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Air pollution and emergency department visits for conjunctivitis: A case-crossover study

100%

Szyszkowicz M., Kousha T., Castner J.

International Journal of Occupational Medicine and Environmental Health

2016

vol. 29

issue 3

381-393

Objectives The purpose of this study was to examine the associations between emergency department (ED) visits for conjunctivitis and ambient air pollution levels in urban regions across the province of Ontario, Canada. Material and Methods Information from the National Ambulatory Care Reporting System was used to create time-series records, for the period of April 2004 to December 2011, on emergency department visits of patients suffering from conjunctivitis. A total of 77 439 emergency department visits for conjunctivitis were analyzed. A time-stratified case-crossover design was applied, completed with meta-analysis in order to pool inter-city results. Odds ratio (OR) for an emergency department visit was calculated in different population strata per one-unit increase (one interquartile range – IQR increase in a pollutant’s daily level) while controlling for the impacts of temperature and relative humidity. Results Statistically significant positive results were observed in the female population sample, for nitrogen dioxide (NO₂) exposure lagged 5–8 days, with the highest result for the 7-day lag (OR = 1.035, 95% CI: 1.018–1.052) and for fine particulate matter with a median aerodynamic diameter of less than 2.5 μm ($\text{PM}_\text{2.5}$), for lags 6 and 7 days, with the highest result for lag 7 (OR = 1.017, 95% CI: 1.003–1.031). In the male population sample, statistically significant positive results were observed for NO₂ at lag 5 days (OR = 1.024, 95% CI: 1.004–1.045) and for ozone (O₃), at lags 0–3 and 7 days, with the highest result for lag 0 (OR = 1.038, 95% CI: 1.012–1.056). Also for males, statistically significant results were observed in the case of $\text{PM}_\text{2.5}$ exposure lagged by 5 days (OR = 1.003, 95% CI: 1.000–1.038) and sulfur dioxide (SO₂) exposure lagged by 1 and 2 days (OR = 1.016, 95% CI: 1.000–1.031 and OR = 1.018, 95% CI: 1.002–1.033). Conclusions The findings of this study suggest that there are associations between levels of air pollution and ED visits for conjunctivitis, with different temporal trends and strength of association by age, sex, and season.

Papain-induced occupational rhinoconjunctivitis and asthma – A case report

67%

Tymoszuk D., Wiszniewska M., Walusiak-Skorupa J.

Medycyna Pracy

2016

vol. 67

issue 1

109-112

W artykule opisano przypadek zawodowej astmy oskrzelowej, alergicznego nieżytu nosa i zapalenia spojówek wywołanych papainą u 50-letniej pakowaczki ziół i przypraw. W badaniu cytologicznym udokumentowano wzrost odsetka eozynofilów w indukowanej plwocinie i popłuczynach nosowych po swoistej próbie prowokacyjnej wziewnej i donosowej z tym enzymem. Zależną od immunoglobuliny E (IgE) nadwrażliwość pacjentki na papainę potwierdzono dodatnimi wynikami punktowych testów skórnych z roztworem tej proteazy. Wyżej wymienione próby prowokacyjne wykazały istotny związek między ekspozycją na papainę a reakcją alergiczną ze strony układu oddechowego. Ponadto swoista próba prowokacyjna donosowa wywołała wzmożoną reakcję ze strony spojówek i istotny wzrost odsetka eozynofilów we łzach mimo braku bezpośredniego kontaktu alergenu ze spojówkami. Med. Pr. 2016;67(1):109–112

This report presents a case of occupational asthma, rhinitis and conjunctivitis to papain in a 50-year-old herbs and spices packer, with documented increased eosinophilia in induced sputum and in the nasal lavage fluids after a specific inhalation challenge test (SICT) and specific nasal challenge test (SNCT) with this enzyme. Immunoglobulin E-mediated (IgE) sensitization to papain was confirmed by positive results of a skin prick test with specific solution. Specific inhalation and nasal challenge tests demonstrated a direct and significant link between the exposure to this protease and the allergic response from the respiratory system. Additionally, the SNCT induced a severe reaction of the conjunctivae and a significant increase in the count of eosinophils in tears, despite the lack of direct contact of the allergen with the conjunctiva. Med Pr 2016;67(1):109–112

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1 International Journal of Occupational Medicine and Environmental Health

1 Medycyna Pracy

1 Castner J.

1 Kousha T.

1 Szyszkowicz M.

1 Tymoszuk D.

1 Walusiak-Skorupa J.

1 Wiszniewska M.

2 2016

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Air pollution and emergency department visits for conjunctivitis: A case-crossover study

Papain-induced occupational rhinoconjunctivitis and asthma – A case report