American Thoracic Society news tips for December

Better contact investigation would help eliminate tuberculosis

In the first study of a representative national sample of 1,080 adults diagnosed with pulmonary sputum positive tuberculosis (TB) and 6,225 of their close contacts, investigators for the Centers for Disease Control and Prevention (CDC) called for specific improvements to help state and local TB programs enhance their effectiveness in dealing with household (live-in) contacts, relatives, leisure time contacts, and others with close exposure to the infectious TB patient. After their comprehensive look at data from 11 TB program sites around the country, the scientists called for programs to devote more time to identifying additional close contacts of active TB patients. Secondly, they urge contact investigators to visit the patient’s home which, in this study, resulted in identifying two additional (especially child) close contacts. Third, they recommended recording the date of the contact’s last exposure to the TB patient for possible follow-up tuberculin tests for those who are negative initially, but who could convert to positive response. They noted also sites that use public health nurses were more likely to start patients with a positive skin test, as well as converters, on treatment for latent TB infection. Finally, they urge use of directly observed therapy to increase the likelihood of contacts completing their treatment. The study appears in the December American Journal of Respiratory and Critical Care Medicine.

High rate of occupational asthma uncovered

Investigators who performed a population-based cross-sectional study in six Canadian communities found that approximately one in three cases of adult-onset asthma could have been caused by occupational asthma. They believe over 18 percent of cases of adult-onset asthma in a Canadian urban population could have been prevented by eliminating exposure at work in combined high-risk occupations and industries. Of 2,974 persons who attended a lab session, answered questions on symptoms and risk factors, and had lung function tests and skin prick test for allergy sensitivity, 383 had physician-diagnosed asthma. Of this group, 166 had adult-onset disease. Of these patients, 27 worked in a defined high risk occupation or industry, and 33 had occupational exposure to a known asthma-causing agent. Although the majority of participants have changed jobs since their asthma began, most still had respiratory symptoms at their current workplace. The research is published in the December American Journal of Respiratory and Critical Care Medicine.

School-aged children show lung function deficits from maternal smoking during gestation

Southern California researchers have found that school-aged children with asthma have large deficits in lung function associated with exposure to maternal smoking while they were still in the womb. They examined the medical history and tobacco exposure data for 5,263 participants in the Children’s Health Study. They found that both boys and girls with a history of exposure in the womb to maternal smoking showed deficits in lung function which were larger for children with asthma. They believe that exposure in the womb to maternal smoking is independently associated with persistent deficits in lung function and that asthmatic children comprise an especially sensitive group for this problem. They urge women to cut back on smoking drastically during their childbearing years. The study appears in the December issue of the American Journal of Respiratory and Critical Care Medicine.

For either the complete text of these articles or to contact the investigators by e-mail, please see the ATS Journal Online Website at http://www.atsjournals.org. Medical and scientific journalists who would like to interview these researchers, receive a complimentary subscription to ATS journals, and/or receive the ATS news briefs by e-mail each month, should contact Lori Quigley at 212-315-6442, by fax at 212-315-6455, or by e-mail at lquigley@thoracic.org.