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Diseases of the respiratory system (except for pneumoconiosis & similar) - 2,965 entries found

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  • Diseases of the respiratory system (except for pneumoconiosis & similar)

2007

CIS 08-601 McGregor D.
Risk of multiple myeloma and cancers of the respiratory system, oesophagus, stomach, pancreas, prostate, testes and skin in firemen
Risque de myélome multiple et de cancers des voies respiratoires, de l'œsophage, de l'estomac, du pancréas, de la prostate, des testicules et de la peau chez les pompiers [in French]
The objective of this literature survey was to evaluate the risk of developing certain types of cancer among firemen. It resulted in the publication of several reports. This report addresses the risk of multiple myeloma and cancers of the respiratory tract, oesophagus, stomach, pancreas, prostate, testicles and skin. It concludes that available epidemiological data do not indicate that the cancers examined in this analysis can be assumed to occur in firefighters as a result of their occupation. This conclusion is based on the absence of a significant increase in risk in most of the studies and the minimal increase in risk in the cases where it is present. See also CIS 08-598/600.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2007. i, 37p. 79 ref. Price: CAD 8.40. Downloadable version (PDF format) free of charge.
http://www.irsst.qc.ca/files/documents/PubIRSST/R-522.pdf [in English]
http://www.irsst.qc.ca/files/documents/PubIRSST/R-521.pdf [in French]

CIS 08-582 Hoppin J.A., Valcin M., Henneberger P.K., Kullman G.J., Umbach D.M., London S.J., Alavanja M.C.R., Sandler D.P.
Pesticide use and chronic bronchitis among farmers in the agricultural health survey
This study evaluated the role played by pesticides as risk factors of chronic bronchitis, using data from the Agricultural Health Study on lifetime pesticide use among doctor-diagnosed cases of chronic bronchitis from 20,908 pesticide applicators. Chronic bronchitis was diagnosed after age of 19 in 654 farmers (3%). Eleven pesticides were significantly associated with chronic bronchitis, the highest odds ratio being found for heptachlor (OR 1.50). Increased prevalence for chronic bronchitis was also seen for individuals who had a history of a high pesticide exposure event (OR 1.85) and for those who also applied pesticides in off farm jobs (OR 1.40).
American Journal of Industrial Medicine, 2007, Vol.50, p.969-979. 44 ref.

CIS 08-330 Reed P.L., Rosenman K., Gardiner J., Reeves M., Reilly M.J.
Evaluating the Michigan SENSOR surveillance program for work-related asthma
Most Occupational Safety and Health Administration (OSHA) inspections are based either on employee complaints or on the targeting of certain industries. This study compared 545 Michigan OSHA inspections performed as part of an occupational asthma prevention programme with 12,268 non-disease initiated OSHA inspections performed during the same time period (1989-2002). Asthma inspections were more likely to be conducted among larger, unionized employers. Although the likelihood of citations, type of citation, and monetary penalties were not different between the two types of inspections, the number of citations and the amount of monetary penalties were more likely for small as compared to large employers and less likely at unionized worksites. Other findings are discussed.
American Journal of Industrial Medicine, 2007, Vol.50, p.646-656. Illus. 22 ref.

CIS 08-400 Stayner L., Bena J., Sasco A.J., Smith R., Steenland K., Kreuzer M., Staif K.
Lung cancer risk and workplace exposure to environmental tobacco smoke
This literature survey sought to quantitatively evaluate the association between workplace environmental tobacco smoke exposure and lung cancer. A meta-analysis of data from 22 studies on workplace exposure to tobacco smoke and lung cancer risk was carried out. Estimates of relative risk from these studies were analyzed by fitting the data to fixed and mixed effects models. Analyses of highly exposed workers and of the relationship between duration of exposure and lung cancer were also performed. The analysis indicated a 24% increase in lung cancer risk (relative risk (RR)=1.24) among workers exposed to environmental tobacco smoke. A two-fold increased risk (RR=2.01) was observed for workers classified as being highly exposed to environmental tobacco smoke. A strong relationship was observed between lung cancer and duration of exposure to environmental tobacco smoke.
American Journal of Public Health, Mar. 2007, Vol.97, No.3, p.545-551. Illus. 53 ref.

CIS 08-348 Gautrin D., Malo J.L., Infante-Rivard C.
Surveillance of occupational asthma among workers in high-risk sectors
Surveillance de l'asthme professionnel chez des travailleurs dans des secteurs à risque [in French]
Occupational asthma is the occupational respiratory disease most frequently recognized by the occupational safety and health commission (CSST) of Quebec, where some 60 new cases are compensated annually, half of which involve young workers. In some industrial sectors, less than five years elapse between the start of exposure and the appearance of the first symptoms. Close to 400 workers that took part in a previous study on apprentices collaborated in this study, whose objective was to characterize the development of occupational asthma over time. Intermediate symptoms leading to the appearance of probable occupational asthma were followed, namely allergic sensitization specific to laboratory animals, flour and latex, based on the initial training of the participating workers, the respiratory symptoms in the workplace and bronchial hyper-reactivity. Findings are discussed.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2007. viii, 45p. Illus. 46 ref. Price: CAD 8.48. Downloadable version (PDF format) free of charge.
http://www.irsst.qc.ca/files/documents/PubIRSST/R-494.pdf [in French]

CIS 08-463 Rosenberg N.
Non-infectious occupational respiratory diseases due to biological agents - Sector of waste collection, sorting and recovery
Affections respiratoires professionnelles non infectieuses dues aux agents biologiques - Secteur des déchets: collecte, tri et valorisation [in French]
This information sheet describes the main respiratory symptoms faced by workers involved in collecting and sorting household waste. These include hypersensitivity pneumopathy, organic dust toxic syndrome, ocular, nasal and bronchial irritation symptoms and chronic bronchitis. Prevention is based on avoiding the inhalation of dusts and microorganisms. It includes the design and layout of equipment, machinery and containers, ventilation of work premises, work organization and the use of personal protective equipment suited to the types of exposures and activities.
Documents pour le médecin du travail, June 2007, No.110, p.229-236. Illus. 27 ref.
http://www.dmt-prevention.fr/inrs-pub/inrs01.nsf/IntranetObject-accesParReference/TR%2039/$File/TR39.pdf [in French]

