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Biomedical subjects

D Teculescu

Publications and source records attributed to D Teculescu.

At least 19 recordsLinked to original sources
PubMed1992

Iron miners--a ten year follow-up.

1167 workers of Lorraine (France) iron mines, a random sample of 5600 workers aged 35 to 55 years, at work in 1975 constituted the initial cohort that was examined twice at 5-year intervals after the first examination. A questionnaire on respiratory symptoms and smoking habits (MRC questionnaire) plus questions on the work history of each participant was completed, vital capacity (VC), forced expiratory volume in one second (FEV1.0), residual volume (RV) and fractional uptake of CO (FuCO) were measured at the first examination and repeated five and ten years later. At the end of the ten year follow-up, 522 subjects were re-examined, 186 were lost to follow-up, 328 answered a mail questionnaire, and 111 had died. The total number of deaths was not different from that of the general population, but for lung cancer the standardized mortality ratio (SMR) was significantly increased (SMR = 3.7). For the miners re-examined, frequency of bronchitis and decrease of functional tests were more related to age and smoking habits than to occupation.

Adult↗
PubMed1991

[Skin sensitivity to respiratory allergens in agricultural workers and wage-earners].

Prick tests were performed with "pneumallergerns" (mites, cereal dusts, animal dander, pollens, moulds--totalling 35 allergens) among 742 agricultural workers of the Meuse department (North East of France) as part of an epidemiological study on respiratory and immuno-allergological problems. Among those with positive skin tests, 47.9% had positive skin tests for mites, 22.4% for cereal dusts, 10.7% for animals, 12.7% for pollens and 7.8% for moulds. Polysensitization was frequent (19.5% of the population). When the skin test was positive for main house dust mites it frequently was positive for storage mites, too. Among vegetal dusts sensitization, soy bean allergy yielded the highest frequency (6.5%). As for animal sensitization, cow dander was the most frequently observed positive test. Sensitization to pollens and moulds was comparatively rare. This study shows the large frequency and diversity of "latent allergy" to pneumallergens among agricultural workers.

Agriculture↗
PubMed1991

Prospective mortality study among iron miners.

A prospective mortality study was conducted over a period of 5 years on a group of 13,801 iron miners, who were alive on January 1, 1982. During this 5-year period, 1813 deaths were registered. For 1222 (67.4%), the cause of death and work history are known. For 135 (7.4%), the cause of death is known, but not the work history. For 455 (25.1%), the cause of death is unknown. Proportional mortality ratio (PMR) is significantly higher than 1 for lung cancer (PMR = 2.51, p less than 0.001) and for stomach cancer (PMR = 2.31, p less than 0.001). The results are discussed in regard to occupational risks that result in these two kinds of increased mortality rates, and the hypothesis of redox activity on the surface of dust particles is advanced as a common denominator.

Adult↗
PubMed1991

[The analysis of bronchial obstruction and its reversibility after bronchodilators using a study of "density-effect" on maximum flow].

The change in maximal expiratory flows after inhalation of gases of various physical properties is studied since 1963. The Montreal team proposed in 1972 the helium-to-air difference in maximal expiratory flows at low lung volumes (delta He) and the volume at which the flows breathing air and the helium-oxygen mixture (the "volume isoflow" - Viso V) as "sensitive tests" for the detection of peripheral airway obstruction. "Density-dependence" (DD) has been widely used subsequently in the study of the site of bronchial obstruction in asthmatics in smokers, in subjects with early chronic bronchitis, subjects with occupational exposures to respiratory irritants, etc. The site of action of bronchodilators according to their nature or route of administration (atropine derivates acting on "central airways", "global" bronchodilation obtained by parenteral administration) was studied using DD. However, the interpretation of these studies was always based on Mead's "equal pressure point" concept minimizing the role played by bronchial wall compliance as put forward by Pride and coll. (1967). The results of certain experimental or clinical studies was found not to agree with the original explanations. Finally, the model of flow limitation recently described by Dawson and Elliott (1977) takes into account gas density and bronchial wall elasticity which determine the speed of waves propagating against flow in elastic tubes, the site of "choke points" and the cross-sectional airway area at this level. Besides methodological problems, the complex nature of mechanisms controlling bronchial flow with gases of different densities and the unavoidable influence of bronchodilators or bronchial wall compliance are major limiting factors for the use of DD in the study of the site of airflow obstruction, and effect of bronchodilator action.

