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Biomedical subjects

M J Abramson

Publications and source records attributed to M J Abramson.

At least 19 recordsLinked to original sources
PubMed2006

Primary prevention of latex related sensitisation and occupational asthma: a systematic review.

METHODS: Eight primary prevention intervention studies on natural rubber latex (NRL) published since 1990 were identified and reviewed. This is the largest evidence base of primary prevention studies for any occupational asthmagen. RESULTS: Review of this small and largely observational evidence base supports the following evidence statement: Substitution of powdered latex gloves with low protein powder-free NRL gloves or latex-free gloves greatly reduces NRL aeroallergens, NRL sensitisation, and NRL-asthma in healthcare workers. Evidence in support of this statement is ranked SIGN level 2+, referring to well conducted case-control or cohort studies with a low risk of confounding, bias, or chance and a moderate probability that the relationship is causal. CONCLUSION: Substitution of powdered latex gloves with low protein powder-free NRL gloves or latex-free gloves promises benefits to both workers' health and cost and human resource savings for employers. This message should be broadly disseminated beyond the hospital sector to include other healthcare settings (such as aged care facilities) as well as food service and other industries where latex gloves might be used.

Air Pollutants, Occupational↗
PubMed2006

How have we been managing chronic obstructive pulmonary disease in Australia?

AIM: Although chronic obstructive pulmonary disease (COPD) is a main cause of disability, hospital admissions and premature deaths in Australia, little is known about the community management of COPD in relation to recently published guidelines. The aim of the article was to report on COPD management in a community based cohort. METHODS: A random sample of adults aged between 45 and 70 years drawn from the electoral roll participated in the study. They completed a detailed respiratory questionnaire, spirometry, methacholine challenge and measurement of transfer factor. COPD was defined according to the Global initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Current asthma was defined as wheeze during the last 12 months together with bronchial hyperreactivity. Subjects were classified as either COPD-only, asthma-only or both asthma and COPD. RESULTS: Of 1224 subjects completing spirometry, 39 (3.5%) met the GOLD criteria for stage 2 or 3 COPD, asthma-only was found in 99 (8.9%) subjects and 40 (3.6%) subjects had both asthma and COPD. The COPD-only group was significantly older than the other two groups. More than 40% of subjects with COPD did not have a diagnosis of COPD from their doctors. Only 48.7% of subjects with COPD had ever been prescribed medication for their breathing. More than two-thirds of all subjects had seen a doctor for breathing problems, but very few had seen a general practitioner in the last 12 months and even fewer had respiratory function tests. CONCLUSIONS: Most subjects with COPD are being undertreated. Diagnosis, monitoring and referral systems should be improved. Preventive activities such as influenza vaccination and smoking cessation should be intensified.

Administration, Inhalation↗
PubMed2005

Mass media interventions for promoting HIV testing.

BACKGROUND: Use of the mass media is one of the important strategies in communicating behavioral change in relation to HIV/AIDS prevention. Mass media are used to promote voluntary HIV counseling and testing and to sustain test-seeking behavior. OBJECTIVES: To assess the effect of mass media interventions and the most effective form of mass media intervention at a general population level or in specific target populations, in relation to changes in HIV testing, compared with a control group or with pre-intervention levels. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2004), MEDLINE (1966 to April 2004), EMBASE (1980 to April 2004), NLM Gateway, CINAHL (1982 to April 2004), AIDSearch (1980 to April 2004), and PsycINFO (1974 to April 2004), Sociological abstracts (1982 to April 2004), and Communication studies (1982 to April 2003). The reference lists of related reviews were searched and experts in the field were contacted to identify ongoing research. Relevant web sites of international agencies (UNAIDS, WHO, UNFPA, World Bank, and Centers for Disease Control and Prevention) were also searched. All these searches were done without language restriction. All databases were searched up to April 2004. SELECTION CRITERIA: Randomized controlled trials, including cluster-randomized trials and controlled clinical trials, that compared either multimedia interventions or one type of media strategy with a control in relation to promotion of HIV testing were included. Interrupted time series analyses that assessed the effect of mass media against no media or an alternative intervention to promote HIV testing were also included. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Study authors were contacted for additional information. Types of mass media interventions, participants, and outcomes were extracted in every possible instance. MAIN RESULTS: Of the 35 references that were identified, two randomized controlled trials, three non-randomized controlled studies, and nine interrupted time series were included in the final analysis. All individual studies concluded that mass media were effective, and this was confirmed by reanalysis of the interrupted time series studies which all had initial impact. Mass media interventions for promotion of HIV testing showed significant immediate (Random effect: Estimated mean = 5.487, 95%CI = 2.370 to 8.605) and overall (Random effect: Estimated mean = 6.095, 95%CI = 1.812 to 10.378) effect. No long-term effects were seen on mass media interventions for promotion of HIV testing (Random effect: Estimated mean = 4.447, 95%CI = -0.188 to 9.082). AUTHORS' CONCLUSIONS: Mass media interventions have immediate and overall effects in promotion of HIV testing. No long-term effects were seen. There was no significant impact of detecting seropositive status after mass media intervention for promoting HIV testing, and this finding was limited to a small number of studies. Further research is required to identify possible effects on seropositivity status after mass media intervention for promotion of HIV testing among high-risk groups in epidemic countries. Additional research is needed to identify the effectiveness of different types of mass media interventions, the cost effectiveness of the interventions, and characteristics of messages.