CIS 08-164 Laukkanen A., Ruoppi P., Remes S., Koistinen T., Mäkinen-Kiljunen S.
Lactase-induced occupational protein contact dermatitis and allergic rhinoconjunctivitis
This article reports a case of protein contact dermatitis and allergic rhinoconjunctivitis from occupational exposure to lactase in a female pharmaceutical worker in Finland. The patient exhibited strong positive responses to lactase in prick tests. In an open application test, lactase elicited whealing, and in patch testing, lactase elicited an eczematous reaction. Serum lactase-specific immunoglobulin E (IgE) antibodies were demonstrated in immunospot and radioallergosorbent test assays, and lactase-IgE-binding fractions were examined in immunoblot and immunoblot inhibition assays. The chamber challenge test was performed to detect the association between lactase sensitization and rhinoconjunctival symptoms. The results confirm previous observations that lactase can induce occupational IgE- mediated respiratory and conjunctival sensitizations, but in addition show that contact skin reactions caused by lactase may also occur.
Contact Dermatitis, Aug. 2007, Vol.57, No.2, p.89-93. Illus. 19 ref.

CIS 08-97 Capone L., Consiglio E., Fulgenzi A.E., Jarés E., Labbate A., Poropat A.
Ministerio de trabajo, empleo y seguridad social
Occupational respiratory diseases
Patología respiratoria de origen ocupacional [in Spanish]
Proceedings of five workshops on occupational respiratory diseases organized in Buenos Aires, Argentina, by the Argentinian labour inspectorate (Spanish acronym SRT), during which statistical data were presented and various cases were discussed. Workshops were held on the following topics: occupational asthma; occupational respiratory infections; chronic obstructive bronchopneumopathies (COBP); pleural diseases; interstitial lung diseases.
Superintendencia de Riesgos del Trabajo (SRT), Bartolomé Mitre 751, C1036AAM Ciudad Autónoma de Buenos Aires, Argentina, 2007. 103p. Illus. 2 ref.

CIS 08-72 Tse L.A., Yu I.T.S., Leung C.C., Tam W., Wong T.W.
Mortality from non-malignant respiratory diseases among people with silicosis in Hong Kong: Exposure-response analyses for exposure to silica dust
The objective of this study was to examine the exposure-response relationships between exposure to silica dust and the mortality from non-malignant respiratory diseases (NMRDs) and chronic obstructive pulmonary diseases (COPDs) among a cohort of 2789 workers with silicosis in Hong Kong. Exposures in each industry were evaluated on the basis of historical industrial hygiene data. Exposure indices included cumulative dust exposure (CDE) and mean dust concentration (MDC). Findings were subjected to statistical analyses. From 1981 to 1999, there were 371 deaths from NMRDs in the cohort, of which and 101 were COPDs. CDE and MDC were significantly associated only with NMRD mortality. Subgroup analysis showed that deaths were significantly associated with both CDE and MDC among underground caisson workers and among those with high exposure to silica dust. A clear upward trend was also found for both NMRDs and COPDs mortality with increasing severity of radiological silicosis.
Occupational and Environmental Medicine, Feb. 2007, Vol.64, No.2, p.87-92. 35 ref.

CIS 08-71 Massin N., Hecht G., Ambroise D., Héry M., Toamain J.P., Hubert G., Dorotte M., Bianchi B.
Respiratory symptoms and bronchial responsiveness among cleaning and disinfecting workers in the food industry
The objectives of this case-control study were to measure the levels of exposure to nitrogen trichloride (NCl3) and aldehydes among cleaning and disinfecting workers of food industry plants and to examine how they relate to irritant and chronic respiratory symptoms. A total of 175 exposed workers recruited from 17 enterprises of the food industry (16 slaughterhouses and one catering firm) and 70 non-exposed workers were examined. Concentration levels of NCl3 and aldhehydes were measured by personal sampling. Symptoms were assessed by means of a questionnaire and a methacholine bronchial challenge test. A statistically-significant concentration-response relationship was found between eye, nasal and throat symptoms of irritation and exposure levels or exposure duration. However, no relation was found between exposure and chronic respiratory symptoms or bronchial hyperresponsiveness.
Occupational and Environmental Medicine, Feb. 2007, Vol.64, No.2, p.75-81. 21 ref.

CIS 08-153 Mendonça E.M.C., Silva R.C.C., Bussacos M.A., Algranti E.
Respiratory impairment in Brazilian foundry workers exposed to sand
Workers in the foundry industry are at risk of respiratory diseases due to exposures such as polycyclic aromatic hydrocarbons, pyrolysis degradation products, mineral dust, organic dust, resins and isocyanates. This cross-sectional study evaluated respiratory morbidity among 598 workers of six foundries in Brazil with sand moulding operations. Medical evaluations consisted of a questionnaire on respiratory symptoms and occupational history, spirometry and chest X-rays. Additionally, workers exposed to resins and a control group underwent bronchial provocation tests. Their mean length of exposure of the workers was 10.1 years and the overall prevalence of pneumoconiosis 4.5%. Chronic bronchitis (CB) and X-ray profusion were significantly related to the quartiles of length of exposure. There were significant risks of abnormal FVC and FEV1 with the presence of pneumoconiosis (odds ratios of 4.63 and 3.34 respectively).
American Journal of Industrial Medicine, Feb. 2007, Vol.50, No.2, p.83-91. Illus. 31 ref.

CIS 07-1375 Levy P.S., Roth H.D., Deubner D.C.
Exposure to beryllium and occurrence of lung cancer: A reexamination of findings from a nested case-control study
This study reanalyzed an earlier nested case-control study of beryllium and lung cancer in view of perceived weaknesses in analysis and study design that could have led to the elevated odds ratios obtained in the study. This reanalysis found no elevated odds ratios for any exposure variable. The conclusions differ from the earlier interpretation that the findings are due to a causal relationship between beryllium exposure and lung cancer. The alternative explanation is that they may be due to methodological problems that could have been controlled by closer matching of controls to cases.
Journal of Occupational and Environmental Medicine, Jan. 2007, Vol.49, No.1, p.96-101. Illus. 9 ref.

