Respiratory symptoms of obstructive lung disease in European crop farmers.

Crop farming as a risk factor for respiratory symptoms of obstructive lung disease was assessed. Random samples of crop farmers from four European countries were studied following a cross-sectional design. A questionnaire on respiratory symptoms and occupation was administered to determine prevalences, and the roles of the various crops as risk factors for respiratory symptoms were assessed through logistic regression modeling. The 4,793 crop farmers included in the study (response rate: 85.3%) reported the following respiratory symptoms: wheezing (14.9%), asthma (3.3%), nasal allergy (14.4%), chronic phlegm (12.4%), organic dust toxic syndrome (ODTS) (15.2%), and symptoms at work (22.0%). In the multivariate analysis, adjusting for age, sex, smoking, country, and exposure to other plants or livestock, flower growing was a risk factor for asthma (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.1-3.9) and cultivating oil plants was associated with ODTS (OR 1.5, 95% CI 1.3-1.9), symptoms at work (OR 1.4, 95% CI 1.2- 1.7), and chronic phlegm (OR 1.3, 95% CI 1.1-1.6). Working inside greenhouses was a marginal risk factor for asthma (OR 2.1, 95% CI 0.9-4.5). We conclude that flower and oil plant production is associated with increased risk of respiratory symptoms in European crop farmers.

[Prevalence and risk factors of respiratory symptoms in farmers; comment]. / Prevalencia y factores de riesgo de síntomas respiratorios en la agricultura y la ganadería.

BACKGROUND: A cross-sectional study was performed to determine the prevalence of respiratory symptoms in farmers and to assess occupational risk factors for respiratory symptoms in this population. METHOD: A questionnaire on respiratory symptoms and occupation was mailed to a sample of 1,191 farmers with descriptive analysis of the symptoms and multivariate analysis through logistic modeling to assess the different risk factors. RESULTS: 1,164 workers answered the questionnaire (response index 98.2%) and 808 subjects were finally included in the study after discarding non exposed workers. The highest prevalences of asthma symptoms (39.2%) and symptoms of nasal allergy (31.6%) were found in poultry workers (p < 0.001, chi square). Sheep workers showed the highest prevalences of chronic phlegm (38.5%), work-related symptoms (53.9%) and symptoms of organic dust toxic syndrome (35.9%) (p < 0.005, chi square). At multivariate analysis, adjusting for age, gender, smoking and other occupational exposures, poultry work was a risk factor for asthma symptoms (OR 2.1; IC 95% 1.2-3.8) and symptoms of nasal allergy (OR 2.3, IC 95% 1.3-4.2), and dairy farming a risk factor for chronic phlegm (OR 1.8, IC 95% 1.1-2.9). Agriculture was not associated with respiratory symptoms. CONCLUSION: In our study risk factors for respiratory symptoms in Spanish farmers were poultry and dairy farming.

[Synchronous multiple primary cancer of the lung: a rare association of small cell carcinoma as the main tumor plus epidermoid carcinoma]. / Neoplasia primaria múltiple pulmonar sincrónica: carcinoma microcítico como tumor principal y carcinoma epidermoide, una asociación infrecuente.

Multiple primary cancer (MPC), a rare finding, is most often seen in the breast. In the lung, this cancer is rare (accounting for between 1.5 and 3% of cases), with epidermoid carcinoma usually being the principal tumor. The presentation of small-cell carcinoma as the principal tumor in MPC is thought to be extremely rare. The criteria for pulmonary MPC described by Martini and Melamed continue to provide the definition of reference. Pulmonary MPC can manifest in a synchronically (simultaneous appearance) or metachronically (with more than two years' lapse in appearance). Patients so-affected are usually male and heavy smokers. Survival with this type of lung cancer is usually less than for a single form. We report the case of a patient with synchronous MPC of the lung, with small cell carcinoma as the principal tumor associated with epidermoid carcinoma. We review the literature on this subject.

An unusual presentation of secondary pleural hydatidosis.

Although pleural involvement is relatively common in cystic hydatid disease, one of the rarest and least known complications is secondary pleural hydatidosis. We report the case of a patient who presented with polycystic secondary pleural hydatidosis 4 yrs after treatment for a pyopneumothorax caused by rupture of a pulmonary cyst near the pleural space. Due to the coexistence of severe chronic obstructive pulmonary disease, surgery was ruled out. The patient was treated with albendazole, with a favourable outcome.