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293. Old and new topics in environmental and occupational lung

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					E-Communication Session                                                                                                                    Room C9b - 08:30-10:30

                                                           T UESDAY, S EPTEMBER 15 TH 2009

                                                                                      TMA stimulation between both groups at each TMA concentration. The results
                                                                                      demonstrate that TMA chemoattracts PMNs obtained from patients with asthma as
                                                                                      well as from healthy subjects and may participate in the pathogenesis of asthmatic
                                                                                      inflammation in genetically susceptible individuals.


                                                                                      E3166
                                                                                      Cloning, expression and purification of a recombinant lipid transfer protein
                                                                                      and an αβ-gliadin from wheat: determination of the diagnostic impact by
                                                                                      specific IgE-measurements
                                                                                      Hans-Peter Rihs 1 , Ingrid Sander 1 , Peter Rozynek 1 , Franziska Rueff 2 ,
                                                                                      Santiago Quirce 3 , Joaquin Sastre 4 , Monika Raulf-Heimsoth 1 , Thomas Brüning 1 .
                                                                                      1
                                                                                        Molecular Genetics, BGFA-Research Institute of Occupational Medicine,
                                                                                      German Social Accident Insurance, Ruhr University Bochum, Bochum, Germany;
                                                                                      2
                                                                                        Clinic for Dermatology and Allergology, LMU Munich, Munich, Germany;
                                                                                      3
                                                                                        Hospital La Paz Servicio de Alergia, Consultas de Alergia Hospital General,
                                                                                      Madrid, Spain; 4 Allergy Service, Fundacion Jimenez Diaz, Madrid, Spain

                                                                                      A lipid transfer protein (LTP; Tri a 14) and a αβ-gliadin from wheat were described
                                                                                      as important allergens in association with baker’s asthma. Tri a 14 yielded a 60%
                                                                                      IgE-response in 40 Spanish bakers (Palacin et al., JACI 2007) and αβ-gliadin a 12%
                                                                                      IgE-frequency in sera of 153 German bakers with occupational asthma (Bittner et
                                                                                      al., JACI 2008). To pursue these results, cDNAs coding for LTP and αβ-gliadin
                                                                                      were amplified from our wheat cDNA phage display library. A recombiant isoal-
                                                                                      lergen of Tri a 14 and a recombinant full-length αβ-gliadin were identified and
                                                                                      transferred into the pMAL-system, for the expression and isolation from E.coli as
                                                                                      part of the maltose-binding protein (MBP, 42.7 kD). Both soluble hybrids were
                                                                                      coupled to Streptavidin-ImmunoCAP and the specific IgE was measured in sera
                                                                                      of 24 Spanish and 40 German bakers with symptoms at work and sensitization
                                                                                      to wheat flour. The MBP-rTri a 14 (52.2 kD) and the MBP-αβ-gliadin (75.6 kD)
                                                                                      showed positive IgE-values (>0.35 kU/L) in one Spanish (4%) and in two German
                                                                                      sera (5%). MBP-αβ-gliadin was positive in two Spanish (8%) and in four (10%)
                                                                                      German sera. All wheat LTP-positive sera displayed a positive peach-specific IgE
                                                                                      value (f95; CAP>1.0 kU/L). This IgE-concordance between rTri a 14 and f95
                                                                                      seems to be the result of common cross-reactive epitopes with peach LTP (Pru
                                                                                      p 3). The IgE-binding frequency observed with our recombinant MBP-αβ-gliadin
                                                                                      was as described. Neither Tri a 14, nor αβ-gliadin is a major wheat allergen in
                                                                                      our patients’ sera. Nevertheless, both recombinant proteins are now available for
                                                                                      extended tests, for instance on microarray platforms.


                                                                                      E3167
                                                                                      Intratracheal instillation of urban dust from augsburg, Germany causes
                                                                                      cardiovascular and inflammatory effects in spontaneously hypertensive rats
                                                                                      (SHR)
                                                                                      S. Upadhyay 1 , K. Ganguly 1 , T. Stoeger 1 , M. Behnke-Semmler 1 , I. Bolle 1 ,
                                                                                      S. Takenaka 1 , G. Matuschek 2 , M. Pitz 3 , J. Cyrys 3 , W. Kreyling 1 , H. Schulz 1 .
                                                                                      1
                                                                                        Institute for Inhalation Biology, Helmholtz Zentrum Munich, German Research
                                                                                      Center for Environmental Health, Munich, Germany; 2 Institute of Ecological
                                                                                      Chemistry, Helmholtz Zentrum Munich, German Research Center for Environ-
                                                                                      mental Health, Munich, Germany; 3 Institute of Epidemiology, Helmholtz Zentrum
                                                                                      Munich, German Research Center for Environmental Health, Munich, Germany

