Y. Karakoca

Prevalence of childhood asthma and allergic diseases in Ankara, Turkey

Kalyoncu AF, Selçuk ZT, Karakoca Y, Emri AS, Çöplü L, Şahin AA, Bariş YI. Prevalence of childhood asthma and allergic diseases in Ankara, Turkey.

Recognition of cigarette brand names and logos by primary schoolchildren in Ankara, Turkey

OBJECTIVE To assess the smoking behaviour of primary schoolchildren and their ability to recognise brand names and logos of widely advertised cigarettes, compared with other commercial products intended for children. DESIGN Cross-sectional survey in classroom settings using a questionnaire designed to measure attitudes towards smoking and the recognition of brand names and logos for 16 food, beverage, cigarette, and toothpaste products. SETTING Ankara, Turkey. SUBJECTS 1093 children (54.6% boys, 44.4% girls) aged 7–13 years (mean = 10, SD = 1), from grades 2–5. The student sample was taken from three primary schools—one school in each of three residential districts representing high, middle, and low income populations. MAIN OUTCOME MEASURES Prevalence of ever-smoking, recognition of brand names and logos. RESULTS Prevalence of ever-smoking was 11.7% overall (13.9% among boys and 9.1% among girls; p<0.05). Children aged eight years or less had a higher prevalence of ever-smoking (19.6%) than older children (p<0.002). Ever-smoking prevalence did not differ significantly across the three school districts. Ever-smoking prevalence was higher among children with at least one parent who smoked (15.3%) than among those whose parents did not (4.8%) (p<0.001). Brand recognition rates ranged from 58.1% for Chee-tos (a food product) to 95.2% for Samsun (a Turkish cigarette brand). Recognition rates for cigarette brand names and logos were 95.2% and 80.8%, respectively, for Samsun; 84.0% and 90.5%, respectively, for Camel; and 92.1% and 69.5%, respectively, for Marlboro. The Camel logo and the Samsun and Marlboro brand names were the most highly recognised of all product logos and brand names tested. CONCLUSIONS The high recognition of cigarette brand names and logos is most likely the result of tobacco advertising and promotion. Our results indicate the need to implement comprehensive tobacco control measures in Turkey.

Environmental Pleural Plaques due to Asbestos and Fibrous Zeolite Exposure in Turkey

There are many districts in central and south-eastern Anatolia where benign and malignant pleural diseases occur as a result of environmental exposure to mineral fibres. Tremolite asbestos is found in the region and, in addition, in certain areas, there is a unique non-asbestos fibre called erionite which is a fibrous zeolite and which causes pulmonary diseases similar to those produced by asbestos. In this article we would like to report the frequency of calcified pleural plaques in a large-scale epidemiological study in Turkey. The presence of such plaques is considered indicative of mineral fibre exposure. The miner alogy of the region, exposure characteristics of the population and frequency of detection by computerised tomography, thoracoscopy and thoracotomy are also given.

FIBRINOLYTIC SYSTEM IN PLASMA AND PLEURAL FLUID IN MALIGNANT PLEURAL MESOTHELIOMA

The two major fibrinolytic activators, urokinase-type plasminogen activator (u-PA) and tissue-type plasminogen activator (t-PA) may play role in tumor spread and metastasis. Malign pleural mesothelioma (MPM) is a kind of tumor with predominantly local invasion and low incidence of distant metastasis. In this study, u-PA, t-PA and PA activator-1 (PAI-1) antigen and activity were measured in plasma and pleural fluid samples from patients with MPM, lung cancer and benign effusion. When compared to the control group, in MPM group, plasma u-PA and t-PA antigen levels were higher, but plasma u-PA and t-PA activity were comparable. PAI-1 antigen was also higher in MPM group. These findings were in contrast to the lung cancer group, in which both activity and immunologic measurement of u-PA and t-PA were higher, but PAI-1 antigen was similar as compared to the control group. It is concluded that excess t-PA and u-PA are balanced in complexes with PAI-1 in MPM, whereas the amount of PAI-1 in plasma is insufficient to overcome the elevated t-PA and u-PA, in lung cancer. Based on these findings, it may be suggested that the balanced fibrinolytic system is responsible for the low incidence of distant metastasis in MPM.

