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Biomedical subjects

M Dahlqvist

Publications and source records attributed to M Dahlqvist.

At least 19 recordsLinked to original sources

Hypertonic saline-dextran improves intestinal perfusion and survival in porcine endotoxin shock.

OBJECTIVE: To examine the effects of hypertonic (7.5%) saline-6% dextran 70 (HSD) and isotonic (0.9%) saline-6% dextran 70 (ISD) on cardiovascular function and intestinal perfusion in experimental endotoxin shock. DESIGN: Experimental, randomized, unblinded, interventional study. SETTING: University experimental animal laboratory. SUBJECTS: Anesthetized and mechanically ventilated landrace pigs (n = 24). INTERVENTIONS: Induction of endotoxin (ET) shock by infusion of Escherichia coil lipopolysaccharide endotoxin (serotype 0111: B4) followed by no fluid treatment (control; C) or small-volume (4 mL/kg) treatment with HSD or ISD. MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure, central venous pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, cardiac output, portal vein blood flow, intestinal microcirculation, intramucosal (regional) P(CO2), intestinal-arterial gap of CO2, and intramucosal pH were monitored, and blood gases were analyzed. Infusion of ET resulted in hypokinetic shock, which in untreated animals led to cardiovascular deterioration and a survival rate of only 33% at 300 mins after start of ET infusion. ISD treatment transiently improved hemodynamic variables and mucosal blood flow but did not affect the survival rate vs. C. Significant beneficial, long-lasting effects of HSD infusion on hemodynamics, especially on mucosal blood flow and intramucosal pH, were demonstrable, resulting in a survival rate of 86%. The relative risk of death at 300 mins was 1.20 for ISD vs. C and 0.17 for HSD vs. C. CONCLUSION: Small-volume HSD resuscitation is much more effective than ISD resuscitation. Variables that were improved include cardiac output, portal blood flow, and intestinal mucosal blood flow in ET shock, all of which improve survival. Such beneficial effects of HSD on splanchnic perfusion may be of value in treating critically ill septic patients in the intensive care unit.

Animals↗

A hand held two-channel vibro-tactile speech communication aid for the deaf: characteristics and results.

The OSCAR-project (Optimal Speech Communication Assistance for Residual Abilities) within the TIDE frame is aiming at processing the speech signal in such a way so that it can be more effectively aurally perceived than with an ordinary hearing aid in case of a very small residual hearing. In case of total deafness the code will be tactile and in some cases a multi modal approach will be tried. One of the sub-results of the OSCAR-project is a hand held vibro-tactile speech communication aid for profoundly hard of hearing and deaf persons. The main idea of the aid is that it should not be a general tactile hearing aid, but rather give optimum tactile support to lip-reading in a close communication situation. It should be used when speech communication is necessary and other methods of communication i.e. sign language, lip-reading, reading and writing etc. does not work. The aid conveys two types of information via its two vibro-tactile transducers; the syllabic rhythm and frication. This paper describes some characteristics of the aid and some results.

Correction of Hearing Impairment↗

Acute effects of exposure to air contaminants in a sawmill on healthy volunteers.

OBJECTIVES: To study whether air contaminants in sawmills can induce acute changes in the upper and lower airways of previously non-exposed subjects. METHODS: Nineteen healthy volunteers were examined to find the concentration of interleukin 6 (IL-6) in nasal lavage fluid and lung function before and after five hour exposure to dusts and fumes generated in a sawmill where timber from Scots pine was sawed. When exposed, the subjects had respirators with and without a particle filter. RESULTS: The median for daily time weighted average concentration of total dust for subjects with respirators without a filter was 0.13 mg/m3, which was significantly higher than the median of 0.04 mg/m3 for subjects who had respirators with a filter. The median for the concentration of IL-6 in the nasal lavage fluid increased after exposure from 0.5 to 5.9 pg/ml in subjects with respirators without a particle filter (P < 0.05). The increase of the concentration of IL-6 was significantly correlated with the dust concentration. A decrease in transfer factor of the lung was significantly correlated with daily time weighted average concentrations of terpenes. CONCLUSION: The findings suggest that healthy volunteers, exposed to air contaminants in a sawmill, show a slight inflammatory reaction. Also, the results of the study indicate the importance of decreasing the concentrations of wood dust in the work environment.

