Tea consumption and risk of lower respiratory tract infections: a two-sample mendelian randomization study.

BACKGROUND: Observational studies have reported the association between tea consumption and the risk of lower respiratory tract infections (LRTIs). However, a consensus has yet to be reached, and whether the observed association is driven by confounding factors or reverse causality remains unclear. METHOD: A two-sample Mendelian randomization (MR) analysis was conducted to determine whether genetically predicted tea intake is causally associated with the risk of common LRTI subtypes. Genome-wide association study (GWAS) from UK Biobank was used to identify single-nucleotide polymorphisms (SNPs) associated with an extra cup of tea intake each day. The summary statistics for acute bronchitis, acute bronchiolitis, bronchiectasis, pneumonia, and influenza and pneumonia were derived from the FinnGen project. RESULTS: We found that genetically predicted an extra daily cup of tea intake was causally associated with the decreased risk of bronchiectasis [odds ratio (OR) = 0.61, 95% confidence interval (CI) = 0.47-0.78, P < 0.001], pneumonia (OR = 0.90, 95% CI = 0.85-0.96, P = 0.002), influenza and pneumonia (OR = 0.91, 95% CI = 0.85-0.97, P = 0.002), but not with acute bronchitis (OR = 0.91, 95% CI = 0.82-1.01, P = 0.067) and acute bronchiolitis (OR = 0.79, 95% CI = 0.60-1.05, P = 0.100). Sensitivity analyses showed that no heterogeneity and pleiotropy could bias the results. CONCLUSIONS: Our findings provided new evidence that genetically predicted an extra daily cup of tea intake may causally associated with a decreased risk of bronchiectasis, pneumonia, and influenza and pneumonia.

Serum vitamin D is associated with improved lung function markers but not with prevalence of asthma, emphysema, and chronic bronchitis.

Hypovitaminosis D has been linked to several non-bone diseases. Relation between 25-hydroxyvitamin D [25(OH)D] and lung function and lung diseases has received little attention at the global level. Cross-sectional data from three National Health and Nutrition Examination Surveys, 2007-2008, 2009-2010, and 2011-2012 were used to investigate the relationship between serum 25(OH)D concentrations and lung function makers [forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)] and lung diseases (asthma, emphysema, and chronic bronchitis) with multivariate regression models (n = 11,983; men, 6,010; women, 5,973). Serum 25(OH)D concentrations were directly associated with FVC and FEV1 (P for trend < 0.01). Individuals in the 4th quartile serum 25(OH)D had significantly higher FVC and FEV1 compared to those in the 1st quartile (P < 0.01). When data were stratified based on gender and smoking status, we found similar associations between serum 25(OH)D concentrations and lung function markers. There was no relation between serum 25(OH)D and prevalence of asthma, chronic bronchitis, and emphysema in US adults. Serum 25(OH)D concentration is associated with improved lung function markers but not with the prevalence of asthma, emphysema, and chronic bronchitis. Controlled studies are needed to determine if the vitamin D supplementation improves lung function in adults and in smokers.

Analysis of the incidence of acute respiratory diseases in the paediatric population in Poland in the light of the "Health Needs Map".

INTRODUCTION: Statistical data on the structure of acute respiratory diseases incidence in the paediatric population are still scarce. The demand for such data results mainly from the need to constantly implement new systemic and economic solutions. The aim of the study was to attempt to use reported data for an assessment of the incidence of acute respiratory diseases in various age groups. MATERIAL AND METHODS: An analysis of selected acute respiratory diseases was conducted in relation to diagnoses reported from 1 January to 31 December 2014 to the National Health Fund (NFZ, Narodowy Fundusz Zdrowia) in accordance with the codes of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. The study was conducted under the Knowledge Education Development operational programme co-funded by the European Social Fund. RESULTS: A total of 101,000 children were hospitalised due to acute respiratory diseases, which amounted to 1,554 hospitalisa-tions per 100.000. The most common causes of hospitalisation were pneumonia and bronchitis/bronchiolitis. Boys were hospital-ised more often in each age group. The shortest average length of stay (ALOS) was 5.21 days and concerned hospitalisation due to bronchitis. The longest length of stay for children was due to tuberculosis (14.3 days). The highest age average of a child was recorded in pleural diseases (10.51 years) and the lowest in bronchitis (2.93 years). Rehospitalisation was necessary in children in whom tuberculosis or pleural diseases were diagnosed (1.43 vs 1.34). A total of 67 inpatient deaths were recorded, of which 19 were due to pneumonia or its complications. CONCLUSIONS: Epidemiological data reported to the National Health Fund (NFZ) seem quite reliable and do not differ significantly from those reported in other European countries. The analysed data may be useful in estimating health needs in paediatrics.