Controlled Clinical Trials as Topic↗
PubMed2005

Caregivers' use of, and attitudes towards, written asthma action plans in North-West Melbourne.

We investigated the attitudes of caregivers towards written asthma action plans (WAAPs). A small number of caregivers participating in a larger randomised controlled trial (RCT) participated in qualitative interviews. 'Ownership and use of WAAPs' and 'Schools and WAAPs' were the main themes to emerge. The new school year is an opportunity to review and update WAAPs.

Journal Article↗
PubMed2005

Changes in indoor allergen and fungal levels predict changes in asthma activity among young adults.

BACKGROUND: Exposures to allergens are thought to be important risk factors for asthma. We conducted a longitudinal study of indoor allergen and fungal levels in Melbourne homes between 1996 and 1998 to examine the effect of changes in allergen exposure upon asthma and associated outcomes. METHODS: Participants were visited at home in 1996 (n=485) and 1998 (n=360), when dust and air samples were collected from their bedrooms and assayed for Der p 1, Fel d 1, ergosterol and fungal propagules. Subjects then attended the lung function laboratory to complete a questionnaire, spirometry, methacholine challenge and skin prick testing. The associations between the change in allergen levels and change in clinical outcomes were examined using multiple logistic and linear regression. RESULTS: Participants whose Cladosporium fungal exposure doubled had 52% greater odds of having had an attack of asthma in the last 12 months. A doubling of fungal exposure was also associated with 53% greater odds of developing atopy. A doubling of Fel d 1 floor levels was associated with 73% increased odds of doctor-diagnosed asthma. A doubling of Der p 1 levels in bed dust was associated with a 64% greater odds of persistent bronchial hyper-reactivity. CONCLUSIONS: These findings provide evidence that changes in indoor levels of fungi and house dust mites can affect the risk of development and persistence of asthma and atopy in adults. Further studies are required to establish any benefit of sustained reductions in indoor allergen exposures, and to determine whether these effects are truly 'allergic' or because of immune stimulation in the airway through other less specific mechanisms.

Adult↗
PubMed2005

Asthma 3+ Visit Plan: a qualitative evaluation.

INTRODUCTION: The Asthma 3+ Visit Plan is a Commonwealth primary care initiative to improve care for patients with moderate or severe asthma through visits to general practitioners (GP). AIMS: To assess the use of, and barriers to, completing the Asthma 3+ Visit Plan in recurrent emergency department attendees; asthma knowledge, symptoms and quality of life were assessed before and after undertaking the plan. METHODS: The design was a predominantly qualitative study. Consenting individuals who presented for emergency treatment for asthma were interviewed before and after completing the Asthma 3+ Visit Plan with their GP. Asthma knowledge, symptom control, quality of life and demographic information were collected and participants underwent in-depth interviews for qualitative analysis. The setting was a tertiary teaching hospital and two suburban hospitals. The participants were 20 recurrent emergency attendees with asthma. RESULTS: Individuals who completed the Asthma 3+ Visit Plan had significant improvements in asthma-related quality of life and asthma knowledge. Qualitative interviews revealed that recurrent emergency attendees for asthma viewed the Asthma 3+ Visit Plan favourably. A good relationship with the GP appeared integral to the success of the Asthma 3+ Visit Plan and patient recall was an important factor in plan completion. Cost was also a barrier to patients completing the plan. CONCLUSION: Our findings support the Asthma 3+ Visit Plan as a discharge strategy for recurrent emergency attendees with asthma.

