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Biomedical subjects

T V O'Donnell

Publications and source records attributed to T V O'Donnell.

At least 19 recordsLinked to original sources
PubMed1995

Asthma and respiratory problems--a review.

Occupational asthma is the principal respiratory health problem within the primary aluminium industry. Current evidence indicates that it is irritant induced and due to occupational exposure to the inhalation of gaseous or particulate fluoride compounds. Following transfer from the occupational exposure of those who develop asthma, there is commonly symptomatic improvement. A programme of compulsory respiratory protection, progressive engineering improvements and of regular screening of potroom workers aimed at early detection, and the transfer of asthmatic workers from that environment has resulted not only in improvement of asthmatic symptoms among them, but also in the majority of an improvement in bronchial responsiveness as assessed by methacholine inhalation. The majority of studies indicate a slightly increased prevalence of symptoms of chronic bronchitis and of chronic obstructive pulmonary disease among workers in carbon bake areas, although tobacco smoking has a greater and additive effect. Only a trivial number of clinical cases of pulmonary fibrosis ascribed to aluminium compounds has been reported. Particle size limits smelter grade primary alumina reaching the alveoli of the lung.

Aluminum↗
PubMed1992

The use of a videotaped questionnaire for studying asthma prevalence. A pilot study among New Zealand adolescents.

OBJECTIVE: To examine the feasibility of measuring asthma prevalence by means of an audio-visual presentation of asthma symptoms and signs (video questionnaire) and to compare this technique with a standard written questionnaire for predicting bronchial hyperresponsiveness. DESIGN: A cross-sectional study comparing the ability of a video questionnaire and a written, interviewer administered questionnaire to predict bronchial hyperresponsiveness. Bronchial responsiveness was measured with hand held nebulisers. SETTING: Community survey of a New Zealand rural secondary school. SUBJECTS: A total of 456 adolescent school children aged 12-19 years (mean 15.5 years). OUTCOME MEASURES: Comparison of the sensitivity and specificity of a standard questionnaire versus a video questionnaire for bronchial hyperresponsiveness. RESULTS: The technique was easy to administer in the community setting. Overall sensitivity and specificity for the prediction of bronchial hyperresponsiveness were similar for the video and interviewer administered questionnaires. CONCLUSIONS: This new technique is easily used in the community setting, and gives predictions of bronchial hyperresponsiveness similar to those of a standard interviewer administered questionnaire. Further examination of the technique in comparisons of asthma prevalence among different populations is planned.

Adolescent↗
PubMed1991

Asthma symptoms, bronchial hyperresponsiveness and atopy in a Maori and European adolescent population.

In 1989 a survey of 543 New Zealand rural adolescents of largely Maori descent was undertaken to determine the prevalence of asthma symptoms, bronchial hyperresponsiveness (BHR) and atopy. The overall prevalence of asthma was estimated at 13.7%, BHR at 13.4% and atopy at 31.1%. These rates were similar across the age range 13 to 18 years. The prevalence of BHR among those without asthma symptoms was 3%. Both current asthma symptoms and BHR were more common among females, but there was no difference between the sexes in the proportion with atopy. The prevalence of asthma symptoms was higher among Maoris than nonMaoris, but this difference disappeared when allowance was made for current smoking. There was a similar prevalence of BHR and atopy between these two ethnic groups. There was a similar prevalence of asthma but lower prevalence of BHR than was reported among 7-10 year olds in an urban Auckland survey. The low prevalence of BHR among those without asthma symptoms, and the uniform frequency of asthma symptoms, BHR and atopy over the age range suggest that adolescents would be a particularly useful population for national or international comparisons of the prevalence of asthma, BHR and atopy.

Adolescent↗
PubMed1991

The changes in smoking habits in a rural adolescent population, 1975-89.

