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Abstract: An in vitro model to study pulmonary translocation was created, using the human cell line Calu-3 and primary rat type II pneumocytes. Cells were seeded on permeable membranes with a 0.4μm or 3μm pore size, utilizing different culture conditions such as medium formulation and cell density. The integrity of the cell monolayer was verified by measuring the transepithelial electrical resistance (TEER) and passage of sodium fluorescein. When seeded on inserts with 0.4μm pore size, the Calu-3 cells and primary rat type II pneumocytes created high TEER values of 949±182Ωcm2 and 400±257Ωcm2, respectively. On membranes with 3μm pores, Calu-3 cells achieved a high TEER value of 500±95Ωcm2. Our experiments indicate that the culture medium was more critical than the cell density, regarding the influence on TEER values. For both cell types a reduction of serum in the medium resulted in a decrease in TEER value. We established a good (‘tight’) monolayer of primary type II pneumocytes in Waymouth medium at a cell density of 0.9×106 cells/cm2; the Calu-3 cells should be grown in DMEM medium containing Hepes at 0.75×106 cells/cm2. [Copyright &y& Elsevier]

The present paper describes the outbreak of health complaints that occurred in Belgium, in June 1999, among schoolchildren and members of the general public in relation to the consumption of Coca-Cola and other soft drinks. The outbreak took place in the wake of a major food crisis, caused by PCB/dioxin contamination of animal feed, that had erupted shortly before. The clinical features (absence of serious poisoning) and epidemiological characteristics of the Coca-Cola outbreak pointed to mass sociogenic illness, and no subsequent toxicological or other data have refuted this hypothesis. [ABSTRACT FROM AUTHOR]

Background More than half the cobalt needed for vehicle electrification originates from the southern part of the Democratic Republic of the Congo (DRC), with a substantial part being extracted by artisanal miners. Aims To investigate oxygen saturation during underground work among cobalt artisanal miners. Methods In a field survey, we measured oxygen saturation (SpO2) and heart rate by pulse oximetry in 86 miners from two underground mines and 24 miners from a surface mine at four different time points: before descent into the mine (T1), at 50 minutes in the mine (T2), upon leaving the shaft (T3), and 10 minutes after having left the mine (T4). Results Miners working underground (–36 to –112 meters) were somewhat older (34.8 ± 6.7 years) than those working in the surface mine (32.0 ± 6.5 years), and they worked more hours daily (12.6 ± 1.2 hours) than controls (9.0 ± 0.0 hours). All participants had SpO2 >95% at T1 and T4. At T2, SpO2 dropped below 93% and 80% in 35% and 10% underground miners, respectively; SpO2 was still <93% at T3 in 13%. SpO2 remained stable among surface miners. Later, we showed that underground ambient oxygen levels decreased well below 21% in several pits. Conclusions Pulse oximetry revealed relevant hypoxaemia during underground work in a substantial proportion of artisanal miners. Such hypoxaemia without evidence of underlying cardiovascular disease is indicative of low ambient oxygen, due to insufficient mine ventilation. This may cause deaths from asphyxia. The hazards of low ambient oxygen in artisanal mines must be prevented by appropriate technical measures ensuring the supply of sufficient fresh air. [ABSTRACT FROM AUTHOR]

Examines the effects of smoking on the lung function and body weight of steelworkers in Brussels, Belgium. Difference between the lung function of smokers and non-smokers; Effects of cigarette smoking on the respiratory tract; Influence of body weight on lung function.

Introduction: In a previous cross-sectional study to determine the prevalence of ED among artisanal mineworkers, we found a significant association between aphrodisiacs consumption and erectile dysfunction (Musa et al. under review). Objective: This study aimed at investigating the main reasons of aphrodisiacs consumption and their possible health effects in male workers in the Katanga province. Methods: We conducted a mixed method study in which a first quantitative phase (survey) was conducted from March 2021 to May 2021, and included by convenience sampling, 127 artisanal miners and 122 drivers of collective taxis. All participants responded to the IIEF in the first survey. We measured urea, creatinine, sGOT, sGPT, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride in serum. The second qualitative phase (interviews) took place later, and included 16 participants from the first quantitative study, 8 in each group. Results: Self-reported aphrodisiacs consumption was 1.6 as prevalent among taxi-drivers compared to miners. ED was 1.5 as prevalent among aphrodisiacs' consumers compared to controls. Total cholesterol and LDL were significantly higher in aphrodisiac consumers than in non-consumers. Cultural perceptions about masculinity, support of erectile function and/or prevention of ED were themes that emerged from interviews in both groups. Two most consumed aphrodisiacs including Securidaca longepedunculata and Mitragyna stipulosa were taken with alcohol. No evidence of nephrotoxicity or hepatotoxicity was found. Conclusions: In a population with high rate of herbal treatment use, we found a high prevalence of natural aphrodisiac plants that are widely consumed instead of pharmacologically proved synthetic drugs probably due to cultural beliefs. More ethno botanical studies of plants consumed as aphrodisiacs including isolation and rigorous identification of the active constituents are needed to provide the poor population with the right information and to protect them against unwanted toxic effects. Disclosure: No. [ABSTRACT FROM AUTHOR]