                                                                                      Rationale: Several epidemiological studies associated exposure to increased lev-
                                                                                      els of particulate matter in Augsburg with cardiovascular mortality and morbidity.
  293. Old and new topics in environmental and                                        Using an experimental setting for replication of epidemiological findings and to
                                                                                      elucidate the potential mechanisms we investigated the cardiopulmonary responses
            occupational lung disease                                                 in SHR, a model for human cardiovascular diseases, following instillation of fine
                                                                                      Augsburg dust samples.
                                                                                      Methods: 250μg, 500μg and 1000μg of fine ambient particles collected from
                                                                                      urban site in Augsburg, were intratracheally instilled in 13 months old SHRs.
E3164                                                                                 Various biomarkers of inflammation were measured from bronchoalveolar lavage
Trimellitic anhydride chemoattracts polymorphonuclear leukocytes obtained             fluid (BALF), blood, lung and heart tissues to assess the inflammatory response
from patients with asthma                                                             following 24h and 72h of instillation. Additionally radio-telemetric analysis was
Rafal Dobek, Ewa Liebhart, Teresa Zak-Nejmark, Grazyna Nadobna,                       performed to investigate the cardiovascular responses following instillation of
Krzysztof Gomulka, Jerzy Liebhart. Department of Internal Medicine and                1000μg particles.
Allergology, Wroclaw Medical University, Wroclaw, Poland                              Results: BALF cell differential and other inflammatory markers [osteopontin,
                                                                                      interleukin-6 (IL-6), C-reactive protein (CRP), and macrophage inflammatory
Trimellitic anhydride (TMA) is known to cause occupational asthma. Though its         protein-2 (MIP-2)] from pulmonary and systemic level were significantly induced
pathogenesis remains unclear, it is considered as non IgE dependant in the majority   following instillation of 1000μg particles. Exposure to 1000μg of ambient particle
of cases. The aim of the study was to asses if TMA could act as a chemoattractant     resulted in significantly reduced heart rate (↓18bpm; 2-3 days delayed). However
for polymorphonuclear leukocytes (PMNs). Twenty patients with asthma (mean            blood pressure was not affected in these animals.
age 27.9±8.6) and 21 healthy subjects (mean age 38.4±10.8) entered the study.         Conclusions: Our data indicates that fine ambient Augsburg particle exposure trig-
PMNs were isolated from heparinized whole blood by Gradisol G gradient. Leuko-        gers particulate matter mediated inflammatory effects in pulmonary and systemic
cyte motility test was performed by means of modified Boyden technique. The            level that might be responsible for the observed cardiovascular response.
lower chambers were filled with medium as a control and TMA in the following
concentrations:10-12 M , 10-10M and 10-8M . The results were expressed as migration
distances. Spontaneous PMNs motility was similar in both groups and equaled           E3168
43.8±8.6 μm in healthy subjects (HS) and 45.4±11.9 μm in asthmatics (A)               Is there any relation between flour specific IgE and IgG4 levels and
(p=0.24). TMA in increasing concentrations caused highly statistically significant     work-related chest symptoms in bakers?
increase in PMNs migration in asthma group to 57.5±17.1 μm; 62.4±15.2 μm and          Meinir Jones, Susana Gómez-Ollés, Sebastian Thomas, Anenta Ratneswaren,
65.6±19.3 μm respectively (p<0.001 for each concentration). The chemotactic           Jessica Harris, Hayley Jeal, Andrew Brant, Paul Cullinan. Occupational and
response in HS group was also significant (p<0.001) but the respective values          Environmental Medicine, Imperial College (NHLI), London, United Kingdom
were slightly lower and equaled 53.1±11.7 μm, 57.3±13.6 μm and 56.5±15.6
μm. However, there were no significant differences in PMNs motility following          Introduction: Baker’s asthma arising from exposure to flour and enzymes re-


                                                                                  548s
                     Abstract printing supported by Chiesi Farmaceutici SpA. Visit Chiesi Farmaceutici SpA. at Stand B.40
E-Communication Session                                                                                                                  Room C9b - 08:30-10:30

                                                            T UESDAY, S EPTEMBER 15 TH 2009

mains a commonly reported cause of occupational asthma. Although mechanisms            ADP exposed mice had significantly increased DNA damage compared to control
involved in modifying the risk of developing work-related chest symptoms are not       (ADP;p=0.004). These results suggest that ADP and TiO2 particles induce pul-
well established, a protective role has been suggested for specific IgG4 antibodies     monary inflammation and oxidative stress. Especially ADP induce DNA damage
in bakers.                                                                             in PBMC. Future studies will be required to confirm the systemic toxic effects of
Aims: To measure levels of flour-specific IgE and IgG4 antibodies in bakers and          particles.
investigate how these relate to work-related chest symptoms.
Methods: A cross-sectional study of 239 workers from supermarket in-store bak-
eries across the United Kingdom was carried out. In 208 sera, flour specific IgG4        E3171
and IgE were measured using an in-house ELISA and RAST respectively. Flour
IgG4 concentrations’ values in the top quartile and IgE values greater or equal to
2% were considered positive. A questionnaire was administered to collect informa-
tion on work-related chest symptoms and current jobs in the bakery. Seventy-one
(29.7%) of those surveyed were bakers; specific IgE and IgG4 were measured in
65 (91.5%).
Results: Twenty percent of bakers suffered work-related chest symptoms and
27.7% were sensitized to flour. Of those with elevated levels of specific IgE
antibodies there was a lower prevalence of work related chest symptoms amongst


                                                                                                                                   WN
those who had a high level of IgG4 (2/8; 25%) than those who had a low level of
IgG4 (4/10; 40%). This difference was not statistically significant (p=0.64).


