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Biomedical subjects

B Brunekreef

Publications and source records attributed to B Brunekreef.

At least 73 records · Page 4Linked to original sources
PubMed2001

Dermal exposure, handwashing, and hand dermatitis in the rubber manufacturing industry.

Skin diseases, such as hand dermatitis, are thought to be a common problem in the rubber manufacturing industry, as workers are exposed to a wide range of chemicals with known irritant and sensitizing potential. We conducted a cross-sectional survey of a representative sample of rubber manufacturing workers (N = 202), selected from nine different rubber companies. Prevalence of hand dermatitis ("major" and "minor" dermatitis) and skin injuries was assessed on the basis of a diagnosis by a dermatologist. We investigated the possible relations between actual skin exposure, handwashing practices, and hand dermatitis. Prevalence of major hand dermatitis (7%) was comparable with that in the general population; however, minor signs of dermatitis were more common among the surveyed population (28%), as were traumata of the skin (17%). Dermal exposure to cyclohexane-soluble agents at work was related to the occurrence of major hand dermatitis, but not to the occurrence of minor hand dermatitis. Moderate and frequent handwashing especially with industrial surfactants containing scrubbing particles were found to be strongly associated with the occurrence of minor dermatitis [odds ratio = 4.27 (95% confidence interval = 0.90-20.27) and odds ratio = 6.38 (95% confidence interval = 1.33-30.17, respectively)].

Administration, Cutaneous↗
PubMed2001

The association between air pollution and heart failure, arrhythmia, embolism, thrombosis, and other cardiovascular causes of death in a time series study.

In a time series study, air pollution was associated with specific cardiovascular causes of death. Deaths due to heart failure (ICD-9 428), arrhythmia (ICD-9 427), cerebrovascular causes (ICD-9 430-436), and thrombocytic causes (ICD-9 415.1, 433-4, 444, 452-3) were more strongly associated with air pollution than cardiovascular deaths (ICD-9 390-448) in general. Excess relative risks were 2.5 to 4 times larger for these categories than for total cardiovascular disease mortality. Heart failure deaths, which made up 10% of all cardiovascular deaths, were found to be responsible for about 30% of the cardiovascular deaths related to particulate matter, SO2, CO, and NO2.

Adult↗
PubMed2001

Repeatability of bronchial hyperresponsiveness to adenosine-5'-monophosphate (AMP) by a short dosimeter protocol.

BACKGROUND: To study bronchial responsiveness to adenosine 5'-monophosphate (AMP) in population surveys, repeatability of a rapid dosimetric method with quadrupling doses was evaluated. METHODS: Volunteers with symptoms of airway respiratory allergy or asthma were invited for AMP challenges on two occasions. After each dose the fall in forced expiratory volume in one second (FEV(1)) compared with the post-saline value was determined. The cumulative doses of AMP needed to cause a fall in FEV(1) of 20% (PD(20)), 15% (PD(15)), and 10% (PD(10)) were calculated. Agreement was evaluated by means of kappa values. After excluding systematic differences in PD values on two occasions (t test), repeatability of a single estimation of the chosen PD values was calculated and expressed in doubling doses (DD). RESULTS: In 28 of 76 subjects a PD(20) was estimated on the two visits, in 29 subjects a PD(15) was estimated, and in 32 a PD(10) was obtained. Kappa values for a positive threshold were 0.89 for a cut off level for a 20% fall in FEV(1), 0.78 for a 15% fall in FEV(1), and 0.76 for a fall in FEV(1) of 10%. The PD values did not differ between the two visits and 95% repeatability of a single estimation was +/-1.7 DD for PD(20), +/-2.2 DD for PD(15), and +/-2.4 DD for PD(10). The quadrupling dose method reduced time by 40% in non-hyperresponsive subjects and no adverse effects were observed. CONCLUSION: The short dosimeter protocol with quadrupling doses for AMP challenges is a rapid, reproducible tool for estimating bronchial responsiveness in population surveys.

Adenosine Monophosphate↗
PubMed2001

Personal and outdoor nitrogen dioxide concentrations in relation to degree of urbanization and traffic density.

To assess differences in exposure to air pollution from traffic in relation to degree of urbanization and traffic density, we measured personal and home outdoor nitrogen dioxide (NO(2)) concentrations for 241 children from six different primary schools in the Netherlands. Three schools were situated in areas with varying degrees of urbanization (very urban, fairly urban, and nonurban) and three other schools were located near highways with varying traffic density (very busy, fairly busy, and not busy). Weekly averaged measurements were conducted during four different seasons. Simultaneously, indoor and outdoor measurements were conducted at the schools. Personal and outdoor NO(2) concentrations differed significantly among children attending schools in areas with different degrees of urbanization and among children attending schools in areas close to highways with different traffic densities. For the children living near highways, personal and outdoor NO(2) concentrations also significantly decreased with increasing distance of the home address to the highway. Differences in personal exposures between children from the different schools remained present and significant after adjusting for indoor sources of NO(2). This study has shown that personal and outdoor NO(2) concentrations are influenced significantly by the degree of urbanization of the city district and by the traffic density of and distance to a nearby highway. Because NO(2) can be considered a marker for air pollution from traffic, the more easily measured variables degree of urbanization, traffic density, and distance to a nearby highway can all be used to estimate exposure to traffic-related air pollution.