CIS 07-1312 Bünger J., Schappler-Scheele B., Hilgers R., Hallier E.
A 5-year follow-up study on respiratory disorders and lung function in workers exposed to organic dust from composting plants
The objective of this case-control study was to evaluate acute and chronic effects of long-term exposure to organic dust on respiratory disorders and lung function among employees of 41 composting facilities in Germany. It involved 218 compost workers and 66 unexposed controls. They were evaluated using a standardized questionnaire, a clinical examination and spirometric measurements. Changes in symptoms, respiratory disorders and lung function were again determined after five years of exposure in 123 compost workers and 48 controls. Working atmosphere measurements were performed at six composting facilities for respirable dust, cultivable microorganisms and endotoxins. Findings are discussed. The exposure to organic dust at workplaces of composting facilities is associated with adverse acute and chronic respiratory health effects, including mucosal membrane irritation, chronic bronchitis and an accelerated decline of forced vital capacity. The pattern of health effects differs from those at other workplaces with exposures to organic dust possibly due to high concentrations of thermo-tolerant or thermophilic actinomycetes and filamentous fungi at composting plants.
International Archives of Occupational and Environmental Health, Feb. 2007, Vol.80, No.4, p.306-312. Illus. 33 ref.

CIS 07-1318 Pisati G., Baruffini A., Bernabeo F., Cerri S., Mangili A.
Rechallenging subjects with occupational asthma due to toluene diisocyanate (TDI), after long-term removal from exposure
The aims of this study were to determine whether toluene diisocyanate (TDI) bronchial hyperresponsiveness persists in subjects with occupational asthma after long cessation of exposure and whether evolution of specific bronchial TDI sensitization and symptoms and functional abnormalities of asthma were coincident, and to define the determinants at the time of diagnosis of patients' outcome. Twenty-five non-atopic spray painters with occupational asthma due to TDI were re-examined approximately five years after removal from exposure. Tests included spirometry, methacholine challenge and TDI-specific IgE. Seven subjects were still TDI-reactors while 18 had lost reactivity to the substance, among whom however eight still retained some asthma features. This study demonstrates that airway sensitization to TDI and symptoms and functional airway abnormalities of asthma can persist for years after cessation of exposure.
International Archives of Occupational and Environmental Health, Feb. 2007, Vol.80, No.4, p.298-305. Illus. 21 ref.

CIS 07-1305 Phakthongsuk P., Sangsupawanich P., Musigsan A., Thammakumpee G.
Work-related respiratory symptoms among cotton-fabric sewing workers
Workers employed in the sewing unit of a 700-bed hospital in the Philippines complained of cough, shortness of breath, and tightness in the chest. The aim of this case-control study was to assess the prevalence of respiratory symptoms among the sewing workers and dust concentration in the workplace. The study involved 22 sewing workers and 22 housekeepers as controls. All the participants responded to the respiratory symptoms questionnaire and underwent spirometric measurements, skin prick tests, chest radiography and methacholine inhalation tests. The sewing workers reported more phlegm, chest tightness and eye irritation than controls. Neither clinical investigations nor respiratory function provided evidence for a significant difference between the sewing workers and the control group. Although the total and respiratory dust concentrations were within normal limits, ventilation improvements were implemented to decrease dust concentrations.
International Journal of Occupational Medicine and Environmental Health, 1st Quarter 2007, Vol.20, No.1, p.17-24. Illus. 27 ref.

CIS 07-1303 Ghosh T., Barman S.
Respiratory problems of workers in the zarda industry in Kolkata, India
Zarda is a type of chewing tobacco popular in India. In zarda factories, workers mix tobacco leaves with various chemicals, then dry the mix in ovens and pack the product for distribution. Workers are highly exposed to tobacco dust. This study was undertaken to assess the pulmonary and respiratory problems of workers in a zarda factory in Kolkata, India. A total of 70 zarda workers were studied. The study involved the completion of a questionnaire on pulmonary and respiratory problems, medical inspections including spirometry and worksite inspections using the OSHA-recommended ergonomics checklist. It was found that many workers complained of respiratory symptoms and that their lung capacity and peak expiratory flow rates were considerably reduced.
International Journal of Occupational Safety and Ergonomics, 2007, Vol.13, No.1, p.91-96. 20 ref.

CIS 07-1056 Barruyer C.
Chronic obstructive pulmonary disease: Hazardous exposures
Bronchite chronique obstructive: des expositions à risques [in French]
Chronic obstructive pulmonary disease (COPD) is characterized by productive cough, shortness of breath and repeated pulmonary infections, leading to respiratory insufficiency and possibly death. While smoking remains the main cause of COPD, other risk factors include occupational exposure to silica, wood and textile fibre dusts. Topics addressed in this review article on COPD: occupations at risk, aggravating effect of smoking, early detection (spirometry), prevention plan and compensation.
Prévention BTP, Feb. 2007, No.93, p.48-50. Illus. 2 ref.

CIS 07-639 Egilman D., Mailloux C., Valentin C.
Popcorn-worker lung caused by corporate and regulatory negligence: An avoidable tragedy
Diacetyl-containing butter flavour was identified as the cause of an outbreak of bronchiolitis obliterans (BO) and other lung diseases in popcorn-plant workers. Litigation documents show that the outbreak was both predictable and preventable. The industry trade organization was aware of BO cases in workers at butter-flavouring and popcorn-manufacturing plants but often failed to implement industrial hygiene improvements and actively hid pertinent warning information. Due to weaknesses in the organization and mandates of regulatory bodies, organizations such as NIOSH, OSHA, the FDA, particularly the "generally recognized as safe" (GRAS) system, and the EPA failed to detect and prevent the outbreak, which highlights the need for systemic changes in food-product regulation, including the need for corporations to act responsibly, for stronger regulations with active enforcement, for a restructuring of the GRAS system, and for criminal penalties against corporations and professionals who knowingly hide information relevant to worker protection.
International Journal of Occupational and Environmental Health, Jan.-Mar. 2007, Vol.13, No.1, p.85-98. Illus. 98 ref.
http://www.ijoeh.com/pfds/IJOEH_1301_Egilman.pdf [in English]

2006

CIS 08-1287 Groneberg D.A., Nowak D., Wussow A., Fischer A.
Chronic cough due to occupational factors
Over the last years, many studies have focused on occupational causes of respiratory diseases. One of the findings is that chronic cough is one of the most prevalent work-related airway diseases. Occupations which are related to the development of cough include coal miners, hard-rock miners, tunnel workers and concrete manufacturing workers. Since chronic cough is often also based on a variety of non-occupational factors such as tobacco smoke, a distinct separation into either occupational or non-occupational causes can be difficult.
Journal of Occupational Medicine and Toxicology, Feb. 2006, Vol.1, No.3, 10p. 118 ref.