Introduction: In a previous cross-sectional study to determine the prevalence of ED among artisanal mineworkers, we found a significant association between aphrodisiacs consumption and erectile dysfunction (Musa et al. under review). Objective: This study aimed at investigating the main reasons of aphrodisiacs consumption and their possible health effects in male workers in the Katanga province. Methods: We conducted a mixed method study in which a first quantitative phase (survey) was conducted from March 2021 to May 2021, and included by convenience sampling, 127 artisanal miners and 122 drivers of collective taxis. All participants responded to the IIEF in the first survey. We measured urea, creatinine, sGOT, sGPT, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride in serum. The second qualitative phase (interviews) took place later, and included 16 participants from the first quantitative study, 8 in each group. Results: Self-reported aphrodisiacs consumption was 1.6 as prevalent among taxi-drivers compared to miners. ED was 1.5 as prevalent among aphrodisiacs' consumers compared to controls. Total cholesterol and LDL were significantly higher in aphrodisiac consumers than in non-consumers. Cultural perceptions about masculinity, support of erectile function and/or prevention of ED were themes that emerged from interviews in both groups. Two most consumed aphrodisiacs including Securidaca longepedunculata and Mitragyna stipulosa were taken with alcohol. No evidence of nephrotoxicity or hepatotoxicity was found. Conclusions: In a population with high rate of herbal treatment use, we found a high prevalence of natural aphrodisiac plants that are widely consumed instead of pharmacologically proved synthetic drugs probably due to cultural beliefs. More ethno botanical studies of plants consumed as aphrodisiacs including isolation and rigorous identification of the active constituents are needed to provide the poor population with the right information and to protect them against unwanted toxic effects. Disclosure: No. [ABSTRACT FROM AUTHOR]

Drugs have been implicated in lung injury as a result of direct pharmacological action, persistence or metabolism in the tissue, or via the production of a reactive metabolite or metabolites. The result of this apparent drug-associated injury ranges from cellular dysfunction through to cell death (apoptosis) and alteration of repair mechanisms that are essential in replacing critical tissue elements and function. There is limited knowledge on how timing of drug administration or drug interactions may interfere with the repair mechanisms or modulate the expression of pulmonary toxicity. Chemotherapeutic drugs and novel agents, such as those targeting the epidermal growth factor receptor (EGFR), appear to affect both normal and neoplastic cells. However, unlike chemotherapy, where the actions are systemic and directly as a result of biotransformation or cell injury, it has been postulated that effects of EGFR-targeting agents are more likely to be focused on epithelia via a pharmacological effect. Furthermore, risk factors for the development of adverse pulmonary reactions, as well as biological markers indicating incipient toxicity, need to be prospectively identified. Proteomics, through the identification of >/=1000 proteins or peptides in blood samples, will hopefully identify candidates for this role. [ABSTRACT FROM AUTHOR]

Chromium-based catalysts are used for the synthesis of polyethylene, but little is known about the hazard and biomonitoring possibilities of this type of chromium for workers who may be occupationally exposed to such compounds. Therefore, the bioavailability and toxicokinetics of chromium were studied in male Wistar rats after a single intratracheal instillation (2 ml/kg body weight) of various doses (1, 5, or 25 mg/kg body weight) of the catalyst (approximately 1% chromium bound to an amorphous silica matrix), either before (CAT-Cr[III]) or after (CATCr[VI]) heat treatment. The results were compared with those of equivalent amounts of two chromium salts (CrCl[sub 3] and K[sub 2]Cr[sub 2]O[sub 7]). Each dose group was composed of three rats. The concentration of chromium was determined by atomic absorption spectrometry in urine (collected daily for 7 d) and in plasma, erythrocytes, lung, and liver tissue obtained 2 d (only highest concentration) and 7 d after dosing. On d 2, a significant increase in lung weight was found in the animals treated with the highest dose of the hexavalent Cr products. On d 7, on the basis of body weights, lung weights, and lung histology, there was no overt toxicity, except after the highest dose of CAT-Cr(VI). The elimination of all forms of chromium was apparently monoexponential, with calculated half-life elimination times in urine of 4-11 h for Cr(III) (CAT-Cr[III] and CrCI[sub 3]) and 8-21 h for Cr(VI) (CAT-Cr[VI] and K[sub 2]Cr[sub 2]O[sub 7]). On d 2, the erythrocytes Cr concentrations were significantly higher for the hexavalent Cr products than for the trivalent Cr products. After 7 d, the erythrocytes Cr concentrations were significantly increased above control values (3 µg/L) only in rats treated with the 2 highest doses of Cr(VI) compounds (12 and 64 µg/L for K[sub 2]Cr[sub 2]O[sub 7], and 14 and 79 µg/L for CAT-Cr[VI]). The present study shows that intratracheally instilled Cr(VI) and Cr(III) have... [ABSTRACT FROM AUTHOR]

