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Objectives. We developed and evaluated a statewide and community-level asthma surveillance system. Methods. Databases and measures included a community prevalence survey, hospital admissions data, emergency department/outpatient clinic visit records, and a physician survey of diagnosis and treatment practices. We evaluated the system in 5 Maine communities varying in population and income. Results. Asthma hospitalizations were high in the rural/low-socioeconomic-status communities studied, although diagnosed asthma was low. Males were more likely than females to experience asthma symptoms, although they were less likely to have been diagnosed with asthma or to have used hospital-based asthma care. Conclusions. Databases were useful for estimating asthma burden and identifying service needs as well as high-risk groups. They were less useful in estimating severity or in identifying environmental risks.

IF THE 1976 OUTBREAK OF LEGIONNAIRE'S DISEASE in a Philadelphia hotel sounded the first alarm on indoor air quality, today's rising rates of asthma and multiple chemical sensitivity--plus new findings […]

The author discusses the comments of Collegium Ramazzini international scientific society regarding the 2014 Helsinki consensus on the diagnosis of various diseases caused by asbestos exposure. The author mentions the four problems according to cm including the detection of asbestos bodies such as chrysotile asbestos, the asbestos fiber in lung tissue which indicates the past exposure to the chemical, and the recognition of chrysotile as type of asbestos fiber in pleural mesothelioma tissue.

From a general medical clinic five women with asbestosis are reported, illustrating a delay in the diagnosis and a general absence of lung cancer. The delay in diagnosis i s attributed to failure to elicit work histories andlor exposures in women presenting in later years as housewives. The infrcquent lung cancer is attributed to less cigarette smoking by women workers compared to men. [ABSTRACT FROM PUBLISHER]

Introduction: Carbon monoxide (CO) poisoning causes hypoxia and inflammation, which could adversely affect muscle. We could find no published information about CO poisoning causing myositis., Case Report: A 53-year-old previously healthy female semi truck driver had CO poisoning from a faulty diesel engine exhaust intermittently over three months, culminating in an episode of acute CO poisoning, with syncope after exiting the truck at the end of the three-month period. Neuropsychological symptoms immediately after the acute poisoning event were followed by the development of fatigue, weakness and myalgias within two months and a diagnosis of "polymyositis" within four months. C-reactive protein and creatine kinase were elevated. Electromyogram showed pure myopathy without sensory abnormalities. Occult malignancy was ruled out. Thigh muscle biopsy revealed severe inflammatory myopathy and myonecrosis. Muscle specialist pathologists interpreted the biopsy as toxic or viral inflammatory myopathy, not polymyositis, with CO poisoning as the likely etiology. She received steroids and mycophenolate. Nineteen months later, a repeat biopsy was negative for inflammation or myopathic process. Alternative diagnoses were ruled out by clinical investigation and her course over the next five years., Conclusion: This patient's presentation and clinical course support a diagnosis of myositis from CO poisoning, although it is possible that the myositis was either idiopathic or post-viral (without evidence of a causative virus)., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission., (Copyright © Undersea and Hyperbaric Medical Society.)

The Children's Environment and Health Action Plan for Europe has established four Regional Priority Goals (RPG) for the protection of the health of children. Hutter et al (JPHP 2009) have developed and tested an accessible method for addressing one aspect of RPG III: indoor and outdoor air pollution. The study provides an accessible method for use by communities to access effects of air pollution in and around the home on the respiratory health of children. This Commentary reviews that study, as well as other evidence in the scientific literature of effects of indoor and outdoor air pollution on children's respiratory health. In addition, this Commentary discusses the importance of air quality in schools to children's respiratory health and to school attendance and performance, citing supportive dat and urging action on this front.

In the evaluation of asbestos-related pulmonary and pleural abnormalities, conventional chest radiography has been shown to have a low sensitivity for the detection of lung nodules and subtle interstitial disease. Pleural plaques may simulate pulmonary nodules, and interstitial processes can be masked by adjacent pleural abnormalities. Dual-energy digital subtraction chest radiography may enable investigators to characterize asbestos-related pulmonary and pleural abnormalities with greater accuracy. "Soft-tissue" images, designed to remove pleural calcifications, may allow for better evaluation of the lung parenchyma. "Bone" images, designed to remove soft-tissue structures, may enhance the detection of pleural calcifications. In this pictorial essay we illustrate the methods, technical considerations, and limitations of dual-energy digital subtraction chest radiography performed with global subtraction weighting factors.