Bilge Hapcioglu

The Effect of Air Pollution and Meteorological Parameters on Chronic Obstructive Pulmonary Disease at an Istanbul Hospital

In this study, the relation between emergency admissions for chronic obstructive pulmonary disease (COPD) at an Istanbul University Hospital between the years 1997 and 2001 and the meteorological and air pollution parameters has been analysed. Admissions were calculated for each month, and the relations between the number of admissions for each month and the corresponding months meteorological parameters (pressure, temperature, moisture) and the average pollution values (CO, SO2, NO, NO2, PM10) were determined. There were 1586 patients included in this study. COPD admissions had a negative significant correlation with temperature (r =-0.72, p<0.001), a positive significant correlation with pressure (r=0.41, p=0.001) and humidity (r=0.34, p=0.007), and also had a positive significant correlation with SO2 (r=0.64, p<0.001), NO (r=0.40, p=0.002), CO (r=0.57, p<0.001) and PM10 (r=0.27, p=0.03). No significant relationship was found for NO2. When the meteorological and clinical parameters were evaluated, it was found that the only variable related to the COPD admissions was temperature. These results for COPD admissions were found to be considerably higher in seasons other than summer (p <0.001). When summer seasonal values were taken as reference (RR=1), RR=1.24 (95% CI: 1.049–1.475) for autumn, RR=1.86 (95%CI: 1.541–2.115) for spring and RR=2.08 (95% CI: 1.793–2.434) for winter. Air pollution and meteorological parameters should be seen as a widespread public health problem, which can trigger admission and even death due to COPD.

Heterotrophic Bacteria and Filamentous Fungi Isolated from a Hospital Water Distribution System

In recent years, hospital infections caused by opportunist micro-organisms in immunosupressed patients groups have become increasingly important. These micro-organisms grow easily in water distribution systems even to the extent of producing bio-film. In the present study the aim was to determine microbial populations in water samples collected from the distribution system of a big hospital. Water samples were collected from one hundred different points around the water distribution system in different sections of the hospital. To analyse the water a membrane filter method was used. In eighty-four samples heterotrophic bacteria were isolated. The most frequent bacteria determined were Bacillusspp. (77%), Bacillus cereus (11%), Pseudomonasspp. (5%) and Staphylococcus spp. (4%). In fifteen samples more than one species of bacteria were isolated. In fifty-one samples, sixteen species of fungi were isolated, the most frequent being Penicilliumspp. (24%), Aspergillusspp. (8%) and Acremoniumspp. (5%). In thirteen samples more than one type of fungi was determined. In only six samples was no growth of fungi or bacteria observed. Over all the one hundred samples the counts of heterotrophic bacteria were not significantly correlated with the filamentous fungi counts (rs 012, p 0.05). Differences in the level of isolation or the concentration of bacteria and fungi between water from three old buildings and water from four new buildings were not significant (p 0.05).

The Effect of Air Pollution and Meteorological Parameters in Istanbul on Hospital Admissions for Acute Coronary Syndrome

It is known that air pollution and meteorological parameters have a negative effect on various respiratory and cardiovascular parameters. In this study, the relationship between emergency hospital admissions for acute coronary syndrome (ACS) and the meteorological and air pollution parameters over the same period were investigated. Some 2889 patients admitted to the emergency internal medicine unit between 1997-2001 were included in this study. The number of patient admissions per month with a diagnosis of ACS were determined and the relationship between meteorological parameters (pressure, temperature, humidity) and mean values of parameters of pollution including carbon monoxide (CO), sulphur dioxide (SO2), nitric oxide (NO), nitrogen dioxide (NO2), mass of particles smaller than 10 m (PM10) were investigated. Monthly admission figures for ACS were positively correlated with pressure and negatively correlated with temperature. No relationship between air humidity and admission for ACS was detected. There was also positive correlation between ACS and SO2, CO, NO and PM10levels. The results showed that the most important meteorological parameter that increased the number of admissions for ACS was a decrease in air temperature, and the most important pollution parameter was SO2. Admission for ACS significantly increased in winters and springs in comparison with summers (RR 1.15%95 CI(1.039-1.279); RR 1.16%95 CI(1.046-1.291)). Air pollution and meteorological parameters should be seen as a widespread public health problem, which can trigger admission and even death due to ACS. Greater effort should be expended to further lower air pollution levels.