CIS 08-844 Boyd R., Cowie H., Hurley F., Ayres J.
Health and Safety Executive
The true cost of occupational asthma in Great Britain
In 2000 the Health and Safety Commission published a ten-year occupational health strategy for the United Kingdom. The strategy sets an ambitious target for occupational asthma (OA) of a reduction of 30% in newly incident cases by 2010. The strategy contains several components, including information, education and research. This study was undertaken to develop detailed estimates of the cost of OA, in order to raise awareness among employers, workers and policy-makers as to the potential gains from adopting measures to reduce the incidence of OA. The total number of newly reported cases of OA in the United Kingdom in 2003 was 631, of which 442 were male workers and 189 were female workers. The total costs to society of these new cases of OA are estimated to range from GBP 71.7-100.1 million, or about GBP 3.4 -4.8 million per year over the lifetime of the disease. Other findings are discussed.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2006. xii, 122p. Illus. 104 réf.
http://www.hse.gov.uk/research/rrpdf/rr474.pdf [in English]

CIS 08-900 Miller B.G., Cowie H.A., Soutar C.A.
Health and Safety Executive
Coal mine dust as a benchmark for standards for other poorly soluble dusts: Partial position report
The aim of this study was to review the epidemiological evidence that could justify applying quantitative risks of chronic obstructive pulmonary disease (derived from coal miners' studies to low solubility dusts in general, using lung function and respiratory symptoms data as diagnostic markers. Work involved comparing published effects of low toxicity mineral dust exposures on lung function in four occupational groups (coal miners, talc workers, PVC workers and heavy clay workers). Coalminers and talc workers had similar exposure levels. PVC workers had lower average exposure levels, but this may be due to an underestimation of cumulative dust exposure in this population. Coalminers showed a decline of 0.19 standardised units of FEV1 for 100 units increase in dust exposure. Corresponding values for talc and PVC were 0.26 and 0.66 respectively. Relative risks of reporting symptoms were very similar for coalminers and heavy clay workers; they could not be calculated for talc or PVC workers, but were clearly of the same order of magnitude.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2006. iv, 19p. 11 ref.
http://www.hse.gov.uk/research/rrpdf/rr470.pdf [in English]

CIS 08-584 Hedlund U., Järvholm B., Lundbäck B.
Persistence of respiratory symptoms in ex-underground iron ore miners
To assess the persistence of respiratory symptoms in ex-miners after cessation of mining exposure, this population-based cross-sectional study used a postal questionnaire comparing prevalence of symptoms between 206 ex-miners who had stopped mining at least one year before the study and 4560 referents not occupationally exposed to irritants or dust. Age, smoking and a family history of asthma were considered as possible confounders in the analysis. Ex-miners had on average been working as miners for 13 years and had stopped mining 16 years before the study. Chronic productive cough and physician-diagnosed chronic bronchitis were significantly more common among ex-miners. Furthermore, there was a trend of other respiratory symptoms being more common in ex-miners.
Occupational Medicine, Sep. 2006, Vol.56, No.6, p.380-385. 34 ref.

CIS 08-661 Niven K.
Health and Safety Executive
An evaluation of chemical disinfecting agents used in endoscopy suites in the NHS
The objective of this research project was to evaluate alternatives to glutaraldehyde for the disinfection of endoscopes. Their benefits and limitations are discussed. The work was undertaken because of the historically high number of cases of occupational asthma caused by glutaraldehyde. It concludes that there is no single most appropriate disinfectant. Many users are moving away from glutaraldehyde towards other products, some of which are also regarded as potential respiratory allergens. The report includes approaches for limiting exposures to disinfecting agents based on HSE's COSHH Essentials (see CIS 00-675), including ventilation and containment.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2006. 28p. Illus. 102 ref.
http://www.hse.gov.uk/research/rrpdf/rr445.pdf [in English]

CIS 08-597 Fishwick D., Bradshaw L., Curran A., Davies J.
Health and Safety Executive
Routes of referral for occupational asthma - A national study
The aim of this study was to document the routes of referral for cases of occupational asthma recruited from six hospitals in the United Kingdom. The study comprised both a retrospective and prospective element. The retrospective study involved collating information regarding cases of occupational asthma reported previously to Surveillance of Work Related and Occupational Respiratory Disease scheme (SWORD). In the prospective study, individuals presenting as new and possible cases of occupational asthma were recruited from each of the collaborating hospitals, and the diagnosis was assessed according to an agreed standard. In addition, the route of referral for these patients and detail of their cases was explored by administering a standard questionnaire to the patients. Findings are discussed and several recommendations are made for reducing the incidence of asthma caused by exposure to substances at the workplace.
HSE Books, P.O. Box 1999, Sudbury, Suffolk CO10 2WA, United Kingdom, 2006. x, 53p. Illus. 7 ref.
http://www.hse.gov.uk/research/rrpdf/rr438.pdf [in English]

CIS 08-387 Cable J.
The silent killer
Nitrogen is an invisible, tasteless and odorless gas that comprises about 78 percent of the air we breathe, but its potential to kill workers in or near confined spaces should never be underestimated. This article describes a fatal nitrogen asphyxiation accident having occurred in an oil refinery, the common causes of accidents involving 80 fatalities and 50 injuries having occurred in the United Stated between 1992 and 2002 and the good practices to adopt for preventing these accidents (alarm systems, continuous atmosphere monitoring, ventilation with fresh air, rescue organization, training).
Occupational Hazards, Sep. 2006, p.40-43. Illus.

