Isocyanate-induced asthma in a car factory.

In a car factory employing 203 women machinists making seat covers more women complained of respiratory symptoms after the introduction of a new seat cover fabric, cropped nylon backed with flame-bonded polyurethane foam (CNPF). 68 women working in the trim shop were studied on the first day back at work after a week's holiday and then at the end of a working week; the incidence of wheezing and/or shortness of breath was greater than expected but there was no difference between peak flow rates. A second study of 192 of the 203 women working in the trim shop confirmed this recent increase in incidence of asthmatic symptoms and showed that significantly more machinists who had worked with this new fabric had a reduced peak flow rate than machinists who had not. Asthma developed in one subject when she was working in the factory sewing CNPF, when she was handling this fabric in the challenge cabinet in the laboratory, and on challenge with toluene di-isocyanate in the laboratory. Airways resistance increased in 3 other workers after exposure to CNPF in the laboratory. Low concentrations (between 0.0003 to 0.003 ppm) of toluene di-isocyanate were found in the air around this fabric. 4 of 9 women with symptoms had IgE antibodies to toluene di-isocyanate.

Characteristics of hospitalized tuberculous patients today.

The characteristics of 149 patients with tuberculosis consecutively discharged from the Tuberculosis Service of the University of Tennessee Hospital in 1975 and 1976 were evaluated. The results of this study indicate the presence in this group of advanced age, alcohol abuse, debility from multiple chronic diseases, drug resistance, and recalcitrance. Despite the unfavorable circumstances surrounding these patients, 118 patients showed bacteriologic and/or roentgenographic evidence of improvement during an average of two to four months of hospitalization. We are not advocating the reversal of the present trend toward brief hospitalization and ambulatory care for the majority of tuberculous patients. However, as a result of this study, we believe hard-core patients of the type described in this paper require significant hospitalization for proper management.

Ambulatory electrocardiography in car workers.

A previous study in a car assembly plant showed that production-line workers had a lower incidence rate of heart attacks than executive staff. In the present study some major coronary risk factors and 24-hour ambulatory electrocardiograms were investigated in two age-matched samples of 30 middle-aged men drawn from these occupations. Men with a known history of heart disease were excluded. Compared with production-line workers, executive staff on average had a higher diastolic blood pressure (P less than 0.05) and fewer took heavy exercise during their leisure time (P less than 0.05). Ventricular premature beats (VPB was also similar for each of the periods of work, leisure and sleep. Apart from isolated ectopic beats, disturbances of rhythm were uncommon, and neither VPB nor other arrhythmias appeared to be induced by occupational factors.

Relationship between lymphocyte response to tetanus toxoid and age of lymphocyte donor.

An investigation of the in vitro responsiveness of peripheral blood lymphocytes to tetanus toxoid was undertaken to determine the extent to which such reactivity might reflect in vivo reactions to tetanus toxoid immunization. It was found that lymphocyte transformation in the presence of tetanus toxoid, as measured by the uptake of tritiated thymidine, did not differ significantly for the group giving local or systemic reactions to tetanus toxoid and an immune control group. However, a striking inverse relation between lymphocyte reactivity to tetanus toxoid and age of the cell donors of both groups became clear. Such an age-related decline in the in vitro responsiveness of peripheral blood lymphocytes to a specific antigen has apparently had not been reported previously in man.

A clinical trial of WRL 105 strain live attenuated influenza vaccine comparing four methods of intranasal vaccination.

A single intranasal dose of 10(7-0) EID50 recombinant WRL 105 strain live attenuated influenza vaccine was administered intranasally to 193 volunteers either as nose drops or by one of three spray devices which produced sprays of differing physical characteristics. In volunteers with homologous haemagglutinating inhibiting antibody titres of less than or equal to 20 before vaccination, seroconversion rates varied widely from 80% following the administration of drops to 71%, 57% and 28% with the three spray devices. In the week following vaccination 16 (22%) of 74 volunteers who were found to show a fourfold or greater antibody response to took analgesics to control symptoms in comparison with 4 (7%) of 58 volunteers who exhibited no serological response to vaccination (P less than 0-05). However, neither the occurrence of upper respiratory nor systemic symptoms were significantly different in these two groups and the degree of attenuation of the recombinant WRL 105 strain appears to be acceptable for future use.