Impulse oscillometry measurement of distal airways obstruction in depleted uranium-exposed Gulf War veterans.

INTRODUCTION: A cohort of Gulf War I veterans who sustained exposure to depleted uranium undergoes biennial surveillance for potential uranium-related health effects. We performed impulse oscillometry and hypothesized that veterans with higher uranium body burdens would have more obstructive abnormalities than those with lower burdens. METHODS: We compared pulmonary function of veterans in high versus low urine uranium groups by evaluating spirometry and oscillometry values. RESULTS: Overall mean spirometry and oscillometry resistance values fell within the normal ranges. There were no significant differences between the high and low uranium groups for any parameters. However, more veterans were classified as having obstruction by oscillometry (42%) than spirometry (8%). CONCLUSIONS: While oscillometry identified more veterans as obstructed, obstruction was not uranium-related. However, the added sensitivity of this method implies a benefit in wider surveillance of exposed cohorts and holds promise in identifying abnormalities in areas of the lung historically described as silent.

Vitamin D and respiratory health in the Busselton Healthy Ageing Study.

BACKGROUND AND OBJECTIVE: The relationship between vitamin D and respiratory disease was examined by cross-sectional analysis of a large community-based sample. METHODS: Serum 25-hydroxyvitamin D (25OHD) and history of respiratory disease, symptoms (recorded by questionnaire) and spirometry were measured in 5011 adults aged 45-69 years. Adjustments were made for age, sex, season and smoking (Model A), plus body mass index (BMI) and physical activity level (Model B), plus history of chronic diseases (Model C). RESULTS: Mean (SD) age was 58 (SD 6) years with 45% males, 10% current smokers and 12% taking vitamin D supplements. The prevalence of 25OHD level <50 nmol/L was 8.0%. In all the three models, 25OHD <50 nmol/L was significantly associated with asthma (Model C: odds ratio (OR): 1.32; 95% CI: 1.00, 1.73), bronchitis (1.54; 1.17, 2.01), wheeze (1.37; 1.10, 1.71) and chest tightness (1.42; 1.10, 1.83). Participants with vitamin D level > 100 nmol/L had higher forced vital capacity (FVC) in all the three models (1.17% higher, compared with the 50-100 nmol/L group in Model C). CONCLUSION: Low levels of serum 25OHD were independently associated with asthma, bronchitis, wheeze and chest tightness after three levels of adjustment for potential confounders. Higher vitamin D levels were associated with higher levels of lung function.

Azole-Resistant Aspergillosis: Epidemiology, Molecular Mechanisms, and Treatment.

Aspergillus fumigatus remains the most common species in all pulmonary syndromes, followed by Aspergillus flavus which is a common cause of allergic rhinosinusitis, postoperative aspergillosis and fungal keratitis. The manifestations of Aspergillus infections include invasive aspergillosis, chronic pulmonary aspergillosis and bronchitis. Allergic manifestations of inhaled Aspergillus include allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. Triazoles are the mainstay of therapy against Aspergillus infections for treatment and prophylaxis. Lately, increased azole resistance in A. fumigatus has become a significant challenge in effective management of aspergillosis. Earlier studies have brought to light the contribution of non-cyp51 mutations along with alterations in cyp51A gene resulting in azole-resistant phenotypes of A. fumigatus. This review highlights the magnitude of azole-resistant aspergillosis and resistance mechanisms implicated in the development of azole-resistant A. fumigatus and address the therapeutic options available.