Airway Obstruction↗
PubMed1990

[Clear definitions of chronic bronchopulmonary diseases: a necessity for practice, teaching and research in pneumology].

Important divergences in the definition of bronchial asthma, chronic bronchitis and pulmonary emphysema have persisted until the middle 1950's. Definitions were first standardized in 1958 by a group of British specialists (CIBA symposium) and made more accurate by the WHO Experts Group on Cor Pulmonale in 1961 and by the American Thoracic Society in 1962. The standardized questionnaire proposed by the British Medical Research Council has been widely adopted. As regards pulmonary emphysema, a precise definition based on anatomical data (dilatation of terminal air spaces with destruction of their walls) has been accepted. For lack of a better basis, chronic bronchitis is defined in clinical terms (almost daily productive cough 3 months each year, at least on 2 consecutive years); the terms "chronic cough" and "recurrent bronchitis" are still controverted. The greatest difficulties have been encountered in the definition of bronchial asthma; despite a second CIBA symposium (1971) devoted to this problem, it has not been possible to improve on the fairly wide physiological definition put forward in 1958 (bronchial obstruction that varies either spontaneously or under the influence of treatment). For about 15 years peripheral airways obstruction (PAO), sometimes called "small airways disease" has been recognized as a special anatomical and functional syndrome.

Asthma↗
PubMed1989

Arc welders' respiratory health evolution over five years.

The respiratory health of 138 arc welders and 106 control subjects in the same company was studied in 1981 and in 1986. Most of the subjects welded mild steel using the Metal Inert Gas (MIG) process. The controls were workers in the same company, not exposed to any known pulmonary risk. The welders and controls in the analysis had not changed their professional activity nor their smoking habits during these five years. The examinations consisted of a questionnaire on respiratory symptoms, a thoracic auscultation, a chest X-ray and lung function tests: flow-volume curve and steady state CO transfer test. The examinations in 1986 confirmed the risk of non specific radiological impairment (pulmonary reticulo-micronodulation) and of obstruction in the small bronchi, which had already been observed in 1981 in the arc welders in this company. These impairments did not seem to have evolved more than in the controls, but do however justify regular surveillance of the respiratory health of arc welders.

Adult↗
PubMed1989

Respiratory hazards in hard metal workers: a cross sectional study.

A cross sectional study was conducted on 513 employees at three hard metal plants: 425 exposed workers (351 men, 74 women) and 88 controls (69 men, 19 women). Cough and sputum were more frequent in workers engaged in "soft powder" and presintering workshops compared with controls (12.5% and 16.5% v 3.5%). Spirometric abnormalities were more frequent among women in sintering and finishing workshops compared with control women (56.8% v 23.8%) and abnormalities of carbon monoxide test were more frequent in exposed groups than in controls; this difference was more pronounced in women (31.4% v 5.6%) than in men (18.5% v 13%). No significant correlation was observed between duration of exposure and age adjusted lung function tests. Slight abnormalities of chest radiographs (0/1, 1/1 according to ILO classification) were more frequent in exposed men than controls (12.8% v 1.9%) and mostly in soft powder workers. In subjects with abnormal chest radiographs FVC, FEV1 and carbon monoxide indices (fractional uptake of CO or CO transfer index or both) were lower compared with those with normal chest radiographs. Although relatively mild, the clinical, radiological, and functional abnormalities uncovered call for a regular supervision of workers exposed to hard metal dust.

Adult↗
PubMed1989

[Respiratory health of children and atmospheric pollution. I. Respiratory symptoms].

The impact on the respiratory system of complex industrial pollution (dust, sulphur dioxide, nitrogen oxides, hydrocarbons) was assessed by an analytical epidemiological study in a population of school children in the northeast of France. The parents of 375 children aged from 9-12 (middle school course 1 and 2) from the polluted zone and 523 children of the same age in a neighboring zone which was not polluted have filled in standardised questionnaires (respiratory symptoms, previous infections and allergies, frequency of infection in infancy; tobacco habits, professional and educational attainments of the parents, domestic environment). In the exposed children the majority of respiratory symptoms were more frequent (e.g., respiratory sounds in the boys, 15.6% against 7.9% p less than 0.01) and the absenteeism from school was more numerous (66.9% against 59.1% p less than 0.01). However, the interpretation of the results had to take into account the existence of confusing factors: parental smoking habits and the use of coal fires increased the prevalence of symptoms in the polluted zone, whereas a less crowded population worked in the inverse direction; likewise the educational level of the parents was higher in the polluted zone. After adjusting for these confusing factors, the frequency of rhinitis and absenteeism from school was significantly higher in exposed children.