                                                                                                                                 RA
Conclusions: A high level of flour specific IgG4 may protect bakers who are
sensitized to flour from having work-related chest symptoms. Further investiga-


                                                                                                                  HD
tions will be needed to test the hypothesis that IgG4 antibodies confer tolerance in
bakers.


E3169
Impact of 9,10-phenanthrenequinone (PQ) on surface reactivity of ultrafine                               W      IT
carbon particles (UfCP): analysis of defence functions of rat alveolar
macrophages
Ingrid Beck-Speier 1 , Furong Tian 1 , Erwin Karg 1 , Shinji Takenaka 1 ,
Wolfgang Beisker 2 , Konrad Maier 1 , Manuela Semmler-Behnke 1 , Tobias Stöger 1 .
1
  Institute for Inhalation Biology, Helmholtz Center Munich, German Research
Center for Environmental Health, Neuherberg/Munich, Germany; 2 Institute
Toxicology, Helmholtz Center Munich, German Research Center for
Environmental Health, Neuherberg/Munich, Germany

Ultrafine ambient particles are involved in pathogenesis of respiratory diseases.
Particle surface area and adsorbed organic compounds including quinones may
determine particle reactivity towards pulmonary target cells.
We hypothesized that coating of UfCP with PQ (PQ-UfPC) as model for                    E3172
combustion-derived particles changes reactivity towards alveolar macrophages           COPD and slate mining: evidence from North Wales
(AM) compared to pristine particles. Phagocytosis, respiratory burst activity and      Stephanie J. MacNeill 1 , John Williams 2 , Michael J. Campbell 3 ,
formation of prostaglandin E2 (PGE2 ) and leukotriene B4 (LTB4 ) were studied.         Neville Hodges 4 , Paul Cullinan 1 . 1 Occupational and Environmental Medicine,
AM of healthy WKY rats were incubated with particles (60 min, 37°C) and                National Heart and Lung Institute (Imperial College), London, United Kingdom;
                                                                                       2
analysed for viability by WST-1 test, for phagocytosis of fluorescent opsonized           Halton Hospital NCH Trust, Halton Hospital NCH Trust, Runcorn, United
zymosan (OZ) by fluorescence and laser scanning microscopy (LSM) and flow                Kingdom; 3 Health Services Research, ScHARR, University of Sheffield, Sheffield,
cytometry, for respiratory bust activity by measuring chemiluminescence, and for       United Kingdom; 4 Ysbyty Gwynedd, Ysbyty Gwynedd, Bangor, United Kingdom
formation of PGE2 and LTB4 by evaluating specific enzyme immunoassays.
Viability was not affected within 1h particle treatment, but after 24h viability of    Introduction: Previous studies have shown that occupational exposure to slate dust
PQ-UfCP-treated AM was strongly reduced (p<0.05). Phagocytosis and respira-            increases the risk of silicosis and tuberculosis. Here we re-examined an historic
tory burst activity were significantly reduced by PQ-UfCP-treated AM (p<0.05).          cross-sectional dataset to assess whether slate miners have an increased risk of
Formation of PGE2 and LTB4 was elevated in UfCP-treated (p<0.05) but not in            COPD.
PQ-UfCP-treated AM. Shown by LSM, actin filaments, being mandatory for these            Methods: A cross-sectional survey of four North Wales (UK) slate mining ar-
processes, were destroyed by uptake of PQ-UfCP in AM.                                  eas was conducted in 1975. 1255 (59%) of those approached fulfilled eligibility
We conclude that reactivity of particulate surface structure has an impact on AM       criteria and participated. Participants completed a questionnaire and underwent
functions. Coating of pristine UfCP with PQ results in reduced phagocytosis, res-      lung function testing. Predicted lung function values were obtained by internal
piratory burst activity, lipid mediator formation and shrinking of actin filaments,     regression.
indicating a diminished defense capacity against infections.                           Results: 726 (58%) of the participants had worked in slate mining from between
                                                                                       1 and 72 years (median=15). Both miners and non-miners were similar in age
                                                                                       (median=49 yrs) and reported high levels of smoking (mining: 85%; non-mining:
E3170                                                                                  83%). Median FEV1 and FVC (% pred) were significantly lower in miners than
Asian dust particles and titanium dioxide-induced pulmonary inflammation,               non-miners (FEV1: 100% vs 105%, p<0.01; FVC: 100% vs 101%, p=0.03) and
oxidative stress and DNA damage                                                        miners were more likely to have COPD (33% vs 26%; p=0.02). Among min-
S.Y. Kyung, S.Y. Jeon, Y.J. Kim, S.P. Lee, J.W. Park, S.H. Jeong. Pulmonology,         ers, there was an apparent increase in COPD with duration of exposure (1-8 yrs:
Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of          OR=1.00; 9-24 yrs: OR=1.06 (0.65, 1.74); 25 yrs+: OR=1.38 (0.80, 2.37)) although
Korea                                                                                  this was not significant after adjusting for age and smoking. Regression analyses
                                                                                       showed that miners had significantly lower FEV1 than non-miners (diff=-3.9, 95%
Inhaled microparticles may have toxic effect to human lung tissue. We investi-         CI: -6.6 to -1.3) after adjusting for smoking. Miners without x-ray evidence of
gated whether Asian dust particles (ADP) and Titanium dioxide (TiO2 ) induce           pneumoconiosis had lower FEV1 than non-miners (101% vs 105%, p<0.01). The
inflamation DNA damage and oxidative stress in mice. We collected particles             difference remained significant in regression analyses after adjusting for smoking
during Asian dust storm periods, and then 0.5 mg of ADP and TiO2 were diluted          (diff=-3.1, 95% CI: -5.7 to -0.5).
with saline. Male C57BL/6 mice, were divided 3 groups; control (saline), ADP           Discussion: These findings suggest that slate miners have an increased prevalence
group, TiO2 . The particles were instilled for 12 weeks via intratracheal route.       of COPD independently of smoking and pneumoconiosis.
After 12 weeks later, mice were sacrified, and studied Comet assay and intracel-
lular ROS measurement with PBMC and histopathologic findings of mice lung
using H&E stain and Masson-trichrome stain (M-T stain), Immunohistochemical
(IHC) stain for 8-oxoguanine. On the findings of H&E stain, mice lung with
ADP and TiO2 showed peribronchiolar/interstitial inflammation, and minimal em-
physematous change (ADP;p=0.000, TiO2;p=0.001). But M-T stain didn’t show
significant fibrotic change between control and particle-exposed group (ADP and
TiO2 ) On the findings of 8-oxoguanine IHC, there was significant increase in
the particle-exposed group compared with control (ADP;p=0.000, TiO2 ;p=0.000).
As the results of PBMC, intracellular ROS of particle-exposed groups more in-
creased than control (ADP;p=0.009, TiO2 ;p=0.014). The DNA damage of mice
PBMC exposed to TiO2 showed no difference compared to control, however