Adolescent↗
PubMed2005

Biological dust exposure in the workplace is a risk factor for chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Although the main risk factor is smoking, 15-19% of COPD even in smokers has been attributed to occupational exposures. The aim of this study was to investigate the association between occupational exposure and risk of COPD. METHODS: Participants were part of a cross sectional study of risk factors for COPD. A total of 1232 completed a detailed respiratory questionnaire, spirometric testing and measurement of gas transfer. Job histories were coded according to the International Standard Classification of Occupations. These codes were then used to establish occupational exposures using the ALOHA job exposure matrix. RESULTS: The prevalence of emphysema was 2.4%, chronic obstructive bronchitis 1.8%, and COPD 3.4%. Subjects ever exposed to biological dusts had an increased risk of chronic obstructive bronchitis (OR 3.19; 95% CI 1.27 to 7.97), emphysema (OR 3.18; 95% CI 1.41 to 7.13), and COPD (OR 2.70, 95% CI 1.39 to 5.23). These risks were higher in women than in men. For biological dust, the risk of emphysema and COPD was also significantly increased in both the duration of exposure categories, again in women but not in men. No significant increased risks for COPD were found for mineral dust (OR 1.13; 95% CI 0.57 to 2.27) or gases/fumes (OR 1.63; 95% CI 0.83 to 3.22). CONCLUSION: In this general population sample of adults, occupational exposures to biological dusts were associated with an increased risk of COPD which was higher in women. Preventive strategies should be aimed at reducing exposure to these agents in the workplace.

Aged↗
PubMed2005

Time to death, airway wall inflammation and remodelling in fatal asthma.

Fatal asthma is characterised pathologically by airway wall remodelling, eosinophil and neutrophil infiltration, accumulation of mucus in the airway lumen and smooth muscle shortening. The durations of fatal attacks of asthma show a clear bimodal distribution. Airway smooth muscle contraction and the accumulation of luminal mucus may contribute to death from asthma and relate to time to death. The current authors have examined these two components in uninflated lung tissue in cases of fatal asthma from the second Victorian asthma mortality study. Based on time from onset of symptoms to death, cases fell into two distinct groups: short course <3 (1.5+/-0.6 mean+/-sd) h; and long course >8 (12.3+/-5.9) h. Short course cases had more muscle shortening, higher levels of salbutamol and higher ratios of neutrophils to eosinophils than long course cases, who tended to have more mucus in the lumen. In conclusion, this study confirms the dichotomy of both time to death and the eosinophil/neutrophil ratio in cases of fatal asthma. It suggests that in short course cases acute airway narrowing is due, predominantly, to bronchoconstriction despite higher blood levels of salbutamol. Mucus accumulation may be more important in long course cases.

Adolescent↗
PubMed2004

Factors associated with ownership and use of written asthma action plans in North-West Melbourne.

PURPOSE: Written asthma action plans (WAAPs) have become a core component of asthma management in Australia. We investigated ownership, utilisation and factors associated with ownership of asthma action plans by caregivers. METHODS: 443/776 (57%) caregivers of children aged 2-14 years with asthma were identified from 32 GP clinics as part of a randomised controlled trial (RCT), and completed self-administered questionnaires. RESULTS: Only 29% of participants owned a WAAP, while 13% possessed verbal instructions, and 56% had no plan. An asthma action plan for children, which was developed by a general practitioner (GP) was more likely to comprise verbal instructions (p = 0.001), while action plans developed by paediatricians were more likely to be written (p < 0.001). Just over one half of caregivers (59%) reported discussing their child's action plan the last time they visited their doctor for asthma. Factors associated with WAAP ownership included nights waking (p = 0.013), self reported severity (p = 0.001), and days lost from school (p = 0.037). Children who had seen a GP in the last 3 months for asthma, or who had been to the Emergency Department (ED) or hospital were more likely to possess a WAAP (p < 0.001). Caregivers who were less satisfied with their child's asthma control were more likely to own a WAAP (p = 0.037). Caregivers with any action plan found it useful and 82% reported using their action plan for management of an acute attack. However, caregivers with a WAAP were more likely to adhere to the plan for an acute attack compared to caregivers with verbal instructions (OR = 4.5, p < 0.05). Caregivers with a WAAP were more knowledgeable about asthma (p = 0.002), better able to recognise the difference between preventer and reliever medications (p = 0.01), and better able to recognise an asthma attack (p = 0.006). CONCLUSIONS: Ownership of WAAPs in this group was still too low. Importantly, caregivers with written instructions were more knowledgeable about asthma and more likely to report following the action plan during an asthma attack.

