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1995

CIS 95-949 Attfield M.D., Seixas N.S.
Prevalencia de la neumoconiosis en relación con la exposición a polvos en una cohorte de mineros y exmineros de las minas de hulla en los Estados Unidos
Prevalence of pneumoconiosis and its relationship to dust exposure in a cohort of U.S. bituminous coal miners and ex-miners [en inglés]
Resultados de los reconocimientos radiológicos realizados a un grupo de 3.194 mineros y exmineros del carbón entre 1985 y 1988. La prevalencia de la neumoconiosis de los hulleros estaba asociada a la exposición acumulativa a los polvos, la edad y la calidad del carbón. Los mineros que habían trabajado con carbones de mediana a mala calidad y habían estado expuestos durante 40 años al límite de 2 mg/m3 fijado por las autoridades federales corrían el riesgo, en una proporción de 1,4 %, de presentar en la jubilación un cuadro de fibrosis pseudotumoral. Se preveía una mayor prevalencia en las categorías menos graves de neumoconiosis de los hulleros. Los mineros empleados en yacimientos de carbón de calidad superior aparecían más expuestos que los que extraían carbones de mediana o mala calidad. Los antiguos mineros que, según sus declaraciones, habían abandonado la mina por razones de salud presentaban anomalías radiológicas más graves que los mineros actualmente en actividad.
American Journal of Industrial Medicine, ene. 1995, vol.27, n°1, p.137-151. Ilus. 25 ref.

1994

CIS 96-2157 Searl A.
Estudio de la durabilidad de las fibras inhaladas y opciones de diseño de fibras más seguras
A review of the durability of inhaled fibres and options for the design of safer fibres [en inglés]
Los riesgos asociados con las fibras inhaladas están en función de su forma, dimensión, composición y durabilidad. En general los minerales asbestósicos son más duraderos que la mayoría de las fibras de vidrio artificiales (MMVF), aunque algunas fibras cerámicas pueden ser más duraderas que el crisotilo. Las fibras de vidrio artificiales más solubles tienen un contenido de álcali (Na y K) y tierras alcalinas (Ca, Mg) relativamente alto, y bajo contenido en aluminio y boro. Las fibras de vidrio artificiales menos solubles son los vidrios de silicio con alto contenido en aluminio (fibras cerámicas). La durabilidad relativa de los distintos tipos de fibra se rige por el medio físico y químico en las que se encuentran. La evaluación exacta de este parámetro es un aspecto importante en la seguridad en el trabajo y precisa de un modelo experimental más elaborado y mejor coordinado. En un futuro se podrá crear fibras sintéticas de vidrio que tengan baja durabilidad en los pulmones y una resistencia adecuada en el entorno en el que se vayan a utilizar.
Annals of Occupational Hygiene, dic. 1994, vol.38, n°6, p.839-855. 67 ref.

CIS 96-1327 Parkes W.R.
Neuropatías de etiología profesional
Occupational lung disorders [en inglés]
Principales puntos del sumario de este manual: morfología del aparato respiratorio; fisiología pulmonar; deposición y depuración de los aerosoles; patogénesis de las nuemoconiosis minerales; imagen óptica de las neuropatías de etiología profesional; epidemiología; bronquitis crónica; obstrucción del paso de aire y enfisema; bronquitis, obstrucción de las vías aéreas y profesión; neumoconiosis asociadas a los minerales no fibrógenos, el carbón y a otras materias carbonosas; silicosis y patologías asociadas; alteraciones relacionadas con el amianto y los silicatos no asbestósicos; beriliosis; disfunciones no neoplásicas debidas a agentes metálicos, químicos y físicos; cáncer pulmonar; neumonía de hipersensibilidad; asma profesional y bisinosis; patologías infecciosas y zoonosis; patologías causadas por otros agentes orgánicos; los pulmones en el espacio y grandes alturas; pulmones y submarinismo.
Butterworth-Heinemann Ltd., Linacre House, Jordan Hill, Oxford OX2 8DP, Reino Unido, 3^a ed., 1994. xix, 892p. Ilus. Ref.bibl. Indice. Precio: GBP 145,00.

CIS 95-2131 Conjunto de comunicaciones presentadas en la Conferencia sobre Persistencia Biológica de las Fibras Sintéticas Respirables y Minerales, Lyon, Francia, 7-9 sept. 1992
Selected papers from the Biopersistence of Respirable Synthetic Fibers and Minerals conference, Sept. 7-9, 1992, Lyon, France [en inglés]
Recopilación de comunicaciones sobre los temas siguientes: significación epidemiológica de la persistencia de las fibras minerales en el tejido pulmonar; persistencia biológica en pulmones de fibras minerales de síntesis con silicatos; persistencia biológica del crisotilo en los pulmones de personas pertenecientes al grupo general de población y de trabajadores expuestos; influencia de la granulometría y la composición química sobre la eficacia de los mecanismos de depuración; análisis del contenido pulmonar de individuos expuestos profesionalmente al amianto crisotilo; placas pleurales asbestósicas debidas a la exposición ambiental en el nordeste de Córcega; retención de las fibras de amianto en el cuerpo humano; análisis comparativo de las partículas inhaladas contenidas en los fluidos de lavado broncoalveolar en el hombre, en el parénquima pulmonar y en los ganglios linfáticos; niveles de fibra y patologías en los trabajadores de una fábrica donde empleaban predominantemente amosita; persistencia biológica de materia mineral de polvos de hulla en los pulmones de mineros silicóticos; persistencia biológica de partículas minerales no fibrosas en el aparato respiratorio de trabajadores que han estado expuestos.
Environmental Health Perspectives, oct. 1994, vol.102, supl.5, p.221-275. Ilus. Ref.bibl.

CIS 95-1769 Fu H., Gu X., Jin X., Yu S., Wu K., Guidotti T.L.
Cáncer de pulmón entre los mineros de estaño del Sudeste de China: exposición a la sílice, silicosis y tabaquismo
Lung cancer among tin miners in Southeast China: Silica exposure, silicosis and cigarette smoking [en inglés]
Se sometió a estudio la incidencia del cáncer pulmonar entre la población minera de la mina de estaño Dachang, en China, conocida por presentar unos niveles relativamente elevados de polvos en suspensión (sílice y otras sustancias potencialmente cancerígenas) y bajas concentraciones de radón. Entre los factores de riesgo asociados al excedente de mortalidad por cáncer de pulmón demostrado, únicamente los años pasados perforando bajo tierra y el índice acumulativo de tabaquismo (producto del consumo diario de cigarrillos por el número de años de consumo) aparecieron como factores de riesgo independientes; no se observó ninguna interacción entre los dos. La presencia de silicosis no contribuía a la predicción del riesgo independientemente del número de años pasados bajo tierra.
American Journal of Industrial Medicine, set. 1994, vol.26, n°3, p.373-381. 18 ref.