Bronchial inflammation in seasonal allergic rhinitis with or without asthma in relation to natural exposure to pollen allergens

BACKGROUND: Nasal inflammation in allergic rhinitis enhances bronchial Th2 driven inflammation and development of asthma. We assessed bronchial inflammation induced by natural allergen exposure during pollen season in patients with pollinosis with or without asthma to show the intensity of inflammation in asthma and rhinitis and possible persistence of inflammation in periods without allergen exposure. METHODS: Sputum was induced in 52 patients with seasonal allergic rhinitis without asthma, 38 patients with seasonal allergic rhinitis and seasonal asthma and 23 healthy volunteers. Sampling was performed 6---8 weeks before the expected beginning of symptoms, during symptomatic period and 6---8 weeks after the end of symptoms. Sputum ECP was measured by means of chemiluminiscent immunometric assay and sputum cell counts were assessed by classical staining and immunocytochemistry. RESULTS: Sputum eosinophils were on the whole higher in both asthma and rhinitis compared to controls (p < 0.001, p = 0.003). The rise of eosinophils during pollen season compared with values out of pollen season was significant in asthma (classical staining) (p = 0.014) and slightlyapparent in rhinitis (immunocytochemistry) (p = 0.073). The seasonal rise of sputum ECP was observed only in rhinitis (p = 0.006). CONCLUSIONS: Inflammation of the lower airway in patients with allergic rhinitis with and without asthma has been confirmed by means of both sputum eosinophil count and sputum ECP level.Persistent inflammation of lower airway in periods without allergen exposure was proven in seasonal asthma. This may have implications for the therapy of seasonal allergic rhinitis with and without asthma in terms of promoting long-term anti-inflammatory treatment

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Nonallergic rhinitis and its association with smoking and lower airway disease: A general population study.

BACKGROUND: The cause of nonallergic rhinitis (NAR) and its relation to lower airway disease remains unclear. The purpose of this study was to perform a descriptive analysis of the occurrence of rhinitis in a Danish general population with focus on NAR and its association with smoking and lower airway disease. METHODS: A population-based, cross-sectional study conducted in Copenhagen, Denmark was performed. A random sample from the general population (n = 7931; age, 18-69 years) was invited to a general health examination including measurements of serum-specific immunoglobulin E (IgE) to common aeroallergens; 3471 (44%) persons were accepted. For further analysis, we divided the population into the following groups: (I) negative specific IgE and no rhinitis (controls); (II) negative specific IgE and rhinitis (NAR); (III) positive specific IgE and rhinitis (allergic rhinitis [AR]); and (IV) positive specific IgE but no rhinitis (sensitized). RESULTS: We found that NAR was associated with asthma (odds ratio [OR] = 2.51 [1.87-3.37]); chronic bronchitis (OR = 2.27 [1.85-2.79]); current smoking (>15 g/day; OR = 1.57 [1.18-2.08]); lower forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratios and reduced FEV(1) values. The association with chronic bronchitis was stronger in NAR than in AR, whereas the opposite was true for asthma. FEV(1)/FVC of <70% was not significantly associated to any group. CONCLUSION: This epidemiological study indicates that both asthma and chronic bronchitis are important comorbidities in NAR confirming the "united airway" hypothesis, and that smoking might be a significant modulator of disease. Although NAR was significantly associated with poor lung function, no significant association with chronic obstructive pulmonary disease was shown.

Postoperative ischemic bronchitis after lymph node dissection and primary lung cancer resection.