Speleotherapy in asthma and allergic diseases

We read the review article by Dr Watkins, on the role of alternative therapies in allergic diseases [1], with great interest. Here are some of the points we would like to mention on this subject. Speleotherapy (subterraneotherapy or underground climatotherapy) is one of the popular alternative therapies employed in allergic diseases, charming many people from various parts of the world who are still seeking some help and health-giving effect in the salt mines or caves. This rather old therapy modality without a scientific explanation is widely practised in some regions of Central Europe, The Balkans and, though it is hard to give exact figures, in Turkey. In Wieliczka salt mine in Poland, during 1958-1964, 100 COPD and bronchial asthma patients underwent speleotherapy. At first the patients stopped all their medications and after 4-7 days, received the therapy course of 4 h a day for 6-8 weeks. They were reported to have improved for 6 months-7 years [2]. Similar studies were published from Poland, Hungary and Czechoslovakia with a cure rate of around 20% for bronchial asthma [3-5]. In the study of the Bystra cave in Czechoslovakia, which included 80 asthmatic children between the ages of 4 and 15 years, a considerable response was noted particularly in the age group of 4-6 years [6]. In the Topolca hospital-cave complex in Hungary more than 4000 COPD patients were treated over a 10-year period and long-term improvement was observed in the majority ofthe patients [7]. Physical characteristics ofthe Topolca cave, such as temperature, humidity, volume, air motion, chemical and dust content, were measured; but no conclusion was derived. Another investigation from the Ukraine has reported positive effects for 1 year or more in 17 of the 32 children suffering from neurodermatitis, who underwent speleotherapy [8]. Asthmatics in Turkey are also known to pay visits to caves for alternative therapy, but there are no detailed studies performed on that subject yet [9]. Caves in Middle Anatolia and Mediterranean coastal regions are preferred, the most popular being the Damlatas cave in Antalya. Speleotherapy cures of 2-3 h a day for 15-21 days were observed to result in a symptomless or minor symptomatic period of an average 2-3 months. This might be a placebo-effect or a questionable antiinflammatory effect. In these aforementioned investigations no firm scientific analysis nor follow-up were performed. So it seems tbat the prejudice of the investigators might have played

Byssinosis and COPD rates among factory workers manufacturing hemp and jute.

OBJECTIVES Prior studies have been performed on cotton textile plants throughout the world. This study was planned to identify the rate of byssinosis and chronic obstructive pulmonary disease (COPD) in hemp and jute workers and those who worked with both of them. MATERIAL AND METHODS The study was realized in a factory which consecutively processed hemp and jute. The study enrollment included 266 people, 164 of whom were active workers and 102 were retired. A questionnaire, plain chest X-rays, physical examination and pulmonary function tests were performed. Dust levels were measured in various sections of the factory during 8 h work shifts. Endotoxin levels of various quality hemp fibers and dusts were measured. RESULTS The rate of byssinosis (28.2%) was higher among the workers that who exposed to both jute and hemp dust. The frequency of chronic bronchitis in retired workers who previously smoked was higher (20%) as compared to currently smoking workers (17%). High dust levels were measured in some parts of the factory (mean (M) = 2.69 mg/m3). Working in dense dust areas, active smoking, being older than 40 years of age, being an ex-smoker, and working in the factory for a period exceeding 15 years were significantly associated with bronchitis and emphysema development. High endotoxin levels were determined for fine hemp dust (605 EU/mg), coarse hemp dust (336 EU/mg) and poor quality hemp fibers (114 EU/mg), whereas in fresh hemp stalks the level of endotoxin was determined to be lower (0.27 EU/mg). CONCLUSIONS Because of high exposures to jute and hemp dusts that are associated with high byssinosis rates, personal protection and environmental hygiene is crucial to prevention of byssinosis.