CIS 95-1314 Boujemaa W., Lauwerys R., Bernard A.
Indices precoces de disfunción renal en los trabajadores que padecen silicosis
Early indicators of renal dysfunction in silicotic workers [en inglés]
El objetivo de este estudio era determinar si la silicosis podía estar asociada a las alteraciones renales detectables a través de los indicadores sanguíneos o urinarios de nefrotoxicidad. El conjunto de individuos estudiados estaba formado por 116 trabajadores varones que habían estado expuestos a la sílice al menos durante 2 años, diagnosticados de silicosis y 61 controles emparejados por la edad. Las pruebas que se les realizaron fueron la investigación de las concentaciones de ß2-microglobulina y creatinina séricas, la excreción urinaria de albúmina, de proteina asociada al retinol y de ß-N-acetil-D-glucosaminidasa. En comparación con los controles, la excreción urinaria de albúmina, de proteina asociada al retinol y de ß-N-acetil-D-glucosaminidasa en los silicóticos era significativamente más elevada. La concentración de ß2-microglobulina en el suero de los individuos silicóticos mostraba una tendencia al alza que llegaba a ser significativa en el subgrupo de los individuos con opacidades pseudotumorales. Los resultados confirman la asociación entre la silicosis y algunas alteraciones renales infra-clínicas. No obstante, ante la ausencia de datos que prueben la existencia de una relación con la duración de la exposición o la gravedad de la silicosis, la aseveración de que la sílice implica estas alteraciones necesita confirmarse a través de más estudios complementarios.
Scandinavian Journal of Work, Environment and Health, jun. 1994, vol.20, n°3, p.180-183. 17 ref.

CIS 95-959 Weiner R., Rees D., Zwi A.
Directivas: control del polvo, la neumoconiosis y la tuberculosis pulmonar en los trabajadores sudafricanos empleados en las fundiciones
Guidelines: Monitoring dust, pneumoconiosis and pulmonary tuberculosis in South African foundry workers [en inglés]
Estas Directivas describen un procedimiento para el control de la exposición a los polvos y de las neumopatías entre los trabajdores de la fundición. También contienen información de carácter general sobre las fundiciones sudafricanas. Se resumen de forma breve los resultados de las últimas encuestas sobre fundiciones y las prácticas de supervisión realizadas en ellas, señalando algunas recomendaciones sobre el procedimiento a seguir para el control de la salud de los trabajadores y las condiciones de empolvamiento en los lugares de trabajo.
National Centre for Occupational Health, P.O. Box 4788, Johannesburg 2000, Sudáfrica, 1994. 20p. 4 ref.

CIS 95-604 Murlidhar V.
El diagnóstico de bisinosis entre los trabajadores del sector textil
The diagnosis of byssinosis among textile workers [en inglés]
Se llevó a cabo una encuesta entre 309 trabajadores de una fábrica textil de Bombay, productora de tejido de algodón. A la vista de los datos obtenidos sobre los síntomas, 237 trabajadores fueron sometidos a pruebas funcionales respiratorias. En resumen, se diagnosticaron 70 casos de bisionosis; 54 de ellos trabajaban en los talleres de hilado y bobinado con alto índice de empolvamiento. La incidencia de la patología aumentaba en función de los años de antigüedad en el puesto. Se discuten las dificultades inherentes al diagnóstico.
Occupational Health and Safety Centre (OHSC), 6 Neelkant Apartments, Gokuldas Pasta Road, Dadar (E), Bombay, India, 1994. 12p. 5 ref.

CIS 95-635 Sjögren B., Ljunggren K.G., Almkvist O., Frech W., Basun H.
Aluminosis y demencia
Aluminosis and dementia [en inglés]
Este breve artículo presenta un estudio de un caso sobre un enfermo, nacido en 1915, que había trabajado en una fábrica de polvo de aluminio entre 1944 y 194. La aluminosis le había sido diagnosticada en 1946. A la edad de 78 años, el paciente padecía una demencia sin presentar ningún otro síntoma de enfermedad cardiovascular. El análisis del líquido cefalorraquídeo permitió descubrir un índice elevado de aluminio.
Lancet, 22 oct. 1994, vol.344, n°8930, p.1154. 5 ref.

CIS 95-574 Bui A.M., Germaud P., Normand de la Tranchade M., Touranchet A.
Ensilaje y aspergilosis broncopulmonar alérgica
Ensilage et aspergillose broncho-pulmonaire allergique [en francés]
Estudio de un caso de aspergilosis broncopulmonar alérgica (ABPA) de etiología profesional. Un paciente de 41 años, agricultor no asmático presentó, durante los períodos de ensilaje del maiz, síntomas respiratorios agudos, asociados a los criterios de diagnóstico de ABPA: hipereosinofilia sanguínea, obstrucción bronquial episódica, aumento del nivel de IgE total y específica frente al aspergilus, infiltrados pulmonares débiles y presencia de Aspergillus fumigatus a nivel de las secreciones bronquiales. La evidencia de concentraciones importantes de esporas de aspergillus en las muestras atmosféricas tomadas en le lugar de trabajo, explica la aparición de esta ABPA en un paciente sin antecedentes bronquiales.
Archives des maladies professionnelles et de médecine du travail, 1994, vol.55, n°5, p.335-337. 9 ref.

CIS 95-209 Pairon J.C., Martinon L., Iwatsubo Y., Vallentin F., Billon-Galland M.A., Bignon J., Brochard P.
Retención de cuerpos de asbesto en los pulmones de los soldadores
Retention of asbestos bodies in the lungs of welders [en inglés]
Encuesta retrospectiva sobre la retención de cuerpos de asbesto en 211 soldadores. Mediante un microscopio óptico se procedió a examinar las muestras de esputo, de líquido de lavado bronco-alveolar y de tejido pulmonar obtenidas por toracotomía. La información sobre los empleos y exposiciones anteriores se obtuvo a través de un cuestionario. Se observó una correlación entre la duración de las operaciones de soldadura y la densidad de los cuerpos asbestósicos en el líquido de lavado bronco-alveolar o el tejido pulmonar. Se deduce del cuestionario que solamente dos de los soldadores que presentaban una retención significativa de cuerpos asbestósicos habían sufrido otra exposición profesional al amianto. El trabajo de soldadura puede originar un incremento de la retención pulmonar de cuerpos asbestósicos y agravar así el riesgo de neumopatía maligna y/o de tipo fibrótico.
American Journal of Industrial Medicine, jun. 1994, vol.25, n°6, p.793-804. Ilus. 35 ref.

