This study provides predictions of asbestos-related mortality even in a selected cohort of exposed subjects, using previous knowledge about exposure-response relationship. The inclusion of individual information in the projection model helps reduce misclassification and improves the results. The method could be extended in other selected cohorts.
The aim of the present study was to obtain information about both drinking and smoking, as well as about alcohol consumption-related problems, among Albanians who have immigrated to Florence, Italy, after the collapse of the Communist regime in 1990. Between October 2001 and January 2002, an opportunistic sample of 141 Albanians living in the city of Florence were interviewed about their alcohol and tobacco use, as well as about their drinking pattern and health problems Interviewees were mainly (81%) males, of an average age of 28, who had been living in Italy for the last 4 years; 92.9% drank alcoholic beverages, the preferred beverages were wine and liquor, and the average daily consumption was 39.5 grams of pure alcohol-males consumed 48.1 grams per day, which was 3.5 times more than a comparable sample of Florentine males. Also Albanians overtook Florentines in terms of the rate of smokers (49.6% vs. 39.6%) and of contact with the emergency rooms (24.1% vs. 0.37%). Such high amounts of alcohol intake may contribute to the reported high rates of accidents and acts of violence involving Albanians in Florence. Some hypotheses were discussed to explain such a high level of alcohol consumption, including the sociocultural change due to emigration. The study's limitations are noted.
One hundred and fourteen subjects with asthma induced by toluene diisocyanate were identified and the pattern of their bronchial responses to challenge with toluene diisocyanate was studied. An occupational type specific bronchial provocation test with toluene diisocyanate (10-25 parts per thousand million for 10-15 minutes) elicited an immediate response in 24, a late response in 50, and a dual response in 40 patients. Subjects with a dual response showed at diagnosis a longer duration of symptoms and a greater prevalence of airway obstruction; in these subjects FEV, (percentage of predicted value) was lower than in subjects with immediate or late reactions to toluene diisocyanate. The percentage of current smokers and ex-smokers was significantly lower in subjects with a late response (26%) than in subjects with immediate or dual responses (56% and 57% respectively). In 27 of the 114 subjects a non-specific challenge test with methacholine was performed and subjects with dual responses showed greater non-specific bronchial hyperresponsivess than the other groups. These results suggest that a dual response to specific challenge in bronchial asthma related to toluene diisocyanate may be associated with more severe disease than other types of response, as assessed by duration of symptoms, baseline airway obstruction, and non-specific bronchial hyperresponsiveness. The high prevalence of non-smokers and low prevalence of smokers in the group with a late response to specific challenge is so far unexplained.
Our study shows a high prevalence of WRA (especially WEA) associated with employment in industries and job titles at risk for airways sensitizers and/or irritants; data also support a role for occupational exposure in determining a poor asthma control and a higher level of asthma severity.
Procedures currently adopted for wheat flour dust exposure during SIC need to be better standardised in order to avoid excessive airborne dust exposure. Over-exposure seems to be of no use for the diagnosis and risks making the asthmatic reaction worse, particularly in patients who are both sensitised to wheat allergens and have NSBH and/or atopy.
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