A survey of tobacco smoking habits in 435 adolescent schoolchildren was undertaken in 1989 in a rural, largely Maori population. The survey questionnaire was identical to that used in a 1975 survey at the same school. Among this group, Maori still smoke more often than nonMaori (36.6% vs 25.2%), and currently this is particularly true for females (46.7% vs 31.3%). Among currently smoking Maori, both in males and females cigarette consumption has significantly risen (median per week: 15 vs 30), despite an overall fall in the proportion of the groups who report smoking within the previous month (57.1% vs 36.6%). As a result, there are now significantly more smokers in the highest consumption group than previously (7.0% vs 12.6%), particularly among Maori females (7.5% vs 16%). Similar but lesser trends have occurred among nonMaori, with the exception that in addition to cigarette consumption, the proportion of females currently smoking has also tended to rise. There remains considerable cause for concern about smoking among this younger age group.

Adolescent↗
PubMed1991

Bronchial responsiveness during regular fenoterol therapy: four months prospective study.

Effects of a regimen of regular high dose beta agonist aerosol as sole therapy (fenoterol 400 micrograms qid) on FEV1 and bronchial responsiveness to methacholine provocation were examined monthly in 16 atopic moderately severe asthmatic subjects in an open uncontrolled four months study. Eleven completed the trial, four dropped out on account of severe acute asthma and one with muscle tremor. Overall there was a small significant drop of mean prebronchodilator FEV1 after one month of 0.27 L (95% confidence interval 0.12, 0.42) but not significant thereafter. The increase of bronchial responsiveness (mean decrease of PD20 of 0.50 doubling doses of methacholine) by the end of month four did not reach statistical significance. Our study which explored potentially adverse effects of this beta agonist regimen showed only small changes of doubtful clinical significance. Drop outs due to acute asthma complicate studies such as this and make conclusions difficult.

Adolescent↗
PubMed1990

Increasing asthma prevalence in a rural New Zealand adolescent population: 1975-89.

A survey of asthma symptoms and spirometry in 435 adolescent schoolchildren was undertaken in 1989 in a rural, largely Maori population. The survey questionnaires were identical to those used in a 1975 survey at the same school. The prevalence of reported asthma or wheeze significantly increased from 26.2% to 34.0%. This increase occurred in groups reporting asthma, and also those reporting wheeze unassociated with colds, but without a previous diagnosis of asthma. There was a tendency for a rise in reported wheeze in Europeans (24.3% to 27.4%) and a significant rise in Maoris (27.1% to 36.2%). The reclassification of other respiratory problems did not account for the increase. Data from this study provides evidence that there has been a rise in the prevalence of asthma in this New Zealand population over a time period of 14 years.

Adolescent↗
PubMed1989

Symptoms of asthma, methacholine airway responsiveness and atopy in migrant Tokelauan children.

503 migrant Tokelauan children between five and 15 years resident predominantly in Porirua and the Hutt Valley were surveyed as part of a study of asthma prevalence in a recently migrant population. The survey consisted of domiciliary interview with parents, physical examination, assessment of bronchial hyperresponsiveness and atopy, by allergen skin prick testing. Forty-three children (8%) had a history of wheezy breathing or asthma. 160 children (32%) had evidence of increased airway responsiveness defined as a PD20 (provocative dose of methacholine causing a less than or equal to 20% fall in FEV1, of less than or equal to 12.2 mumoL methacholine). Of the 43 children with a history of asthma, 40 (93%) had evidence of bronchial hyperresponsiveness, 36 (84%) were atopic and 35 (81%) had both bronchial hyperresponsiveness and atopy. Forty-five children (9%) were found to be wheezing on the day of examination only 16 of these had a history of wheezing. Twenty seven of the wheezing children demonstrated bronchial hyperresponsiveness and 22 of these were atopic. Of the 18 children wheezing but with no evidence of bronchial hyperresponsiveness only six were atopic. These contrasting findings suggest differences in the cause of symptoms among the children. Regional differences were observed for the prevalence of symptoms and signs of asthma, bronchial hyperresponsiveness and atopy. Hutt Valley Tokelauan children exhibited a higher prevalence than the Porirua children. Migrants to the Hutt Valley and Porirua are from different atolls, and these differences raise the possibility of a genetic influence on the development of asthma.