CIS 94-2112 Buick J.B., Lowry R.C., Magee T.R.A.
Isolation, enumeration, and identification of gram negative bacteria from flax dust with reference to endotoxin concentration
To investigate the microbial contamination of flax dust in the linen industry, particularly the gram negative bacteria, (GNB) content and associated endotoxin level, standard bacteriological techniques were used. The results were contrasted with studies in the cotton industry. The microbial flora of cotton and flax is similar but greater GNB contamination, with consequently higher endotoxin levels, was found in flax. Flax byssinosis and cotton byssinosis may share a common microbial aetiology.
American Industrial Hygiene Association Journal, Jan. 1994, Vol.55, No.1, p.59-61. 14 ref.

1993

CIS 98-530 Trabajo en ambientes con polvo: cómo prevenir la neumocosis
Dusty work: How to protect yourself from pneumoconiosis [en inglés]
Temas tratados: control del polvo; determinación en aire; equipos de protección respiratoria; inspección; legislación; material de formación; neumoconiosis; orden y limpieza; películas sobre prevención; polvos en suspensión en el aire; vigilancia médica.
Public Relations Consultant Co., Ltd., 3-3-11 Ginza, Chuo-ku, Tokyo, Japón, 1993. Videocasete PAL. Precio: JPY 59.000, USD 510,00.

CIS 96-2114 Choudat D., Triem S., Weill B., Vicrey C., Ameille J., Brochard P., Letourneux M., Rossignol C.
Síntomas respiratorios, función pulmonar y neumoconiosis en los protésicos dentales autónomos
Respiratory symptoms, lung function and pneumoconiosis among self employed dental technicians [en inglés]
A partir del registro de trabajadores autónomos residentes en Paris, se estudió a un grupo de 105 protésicos dentales (divididos en dos grupos de edad) para evaluar la exposición profesional, determinar síntomas respiratorios, e investigar transtornos inmunológicos y hacer una comparativa con un grupo control. Los resultados contrastan con los informes anteriores sobre la aparición de anticuerpos, e incluso con las enfermedades del tejido conjuntivo en los protésicos dentales. En resumen, el estudio confirma un incremento del riesgo de neumoconiosis entre los protésicos dentales. Además, pueden presentar asociadas otras alteraciones respiratorias tales como alteraciones de la función pulmonar, especialmente en los casos asociados al consumo de cigarrillos. Estos resultados confirman la necesidad de control del entorno de trabajo y la realización reconocimientos médicos incluso tras la jubilación.
British Journal of Industrial Medicine, mayo 1993, vol.50, n°5, p.443-449. Ilus. 29 ref.

CIS 96-625 Dodson R.F., O'Sullivan M., Corn C.J., Garcia J.G.N., Stocks J.M., Griffith D.E.
Análisis de los cuerpos ferruginosos en el líquido del lavado broncoalveolar en los trabajadores de fundición
Analysis of ferruginous bodies in bronchoalveolar lavage from foundry workers [en inglés]
Los cuerpos ferruginosos clásicos en las muestras de tejidos se consideran marcadores de una exposición pasada al amianto. Estudios recientes han demostrado que la presencia de cuerpos ferruginosos en el líquido del lavado broncoalveolar está asociada a una exposición al amianto y que, a menudo, constituye una referencia más sensible que la historia profesional. Se tomaron muestras del lavado broncoalveolar a cinco trabajadores de la fundición, que fueron examinadas con microscopía óptica para establecer la presencia de los cuerpos ferruginosos y con microscopía electrónica por transmisión para caracterizar la carga de fibras no recubiertas y analizar los núcleos de los cuerpos ferruginosos. Todas las muestras observadas con pocos aumentos (200x) contenían cuerpos ferruginosos. Con mayor aumento (400x) se identificó un grupo que presentaba una delgada cintilla negra. La utilización de la microscopía electrónica por transmisión para los componentes de los núcleos de los cuerpos ferruginosos y las partículas no recubiertas ha confirmado la fiabilidad de la microscopía óptica de gran aumento para la diferenciación de la mayor parte de estos núcleos no asbestósicos.
British Journal of Industrial Medicine, nov. 1993, vol.50, n°11, p.1032-1038. Ilus. 24 ref.

CIS 96-624 Dalphin J.C., Debieuvre D., Pernet D., Maheu M.F., Polio J.C., Toson B., Dubiez A., Monnet E., Laplante J.J., Depierre A.
Prevalencia y factores de riesgo de bronquitis crónica y pulmón de granjero en los productores lecheros en Francia
Prevalence and risk factors for chronic bronchitis and farmer's lung in French dairy farmers [en inglés]
Se sometió a estudio la prevalencia de la bronquitis crónica y de la forma clínica del pulmón del granjero en 30 cantones del dèpartament francés del Doubs en función de factores individuales (edad, sexo y consumo de tabaco) y geográficos (altitud). Cinco mil setecientos tres productores lecheros participaron en este estudio rellenando un cuestionario médico. La prevalencia de bronquitis crónica y de la forma clínica del pulmón de granjero era respectivamente de 9,3 % y de 1,4 %. Se utilizó un modelo de regresión logística para evaluar los factores de riesgo de bronquitis crónica y de pulmón de granjero. El riesgo de bronquitis crónica estaba asociado al sexo masculino (p 10-4), la edad (p 10-4), el tabaquismo (p 10-4) y la altitud (p 10-4). Se ha asociado un riesgo de forma clínica del pulmón de granjero con los no fumadores (p 0,05) y linealmente con la altitud (p 10-4). Asimismo, se ha destacado una marcada asociación positiva entre la bronquitis crónica y el pulmón de granjero (OR 19,5 (IC 95 %: 12,1 - 31,4)), tras el ajuste en función de factores de confusión. Este estudio pone de relieve esencialmente el aumento muy significativo de la prevalencia de estas enfermedades en función de la altitud.
British Journal of Industrial Medicine, oct. 1993, vol.50, n°10, p.941-944. 15 ref.