                                                                                   549s
                     Abstract printing supported by Chiesi Farmaceutici SpA. Visit Chiesi Farmaceutici SpA. at Stand B.40
E-Communication Session                                                                                                                        Room C9b - 08:30-10:30

                                                              T UESDAY, S EPTEMBER 15 TH 2009

E3173                                                                                     suring for 8-years interval at the foundry workers who were exposed to different
Female pleural mesothelioma in a French population-based case-control                     concentration mineral dust.
study                                                                                     Subjects and Method: This is cross section study which included 78 foundry-
Patrick Brochard 1 , Aude Briand 1 , Céline Gramond 1 , Stéphane Ducamp 2 ,               workers average age on the start of 30,8 years, average high 174,2 and average
Sabyne Audignon 1 , Françoise Galateau-Sallé 3 , Jean Claude Pairon 4 ,                   exposition to dust of 8,7 years who were followed-up 8 years. One half of them
Philippe Astoul 5 , Soizick Chamming’s 6 , Anabelle Gilg Soit Ilg 2 ,                     were exposed to allowed concentration mineral dust (MAC), and another part was
Ellen Imbernon 2 , Marcel Goldberg 2 , Patrick Rolland 2 . 1 Laboratoire Santé            exposed 2 time higher concentration dust than allowed (F). We used ERS norms
Travail environnement, Université de Bordeaux 2, Bordeaux, France;                        for spirometric tests and static t-test for connection samples.
2
  Département Santé Travail, Institut de Veille Sanitaire, Saint Maurice, France;         Results: All values of spirometric tests were declined after 8 years exposition
3
  Service d’anatomie Pathologique, CHU de caen, Caen, France; 4 Inserm U955,              mineral dust. Differences were statistic significant as we showed in table. For the
Université Paris 12, Créteil, France; 5 Département des Maladies Respiratoires,           same time ERS norms predicted a few time lower decline spirometric tests for
Hôpital Sainte Marguerite, Marseille, France; 6 IIMTPIF, Université Paris                 persons same age and height as we estimated.
Descartes, Paris, France
                                                                                          Concentration          FVC (ml)           FEV1(ml)           FEF50             FEF25
Introduction: Mesothelioma is still a major concern in industrialised countries
mainly in relation to occupational exposure to asbestos. A national program of            Allowed                 -316*               -324**           -512***          -584***
surveillance of mesothelioma has been initiated in France since 1998, registering         Higher (2×)            -535***             -580***           -724***          -795***
all new cases of pleural mesothelioma living in 19 French districts (25% of the           Predicts ERS          norms - 53              -90              -150             -210
French population). The aim of this study was to report characteristics of female         *P<0, 05 **p<0, 01 *** p<0,001
mesothelioma from this population.
Methods: A case-control study was conducted between 1998 to 2002 within the               Conclusion: Exposition of 8 years to mineral dust in allowed concentration was
program, including 462 cases. All alive confirmed cases were included. Two con-            enough to cause statistic significant decline all results of spirometric tests compared
trols matched for sex, age and districts were selected from general population. Data      with previous results. Declines all values of spirometric tests in the bout groups
were collected with face-to-face interviews using a standardised questionnaire. All       were a few time higher of the predict ERS norms declines for persons this age and
occupational and environmental data were analyzed by industrial hygienists blind          high for this period.
to subject’s status.
Results: Female case-control study included 91 cases, matched to 165 controls.
Histological pattern and mean age were similar in men and women. Among                    E3176
women, occupational exposure to asbestos was identified as possible and probable           Serum haem oxygenase-1 as marker of lung function in patients with chronic
in 24.2% and 18.7%, respectively. Attributable risk to occupational asbestos ex-          silicosis
posure was 42.8% (95% CI: 31.4-54.2). Non-occupational asbestos exposure was              Takashi Sato 1 , Yoshiaki Saito 2 , Dennis Klinman 3 , Nobuaki Kobayashi 1 ,
identified as possible in 21.2% and probable in 3.8% (mainly as para-occupational          Kei Mishina 1 , Satoshi Inoue 1 , Makoto Kudo 1 , Naoki Miyazawa 1 ,
exposure). Attributable risk to non-occupational asbestos exposure was 21.5%              Yuji Watanuki 1 , Takeshi Kaneko 1 , Yoshiaki Ishigatsubo 1 . 1 Internal Medicine
(95% CI: 8.6-34.4). Other factors were not contributive.                                  and Clinical Immunology, Yokohama City University Graduate School of
Conclusion: Among women, recognized asbestos exposure explain only half of                Medicine, Yokohama, Kanagawa, Japan; 2 Respiratory Medicine, Labor Welfare
new diagnosed cases of pleural mesothelioma. Investigations of female cases must          Hospital for Silicosis, Tochigi, Japan; 3 Center for Cancer Research, Cancer and
be purchased in order to explore unrecognized environmental exposure to asbestos          Inflammation Program, National Cancer Institute, National Institute of Health,
or to other etiological factors.                                                          Frederick, MD, United States of America

