Airborne Agents Research Articles

Association between exposure to external airborne agents and autoimmune disease

The etiology of autoimmune disease pathogeneses remains obscure, and the impact of general environmental or occupational exposure to external airborne agents (EAA) on autoimmune diseases remains understudied. This study was conducted to elucidate the association between exposure to EAA and the risk of autoimmune diseases according to exposure type. From the NHIS-NSC (2002–2019), 17,984,963 person-years were included in the data analysis. Autoimmune diseases were categorized based on the InterLymph classification. We estimated the incidence and rate ratio of autoimmune diseases according to the EAA exposure. Association between exposure and autoimmune diseases was investigated using logistic regression analysis, adjusted for potential confounders. Of the 1,082,879 participants, 86,376 (8.0%) were diagnosed with autoimmune diseases. Among these, 208 (14.1%) experienced severe exposure to EAA. Total EAA exposure was significantly associated with any autoimmune disease (OR: 1.29, 95% CI: 1.11–1.49) and organ-specific diseases (OR: 1.28, 95% CI: 1.08–1.53). Inorganic dust exposure was associated with organ-specific diseases (OR, 1.38; 95% CI: 1.01–1.81). Exposure to other dust was significantly associated with any autoimmune disease (OR: 1.35, 95% CI: 1.10–1.66), connective tissue diseases (OR: 1.43, 95% CI: 1.03–1.99), and organ-specific diseases (OR: 1.28, 95% CI: 1.00–1.65). Exposure to EAA was predominantly related to psoriasis, rheumatoid arthritis (RA), and type 1 diabetes (T1DM). We found that exposure to EAA is a potential risk factor for autoimmune diseases, especially psoriasis, RA, and T1DM. Our findings provide insight into the role of exposure to severe airborne agents in the pathogenesis of autoimmune diseases.

Associations between an international COVID-19 job exposure matrix and SARS-CoV-2 infection among 2 million workers in Denmark.

This study investigates the associations between the Danish version of a job exposure matrix for COVID-19 (COVID-19-JEM) and Danish register-based SARS-CoV-2 infection information across three waves of the pandemic. The COVID-19-JEM consists of four dimensions on transmission: two on mitigation measures, and two on precarious work characteristics. The study comprised 2 021 309 persons from the Danish working population between 26 February 2020 and 15 December 2021. Logistic regression models were applied to assess the associations between the JEM dimensions and overall score and SARS-CoV-2 infection across three infection waves, with peaks in March-April 2020, December-January 2021, and February-March 2022. Sex, age, household income, country of birth, wave, residential region and during wave 3 vaccination status were accounted for. Higher risk scores within the transmission and mitigation dimensions and the overall JEM score resulted in higher odds ratios (OR) of a SARS-CoV-2 infection. OR attenuated across the three waves with ranges of 1.08-5.09 in wave 1, 1.06-1.60 in wave 2, and 1.05-1.45 in those not (fully) vaccinated in wave 3. In wave 3, no associations were found for those fully vaccinated. In all waves, the two precarious work dimensions showed weaker or inversed associations. The COVID-19-JEM is a promising tool for assessing occupational exposure to SARS-CoV-2 and other airborne infectious agents that mainly spread between people who are in close contact with each other. However, its usefulness depends on applied restrictions and the vaccination status in the population of interest.

COVID-19 and beyond: Reassessing the role of thymosin alpha1 in lung infections.

The recent COVID-19 pandemic has catalyzed the attention of the scientific community to the long-standing issue of lower respiratory tract infections. The myriad of airborne bacterial, viral and fungal agents to which humans are constantly exposed represents a constant threat to susceptible individuals and bears the potential to reach a catastrophic scale when the ease of inter-individual transmission couples with a severe pathogenicity. While we might be past the threat of COVID-19, the risk of future outbreaks of respiratory infections is tangible and argues for a comprehensive assessment of the pathogenic mechanisms shared by airborne pathogens. On this regard, it is clear that the immune system play a major role in dictating the clinical course of the infection. A balanced immune response is required not only to disarm the pathogens, but also to prevent collateral tissue damage, thus moving at the interface between resistance to infection and tolerance. Thymosin alpha1 (Tα1), an endogenous thymic peptide, is increasingly being recognized for its ability to work as an immunoregulatory molecule able to balance a derailed immune response, working as immune stimulatory or immune suppressive in a context-dependent manner. In this review, we will take advantage from the recent work on the COVID-19 pandemic to reassess the role of Tα1 as a potential therapeutic molecule in lung infections caused by either defective or exaggerated immune responses. The elucidation of the immune regulatory mechanisms of Tα1 might open a new window of opportunity for the clinical translation of this enigmatic molecule and a potential new weapon in our arsenal against lung infections.