BACKGROUND: The purpose of this study was to determine the incidence and symptoms of postoperative ischemic bronchitis (POIB) after systematic lymph node dissection (LND) and evaluate the effect of hyperbaric oxygen therapy in patients with primary lung cancer. METHODS: From January 2004 to December 2009, 1,071 patients underwent a standard resection for non-small cell lung cancer and radical systematic lymph node dissection. Fiberoptic bronchoscopy was performed systematically between days 7 and 12. We analyzed the clinical and biologic signs of POIB. Once the diagnosis established a treatment by hyperbaric oxygen, therapy was undertaken. RESULTS: A POIB was observed in 34 patients (3.21%) (2 women and 32 men). Mean age was 59 ± 10 years (range, 25 to 79 years). A POIB occurred within 8 ± 3 days; after right pulmonary resection (n = 21; 62%) and after left resection (n = 13; 38%). A POIB appeared asymptomatically for 27 patients (80%), whereas only 7 patients (20%) presented with fever and hyperleukocytosis. Their localization were bronchial stumps (n = 21; 62%), homolateral bronchial tree (n = 11; 32%), or extension toward the contralateral bronchial tree (n = 2; 6%). The mean number of hyperbaric oxygen therapy sessions was 14 (1 to 48). A POIB worsening was observed in 6 patients (18%), requiring a surgical rescue therapy. CONCLUSIONS: The clinical presentation of POIB is poor and systematic fiberoptic bronchoscopy should be performed, especially in patients with a high risk of bronchopleural fistula. Hyperbaric oxygen therapy in the management of ischemic bronchitis may be a promising adjunctive treatment.

The prevalence, characteristics of and risk factors for eczema in Belgian schoolchildren.

Childhood eczema is common in infants, but its nature and extent during later childhood remains unclear. In this cross-sectional study we examined the prevalence and characteristics of eczema in an unbiased community population of 2,021 Belgian schoolchildren, aged 3.4 to 14.8 years with skin prick testing and parental questionnaires. Our study identified an eczema prevalence of 23.3% and a considerable allergic comorbidity, mainly in sensitized children. The reported prevalence of eczema in infancy was 18.5% and for current eczema 11.6%. The overall sensitization rate (33.2%) as well as sensitization rates for the individual allergens were significantly higher in children with "eczema ever." Sensitization to Dermatophagoides pteronyssinus (19.6%), mixed grass pollen (15.1%), and cat (9.1%) were most common. Until the age of 6 years, boys with eczema were significantly more sensitized than girls (p = 0.007). Children with both eczema in infancy and current eczema show a tendency to be more sensitized than children with eczema in infancy only or current eczema only, but significance was only noted for a few individual allergens. Analysis of factors associated with eczema revealed a predominantly atopic profile characterized by family or personal history of allergy. Breastfeeding and environmental factors seemed to assume little relevance except for a protective effect of prematurity and having a dog at birth.

Contaminación atmosférica y salud infantil en áreas urbanas e industriales de La Plata, Argentina / Air pollution and children's health in urban and industrial areas of La Plata, Argentina

El impacto de la exposición a contaminantes ambientales sobre la salud humana ha sido ampliamente investigado, encontrándose que muchos problemas de salud están relacionados con la contaminación del aire. En el presente trabajo se analizan los resultados obtenidos de un relevamiento empleando cuestionarios epidemiológicos a niños en edad pre-escolar de la ciudad de La Plata, capital de la Provincia de Buenos Aires, Argentina, y sus alrededores. Para el estudio se consideraron cuatro zonas, una típicamente urbana, otra con influencia industrial, otra de característica semi-rural y una residencial. Los resultados obtenidos evidencian, en cuanto a las enfermedades asociadas a las zonas en estudio, correlaciones significativas entre la zona industrial y dos tipos de afecciones: bronquitis crónica y piel fotosensible. Estos resultados están en concordancia con el elevado nivel de partículas, compuestos orgánicos asociados con las mismas y compuestos orgánicos volátiles hallados en la zona industrial en comparación con las zonas control. Otras correlaciones significativas encontradas se refieren a mayor predisposición a padecer bronquitis en la población que utiliza querosén como combustible para cocinar y calefacción doméstica y el desarrollo de bronquiolitis en zonas con tránsito vehicular congestionado. Estos resultados contribuyen con información de base de gran utilidad para contextualizar futuros estudios epidemiológicos en la región.