Background Following a train derailment, several tons of acrylonitrile (ACN) exploded, inflamed and part of the ACN ended up in the sewage system of the village of Wetteren. More than 2000 residents living in the close vicinity of the accident and along the sewage system were evacuated. A human biomonitoring study of the adduct N -2-cyanoethylvaline (CEV) was carried out days 14–21 after the accident. Objectives (1) To describe the short-term health effects that were reported by the evacuated residents following the train accident, and (2) to explore the association between the CEV concentrations, extrapolated at the time of the accident, and the self-reported short-term health effects. Methods Short-term health effects were reported in a questionnaire (n=191). An omnibus test of independence was used to investigate the association between the CEV concentrations and the symptoms. Dose-response relationships were quantified by Generalized Additive Models (GAMs). Results The most frequently reported symptoms were local symptoms of irritation. In non-smokers, dose-dependency was observed between the CEV levels and the self-reporting of irritation (p=0.007) and nausea (p=0.007). Almost all non-smokers with CEV concentrations above 100 pmol/g globin reported irritation symptoms. Both absence and presence of symptoms was reported by non-smokers with CEV concentrations below the reference value and up to 10 times the reference value. Residents who visited the emergency services reported more symptoms. This trend was seen for the whole range of CEV concentrations, and thus independently of the dose. Discussion and conclusion The present study is one of the first to relate exposure levels to a chemical released during a chemical incident to short-term (self-reported) health effects. A dose-response relation was observed between the CEV concentrations and the reporting of short-term health effects in the non-smokers. Overall, the value of self-reported symptoms to assess exposure showed to be limited. The results of this study confirm that a critical view should be taken when considering self-reported health complaints and that ideally biomarkers are monitored to allow an objective assessment of exposure. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article on exercise intolerance among asthmatic persons, published on the previous issue of the journal.

The upper and lower airways are closely linked from an anatomical, histological and immunological point of view, with inflammation in one part of the airways influencing the other part. Despite the concept of global airway disease, the upper airways tend to be overlooked by respiratory physicians. We provide a clinical overview of the most important and recent insights in rhinitis and rhinosinusitis in relation to lower airway disease. We focus on the various exogenous and endogenous factors that play a role in the development and aggravation of chronic upper airway inflammation. In addition to the classical inhaled allergens or microorganisms with welldefined pathophysiological mechanisms in upper airway disease, environmental substances such as cigarette smoke, diesel exhaust particles and occupational agents affecting lower airway homeostasis have recently gained attention in upper airway research. We are only at the beginning of understanding the complex interplay between exogenous and endogenous factors like genetic, immunological and hormonal influences on chronic upper airway inflammation. From a clinical perspective, the involvement of upper and lower airway disease in one patient can only be fully appreciated by doctors capable of understanding the interplay between upper and lower airway inflammation. [ABSTRACT FROM AUTHOR]

Background On Saturday May 4, 2013, a train transporting chemicals derailed in the village of Wetteren (Belgium) and caused a leak of acrylonitrile (ACN). Objectives To assess the human exposure to acrylonitrile in the local population with the highest suspected exposure. Methods Between May 18–25, 242 residents participated in the study. N -2-cyanoethylvaline (CEV), a biomarker that is highly specific for ACN exposure, was measured in the blood. To account for potential influence by smoking, cotinine was determined in the urine. Participants also filled in a short questionnaire. Results In the evacuated zone, 37.3% of the non-smokers and 40.0% of the smokers had CEV concentrations above the reference values of 10 and 200 pmol/g globin, respectively, at the time of the train accident. Spatial mapping of the CEV concentrations depending on the residential address showed a distribution pattern following the sewage system. Discussion and conclusion The train derailment resulted in a highly atypical sequence-of-events. In addition to exposure in the direct vicinity of the site of the train derailment, exposure also occurred via the sewage system, into which acrylonitrile had entered shortly after the accident. [ABSTRACT FROM AUTHOR]