Air Pollution↗
PubMed2001

Respiratory infections in infants: interaction of parental allergy, child care, and siblings-- The PIAMA study.

OBJECTIVE: To investigate the association between contacts with other children and the development of respiratory infections in the first year of life in children with or without genetic predisposition for allergy. METHODS: Children (n = 4146) who participate in a prospective birth cohort study (Prevention and Incidence of Asthma and Mite Allergy study) were investigated. Questionnaires were used to obtain information on doctor-diagnosed upper respiratory tract infection (URTI) and lower respiratory tract infection (LRTI), child care attendance, having siblings, family history of allergic disease, and various potential confounders. RESULTS: Child care attendance in the first year of life was associated with doctor-diagnosed URTI (adjusted odds ratio [AOR]: 2.7; 95% confidence interval [CI]: 2.1-3.4 for large child care facility vs no child care) and doctor-diagnosed LRTI (AOR: 5.6; 95% CI: 3.9-7.9). Having siblings was associated with doctor-diagnosed LRTI (AOR: 2.6; 95% CI: 2.0-3.4). In addition, children who have allergic parents and attend child care or have older siblings have a higher risk of developing doctor-diagnosed LRTI than do children who have nonallergic parents. CONCLUSIONS: Child care attendance or having siblings increases the risk of developing doctor-diagnosed LRTI in the first year of life to a greater extent in allergy-prone children than in children who are not allergy prone.

Adult↗
PubMed2000

Incidence of influenza-like illness, measured by a general practitioner sentinel system, is associated with day-to-day variations in respiratory health in panel studies.

During three consecutive winters beginning in 1992-1993, the association between the incidence of influenza and influenza-like illness (ILI), measured by a general practitioner sentinel system, and respiratory health was investigated in an air pollution panel study. Data from 22 panels of children (7-11 years old) and adults (50-70 years old) in the Netherlands were used. ILI incidence was associated with peak expiratory flow, respiratory symptoms, and bronchodilator use. Peak ILI incidence of 122 cases/10,000 subjects was associated with a decrement in peak expiratory flow of 6% and a 3- to 4.5-fold increase in symptom reporting and bronchodilator use. In panel studies, ILI incidence might be used to adjust for confounding by acute respiratory infections.

Aged↗
PubMed2000

PM10 elemental composition and acute respiratory health effects in European children (PEACE project). Pollution Effects on Asthmatic Children in Europe.

The ability of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10) to cause respiratory health effects possibly depends on their composition. This study evaluated whether the soluble elemental concentrations in PM10 were related to acute respiratory health effects. The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of PM10 and other air pollution components on the respiratory health of children with chronic respiratory symptoms in urban and suburban panels. Children, 1208, divided among 17 panels were followed for > or =2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by twice daily peak expiratory flow (PEF) measurements and a symptom diary. Median concentrations of iron ranged 105-1,110 ng x m(-3) in the urban and 32-517 ng x m(-3) in the suburban locations. The daily concentrations of most elements were not associated with daily variation in PEF, prevalence of respiratory symptoms or bronchodilator use. Silicon and iron concentrations tended to be negatively associated with PEF, and positively associated with the prevalence of phlegm. In two pollutant models, PM10 effect-estimates on phlegm prevalence were reduced and lost significance, whereas the effect-estimates of iron or silicon remained essentially unchanged. The effects of silicon and iron could not be separated. In conclusion, this study provides only weak support for the hypothesis that daily fluctuations in soluble elemental concentrations in ambient particulate matter are responsible for acute health effects.

Air Pollution↗
PubMed2000

Acute effects of air pollution on respiratory health of 50-70 yr old adults.

The aim of this study was to investigate the association between daily changes in respiratory health and air pollution in 489 adults, aged 50-70 yrs, with and without chronic respiratory symptoms, living in urban and nonurban areas in the Netherlands. Subjects were selected from the general population with a screening questionnaire. During three consecutive winters starting in 1992/1993, peak expiratory flow (PEF) and respiratory symptoms were registered in a daily diary. Daily measurements of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10), black smoke (BS), sulphate, sulphur dioxide (SO2) and nitrogen dioxide (NO2) were conducted. The difference in PM10, BS and sulphate concentrations between urban and nonurban areas was small, but there was more contrast in the concentrations of SO2 and NO2. In symptomatic subjects from urban areas, PM10, BS, sulphate and SO2 concentrations were associated with the prevalence of large decrements in morning PEF (>20% below the median). BS in particular was also associated with upper respiratory symptoms (URS). The magnitude of the effect estimates was in the order of an 80% increase in PEF decrements and a 20% increase in URS for a 40 microg x m-3 increase of the same day BS concentration. In symptomatic subjects from nonurban areas, no consistent associations between air pollution and health indicators were observed. However, the differences in effect estimates between urban and nonurban symptomatic panels were small and nonsignificant. In nonsymptomatic adults from both areas, no consistent pattern of associations with air pollution was found. In conclusion, air pollution effects were only found in symptomatic adults in the urban areas.