CIS 08-328 Guber A., Lerman S., Lerman Y., Ganor E., Trajber I., Edelstein E., Fireman E.
Pulmonary fibrosis in a patient with exposure to glass wool fibers
Glass wool or vitreous fibres are non-crystalline inorganic substances made primarily from rock, slag, glass or other processed minerals. They belong to the man-made mineral fibres group and their respiratory effects are well described. In the absence of firm evidence until now that exposure to these fibres is associated with lung fibrosis, pleural lesions or non-specific respiratory diseases in humans, this case description of interstitial fibrosis, which implies a direct association between long-term exposure to glass wool and the clinical outcome, is of particular interest.
American Journal of Industrial Medicine, Dec. 2006, Vol.49, No.12, p.1066-1069. Illus. 11 ref.

CIS 08-337 Oliver L.C., Miracle-McMahill H.
Airway disease in highway and tunnel construction workers exposed to silica
Workers employed in the construction of a tunnel were exposed over an 18-month period to respirable crystalline silica at concentrations that exceeded the OSHA permissible exposure limit. The present study examines workplace exposures and occurrence of airway disease in these workers. Medical and occupational histories and chest radiographs were obtained on 343 workers who had worked on the site during the period in question. Chest radiographs were interpreted according to the ILO-1980 system of classification. Questionnaire responses allowed the identification of symptoms consistent with asthma, chronic bronchitis, shortness of breath and physician-diagnosed asthma (current vs. not current). Relationships between these symptoms and several specific tasks were examined. No cases of silicosis were found on chest X-ray. Overall prevalence of chronic bronchitis, symptoms consistent with asthma, shortness of breath and physician-diagnosed asthma was 10.7%, 25%, 29%, and 6.6%, respectively. A healthy worker effect is suggested. Other findings are discussed.
American Journal of Industrial Medicine, Dec. 2006, Vol.49, No.12, p.983-996. 41 ref.

CIS 08-342 Maqueda J., Buendía M.J, Gallego I., Muñoz C., Roel J.M.
Evaluation of a specific protocol for the health surveillance of occupational asthma using the AGREE instrument
Estudio de evaluación del protocolo de vigilancia sanitaria específica del asma laboral mediante el instrumento AGREE [in Spanish]
In this study, a specific protocol for the health surveillance of occupational asthma was evaluated by a panel of four specialists experienced in different fields of occupational medicine. Strengths and weaknesses of the protocol were highlighted and the validity of the AGREE instrument was demonstrated. Areas for updating and improving the protocol are proposed.
Medicina y seguridad del trabajo, Dec. 2006, Vol.LII, No.205, p.13-21. 16 ref.

CIS 08-376 Renström A., Mattsson M.L., Blidberg K., Doekes G., Bogdanovic J., Tovey E.
Nasal air sampling for measuring inhaled wheat allergen in bakeries with and without facemask use
In this study, novel intranasal air samplers (INAS) were used to assess wheat allergen exposure and evaluate respiratory protection in bakeries. Two models of INAS (INAS-M1 and INAS-M2) were compared with the usual method of personal air sampling of inhalable dust (filters mounted in the breathing zone of subjects carrying portable air pumps), both with and without facemasks. Wheat allergen levels were measured using a sandwich immunoassay. Allergenic particles were immuno-stained for microscopic visualization. Personal air sampling correlated well with INAS-M1 and INAS-M2. INAS-M2 collected particles more effectively than INAS-M1. Facemasks reduced inhalation of wheat allergen by 96% and 93% measured using INAS-MI and INAS-M2, respectively. In conclusion, nasal air sampling can complement personal air sampling to measure short-term exposure and evaluate respiratory protection. To prevent baker's asthma, facemasks may be an effective solution in addition to improving workplaces.
Journal of Occupational and Environmental Medicine, Sep. 2006, Vol.48, No.9, p.948-954. Illus. 25 ref.

CIS 08-397 Hahn E.J., Rayens M.K., York N., Okoli C.T.C., Zhang M., Dignan M., Al-Delaimy W.K.
Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers
In this study, bar and restaurant workers' exposure to secondhand smoke (SHS) was compared before and three and six months after implementation of a smoke free ordinance in the county of Lexington, Kentucky, United States. Subjects consisted of 105 smoking and nonsmoking workers from randomly-selected establishments. Nicotine was determined in hair, while data on smoking, self-reported exposure to SHS and respiratory symptoms were collected during interviews. Thirty-eight percent were current smokers. When controlling for cigarettes per day, there was a significant decline in hair nicotine after three months, which was maintained after six months. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. Regardless of smoking status, respiratory symptoms declined significantly.
Journal of Occupational and Environmental Medicine, Sep. 2006, Vol.48, No.9, p.906-913. Illus. 57 ref.

CIS 08-395 Gennaro V., Montanaro F.
Pleural mesothelioma among asbestos-exposed workers in petroleum refineries: A work-related disease and a sentinel event
Il mesotelioma pleurico nei lavoratori esposti ad amiento nelle raffinerie du petrolio: malattia professionale ed evento sentinella [in Italian]
Petroleum refinery workers were not considered at risk for asbestos-related pathologies, in spite of the documented presence of asbestos at their place of work. This article reports the findings of epidemiological studies which demonstrate a high risk of pleural mesothelioma and point to the occupational origin of some asbestos-related pathologies among the maintenance staff of the refineries. Case-control and cohort studies, conducted in Italy and Canada, analysed the subgroup most heavily exposed to asbestos (maintenance staff) and the control groups not exposed (office staff and the general population). Relative risk (RR) and attributable risk (AR) were estimated using Poisson regression. The studies on maintenance staff showed a very high AR for pleural mesothelioma (96-100%) and lung cancer (42-49%), and an excess of mortality due to all neoplastic and non-neoplastic causes.
European Journal of Oncology, Sep. 2006, Vol.11, No.3, p.185-191. Illus. 21 ref.

CIS 08-89 Kreiss K., Esfahani R.S., Antao V.C.S., Odencrantz J., Lezotte D.C., Hoffman R.E.
Risk factors for asthma among cosmetology professionals in Colorado
There have been several reports of asthma among cosmetology professionals. This study examined the prevalence, work-attributable risk and tasks associated with asthma in this sector. A stratified random sample of cosmeticians, manicurists, barbers and cosmetologists holding licenses in the State of Colorado were selected for a mail survey. The prevalence of physician-diagnosed asthma among the 1883 respondents (68% response rate) was 9.3%; of these, 38% developed asthma after entering the cosmetology profession. Multivariate analyses showed that hairstyling, the application of artificial nails and shaving and honing were significantly associated with asthma arising in the course of employment with relative risks of 2.6-2.9. It is concluded that the increased risk of asthma with onset during employment among cosmetologists is probably attributable to exposure to sensitizers and irritants in tasks demonstrated to be associated with asthma.
Journal of Occupational and Environmental Medicine, Oct. 2006, Vol.48, No.10, p.1062-1069. Illus. 30 ref.

