Functional upper airways obstruction presenting as asthma.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to R M Niven.
Explore the source record for details and available documents.
In order to compare and contrast the sampling response to cotton dust of two forms of dust sampling 85 work areas were identified over a 2-year period for investigation in eight Lancashire spinning mills. Three hundred and five work area dust samples were undertaken and 252 personal dust samples were performed. Operatives who spent a minimum of 80% of their working shift in the area in which work area sampling was also performed were selected for personal sampling. Work area dust exposures have recently shown an upward trend, with highest concentrations occurring in the ring spinning room (median 1.15 mg m-3, range 0.82-2.06). Personal dust samples showed a reduction in dust exposures as cotton processing progressed, from a high in the opening room (median value of 6.24 mg m-3, range 1.0-41.5) to a minimum of 1.02 mg m-3 (range 0.30-0.93) in the winding room. The ratio of measured personal sampling dust exposure to work area sampling exposure was used to compare the relative performance of the two techniques. This ratio was highest in the early processes. There was a 7.8-fold difference in measurement between the two techniques in the opening processes, falling to 4.9 in carding and 4.2 in the other card-room processes. However in ring spinning the ratio was only 1.4, suggesting a degree of comparability in the methods at this stage of processing. The value rose to 2.5 for the last stage (winding). Respiratory disease is known to occur predominantly in the early stages of processing (opening and carding) where high dust concentrations are found using the personal technique. These data support the use of personal sampling for setting exposure limits to cotton dust in preference to the current recommended method using work area sampling techniques, which may significantly underestimate dust exposure in the high risk work areas and is outdated.
A total of 645 cotton mill operatives were administered a respiratory questionnaire. Of these, 85 (13.2%) complained of one or more work-related respiratory symptoms: 23 (3.6%) had byssinosis and the remaining 62 had symptoms not conforming to byssinosis (nonbyssinotic symptomatics, NBS). All byssinotic, 56 NBS, and 84 matched asymptomatic operatives underwent pulmonary function testing (FEV1 and FVC), skin testing to common allergens, and histamine bronchial challenge. Work area and personal breathing zone cotton dust concentrations were assessed, and a cumulative cotton dust exposure index was calculated for each individual. Byssinotic, NBS, and asymptomatic operatives all had reduced FEV1; observed mean liters (95% CI); predicted mean: byssinosis, 2.36 (2.09 to 2.63), 3.02; NBS, 2.94 (2.71 to 3.17), 3.29; and asymptomatic, 3.12 (2.95 to 3.29), 3.31. Only byssinotic subjects had evidence of impaired FVC: 3.31 (2.97 to 3.65), 3.69. The majority of byssinotic operatives (18 of 23) had bronchial hyperreactivity (BHR) in comparison with 21 of 56 NBS and 14 of 84 asymptomatic operatives. Mean log PD20 (95% CI) values were significantly lower in the byssinotic group -0.72 (-1.42, -0.02) than in NBS 0.57 (0.08, 1.06) and asymptomatic subjects 0.57 (-0.26, 1.39). The distribution of atopy did not differ significantly between groups, and lung function did not differ significantly between atopic and nonatopic subjects. The cumulative cotton dust exposure index was the only dust parameter to be significantly greater in those with BHR (mean mg-yr/m3 [95% CI] 14.13 [13.1 to 15.1]) than those with normal reactivity [5.35 (3.9 to 6.8)].
Explore the source record for details and available documents.
Acute demyelinating polyneuropathy has been reported only twice as a presenting feature of systemic lupus erythematosus (SLE) in female patients. We report a male presenting with an acute demyelinating polyneuropathy who subsequently was found to have SLE.