                                                                                          Background: We previously observed that serum haem oxygenase (HO)-1, a
E3174                                                                                     marker of oxidative stress, was increased in patients with silicosis. Serum HO-1
Silicosis trends in South African gold miners: 1975-2007                                  levels correlated positively with measures of lung function (FEV1: r = 0.39,
Gill Nelson 1,2 , Jill Murray 1,2 , Brendan Girdler-Brown 3 , Ntombizodwa Ndlovu 1 .      p = 0.008), suggesting that HO-1 might represent a useful marker of disease
1
  Pathology Dept., National Institute for Occupational Health, NHLS,                      progression (Am J Respir Crit Care Med 2006;174:906).
Johannesburg, South Africa; 2 School of Public Health, University of the                  Objective: To evaluate the association between serum HO-1 levels and changes in
Witwatersrand, Johannesburg, South Africa; 3 School of Health Systems and                 lung function in patients with silicosis.
Public Health, University of Pretoria, Pretoria, South Africa                             Methods: We screened 42 male ex-smokers with a diagnosis of chronic silico-
                                                                                          sis (mean age 72 yr). A group of sex and age matched controls (N = 42) was
Introduction: The worldwide burden of silicosis remains high, especially in de-           used to establish upper limit of normal values for serum HO-1 (5.5 ng/ml) and
veloping countries. No data on disease trends in South African miners have been           high-sensitive C-reactive protein (CRP, 1.8 mg/L). Data from 29 of the silicosis
published since 1991.                                                                     subjects was evaluable (eg, provided interpretable serum collected one year apart
Objective: To describe trends in silicosis at autopsy in South African gold miners        and pulmonary function tests retrospectively reviewed over 5 years).
over 33 years and to quantify the contribution of age at autopsy and duration of          Results: Among the 29 evaluable patients, 14 had elevated HO-1 levels and 13
service, as surrogate measures for cumulative dust exposure.                              had elevated CRP levels. FEV1 and FEV1/FVC declined significantly less rapidly
Methods: All South African miners and ex miners are eligible for examination              in subjects with elevated serum HO-1 when compared to those with normal values
of the hearts and lungs for compensable occupational disease, regardless of the           (-53.4 vs -86.4 ml/year, p = 0.023 and -0.3 vs -1.2%/year, p = 0.019, respectively).
clinical cause of death. Gold miners were stratified by population group because           In contrast, there was no significant difference in the rate of decline of FEV1 or
of historical differences in exposure, patterns of employment and utilisation of          FEV1/FVC in subjects with high vs normal CRP levels (-64.5 vs -48.1 ml/year,
health services (a legacy of the Apartheid era). Trends in silicosis prevalence were      p = 0.17 and -1.0 vs -0.9%/year, p = 0.90, respectively). Baseline characteristics
described. Odds ratios were calculated for age at autopsy, duration of exposure,          were not significantly different between the high vs normal HO-1 group.
and year of autopsy.                                                                      Conclusion: These findings indicate that serum HO-1 is a more sensitive predictor
Results: While crude annual rates of silicosis in white miners decreased slightly,        of changes in lung function than serum CRP in patients with silicosis.
they remain high at around 300 per 1000. Rates in black miners increased from
33 to 335 per 1000 and are currently higher than those in white miners. Age and
duration of service were significant predictors of silicosis. Adjusted odds of having      E3177
silicosis increased by 4% for each advancing year of autopsy in black miners              Occupational exposure and alteration of lung functions in stone crushing
(calendar effect). There was a slight downward trend in white miners.                     community in Tamilnadu, India – a cross sectional study
Conclusions: Silicosis continues to be a major problem in the South African gold          Vijayalakshmi Thanasekaraan 1 , Jayachandran Palsamy 2 , Priscilla Johnson 3 ,
mining industry. The country is committed to the ILO/WHO Global Elimination               Thangavel Gurusamy 4 , Venkatesh Dass 5 , Kalpana Balakrishnan 7 . 1 Chest
of Silicosis Programme objectives to eliminate silicosis by 2030 but this will            Medicine, Sri Ramachandra Medical College, Chennai, Tamilnadu, India;
                                                                                          2
require extraordinary efforts. The autopsy database allows for disease surveillance,        Environmental Health Engineering, Sri Ramachandra Medical College,
necessary to monitor the Programme’s success.                                             Chennai, Tamilnadu, India; 3 Physiology, Sri Ramachandra Medical College,
                                                                                          Chennai, Tamilnadu, India; 4 Environmental Health Engineering, Sri
                                                                                          Ramachandra Medical College, Chennai, Tamilnadu, India; 5 Environmental
E3175                                                                                     Health Engineering, Sri Ramachandra Medical College, Chennai, Tamilnadu,
Declines values of spirometric tests at the foundry-workers after 8 year                  India; 6 Physiology, Sri Ramachandra Medical College, Chennai, Tamilnadu,
exposition to different concentration mineral dust                                        India; 7 Environmental Health Engineering, Sri Ramachandra Medical College,
Snezana Ignjatovic 1 , Vladana Miloskovic 2 , Vladimir Ignjatovic 3 ,                     Chennai, Tamilnadu, India
Slavisa Ignjatovic 3 , Ljiljana Corkovic 4 . 1 Pulmology, Institute for Occupational
Health "Zastava", Kragujevac, Republic of Serbia; 2 Pulmology, Pulmonary                  Background: Worldwide, 386,000 deaths and nearly 6.6 million Disability-
Diseases and TB Health Center, Kragujevac, Republic of Serbia; 3 Internal                 Adjusted Life Years (DALYs) were attributed due to exposure to occupational
Clinical, Clinical Center, Kragujevac, Republic of Serbia; 4 Pulmology, Clinical          airborne particulates. Silicosis, the untreatable progressive disease is one such
Hospital Center “ Dr. D. Misovic", Beograd, Republic of Serbia                            occupational hazard that is responsible for such high morbidity and mortality in
                                                                                          industrial workers.
Aim: To estimate differences in values of spirometric tests between two mea-              Aim of the study: This cross sectional study was designed to evaluate the res-