Pioneers in Dermatology and Venereology: An Interview with Professor An Goossens.

Following my education as a pharmacist at KU Leuven, I obtained a ‘Certificate of Cosmetopharmacy at Nantes University’ (France), which included a course in Dermatology given by very inspiring teachers H. Barrière and P. Litoux. Back in Belgium, I spent 4 months in the department of Dermatology in Leuven with Prof. H. Degreef, after which I had the opportunity to spend 9 months in Prof. A.A. Fisher's office in NY to specialize in contact allergy. Prof. A.A. Fisher from New York University and Professor S. Fregert from Lund University, Sweden. Professors A.A. Fisher and H. Degreef. Dooms-Goossens A et al. Computer-assisted monitoring of contact dermatitis. Contact Dermatitis 1980; 6: 123–7. Dooms-Goossens A et al. Contact dermatitis caused by airborne agents. A review and case reports. J Am Acad. Dermatol. 1986; 15: 1–10. Coopman S, Degreef H, Dooms-Goossens A. Identification of cross-reaction patterns in allergic contact dermatitis from topical corticosteroids. Br J Dermatol 1989; 121: 27–34. Lepoittevin JP, Drieghe J, Dooms-Goossens A. Studies in patients with corticosteroid contact allergy. Understanding cross-reactivity among different steroids. Arch Dermatol. 1995; 131: 31–7. Gilissen L, Goossens A. Frequency and trends of contact allergy to and iatrogenic contact dermatitis caused by topical drugs over a 25-year period; Contact allergy to Contact Dermatitis 2016; 75: 290–302. President of the European Society of Contact Dermatitis (ESCD) 2010–2012, of the European Environmental Contact Dermatitis Research Group (EECDRG) 1999–2002, and the Belgian Contact Dermatitis Group (BCEDG) 1993–1996, and 2004–2007. Being a pharmacist working as a scientific researcher and head of the Contact-allergy unit at the University dermatological department KU Leuven, having trained hundreds of dermatological residents in contact allergy, both nationally and internationally. None. Meeting so many kind colleagues and friends worldwide sharing the same interest. A.A. Fisher. Arts, music, learning languages, sports and cooking. All the good ones… Far too much interest in cosmetic dermatology, hence, shortage of interest in dermatological diseases, including contact dermatitis. Further research in biologics. Be involved with the patients! *Note: The Pioneers in Dermatology and Venereology interview was conceived and conducted by Johannes Ring. None Declared. The authors have no conflict of interest to declare.

The Impact of Heating, Ventilation, and Air-Conditioning Design Features on the Transmission of Viruses, Including SARS-CoV-2: Overview of Reviews.

The COVID-19 or SARS-CoV-2 outbreak was declared a pandemic by the World Health Organization in March 2020. Almost 2 years later (early February 2022), the World Health Organization reported over 383 million cases of the disease caused by the virus, with over 5.6 million deaths worldwide. Debate regarding the routes of transmission was substantial early in the pandemic; however, airborne transmission emerged as an important consideration. Infectious airborne agents can spread within the built environment through heating, ventilation, and air-conditioning (HVAC) systems. Multiple features of HVAC systems can influence transmission (eg, ventilation, filtration, UV radiation, and humidity). Understanding how HVAC features influence airborne transmission is critical to mitigate the spread of infectious agents. Given the airborne transmission of SARS-CoV-2, an overview of reviews was conducted to understand what is already known from the scientific literature about how virus transmission may be affected by HVAC design features in the built environment. Ovid MEDLINE and Compendex were searched from inception to January 2021. Two reviewers independently screened the titles, abstracts, and full text of potentially relevant reviews, using a priori inclusion criteria: systematic reviews examining the effects of HVAC design features on virus transmission. Two reviewers independently assessed the methodological quality using AMSTAR2. Searching identified 361 citations, of which 45 (12.5%) were potentially relevant and 7 (2%) were included. Reviews were published between 2007 and 2021 and included 47 virus studies. Two earlier reviews (2007 and 2016) of 21 studies found sufficient evidence that mechanical ventilation (airflow patterns and ventilation rates) plays a role in airborne transmission; however, both found insufficient evidence to quantify the minimum mechanical ventilation requirements. One review (2017) of 9 studies examining humidity and indoor air quality found that influenza virus survival was lowest between 40% and 80% relative humidity; the authors noted that ventilation rates were a confounding variable. Two reviews (2021) examined mitigation strategies for coronavirus transmission, finding that transmission decreased with increasing temperature and relative humidity. One review (2020) identified 14 studies examining coronavirus transmission in air-conditioning systems, finding that HVAC systems played a role in virus spread during previous coronavirus outbreaks. One review (2020) examined virus transmission interventions in public ground transportation, finding ventilation and filtration to be effective. Seven reviews synthesizing 47 studies demonstrated a role for HVAC in mitigating airborne virus transmission. Ventilation, humidity, temperature, and filtration can play a role in the viability and transmission of viruses, including coronaviruses. Recommendations for minimum standards were not possible owing to few studies investigating a given HVAC parameter. This overview examining HVAC design features and their effects on the airborne transmission of viruses serves as a starting point for future systematic reviews and identifying priorities for primary research.