Adult↗

An Indicator for Assessing Respirable Soot Particles in Diesel Exhaust during Occupational Exposures.

Both acute and chronic impairments of lung function have been demonstrated in humans after exposure to diesel exhaust. The concentration of soot particles in the diesel exhaust is significantly related to its effects on health. The aim of the present analysis was to study the relationship between the concentration of respirable dust as an indicator of exposure to soot particles in diesel exhaust and a biologic exposure indicator variable, i.e., transient lung function decrease. Daily time-weighted average concentrations of carbon monoxide and nitrogen dioxide amounted to 9 % and 25% of the applicable hygienic limit values. Time-weighted average concentration and the proportion of respirable dust in total dust during a workshift were significantly correlated with across-shift decreases in lung function. In the absence of a suitable measure for total diesel exhaust exposure, the ratio of the proportion of respirable dust in total dust in a workplace may serve as an indicator of the concentration of soot particles in diesel exhaust.

Journal Article↗

Experimental evaluation of the effect of filtration of diesel exhaust by biologic exposure indicators.

The airway resistance, compliance of the respiratory system, transfer factor, and alveolar volume of 33 healthy rabbits were studied before and after exposure to diluted diesel exhaust generated in an experimental motor. Three diesel fuels and two particle traps were tested. Subsequent to the post-exposure lung function measurements, the animals were sacrificed and the lungs were processed for morphologic examination. The concentrations of particles, nitrogen dioxide, and formaldehyde were measured. The inflammatory airway changes were most pronounced in animals exposed to exhaust from standard fuel. Small changes were identified in animals exposed to exhaust filtered through the catalytic trap as well or exposed to unfiltered exhaust from fuels intended for densely built-up areas. Increase in compliance of the respiratory system was associated with the concentration of soot particles and formaldehyde. Compliance decreased significantly in animals exposed to exhaust from standard fuel filtered through the particle traps and increased almost significantly in animals exposed to unfiltered exhaust from the same fuel.

Air Pollutants↗

Does abnormal single-breath nitrogen wash-out predict an accelerated decline in FEV1 in lung-healthy subjects?

Single-breath nitrogen wash-out and forced expirograms measured on two occasions, 8 years apart, were analysed for 24 subjects with varying degrees of peripheral airway involvement. Correlation analyses were carried out between closing volume in percentage of vital capacity (CV%), the slope of the alveolar plateau (phase III) and forced expiratory volume in 1 s (FEV1) for both occasions. The correlations between CV% and phase III measured on the first occasion and the long-term change in FEV1 were also studied. It is concluded that large deviations are required for CV% as well as phase III before any pathological decreases in the large airways will occur. The prognostic value of an abnormal single-breath nitrogen wash-out seems to be limited, at least in lung-healthy subjects.

Adult↗

Effects within the week on forced vital capacity are correlated with long term changes in pulmonary function: reanalysis of studies on car painters exposed to isocyanate.

OBJECTIVES: To examine if car painters who work with polyurethane paints that contain hexamethylenediisocyanate (HDI) and hexamethylenediisocyanate biuret trimer (HDI-BT) develop acute as well as chronic impairment of lung function. METHODS: In this study data were reanalysed from two earlier studies on a group of car painters to see if a decrease in lung function within the week is a marker of vulnerability in those workers. Data on changes in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) within the week were available for 20 car painters who were also examined six years later. RESULTS: 10 men showed a decline in FVC within the week. There were no significant differences in age, duration of employment, exposures during the follow up period, or smoking between car painters who had decline in lung function within the week and car painters who had not. A significant correlation was found between the change in FVC within the week and the long term (six year) change in FVC, standardised for the effects of aging and smoking, and adjusted for the number of peak exposures. CONCLUSIONS: The results suggest that the decrease in FVC within the week might serve as a guide to identify car painters at risk of a further decrement in lung function above the effects of aging, smoking, and exposure.

Adult↗

The significance of an across-shift decrease in vital capacity--a re-analysis of a study on subjects exposed to diesel exhaust.