                                                                                       550s
                      Abstract printing supported by Chiesi Farmaceutici SpA. Visit Chiesi Farmaceutici SpA. at Stand B.40
E-Communication Session                                                                                                                     Room C9b - 08:30-10:30

                                                            T UESDAY, S EPTEMBER 15 TH 2009

piratory effects of occupational exposure to particulate matter among the stone         E3180
crushing community.                                                                     Medium density fibre board as a cause of occupational astma: 2 case reports
Materials and methods: This study was conducted among the employees and                 Clare Burton 1,2 , Lisa Bradshaw 1,2 , Anthony Darby 1,2 , Chris Barber 1,2 ,
their dependents (n= 504) in stone crushing units. The investigations included          Raymond Agius 3 , David Fishwick 1,2 . 1 Centre for Workplace Health, Health and
detailed personal interviews, clinical examination, spirometry and radiographic         Safety Laboratories, Buxton, Derbyshire, United Kingdom; 2 Respiratory
examination of the chest. Pulmonary function parameters such as FEV1 FVC,               Function Unit, Sheffield Teaching Hospital Trust, Sheffield, South Yorkshire,
FEV1 /FVC%, PEFR and FEF25-75 were evaluated.                                           United Kingdom; 3 Centre of Occupational and Environmental Health, Ellen
Results: The mean age of the study group was 37.3±12.8 years and mean years of          Wilkinson Building, University of Manchester, Manchester, Greater Manchester,
exposure was 11.27±8.4 years. 107 (21.6%) workers were found to have reduced            United Kingdom
FVC and 110 (22.2%) had reduced FEV1 and 137 (27.2%) had radiological
abnormalities. There was a statistically significant decline in the lung functions of    Medium Density Fibreboard (MDF) is a wood composite material, primarily soft-
the stone quarry workers with increasing years of exposure.                             wood, bonded with a synthetic formaldehyde based resin. It is increasingly used
Conclusion: The results of our study indicate reduction in pulmonary functions          as it has various advantages over natural woods.
with exposure to particulate matter from stone crushing operations. This highlights     Between 1991 - 2007 twenty one cases of occupational sensitisation to MDF
the need of implementing preventive measures, such as engineering controls, Per-        were reported to the UK voluntary reporting scheme SWORD (18 reported as
sonal Protective Equipments and periodic health surveillance. These measures will       occupational asthma and 3 as occupational rhinits). All workers were male with a
reduce the morbidity and mortality due to Silica related respiratory diseases.          mean age of 48 years. Nine worked in education, six in furniture manufacturing or
                                                                                        joinery and seven in other employements. Whilst this reporting scheme identifies
                                                                                        small numbers of cases of OA due to MDF, the robust evidence base supporting
E3178                                                                                   this link is generally lacking. We therefore present two case reports of patients
Pleural plaques in dentists from occupational asbestos exposure                         diagnosed with OA caused by MDF.
Lazaros Sichletidis 1 , Dionisios Spyratos 1 , Diamantis Chloros 1 ,                    Case one; a 55 year old technology teacher working with MDF for 20 years
Kleopas Michailidis 2 , Ioanna Fourkiotou 1 . 1 Pulmonary Clinic, Laboratory for        presented with a10 year history of work related wheeze. The patient underwent
The Investigation of Environmental Diseases, Aristotle University of Thessaloniki,      standard serial peak flow (sPEF) assessment, on inhaled steroids, analysed by the
Thessaloniki, Greece; 2 Dept. of Mineralogy-Petrology-Economic Geology, School          OASYS2 software. As the results were equivocal (work effect index 2.35), the
of Geology, Aristotle University of Thessaloniki, Thessaloniki, Greece                  patient underwent a controlled specific challenge to MDF. This produced a positive
                                                                                        early and late response.
Background: White asbestos (chrysotile) has been used in dentistry as a lining          Case two; A 48 year old joiner working with MDF for 7 years presented with a 5
material for casting rings since 1930. Even though technicians and dentists are         year history of work related cough. His sPEF data showed a significant work effect
potentially exposed to asbestos, radiographic appearance of pleural plaques (PP)        (index 2.9) and a specfic challenge test noted a positive late response. Specific IgE
is seldom described in the literature.                                                  to soft and hard wood was negative in both workers. Their work related symptoms
Aim: We report 3 cases of dentists presenting with PP secondary to occupational         improved dramatically on final cessation of exposure.
exposure while manipulating asbestos foils during casting operations.                   Although the exact allergen within the MDF is not known these cases lend further
Patients and methods: All patients (males 68, 74 and 80 year old) presented with        support to MDF as a cause of OA.
respiratory symptoms and PP on chest x-rays not related to their symptoms. The
presence of plaques was confirmed on CT scans. They were working as dentists
for 35-45 yrs and were exposed to asbestos exclusively during casting procedures.       E3181
In order to confirm asbestos exposure we designed an experiment: pieces of dry           Silicosis: is there anything different after 20 years?
asbestos were torn from metal sheets, soaked in water and a mould was shaped.           Armand-Gabriel Rajnoveanu 1 , Ruxandra-Mioara Rajnoveanu 2 . 1 Occupational
The structure was dried out in a furnace. Then a piece of gold was put in the           Health, Medicine and Pharmacy University, Cluj-Napoca, Cluj, Romania;
                                                                                        2
asbestos mould and melted by a flame-thrower. The procedure was repeated for 4             Pneumology, Medicine and Pharmacy University, Cluj-Napoca, Cluj, Romania