CIS 95-2133 Karjalainen A., Antilla S., Heikkilä L., Kyyrönen P., Vainio H.
Lóbulo de origen del cáncer de pulmón en pacientes expuestos al amianto con o sin fibrosis intersticial difusa
Lobe of origin of lung cancer among asbestos-exposed patients with or without diffuse interstitial fibrosis [en inglés]
Scandinavian Journal of Work, Environment and Health, abr. 1993, vol.19, n°2, p.102-107. 31 ref. ###

CIS 95-1774 Kaburaki K., Nagumo M.
De la esperanza de vida de los individuos neumoconióticos en una mina
Bō kōzan ni okeru jinpai chōki ryōyōsha no raifu supan ni tsuite [en japonés]
Se analizan los datos de 109 pacientes aquejados de neumoconiosis en fase 4, según la clasificación japonesa, que fallecieron entre 1948 y 1993. Todos ellos habían seguido tratamientos de larga duración. La media de edad en el momento de la muerte fue creciendo de 48,0 ± 3,8 entre los años 40 a 75,2 ± 5,7 en los 90. Asimismo, la media de edad en la que fueron diagnosticados aumentó pasando de 46,7 ± 3,9 a 58,3 ± 10,1 años. Se constató la misma tendencia entre los sujetos afectados de neumoconiosis en otros estadíos. La instalación más tardía de la patología y el incremento de la esperanza de vida en estos últimos años se deben probablemente a: 1) una limitación de la exposición al polvo gracias a los medios técnicos de prevención desarrollados y 2) a las mejoras aportadas a la gestión de la salud laboral y al sistema de indemnización de los trabajadores.
Annual Reports of the Medical Research Society for Mining and Smelting, 1 nov. 1993, n°32, p.23-28. Ilus. 3 ref.

CIS 95-620 Ugaki M.
Neumoconiosis y disfuncionamiento respiratorio. Análisis de los gases en sangre y evaluación
Jinpai shō no kokyū kinō shōgai. Ketsueki gasu bunseki oyobi hantei o megutte [en japonés]
La reglamentación japonesa sobre las neumoconiosis estipula que el análisis de los gases sanguíneo cuyo fin sea la evaluación del disfuncionamiento respiratorio, debe efectuarse en muestras de sangre extraidas del lóbulo de la oreja con tubo capilar. En la experiencia que se presenta en este artículo, la reproductibilidad de los resultados obtenidos a través de la toma de muestras en el lóbulo de la oreja era menor que la de los muestreos conseguidos con sangre arterial extraida con jeringa. Aunque el valor de la diferencia alvolo-arterial presente en la presión parcial de oxígeno (AaDO2), que se utiliza como criterio para la determinación del disfuncionamiento respiratorio en la reglamentación japonesa sobre las neumoconiosis, concuerda con el 5º percentil constatado en los voluntarios sanos, la AaDO2 aumentaba con la edad. De ahí, que haya que corregir ese criterio en los trabajadores de mayor edad. No se observó ninguna diferencia ni en lo relativo a la presión arterial de oxígeno en la sangre arterial, ni en lo que respecta a la AaDO2 entre hombres y mujeres o entre fumadores y no fumadores.
Japanese Journal of Traumatology and Occupational Medicine, 1 set. 1993. vol.41, n°9, p.567-574. 16 ref. Ilus.

CIS 94-1590 Rosenberg N.
Lung berylliosis
Bérylliose pulmonaire [en francés]
Data sheet on lung berylliosis. Pathophysiology: pathogenesis of acute berylliosis; pathogenesis of chronic berylliosis. Prevalence and epidemiology. Diagnosis of berylliosis: acute berylliosis; chronic lung berylliosis (diagnosis in the workplace, diagnosis in specialized environments; aetiologic diagnosis). Evolution. Prevention: medical and technical prevention. Compensation in France.
Documents pour le médecin du travail, 3rd Quarter 1993, No.55, p.259-263. 41 ref.

CIS 94-1589 Shih J.F., Hunninghake G.W., Goeken N.E., Galvin J.R., Merchant J.A., Schwartz D.A.
The relationship between HLA-A, B, DQ, and DR antigens and asbestos-induced lung disease
To evaluate the relationship between human leukocyte antigen (HLA) and both asbestos-induced pulmonary fibrosis and pleural fibrosis, HLA-A, B, C, DQ and DR phenotypes were obtained in 42 long-term asbestos-exposed workers. There was an increased percentage of HLA-A29, HLA-B44, and HLA Bw4 in the subjects with asbestosis. In addition, there was a marginally positive relationship between HLA-A29 and the severity of pulmonary fibrosis. Similarly, there was a higher prevalence of HLA-DRw53 and DQ2 in the subjects with asbestos-induced pleural fibrosis. HLA-A29, HLA-B44, HLA-Bw4, HLA-DRw53, and HLA-DQ2 do not have a significantly shorter duration or latency of asbestos exposure. These results suggest that the HLA-A29 phenotype may be associated with the development of asbestosis and the HLA-DQ2 phenotype with the development of asbestos-induced pleural fibrosis. Caution is advised, however, in that the associations are not particularly strong, physiological correlation is lacking, and previous studies do not support the findings.
Chest, July 1993, Vol.104, No.1, p.26-31. 28 ref.

CIS 94-1657 Di Donna V., Bernardini P., Gerardino L., Giordano A.
Pulmonary silicosis associated with MacLeod's syndrome: A case report
Silicosi polmonare associata a sindrome di MacLeod: Nota su un caso [en italiano]
This article reports a case of silicosis associated with idiopathic unilateral hyperlucent lung - MacLeod's disease (ML) - in a 65-year old miner. The patient had been exposed to silica dust for about 15 years as a truck operator in water supply tunnelling work. Impaired ventilatory function due to left pulmonary dystrophy was the favouring or even the causal factor of dust accumulation in the functionally active right lung and of the tissue reaction to the dust, leading to interstitial fibrosis. Revealed pathogenic alterations: absence of ventilation associated with severe vascular impairment in the left lung, inequality of the ventilation/perfusion rate, due to pneumoconiosis, in the right lung. ML is rare, but must be considered a mandatory contra-indication for work involving dust exposure risk since it can cause an occupational disease even if environmental exposure standards are observed. Summary in English.
Medicina del lavoro, Sep.-Oct. 1993, Vol.84, No.5, p.387-393. Illus. 15 ref.