Background On May 4, 2013, a train transporting chemicals derailed in Wetteren, Belgium. Several tanks loaded with acrylonitrile (ACN) exploded, resulting in a fire and a leakage of ACN. Objectives To determine exposure to ACN and to assess discriminating factors for ACN exposure in the emergency responders involved in the on-site management of the train accident. Methods The study population consisted of 841 emergency responders. Between May 21 and June 28, they gave blood for the determination of N -2-cyanoethylvaline (CEV) hemoglobin adducts and urine for the measurement of cotinine. They also filled in a short questionnaire. Results 163 (26%) non-smokers and 55 (27%) smokers showed CEV concentrations above the reference values of 10 and 200 pmol/g globin, respectively. The 95th percentile in the non-smokers was 73 pmol/g globin and the maximum was 452 pmol/g globin. ACN exposure among the non-smokers was predicted by (1) the distance to the accident, (2) the duration of exposure, and (3) the occupational function. Discussion and conclusion Emergency responders involved in the on-site management of the train accident were clearly exposed to ACN from the accident. However, the extent of exposure remained relatively moderate with CEV concentrations staying within the ranges described in literature as background for a smoking population. Moreover, the exposure was less pronounced in the emergency responders as compared to that in the local population. [ABSTRACT FROM AUTHOR]

The term irritant-induced (occupational) asthma ( IIA) has been used to denote various clinical forms of asthma related to irritant exposure at work. The causal relationship between irritant exposure(s) and the development of asthma can be substantiated by the temporal association between the onset of asthma symptoms and a single or multiple high-level exposure(s) to irritants, whereas this relationship can only be inferred from epidemiological data for workers chronically exposed to moderate levels of irritants. Accordingly, the following clinical phenotypes should be distinguished within the wide spectrum of irritant-related asthma: (i) definite IIA, that is acute-onset IIA characterized by the rapid onset of asthma within a few hours after a single exposure to very high levels of irritant substances; (ii) probable IIA, that is asthma that develops in workers with multiple symptomatic high-level exposures to irritants; and (iii) possible IIA, that is asthma occurring with a delayed-onset after chronic exposure to moderate levels of irritants. This document prepared by a panel of experts summarizes our current knowledge on the diagnostic approach, epidemiology, pathophysiology, and management of the various phenotypes of IIA. [ABSTRACT FROM AUTHOR]

Chronic inflammation of the upper airways is common and can arbitrarily be divided into rhinitis and rhinosinusitis. Infection and allergy represent two well-characterized and most frequently diagnosed etiologies of upper airway inflammation. Persistent upper airway inflammation caused by agents inhaled in the work environment represents a diagnostic challenge in clinical practice, and its pathophysiology has been little studied. Occupational rhinitis is a recognized medical condition with diagnostic and therapeutic guidelines. In contrast, only limited evidence is available about the relationship between work exposures and rhinosinusitis. This review aims at providing a comprehensive overview of the available literature on occupational upper airway disease with a focus on pathophysiological mechanisms and with an emphasis on the current unmet needs in work-related upper airway disease. [ABSTRACT FROM AUTHOR]

Chronic respiratory diseases (CRD) are de facto neglected diseases in Sub-Saharan Africa (SSA) although prevalences are significantly rising and more women and young people are affected. Disabilities from CRD lead to decreased productivity and steep increases in direct and indirect costs for individuals, families, and society. The wide implications are recognized but serious challenges to effective action remain. We conducted scoping reviews of literature and policy documents on CRD and interviewed key informants to identify specific determinants and current health system responses in SSA to formulate targeted and feasible strategies that could inspire future interventions to address the issue. In SSA, air quality is poor and worsening (100% exposed to PM2.5 levels exceeding WHO guideline value), affecting development of and damaging lungs. Poor air quality is driven by socio-demographic phenomena with accelerated rural-to-urban migration and mobility needs; industrial and agricultural pollution; fossil fuel driven transport; inadequate waste management; electric power generation. A large component is indoor air pollution from inefficient burning technologies of unclean fuels and tobacco smoke, combined with insufficient ventilation. Health systems responses to CRDs are poor/non-existent. Medications are rarely available, CRD knowledge is low among healthcare professionals and the population, prevention activities are lacking. Holistic approaches to tackle outdoor & indoor air pollution and labour regulations for decent work can be part of the solutions. ‘‘Basic CRD care packages’’ can be introduced and decision-support to healthcare professionals offered. Engagement of stakeholders (communities; civil society, e.g., women’s organisations, professional associations) can be commenced. Sporadic/scattered projects/programs can be stimulated towards synergistic actions. An assessment tool determining contextual applicability of strategies can help tailor appropriate responses. Key messages: Chronic respiratory diseases (CRD) are on the rise in subSaharan Africa, commonly caused by outdoor air pollution (bronchial asthma) & use of biomass fuels (chronic obstructive pulmonary disease). Contextualized multisectoral actions are needed to tackle bad air and its causes (rapid urbanization; industrial, agricultural pollution; unclean fuels, etc) and address CRDs and risk factors. [ABSTRACT FROM AUTHOR]

