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D Choudat

Publications and source records attributed to D Choudat.

At least 37 records · Page 2Linked to original sources

[Occupational asthma caused by buckwheat flour].

Buckwheat flour, mainly used for pancakes, may induce asthma following inhalation and anaphylactic reactions following ingestion. These allergic reactions are mediated by specific IgE and may be confirmed by skin test and radio-allergo-sorbent test. The occupational asthma of a patient working in pancake restaurant was confirmed by specific challenge test with a computerised device to generate particles. A very small amount of buckwheat flour (10 micrograms) induced an immediate fall of the FEV1 to 56% of the initial value. No bronchial reaction was observed with lactose nor with wheat flour. Specific bronchial challenge identifies the allergen responsible for asthma, measures the level of sensitization and thus can prevent the occupational exposure.

Adult↗

Occupational exposure to poultry and prevalence of antibodies against Marek's disease virus and avian leukosis retroviruses.

OBJECTIVES: To compare the prevalence of antibodies against Marek's disease herpes virus (MDV) and against avian leukosis viruses type C (ALV) in groups of workers exposed to poultry and in unexposed groups. METHODS: Antibodies directed against avian viral proteins were detected by enzyme linked immunosorbent assay in 549 subjects. Exposure to chickens was high in two subgroups: farmers on intensive chicken farms and workers at chicken slaughterhouses. One subgroup, traditional farmers on dairy or pig farms with poultry, had moderate exposure to poultry. Another subgroup, farmers and slaughterhouse workers on quail farms, had high exposure to quails. Three subgroups were not exposed to chickens: farmers on dairy or pig farms without poultry, workers at cattle slaughterhouses, and white collar workers. Also, MDV antibodies were tested after serum sample adsorption with chicken antigens in 134 serum samples. RESULTS: The prevalence of antibodies against MDV was significantly higher in the exposed subgroups than in unexposed groups (odds ratio (OR) 6.17; 95% confidence interval (95% CI) 3.91-9.75). No association was found between seroprevalence and age. However, higher prevalence was found among women and was related to duration of exposure to chickens. The concentration of antibodies from a few subjects remained very high after adsorption. Significant differences between the men and women were found for the prevalence of antibodies for ALV but were not related to exposure to chickens. CONCLUSIONS: The prevalence of antibodies against MDV was significantly higher among workers exposed to chickens and was related to sex and duration of exposure. The higher prevalence of antibodies against avian oncogenic viruses found among women compared with men may be induced by differences in exposure or by genetic factors. The meaning of these high titres could be related to the presence of MDV in humans. Because the involvement of animal oncogenic viruses in human cancer is indicated by epidemiological and some experimental studies, the integration of viral DNA in human cells needs to be investigated.

Alpharetrovirus↗

Respiratory symptoms, ventilatory impairment, and bronchial reactivity in oil mist-exposed automobile workers.

Studies concerning the respiratory effects of oil mists are sparse and contradictory. The aim of this study was to determine the respective effects of occupational exposure to straight cutting oils and soluble mineral oils on the prevalence of respiratory symptoms, ventilatory impairment, and bronchial reactivity. The population study consisted of 308 male workers of a large French car-making plant, including 40 subjects chronically exposed to straight cutting oils (group S), 51 subjects chronically exposed to soluble mineral oils (group E), 139 subjects with chronic dual exposure to straight cutting oils and soluble mineral oils (group D), and 78 unexposed assembly workers used as a control group (group C). Worker evaluation included a standardized questionnaire, measurement of pulmonary function, and a methacholine challenge. Oil mist concentration at the work place was determined by gravimetric analysis. The arithmetic mean concentration was 2.6 +/- 1.8 mg/m3. The geometric mean concentration was 2.2 +/- 1.9 mg/m3. The prevalence of respiratory symptoms did not differ significantly among the four groups. However, the subjects exposed to straight cutting oils (group S + group D) had a significantly higher prevalence of chronic cough and/or phlegm than the others (group E + group O): 25.7% vs. 16.3% (p = 0.048). Furthermore, the prevalence of cough and/or phlegm increased significantly (p = 0.03) with increasing duration of exposure to straight cutting oils after adjustment on smoking categories. Lung function tests did not differ significantly among the four groups but we observed a significant decrease of forced expiratory volume in 1 sec (FEV1), forced expiratory flow during the middle half of forced vital capacity (FEF25-75), and maximal flow rate at 50% and 25% of exhaled forced vital capacity (V50 and V25) according to duration of exposure among smokers exposed to straight cutting oils, suggesting a synergistic effect of tobacco and insoluble oils. No effect of exposure to mineral oils on bronchial reactivity was demonstrated. It is concluded that despite low levels of pollution by oil mists, the present study has shown tenuous adverse chronic effects of straight cutting oils on respiratory symptoms and lung function. However, no adverse effect of soluble mineral oils was demonstrated. These results suggest that threshold limit values for mineral oils should be reassessed.