Establishment and characterization of the immortalized porcine lung-derived mononuclear phagocyte cell line.

Mononuclear phagocytes (MNP), including monocytes, dendritic cells (DC), and macrophages, play critical roles in innate immunity. MNP are abundant in the lungs and contribute to host defense against airborne agents and pulmonary immune homeostasis. In this study, we isolated porcine lung-derived MNP (PLuM) from primary cultures of parenchymal lung cells and then immortalized them by transferring the SV40 large T antigen gene and porcine telomerase reverse transcriptase gene using lentiviral vectors. The established cell line, immortalized PLuM (IPLuM), expressed DC/macrophage markers; i.e., CD163, CD172a, and major histocompatibility complex class II, whereas they did not express a porcine monocyte-specific marker, CD52. The expression patterns of these cell surface markers indicate that IPLuM originate from the DC/macrophage lineage rather than the monocyte lineage. The bacterial cell wall components muramyl dipeptide and lipopolysaccharide induced the production of the interleukin-1 family of pro-inflammatory cytokines in IPLuM. Phagocytotic activity was also detected by time-lapse fluorescence imaging of live cells when IPLuM were cultured in the presence of pHrodo dye-conjugated E. coli BioParticles. It is worth noting that IPLuM are susceptible to African swine fever virus infection and support the virus' efficient replication in vitro. Taken together, the IPLuM cell line may be a useful model for investigating host-agent interactions in the respiratory microenvironments of the porcine lung.

Increased CO2 levels in the operating room correlate with the number of healthcare workers present: an imperative for intentional crowd control

The air in an operating room becomes more contaminated as the occupancy of the room increases. Individuals residing in a room can potentially emit infectious agents. In order to inhibit and better understand the epidemiology of surgical site infections, it is important to develop procedures to track room occupancy level and respiration. Exhaled CO2 provides a respiratory byproduct that can be tracked with IR light and is associated with human occupancy. Exhaled CO2 can also be used as an indirect measure of the potential release and level of infectious airborne agents. We show that non-dispersive infrared CO2 sensors can be used to detect CO2 in operating room air flow conditions of 20 air changes per hour and a positive pressure of 0.03 in. H2O. The CO2 concentration increased consecutively for occupation levels of one to four individuals, from approximately 65 ppm above the background level when one individual occupied the operating room for twenty minutes to approximately 300 ppm above the background when four individuals were present for twenty minutes. The amount of CO2 detected increases as the number of occupants increase, the activity level increases, the residency time increases and when the ventilation level is reduced.