Background: With the availability of compact, portable, effective microspirometers, pulmonary function tests no longer need to be performed only in specialized laboratories. However, the perception persists that small flow-sensing devices are less accurate than volume-sensing spirometers. Objectives: To study the accuracy of spirometry performed with the MIR Spirobank® and to investigate how accurately trained primary-care physicians can perform spirometry using a portable electronic spirometer. Methods: Patients with suspected occupational asthma were submitted to specific bronchial challenge tests in the pulmonary function laboratory according to published recommendations. Serial measurements were performed with the Jaeger MasterScope device (reference standard) or the Spirobank device. Data were generated from 908 parallel measurements on 34 patients. Furthermore, 16 patients with documented moderate to severe COPD were examined in a carousel set-up by four trained physicians who each used his/her own Spirobank device coupled to a laptop computer. Results: The Spirobank spirometer performed very well compared with the Jaeger MasterScope in a laboratory environment, displaying an underestimation of the forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) of 2-5%. High correlations were found for the pulmonary function parameters. The highest correlation was for FEV1 (r2 = 0.949) and the lowest for the maximum expiratory flow at 25% of FVC (MEF25) (r2 = 0.864). Only 2% of the observed variation in the measurement results could be explained by the type of device. Conclusions: The Spirobank device seems to be appropriate for research purposes if the standardized protocol is used correctly and the acceptability criteria are respected. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Chronic rhinosinusitis ( CRS) is a frequent condition that is treated by functional endoscopic sinus surgery ( FESS) when medical treatment fails. Endogenous as well as exogenous factors may be responsible for persisting symptoms after FESS. The role of occupational exposures on success of FESS has never been investigated. Methods In this case-control study, we tested the hypothesis that the outcome of FESS procedures is related to exposures at work. Questionnaires were sent to 890 patients who had undergone one or more FESS procedures and to 182 controls. Three independent experts assessed blindly the reported work exposures to inhaled agents. The relationship between exposure and the number of FESS procedures was analyzed. Results Relevant occupational exposure was reported by 25% of all responding patients undergoing FESS ( n = 467) and 12% of controls ( n = 69). The prevalence of occupational exposures increased linearly with the number of FESS procedures from 21% in those who had one FESS to 44% in those who had four or more FESS (χ2 = 12.74, P < 0.001). Logistic regression analysis with adjustments for potential confounders, including smoking, atopy, and asthma, confirmed that the odds ratio ( OR) for reporting occupational exposures was significantly higher in those needing more than one FESS ( OR = 1.64) or more than two FESS ( OR = 1.97). These results were mainly driven by exposure to low molecular weight agents. Conclusion Exposure at work appears to be a risk factor for the occurrence of CRS and for its recurrence or persistence, as evidenced by the need for revision surgery. [ABSTRACT FROM AUTHOR]

Abstract: Konzo is an upper motor neuron disease characterized by sudden-onset and irreversible spastic paraparesis occurring in nutritionally compromised people. It is associated with consumption of insufficiently processed cyanogenic-toxic cassava. Cassava, the main caloric source in the Democratic Republic of Congo, has been safely consumed for decades in the Eastern Province of South-Kivu. However, in the context of long-lasting war and violent conflicts, cases of spastic paraparesis resembling konzo appeared in a populous area (Burhinyi). Two field surveys (2003 and 2005) identified 41 subjects meeting clinical criteria of konzo and suffering from (chronic) malnutrition. Their urinary thiocyanate concentrations (median 129, range 20–688, SD 146μg/L), and cyanogen levels (median 20ppm, range 5–300ppm, SD 73ppm) in cassava roots from their household stocks were high. The source of cyanogenic-toxicity was unprocessed fresh cassava roots during harvest period, but probably also insufficiently processed roots. This first report of konzo in South-Kivu concludes that occurrence of konzo was triggered by food shortages because of the longstanding state of insecurity. Contributory factors included the introduction of new varieties of (bitter) cassava, but konzo may actually be caused by a combination of factors that are yet to be understood. [Copyright &y& Elsevier]

