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Biomedical subjects

A L Hartmann

Publications and source records attributed to A L Hartmann.

17 recordsLinked to original sources
PubMed2001

The "egg-egg" syndrome: occupational respiratory allergy to airborne egg proteins with consecutive ingestive egg allergy in the bakery and confectionery industry.

Allergies to various inhalative allergens are a serious problem in the bakery and confectionery industry. Sensitization to wheat flour and enzymes such as alpha-amylase are a frequent cause of occupational asthma. Airborne egg allergens have been reported as another cause of respiratory allergy. We examined bakery and confectionery workers with respiratory symptoms due to egg aerosols. Skin tests (SPT), scratch tests (ST), nasal provocation tests (NPT) and serological examinations (IgE) were performed. Lung function was assessed by spirometry, and continuous registration of aerosols and particulates as well as gravimetric sampling was done at the workplace. Four bakery and two confectionery workers intensively exposed to airborne egg proteins suffered from conjunctivitis and rhinitis, four also from asthma. Subsequently, three of these four workers reported symptoms after ingestion of food that contained egg. SPT with commercial egg white and egg yolk extracts were negative in four cases. Only two employees had clearly positive SPT to commercial egg allergens and reacted also to wheat flour extracts. Scratch tests with native egg proteins were positive in four employees. Specific IgE to egg white and egg yolk were positive (CAP > or = 2) in three and in four cases, respectively, whereas they were negative in two cases. Elevated levels of specific IgE to lysozyme were detected in four employees. Two workers were sensitized to lysozyme but not to other egg proteins. The clinical relevance of egg sensitization was confirmed by continuous air sampling and by correlating the onset of the respiratory symptoms which were reflected by a significant decline (> or = 30%) of the forced one second capacity (FEV1) in two workers. Sieving of egg white powder and an inadequate spray station for liquid eggs were identified as sources of excessive allergen exposure. Bakery and confectionery workers exposed to airborne egg proteins are at risk of developing occupational asthma and subsequent nutritive egg allergy. To our knowledge, these are the first cases of inhalative egg allergy and subsequent nutritive egg allergy reported in the literature, which we refer to as the "egg-egg syndrome" in analogy to the already known "bird-egg" and "egg-bird" syndromes.

Adult↗
PubMed1998

[Contribution of the Allergy Clinic to occupational asthma and allergic alveolitis].

Among the contributions of the Allergy Unit the following premier descriptions are to be mentioned particularly: humidifier fever, detergent enzymes, penicillium as cause of cheesewasher's asthma, rennet, wax moth, aureobasidium pullulans in cooling lubricant as cause of hypersensitivity pneumonitis in a hard metal grinder, pectinase, amylase, pepsin, indigenous bat, edible boletus. Starting with these and other occupational illnesses elucidated and described by the Allergy Unit, the importance of the exposure conditions for epidemiology, diagnosis, treatment and prevention is demonstrated. The risk indicator atopy has to be considered while selecting an occupation and a workplace, but should not be unjustly overestimated.

Allergy and Immunology↗
PubMed1994

Topographic organization in the anterior commissure of developing hamsters.

The present study has examined the existence of a topographic organization in the anterior commissure (AC) of developing hamsters. Fluorescent carbocyanine crystals (DiI and/or DiA) were implanted into different rostrocaudal and dorsoventral sectors of the paleocortex of hamsters ranging in age from E15 to P10 (E16 = P1 = date of birth). The cerebral hemispheres of each brain were cut horizontally and sagittally, respectively, and the sections were observed under a fluorescence microscope coupled to a computerized reconstruction system. A distinct topographic organization of AC fibers was observed along the rostrocaudal axis starting at E15, and continued unchanged thereafter. These results support the hypothesis that the orderly pattern of AC fibers is achieved by active positioning during the first days after crossing the midplane rather than by a regressive sculpting from an initially disorganized pattern.

Animals↗
PubMed1993

[Alcohol, occupational accidents and their sequelae].

Alcohol is a considerably more important risk factor for non occupational accidents than for occupational accidents, but somatic and psychosocial consequences of chronic alcohol consumption can also have very negative influences on the course of healing and professional rehabilitation. Three cases illustrate the importance of the primary and secondary prevention. They did charge the workers' compensation account of the companies involved with more than one million francs, with corresponding increases in workers' compensation premiums.

Accidents, Occupational↗
PubMed1993

Effects of a bronchoprovocation challenge test with cigarette sidestream smoke on sensitive and healthy adults.