Air Pollution↗
PubMed1989

[Respiratory health of children and atmospheric pollution. II. Ventilatory function].

Respiratory function (forced vital capacity-FVC; forced expired volume in one second-FEV1; maximal mid-expiratory flow-DEMM; peak flow-DP; maximal expiratory flow at 75-50-25% of vital capacity CV-DEMx) was studied in children of comparable age, sex and height (9 to 12 years) in a polluted zone (the exposed group n = 223) and a neighboring non-polluted zone (the control group n = 211) in the north of Lorraine. There was no significant difference in ventilatory function between the two groups. Amongst other factors capable of influencing the ventilatory function in the children we found an influence of parental smoking habits (particularly the mothers) identifiable in the non-exposed zone, above all in boys. A sub-segment analysis identified that in the absence of parental smoking, there was a negative influence of open coal fires. The discordance between the results of the measures of respiratory function and the prevalence of different respiratory symptoms, of acute infections and absenteeism from school, is probably explained by the interference of other factors which were not controlled in this study (e.g., ethnic factors and physical activity) and by the moderate level of the pollution; an over-reporting of respiratory symptoms by parents in the exposed zone could not be excluded.

Air Pollution↗
PubMed1989

[The respiratory health of children and industrial and domestic air pollution].

At the request of its inhabitants, an epidemiological survey was conducted among the children of Carling, a particularly polluted industrialized town in the department of the Moselle in North-East France. Contrary to all expectations, no major toxic effect of industrial pollution on the respiratory health of the children was found. There was some correlation between the fact of living in a polluted area and a claimed respiratory morbidity. However, the potentially harmful effect of atmospheric pollution could not be translated in terms of abnormalities of respiratory function. In contrast, a significant effect of the smoking habits of the parents, and particularly of the mothers, on respiratory symptoms and spirographic data of their children was observed.

Air Pollution↗
PubMed1988

Respiratory symptoms or signs on the day of the study alter pulmonary function in teenagers.

Pulmonary function variables (forced expiratory flows and vital capacity, static lung volume, alveolar N2 slope, closing volume and closing capacity) were compared in a group of 10-16 year old children with (n = 65) and without (n = 440) symptoms or signs of mild acute respiratory infection ('common cold'). Symptomatic children had a significant impairment of forced expiratory vital capacity and flows, with no change in static volumes, alveolar N2 slopes and closing volumes. The effect was present only in boys (in whom RV/TLC and phase III slope were borderline abnormal), was more evident in older children (13 to 16 years) and was independent of the smoking habits or the presence of chronic respiratory symptoms. The results are in favour of a predominant involvement of upper airways, but signs of lower airways dysfunction are present in boys and in children 13 to 16 years old.

Acute Disease↗
PubMed1987

["Physiologic" aging in 5 years of pulmonary function in 140 iron miners].

Ageing of the lung function in 5 years was studied in a group of 140 iron-ore miners, aged initially from 36 to 55 years. These men had no respiratory symptom and no pulmonary radiological abnormality. The sample was stratified on age and smoking. These factors were studied by a two-way analysis of variance. Lung function testing was performed twice, at 5 years of interval, in the same conditions. It consisted in: spirometry (for measuring FVC, FEV1, FEV1/FVC); a bronchial challenge test with acetylcholine (measurement of the fall of FEV1 after the test); measurement of total lung capacity (TLC) and residual volume (RV) by the open-circuit helium dilution method, and measurement of the transfer factor of the lung for CO, by the steady-state method (TCO/V). The only indices, whose values significantly changed in 5 years were: FVC, FEV1 and TCO/V. Their decrease rate did not appear to be significantly linked to age nor to smoking. According to these results, it seems that the decline of the pulmonary function is relatively constant during the middle period of life and that it is not strongly influenced by smoking, but only among subjects who remain without any respiratory symptom.

Adult↗
PubMed1986

A longitudinal study of symptoms and respiratory function tests in iron miners.