Age Distribution↗
PubMed2000

Personal exposure to fine particulate matter in elderly subjects: relation between personal, indoor, and outdoor concentrations.

The time-series correlation between ambient levels, indoor levels, and personal exposure to PM2.5 was assessed in panels of elderly subjects with cardiovascular disease in Amsterdam, the Netherlands, and Helsinki, Finland. Subjects were followed for 6 months with biweekly clinical visits. Each subject's indoor and personal exposure to PM2.5 was measured biweekly, during the 24-hr period preceding the clinical visits. Outdoor PM2.5 concentrations were measured at fixed sites. The absorption coefficients of all PM2.5 filters were measured as a marker for elemental carbon (EC). Regression analyses were conducted for each subject separately, and the distribution of the individual regression and correlation coefficients was investigated. Personal, indoor, and ambient concentrations were highly correlated within subjects over time. Median Pearson's R between personal and outdoor PM2.5 was 0.79 in Amsterdam and 0.76 in Helsinki. For absorption, these values were 0.93 and 0.81 for Amsterdam and Helsinki, respectively. The findings of this study provide further support for using fixed-site measurements as a measure of exposure to PM2.5 in epidemiological time-series studies.

Aged↗
PubMed2000

Daily mortality and air pollution in The Netherlands.

We studied the association of daily mortality with short-term variations in the ambient concentrations of major gaseous pollutants and PM in the Netherlands. The magnitude of the association in the four major urban areas was compared with that in the remainder of the country. Daily cause-specific mortality counts, air quality, temperature, relative humidity, and influenza data were obtained from 1986 to 1994. The relationship between daily mortality and air pollution was modeled using Poisson regression analysis. We adjusted for potential confounding due to long-term and seasonal trends, influenza epidemics, ambient temperature and relative humidity, day of the week, and holidays, using generalized additive models. Influenza episodes were associated with increased mortality up to 3 weeks later. Daily mortality was significantly associated with the concentration of all air pollutants. An increase in the PM10 concentration by 100 micrograms/m3 was associated with a relative risk (RR) of 1.02 for total mortality. The largest RRs were found for pneumonia deaths. Ozone had the most consistent, independent association with mortality. Particulate air pollution (e.g., PM10, black smoke [BS]) was not more consistently associated with mortality than were the gaseous pollutants SO2 and NO2. Aerosol SO4(-2), NO3-, and BS were more consistently associated with total mortality than was PM10. The RRs for all pollutants were substantially larger in the summer months than in the winter months. The RR of total mortality for PM10 was 1.10 for the summer and 1.03 for the winter. There was no consistent difference between RRs in the four major urban areas and the more rural areas.

Adolescent↗
PubMed2000

A case-control study of plasma antioxidant (pro-)vitamins in relation to respiratory symptoms in non-smokers.

The aim of this study was to investigate the relations between plasma levels of antioxidants, beta-carotene and alpha-tocopherol, and chronic respiratory symptoms in Dutch adults who never smoked or were long-term former smokers. Cases (who reported one or more respiratory symptoms) and controls were selected from a population-based cross-sectional study. Plasma concentrations of antioxidants were determined in 491 cases and 496 controls. ORs for the presence of chronic respiratory symptoms were estimated for quintiles of plasma antioxidant concentration after adjustment for age, gender, and body mass index. The OR of respiratory symptoms in all but the highest quintile of plasma beta-carotene decreased and were slightly below one. We saw no meaningful relation with plasma alpha-tocopherol.

Adult↗
PubMed2000

Using nicotine measurements and parental reports to assess indoor air: the PIAMA birth cohort study. Prevention and Incidence of Asthma and Mite Allergy.

We used two methods to collect data on indoor smoking exposure of 3-month-old infants. First, parents of approximately 100 children completed a questionnaire. We then measured nicotine in the air of the living rooms in smoking and non-smoking households with a passive sampler for a period of 2 weeks, several months after the questionnaire had been completed. Smoking habits reported in the questionnaire generally with reported number of cigarettes smoked during the measurement weeks, and with nicotine concentrations in the air. These results suggest that exposure classification based on questionnaire data is likely to be reasonably valid.

Air↗