The influence of air pollution on human health has been studied during the last decades. In this sense, several epidemiological studies have shown an association between air pollutants and various diseases. In the present study an epidemiological questionnaire was applied to a population of children between 3 and 6 years of La Plata and its neighbouring areas, in Buenos Aires, Argentina. Four different areas were considered: urban, industrial, semi-rural and residential. Results show significant correlations between industrial area and chronic bronchitis and skin photosensitivity. These results depend on the high levels of particles, organic compounds bound to particles and volatile organic compounds found in the industrial area compared to control zones. Other significant correlations are related to the use of kerosene for heating and cooking, and a predisposition to develop bronchitis. Besides, the analyses of questionnaires show a correlation between bronchiolitis and heavy traffic. This investigation contributes with preliminary information to future epidemiological studies in the region.

Infants fed docosahexaenoic acid- and arachidonic acid-supplemented formula have decreased incidence of bronchiolitis/bronchitis the first year of life.

To assess the effect of docosahexaenoic acid and arachidonic acid supplementation in infant formula on the incidence of respiratory illnesses, pediatricians assigned infants to receive docosahexaenoic acid/arachidonic acid-supplemented formula or control formula. Anthropometrics, medical history, and illnesses were reported. Among 1342 infants, there was a higher incidence of bronchiolitis in control versus docosahexaenoic acid/arachidonic acid-supplemented groups at 5, 7, and 9 months (P < .01). Weight, length, and head circumference were similar for both groups. Infants fed formula supplemented with 0.32% docosahexaenoic acid and 0.64% arachidonic acid experienced a lower incidence of bronchiolitis compared with infants fed formula supplemented with no docosahexaenoic acid/arachidonic acid or lower levels of docosahexaenoic acid/arachidonic acid in the first year of life.

[The prevalence of skin and mucosal symptoms in gardeners handling Ficus benjamina (weeping fig) and Hedera helix (ivy). A cross-sectional study]. / Praevalensen afhud- og slimhindesymptomer blandt gartnere der omgås Ficus benjamina (stuebirk) og Hedera helix (vedbend). Et tvaersnitsstudie.

INTRODUCTION: Allergic and toxic initiative symptoms from skin, eyes and respiratory tract are well known among gardeners This study reports the prevalence of these symptoms among gardeners working with Ficus Benjamina (Fb) and Hedera helix (Hh). MATERIAL AND METHODS: A questionnaire concerning allergic/toxic-irritative symptoms from skin, eyes and respiratory tract were forwarded to 57 gardeners. A total of 49 questionnaires were returned and matched on sex and age with a control group. A number of 46 women and 52 men participated, with a mean age of 39 (SD 9.7). Differences in frequencies of symptoms were expressed as odds ratio (OR) with a security level of 95% after conditioned logistic regression; other results were calculated from Mantel-Haenzel test. RESULTS: There were more complaints among gardeners compared to the control group f as to symptoms of asthmatic bronchitis (OR 4.6 [0.98-21.2]), rhino conjunctivitis (OR 6.4 [2.1-20.2]) and skin symptoms (OR 4.3 [1.5-12.5]). The symptoms were especially profound among the caretakers of Fb and Hh and to a lesser degree among gardeners working in greenhouses growing Fb and Hh. The symptoms of the gardeners were to a higher degree independent of the season (OR 3.1 [1.1-9]), related to working environment (OR 16.1 [3.3-78.9]) and indoor work (OR 24 [4.8-118.7]). DISCUSSION: This study seems to demonstrate high frequencies of apparently allergic and/or toxic irritative symptoms among gardeners and should be followed by a study including clinical examinations. With knowledge of the allergenic and toxic irritative properties of Fb and Hh it seems problematic that these plants are found in such high numbers in public and private places. Allergic testing including these plants should be performed to a higher degree than is actually the case.