Nanomaterials have different chemical, physical and biological characteristics than larger materials of the same chemical composition. These differences give nanotechnology a double identity: their use implies novel and interesting medical and/or industrial applications but also potential danger for human and environmental health. Here, we briefly review the most important types of nanomaterials, the difficulties in assessing safety or toxicity, and describe existing test protocols used in nanomaterial safety evaluation. In general, the big challenge of nanotechnology, particularly for nanomedicine (nano-bioengineering), is to understand which nano-specific characteristics interact with particular biological systems and functions in order to optimize the therapeutic potential and reduce the undesired responses. The evaluation of the safety of medicinal nanomaterials, especially for long-term application, is an important challenge for the near future. At present, it is still too early to predict, on the basis of the characteristics of the nanomaterial, a possible biological response because no reliable database exists. Therefore, a case-by-case approach for hazard identification is still required, so it is difficult to establish a risk assessment framework. [ABSTRACT FROM AUTHOR]

In a mouse model of chemical-induced asthma, we investigated the effects of multiple challenges, using toluene diisocyanate (TDI), a known cause of occupational asthma. On days 1 and 7, BALB/ c mice received TDI or vehicle (acetone/olive oil). On days 10, 13 and 16 the mice received an intranasal instillation of TDI. Ventilatory function (Penh) was monitored by whole body plethysmography for 40 min after each challenge. Reactivity to methacholine was measured 22 h later. Pulmonary inflammation, TNF-α and MIP-2 levels were assessed 24 h after the last challenge by broncho-alveolar lavage (BAL). Other immunological parameters included total IgE, lymphocyte sub-populations in auricular and cervical lymph nodes, and IL-4, IFN-γ and IL-13 levels in supernatants of lymph node cells, cultured with or without concanavalin A. Early ventilatory function and airway reactivity increased in all groups that received a dermal application and one or multiple intranasal challenges of TDI. After multiple challenges, lung inflammation was characterized by neutrophils (∼15%), and eosinophils (∼4%), along with an increase in BAL MIP-2 and TNF-α levels. The auricular and cervical lymph node cells of all sensitized mice showed an increase in B cells, Th cells and an increased concentration of in vitro release of IL-4, IFN-γ and IL-13 after stimulation with concanavalin A. Total serum IgE was elevated in dermally TDI-sensitized mice. This protocol including multiple challenges results in a model that resembles human asthma, indicating that responses found in the model using a single challenge could be a good first indication for the development of asthma. [ABSTRACT FROM AUTHOR]

Drugs have been implicated in lung injury as a result of direct pharmacological action, persistence or metabolism in the tissue, or via the production of a reactive metabolite or metabolites. The result of this apparent drug-associated injury ranges from cellular dysfunction through to cell death (apoptosis) and alteration of repair mechanisms that are essential in replacing critical tissue elements and function. There is limited knowledge on how timing of drug administration or drug interactions may interfere with the repair mechanisms or modulate the expression of pulmonary toxicity. Chemotherapeutic drugs and novel agents, such as those targeting the epidermal growth factor receptor (EGFR), appear to affect both normal and neoplastic cells. However, unlike chemotherapy, where the actions are systemic and directly as a result of biotransformation or cell injury, it has been postulated that effects of EGFR-targeting agents are more likely to be focused on epithelia via a pharmacological effect. Furthermore, risk factors for the development of adverse pulmonary reactions, as well as biological markers indicating incipient toxicity, need to be prospectively identified. Proteomics, through the identification of?1000 proteins or peptides in blood samples, will hopefully identify candidates for this role.British Journal of Cancer (2004) 91(Suppl 2), S31-S37. doi:10.1038/sj.bjc.6602065 www.bjcancer.com [ABSTRACT FROM AUTHOR]

Background: Numerous studies have shown a strong association between daily mortality and small particulate with a diameter of <10 µm (PM10) air pollution, but the effects of season have not always been well characterised. Aim: To study the shape of the association between short-term mortality and PM10 across seasons and quintiles of outdoor temperature. Design, setting and participants: Daily data on mortality (n = 354 357), outdoor temperature and PM10 in Flanders, Belgium, from January 1997 to December 2003, were analysed across warm versus cold periods of the year (April-September v October-March), with seasons and quintiles of outdoor temperature as possible effect modifiers. Results: There was a significant (p<0.001) interaction between PM10 and period of the year in relation to mortality. To allow for non-linearity, daily mean PM10 concentrations were categorised into quartiles. Season-specific PM10 quartiles showed a strong and steep linear association between mortality and PM10 in summer and a less linear association in spring and autumn, whereas in winter the association was less strong and mortality was only increased in the highest PM10 quartile. The effect sizes expressed as the percentage increase in mortality on days in the highest season-specific PM10 quartile versus the lowest season-specific PM10 quartile were 7.8% (95% CI 6.1 to 9.6) in summer, 6.3% (4.7 to 7.8) in spring, 2.2% (0.58 to 3.8) in autumn and 1.4% (0.06 to 2.9) in winter. An analysis by quintiles of temperature confirmed these effect sizes. Conclusion: The short-term effect of particulate air pollution on mortality strongly depends on outdoor temperature, even in a temperate climate. [ABSTRACT FROM AUTHOR]