Occupational exposure to diesel exhaust may develop acute as well as chronic lung function impairment. In this study, data from an earlier study on a group of subjects working at tunnel construction site were analyzed. The aim of the analysis was to examine the significance of an across-shift decrease in vital capacity with concern to other lung physiological measurements. There were no statistically significant differences, either in the average age, time of employment, vital capacity before a working shift after two days of no exposure, or the distributions of smoking habits and respiratory symptoms, between the eight workers who had an across-shift decrease in vital capacity and the five workers who had not. Subjects with an across-shift decrease in vital capacity had a significantly greater across-shift decrease in residual volume and total lung capacity than subjects without an across-shift decrease in vital capacity. The pathophysiological mechanisms for this across-shift decrease in residual volume is not fully understood. However, an altered defence mechanism in the lung may play a role for a prolonged retention time for the particles in the inhaled diesel exhaust, resulting in the across-shift decrease in residual volume. The results thus suggest that measurements of across-shift vital capacity is of importance in identifying susceptible subjects with occupational exposure to diesel exhaust.

Adult↗

Acute effects on forced expiratory volume in one second and longitudinal change in pulmonary function among wood trimmers.

Wood trimmers are exposed to molds that periodically grow on timber, and may develop acute as well as chronic pulmonary function impairment. This study examined whether these acute changes in pulmonary function are predictors for a longitudinal deterioration in pulmonary function, beyond normal aging and exposure. Across-shift changes in pulmonary function, measured during a working week, were evaluated in 15 wood trimmers with a follow-up time of 27 months. Twenty-six sawmill workers, employed at the same plants as the wood trimmers, served as control subjects. The highest concentration of viable mold spores for the wood trimmers was 10(6) colony-forming units (cfu)/m3, i.e., several times higher than the corresponding value for the sawmill workers. At the follow-up, wood trimmers had a lower forced vital capacity (FVC) on average, after adjustment for age and height, compared to the sawmill workers. In addition, a correlation was found between the across-week change in forced expiratory volume in 1 second (FEV1) and the decline in FEV1 between the first and the second occasion, after adjusting for normal aging in nonsmoking wood trimmers (r2 = 84%, p < 0.001). The results from the present study suggest that across-shift decrease in FEV1 (measured during a working week) might serve as a guide to identify subjects being at risk for a further decrement in pulmonary function over and above the effects of normal aging and exposure to mold spores in the wood trimming department.

Air Pollutants, Occupational↗

Repeated measurements of transfer factor in rabbits: an animal model suitable for evaluation of short-term exposure.

Acute temporary changes in lung function may be of use as a biological exposure indicator. However, studies of humans occupationally exposed to complex airborne irritants are often expensive and time demanding. Therefore, an animal model could be a valuable complement. A rabbit model has been evaluated where transfer factor was measured twice during the same day, and with the rabbit awake and available for exposure, in between. Anaesthesia and intubation in 22 rabbits (2.6 [0.2] kg [Mean (SD)]) were immediately followed by two measurements of transfer factor and alveolar volume. Transfer factor was estimated by the single breath CO-technique used in humans. The samples were analysed for CO and He on a gas chromatograph. After one pair of measurements the rabbit was allowed to wake up and after 5 h the duplicate measurements were repeated. The mean values of transfer factor, alveolar volume and transfer constant were 0.50 (0.09) mmol min-1 kPa-1, 127 (8) ml and 3.9 (0.6) mmol min-1 kPa-1 l-1, respectively. The intraindividual coefficients of variation were 7.3%, 5.3% and 6.7%, respectively. Five hours later when the duplicate measurements were repeated, transfer factor, alveolar volume and transfer constant were unchanged still. The results suggest that relatively small changes in transfer factor may be detected without losing power, and thus that this model could be used as a biological exposure indicator.

Anesthesia↗

Small airways function in aluminium and stainless steel welders.