Journal Article↗
PubMed2004

Maternal breast milk long-chain n-3 fatty acids are associated with increased risk of atopy in breastfed infants.

BACKGROUND: Australia has one of the highest prevalence rates internationally of allergic conditions, such as asthma and eczema. Atopy is one hallmark for the development of allergic disease and predisposes to allergic inflammation in the target organs. omega-3 (n-3) fatty acids (FAs) are thought to act as precursors to the formation of less active inflammatory mediators, with the potential to reduce inflammation. OBJECTIVE: To investigate whether increased n-3 FA levels in maternal breast milk are associated with a lower risk of developing atopy in infancy. METHODS: Subjects were part of the prospective Melbourne atopy cohort study, which involved 620 children born into families where at least one first-degree relative had an atopic disease. Some 224 women (mean age 31.4+/-4.2 (SD) years, with 73.2% (n=164) having self-reported atopy) provided either a colostrum (n=194) or 3-month expressed breast milk (EBM) sample (n=118). Maternal colostrum and 3-month EBM samples were analysed for FA content by gas chromatography. Skin prick tests (SPTs) to six common allergens were performed on infants at 6, 12 and 24 months of age and on mothers who agreed at study entry. RESULTS: For infants sensitized to foods at 6 months (n=29), the total n-3 FA level in the colostrum was significantly higher (P=0.004) as were levels of individual long-chain n-3 FAs, docosoapentaenoic acid (DPA, C22:5, P=0.001) and docosahexaenoic acid (DHA, C22:6, P=0.002) than in non-sensitized infants. Infants with aero-allergen sensitization at 24 months (n=30) had higher levels of the n-3 FA, DPA (P=0.002) and DHA (P=0.007), and similarly higher total n-3 FA (P=0.009) in maternal colostrum than those infants who were not sensitized. CONCLUSION: Higher n-3 FA levels in the colostrum do not appear to confer protection against, but may be a risk factor for, the eventual development of atopy in high-risk breastfed infants.

Adult↗
PubMed2004

Symptoms and medical conditions in Australian veterans of the 1991 Gulf War: relation to immunisations and other Gulf War exposures.

AIMS: To investigate whether Australian Gulf War veterans have a higher than expected prevalence of recent symptoms and medical conditions that were first diagnosed in the period following the 1991 Gulf War; and if so, whether these effects were associated with exposures and experiences that occurred in the Gulf War. METHODS: Cross-sectional study of 1456 Australian Gulf War veterans and a comparison group who were in operational units at the time of the Gulf War, but were not deployed to that conflict (n = 1588). A postal questionnaire was administered and the likelihood of the diagnosis of self-reported medical conditions was assessed and rated by a medical practitioner. RESULTS: Gulf War veterans had a higher prevalence of all self-reported health symptoms than the comparison group, and more of the Gulf War veterans had severe symptoms. Increased symptom reporting was associated with several exposures, including having more than 10 immunisations, pyridostigmine bromide tablets, anti-biological warfare tablets, pesticides, insect repellents, reportedly being in a chemical weapons area, and stressful military service experiences in a strong dose-response relation. Gulf War veterans reported psychological (particularly post-traumatic stress disorder), skin, eye, and sinus conditions first diagnosed in 1991 or later more commonly than the comparison group. Over 90% of medical conditions reported by both study groups were rated by a medical practitioner as having a high likelihood of diagnosis. CONCLUSION: More than 10 years after the 1991 Gulf War, Australian veterans self-report all symptoms and some medical conditions more commonly than the comparison group. Further analysis of the severity of symptoms and likelihood of the diagnosis of medical conditions suggested that these findings are not due to over-reporting or to participation bias.

Adult↗
PubMed2004

Fatty acid levels and risk of asthma in young adults.

