Wojciech Dudek
Research interests
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InterestsOccupational asthma, Occupational allergy
Publications
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[The real value of diagnostic methods in case of long time of cessation of occupational exposure to diisocyanates among patients diagnosed in the nofer institute of occupational medicine in Łodź].
Medycyna pracy. 01/2011; 62(6):567-77.
The aim of the study was to analyze the data obtained during the diagnostic process and their real values in the final diagnosis of patients exposed to diisocyanates amd suspected of occupational allergic disease of the respiratory system The patients have been hospitalized in the Nofer Institute of... [more] The aim of the study was to analyze the data obtained during the diagnostic process and their real values in the final diagnosis of patients exposed to diisocyanates amd suspected of occupational allergic disease of the respiratory system The patients have been hospitalized in the Nofer Institute of Occupational Medicine over recent 11 years. In 1999-2009 we hospitalized 37 patients exposed to diisocyanates and suspected of occupational asthma. Test results of 37 patients were analyzed. The patients were divided into three groups of those with diagnosed occupational asthma, with diagnosed non-occupational asthma and those without any allergic airway disease. 40.0% of patients with occupational asthma, 64.3% of patients with non-occupational asthma and 15.4% of patients without any allergic disease were sensitized to at least one of common allergens. We did not find any specific IgE to diisocyanates. Specific challenge tests were performed in all the 37 subjects. We observed positive results of SIT with diisocyanates in 10 patients. Only specific challenge test with diisocyanates showed the real diagnostic value in case of a 7.5-year cessation of exposure. Determination of serum specific IgE to diisocyanates does not seem to be of clinical value in the diagnosis of diisocyanate-induced asthma in case of a 7.5 year cessation of exposure. Atopy is not the risk factor in diisocyanate-induced asthma.
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[Coexistence of two occupational infectious diseases in one patient--borreliosis and tick-borne encephalitis--a case report].
Medycyna pracy. 01/2011; 62(3):339-44.
Recently, infectious diseases have been found to be the most frequent among occupational diseases. Borreliosis, the most common among them, as well as tick-borne encephalitis is transmitted by ticks. Recognition of occupational etiology of such diseases is possible only when the relationship between... [more] Recently, infectious diseases have been found to be the most frequent among occupational diseases. Borreliosis, the most common among them, as well as tick-borne encephalitis is transmitted by ticks. Recognition of occupational etiology of such diseases is possible only when the relationship between the infection, occupational exposure and performed work is proved. A case report of a forest worker with borreliosis coexisting with tick-borne encephalitis is presented. Despite nonconcurrent recognition of both diseases it was highly possible that contagion took place at the same time or at a very short time interval. Despite high prevalence of tick-borne diseases, occupational etiology of these two infectious diseases in one patient is very rarely recognized.
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[Health hazards associated with occupational exposure to birds].
Medycyna pracy. 01/2010; 61(2):213-22.
The occupational group particularly exposed to contact with birds are zoo keepers, animal shop workers, individual bird's keepers and food industry workers. Work associated with contact with birds may contribute to the development of different symptoms and diseases, including allergic and contag... [more] The occupational group particularly exposed to contact with birds are zoo keepers, animal shop workers, individual bird's keepers and food industry workers. Work associated with contact with birds may contribute to the development of different symptoms and diseases, including allergic and contagious ones. This paper reviews the most common allergens occurring in the environment of bird's keepers, namely: feathers, egg proteins, allergens of plant origin, acarinae, allergens from latex and disinfectants. The most common health effects associated with occupational exposure to birds are also presented. Taking account of not fully understood pathogenesis of allergy to these allergens, complexity of occupational exposure and a possible coincidence of non-specific irritant effects of factors present in work environment, the diagnostic and certification procedures for occupational allergic diseases require highly specialized investigations. Objective and subjective medical examinations, taken medical history and physical examination also play a significant role in diagnostics of contagious diseases, whereas different laboratory tests are used in searching for their etiologic factors. The prevention of diseases associated with occupational exposure to birds comprises educational work, technical actions (hygiene prophylaxis) and medical prophylaxis.
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Occupational asthma due to turpentine in art painter - case report.
International journal of occupational medicine and environmental health. 10/2009;
Turpentine is a fluid obtained by distillation of wood resins containing mixture of terpens. It can act as an irritant and sensitiser. Most common health problem among workers exposed to turpentine is contact dermatitis. Little is know about turpentine to cause type I hypersensitivity reaction. We p... [more] Turpentine is a fluid obtained by distillation of wood resins containing mixture of terpens. It can act as an irritant and sensitiser. Most common health problem among workers exposed to turpentine is contact dermatitis. Little is know about turpentine to cause type I hypersensitivity reaction. We present a case of a 27-year old art painter using turpentine as a thinner for oil-based paints. She developed asthmatic reactions after 5 years of working with turpentine. A number of clinical procedures were performed, including clinical examination, routine laboratory tests, total serum IgE, skin prick tests to common aeroallergens, metal salts, oil-based paints and balsamic turpentine, resting spirometry test, histamine challenge, and a single-blind, placebo-controlled specific inhalation challenge with balsamic turpentine. Clinical findings and laboratory test results were normal but a significant bronchial hyperreactivity was found. During the specific challenge, dyspnoea and decreased forced expiratory volume (FEV1) were observed in late phase of asthmatic reaction. An increased proportion of eosinophils in induced sputum could also be noted 24 h after the challenge. Positive clinical response to the specific challenge as well as the morphological changes found in induced sputum served as the basis for diagnosing occupational asthma. To our knowledge, this is the first well-documented case of turpentine-induced occupational asthma.