The effect of welding fumes on small airways was studied in 25 male subjects who welded in aluminium (Al) and to some extent also in stainless steel (SS). Despite a low exposure to welding fumes as compared to the permissible exposure limits, excretion of Al in urine was found to be increased in all subjects (median value: 0.29 mmol/mol creatinine on Friday afternoon, as compared to an upper reference level of 0.10 mmol/mol creatinine). In addition, the welders displayed increased prevalences of work-related eye and airways (pharyngitis and non-specific bronchial hyperreactivity) symptoms, as compared to 25 matched controls. Short-term welders (< or = 2.5 years) had more symptoms related to the upper airways than did long-term welders, which may indicate a selection. Spirometry, closing volume and volume of trapped gas (VTG) did not deviate. However, after methacholine inhalation, the long-term welders had a significantly steeper slope of the alveolar plateau on the single-breath nitrogen wash-out test, and a slight increase in VTG, as compared to the short-term welders and the controls. These findings may indicate a welding fume-induced increase in the reactivity of the small airways. Because Al welding was far more frequent than SS welding, an association with the former seems likely.

Adult↗

Lung function and precipitating antibodies in low exposed wood trimmers in Sweden.

Wood trimmers are exposed to molds that periodically grow on timber that may induce alveolitis and obstructive lung disease. We have evaluated respiratory symptoms, bronchial reactivity, and lung function in 28 wood trimmers at a Swedish sawmill and in 19 unexposed office workers. Eleven (sero-positive) of the wood trimmers had precipitating antibodies in peripheral blood against one or several molds. The exposure to dust (median 0.26 mg/m3), viable mold spores (median 2950 cfu/m3), viable bacteria (median 370 cfu/m3), airborne endotoxins (range 0.0015-0.0025 microgram/m3), and terpenes (range 0.4-23 mg/m3) was lower than levels that earlier have been reported to affect lung function. The wood trimmers reported an increased prevalence of cough and breathlessness. They also showed signs of a mild obstructive impairment with a tendency to increase bronchial sensitivity to metacholine and decreased FEV1 after 2 days free from exposure. FEV1 decreased more during the working week in the sero-positive workers than among the sero-negative workers, and for the whole group the decrease in FEV1 and MEF25 was correlated to the degree of mold exposure.

Adult↗

Lung function and exposure to asbestos among vehicle mechanics.

Vehicle mechanics (n = 99) exposed to asbestos (annual median value 0.08 f/ml), and local controls (n = 83) not occupationally exposed to asbestos were studied with regard to symptoms and pulmonary function. The inclusion criteria to participate in this study was an age of at least 40 years with no known exposure to lung irritating agents, and for the exposed subjects, more than 15 years occupational exposure to asbestos with at least 20 years from the first exposure. The subjects were studied during identical conditions by means of dynamic and static spirometry, single breath wash-out with nitrogen (N2) and carbon monoxide (CO). The median for cumulative exposure of asbestos during the entire work life among the studied mechanics was 2.3 f*y/ml. The mechanics had reduced transfer factor (TLCO), after adjustment for age, height, and smoking category. A significant dose-response relationship was noted between the cumulative exposure of asbestos and CV%. The findings suggest a slight influence of small airways and alveoli. The evaluation of the prognostic significance of this requires a longitudinal study.

Adult↗

Signs of alveolar inflammation in non-smoking Swedish wood trimmers.

Wood trimmers are periodically exposed to mould and may develop extrinsic allergic alveolitis (EAA). To investigate if there were any signs of EAA in wood trimmers with low exposure, 19 non-smoking wood trimmers underwent bronchoalveolar lavage (BAL), spirometry, and measurement of diffusion capacity (TLCO). The group was subdivided into those with (n = 9) and without serological antibodies against mould. In 14 workers the TLCO was measured both at the beginning and at the end of a week at work. Twenty five healthy non-smokers served as BAL controls and 19 healthy non-smokers as lung function controls. The median exposure of total dust was well below the Swedish threshold value, and the exposure of mould and bacteria was also low. The cell concentrations and the proportions of the various alveolar cells did not differ between the groups. The concentrations of the soluble components albumin, fibronectin, and hyaluronan were, however, significantly increased (p less than 0.001 for all) in the workers. No difference was found in lung function between the workers and the controls, and the TLCO was not impaired during a week at work. The groups of seropositive and seronegative workers did not differ in any of these parameters. The results are interpreted as a low intensity alveolar inflammation. The presence of precipitating antibodies against mould did not predict any greater risk of developing a more intense inflammation. Analysis of soluble non-cellular BAL components seems to reflect a discrete ongoing alveolar inflammation better than cell counts only.