BACKGROUND: There is current interest in the possible protective effect of long chain (n-3) fatty acids from fish in chronic lung diseases such as asthma. The aim of this community based cross sectional study was to determine whether plasma long chain (n-3) fatty acids, as a measure of dietary intake, differed between 1601 young adults with and without asthma. METHODS: Subjects of mean (SD) age 34.6 (7.1) years completed a detailed respiratory questionnaire, food frequency questionnaire, skin prick testing, and lung function tests including methacholine challenge test for bronchial hyperreactivity (BHR) and had venous blood taken for analysis of plasma fatty acids. Plasma fatty acid levels (%) were analysed using multiple logistic regression with alternative definitions of asthma and atopy as the outcomes. RESULTS: Atopy was not associated with any plasma fatty acid. The n-3 polyunsaturated fatty acids and n-6:n-3 ratio were not consistently associated with asthma or atopy. The n-6 polyunsaturated fatty acid dihomo gamma-linolenic acid (DHGLA) was positively associated with current asthma (OR=1.30, 95% CI 1.06 to 1.60), asthma (OR=1.34, 95% CI 1.13 to 1.60), and doctor diagnosed asthma (OR=1.25, 95% CI 1.06 to 1.48). CONCLUSION: Plasma n-3 fatty acids are not associated with a reduced risk of asthma or atopy among young adults. The association of DHGLA with asthma warrants further research to determine a cause-effect relationship.

Adult↗
PubMed2004

Respiratory health status of Australian veterans of the 1991 Gulf War and the effects of exposure to oil fire smoke and dust storms.

BACKGROUND: Since the 1991 Gulf War concerns have been raised about the effects on veterans' health of exposures to Kuwaiti oil fire smoke and to dust storms. METHODS: A cross sectional study compared 1456 Australian Gulf War veterans with a randomly sampled military comparison group (n = 1588). A postal questionnaire asked about respiratory conditions, exposures, medications, tobacco use, demographic characteristics, and military service details. During a medical assessment, spirometric tests and a physical examination were performed and a respiratory questionnaire was administered. RESULTS: The response rate for the Gulf War veteran group was 80.5% and for the comparison group 56.8%. Australian Gulf War veterans had a higher than expected prevalence of respiratory symptoms and respiratory conditions suggesting asthma (OR 1.4; 95% CI 1.1 to 1.9) and bronchitis first diagnosed since the Gulf War (OR 1.9; 95% CI 1.2 to 3.1) but did not have poorer lung function or more ventilatory abnormalities than the comparison group. Veterans who reported exposure to oil fire smoke had slightly poorer forced vital capacity (difference between means -0.10 l; 95% CI -0.18 to -0.03) and those exposed to dust storms had a slightly better peak expiratory flow rate (difference between means 12.0 l/min; 95% CI 0.6 to 23.4) than veterans who did not report exposure. Veterans who were in the Gulf at or after the start of the oil fires had more respiratory conditions suggesting asthma (OR 1.7; 95% CI 1.0 to 2.9) than those who completed their deployment before this time. CONCLUSIONS: Increased self-reporting of respiratory symptoms, asthma, and bronchitis by veterans was not reflected in poorer lung function. The findings do not suggest major long term sequelae of exposure to oil fire smoke or dust storms.

Adult↗
PubMed2003

Residential characteristics predict changes in Der p 1, Fel d 1 and ergosterol but not fungi over time.

BACKGROUND: Allergen and fungal exposures are important risk factors for asthma. We conducted a longitudinal analysis of allergen levels in Melbourne homes between 1996 and 1998 to examine the effects of changing residential characteristics on allergen and fungal levels. We also examined the changes in levels of indoor allergens. METHODS: The subjects were participants in the European Community Respiratory Health Survey (ECRHS) in Melbourne. In 1996, 485 subjects participated in a follow-up study, which involved both home and laboratory visits. Dust and air samples were collected from participants' bedrooms and a validated residential questionnaire was administered. In 1998, 360 participants underwent further follow-up. House dust mite (Der p 1) and cat allergens (Fel d 1) and ergosterol were measured in dust. RESULTS: We observed moderate within home correlations between 1996 and 1998 in floor Der p 1 (intraclass correlation ICC=0.48), bed Der p 1 (ICC=0.61), Fel d 1 (kappa=0.53) and ergosterol (ICC=0.28) levels. We found that the floor Der p 1 levels decreased from 1996 to 1998 in the homes of participants who moved to an attached home, moved their bedrooms to the first floor, removed fitted carpet or central heating. Replacing or vacuuming the mattress more than twice per year reduced levels of Der p 1 in the bed. Ergosterol levels were reduced by removing visible mould and fitted carpet. CONCLUSIONS: These findings provide evidence to support current advice with regard to allergen avoidance in patients with dust mite and fungal allergies.