3D modelling and simulation of the dispersion of droplets and drops carrying the SARS-CoV-2 virus in a railway transport coach

Computational fluid dynamics (CFD) modelling and 3D simulations of the air flow and dispersion of droplets or drops in semi-confined ventilated spaces have found topical applications with the unfortunate development of the Covid-19 pandemic. As an illustration of this scenario, we have considered the specific situation of a railroad coach containing a seated passenger infected with the SARS-CoV-2 virus (and not wearing a face mask) who, by breathing and coughing, releases droplets and drops that contain the virus and that present aerodynamic diameters between 1 and 1000 µm. The air flow is generated by the ventilation in the rail coach. While essentially 3D, the flow is directed from the bottom to the top of the carriage and comprises large to small eddies visualised by means of streamlines. The space and time distribution of the droplets and drops is computed using both an Eulerian model and a Lagrangian model. The results of the two modelling approaches are fully consistent and clearly illustrate the different behaviours of the drops, which fall down close to the infected passenger, and the droplets, which are carried along with the air flow and invade a large portion of the rail coach. This outcome is physically sound and demonstrates the relevance of CFD for simulating the transport and dispersion of droplets and drops with any diameter in enclosed ventilated spaces. As coughing produces drops and breathing produces droplets, both modes of transmission of the SARS-CoV-2 virus in human secretions have been accounted for in our 3D numerical study. Beyond the specific, practical application of the rail coach, this study offers a much broader scope by demonstrating the feasibility and usefulness of 3D numerical simulations based on CFD. As a matter of fact, the same computational approach that has been implemented in our study can be applied to a huge variety of ventilated indoor environments such as restaurants, performance halls, classrooms and open-plan offices in order to evaluate if their occupation could be critical with respect to the transmission of the SARS-CoV-2 virus or to other airborne respiratory infectious agents, thereby enabling relevant recommendations to be made.

Occupational exposure influences control of disease in patients with chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) is a frequent condition that is treated by endoscopic sinus surgery (ESS) when medical treatment fails. Irritating or sensitizing airborne agents can contribute to uncontrolled CRS. A prior study showed a linear correlation between occupational exposure and the number of ESS. In this cross-sectional study we tested the hypothesis that occupational exposure is a risk for undergoing ESS. We sent questionnaires enquiring occupational exposure in patients with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). An expert assessed blindly the reported work exposures to inhaled agents. The relationship between occupational exposure on undergoing ESS was analysed. Among all patients who underwent ESS (n=343), 30% reported a relevant occupational exposure, which is significantly higher than the 4.8% found among CRS patients that underwent no prior sinus surgery (n=21). Besides occupational exposure, self-reported doctor-diagnosed asthma were independent variables contributing to the chance of undergoing ESS. In our study we confirm occupational exposure as a risk factor for uncontrolled CRS, if defined by undergoing ESS. In CRS patients with uncontrolled symptoms, despite maximal conservative therapy, the clinician should explore the possible contribution of occupational exposure.

Barrier resuscitation by lay rescuers during COVID-19 pandemic

Aerosols generated from chest compressions and ventilation attempts in patients with cardiac arrest may cause airborne infections. Accordingly, the interim international resuscitation guidelines have restricted basic life support by lay rescuers to compression only and the use of an automated external defibrillator during the COVID-19 pandemic. Although these measures may diminish the risk of infection for laypersons, the missing respiratory support can be detrimental for patients with hypoxia-related cardiac arrest. To overcome this shortcoming we want to introduce a special tool that allows ventilation during barrier resuscitation by laypersons. We hypothesize that the application of a device made of a polyvinyl chloride shield with a centrally installed S-shaped ventilation pipe with integrated filter can provide adequate ventilation while concurrently protecting patient and rescuer from airborne agents. Aerosols from air leakage are removed by adhesion and drainage below the barrier. No specific training other than basic life support is needed. We suggest that a tool of this kind be considered essential equipment and stored together with disposable gloves in public access locations.

Epidemiology of Kawasaki Disease in Europe.

Aim of the review: To review major epidemiological aspects of Kawasaki disease (KD) in Europe, describing demographic characteristics, revising its incidence along with time trends and geographic variations, and describing migration studies to provide clues about its etiology.Recent findings: The annual incidence of KD in Europe is about 10–15 per 100,000 children under 5 years old and seems to be relatively stable over time and space. Demographic characteristics are in line with those in other countries of the world, with a higher incidence in children from Asia and possibly North African origin. All studies performed across Europe found a coherent seasonal distribution of KD onset peaking from winter to early spring. This seasonal distribution was consistent over the years and suggests a climate-related environmental trigger. The occurrence of peaks during pandemics, microbiological findings and a possible link with southerly winds support the hypothesis of an airborne infectious agent. Neither other airborne agents such as pollutants or pollens nor urbanization and industrialization seem to have major effect on the etiology.Conclusion: Discrepancies in KD incidence rates across studies were due more to methodological differences, variation in definitions and awareness of the disease than a real increase in incidence. Genetic predisposition is undeniable in KD, but environmental factors seem to play a pivotal role. Several lines of evidence support a non-exclusive airborne infectious agent with a protective immune response by the host as a key factor in inducing the inflammatory cascade responsible for symptoms and complications.