Myocardial infarction in car assembly workers.

The incidence of myocardial infarction and the return to work for survivors were studied among the employees of an English car assembly plant by analysing 12 811 medical records of persons employed during the seven years between January 1966 and December 1972. The standardized morbidity ratio of myocardial infarction found in this study calculated on the basis of incidence rates reported by Kinlen )1973) for the Oxford community in which the factory was situated was 90. The standardized morbidity ratio from production line workers only was 66 and that for the monthly paid staff 272. Of the production line workers who survived the attack 22 (90%) returned to their previous jobs without undue difficulty and with two exceptions within four months of the onset of their illness; there was no relation between length of absence and age at the time of attack. These findings suggest that workers in mass production jobs such as car assembly are not special risk from myocardial infarction, and most of those who survive a heart attack are able to return to their former work. Taken with Kinlen's (1973) study and that of Armstrong et al. (1972) in Edinburgh, they also bear out mortality data by indicating that in Oxfordshire the incidence of coronary heart disease is lower than the British average.

A clinical trial of WRL 105 strain live attenuated influenza vaccine comparing four methods of intranasal vaccination.

A single intranasal dose of 10(7.0)EID50 recombinant WRL 105 strain live attenuated influenza vaccine was administered intranasally to 193 volunteers either as nose drops or by one of three spray devices which produced sprays of differing physical characteristics. In volunteers with homologous hemagglutinating inhibiting antibody titres of less than or equal to 20 before vaccination, seroconversion rates varied widely from 80% following the administration of drops to 71%, 57% and 28% with each of the spray devices. In the week following vaccination 16 (22%) of 74 volunteers who were found to show a fourfold or greater antibody response took analgesics to control symptoms in comparison with 4 (7%) of 58 volunteers who exhibited no serological response to vaccination (p less than 0.05). However, neither of the occurrence of upper respiratory nor systemic symptoms were significantly different in these two groups and the level of attenuation of the recombinant WRL 105 strain appears to be acceptable for future use.

Reactions to tetanus toxoid.

In a factory population the occurrence of reactions to tetanus toxoid was recorded after 6740 injections. The incidence of general reactions was 0.3% and of local reactions 2.6%. The local reaction rate to the first injection of the basic immunization course was 0.9%, to the second injection 2.7%, and to the third injection 7.4%. To booster injections the rate was 1.6%. The local reaction rate was appreciably higher in women than in men - 14.4% and 5.7% respectively in the case of the third injection - and the incidence among women increased with age.Tetanus vaccine containing 10 Lf of toxoid caused fewer reactions than one containing 20 Lf, but a reduction in the content of aluminium adjuvant did not affect the reaction rate.Almost all reactors were found to have a satisfactory serum antitoxin concentration at the time of the reaction or developed a satisfactory immunity within 1-6 months.Skin tests were made in 32 hypersensitive patients. Neither the diluent, thiomersal preservative, nor the culture medium appeared to be responsible for hypersensitivity. The degree of hypersensitivity elicited by a special highly purified toxoid was only very slightly less than that elicited by the commercially pure toxoid. It is suggested that reactions are largely due to the toxoid antigen itself rather than to impurities or other components of the vaccine.

Reacciones adversas a la anatoxina tetánica: Causas y tratamiento / Adverse reactions to tetanus toxoid: causes and treatment

Se presentan los resultados preliminares del análisis de las tasas de reacción a la anatoxina tetánca, teniendo en cuenta diversos factores, y se hacen observaciones sobre las vías de aplicación (intramuscular y subcutánea), la posible conveniencia del empleo de material menos potente y la aparente inmunidad más duradera de la anatoxina adsorbida en comparación con la anatoxina simple