CIS 08-166 Xiao G.B., Morinaga K., Wang R.Y., Xu L.R., Ma Z.H., Zhang X., Kishimoto T., Kohyama N.
Lung disorders of workers exposed to rush smear dust in China
A growing proportion of tatami mats are produced in the Zhejiang province of China for export to Japan. The mats are made from rush. One of the production steps requires smearing the freshly-cut rush with clay to prevent colour fading and increase strength. During subsequent steps, workers are heavily exposed to clay dust which contains 20-30% free silica and is therefore a potential cause of pneumoconiosis. To evaluate lung disorders among workers exposed to this dust, a cross-sectional study was carried out on 1709 workers (788 men, 921 women) in 80 factories. Data were collected by means of questionnaires, medical examinations including a chest X-ray and lung function tests and total and respirable dust measurements. Tatami mat workers were found to be at high risk for pneumoconiosis, with a dose-response relationship between dust levels and the prevalence of pneumoconiosis. A similar relationship between the prevalence of cough and sputum and the length of employment was found for non-smoking workers but not for smoking workers. Other findings are discussed.
Industrial Health, Oct. 2006, Vol.44, No.4, p.556-563. Illus. 15 ref.
http://www.jniosh.go.jp/old/niih/en/indu_hel/2006/pdf/indhealth_44_4_556.pdf [in English]

CIS 08-67 Lucas D., Jegaden D., Lodde B., Arvieux C., Dewitte J.D.
Occupational asthma in maritime environment
In the maritime environment, employees are exposed to various chemical and biological substances, some of which may cause occupational asthma. This is the case for some fished products such as crustaceans and molluscs, but also for cereals carried as cargo or for certain chemicals, either carried as cargo or used in the maintenance of ships. This article consists of a literature review of known etiological factors of occupational asthma to which seafarers and other maritime workers are likely to be exposed.
International Maritime Health, 2006, Vol.57, No.1/4, p.177-187. 72 ref.

CIS 07-1316 Hedlund U., Järvholm B., Lundbäck B.
Persistence of respiratory symptoms in ex-underground iron ore miners
The objective of this case-control study was to assess the persistence of respiratory symptoms in ex-miners after cessation of mining exposure. Data were collected by means of a questionnaire comparing the prevalence of symptoms between ex-miners who had stopped mining at least one year before the study and referents not occupationally exposed to irritants or dust. Age, smoking and a family history of asthma were considered as possible confounders in the analysis. A total of 206 ex-miners and 4560 referents participated. Ex-miners had on average been working as miners for 13 years and had stopped mining 16 years before the study. Chronic productive cough and physician-diagnosed chronic bronchitis were significantly more common among ex-miners. Furthermore, there was a trend that other respiratory symptoms were more common in ex-miners.
Occupational Medicine, 2006, No.56, p.380-385. 34 ref.

CIS 07-1319 Jensen A., Dahl S., Sherson D., Sommer B.
Respiratory complaints and high sensitization rate at a rennet-producing plant
Workers in a rennet producing plant reported airway symptoms, mainly rhinitis. Rennet was produced as fluid and powder with proteolytic enzymes as the active component. Data on airway symptoms and known allergies were collected and prick tests with the rennet types produced in the plant and standard allergens were carried out on 35 exposed employees. An identical prick test was carried out on 28 unexposed controls. Twenty-one employees had hay fever-like symptoms, including 10 mainly at work. Nine had mild to moderate asthma-like symptoms, including six mainly at work. Fourteen had a positive prick test to one or more rennets. The sensitization rate was highest among employees with regular contact to rennet powder.
American Journal of Industrial Medicine, Oct. 2006, Vol.49, No.10, p.858-861. Illus. 6 ref.

CIS 07-1300 Leigh J., Henderson D.
Lung cancer related to asbestos exposure: Causation and compensation
Based on a literature survey, this article reviews the evidence for lung cancer causation as a result of asbestos exposure and the effect that smoking has on this relationship. The effects of asbestos fibre type are also discussed. Medico-legal criteria for attributing lung cancer causation to asbestos exposure are proposed. The effects of genetic susceptibility and the possibility of causal apportionment systems are also discussed.
Journal of Occupational Health and Safety - Australia and New Zealand, Oct. 2006, Vol.22, No.5, p.449-462. 71 ref.

CIS 07-1383 Boylstein R., Piacitelli C., Grote A., Kanwal R., Kullman G., Kreiss K.
Diacetyl emissions and airborne dust from butter flavorings used in microwave popcorn production
Occupational exposure to butter flavourings has been associated with chronic obstructive lung disease. Severe respiratory effects have been reported in rats exposed to butter flavouring vapours and to diacetyl, a diketone found in most butter flavourings. This study assessed diacetyl emissions and airborne dust levels from flavourings used by several microwave popcorn manufacturing companies. Samples of flavourings were heated to 50°C, and gas chromatography was used to measure the organic compounds emitted. Workplace air sampling was also conducted for diacetyl and for total and respirable dust during the mixing of flavourings with heated soybean oil. Powder flavourings were found to give off much lower diacetyl emissions than pastes or liquids. However, a substantial amount of the airborne dust generated by handling powder flavourings was respirable and could thus pose its own respiratory hazard. Companies that use butter flavourings should consider flavourings with lower diacetyl emissions and the use of ventilation and engineering controls to minimize exposures. Until controls are fully implemented, companies should institute the mandatory use of respirators for all exposed workers.
Journal of Occupational and Environmental Hygiene, Oct. 2006, Vol.3, No.10, p.530-535. Illus. 9 ref.