Background The expression of HLA-DR on the cell membrane of antigen-presenting cells is of major importance for the induction of an allergic response in the airways. Environmental particulates are thought to play an important role in inducing or enhancing allergic sensitization, possibly by increasing the expression of HLA-DR on the cell membrane of antigen-presenting cells. In addition, these particulates may synergize with common sensitizing agents in inducing or enhancing HLA-DR and thus antigen presentation. Objective In this study, we investigated the potential of three particle types, namely carbon black, diesel exhaust particles and urban air particulates (0.1–1000 ng/cm2 ), to induce the expression of HLA-DR on differentiated THP-1 cells, taken as a model for alveolar macrophages. We also assessed the ‘adjuvant’ potential of the particles on interferon (IFN)-γ, a known enhancer of HLA-DR. Results By themselves, the particles (0.1–1000 ng/cm2 ) were not able to induce HLA-DR on the THP-1 cells after an incubation of 48 h. However, even at very low concentrations, carbon black (from 1 ng/cm2 on) and diesel exhaust particles (from 0.1 ng/cm2 on), interacted with IFN-γ (100 U/mL) to enhance HLA-DR expression (up to 2.5-fold increase). Conclusion This finding may reflect in vitro one of the mechanisms by which pollutant particles exert an ‘adjuvant’ activity and may partially explain how exposure to particles can be related to the enhancement of allergic sensitization. [ABSTRACT FROM AUTHOR]

Abstract: Recent studies indicate that inhaled ultrafine particles can pass into the circulation. To study this translocation in an in vitro model three types of pulmonary epithelial cells were examined. The integrity of the cell monolayer was verified by measuring the transepithelial electrical resistance (TEER) and passage of sodium fluorescein. TEER was too low in A549 cells. In these preliminary experiments, TEER values of 1007±300 and 348±62Ωcm2 were reached for the Calu-3 cell line, using permeable membranes of 0.4 and 3μm pore size, respectively. Growing primary rat type II pneumocytes on 0.4μm pores, a TEER value of 241±90Ωcm2 was reached on day 5; on 3μm pores, no acceptable high TEER value was obtained. Translocation studies were done using 46nm fluorescent polystyrene particles. When incubating polystyrene particles on membranes without a cellular monolayer, significant translocation was only observed using 3μm pores: 67.5% and 52.7% for carboxyl- and amine-modified particles, respectively. Only the Calu-3 cell line was used in an initial experiment to investigate the translocation: on 0.4μm pores no translocation was observed, on 3μm pores ∼6% translocation was observed both for carboxyl- and amine-modified particles. [Copyright &y& Elsevier]

Background: A few studies have compared indoor allergens and endotoxin levels between urban and rural settings as important determinants for asthma and atopy in children. However, no study was done in the Middle East or investigated refugee camps. Methods: As part of a nested case-control study in Ramallah in 2001, we measured house dust mite and pet allergens, as well as endotoxin in dust collected from 110 children's mattresses and living room floors. Results: Geometric mean (GM) concentrations of Dermatophagoides pteronyssinus (Der p1) antigen were 4.48 μg/g in mattress dust and 1.23 μg/g floor dust. The highest Der p1 levels were seen in refugee camps. Concentrations of Dermatophagoides farinae antigen (Der f1) were much lower (< 0.08 μg/g dust). Concentrations of cat allergen (Fel d1) were highest in villages, and those of dog allergen (Can f1) were highest in mattresses from cities and in floor dust from refugee camps. GM of endotoxin levels were 25.7 EU/mg in mattress dust and 49 EU/mg dust in floor dust. Conclusions: Concentrations of Der p1 were high compared to Western European countries, but were lower compared to UK and Australia. Levels of pet allergens were lower than in Western Europe. Endotoxin levels were higher compared to developed countries. Indoor environmental factors such as dampness seemed to be important determinants for allergen and endotoxin, but living habits such as lack of mattress cover appeared unimportant. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the role of particle number, total surface area, mass and surface chemical groups in (Kf,c) changes. The lung effects of four different fine (110 nm) and ultrafine (24 nm) polystyrene particles have been tested in an isolated perfused rabbit lung model. Pulmonary microvascular permeability (Kf,c) modifications were measured in response to intratracheal particle challenge. Polystyrene particles, mainly located in alveolar spaces and macrophages, induced a Kf,c increase that was related to the total surface area and number of particles rather than to the instilled mass. Moreover, the positively charged amine-modified polystyrene particles were more effective in the Kf,c response than the negatively charged carboxylate-modified polystyrene particles. We concluded that particle number and diameter that mathematically equally determined total surface area do not have the same importance in explaining the biological effects observed and that particle number could be an alternative to total surface area to describe the particle exposure. Furthermore, surface properties of polystyrene particles need to be considered to investigate the microvascular permeability changes measured in our model. [Copyright &y& Elsevier]