A first survey has been conducted on 1179 iron-ore mine workers, 35-55 years old, who were randomly selected from 5900 at work with normal chest roentgenograms. Five years later, 871 of them were re-examined. Both surveys included a standard respiratory symptoms questionnaire (British MRC), a physical examination of the chest, and measurement of pulmonary function (vital capacity - VC; forced expiratory volume during 1 s - FEV1.0; residual volume - R.V. by helium dilution: carbon monoxide uptake - FuCO by the steady-state method). Both surveys were done by the same research team under identical conditions, using the same equipment. The mine technical services determined the dust and noxious gas concentrations at work places. No evidence of worsening of respiratory health status was observed overall. Symptoms of chronic bronchitis and asthma were recorded with a similar prevalence in both surveys; the decline in lung function was minimal for the total sample. However, our aim was to compare changes that were observed in groups differing by work place (surface or underground) or by activity (active or retired). Analysis showed that development of respiratory symptoms was more frequent and decline in lung function accelerated in the 5-year interval among underground workers who were still active as compared to those retired. In all subgroups (surface or underground workers, active or retired), decline of lung function values was more marked in smokers compared to non-smokers.

Adult↗
PubMed1985

Lung function and clinical findings in a cross-sectional study of arc welders. An epidemiological study.

An epidemiological, cross-sectional study was conducted in order to assess non-neoplasic effects on the lung due to chronic exposure to arc welding fumes and gases. The study involved 346 arc welders and 214 control workers from a factory producing industrial vehicles. These workers (welders and controls) had never been exposed to asbestos. Respiratory impairments were evaluated by using a standardized questionnaire, a clinical examination, chest radiophotography and several lung function tests (spirometry, bronchial challenge test to acetylcholine, CO transfer tests according to the breath-holding and the steady-state methods, N2 washout test). The only significant differences between the welders overall compared to the controls were a slightly higher bronchial hyper-reactivity to acetylcholine and a lower lung diffusing capacity for CO in the welders. However, non-specific, radiologic abnormalities (reticulation, micronodulation) and obstructive signs were more frequent in the most exposed welders (welding inside tanks) than in welders working in well ventilated workplaces. The nature of the metal welded (mild-steel, stainless steel, aluminium) did not seem to have an influence on respiratory impairments. In the mild-steel welders, respiratory symptoms (dyspnoea, recurrent bronchitis) and obstructive signs were more frequent in the welders using a manual process than in the welders involved with the semi-automatic process (MIG). For all the workers (welders and controls), smoking had a markedly adverse effect on respiratory symptoms and lung function. Moreover, smoking seemed to interact with welding since CO lung transfer was more impaired in smoking welders than in smoking controls.

Adult↗
PubMed1985

[Computerizing the single-breath nitrogen washout test].

The classical assembly used for the single breath nitrogen washout implies the manipulation of valves by the operator, a perfect coordination of respiratory maneuvers by the subject and a rigid standardization of the interpretation of the tracings by the technicians doing the calculations. We present a computerized analysis of the single breath nitrogen test, based on a microcomputer (Apple II 48K) solving most of the problems above. The opening of the valves is operated by the computer program recorded on disk; the tidal volume and expiratory flow are displayed on the screen on line allowing the subject to comply with the requested limits; the nitrogram is displayed at the end of the test, allowing the technician to explain the errors (if any). The program then goes on computing the slope of phase III, the closing volume, total lung capacity and its subdivisions for each trial, and the average values for two or three trials accepted by the operator. The system worked satisfactorily during a pilot study in healthy adults (variability and reproducibility) and was particularly useful in a field survey of children and adolescents.

Closing Volume↗
PubMed1985

[Effects of incomplete inspiration and previous pulmonary volume history on the nitrogen test].

The effect of incomplete inspiration and of preceding lung volume history on the different parameters of the expired nitrogen curve after inhaling pure oxygen were studied in 12 healthy non-smokers, aged 21 to 35. The equipment used was attached to a mini-computer enabling the regulation of the measurements and the performance of the tests with immediate calculations on the different indices derived from the curve (VC, RV, TLC, delta N2, CV-closing volume, CV/VC). With each subject three measurements were made: measurements in the normal way (N) after incomplete inspiration (I) and finally after 5 forced inspirations and expirations (previous history - P). The procedure (I) gave values of VC and TLC which were lower than those observed with the other methods and the slope of delta N2 and the CV/VC were higher. After the previous lung volume history (P) VC and TLC were significantly higher, the CV/VC ratio was lower (due to the increase of CV). The measurement technique was not influenced either within sessions or between sessions a week apart.

Adult↗