Adult↗

Chronic and acute respiratory effects among grain mill workers.

Exposure to flour dust may induce chronic respiratory manifestations as well as acute ventilatory effects. We compared the prevalence of respiratory symptoms, ventilatory impairment, and variations in pulmonary function over the workshift in a group of mill workers exposed to wheat flour and in referent workers. One hundred and forty-two men exposed to flour in a mill and 37 referent workers were included in this study. Each subject completed a standardized questionnaire. Pulmonary function tests were performed before and after the workshift. The assessment of environmental exposure to flour showed high concentrations during some jobs with a high percentage of inhalable particles and a low concentration of respirable particles. The exposed workers had a significantly higher prevalence of usual cough and usual phlegm than the referents. The prevalence of asthma, based on the questionnaire, was similar. Before the workshift, the exposed workers had significantly lower mean lung function values for peak flow rate and forced expiratory flow rate at 75% of the vital capacity than the referents. After the workshift, all the lung function values showed a slight decrease, significant for forced vital capacity and forced expiratory volume during 1 s in both groups. Among the exposed workers, the asthmatic subjects had a significantly higher decrease across the shift than the nonasthmatic workers. This result is probably linked to bronchial hyperreactivity. Among nonasthmatic subjects, the decrease was larger in nonexposed workers than in exposed workers. A higher prevalence of respiratory symptoms and lower pulmonary function values were observed among mill workers by comparison with referents. Moreover, the data suggest that asthmatic status and the time of spirometric measurements need to be taken into account in epidemiological studies on exposure to airborne allergens. In addition, the study does not exclude a healthy worker effect with selection of dust-resistant subjects or better identification of asthmatic subjects among the workers exposed to an allergenic substance than among the nonexposed workers.

Adult↗

Occupational lung diseases among dental technicians.

Dental technicians are exposed to various dusts including silica, alloys, and acrylic plastics which may induce pneumoconiosis and probably other occupational lung diseases. The prevalence of pneumoconiosis is very high and related to the duration of exposure: 3 epidemiological studies have found a prevalence of pneumoconiosis 1/0 or greater of about 15% in technicians with 20 or more years' exposure. However, silica is probably not the sole causative agent. In addition to pneumoconiosis, this occupational exposure may induce minor lung function impairment, especially among smokers. However, the effect of cigarette smoking on lung function is greater than the effect of occupational exposure. Cases of occupational asthma, bronchial cancer and mesothelioma, and connective tissue diseases have been reported and are suspected to be work related, but epidemiological studies are needed. Pneumoconiosis is a frequent risk among dental technicians and compensation should be paid to those suffering from this work-related disease. Information about occupational lung diseases and adequate technical prevention measures are necessary for dental technicians.

Asthma↗

Respiratory symptoms and bronchial reactivity among pig and dairy farmers.

