Sputum induction has recently been proposed as the only direct noninvasive method for measuring airway inflammatory indices. The reference values and the distribution of cells in induced sputum in a control population have not yet been well defined. We therefore evaluated data from a large number of healthy volunteers. One hundred fourteen healthy, nonatopic, nonsmoking volunteers without airway hyperreactivity were enrolled (age: 38 +/- 13 yr [mean +/- SD]; FEV(1): 105 +/- 10% predicted; provocative dose of methacholine inducing a 20% decrease FEV(1) > 3,200 microgram). Ninety-six subjects (84%) produced adequate analysis samples. The subjects had a normal age distribution. Their induced sputum was rich in macrophages (69.2 +/- 13%) and neutrophils (27.3 +/- 13%), and poor in eosinophils (0.6 +/- 0.8%), lymphocytes (1.0 +/- 1.2%), and epithelial cells (1.5 +/- 1.8%). Only macrophages and neutrophils showed a normal distribution; total and differential counts of other cells did not. We propose that these data be used in comparison of the induced sputum cells of normal subjects and those of patients with airway inflammation.

Our findings indicate that castor bean is the major cause of occupational sensitization among coffee workers, whereas smoking and atopy act as enhancing factors.

A new case of rare-earth (RE) pneumoconiosis is described. The subject had worked as a photoengraver for 13 years and had not been exposed for 17 years. Chest X-ray showed a diffuse nodular pattern (q 2/3-ILO/1980). The patient was asymptomatic despite a restrictive spirometric impairment. The diagnosis derived from the finding, in the bronchoalveolar lavage fluid, of abnormal levels of La, Ce, Nd, Sm, Tb, Yb, and Lu. The presence of these elements was demonstrated by two methods: the neutron activation analysis and (as regards Ce alone) the X-ray energy spectrometry of mineral particles observed with electron microscope. Abnormal levels of rare earths were demonstrated also in the nails, suggesting an absorption of the RE from the lung.

Twenty-six workers in a hard metal manufacturing plant were monitored by cobalt urinary and ambient air measurements during the first month after summer holidays. Cobalt determinations were performed utilizing AAS, with a preliminary chelation and extraction procedure for urinary samples. Almost all personal ambient air samples turned out to be under the cobalt dust TLV of 0.1 mg/m3. When restarting work after the holidays, urinary values did not differ from the control group. At the end of the first working week, urinary cobalt had increased four fold, then decreased to the original values on the following Monday before restarting work. Thereafter, the weekend was no longer sufficient to reduce the levels to normal urinary cobalt values. The values rose to the same level observed before the holidays, and dit not substantially decrease even after the weekend. End-shift urinary cobalt values showed a good relationship with present as well as with mean past exposure on the first and the fifth weekday, but the third day did not. The correlation was better with present exposure on Monday and with mean past exposure on Friday. The observed differences may be explained by the minor influence of recent exposure on present exposure on Monday. The highest values were found on Wednesday. We suggest the utilization of end-shift urinary cobalt determination as a measure of the present exposure on Monday, and of mean recent or preceding exposure on Friday.

A case of occupational asthma in a wool and cotton dyer handling reactive dyes is described. The patient was skin positive, but asymptomatic to house dust mites. A bromoacrilamidic dye (Lanasol Yellow 4G) has been identified through chamber inhalation challenge as being responsible for the sensitization. A very short (4-minute) exposure produced a severe immediate obstructive ventilatory defect followed by arterial hypotension and urticaria. Bronchial hyperresponsiveness as tested through metacholine challenge was absent both in basal conditions and after the dye challenge. Both prick and patch test for the dye were positive in the absence of any sign of contact dermatitis.

The observation of photocontact dermatitis from Heracleum mantegazzianum Sommier et Levier in 2 gardeners at work prompted the analysis of furocoumarin content of stem, leaves and fruits of the plant during a period of 1 year. Their concentration was found to be maximal in fruit, intermediate in leaf, and minimal in stem. Psoralen was the most prevalent substance in the leaf and bergapten in the fruit. In the stem, in contrast, individual furocoumarins were found in lower but variable concentrations. 3 furocoumarin seasonal peaks were observed in the leaf: the maximal peak occurred in June, the intermediate in August, the minimal in November. This trend corresponds to 3 biological phases of the weed.

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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.