In order to study the acute effects of environmental tobacco smoke on lung function, a cigarette sidestream smoke provocation test (analogous to a nonspecific bronchial provocation test) was performed. Ten persons with airways hyperreactive to methacholine and ten normoreactive persons were tested. A dose-response relationship was found for symptoms. The lung function of the normoreactive persons was not altered by short-time inhalation of sidestream smoke. The hyperreactive subjects, however, experienced significant decreases in FEV1, FVC, and MEF50. The decrease was most pronounced after the lowest dose of 2 ppm smoke-induced CO, leading to a mean fall of 6.3 percent in FEV1. Five of ten subjects with hyperreactive airways showed a decrease in FEV1 of more than 10 percent during the sidestream smoke provocation, one of them a decrease of over 20 percent after inhalation of 16 ppm CO sidestream smoke. We conclude that even short exposure to low concentrations of cigarette sidestream smoke causes significant impairment of lung function in sensitive persons.

Adult↗
PubMed1989

[Motivation of the employer for accident prevention and rehabilitation through risk-justified premiums].

The Swiss workers' compensation law prescribes experience rating. Successful efforts of an employer to reduce the risk of accidents through adequate preventive measures on one hand, and on the other hand to keep subsequent costs of still occurring accidents low with quick, consistent and generous measures of rehabilitation, will therefore result in a lower insurance rate. The motivating influence and success of this self-responsibility is pointed out with the figures of a trading company who had been detached from a large risk-community due to bad results. The success with accident prevention and the very favourable ratio achievable of costs for medical treatment (as a measure for the severity of the injuries) to daily payments and costs for permanent disabilities is shown with the example of a construction machinery company. What relations and consecutive costs result from (partly conscious) neglect of rehabilitation is demonstrated with the figures of a construction company.

Accidents, Occupational↗
PubMed1989

[Concept: occupational medicine 2000].

The group of physicians practising occupational medicine in Switzerland is actually still small, and it will need a very important development to reach, on a nation-wide base and not only within a few large companies, a standard of occupational medicine which satisfies from a social security as well as from an economical point of view. The occupational medicine has, therefore, to elucidate to the social partners and to the public the benefit for health and public welfare of its preventive activity at the workplace. The following goals are thus to be pursued: Further development of a legal basis in Switzerland equal to the standard of the neighbouring countries of the European Community Provision of sound models assuring occupational medical care of all business, in particular of the small and middle-sized business Promotion of student's education, specialist formation and continuative schooling in occupational medicine Provision of an adequate university teaching and research capacity with firm links to the practice A more powerful and competent representation of occupational medical aspects in actual discussions of health legislation and social legislation.

Forecasting↗
PubMed1989

[Respiratory allergies in bakers].

The intensity of flour dust exposure is decisive for the incidence and severity of respiratory allergies and asthma in bakers. The most severe conditions of chronic airways obstruction are observed amongst bakers who are allergic to flour and housedust mite. A considerable reduction of flour dust exposure can already be achieved with care while pouring the flour, while powdering with flour, while cleaning and by delegating dusty tasks, with covers -- especially a lid on the dough kneading machine -- and of course also by wearing a disposable mask. One should aim at additional technical dust control measures. If a satisfactory control of the disease is not achievable with the complementary inhalation of DNCG and if necessary a beta 2 stimulator, a change of occupation appears to be urgent. But first of all one should check whether an increased exposure to flour dust (unhindered work!) did oppose the effect of the medication.

Dust↗
PubMed1987

[New forms of work in general practice].

A trial with job rotation between repetitive jobs failed within a year after initial enthusiasm among the workers. Stress may increase to an intolerable level with the number of tasks, with higher qualified work and due to the lack of familiarity with fellow workers in ever changing settings.

Adolescent↗
PubMed1985

[Atopy screening: prick multitest, total IgE or RAST? On the value of allergologic testing of the staff of an industrial bakery].