Quantification of long-term accumulation of inhaled ultrafine particles via human olfactory-brain pathway due to environmental emissions – a pilot study

Olfactory pathway as a viable route for brain uptake of environmental pollutants has been hypothesized in past decade. In such a hypothesis, subclinical low-dose exposure and chronic brain accumulation of exogenous airborne agents are critical to define neurodegenerations, however the information is extremely lacking. Advances in granular measurement of air pollutants, real-time personal exposure monitoring and big data analytics have opened-up an unprecedented opportunity to enable researchers conduct longitudinal investigation and potentially link the external environment condition to risks of human developing neurodegenerative diseases in a foreseeable future. Detailed case studies are provided in this work that illustrate the quantification of human brain accumulation of ultrafine particles (UFPs) from exposure, surface deposition, and pathway penetration via the transport route of nasal olfactory in prolonged timespans. The study links the individual components along the olfactory pathway, showcases the available research capacity, and pinpoints the critical areas of research need in environmental, toxicological and epidemiological studies, significant to a joint effort to bring together an interdisciplinary solution to uncover the insight of time course and dose dependency between environmental exposure and risk of developing neurodegenerative diseases in a foreseeable future. It should be noted that current study assumes that nanoparticle penetration along the olfactory pathway is unidirectional and follows the rate observed in the rodent study. Tissue responses in determining the penetration and retention corresponding to size and composition of the inhaled nanoparticles are not considered.

Microbial Contamination and Antimicrobial Resistance Profiles Indicate Potential Risks of Infection at the Veterinary Medical Teaching Hospital - UFRGS, Porto Alegre, Brazil

Background: This study aimed to assess the level of bacterial contamination in the Small Animals Sector of the Veterinary Medical Teaching Hospital (HCV) of the Universidade Federal do Rio Grande do Sul (UFRGS). Firstly, a committee was invited to complete a questionnaire and to list critical sample sites for collection. With the identification of the places to be sampled, collections were made with sterile swabs on different surfaces of environments of the Veterinary Hospital. The identification of important bacteria in the veterinary area, in the different sampled environments, raises the concern for hygiene procedures in the veterinary hospital environment.Materials, Methods & Results: Sixteen samples were collected from these different areas, and microbiological analyses were performed. Standard counts of viable and strictly aerobic mesophilic microorganisms were realized. Collections were made to assess ambient air quality. With the microbiological analysis performed, bacteria of clinical importance were identified. To assess the resistance profile of the bacteria, the susceptibility test to antimicrobials was performed. MALDI-TOF/MS measurement identified 29 bacteria at the genus level and 10 bacteria at the species level and the antimicrobial susceptibility test was realized. Most of the isolates identified (60%) were bacteria of the genus Staphylococcus spp. Regarding antimicrobial susceptibility analysis the 10 bacteria identified at the species level were assessed. Test results showed that the isolates S. aureus, S. epidermidis and S. haemolyticus - collected from treatment room 2 - and S. haemolyticus, which had been isolated from samples from treatment room 2 of the cattery, presented multiresistance. Pantoea ananatis isolates from room 5 also showed a multiresistant profile for erythromycin, cephalothin, vancomycin and ampicillin. Micrococcus luteus isolates from the x-ray room and the kennel showed resistance to ceftazidime. Staphylococcus equorum isolates from room 4 were sensitive to all tested antimicrobials. Discussion: In Brazilian legislation there are no official microbiological parameters for surfaces in a veterinary hospital environment. The microorganisms present in the air are transient and variable, and the number and types of airborne agents is determined by the various sources of contamination in the environment. These microorganisms can be found in suspension, particulate matter and water droplets. Veterinary medical care tables are potentially contaminated by the animals handling, including those that sometimes defecate or urinate during their medical visit. Frequent handwashing is also known to be an important means of personal protection and disease prevention, although it is estimated that only 40% of practitioners do so routinely. Based on these results, we recommend a plan of bacterial control and disinfection that should be implemented to ensure more effective sanitary conditions. Microorganism counts were high in some of the veterinary hospital environments tested, indicating that current disinfection and hygiene practices are not sufficient to control the establishment of these microorganisms at the study sites. In view of this, it is reasonable to conclude that permanent monitoring and assessment of the effectiveness of hygiene protocols is needed in different sectors of the hospital. This may be an essential tool in a preventive approach to stop the spread of selectively resistant microorganisms, as well as cases of hospital infections. In addition, continuous staff training and awareness of the importance of personal and environmental hygiene is vital for minimizing the presence of these microorganisms in hospitals and avoid their transmission to patients. Finally, a more systematic hygiene guideline should be implemented in areas that showed higher counts.