Adult↗

Lung function and exposure to paper dust in bookbinders--a pilot study.

Lung function deterioration has been reported among workers exposed to heavy exposure to paper dust (greater than 5 mg/m3). This pilot study was undertaken in order to evaluate the health effects of low exposure to paper dust (less than or equal to 1 mg/m3) in bookbinders. The study population consisted of 20 exposed subjects and 18 local office subjects. They were studied during identical conditions by means of dynamic and static spirometry, single breath wash-out with nitrogen (N2) and carbon monoxide (CO). The 90th percentile for daily average values of total dust was 0.6 mg/m3. Non-smoking exposed subjects had on the average an increase in FEV% (forced expiratory volume in one second in percentage of vital capacity) when compared to non-smoking local control subjects. We found a weak correlation between the increase in FEV% and daily average values of total dust (probably reflecting a higher exposure in the past). The results suggest that a low exposure to paper dust in bookbinders with a time of employment more than 10 years might cause a slight lung function deterioration without a clinical relevance.

Adult↗

Temporary health effects from exposure to water-borne paints.

Temporary health effects of exposure to experimental paints were studied. Ten painters feeling nuisance from water-borne paints and eight painters not feeling such nuisance applied eight experimental water-borne paints according to normal work routines. The effects were a decrease in forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow, an increase in urine excretion, and a decrease in urine density. A small, but statistically highly significant, increase in the mean volume of erythrocytes was observed. The effects were similar in the two groups, but the "nuisance group" reacted with a larger urine excretion and a larger increase in the mean volume of erythrocytes. The effects did not influence physical work capacity. The effects on the lungs and urinary excretion were probably not associated with the organic solvents or ammonia in the paints. Instead, they were probably due to derivatives of isothiazolinone. This assumption needs verification.

Adult↗

Pulmonary function in workers exposed to diesel exhausts: the effect of control measures.

To assess the protective effect of exhausts pipe filters or respirators on pulmonary function, 15 workers in a tunnel construction site, truck and loading machine drivers, rock workers, and others were studied. The total and respirable dust, combustible matter in respirable dust, carbon monoxide, nitrogen monoxide and nitrogen dioxide were measured for each subject during entire work shifts. The effect of the exposure on the lung function variables was measured by dynamic spirometry, carbon monoxide single breath technique, and nitrogen single breath wash-out. The exhaust pipe filtering had a protective effect, directly discernible in the drivers on vital capacity and FEV1.0 and for the whole group on FEV% and TLco. The dust respirators had no effect, probably because of the difficulties in correctly using personal protection under the circumstances in the tunnel. In the absence of a true exposure assessment, control measures for diesel exhausts can be tested by medical effect studies. Catalytic particle filters of diesel exhausts are one method of rendering the emissions less irritant, although they will not remove irritant gases. An indicator of diesel exhaust exposure should include the particle fraction of the diesel exhausts, but a discrimination between different sources of organic dust must be possible.

Adult↗

Impeded lung function in moulders and coremakers handling furan resin sand.

A total of 39 moulders and coremakers exposed to furan resin sand and 27 unexposed local controls were examined by lung-function tests before and after a work shift. In all, 28 of the subjects exposed to furan resin sand and the control group were evaluated by dynamic spirometry and nitrogen washout. The remaining 11 subjects exposed to furan resin sand were studied using both static and dynamic spirometry and the CO single-breath technique. The time-weighted average exposure to furfuryl alcohol was about 7 mg/m3, with peak values exceeding the present Swedish short-term exposure limit (40 mg/m3). The exposure to respirable dust and formaldehyde as time-weighted over the shift was less than 2 mg/m3 and 0.4 mg/m3, respectively, in all groups. During the work shift studied, the 28 exposed subjects had more complaints of airway symptoms than did the controls, showing an average decrease of 0.21 in forced vital capacity but no fall in any other lung-function variable. The remaining 11 exposed subjects demonstrated a post-shift decrease in total lung capacity. The results indicate an acute restrictiveness induced by exposure to furan resin sand, but the underlying mechanism is unclear. Chronic impairment of lung function was not observed.

Adult↗