hours. An air pump with a filter was placed at the breathing zone of the worker.
The filter was checked with contrast phase microscope. Dry asbestos sheets were          We retrospectively reviewed medical records of new cases of silicosis, identified
scanned with x-ray diffraction (XRD) and electron microscope (EM).                      from our hospital registry of silicosis, admitted during 1980-1985 (93 cases -
Results: Analysis of the filter demonstrated a concentration of 0.008 fibers/cm3          group I) and 2000-2005 (62 cases -group II) and we compared their age, gender
during the sampling period. XRD analysis revealed that the material consisted of        distribution, smoking habit, type of industry, co-morbidities, radiological findings
chrysotile exclusively, a fact that confirmed with EM.                                   (according to ILO Classification of Radiographs of Pneumoconiosis), pulmonary
Conclusion: These cases represent a rare form of asbestos exposure. Everyday            function tests (PFT).
occupational exposure for many years even to very low asbestos levels, under poor       Results: mean age for the first diagnostic of silicosis (51 versus 52 years-age); sex
ventilation conditions in a closed space, could cause pleural lesions.                  distribution: women group I -0%; group II -16%. Industry: group I -97% mining;
                                                                                        group II -38% mining, foundries -52%, others -10% cases. Smoking habit (58% -
                                                                                        group I, 55% - group II, current or ex-smokers). Opacities profusion and size on
E3179                                                                                   radiographs and pulmonary function tests results. If in group I we found a fairly
Talc-associated lung damage by chronic injection drug use on evidence of                even distribution for profusions (23% - 1, 26% - 2, 16% - 3), radiographs with
forensic autopsies                                                                      ax symbol (13%) and with large opacities (22%), in group II profusion 1 was
Lev Grinberg 1 , Artyom Nevolin 2 , Dmitriy Kondrashov 3 . 1 Pathology, Ural State      predominant (68%) and profusion 2 (19%) was also significant. On the other hand,
Medical Academy, Yekaterinburg, Russian Federation; 2 Autopsy, Sverdlovsk               in group I restrictive pattern at PFT was in the first place (42%) and obstructive
Region Forensic Center, Yekaterinburg, Russian Federation; 3 Pathology, Ural            pattern in group II (52%).
Research Institute for Phthisiopulmonology, Yekaterinburg, Russian Federation           Conclusions: there are differences between these two groups but in a different
                                                                                        way then we expected. Profusion and opacities size are less severe in the last years,
A wide spread of chronic injection drug use (CIDU) has been registered in Rus-          probably due to more effective surveillance programs. Some change appeared also
sia over the last 10-15years. It is accompanied by rising mortality from acute          in pulmonary dysfunction pattern, suggesting that restrictive dysfunction charac-
poisoning with opiates (heroin). Moreover, there are no reliable morphological          terises more often severe cases of silicosis. Pneumoconiosis is no longer a male
criteria of CIDU. However, it is known that drugs can be injected together with         specific disease and mining tends to be replaced by other occupations and we have
talc-containing additions which causes granulomatous changes in lungs to the            to do more in the smoking cessation field.
extent of emphysema development.
The study includes 100 autopsy cases of persons with CIDU who died of acute
poisoning with opiates in 2007- 2008. Lung tissue specimens stained with haema-         E3182
toxylin and eosin were investigated in transmitted and polarized light. In 93 cases     Seasonal differences of quality of life in asthmatics with cold airway
talc-containing anisotropous crystals in lungs were revealed. In 17 cases there were    hyperresponsiveness
giant cell granulomas in interstitium around talc crystals. Crystals were revealed      Natalia L. Perelman. Laboratory of Prophylaxis of CRD, Far Eastern Scientific
in lumen of alveolar septum capillary tubes in 50, in vascular walls in 52, near        Center of Physiology and Pathology of Respiration, Blagoveschensk, Russian
vessels in 40, in lumen of minute vessels in 28 cases. The size of the crystals         Federation
varied within 5-20 mcm. Their number varied from 5-10 to 1-2 per high power
field with 400 amplification.                                                             Aim: To find out peculiarities of health-related quality of life in adult asthmatics
Thus, the presence of talc-containing anisotropous crystalls in lungs is a reliable     with cold airway hyperresponsiveness (CAHR) in contrast seasons.
and highly sensitive (93%) morphological CIDU marker in current conditions in           Methods: The case-control study included 58 adult asthmatics (from mild to se-
Russia. Clinical significance of this morphological phenomenon calls for further         vere asthma) with CAHR and 53 patients without CAHR which were evaluated in
investigation.                                                                          summer and winter seasons consistently. The quality of life was assessed by SF-36
                                                                                        and AQLQ questionnaires, airway hyperresponsiveness to cold air was identified
                                                                                        by clinical anamnesis data.
                                                                                        Results: In the group of patients without CAHR no significant differences in
                                                                                        the quality of life in summer and winter in all domains of both question-
                                                                                        naires were detected. By SF-36 we revealed statistically significant differences in
                                                                                        the PF (56,55±5,10, p<0,05), BR (56,33±4,87, p<0,05) and GH (40,97±2,23,