Exposures to the Kuwait oil fires and their association with asthma and bronchitis among gulf war veterans.

Military personnel deployed to the Persian Gulf War have reported a variety of symptoms attributed to their exposures. We examined relationships between symptoms of respiratory illness present 5 years after the war and both self-reported and modeled exposures to oil-fire smoke that occurred during deployment. Exposure and symptom information was obtained by structured telephone interview in a population-based sample of 1,560 veterans who served in the Gulf War. Modeled exposures were exhaustively developed using a geographic information system to integrate spatial and temporal records of smoke concentrations with troop movements ascertained from global positioning systems records. For the oil-fire period, there were 600,000 modeled data points with solar absorbance used to represent smoke concentrations to a 15-km resolution. Outcomes included respiratory symptoms (asthma, bronchitis) and control outcomes (major depression, injury). Approximately 94% of the study cohort were still in the gulf theater during the time of the oil-well fires, and 21% remained there more than 100 days during the fires. There was modest correlation between self-reported and modeled exposures (r = 0.48, p < 0.05). Odds ratios for asthma, bronchitis, and major depression increased with increasing self-reported exposure. In contrast, there was no association between the modeled exposure and any of the outcomes. These findings do not support speculation that exposures to oil-fire smoke caused respiratory symptoms among veterans.

[The nutritional status change the effectiveness of a dietary supplement of lactic bacteria on the emerging of respiratory tract diseases in children]. / El estado nutricional modifica la efectividad de un suplemento dietario de bacterias lácticas sobre la aparición de patologías de vías respiratorias en niños.

One hundred children 6 to 24 month old, normal or undernourished according to weight for height index, received during three months--autumn to winter--a dietary supplement of live Lactobacillus acidophilus and Lactobacillus Casei, 10(7)-10(8)/ml in fermented milk (LB) or an equivalent amount of fluid milk (L) as control. Children's follow-up was performed as outpatients in the Hospital Posadas (Great Buenos Aires). Episodes of respiratory tract infections were recorded and classified according to severity as: Pneumonia (N); Bronchitis (B), Recurrent Obstructive Bronchitis (BOR) and upper respiratory tract infections (CVAS). 58% of children fitted the study protocol, 22 in the LB and 36 in the L group; 21 were undernourished and 37 presented normal weight/height. No deaths were recorded. Total episodes were 103: 34 in LB and 69 in L, that means a frequency of 1.55 and 1.92 episodes/children respectively. In LB a maximum of 3 episodes/children was recorded, meanwhile the number reached 7 in L (p = 0.0373). Severity was higher in L than LB: 0.06 vs. 0 for N; 0.69 vs. 0.45 for B + BOR and 1.17 vs. 1.09 for CVAS. In the control group frequency of severe pathologies was about twice in undernourished than in normal: 0.08 vs. 0.04 for N; 1.08 vs. 0.50 for B + BOR; no difference was found for CVAS. Live lactobacillus supplement suppressed pneumonia and decreased bronchitis in undernourished as well as in normal. In this study undernutrition not only increased the chance of suffering severe acute respiratory tract infections but also impaired the effectiveness of the supplement to decrease severity. The effect is explained on the basis of the immunocompetence depression linked to an inadequate nutritional status.

Life with and without disease: women experience more of both.

This paper examines gender differences in life with and without six major diseases, including both mortal and morbid conditions. Disease prevalence and health behavior data are from the 1993-1995 National Health Interview Surveys for the United States. Vital registration data are the source of mortality rates used in computing life expectancy. The Sullivan method is used to estimate life lived with and without disease and risky behavior for men and women at various ages. Women live more years with each of the diseases examined, and, for arthritis, the extended years with disease are greatest. Women also live more years than men free of each of these diseases with the exception of arthritis. Gender differences in life without two health-risk behaviors are also discussed. Men spend more years of their lives overweight and have fewer years during which they see a doctor.