CIS 94-1242 Kusiak R., Liss G.M., Gailitis M.M.
Cor pulmonale and pneumoconiotic lung disease: An investigation using hospital discharge data
Cor pulmonale has been reported in the past to be associated with pneumoconioses as an end-stage complication. Whether the association can be demonstrated among cases of pneumoconioses acquired in more recent decades is still not clear. The authors examined the relation between these conditions using data summarized in hospital records in Ontario for males discharged between 1979 and 1990 with a diagnosis of chronic cor pulmonale or one of the pneumoconioses. Based on the age-specific frequency rates, cor pulmonale was diagnosed 17 times more frequently than expected among men with pneumoconioses than among other men admitted to hospital. The results show that cor pulmonale still appears to be associated with dust exposure at the workplace and demonstrates the usefulness of hospital discharge information in addressing questions in occupational health.
American Journal of Industrial Medicine, Aug. 1993, Vol.24, No.2, p.161-173. 36 ref.

CIS 94-1247 Muir D.C.F., Julian J.A., Roos J.O., Maehle W.M., Chan J., Mountain W., Morgan W.K.C.
Classification of radiographs for pneumoconiosis: The Canadian pneumoconiosis reading panel
A method of providing experience for readers in the classification of radiographs for pneumoconiosis is described. It is based on an exchange of films by mail, with provision for ongoing feedback of results. The effects of this feedback on reading levels is described. The method is suitable for readers who are unable to attend major centres for formal instruction, and has the additional advantage of continual monitoring of reading levels.
American Journal of Industrial Medicine, Aug. 1993, Vol.24, No.2, p.139-147. 8 ref.

CIS 94-1240 Eterović D., Dujić Ž., Tocilj J., Čapkun V.
High resolution pulmonary computed tomography scans quantified by analysis of density distribution: Application to asbestosis
A new method for quantitative evaluation for high resolution computed tomography (HRCT) of the lungs was developed by assessment of the distribution of radiological densities within the lung slices. To improve the sensitivity of detection of abnormalities, the density distributions were analyzed using a curve fitting technique. The method was applied to seven patients with early asbestosis, 15 with advanced asbestosis and 13 normal controls. Results of the study indicated that the curve fitting technique enables a more objective assessment of HRCT pulmonary scans, especially in the early stage of asbestosis.
British Journal of Industrial Medicine, June 1993, Vol.50, No.6, p.514-519. Illus. 22 ref.

CIS 94-1238 Forst L.S., Abraham J.
Hypersensitivity pneumonitis presenting as sarcoidosis
A case report is presented to illustrate a misdiagnosis of sarcoidosis in a spraypainter whose history was suggestive of hypersensitivity pneumonitis caused by exposure to toluene diisocyanate in the workplace. The two diseases have similar clinical, laboratory and pathological features and are thus difficult to distinguish. Since early recognition of hypersensitivity pneumonitis can lead to complete reversal of the disease in many cases, it is important to make the diagnosis as early as possible.
British Journal of Industrial Medicine, June 1993, Vol.50, No.6, p.497-500. Illus. 15 ref.

CIS 94-1314 Doll R.
Mortality from lung cancer in asbestos workers
Reprint of a classic study originally published in the BJIM in 1955 (12:81-86). A mortality study was carried out on 113 men who had been potentially exposed to asbestos dust for at least 20 years. 39 deaths occurred, compared with 15.4 expected in the whole male population. The excess was entirely due to excess deaths from lung cancer (11 against 0.8 expected) and from other respiratory and cardiovascular diseases (22 against 7.6 expected); all cases of lung cancer were associated with the presence of asbestosis. Results of this study together with available necroscopy data indicate that the risk of lung cancer has become progressively less since the introduction of regulations for the control of asbestos dust in 1931.
British Journal of Industrial Medicine, June 1993, Vol.50, No.6, p.485-490 (given as p.81-86). 14 ref.

CIS 94-1282 Dufresne A., Loosereewanich P., Harrigan M., Sébastian P., Perrault G., Bégin R.
Pulmonary dust retention in a silicon carbide worker
Pulmonary dust retention was determined in lung tissue removed from a man who worked 42 years in the vicinity of an Acheson furnace of a silicon carbide plant and developed carborundum pneumoconiosis. Special attention was paid to the retained silicon carbide fibres in the lung parenchyma. The concentration of silicon carbide fibres longer than 5µm was 39,300 fibres/mg dry lung. These fibres had a similar morphology to fibres observed in the working environment. The observed pulmonary retention is longer than that of asbestos in exposed workers.
American Industrial Hygiene Association Journal, June 1993, Vol.54, No.6, p.327-330. Illus. 18 ref.

CIS 94-1231 Pappas G.P., Newman L.S.
Early pulmonary physiologic abnormalities in beryllium disease
By using the beryllium-specific blood lymphocyte transformation test (BeLT) as a screening tool, it is possible to identify beryllium disease before clinical symptoms or radiographic abnormalities develop. Two groups were compared: (1) "surveillance-identified" early beryllium disease patients, detected using the BeLT in workplace screening (n=21), and (2) "clinically identified" beryllium disease patients who had symptoms or radiographic abnormalities (n=15). Physiological abnormalities occurred in 12 of 21 (57%) surveillance-identified patients. In comparison, 93% of the clinically identified patients had one or more abnormalities, the most sensitive indicator being the exercise capacity. Clinically identified patients performed less work, had more severe gas exchange abnormalities, and had higher dead space to tidal volume ratio (VD/VT) at maximal exercise than did surveillance-identified patients. These results show that alterations in gas exchange and the pulmonary vascular bed occur early in beryllium disease.
American Review of Respiratory Disease, Sep. 1993, Vol.148, No.3, p.661-666. 40 ref.

CIS 94-1229 Lalancette M., Carrier G., Laviolette M., Ferland S., Rodrique J., Bégin R., Cantin A., Cormier Y.
Farmer's lung - Long-term outcome and lack of predictive value of bronchoalveolar lavage fibrosing factors
This study evaluates the long-term outcome of farmer's lung (FL), adding high-resolution computed tomograms (HRCT) to previously reported procedures and verifying whether bronchoalveolar lavage (BAL) fluid markers or fibrogenic factors (FF) predict outcome. Pulmonary function tests on FL subjects revealed an obstructive profile in 13 subjects and normal values in 16. Chest radiographs (CXR) were normal in 22 subjects, abnormal in six, and suggestive of emphysema in five. HRCT revealed emphysema in nine subjects and 19 were normal. There was a good correlation between the findings on pulmonary function tests and HRCT; however, CXR alone did not suggest the existence of emphysema in four subjects who had such findings on HRCT. No correlations were found between most outcome parameters and the level of the BAL FF measured six years previously. Airflow obstruction with or without emphysema is an important long-term sequela of FL and BAL FF do not predict outcome in this disease.
American Review of Respiratory Disease, July 1993, Vol.148, No.1, p.216-221. Illus. 32 ref.