Effect of Severe External Airborne Agents' Exposure on Dementia.

The impact of occupational and environmental exposure to external airborne agents on cognitive function, especially in incidence of dementia, is understudied. The present study was conducted to elucidate the association between severe external airborne agents’ exposure and incidence of dementia among an elderly population and to explore the effects of exposure to severe external airborne agents on preclinical dementia using the screening test of dementia. From the National Health Insurance Service-Health Screening Cohort (NHIS-HealS, 2002–2015), 514,580 participants were used for data analysis. We estimated the standardized incidence ratio (SIR) according to the exposure to external airborne agents. Of the total participants (n = 514,580), 1340 (0.3%) experienced severe external airborne agents exposure, and 26,050 (5.1%) had been diagnosed with dementia. The SIRs (95%CI) of dementia in Alzheimer’s disease, vascular dementia, dementia in other diseases, and unspecific dementia were 1.24 (1.01–1.49), 0.88 (0.37–1.32), 1.16 (0.01–2.77), and 0.69 (0.36–1.02), respectively. The risk of testing positive in the dementia screening significantly increased with exposure to severe external airborne agents after adjusting for all confounding variables. This study found that exposure to severe external airborne agents is a potential risk factor for dementia, especially in Alzheimer’s disease. It is essential to create international awareness regarding the effect of airborne agents’ exposure on dementia.

The central role of the nasal microenvironment in the transmission, modulation, and clinical progression of SARS-CoV-2 infection.

The novel coronavirus SARS-CoV-2 enters into the human body mainly through the ACE2 + TMPRSS2+ nasal epithelial cells. The initial host response to this pathogen occurs in a peculiar immune microenvironment that, starting from the Nasopharynx-Associated Lymphoid Tissue (NALT) system, is the product of a long evolutionary process that is aimed to first recognize exogenous airborne agents. In the present work, we want to critically review the latest molecular and cellular findings on the mucosal response to SARS-CoV-2 in the nasal cavity and in NALT, and to analyze its impact in the subsequent course of COVID-19. Finally, we want to explore the possibility that the regulation of the systemic inflammatory network against the virus can be modulated starting from the initial phases of the nasal and nasopharyngeal response and this may have several clinical and epidemiological implications starting from a mucosal vaccine development.

Catching and killing of airborne SARS-CoV-2 to control spread of COVID-19 by a heated air disinfection system

Airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via air-conditioning systems poses a significant threat for the continued escalation of the current coronavirus disease (COVID-19) pandemic. Considering that SARS-CoV-2 cannot tolerate temperatures above 70 °C, here we designed and fabricated efficient filters based on heated nickel (Ni) foam to catch and kill SARS-CoV-2. Virus test results revealed that 99.8% of the aerosolized SARS-CoV-2 was caught and killed by a single pass through a novel Ni-foam–based filter when heated up to 200 °C. In addition, the same filter was also used to catch and kill 99.9% of Bacillus anthracis, an airborne spore. This study paves the way for preventing transmission of SARS-CoV-2 and other highly infectious airborne agents in closed environments.

External Airborne-agent Exposure Increase Risk of Digestive Tract Cancer

Previous studies have suggested that in addition to respiratory system cancers, exposure to external airborne agents (EAAs) may also affect the risk of digestive tract cancer. However, previous epidemiological studies have been limited. To clarify this relationship, we conducted a Workers’ Korea National Health Insurance Service cohort study. The EAA exposure group comprised participants who had ever visited a hospital as an inpatient for ‘lung diseases due to external agents’. The reference population comprised men from the general working population. The EAA exposure group and reference group included a total of 98,666 and 79,959,286 person-years, respectively. Age-adjusted standardized incident rates (SIRs) with 95% confidence intervals (95%CI) were calculated for each 5-year age stratum. The SIR (95% CI) of EAA exposure was 1.30 (1.19–1.38) for all digestive tract cancers. The highest risk associated with EAA exposure was observed for oral cancer, followed by esophageal and stomach cancers [SIRs (95%CI): 3.96 (3.02–4.78), 3.47(2.60–4.25), and 1.34(1.17–1.47), respectively.] These statistically significant associations did not be attenuated in a subgroup analysis using logistic regression adjusted for age, smoking and alcohol consumption. Our findings suggest that EAA exposure should address risk reduction of both digestive tract and respiratory system cancers.