OBJECTIVES: This study assessed the prevalence of respiratory manifestations among French pig and dairy farmers and determined the relationship between bronchial reactivity and respiratory manifestations. METHODS: The pig farmers included 102 men working more than half-time inside swine confinement buildings. There were 51 male dairy farmers and 81 male referents. The demographic characteristics of the three groups were similar except for more smokers among the referents. Each subject completed a standardized questionnaire. Pulmonary function tests were performed before and after a methacholine challenge (cumulative doses 80, 240, and 560 micrograms). Airborne dust, ammonia, and carbon dioxide were measured inside 28 swine confinement buildings. RESULTS: The pig farmers were exposed to a total dust level of 2.41 mg.m-3. The respirable particle concentration was low. The pig and dairy farmers had a significantly higher prevalence of cough and morning phlegm than the referents. Before the methacholine challenge, the dairy farmers had nonsignificantly lower mean lung function values than the other groups. Among the subjects with no history of asthma, nonspecific bronchial hyperreactivity was significantly higher among the pig and dairy farmers than among the referents. There was a fall in the forced expiratory volume in 1 s (FEV 1.0) that was greater than 10% in 6.7% of the referents, 17.9% of the swine workers, and 35.6% of the dairy farmers. This result was unchanged after adjustment for the initial FEV1.0. CONCLUSIONS: The prevalence of respiratory symptoms was significantly higher among the pig farmers without base-line lung function impairment. However, both the pig and the dairy farmers had increased bronchial reactivity.

Adult↗

Respiratory symptoms, lung function, and pneumoconiosis among self employed dental technicians.

From the registry of self employed workers living in Paris, a group of 105 dental technicians was studied to evaluate occupational exposure, to determine respiratory manifestations, and to investigate immune disturbances. Seventy one dental technicians (age range 43-68: group D), 34 dental technicians younger than 43 or older than 68 (group d), and 68 control workers (age range 43-66: group C) were investigated. The demographic characteristics and the smoking habits of the groups D and C did not differ significantly. The dental technicians often worked alone (43.7%) or in small laboratories without adequate dust control. The mean duration of their exposure was long (group D 34.0 (SD 8.4) years). The prevalence of respiratory symptoms did not differ between groups D and C except for the occurrence of increased cough and phlegm lasting for three weeks or more over the past three years (group D 16.9%, group C 2.9%, p < 0.007). The effect of cigarette smoking on respiratory symptoms and lung function was obvious. All mean values of lung function for dental technicians and controls were within normal limits. Significant decreases in all mean lung function values were found among smokers by comparison with non-smokers, however, and a positive interaction with occupational exposure was established. The x ray films of dental technicians (n = 102, groups D and d) were read independently by four readers and recorded according to the International Labour Office classification of pneumoconioses. The prevalence of small opacities greater than 1/0 was 11.8% with a significant increase with duration of exposure. The prevalence among dental technicians with 30 years or exposure or more was significantly higher (22.2%) than those with less than 30 years (3.5, p < 0.004). The prevalence of autoantibodies (rheumatoid factors, antinuclear antibodies, and antihistone antibodies) was not significantly different in the groups D and C. When positive, autoantibodies only occurred at low concentrations. This finding contrasts with previous reports on the occurrence of autoantibodies and even of connective tissue diseases in dental technicians. In conclusion, the study confirms an increased risk of pneumoconiosis among dental technicians. Moreover, there may be other lung disorders such as impairment of lung function especially in association with cigarette smoking.

Adult↗

[Risk factors for tumors of the bladder. Epidemiological study of 701 patients in Ile-de-France].

The authors present the results of an investigation conducted, under the aegis of the PETRI association, on 701 patients living in the Paris region who, over a 1-year period, had asked the medical advisers of the Social Security Sickness Benefits department to dispense them from paying their portion of the cost of treatment on the ground that they had cancer of the bladder*. The purposes of the investigation were to obtain accurate data concerning the role played by tobacco and alcohol abuse in bladder cancer and to look for possible occupational exposures. The smoking and drinking habits of 636 patients could be analyzed: 89 percent of the men were, or had been, smokers with an average consumption of 33 packs per annum, and with a frequent overconsumption of alcoholic drinks. The professional cursus of 665 patients (31 percent active, 64 percent retired) could be established. The study confirmed that tobacco smoking and alcohol abuse, as well as certain occupational factors, play a role in the development of bladder cancer. Some professional sectors, such as the plastic industry or the hide and leather work, were better represented among these patients than would have been expected from their distribution in the active population. Surveillance of the population exposed by industrial doctors, and follow-up of people who have retired from some sectors of activity are as essential as anti-smoking campaigns.