Summary Background Our prevalence study on Palestinian school children aged 6–12 years showed lower rates for asthma and asthma symptoms than economically developed and industrialized countries. Reasons for such differences are largely unknown, and could possibly be related to different environmental and lifestyle factors. Objective To investigate familial, early life exposures and indoor environmental determinants for asthma in children in Palestine. Methods From the population of our previous study, a group of 273 children with wheeze in the past 12 months (of whom 99 children had physician-diagnosed asthma) were matched with an equal number of non-wheezing controls. This case-control study involved a parental questionnaire; skin prick testing (SPT) with mixed house dust mites, cat and dog dander, mixed grass, mixed trees pollen, Alternaria tenuis, olive tree and cockroach extracts; and serum for total and specific IgE for the same eight allergens. Results Paternal asthma and maternal hayfever significantly tripled the risk for their children to have wheezing. Previous diagnoses of bronchial allergy, bronchitis, pneumonia, or whooping cough, and positive SPT for house dust mites and cockroaches were significantly more likely among wheezing and asthmatic children than controls. Specific IgE levels for house dust mites and cat allergens showed significantly higher risk for reported wheezing. After adjustment for several environmental and sociodemographic factors using multivariate logistic regression analysis, paternal asthma, maternal hayfever, damp houses, cat and cockroach SPT positivity proved to be strong predictors for wheezing symptoms. Conclusion Our study confirmed that familial ‘atopic’ diseases are significant predictors of childhood asthma in Palestinian children. Moreover, indoor environment such as presence of cats and domestic moulds also appear to play a role. Our findings are consistent with studies in Canada, New Zealand,... [ABSTRACT FROM AUTHOR]

Presents the case of a 34-year-old man with dry cough and progressive breathlessness on exercise. His participation in world championship for magicians and how he used to blow up about 10 000 balloons per year; His medical history; Results of chest cardiograph; Conclusion that exposure to balloons is the reason for his lung disease; Talc found in the balloons.

The case is presented of a man with allergic contact dermatitis and occupational asthma due to triglycidylisocyanurate (TGIC), which is used as a hardener in thermosetting powder paint. The contact dermatitis was confirmed by patch testing (TGIC 0.5% and 5% in petrolatum), and the occupational asthma was confirmed by bronchial provocation testing: two challenges to an aerosol of lactose containing TGIC (0.05% and 0.1%, w/w, each for 0.5+1+2+4 min) led to a maximal decrease in FEV1 of 22% and 31% after 6 and 4 h, respectively. Skin prick tests with unconjugated TGIC were possibly positive. This case confirms that exposure to TGIC in powder paints may cause not only contact dermatitis, but also occupational asthma. [ABSTRACT FROM AUTHOR]

Presents several letters related to the field of medicine in Great Britain. Discussion on the management of menopause; Elaboration on whooping cough and the pertussis vaccine; Matters pertaining to hours of work of junior doctors.

Anecdotal reports of erectile dysfunction (ED) among mineworkers in the area led us to conduct an explorative study to investigate the possible association between ED and working in mining-related jobs. The proportion of mining-related jobs was higher among sildenafil-buyers (19/42, 45%) than among painkiller-buyers (7/42, 17%), yielding an Odds Ratio (OR) of 4.1 [95% Confidence Interval (CI) 1.5-11.3; p=0.009]. The proportion of mining-related jobs was higher among men with ED (defined as IIEF6 < 26) (24/45, 54%) than among men without ED (2/39, 5%) [OR 21.1 (95% CI 4.5-98.4; p< 0.001)]. [Extracted from the article]

A letter to the editor is presented in response to the article "Stronger associations between daily mortality and winter: evidence from a heavily polluted region in fine particulate air pollution in summer than in Western Europe," by T. S. Nawrot in the previously published issue.

Presents a correction to an error made in the article 'Loss of HIF-2alpha and inhibition of VEGF fetal lung maturation, whereas treatment with VEGF prevents fatal respiratory distress in premature mice,' by V. Compernolle et al published in 'Nature Medicine' journal in 2002.