Occupational asthma due to colistin in a pharmaceutical worker.

To our knowledge, this is the first case report of a 24-year-old man working in a pharmaceutical company transporting and storing raw materials who developed occupational asthma (OA) to colistin. The specific inhalation challenge confirmed the diagnosis of OA to colistin. Specific IgE was not detected, because dot-blot analysis was negative at all colistin concentrations tested. To our knowledge, OA due to a peptide antibiotic has not previously been described. This antibiotic should be listed as a trigger of OA.

Lipoatrofia semicircular de origen laboral / Occupational semicircular lipoatrophy

Objetivo: En 2007 se notificaron en Cataluña una serie de casos de lipoatrofia semicircular potencialmente relacionados con determinados factores de riesgo presentes en los puestos de trabajo. El objetivo del presente trabajo es proponer una definición y clasificación de caso de lipoatrofia semicircular de origen laboral (LSOL) y describir los resultados de los casos estudiados en la Mutua Asepeyo en Cataluña. Métodos: Se examinaron 153 trabajadores con sospecha de lipoatrofia semicircular con un mismo protocolo de actuación. Se describen los resultados de 148 casos atendidos consecutivamente y pertenecientes a 27 empresas diferentes. El estudio se llevó a cabo entre abril y septiembre de 2007. Resultados: El mayor porcentaje de casos de lipoatrofia semicircular se da en mujeres (94%), con un rango de edad predominante para los dos sexos entre 31 y 41 años (46%), con normopeso (69%), con afectación en los muslos (96%) y en trabajadores con tareas administrativo-ofimáticas (97%) que referían apoyarse en la mesa de trabajo como factor de riesgo relacionado con su patología(58%). Adicionalmente, se objetiva el aumento de las cargas electrostáticas y la disminución de la humedad relativa ambiental en 19 casos procedentes de 6 empresas. Conclusión: La vigilancia médica de los trabajadores afectados por lipoatrofia semicircular debe realizarse de forma protocolizada para identificar adecuadamente los casos de origen laboral. En nuestro estudio, el origen laboral del problema se ha podido determinar aproximadamente en la mitad de los casos. Aunque sigue sospechándose etiología laboral en la mayoría de los casos, ha sido imposible disponer, en esta fase del estudio, de las mediciones técnicas necesarias para identificar los factores de riesgo laborales considerados como potencialmente causales(AU)

Objective: In 2007 several cases of semicircular lipoatrophy were reported as potentially related to occupational risk factors. The aim of this study is to propose a case defi nition and classifi cation for occupational semicircular lipoatrophy (OSL) and to summarize the results of the cases examined through the Asepeyo insurance company in Cataluña. Methods: 153 workers with suspected semicircular lipoatrophy were examined using a standardized protocol. Results for 148 consecutive cases, from 27 different companies, are described. The evaluations were conducted between April and September of 2007. Results: Most cases with semicircular lipoatrophy were women (94%), with a similar age range for both sexes, between 31 and 41 years (46%); normal body mass index (69%); lesions appearing on the thighs (96%); in jobs with administrative or office-related tasks(97%); and with a high proportion (58%) of patients reporting leaning on their desks as a risk factor (58%). Additionally, increases inelectrostatic charge burden and decreases in ambient relative humidity were confirmed in 19 cases from six different companies. Conclusions: Surveillance of workers with semicircular lipoatrophy would benefit from specific protocols to allow identification of work-related cases. In this study, an association between the case and the working conditions was observed in approximately half of the cases. Even though the majority of the cases are suspected to be work-related, it has not been possible to confirm these, given the absence of objective measurements of the suspected occupational causes(AU)

Prevención y control de la tuberculosis en el medio laboral / Tuberculosis control and prevention in occupational settings

La exposición laboral al Mycobacterium Tuberculosis no es excepcional en la práctica clínica habitual en salud laboral, tanto en puestos de trabajo considerados de alto riesgo (por ejemplo, sanitarios) como en situaciones casuales en las que se produce un contagio entre el colectivo laboral de cualquier empresa. A continuación se describen, desde el punto de vista de la medicina del trabajo, las estrategias oportunas para el abordaje de ambas situaciones y la correcta toma de decisiones. Se destaca la importancia de pensar en la tuberculosis como patología posible en un trabajador sintomático respiratorio detectado durante la vigilancia medica periódica

Occupational exposure to Mycobacterium tuberculosis is not an unusual circumstance in the clinical practice of occupational health, both in workers in high-risk occupational settings (e.g., healthcare workers) as well as in situations where an exposure affects the workforce of any company. We describe, from an occupational medicine perspective, recommended strategies for the management of both situations, including indications for appropriate decision-making. The importance of thinking about tuberculosis in a worker with respiratory symptomatology, detected during medical surveillance, is emphasized