Adult↗

Occupational exposure to amorphous silica dust and pulmonary function.

Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a control group comprising 90 workers of equivalent socioeconomic state in the same plant. Flow volumes were determined, blood gas concentrations were measured at rest and during exercise, chest radiographs were obtained, and data about respiratory symptoms were collected by questionnaire. A dust exposure index was calculated for each exposed worker. It was not possible to differentiate between the two groups from the questionnaire, blood gas analysis, or chest radiographs. On the other hand, the tests of respiratory function showed a significant decrease in forced expiratory flow (FEF25-75, FEF50, and FEF75) in the exposed group compared with the controls, although no correlation was found between the exposure index and pulmonary function. It appears that smoking and exposure to amorphous silica synergise to induce small airway disease.

Adult↗

Urinary neopterin in pulmonary sarcoidosis. Relationship to clinical and biologic assessment of the disease.

Neopterin is a metabolite of guanosine-triphosphate, released in vitro by macrophages under the control of gamma-interferon and described as a marker of T cell activation in vivo. We have compared the urinary neopterin/creatinine ratio (mumol/mol) in patients with pulmonary sarcoidosis (n = 66), interstitial lung diseases other than sarcoidosis (nonsarcoid ILD, n = 35), and 45 normal control subjects. For the sarcoid population as a whole, urinary neopterin was higher (496 +/- 52 mumol/mol [mean +/- SEM]) than in control subjects (126 +/- 5 mumol/mol) (p less than 0.001). In patients with nonsarcoid ILD, urinary neopterin was frequently higher in granulomatous and/or lymphoproliferative diseases (hypersensitivity pneumonitis, tuberculosis, primitive Sjögren's syndrome, and malignant lymphomas) (781 +/- 193 mumol/mol, n = 10) but remained normal in other types of nonsarcoid ILD [( 163 +/- 14 mumol/mol, n = 25]: histiocytosis X, idiopathic pulmonary fibrosis, lung collagen-vascular diseases, diffuse neoplasms, pneumoconiosis; p less than 0.001 compared with sarcoidosis). We have also evaluated the relationship between urinary neopterin and the clinical or biologic markers currently used to assess sarcoidosis: alveolar lymphocytosis in lavage fluid (ALY), 67-gallium scan semiquantitative index (67Ga), or serum angiotensin-converting enzyme (SACE). Sarcoid patients with the highest urinary neopterin were those in whom mean values of these markers were the highest (p less than 0.05, all comparisons). Patients with positive markers (i.e., either clinical expression of sarcoidosis-ALY greater than 30%-67Ga greater than 20-SACE greater than 60 U/ml) had significantly higher urinary neopterin levels than did other sarcoid patients (p less than 0.05, all comparisons).

Adult↗

Allergy and occupational exposure to hydroquinone and to methionine.

Respiratory manifestations have been reported after exposure to hydroquinone and to methionine. One hundred and three men in the same chemical plant were divided into three groups according to their exposure and compared by questionnaire, respiratory functional tests with methacholine then salbutamol challenges, and measurements of serum immunoglobulins G and E. Group H included 33 workers exposed to hydroquinone, trimethyl-hydroquinone, and retinene-hydroquinone. Group M included 15 workers exposed to methionine. Group C was a control group of 55 workers. The prevalence of respiratory symptoms was higher in the two exposed groups. Before challenges, pulmonary function values were significantly lower in groups H and M than those in group C. The challenges induced significant variations in the three groups but these variations were less pronounced in group M than in the other groups. The level of immunoglobulin G in group H (m +/- SD = 12.5 gram/liter +/- 2.6) was significantly higher than in group C (10.6 gram/liter +/- 2.4; p less than 0.002). The level of immunoglobulin E in group H (m = 140 IU/l) was also higher in group C (109 IU/l) but this difference was not significant. These findings suggest that exposure to methionine and to hydroquinone and its derivatives induce ventilatory impairment, perhaps by an immunological mechanism.