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                                                            T UESDAY, S EPTEMBER 15 TH 2009

p<0,05) domains during a winter season in comparison with summer (62,29±5,08;
65,86±4,61 and 46,51±2,75, respectively) in the group of patients with CAHR.
While assessing health-related specific quality of life by AQLQ, significant sea-
sonal (winter-summer) differences were found out in activity (3,40±0,20 and
4,21±0,24, p<0,05), symptoms (3,64±0,24 and 4,37±0,26, p<0,05), emotions
(3,93±0,24 and 4,53±0,27, p<0,05) domains and overall score (3,58±0,22 and
4,29±0,24, p<0,05).
Conclusions: The results suggest that seasonal differences in quality of life level
are dependent on CAHR presence in patients with asthma who live in continental
climate. In patients with CAHR physical and emotional function as well as activity
decreases, individual respiratory discomfort intensifies, disease symptoms is more
pronounced and general quality of life substantially impairs in winter.


E3183
Asthma and occupation in the 1958 birth cohort: potential misclassifications
in exposure
Rebecca Ghosh, Paul Cullinan, Deborah Jarvis. NHLI, Imperial College, London,
United Kingdom; Occupational and Environmental Medicine, Imperial College,
London, United Kingdom; Respiratory Epidemiology & Public Health, Imperial
College, London, United Kingdom

Workplace exposures are a common contributor to adult asthma, accounting for an
estimated 10% of all new or recurrent disease. Currently most information on the
burden of work-related asthma is based on cross-sectional or surveillance data.
Using longitudinal information between ages 16 and 35 from a national (1958,
n=11,000) UK birth cohort we compared the sensitivity and specificity of different
approaches to occupational coding. Text descriptions of >66,000 different jobs
were coded using the Standard Occupational Classification 1990(SOC-90) and
subsequently converted, by automated software, to ISCO-88. These new codes
were checked manually and, where appropriate, re-coded by hand prior to their
use in an asthma-specific job exposure matrix.
Manual re-coding resulted in changes to 49% of jobs; overall this gave a kappa of
0.60 indicating moderate agreement between the generated and manual ISCO-88
codes. Examples for some specific jobs of interest with percentage agreement are
displayed below:

Job                                SOC-90   ISCO-88   Manual ISCO-88   % Agreement
                                     (n)      (n)          (n)
Hairdressers                         482      482          698             68
Bakers                               84       84           210             38
Paint Sprayers                       45        0           179              0
Welders                              306      306          430             67
Nurses                              1955     1955         2011             89
Meat- & fish-processors               NA        0           73               0
Butchers, fishmongers and related     186      186          218             82


Both the original SOC90 coding and the use of an automated conversion to ISCO-
88 resulted in some important misclassifications of relevant occupations, which
when merged with a JEM would result in less accurate exposure assignments.




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