Use of antimicrobial agents for community-acquired lower respiratory tract infections in hospitalised children.

Data collected from 613 children aged 2-14 years who had been hospitalized for acute bronchitis, wheezing, or pneumonia were analysed to evaluate the prescribing practices of pediatricians treating community-acquired lower respiratory tract infection. Antibiotics were prescribed for 92.1% of the children: 85% had acute bronchitis, 72% had wheezing, and 97.9% had pneumonia. A high frequency of antibiotic overuse and inappropriate prescriptions was noted. In order to contain costs and limit the risk of resistant bacteria emerging, it is urgent that pediatricians and parents be educated in the proper use of antibiotics.

Obsessive-compulsive disorder and immunocompetence.

OBJECTIVE: A postinfectious, autoimmune response may be associated with the development of pediatric obsessive-compulsive disorder (OCD). According to this model, antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection. This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms. One implication of this model is that prolonged immunologic stress may be a risk factor for OCD. That is, immunologic stress may compromise the blood-brain barrier and permit the influx of antistriatal antibodies into the central nervous system. This article explores one part of this putative relationship by investigating whether adult OCD patients, compared to members of other psychiatric groups, demonstrate a higher incidence of recurrent infections and other conditions suggestive of compromised immune function. METHOD: To test this hypothesis, we conducted a medical records review of 100 consecutive patients evaluated at a private psychiatric clinic specializing in the treatment of anxiety disorders. Sixty-five patients met diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD, posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder with agoraphobia, and dysthymic disorder. Each medical record was reviewed for the presence of target syndromes or presenting symptoms suggestive of compromised immune function. RESULTS: Chart review revealed an increased rate of immune-related symptoms and syndromes among OCD patients in comparison to other anxiety and mood disorder groups. Groups did not differ significantly in the incidence of non-immune symptoms and syndromes. CONCLUSION: Adult OCD patients appear to have an increased rate of immune-related diseases above and beyond that seen in other psychiatric disorders.

Lung health in sawmill workers exposed to pine and spruce.

Workers exposed to a variety of wood dusts have been shown to exhibit occupational asthma, lung function deficits, and elevated levels of respiratory symptoms. Despite the popularity of pine and spruce, the health effects of exposures to these woods have not been extensively investigated. A study was undertaken to investigate the respiratory health of a group of sawmill workers processing pine and spruce (n = 94). Data collection included a respiratory symptom questionnaire, spirometry, and allergy skin testing. The sawmill workers were compared with a group of oil field workers from the same geographic area who underwent the same study protocol (n = 165). The results showed that the sawmill workers had significantly lower average values for FEV1 and FEV1/FVC (%), adjusted for age, height, and smoking. The largest differences were for current smokers. Significantly elevated age and smoking-adjusted odds ratios (OR) were detected for shortness of breath (2.83; 95% confidence interval [CI], 1.47 to 5.46) and wheeze with chest tightness (2.58; 95% CI, 1.18 to 5.62). Nonsignificant elevations were also seen for usual cough (1.47; 95% CI, 0.68 to 3.16), usual phlegm (1.94; 95% CI, 0.98 to 3.87), shortness of breath with exercise (1.45; 95% CI, 0.66 to 3.20), chest tightness (1.43; 95% CI, 0.80 to 2.57), and attacks of wheeze (1.70; 95% CI, 0.79 to 3.68). Sawmill workers were 2.5 times as likely as oil field workers to report current asthma (95% CI, 0.76 to 8.32). Workers employed more than 3 years showed significantly more asthma (OR = 3.67; 95% CI, 1.00 to 13.5) and bronchitis (OR = 2.14; 95% CI, 1.02 to 4.52). Sawmill workers were only 43% as likely to report a history of hay fever (95% CI, 0.20 to 0.94). These health effects were noted despite an average concentration of respirable dust of 1.35 mg/m3 (range, 0.1 to 2.2 mg/m3). These levels are below the present occupational standard.