Adult↗

[Human Pasteurella multocida infections. Value of serological diagnosis].

In five human cases of Pasteurella multocida infection, high titres of specific antibodies were found by indirect haemagglutination (capsular antigens) and agglutination (somatic antigens). The specificity of the antibodies fitted with the serotypes of the isolated strains (three A 3 and two A 7). Subsequent changes in antibody titres in human beings were similar to those observed in animals. The risk of this animal-acquired infection being probably underestimated in medical practice, the usefulness of these tests in human beings is discussed.

Adult↗

Variation of lung function during the workshift among cotton and jute workers.

Cotton and jute dust exposure is known to induce reversible airway obstruction. We compared 50 exposed workers to 99 non exposed workers for the prevalence of respiratory symptoms and ventilatory impairment, and for variations in pulmonary function after five working days and after inhalation of salbutamol. The prevalence of respiratory symptoms was not significantly different between the two groups. Pulmonary function was not different on Monday morning, however, significant differences were observed on Friday afternoon. The exposed workers had a lower flow rate at 75% of exhaled forced vital capacity than controls (P less than 0.01). Salbutamol induced greater bronchodilatation in the exposed group. Comparison with a control group is necessary to take into account the change in pulmonary function. Repeated tests, combined with pharmacological tests, are able to differentiate the lung function pattern of exposed and non exposed workers.

Adult↗

Occupational exposure to animals and antibodies against Pasteurella multocida.

The relation between occupational exposure to cattle and prevalence of antibodies against Pasteurella multocida was evaluated in 680 workers. Three groups of exposed workers in abattoirs and slaughterhouses (S), in industrial breeding (I), and in traditional breeding (T) were compared with control workers not exposed to cattle or chicken (C). The prevalence of antibodies against capsular antigen A determined by indirect haemagglutination was significantly higher in the exposed groups (S: 26.2%; I: 29.0%; T: 32.1%) than in the control group (C: 14.0%). The prevalence of antibodies against capsular antigen D did not differ significantly between the groups. The prevalence of antibodies against one or more somatic antigens 1,2,3,7,8, or 9 was higher in the exposed groups with a significant difference only for group T versus group C (p less than 0.05). There was also a significant relation between antibodies against capsular antigen A and the contacts with pets. This high prevalence of antibodies against P multocida suggests that the infection is frequently subclinical and not only a disease associated with pets but also an occupationally related infection.

Abattoirs↗

Specific antibody response to Pasteurella multocida.

Six patients with culturally proven Pasteurella multocida infection were evaluated serologically. The infections were 1 foot abscess, 1 septicemia, 3 bronchitis and 1 bronchopneumonia. Most of them were elderly women closely exposed to pets or domestic animals. The serotypes of the strains were determined in 5 cases (3 A3, 2 A7). Specific antibodies against capsular and somatic antigens of P. multocida were determined by indirect hemagglutination and agglutination respectively. The antibodies were strictly directed against the capsular and somatic specificities of the isolated strain. The range of the serum antibody titers were 20 to 2,560 to capsular antigens and 5 to 640 to somatic antigens within 2 weeks after the first clinical signs of infection. Several months after successful treatment, the capsular antibodies were lower while the somatic antibodies had almost disappeared. These findings suggest a good sensitivity for these serologic methods in active cases. Declining antibody titers follow healing. Cross-reactivity of the serologic tests with other bacteria was not observed. Serologic diagnosis of P. multocida infections is a possible alternative to direct diagnosis when cultures are negative or when unusual localizations must be confirmed.

Adult↗

Superinfection by Aspergillus fumigatus of a pulmonary lesion caused by Mycobacterium xenopi.

A 36-year-old man had a pulmonary infection with a cavity in the right upper lobe caused by Mycobacterium xenopi. A superinfection by Aspergillus fumigatus occurred 1 year later. Both organisms were found in the resected lung specimen. The patient remained asymptomatic after surgery. The superinfection of healed tuberculous lesions by 'atypical' mycobacteria or Aspergillus species is well known but the co-existence of the 2 organisms is very rare.

Adult↗