A recent study provides new evidence that working conditions put popcorn production workers' health at risk. Researchers from Morgantown, WV, Bethesda, MD, and San Francisco, CA, administered a questionnaire, spirometry testing, and sputum induction to 81 workers employed by a popcorn factory. Fifty-nine workers had a history of high exposure to popcorn flavoring vapors, with positions in mixing, microwave packing, maintenance, and quality control, while 22 workers had a low exposure to flavoring vapors, with positions in office, polyethylene packaging, warehouse, and outside sections of the plant. Study results show that neutrophil concentrations in nonsmoking workers were significantly higher than those of the healthy nonsmoking control group, and sputum interleukin-8 and eosinophil cationic protein levels were higher in high-exposure workers than in low-exposure workers. These findings indicate that high exposure to popcorn flavoring agents is significantly associated with neutrophilic airway inflammation in popcorn production workers. Neutrophilic airways inflammation is a potentially important underlying factor in the development of the bronchiolitis obliterans syndrome (BOS), previously documented in workers at this plant. The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
Snoring Causes Identified
In a study of 40 patients, researchers from Slovenia used CT scan imaging of the head and neck region to identify the structures responsible for snoring. Based on questionnaires filled out by study participants and their spouses, patients were divided into groups, with 14 nonsnorers, 13 moderately loud snorers, and 13 loud snorers. The results show that how loudly people snored was directly proportional to the extent of inspiratory pharyngeal narrowing, which was 3.59 on average for nonsnorers, 4.71 on average for moderately loud snorers, and 8.60 for loud snorers. Findings also suggest that the soft palate is the main structure that causes snoring, as nonsnorers' soft palates measure at 3.5 cm, and snorers' measure at 4.0 cm. These findings support Bernoulli's principle, that streaming air is the most important factor in the pathophysiology of snoring. Body mass index and age were also both higher in those who snored. Although 24 patients were found to have obstructive and/or subjective nasal breathing impairment, these impairments were only significant when associated with the loud snoring group, which implies that obstacles in the nose are not responsible for snoring but may amplify the loudness. The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.
SABA Fills Mark Reflect Asthma Morbidity
Short-acting (-agonist (SABA) prescriptions could be used as a surrogate marker for asthma morbidity of steroid and nonsteroid users, according to a new study. Using claims data for recipients covered by Illinois Medicaid, with a diagnosis of asthma from fiscal year 1996 through June 1998, researchers from Chicago, IL, obtained the claims for SABA- and asthma-related emergency department (ED) visits and hospital admissions for 31,140 adults. Study results show an average of 6.7 SABA fills per person per year, and 138 hospitalizations per 1,000 men and 116 per 1,000 women. The most significant association between SABA prescriptions and ED visits or hospital admissions for asthma were when both occured on the same day. For individuals visiting the ED but not being hospitalized, 16.7% filled a SABA prescription on the same day. The figure dropped to 2.1% for hospitalized individuals. Male steroid users had a 3.4 times greater odds of filling a prescription on the day they had an ED or hospital visit, when compared to a day they did not have an ED/hospital visit, while this figure was 2.9 for women. For nonsteroid users, men were 4.6 times more likely to fill a SABA prescription on the same day as a ED/hospital visit, while women were 5.5 times more likely. A lesser but still significant association was found between the ED visits or hospital admissions occurring one to four days days before a SABA prescription, but no association was established when a SABA prescription date preceded a hospital admission or an ED visit. The study appears in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.