Adolescent↗
PubMed1989

Potroom asthma: New Zealand experience and follow-up.

Occupational asthma related to work in potlines in an aluminum smelter has been diagnosed on clinical criteria in 57 workers. About half were regular tobacco smokers but atopy was uncommon. There was a wide range in the time for which each had been employed prior to development of symptoms, but the average was about 20 months. Thirty-four showed nonspecific bronchial hyperreactivity to methacholine. At annual reviews over a period of 5 years following transfer to other work at the smelter, the majority improved in symptoms in 1-2 years and bronchial hyperreactivity returned to normal. However, over the subsequent 3 years, deterioration, not limited to tobacco smokers or atopic subjects, has occurred in some subjects.

Aluminum↗
PubMed1989

The relationships between atopy, bronchial hyperresponsiveness, and a family history of asthma: a cross-sectional study of migrant Tokelauan children in New Zealand.

We have examined age-related changes in the association between nonspecific bronchial hyperresponsiveness (BHR) and atopy in 494 second-generation Polynesian migrant children, aged 5 to 15 years. BHR (provocative dose of methacholine, less than or equal to 7.8 mumol, causing a 20% fall in FEV1) was present in 125 children (25.3%). Atopy (skin wheal, greater than or equal to 4 mm diameter) was present in 157 children (32%). BHR associated with atopy demonstrated a constant age-related frequency in the 7- to 15-year-old children that was influenced by a family history (FH) of asthma (FH, 50%; no FH, 34%; p = 0.051). BHR not associated with atopy demonstrated a marked decreasing frequency with age from 25% in 5- to 7-year-old children to 3% in 13- to 15-year-old children and was uninfluenced by an FH of asthma. We conclude that the differences in the frequency of BHR with age, together with the genetic influence on BHR associated with atopy, compared with the findings in nonatopic children, indicate distinct heterogeneity in the pathogenesis of BHR in these Tokelauan children. These differences may be important for understanding the relationships between nonspecific BHR, atopy, and asthma in children.

Adolescent↗
PubMed1988

Challenges to health in working life.

Hospital admissions, cancer statistics, causes of death and data from general practice consultations have been reviewed to identify the challenges to health within the working life. Morbidity resulted commonly from trauma, malignant neoplasms especially of the female breast, melanoma, colorectal and cervical tumours, locomotor disorders especially of the spine, ischaemic heart disease, obstructive respiratory disorder, gynaecological problems, psychiatric disorders, hearing impairment and diabetes mellitus. Support for basic research and studies relating to approaches aimed at influencing community attitudes are discussed. Areas of particular research possibilities in New Zealand are identified in psychiatry, cost benefit studies in surgery, and health screening. A case is made for a strong improved complementary research effort within the clinical areas of the health service both in hospitals and in general practice especially in clinical conditions such as asthma and diabetes. Seeding money for voluntary societies and foundations closely involved with research and scientific merit may facilitate further financial support to such voluntary organisations and the prospect of expansion by them of the support of peer-reviewed research projects.

Adolescent↗
PubMed1988

Viral respiratory tract infection and exacerbations of asthma in adult patients.

The role of viral respiratory tract infections in acute exacerbations of asthma was studied prospectively in 31 patients with atopic asthma aged 15-56 years. Patients recorded symptom scores for asthma and peak expiratory flow rate daily for 11 months. In addition, they reported for detailed clinical, functional, and virological study every four weeks and as soon as possible after the onset of worsening asthma or symptoms suggesting a respiratory tract infection. Thirty viral identifications were made, of which 18 (60%) were associated with an exacerbation of asthma. Viral respiratory tract infection was identified in 18 (10%) of the 178 exacerbations of asthma, and in 10 (36%) of the 28 severe exacerbations. The frequency of viral identifications in 16 non-asthmatic, control subjects during the same period was similar. It is concluded that viral respiratory tract infections may cause or be associated with exacerbations of asthma in adults, and that they are an important factor in severe exacerbations.

Acute Disease↗