Tine Birgitte Malling

The population attributable fraction of occupational COPD among Danish women

Women have a different clinical expression of chronic obstructive pulmonary disease (COPD) [1] and are more prone to developing COPD than men with similar exposures. These findings have been ascribed variously to a different susceptibility to tobacco smoke and anatomic, hormonal and behavioural differences [2]. Women have been shown to perform work with lower exposures than men within the same occupation and industry [3]. Despite these obvious and important gender differences, few studies have focused on occupational COPD in women. The population attributable fraction (PAF) for COPD due to occupational exposure to vapour, gases, dust and fumes (VGDF), irrespective of sex, is ∼15% [4, 5]. However, to our knowledge, no estimates have been published that focus solely on women. We thus analysed cross-sectional data among 1626 Danish women aged 45–84 years in relation to occupational COPD. The analyses add important information to our previously published population-based study [6]. The PAF of occupational COPD among Danish women http://ow.ly/CEmy308XEgl

0191 Are indoor concentrations of airborne mould spores in non-industrial environments sufficiently high to cause hypersensitivity pneumonitis?

Objectives Antigen exposure is the only diagnostic criteria specific for hypersensitivity pneumonitis (HP) compared with other interstitial lung diseases. Indoor mould exposure in non-industrial environments has been claimed to cause HP, but little is known about exposure levels. Our objective was to compare indoor concentrations of airborne mould spores for patients diagnosed with indoor HP with background levels and levels measured for patients diagnosed with farmers’ lung and suberosis. Method We included 8 patients diagnosed with HP based on characteristic clinical findings, signs of indoor mould growth at home or at their non-industrial work place, and increased levels of precipitating antibodies for moulds. We collected 110 air samples from all affected rooms, adjacent rooms, and outdoor. Results The average total spore concentrations varied between 22 000 and 36 000 spores per m3, and the average viable concentrations between 35 CFU/m3 and 457 CFU/m3, with no clear association between spore concentration and affected rooms, adjacent rooms and outdoor. Conclusions The observed levels did not exceed usual indoor and outdoor levels and were orders of magnitude below levels measured for patients diagnosed with farmers’ lung and suberosis, and we question if indoor mould levels in non-industrial environments are sufficient to cause HP. Relying solely on signs of moulds or presence of precipitating antibodies when diagnosing HP may cause other interstitial lung diseases to be overseen and patients may take initiatives such as quitting the job or leaving their homes that will not alleviate their disease but have significant social consequences.

Rare α1-antitrypsin genotype in a grass seed worker

To the Editor: We hereby present a case of chronic obstructive pulmonary disease (COPD) caused by a combination of occupational dust exposure and severe α1-antitrypsin (α1-AT) deficiency. On evaluation of the genetics of this severe α1-AT deficiency, an apparent PiMM genotype was revealed to be heterozygotic for two different rare deficient alleles. In 2008, a 62-year-old man was referred to Dept of Occupational Medicine, Aalborg University Hospital, Aalborg, Denmark, by his general practitioner (GP) to assess whether his reduced lung function was related to occupational dust exposure. For 26 years, he had been employed at a factory that produces grass seed, predominantly from rye grass. The factory received grass seeds from farmers in a dried condition, which were then cleaned and packed in bags for resale. Grass seeds were loaded as loose seeds, and mechanically cleaned, filtered and sorted. During the first 10–15 years of his employment, the process caused heavy dust development, especially when the grass seeds were cleaned but also when the cleaned seeds were weighed. From the early 1990s, the dust filters were improved on the cleaning machine, but still, a considerable dust exposure was reported. However, dust measurements were never performed. The staff did not wear dust …

Genetic polymorphisms in antioxidative enzymes are associated to FEV(1) in smokers independently of asthma

Introduction:  In this study, we hypothesised that the genotypes coding for low antioxidative enzyme activity are associated with asthma and reduced lung function.