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Background Occupational respiratory allergy to green coffee beans (GCB) and to castor beans (CB) was studied in 112 workers in a modern coffee manufacturing plant of Trieste (Italy), where the process is completely automatic, the environmental conditions are good and where exposure to CB can be considered absent because since 1970, only new sacks have been used for coffee transportation. Methods All subjects were interviewed by a trained doctor using a questionnaire to investigate allergic symptoms and predisposing factors. Sensitization to GCB and to common allergens (pollens, molds, house dust mites) were evaluated by the skin‐prick test. The serum of subjects with a positive skin‐prick test to CGB or who had symptoms at work was tested for specific IgE (RAST) for GCB and CB. Lung function was evaluated by a Ponigraph spirometer. Results Sensitization to GCB was found in 25.8% of green coffee workers (31 cases), in 2.7% of roasted coffee workers (37 cases) and in 4.5% of the clerks (44 cases), p < 0.01. The evaluation of IgE specific for CB gave positive results only in 3 of 10 subjects sensitized to GCB. A total of 20% of GCB workers (6 cases) complained of work‐related respiratory symptoms (asthma and/or rhinitis) compared with only one subject in the roasted coffee group and one in the control group (p < 0.01). Asthma was reported by 2/31 of the green coffee workers and by 1/44 of roasted coffee workers. Conclusions There was a significant correlation between sensitization to GCB and work related symptoms (p < 0.01), common allergic symptoms (p < 0.05) and atopy by prick test (<0.01). These results point to the need to evaluate atopic status in workers and identify the most susceptible subjects, with the aim of informing them of their at‐risk status and monitoring their progress. This makes it possible to diagnose sooner those symptoms possibly indicative of a work‐related disease, because even in presence of good environmental conditions and even when symptoms are mild, it is almost always the atopic subjects who are affected. Am. J. Ind. Med. 34:623–627, 1998. © 1998 Wiley‐Liss, Inc.

Objectives-To assess the prevalence of atopy in a vocational school so as to evaluate the feasibility of pre-employment screening. Methods-The prevalence of atopy by family diathesis, prick tests, immunoglobulin E (IgE) concentrations, and personal history of allergic respiratory diseases was investigated in 144 trainee bakers and 81 students on a graphic artists course (mean age 15*4 years). Skin sensitisation to wheat, rye, and barley flours, to a amylase, and to storage mites was also evaluated. Results-Personal allergic symptoms were reported by 13-2% of the bakers and 14-7% of the graphic artists and there was a significant association between symptoms and atopy by prick tests (odds ratio (OR) 17-2; 95% confidence interval (95% CI) 5.27-56.4) and by family history (OR 3*11; 95% CI 1-02-9-53). When bakers were grouped according to the presence of allergic symptoms and results of immunological tests, 6-90/o had asthma, 6-3% had rhinoconjunctivitis, and a high percentage (28*5%) were without symptoms but scored positive on prick tests or family symptoms. Skin sensitisation to storage mites had similar prevalences (16%) in the two groups of trainees and occurred nearly always in atopic people. Positive skin tests to wheat flour (3 5%), rye (0.7%), and a amylase (0.7%/6) were specific to bakers. Conclusions-Pre-employment screening is a useful source of medical information and allows for counselling. The presence of asthma, or of another allergic disease in a severe form, is suggested as a criterion for excluding students of a vocational school from raining as bakers.Student bakers without allergic symptoms but atopic by other criteria should be informed about their risks of developing occupational asthma, and periodic check ups must be recommended.Screening studies in vocational school provide a better understanding of specificity of skin sensitisation to occupational allergens. (Occup Environ Med 1995;52:279-283)

In 2001, for the first time in its life, the AISG is holding its Annual Meeting far away from its traditional venue, i.e. Rapallo.The explanation for this decision on the part of its Directive Council, approved, moreover, enthusiastically, by the great majority of its members, lies, in my opinion, in two good reasons: 1 the concomitant IGS with the weight of its programme and the number of participants, as well as the outstanding names present; 2 the attractive beauty of this famous city of Prague, so full of history and charming spots.Our idea has been very much appreciated by our Greek colleagues, who have decided to join us in this initiative, which, on the other hand, has been supported right from the beginning as well by the organizers of IGS, Prof Melamed and Prof Schumann. To both of them go our sincere thanks for their welcome and collaboration.Let us think of it this way, however, that a third good reason for joining our forces may lie in the desire not only to exchange ideas and knowledge, but to meet friends who, for many reasons of life, we see all too rarely and with whom it is so nice to spend some time in a pleasant atmosphere speaking of many topics not necessarily only of ophthalmology.Also for this reason, let us succeed in respecting the times of the programme so as to have more time for enjoying ourselves. 7Prague opening remarks Partly as a result of my participation as moderator in the 1999 American Academy of Ophthalmology Glaucoma Subspecialty Day Symposium on Normal Tension Glaucoma, I have been requested to present an overview on this topic. Having made liberal use of materials provided by each of the speakers in the symposium, I wish to thank Drs Brian Lee, David Greenfield and Roger Hitchings and acknowledge their contributions. This presentation will be divided into the following four sections:I. The misnomer of normal tension glaucoma (NTG). II. Potentially contributing factors in the pathogenesis of glaucoma and their relevance to normal tension glaucoma. III. Potentially differentiating characteristics between glaucoma with normal IOP and glaucoma with elevated intraocular pressure (IOP). IV. Lessons learned from the Normal Tension Glaucoma Study. I. The misnomer of normal tension glaucoma (NTG)There is considerable controversy on whether normal tension glaucoma represents a distinct entity or is simply primary openangle glaucoma (POAG) with IOP within the normal range. Because IOP is a continuous variable with no definite dividing line between normal and abnormal, many authorities are questioning whether the term normal tension glaucoma should be abandoned. Normal tension glaucoma is typically defined as a glaucomatous optic neuropathy despite IOP consistently below 21 mmHg. The question must therefore be asked, 'What's so special about 21 mmHg?' Answering that question requires a review of Leydhecker's landmark investigation of 1958 wherein the IOPs of 20 000 eyes were obtained with Schiotz tonometry (Leydhecker et al. 1959). The mean IOP was found to be 15.5 mmHg with a standar...