Respiratory Problems in Tannery Workers in Istanbul

Tannery workers are exposed to many chemical and physical hazards. The current study involved 730 workers from 23 leather factories located in the Tuzla Organized Industry Region, Istanbul. Participants were interviewed and underwent clinical examination. After the basic physical examination, respiratory functions were measured by spirometer and the workers questioned about asthma. Health problems included gastrointestinal complaints (7.30%), bronchitis (3.11%) and asthma (3.0%). Signs of bronchial obstruction — wheeze and rhonchus — were detected in 71 (9.72%) workers. A deficit in the values of FVC%, FEV 1%, FEV1/FVC%, PEF%, FEF25— 75% was set nominally at 80% of the respiratory function test parameters. Decreased pulmonary function results were found for FVC% in 36 (4.93%) workers, FEV1 in 71 (9.72%), FEV1/FVC in 18 (2.59%), PEF in 183 (25.1%) and FEF25—75% in 204 (27.94%). The number of those with respiratory obstruction detected by spirometry was 294 cases (40.27%), more than the number of cases, 263 (36.02%), who claimed res- piratory problems in the questionnaire. This study was a contribution towards efforts to improve the factory envi- ronment and control workplace risks. Together with med- ical examinations before and during employment and provision of continuous health services and training will reduce the risk of occupational disease to a minimum. Introduction Leather production is one of the worlds oldest trades, consisting of a chemical process that turns animal hides into the much less perishable material, leather. As part of this process, after the removal of the epidermis and subcu- taneous tissue, the dermal collagen fibres are stabilized by means of chemical treatment known generically as tanning [1]. Employees who work in tanneries are liable to be affected by their exposure to lots of hazardous materials and processes during tanning. These hazards can be grouped into four categories: biological, physical and chemical hazards and work accidents.

Biological Hazards in Tannery Workers

A total of 431 workers from 14 leather factories located in the Tuzla Organized Industry Region, Istanbul were involved in the study. Subjects were interviewed and examined individually with regard to asthma symptoms. Physical examinations were undertaken and respiratory function measured by spirometer. Moreover, the atmosphere of the working areas in the factories was assessed microbiologically. The fungal genera most often detected were Penicillium spp., followed by Aspergillus spp., Alternaria spp., Scopulariopsis spp., and Cladosporium spp. multiplying at differing rates. The number of those physically examined with indications of peripheral respiratory obstruction was 176 (40.8%) while those with suspected asthma following questioning was 153 (35.5%). The obstruction demonstrated by the use of respiratory function tests was associated with the mold isolated from the environment and was included in the logistic model that was developed as a risk factor for increasing obstruction. Workers employed in tanneries encounter many health problems. These may be reduced by: improving the factory environment, environmental control of allergens, elimination of allergen reservoirs, control of humidity and reducing exposure to excessive heat or cold. In addition there should be air filtration and vacuum cleaning to control dust mites and control of other workplace risks not necessarily associated with tanning. Importantly, workers should have medical examinations before employment and periodic examinations during training and employment to reduce the risk of occupational diseases to a minimum.

Assessment of Nasal Swab Samples, Environmental Microbiological Analyses and Respiratory Function Tests of Bakery Workers Working Under Modern Conditions: A Brief Report

Studies have shown that bakery workers may develop asthma and rhinitis as a result of their occupation and approximately 30% of bakery workers and wheat farmers will become sensitised. This ratio can change depending on the exposure time and a history of atopy. The present study has looked at the relationship between nasal and environmental flora and pulmonary function in such workers to see if it can explain the occurrence of asthma and rhinitis. Workers from three of the largest bakery companies in Istanbul were recruited, a total of 372 people; 223 bakery workers and 149 administrative employees of the same companies as a control group. Face to face interviews were conducted to determine asthma status and all were given physical examinations with nasal flora samples collected by sterile swabs. Aerial samples were taken from administrative and product departments for microscopic examination. Compared to administrative staff, bakery workers had insignificantly more asthma symptoms (p> 0.05).C. albicanswas isolated from four (1.9%) nasal samples from bakery workers and one (0.7%) from the control group (p> 0.05). A statistically significant level of wheeze (X2= 4.65, p= 0.03, OR= 2.32 95% CI (1.06–5.07)), suggesting bronchial obstruction, was detected in 28 (13.1%) bakery workers and in nine people (6.1%) from the control group. Looking at smoking and non-smoking groups, a significant decrease was observed for PEF (%) in the smokers and FEV1/FVC (%) in the non-smokers. These results suggest that pulmonary function of bakery workers is slightly impaired even with modern engineering controls.