The predictive value of diagnostic tests for the recognition and differentiation of allergic diseases of the immediate type has been evaluated on the basis of the results of a non-selective allergologic-pneumologic examination of the staff of an industrial bakery. Out of the 314 subjects tested, 22 (7%) had a respiratory allergy against flour (flour rhinitis and/or flour asthma), and 21 (6.7%) a preexistent atopic disease without actual symptoms of flour allergy. Thus the predominance of atopy in the group examined was 13.7%. A prick-multitest was carried out in all 314 subjects on each forearm and allowed simultaneous and easy application of twice eight test substances ("atopy-screening" and "bakery-line"). 50% of the bakers with flour allergy also showed positive skin tests with non-occupational inhalative allergens (housedust, housedust mite, pollen) while only 9.2% of the subjects without respiratory allergy to flour did so. 17.1% of the heavily exposed, asymptomatic bakers showed a positive immediate reaction to the highly sensitive intracutaneous test with wheat flour. Here the problem of latent sensitization arises. With histamine the prick-multitest resulted - compared to the intracutaneous test - in 1.6% "false negative" and 3.2% only questionably positive results. Furthermore, 6.1% of the subjects showed a strong, and 3.2% a very strong, nonspecific reaction to the control solution glycerin. Despite these restrictions the prick-multitest proved far superior to measurement of total serum IgE for screening of atopy. Technical improvements have been made in the meantime by the manufacturer. Specific IgE was detected in RAST screening in 59 of the 306 subjects who underwent blood tests. The geometric mean of total IgE values was only 75 U/ml, and for the RAST-negative subjects 23.3 U/ml, while their 95% confidence level was 225 U/ml. This logarithmic-normal distribution of the measured values, together with the excessive normal-atopic overlap, makes it impossible to lay the test cutoff point in a way which results in an acceptable relation between sensitivity and specificity. For the population examined the sensitivity of the total IgE measurement was already below 50% at a cutoff point of 80 U/ml, while the positive predictive value did not yet reach 50% at 160 U/ml. This diagnostic test is at present certainly used too often and without sufficient awareness of its very limited predictive value. As a screening method the RAST is too expensive. Furthermore, the problem of a latent sensitization also exists for the RAST.

Adolescent↗
PubMed1984

[Allergic asthma from enzymes in drugs].

Two patients, both non-atopic, developed asthma after exposure to drugs containing enzymes. RAST identified trypsin as the causative allergen in both cases, with, additionally, amylase and pepsin in the second patient. All enzymes so far recognized as respiratory allergens, and those widely used in drugs, are presented in tabular form.

Amylases↗
PubMed1983

[Magnesium oxide as cause of metal fume fever].

Seven foundry workers are described who all developed pulmonary symptoms and in the majority of cases recurrent occupational fever; the onset of these episodes coincided with the introduction of a new founding technique resulting in exposure to magnesium oxide fumes. The foreman - most exposed because responsible for vaccination of the melted iron with metallic magnesium - developed disabling pneumopathy. The feverish episodes are interpreted as metal fume fever and in 6 patients the pneumopathy is considered to be due to alkalitoxic damage to the small airways and alveoli caused by the magnesium oxide fumes. The seventh patient suffered from allergic asthma bronchiale. Differentiation from hypersensitivity pneumonitis and from humidifier fever of nonallergic etiology is discussed.

Adult↗
PubMed1982

[Occupation-related bronchial asthma caused by ampicillin. Diagnostic significance of occupation-specific inhalation provocation tests].

The case of a 58-year-old employee of an antibiotic-producing factory with occupationally related disorders (asthmatic dyspnea, episodic fever in the evening and malaise) is presented. A change of workplace did not completely relieve the patient. The further course was complicated by nephrolithiasis with urinary infection requiring nephroureterotomy. The extensive allergological investigation resulted in absolutely negative skin tests of the immediate and delayed type with environmental allergens including moulds and antibiotics. The serological examinations showed a high total IgE level and positive specific IgE to benzylpenicilloyl (BPO). The arterial blood gas analyses at rest showed that the patient hyperventilated massively. Consecutive inhalation of lactose, tetracycline, ampicillin and chloramphenicol dust administered by Spinhaler turboinhaler produced a delayed asthmatic reaction with an FEV1 a fall of 42% five hours after provocation, accompanied by general symptoms identified by the patient as here former disorders. Circulating immunocomplexes (C1q-binding test) were now positive, as was anti-BPO-IgG, while anti-BPO-IgE decreased slightly.

Ampicillin↗
PubMed1982

[Occupational medicine studies of train conductors and switchmen of the Federal Swiss Railway].

Railway controllers and points men of the Swiss Railways retire more often prematurely because of medical reasons than civil servants. A pilot study on 120 controllers and 60 points men revealed adverse effects of the irregular working hours as well as of mental loads. Furthermore, the controllers disclose symptoms and signs caused by physical and environmental loads.

Alcohol Drinking↗