = 2.51, p less than 0.001) and for stomach cancer (PMR = 2.31, p less than 0.001). The results are discussed in regard to occupational risks that result in these two kinds of increased mortality rates, and the hypothesis of redox activity on the surface of dust particles is advanced as a common denominator.

An analysis of the risk factors for pertussis and the possible respiratory sequels was carried out in a sample of 499 children and adolescents aged 10-16 years from the general population in north-eastern France. 44 subjects (8.8%) had pertussis during childhood; and the sex ratio was 1 in these cases. Pertussis was significantly associated with a maternal history of respiratory disease, residence in a rural area and coal heating. In a multiple logistic regression model, a maternal history of respiratory disease was the only significant factor (p = 0.01), the number of siblings being of borderline significance (p = 0.06). No increase in respiratory symptoms or asthma prevalence was found in our subjects who had pertussis during childhood.

Prick tests were performed with "pneumallergerns" (mites, cereal dusts, animal dander, pollens, moulds--totalling 35 allergens) among 742 agricultural workers of the Meuse department (North East of France) as part of an epidemiological study on respiratory and immuno-allergological problems. Among those with positive skin tests, 47.9% had positive skin tests for mites, 22.4% for cereal dusts, 10.7% for animals, 12.7% for pollens and 7.8% for moulds. Polysensitization was frequent (19.5% of the population). When the skin test was positive for main house dust mites it frequently was positive for storage mites, too. Among vegetal dusts sensitization, soy bean allergy yielded the highest frequency (6.5%). As for animal sensitization, cow dander was the most frequently observed positive test. Sensitization to pollens and moulds was comparatively rare. This study shows the large frequency and diversity of "latent allergy" to pneumallergens among agricultural workers.

Respiratory function (forced vital capacity-FVC; forced expired volume in one second-FEV1; maximal mid-expiratory flow-DEMM; peak flow-DP; maximal expiratory flow at 75-50-25% of vital capacity CV-DEMx) was studied in children of comparable age, sex and height (9 to 12 years) in a polluted zone (the exposed group n = 223) and a neighboring non-polluted zone (the control group n = 211) in the north of Lorraine. There was no significant difference in ventilatory function between the two groups. Amongst other factors capable of influencing the ventilatory function in the children we found an influence of parental smoking habits (particularly the mothers) identifiable in the non-exposed zone, above all in boys. A sub-segment analysis identified that in the absence of parental smoking, there was a negative influence of open coal fires. The discordance between the results of the measures of respiratory function and the prevalence of different respiratory symptoms, of acute infections and absenteeism from school, is probably explained by the interference of other factors which were not controlled in this study (e.g., ethnic factors and physical activity) and by the moderate level of the pollution; an over-reporting of respiratory symptoms by parents in the exposed zone could not be excluded.

A first survey has been conducted on 1179 iron-ore mine workers, 35-55 years old, who were randomly selected from 5900 at work with normal chest roentgenograms. Five years later, 871 of them were re-examined. Both surveys included a standard respiratory symptoms questionnaire (British MRC), a physical examination of the chest, and measurement of pulmonary function (vital capacity - VC; forced expiratory volume during 1 s - FEV1.0; residual volume - R.V. by helium dilution: carbon monoxide uptake - FuCO by the steady-state method). Both surveys were done by the same research team under identical conditions, using the same equipment. The mine technical services determined the dust and noxious gas concentrations at work places. No evidence of worsening of respiratory health status was observed overall. Symptoms of chronic bronchitis and asthma were recorded with a similar prevalence in both surveys; the decline in lung function was minimal for the total sample. However, our aim was to compare changes that were observed in groups differing by work place (surface or underground) or by activity (active or retired). Analysis showed that development of respiratory symptoms was more frequent and decline in lung function accelerated in the 5-year interval among underground workers who were still active as compared to those retired. In all subgroups (surface or underground workers, active or retired), decline of lung function values was more marked in smokers compared to non-smokers.

Ventilatory function (forced vital capacity, forced expiratory volume in one second, forced expiratory flows), static lung volumes, phase III slope and closing volume (single-breath nitrogen washout test) were measured in 499 children and adolescents aged 10-16 yrs from a general population sample in North-East France. A history of whooping cough was given by 44 children (22 of each sex); their results were compared to those of the 455 children (215 girls) with a negative history. The only difference between the two groups was a minimal increase in the residual volume/total lung capacity ratio in cases (19.2 +/- 3.1 vs 18.0 +/- 2.9%). We conclude that uncomplicated whooping cough in early childhood did not lead to significant pulmonary function abnormality in this population of children born after 1967.

At the request of its inhabitants, an epidemiological survey was conducted among the children of Carling, a particularly polluted industrialized town in the department of the Moselle in North-East France. Contrary to all expectations, no major toxic effect of industrial pollution on the respiratory health of the children was found. There was some correlation between the fact of living in a polluted area and a claimed respiratory morbidity. However, the potentially harmful effect of atmospheric pollution could not be translated in terms of abnormalities of respiratory function. In contrast, a significant effect of the smoking habits of the parents, and particularly of the mothers, on respiratory symptoms and spirographic data of their children was observed.

Ageing of the lung function in 5 years was studied in a group of 140 iron-ore miners, aged initially from 36 to 55 years. These men had no respiratory symptom and no pulmonary radiological abnormality. The sample was stratified on age and smoking. These factors were studied by a two-way analysis of variance. Lung function testing was performed twice, at 5 years of interval, in the same conditions. It consisted in: spirometry (for measuring FVC, FEV1, FEV1/FVC); a bronchial challenge test with acetylcholine (measurement of the fall of FEV1 after the test); measurement of total lung capacity (TLC) and residual volume (RV) by the open-circuit helium dilution method, and measurement of the transfer factor of the lung for CO, by the steady-state method (TCO/V). The only indices, whose values significantly changed in 5 years were: FVC, FEV1 and TCO/V. Their decrease rate did not appear to be significantly linked to age nor to smoking. According to these results, it seems that the decline of the pulmonary function is relatively constant during the middle period of life and that it is not strongly influenced by smoking, but only among subjects who remain without any respiratory symptom.

The impact on the respiratory system of complex industrial pollution (dust, sulphur dioxide, nitrogen oxides, hydrocarbons) was assessed by an analytical epidemiological study in a population of school children in the northeast of France. The parents of 375 children aged from 9-12 (middle school course 1 and 2) from the polluted zone and 523 children of the same age in a neighboring zone which was not polluted have filled in standardised questionnaires (respiratory symptoms, previous infections and allergies, frequency of infection in infancy; tobacco habits, professional and educational attainments of the parents, domestic environment). In the exposed children the majority of respiratory symptoms were more frequent (e.g., respiratory sounds in the boys, 15.6% against 7.9% p less than 0.01) and the absenteeism from school was more numerous (66.9% against 59.1% p less than 0.01). However, the interpretation of the results had to take into account the existence of confusing factors: parental smoking habits and the use of coal fires increased the prevalence of symptoms in the polluted zone, whereas a less crowded population worked in the inverse direction; likewise the educational level of the parents was higher in the polluted zone. After adjusting for these confusing factors, the frequency of rhinitis and absenteeism from school was significantly higher in exposed children.