CIS 07-1365 Valberg P.A., Long C.M., Sax S.N.
Integrating studies on carcinogenic risk of carbon black: Epidemiology, animal exposures, and mechanism of action
In this literature survey on the toxicology of carbon black (CB), epidemiology and laboratory studies were reviewed from 1996, when IARC classified carbon black as a group 2B carcinogen (probably carcinogenic to humans). Findings are discussed. High levels of inhaled CB were linked with rat lung tumours in 1996, but today scientists increasingly recognize that rats exhibit a unique lung tumour response to all inert inhaled particles that is unlikely to be relevant to humans. Toxicity in rats results from the particle overload, and not from the particles' chemistry. Research published after 1996 has not identified an increase in support for CB cancer risk, but rather, points to limited and inadequate evidence for carcinogenicity. Overall, the new epidemiological evidence decreases concerns for cancer risk compared with pre-1996 evidence.
Journal of Occupational and Environmental Medicine, Dec. 2006, Vol.48, No.12, p.1291-1307. 76 ref.

CIS 07-1295 Meguellati-Hakkas D., Cyr D., Stücker I., Févotte J., Pilorget C., Luce D., Guénel P.
Lung cancer mortality and occupational exposure to asbestos among telephone linemen: A historical cohort study in France
The objective of this cohort study was to analyse mortality from lung cancer in telephone linemen exposed to low levels of asbestos during the installation of telephone cables. A total of 308 lung cancer deaths were identified in the cohort. Exposure to asbestos and other occupational carcinogens was assessed using a job-exposure matrix. The relative risk for lung cancer death associated with an estimated exposure of approximately 2 fibres/cc-years was 2.1 as compared with workers exposed to less than 0.5 fibres/cc-years. Mean annual exposure or exposure duration were not clearly related to lung cancer. Adjustment for other occupational lung carcinogens did not change this finding. The observed mortality by lung cancer associated with asbestos exposure at low levels is higher than the prediction based on linear extrapolations from data on highly exposed occupational cohorts.
Journal of Occupational and Environmental Medicine, Nov. 2006, Vol.48, No.11, p.1166-1172. 20 ref.

CIS 07-1060 Lee D.J., Fleming L.E., LeBlanc W.G., Arheart K.L., Chung-Bridges K., Christ S.L., Caban A.J., Pitman T.
Occupation and lung cancer mortality in a nationally representative U.S. cohort: The National Health Interview Survey (NHIS)
The objective of this study was to assess the risk of lung cancer mortality in a representative sample of U.S. workers by occupation. The National Death Index identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking- adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR 3.0), non-specified mechanics and repairers (HR 2.8), financial records processing occupations (HR 1.8), freight, stock, and materials handlers (HR 1.5) and precision production occupations (HR 1.4).
Journal of Occupational and Environmental Medicine, Aug. 2006, Vol.48, No.8, p.823-832. 61 ref.

CIS 07-1076 Purdue M.P., Järvholm B., Bergdahl I.A., Hayes R.B., Baris D.
Occupational exposures and head and neck cancers among Swedish construction workers
The relationship between selected occupational exposures and cancers of the oral cavity, pharynx and larynx was investigated using data from a large cohort of Swedish construction workers. Altogether 510 squamous cell carcinomas (171 in the oral cavity, 112 in the pharynx, 227 in the larynx) were identified during 1971-2001 among 307,799 male construction workers. Exposures to diesel exhaust, asbestos, organic solvents, metal dust, asphalt, wood dust, stone dust, mineral wool and cement dust were assessed using a job-exposure matrix. Rate ratios (RR) were calculated for these cancers in relation to occupational exposure, using Poisson regression with adjustment for age and smoking status. Asbestos exposure was related to an increased laryngeal cancer incidence (RR 1.9). Excesses of pharyngeal cancer were observed among workers exposed to cement dust (RR 1.9). No occupational exposures were associated with oral cavity cancer. These findings did not materially change upon additional adjustment for smoking.
Scandinavian Journal of Work, Environment and Health, Aug. 2006, Vol.32, No.4, p.270-275. 49 ref.

CIS 07-1206 Rylander R., Carvalheiro M.F.
Airways inflammation among workers in poultry houses
This study evaluated the usefulness of airway responsiveness measurements to diagnose the presence of airways inflammation and relate this to occupational exposure among poultry workers. The group studied comprised 42 non-smoking poultry workers and 40 non-smoking controls unexposed to organic dusts. The presence of symptoms was evaluated using a standardized questionnaire for organic dust exposures. Airway responsiveness was measured using the methacholine challenge test. The concentrations of airborne endotoxin and (1-3)-β-D-glucan were measured. Exposure levels were in excess of those expected to cause effects in the airways. Compared to controls, exposed workers had significantly higher airway responsiveness and a higher prevalence of toxic pneumonitis, airways inflammation and chronic bronchitis. Endotoxin levels in the poultry buildings exceeded those suggested in earlier studies as the threshold value for airways inflammation.
International Archives of Occupational and Environmental Health, June 2006, Vol.79, No.6, p.487-490. 26 ref.

CIS 07-1112 Fernández-Nieto M., Quirce S., Carnés J., Sastre J.
Occupational asthma due to chromium and nickel salts
Exposure to chromium and nickel salts is a poorly characterized cause of occupational asthma. This article describes four patients with work-related asthma due to metallic salts. Skin tests to potassium dichromate and nickel sulfate were performed. The patients also underwent methacholine inhalation tests and specific inhalation challenges (SIC) with chromium and nickel salts. Two patients showed positive skin tests to potassium dichromate and nickel sulfate. All patients had bronchial hyperresponsiveness to methacholine, which increased 24h after SIC with metallic salts. SIC with potassium dichromate elicited late asthmatic reactions in two workers, one subject had an early asthmatic reaction, and another subject showed a dual asthmatic reaction. SIC with nickel sulfate induced a dual asthmatic reaction in one subject and a late asthmatic reaction in another. Chromium and nickel salts can give rise to occupational asthma in exposed workers. The underlying mechanism may be IgE-mediated.
International Archives of Occupational and Environmental Health, June 2006, Vol.79, No.6, p.483-486. 16 ref.