CIS 94-1278 Bresnitz E.A., Gilman M.J., Gracely E.J., Airoldi J., Vogel E., Gefter W.
Asbestos-related radiographic abnormalities in elevator construction workers
Elevator construction workers are exposed to asbestos dust during construction and refurbishment work on older buildings. The study screened a cohort of workers, all with more than 20 years of employment in the industry, with clinical examinations, chest radiography ("B" reader interpretations), and routine spirometry. Twenty of the 91 workers (22%) had evidence of pleural disease, but none had an interstitial process consistent with asbestosis. Of those with pleural thickening, 15 had bilateral circumscribed plaques and five had unilateral plaque formation. There were no cases of diffuse pleural thickening, benign pleural effusions, or mesothelioma in the cohort. The difference in the mean body mass index of those with pleural abnormalities (29.18 ± 3.95) and those without (27.7 ± 3.86) was not statistically significant (p=0.135). The results of this study show that elevator construction workers have an increased risk for the development of asbestos-related pleural disease.
American Review of Respiratory Disease, June 1993, Vol.147, No.6, p.1341-1344. 26 ref.

CIS 94-1412 Marx J.J., Twiggs J.T., Ault B.J., Merchant J.A., Fernandez-Caldas E.
Inhaled aeroallergen and storage mite reactivity in a Wisconsin farmer nested case-control study
A study was undertaken to assess the role of antibody (Ab) to a panel of antigens associated with hypersensitivity pneumonitis in the development of lung disease among dairy farmers. Immunological reactivity to inhaled allergens was assessed in Ab+ cases and compared to control subjects. The most prevalent allergens among the cases as determined by either skin test or RAST assays were the house dust mites (HDM) (21.6%), storage mites (11.2%), grain smuts (11.2%), Cladosporium (7.5%), Aspergillus (6.0%), and cattle (5.2%). Of the storage mite reactors, IgE to Lepidoglyphus destructor was the most frequently found. Reactions to HDM, storage mites, and grain smuts were significantly more frequent among the cases (p<0.05). There is a significant increase in reactivity to certain inhaled allergens among those dairy farmers reporting barn-associated respiratory symptoms that is unrelated to past exposure to the causative agents of farmer's lung disease.
American Review of Respiratory Disease, Feb. 1993, Vol.147, No.2, p.354-358. 19 ref.

CIS 94-1310 Kotloff R.M., Richman P.S., Greenacre J.K., Rossman M.D.
Chronic beryllium disease in a dental laboratory technician
Workers involved in the manufacture of dental prostheses are exposed to a number of potentially harmful substances capable of inducing lung disease. This report describes a dental laboratory technician who developed chronic beryllium disease as a result of workplace exposure. The diagnosis of chronic beryllium disease was suspected from the clinical, radiographic, and histological features and confirmed by the in vitro proliferation of lung lymphocytes in response to beryllium salts. The potential risks of beryllium use in the dental industry have been recognized for some time, but this is the first documentation of chronic beryllium disease in this population of workers. Because chronic beryllium disease may be easily confused with sarcoidosis, awareness of this occupational association is essential in preventing misdiagnosis and in providing appropriate management.
American Review of Respiratory Disease, Jan. 1993, Vol.147, No.1, p.205-207. Illus. 18 ref.

CIS 94-967 Kröling P.
Symptoms, causes and prophylaxis of sick building syndrome
Symptome, Ursachen und Prophylaxe des Sick-Buildings-Syndroms [en alemán]
Health problems linked to the sick building syndrome (SBS) are mostly unspecific and often can only be evaluated through subjective parameters. This article on problems of persons working in air-conditioned buildings undertakes to differentiate the physical, hygiene and technical problems in relation to SBS. Representative questionnaires were developed and measurement campaigns in selected buildings were undertaken. Prophylactic and sanitary measures are presented which include the appropriate choice and the maintenance of the system and of the filter used in the air-conditioning system. Summaries in English and German.
Sichere Arbeit, 1993, No.3, p.12-21. Illus. 41 ref.

CIS 94-884 Hnizdo E., Sluis-Cremer G.K.
Risk of silicosis in a cohort of white South African gold miners
The risk of silicosis was investigated in a cohort of 2,235 white South African gold miners who had, on average, 24 years of net service from 1940 to the early 1970s and who were followed up to 1991 for radiological signs of onset of silicosis (ILO category 1/1 or more). There were 313 (14%) miners who developed signs of silicosis at an average age of 55.9 years. The latency period was largely independent of the cumulative dust exposure. In 57% of the silicotics, the radiological signs developed, on average, 7.4 years after mining exposure ceased. The risk of silicosis increased exponentially with the cumulative dust dose, the accelerated increase being after 7mg/m³-years. At the highest exposure level of 15mg/m³-years, which represents approximately 37 years of gold mining at an average respirable dust concentration of 0.4mg/m³, the cumulative risk for mining for silicosis reached 77%. In conclusion, the risk of silicosis was strongly dose dependent; however, the latency period was largely independent of the dose.
American Journal of Industrial Medicine, Oct. 1993, Vol.24, No.4, p.447-457. Illus. 22 ref.

CIS 94-878 Hnizdo E., Murray J., Sluis-Cremer G.K., Thomas R.G.
Correlation between radiological and pathological diagnosis of silicosis: An autopsy population based study
The radiological findings for the profusion of rounded opacities were compared with pathological findings for parenchymal silicosis in 557 gold miners who had, on average, 2.7 years between the radiological and pathological examination. Three readers read the radiographs, and ILO category 1/1 or more was defined as a positive diagnosis of silicosis. The sensitivity values were 0.393, 0.371, and 0.236, and the specificity values were 0.987, 0.965, and 0.978, for three readers, respectively. The sensitivity of the readers improved with increasing degree of autopsy silicosis, but a large proportion of those with a moderate and marked degree os silicosis were not diagnosed radiologically. The diagnostic sensitivity of the radiological test could be improved by using category 0/1 as a cutoff point for workers exposed to a high average concentration of respirable silica dust. The diagnostic specificity of radiology could be improved by using category 1/0 or 1/1 as a cutoff point for a positive diagnosis for workers exposed to a low average concentration of respirable silica dust.
American Journal of Industrial Medicine, Oct. 1993, Vol.24, No.4, p.427-445. Illus. 14 ref.

