The record of daily average grass pollen concentrations monitored at St Mary's Hospital, Paddington, London, U.K. since 1961 is the longest duration pollen data set in Europe. Analysis of the results identifies the trends and characteristics of grass pollen seasons over three decades. During this time seasonal allergic rhinitis has increased significantly in Britain. The annual start dates, length of season and severity are examined in relation to the main meteorological variables of cumulated temperatures above 5.5 degrees C and precipitation measured at one site within London and two in the surrounding rural areas. Land-use changes are also considered. Significant decreases have taken place in both the duration and severity of the seasons, particularly between the 1960s and the early 1970s but also through the last 20 yr. This is largely a result of a decrease in pollen abundance in the region. The decline in pollen counts has slowed in recent years due to the increase in flowering grasses caused by the set-aside policy and by uncut verges. Grass pollen seasons have tended to start later over the last two decades, despite an increase in the cumulated temperature profiles during late winter and spring. Empirical models have been developed using multiple regressions to incorporate meteorological and pollen data for the last 20 yr in order to forecast the start dates, duration and severity of the grass pollen seasons. These models were applied successfully using the data for 1991 and 1992. Predictions of the main characteristics of the pollen seasons can be obtained relatively early in the year through the use of these models by employing the monthly weather forecasts in conjunction with long-term average weather profiles.

The contrasting patterns both in the pollen records and land-use changes between the three sites emphasize the need for regional data. The predictive models achieved a high degree of explanation enabling pollen season severity to be forecast with high confidence shortly before the start date.

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The toe-nail dust produced in chiropodial practice causes allergic hypersensitivity and Trichophyton rubrum is the most common fungal cause of nail dystrophy. Use of drills and burrs to reduce the thickness of hyperkeratotic nails generates dust and chiropodists develop precipitins to T. rubrum. A survey into the prevalence of these antibodies in 11-2% of state-registered chiropodists is described and 14% of the profession estimated to have antibodies to T. rubrum. In response to a questionnaire 49% stated that toe-nail dust troubled them; complaints of nasal and eye symptoms were 72 and 41% respectively. In 384 chiropodists ventilatory function was tested with a vitaiograph. Restrictive lung disease appears to be more common in chiropodists than other sedentary workers.

sYNoPsis The use of Counter immunoelectrophoresis (CIE) for the detection of pneumococcal capsular antigen in the sputum and serum of patients suffering from acute respiratory infections is described. The CIE of sputum gave positive results in 224 (99 %) out of 225 samples in which Streptococcus pneumoniae was isolated by cultural techniques, and in 23 (9 %) out of 262 samples in which no or other potential pathogens had been isolated. In the detection of capsular antigen in serum, CIE was positive in 32 (35 %) out of 92 pneumonia cases and was associated with an increase in mortality.In the clinical management of pneumonia where the patient receives antimicrobial therapy before the causal organism has been identified, a specific bacteriological diagnosis is frequently rendered impossible because of the growth of such replacement organisms as Escherichia coli and Klebsiella species (Spencer and Philp, 1973). Since the detection of antibodies or polysaccharide capsular antigens might be of value in this situation, the use of Electrosynerese (Bussard, 1959), a development from the technique of Lang and Haas (1957), or Counter immunoelectrophoresis (CIE), as it is more commonly termed, has been investigated. The present report is primarily concerned with the diagnostic and prognostic use of this technique in pneumonia due to Streptococcus pneumoniae. Patients and Methods PATIENTSA group of 225 consecutive patients, in whom Str. pneumoniae had been isolated from the sputum as the potential pathogen, was balanced with a control group of 262 patients from whom another or no potential pathogen had been isolated. The first group was subdivided into three categories: (1) patients with clinical pneumonia confirmed by chest x-rays, (2) patients with exacerbations of chronic lung diseases, eg, bronchitis, asthma, and Received for publication 6 August 1975 bronchiectasis, and (3) surgical postoperative patients who had developed a productive cough but did not fall into the previous two categories. SAMPLESSputum and serum were collected from the patients as soon as the clinical diagnosis had been made. The sputa were cultured on blood agar under carbon dioxide at 37°C. These were read after overnight incubation, and potential pathogens were identified by standard methods (Cowan and Steel, 1974). Very small numbers of potential pathogens found only in the inoculation well were not regarded as significant. IMMUNOELECTROPHORESISCounter Immunoelectrophoresis (CIE) This was performed with a method based on that of Dorff et al (1971). The stock buffer used was barbitone/sodium barbitone, pH 8-2, and microscope slides were covered with 0 9% agarose (Miles-Seravac Ltd, Maidenhead, Berks) in halfstrength buffer sufficient to give a depth of 1 mm of agarose. Ten ,ul amounts of antibody or test fluid were employed and a constant voltage of 20 V per cm was applied for one hour at room temperature. After electrophoresis the gel was washed in 5% sodium citrate for 15 minutes and examined by reflected light for lines of precipitation. Ge...

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