CIS 07-801 Rosenberg N.
Occupational rhinitis and asthma caused by plants
Rhinite et asthme professionnels aux végétaux [in French]
Exposure to plants may cause rhinitis, conjunctivitis, asthma or urticaria. Diagnosis is usually based on the concurrent existence of work-related symptoms and positive skin and/or serum allergy tests. This review article describes the allergic reactivity of various plant allergens, identifies the agents responsible for rhinitis and asthma in various agricultural and industrial sectors and examines diagnostic methods. Prevention requires reducing to a minimum all work tasks involving the formation of large quantities of dust.
Documents pour le médecin du travail, Dec. 2006, No.108, p.557-569. Illus. 104 ref.
http://www.dmt-prevention.fr/inrs-pub/inrs01.nsf/IntranetObject-accesParReference/TR%2038/$File/TR38.pdf [in French]

CIS 07-800 Matrat M., Andujar P., Pairon J.C.
Occupational respiratory diseases
Maladies respiratoires professionnelles [in French]
This article presents the findings of eight studies on occupational respiratory diseases. Contents: relationship between occupational exposure and chronic bronchitis risk; metal fume fever among welders and the risk of subsequent occurrence of welding-related asthma; respiratory function among asbestos workers and thoracic tomodensitometry data; exposure to asbestos and risk of bronchopulmonary cancer; risk of respiratory cancers due to asbestos exposure following the 11 September 2001 attack; serum osteopontine as a marker of pleural mesothelioma among persons exposed to asbestos; silicosis and bronchopulmonary cancer risk from silica exposure among construction workers; lung inflammation in mice following skin exposure to latex.
Documents pour le médecin du travail, Dec. 2006, No.108, p.495-505. Illus. 16 ref.
http://www.dmt-prevention.fr/inrs-pub/inrs01.nsf/IntranetObject-accesParReference/TF%20156/$File/TF156.pdf [in French]

CIS 07-798 Johnson A., Toelle B.G., Yates D., Belousova E., Ng K., Corbett S., Marks G.
Occupational asthma in New South Wales (NSW): A population-based study
The aim of this cross sectional, population-based study was to examine the contribution of workplace exposures to the development of asthma in adults in the Australian State of New South Wales (NSW). Data were collected by means of a questionnaire returned by 5331 randomly-selected subjects aged between 18 and 49 years (response rate 37%). Among 910 subjects with asthma, 383 subjects reported adult-onset disease. After adjusting for sex, age and smoking, working in any high-risk job or exposure at the time of asthma onset was significantly associated with adult-onset asthma (odds ratio 1.51). The population-attributable risk of adult-onset asthma for either a high-risk job or an exposure was 9.5%. Other findings are discussed.
Occupational Medicine, June 2006, Vol.56, No.4, p.258-262. 19 ref.

CIS 07-884 Jones A.Y.M., Lam P.K.W., Dean E.
Respiratory health of bus drivers in Hong Kong
This cross-sectional study was conducted to evaluate the lung function and respiratory symptoms of Hong Kong bus and tram drivers exposed to air pollutants. Demographic information, pulmonary function, respiratory symptoms and blood lead levels in 358 male drivers of air-conditioned buses (ACB) were compared with 129 male drivers of non-air-conditioned buses (NACB). Particulate matter, carbon dioxide and carbon monoxide levels were measured in 16 air-conditioned and 15 non-air-conditioned trams along the same route. Findings are discussed. Overall, the lung function of NACB drivers was poorer than that of ACB drivers, probably due to prolonged exposure to air pollutants. However, the higher blood lead levels in ACB drivers could be the result of air recirculation.
International Archives of Occupational and Environmental Health, May 2006, Vol.79, No.5, p.414-418. 23 ref.
http://www.springerlink.com/content/ym2560nmh2319040/fulltext.pdf [in English]

CIS 07-580 Świątkowska B.
About occupational risk factors for lung cancer
O zawodowych czynnikach ryzyka raka płuca [in Polish]
The major occupational risk factors for lung cancer are discussed. The types of activities and occupations that are considered to increase risk of the disease are listed and suspected casual factors for the origin of cancers are examined. The characteristics of some carcinogenic substances are presented.
Prewencja i Rehabilitacja, 2006, No.1, p.7-14. 25 ref.
http://www.zus.pl/files/PR012006.pdf [in Polish]

CIS 07-579 Ghasemkhani M., Kumashiro M., Rezaei M., Anvari A.R., Mazloumi A., Sadeghipour H.R.
Prevalence of respiratory symptoms among workers in industries of South Tehran, Iran
The aim this cross-sectional study was to determine the prevalence of respiratory symptoms resulting from occupational lung hazards among workers in industries of South Tehran, Iran. Data on demographic characteristics, cigarette smoking, occupational history and respiratory symptoms were collected from workers through multistage sampling. Among the 880 workers studied, 252 were smokers. Also, it was observed that workers were exposed to pollutants such as dust, gas and fume pollutants. The prevalent respiratory symptoms were cough (20.7%), phlegm (41.6%), dyspnoea (41.7%), chest tightness (27.4%) and nose irritation (23.5%). It is concluded that occupational exposures among workers in industries of South Tehran may cause respiratory symptoms and disorders. Various engineering controls and industrial hygiene measures are recommended.
Industrial Health, Apr. 2006, Vol.44, No.2, p.218-224. 27 ref.
http://www.jniosh.go.jp/old/niih/en/indu_hel/2006/pdf/indhealth_44_2_218.pdf [in English]

CIS 07-577 Henneberger P.K., Derk S.J., Sama S.R., Boylstein R.J., Hoffman C.D., Preusse P.A., Rosiello R.A., Milton D.K.
The frequency of workplace exacerbation among health maintenance organisation members with asthma
The objective of this investigation was to determine the prevalence of workplace exacerbation of asthma (WEA). Members of a health maintenance organization with asthma aged 18-44 were enrolled into the baseline survey of a longitudinal study. Diagnosis and treatment were confirmed by a review of medical records. A work related symptom score was assigned to each participant based on responses to questions about work-related asthma symptoms, medication use and symptom triggers. Blinded to participants' answers to these questions, two researchers independently reviewed the self-reported work histories and assigned exposure ratings. A final exposure score was then calculated. Participants with sufficient evidence for work related symptoms and exposure were classified as having WEA. Of the 598 participants with complete data, 557 were working, and 136 fulfilled the criteria for WEA. Those with WEA were more likely to be male and to report that they had been bothered by asthma symptoms during the past seven days.
Occupational and Environmental Medicine, Aug. 2006, Vol.63, No.8, p.551-557. Illus. 33 ref.

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