CIS 94-887 French Society of Occupational Medicine - 24 October 1992 Meeting
Société française de médecine du travail - Séance du 24 octobre 1992 [en francés]
Summary of papers presented at the 24 Oct. 1992 Meeting of the French Society of Occupational Medicine. Titles: "Infos Risques": a documentation service on occupational and industrial hazards - survey of 18 months of operation; a contribution to the study of lung fibrogenicity of right and left isomers of α-quartz (natural quartz); contribution of analytical transmission electron microscopy to the assessment of exposure to mineral particles in humans; bronchial non-specific hyperreactivity and occupational exposure to mineral oils; a case of toxic hepatitis caused by carbon tetrachloride (CCl₄); asbestos-related round atelectasis.
Archives des maladies professionnelles, 1993, Vol.54, No.5, p.440-443.

CIS 94-560 Merler E., Capocaccia R.
Asbestosis mortality in Italy
A total of 204 deaths due to asbestosis occurred in Italy during the period 1970-1989, including 24 women; asbestosis death rates (per million) were 0.31±0.05 among males and 0.4±0.02 among females. The rates increased a little when comparing 1980-89 with 1970-79. Deaths were concentrated in a limited number of geographical areas where an extensive industrial use of asbestos is known to have occurred and where there were also high rates of mortality due to primary pleural tumours.
Medicina del lavoro, July-Aug. 1993, Vol.84, No.4, p.286-289. 17 ref.

CIS 94-605 Johnson W.M., Busnardo M.S.
Silicosis following employment in the manufacture of silica flour and industrial sand
Description of silicosis in a patient with chronic obstructive pulmonary disease who worked as a maintenance mechanic for less than 5 years in a plant in South Carolina producing silica flour and industrial sand. An open lung biopsy showed an early stage of silicosis manifested by perivascular and peribronchial collections of macrophages as well as early granuloma formation. Excessive occupational exposure levels of respirable free silica were documented.
Journal of Occupational Medicine, July 1993, Vol.35, No.7, p.716-719. 24 ref.

CIS 94-218 Peng L., Wang X.
Lymphocyte B and T cell subsets in peripheral blood from patients with asbestosis
Peripheral blood lymphocytes were analyzed in 55 asbestos-exposed workers and 40 controls. Results agreed with previous findings showing aberrations of cell-mediated immunity (reduced T cell numbers) and hyperactive humoral immunity (increased percentage of B cells) in the exposed subjects. A correlation between changed lymphocyte activity and radiological abnormalities of the lung was also found. The findings contribute to the investigation of the immunological pathogenesis of asbestosis.
British Journal of Industrial Medicine, Feb. 1993, Vol.50, No.2, p.183-184. 6 ref.

CIS 94-324 Murray J., Reid G., Kielkowski D., de Beer M.
Cor pulmonale and silicosis: A necropsy based case-control study
The presence of cor pulmonale at death in relation to other factors such as emphysema, silicosis, and thromboembolism was analyzed in a case-control study of 732 South African gold miners. Marked emphysema was the highest risk factor with an odds ratio of 21.32 (95% confidence interval (95% CI) 5.02-90.7), then extensive silicosis (OR 4.95, 95% CI 2.92-8.38) and thromboembolic disease (OR 1.92, 95% CI 1.37-2.69). Age and smoking were not significant predictors of cor pulmonale.
British Journal of Industrial Medicine, June 1993, Vol.50, No.6, p.544-548. 28 ref.

CIS 94-307 Kreiss K., Wasserman S., Mroz M.M., Newman L.S.
Beryllium disease screening in the ceramics industry - Blood lymphocyte test performance and exposure-disease relations
Nine new cases of biopsy-confirmed chronic beryllium disease were identified among 505 employees and ex-employees in a company that had manufactured beryllia ceramics from 1958 to 1975. Of tests commonly used in medical surveillance, only a confirmed blood beryllium lymphocyte transformation test had a high positive predictive value for beryllium disease (100%). However, two beryllium disease cases had either a normal or inconsistently abnormal blood test and were identified for diagnostic work-up by abnormal chest radiography. The only risk factor for beryllium disease was beryllium exposure. Degree of exposure was associated with disease rates, which ranged from 2.9% to 15.8% for beryllia-exposed subgroups. The data support efforts to prevent beryllium disease by lowering beryllium exposures and to identify subclinical and early disease by broad-based medical surveillance using the blood beryllium lymphocyte test and chest radiography.
Journal of Occupational Medicine, Mar. 1993, Vol.35, No.3, p.267-274. 13 ref.

CIS 94-141 Lehmann M.
Air humidification
Luftbefeuchtung [en alemán]
Umidificazione dell'aria [en italiano]
Humidification de l'air [en francés]
Some enterprises require the installation of humidification equipment because constant relative humidity is necessary in the production process. However, poorly or infrequently cleaned humidifiers can cause diseases, such as "humidifier fever" or "humidifier lung". This booklet describes measures for preventing these diseases.
SUVA, Arbeitssicherheit, Postfach, 6002 Luzern, Switzerland, Sep. 1993. 8p. Illus. 3 ref.

CIS 93-1884 Klaas V.E.
A diagnostic approach to asbestosis, utilizing clinical criteria, high resolution computed tomography, and gallium scanning
Seventy-five individuals known to have significant exposure to asbestos were evaluated by physical examination; pulmonary function tests (PFT), chest radiographs, high resolution computed tomography (HRCT), gallium-67 scanning, and various laboratory tests. Sixteen subjects met three of the following four criteria and were considered to have clinical asbestosis: 1) bibasilar rales, 2) FVC<80% of predicted, 3) DLCO<80% of predicted, and 4) an abnormal chest radiograph. Evaluations which included HRCT and Ga scanning detected pulmonary disease in these asbestos-exposed individuals in many cases where other modalities were unable to demonstrate significant abnormalities. While only 21% of the subjects satisfied commonly accepted criteria for the diagnosis of asbestosis, 75% had evidence of disease by both HRCT and gallium scanning. These data suggest that it may be time to include HRCT and Ga scanning when evaluating asbestos-exposed individuals, especially in cases where evaluations by physical exam, PFTs, and chest radiographs are non-diagnostic.
American Journal of Industrial Medicine, May 1993, Vol.23, No.5, p.801-809. 18 ref.