Association of respiratory morbidity with duration of work among puffed rice workers in Davanagere city, Karnataka, India

Background: Occupational respiratory disease can be defined as an acute or chronic disorder that arises from the inhalation of air-borne agents in the work place. Puffed rice is a famous food item in Karnataka, which is produced in a cluster of small units. Industrial dust inhalation over a long period of time leads to proliferative and fibrotic changes in the lungs.Methods: A cross sectional study was conducted among puffed rice workers in Bashanagar, urban field practice area of SSIMS and RC, Davanagere. From January 2017 to December 2017. The study population included 550 puffed rice unit workers. Data was collected using structured interview along with anthropometric measurements. Spirometry was done by using RMS (Helio’s) Spirometer.Results: In this study significant association was found between respiratory morbidity and duration of work. The risk of obstructive lung disease was 0.18 (0.03-1.40) times less among workers who worked for <5 years compared to workers who worked for more than 20 years. The risk of restrictive lung disease was 0.35 (CI 0.16-0.77) times lower among workers who worked for <5 years compared to the workers who worked for > 20 years and the association was statistically significant with p value of 0.010.Conclusions: The risk of respiratory morbidity was significantly associated with increase in the duration of work.

Airborne mycotoxins in waste recycling and recovery facilities: Occupational exposure and health risk assessment

Mycotoxins are metabolites secreted by certain types of moulds, and some of them can be harmful to health. The objective of this study was to estimate the level of exposure to airborne aflatoxin B1, ochratoxin A, gliotoxin and sterigmatocystin in waste recycling and recovery facilities. An additional goal was to assess the related health risks for workers. Targeted mycotoxins were analysed quantitatively in 94 air samples collected in five sites using ultra-performance liquid chromatography coupled with high resolution mass spectrometry. The level of exposure to mycotoxin during working day scenarios was compared to benchmark values, either health-based guidelines when available or the concentration of no toxicological concern (CoNTC) when not. Eleven per cent of samples showed quantifiable measurement results. Aflatoxin B1 and sterigmatocystin were quantified at the mechanical separation area in mechanical–biological treatment (MBT) facilities and in the materials recovery facility (MRF), but not in composting plants and composting units in MBT facilities. The levels of exposure were all below 1 ng m−3. This is the first time exposure to sterigmatocystin in waste management facilities is reported and quantified. Ochratoxin A and gliotoxin were not quantified in any of the air samples. Health risk assessment approaches did not suggest a significant threat to workers’ health. These data do not suggest the need for specific prevention measures in addition to those against other airborne biological agents.

Environmental Factors and Kawasaki Disease Onset in Emilia-Romagna, Italy.

Kawasaki disease (KD)is an idiopathic acute febrile illness that primarily occurs in children <5 years of age and can lead to artery lesions if not promptly treated. Recent studies have shown possible correlations between KD onset and currents and air pollutants.The present study describes results on the correlation between environmental conditions, frequency, and variability ofKD onset in children under five years of age in Emilia-Romagna, a region of Northern Italy, over the period from 2000 to 2017. Since there are substantial climatic differences between the western-central (Emilia) and the eastern area (Romagna) of the region, the data for these areas are analyzed separately. The environmental factors considered are observed local surface daily temperature, daily precipitation, upper air wind regimes, and local air pollution. The results indicate that in Emilia-Romagna, KD onset occurs mainly during late autumn and early spring, which is in agreement with the literature. The frequency of KD onset in Emilia is significantly higher in months characterized by a high frequency of southerly flow, which is associated with milder than average night-time temperature, and in years with a prevailing south-westerly mean flow. These results are consistent with other studies, suggesting that certain wind conditions are more favorable for disease onset, which are possibly associated with one or more airborne agents.