Adult↗
PubMed2003

How well do doctors know their patients with severe asthma?

BACKGROUND: Rates of asthma mortality have fallen in Australia since the commencement of the National Asthma Campaign and promotion of the Australian asthma management plan. New strategies are now needed to further reduce mortality. AIM: To examine agreement about key features between asthma patients and their general practitioners (GPs). METHODS: We interviewed: (i) the next of kin of 56 asthma deaths, (ii) 91 asthma patients presenting to emergency departments with acute severe asthma and (iii) 147 of their GPs. RESULTS: Agreement was substantial for usage of oral symptomatic medication, but poor for inhaled symptomatic and preventive medications. There was moderate agreement regarding hospital admissions within the last 12 months among the cases, but little about other markers of severity. There was moderate agreement where the presenting or fatal attack was triggered by an upper respiratory-tract infection or aspirin. The next of kin and GPs agreed about family problems, but not about other psychosocial issues. They also agreed about which cases had been given action plans or verbal instructions, but few other aspects of asthma management. There was also moderate agreement regarding the use of peak flow meters by the controls. CONCLUSIONS: Doctors often have relatively poor insights into self-management practices, social background or trigger factors, even in high-risk patients. This should be considered when planning future campaigns to improve asthma management and further reduce mortality.

Adult↗
PubMed2003

Screening for lung cancer: a systematic review and meta-analysis of controlled trials.

BACKGROUND: Lung cancer is a substantial public health problem in western countries. Previous studies have examined different screening strategies for lung cancer but there have been no published systematic reviews. METHODS: A systematic review of controlled trials was conducted to determine whether screening for lung cancer using regular sputum examinations or chest radiography or computed tomography (CT) reduces lung cancer mortality. The primary outcome was lung cancer mortality; secondary outcomes were lung cancer survival and all cause mortality. RESULTS: One non-randomised controlled trial and six randomised controlled trials with a total of 245 610 subjects were included in the review. In all studies the control group received some type of screening. More frequent screening with chest radiography was associated with an 11% relative increase in mortality from lung cancer compared with less frequent screening (RR 1.11, 95% CI 1.00 to 1.23). A non-statistically significant trend to reduced mortality from lung cancer was observed when screening with chest radiography and sputum cytological examination was compared with chest radiography alone (RR 0.88, 95% CI 0.74 to 1.03). Several of the included studies had potential methodological weaknesses. Controlled studies of spiral CT scanning have not been reported. CONCLUSIONS: The current evidence does not support screening for lung cancer with chest radiography or sputum cytological examination. Frequent chest radiography might be harmful. Further methodologically rigorous trials are required before any new screening methods are introduced into clinical practice.

Controlled Clinical Trials as Topic↗
PubMed2001

Respiratory symptoms and lung function in bauxite miners.

OBJECTIVES: To determine whether cumulative bauxite exposure is associated with respiratory symptoms or changes in lung function in a group of bauxite miners. METHODS: Current employees at three bauxite mines in Australia were invited to participate in a survey comprising: questionnaire on demographic details, respiratory symptoms, and work history; skin prick tests for four common aeroallergens; and spirometry. A task exposure matrix was constructed for bauxite exposure in all tasks in all jobs based on monitoring data. Data were examined for associations between cumulative bauxite exposure, and respiratory symptoms and lung function, by regression analyses. RESULTS: The participation rate was 86%. Self-reported work-related respiratory symptoms were reported by relatively few subjects (1.5%-11.8%). After adjustment for age and smoking no significant differences in the prevalence of respiratory symptoms were identified between subjects, in the quartiles of cumulative bauxite exposure distribution. The forced expiratory volume in I s (FEV1) of the exposed group was found to be significantly lower than that for the unexposed group. After adjustment for age, height, and smoking there were no statistically significant differences between quartiles in FEVI, forced vital capacity (FVC) and FEVl/FVC ratio. CONCLUSIONS: These data provide little evidence of a serious adverse effect on respiratory health associated with exposure to bauxite in an open-cut bauxite mine in present day conditions.

Adult↗