CIS 93-2063 Mamolen M., Lewis D.M., Blanchet M.A., Satink F.J., Vogt R.L.
Investigation of an outbreak of "Humidifier Fever" in a print shop
An outbreak of "humidifier fever" affected 16 (57%) of 28 workers in a print shop. The most common symptoms were myalgia, chills or subjective fever, and cough. Illness began 5-13 hours after entering the workplace, and lasted 2-24 hours. A humidifier in use on the day of the outbreak was found to be contaminated with fungi, amoebae, and Gram-negative bacteria. The risk of illness was highest for those who had been on the job three months before the outbreak, a time when the humidifier was in constant use. Serological studies of print shop workers showed positive reactions to extracts of organisms isolated from the humidifier, but could neither distinguish ill from well workers, nor identify causative organisms. The presence of endotoxin-producing bacteria and the clinical syndrome are consistent with an organic dust toxic syndrome. Previous exposure appeared to be the major risk factor for illness.
American Journal of Industrial Medicine, Mar. 1993, Vol.23, No.3, p.483-490. 19 ref.

CIS 93-1895 Hurych J., Lesage M., David A.
Eighth international conference on occupational lung diseases - Proceedings
Huitième conférence internationale sur les maladies pulmonaires professionnelles - Compte rendu [en francés]
Proceedings of the eighth international conference on occupational lung diseases held in Prague, Czechoslovakia, 14-17 September, 1992. Papers are presented under the following headings: monitoring of exposure to asbestos; asbestos-related diseases (epidemiology, cancer); lung cancer; international activities; man-made fibres; coalworkers' pneumoconiosis; silicosis; pneumoconiosis (general aspects, biochemistry); ILO classification of radiographs of pneumoconioses; allergy and organic dust; chemicals; hard metals; welding; working environment, monitoring and control (general aspects, coal mines); experimental studies (aetiopathogenesis, biological reaction to dust); experimental therapy.
Czech Medical Society J.Ev.Purkyně, Society of Occupational Health, 100 42 Prahá 10, ¿robárova 48, Czech Republic, 1993. 3 vols. 1,356p. Illus. Bibl.ref. Price: USD 30.00.

CIS 93-1996 Hilt B.
Nordic Expert Group for the Documentation of Exposure Limits. 106. Crystalline silica
Nordiska Expertgruppen för Gränsvärdesdokumentation. 106. Krystallinsk silika [en noruego]
Crystalline silica (SiO₂) is the most abundant element in the earth's crust. This criteria document reviews environmental and occupational exposure to silica-containing dust and various health effects which may result from such exposure. The epidemiological and experimental evidence for a possible carcinogenic effect of silica dust is reviewed and discussed. Exposures which are today regarded as low enough to prevent the occurrence of silicosis (<0.04mg/m³ of respirable crystalline silica), will probably also be sufficiently low to prevent any possible observable increase risk of lung cancer in humans.
Arbetsmiljöinstitutet, Förlagstjänst, 171 84 Solna, Sweden, 1993. 77p. 439 ref.

1992

CIS 95-971 Nurminen M., Corvalan C., Leigh J., Baker G.
Predicción de la silicosis y el cáncer pulmonar entre la población activa australiana expuesta a la sílice
Prediction of silicosis and lung cancer in the Australian labor force exposed to silica [en inglés]
Actualmente el 77% de la población australiana con riesgo está expuesta a unos niveles de polvos de sílice de
Scandinavian Journal of Work, Environment and Health, dic. 1992, vol.18, n°6, p.393-399. 11 ref.

CIS 94-945 Arenas-Huertero F., Salazar Flores M., Pasquel-García P.
Ferruginous bodies in cases with occupational and non-occupational exposure to inorganic dusts - A study of 40 matched cases
Concentrations of ferruginous bodies (FB) were estimated in samples of lung tissue obtained from 40 patients with a history of exposure to inorganic dusts and from 40 controls with no such exposure. Concentrations of FB in the exposed patients were higher than in the controls; 70% of exposed patients had more than 100f/g of dry lung tissue compared to 27.5% in the control cases. It was concluded that lung digest and fibre counts help to confirm exposures to inorganic dusts above the background values found in the general population. A table shows occupations, working time and fibre concentrations in 19 cases with pneumoconiosis.
Archives of Medical Research, Winter 1992, Vol.23, No.4, p.169-175. Illus. 21 ref.

CIS 94-944 Lehnert G., Raithel H.J., Valentin H.
Asbestos exposure, asbestosis, and lung cancer
Asbestfeinstaubexposition, Asbestose und Lungenkrebs [en alemán]
The connection between asbestos exposure, asbestosis and pleural or peritoneal mesothelioma has been well established by epidemiological studies. On the other hand, it is still unclear whether asbestos-exposed persons without asbestosis are also at a higher risk of developing mesothelioma. In order to answer this question, the international literature of the past ten years is reviewed. No evidence is found in support of an asbestos-related lung cancer without asbestosis or asbestos-induced lesions of the pleura. It is recommended that this kind of lung cancer not be included in the German list of occupational diseases.
Arbeitsmedizin - Sozialmedizin - Präventivmedizin, Mar. 1992, Vol.27, No.3, p.96-101. Illus. 28 ref.

CIS 94-892 French Society of Occupational Medicine of Dauphiné-Savoie - Meeting of 25 Oct. 1991
Société de médecine du travail Dauphiné-Savoie - Réunion du 25 octobre 1991 [en francés]
Topics of communications presented at the meeting of 25 Oct. 1991 of the French Society of Occupational Medicine for Dauphiné-Savoie: tobacco growing and alveolitis (3 cases); polymer-fume fever associated with the use of mould-release agents containing fluorocarbons (1 case); asthma and bronchio-alveolitis due to Penicillium nalgiovense in sausage mould (2 cases); screening campaign for breast, colorectal and cervical cancer among women aged 50-69 in the French department of Isère; critical assessment of 1,724 spirographic tests; review of the videocassette "Attention Phosgène"; use of audiovisuals and other available materials for training sessions; development of a multidisciplinary health and safety training programme for electroplaters; industrial medicine and video on the job site and in inter-enterprise services.
Archives des maladies professionnelles, 1992, Vol.53, No.7, p.665-678.

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