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Work-related respiratory symptoms in bird zoo keepers--questionnaire data.
International journal of occupational medicine and environmental health. 01/2009; 22(4):393-9.
To investigate the risk factors for the development of airway diseases from occupational exposure to birds' allergens among Polish zoo garden keepers caring for birds. Two hundred workers responded to the questionnaire including the history of work-related symptoms, job characteristics, descript... [more] To investigate the risk factors for the development of airway diseases from occupational exposure to birds' allergens among Polish zoo garden keepers caring for birds. Two hundred workers responded to the questionnaire including the history of work-related symptoms, job characteristics, description of occupational exposure, information on smoking habit, contact with birds and animals at home and family history of allergic diseases. General work-related symptoms were reported by 58 subjects (29%), whereas work-related respiratory symptoms were found in 40 workers (20%). The multivariate logistic regression analysis confirmed the significant role of positive family history of atopy and occupational contact with parrots either in the development of work-related symptoms or work-related respiratory allergic symptoms. The findings may confirm that work-related respiratory symptoms are an important health problem among zoo bird keepers in Poland.
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Exhaled Nitric Oxide Levels After Specific Inahalatory Challenge Test in Subjects with Diagnosed Occupational Asthma.
International journal of occupational medicine and environmental health. 11/2008;
Objectives: Measuring exhaled nitric oxide (eNO) is a useful method for the assessment of bronchial inflammation in asthmatic subjects. The aim of the study was to evaluate the changes in eNO level in the subjects with suspected occupational asthma (OA) after a specific inhalation test (SIT) with oc... [more] Objectives: Measuring exhaled nitric oxide (eNO) is a useful method for the assessment of bronchial inflammation in asthmatic subjects. The aim of the study was to evaluate the changes in eNO level in the subjects with suspected occupational asthma (OA) after a specific inhalation test (SIT) with occupational agents. Materials and Methods: Forty two patients, including 17 farmers, 15 bakers and 10 health care workers had a physical examination, skin prick tests with common and occupational allergens, total serum IgE level, specific anti-allergen IgE determinations, spirometry and SIT. Also, morphological changes in induced sputum (ISP) and nasal lavage fluid (NLF) were analysed and eNO measurements were performed. Results: SIT revealed a significant increase in the proportion of eosinophils in NLF and in ISP in the cases with diagnosed OA. Moreover, these cases showed significantly increased eNO levels only 24 h after SIT, compared to the measurements before SIT. We also found a significant correlation between eNO level at 24 h after SIT and the percentage of eosinophils in NLF before, and 4 and 24 h after SIT, as well as in ISP before and 24 h after SIT in all subjects with diagnosed OA. Conclusion: The findings may confirm the usefulness of exhaled nitric oxide measurements for diagnosing OA.
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IL-18 Levels in Nasal Lavage After Inhalatory Challenge Test with Flour in Bakers Diagnosed with Occupational Asthma.
International journal of occupational medicine and environmental health. 08/2008;
Objectives: The authors discuss the outcomes of a study on IL-18 concentration in nasal washings after the inhalatory challenge test with flour allergens (ICHT-F) in bakers with flour-induced occupational airway allergy (OAA) Methods: We measured IL-18 concentration using ELISA kit and assessed morp... [more] Objectives: The authors discuss the outcomes of a study on IL-18 concentration in nasal washings after the inhalatory challenge test with flour allergens (ICHT-F) in bakers with flour-induced occupational airway allergy (OAA) Methods: We measured IL-18 concentration using ELISA kit and assessed morphological changes in nasal lavage fluid (NLF) before, and 4 h and 24 h after ICHT-F in three groups of subjects: Group A - 9 patients with diagnosed OAA (occupational asthma and rhinitis), Group B - 10 patients with atopic asthma and rhinitis, and Group C - 9 healthy volunteers. Results: In Group A, significant differences in the basophil proportion in NLF were noted only 24 h after ICHT-F. Both the basophil proportion and total eosinophil count were higher in Group A than in Group C at this time-point. Group A also showed a statistically significant increase in IL-18 levels 4 h after the challenge. A significant relationship was noted between the proportion of basophils 4 h after ICHT-F and IL-18 level at 24 h after the test. Conclusions: This is the first study demonstrating an increased expression of IL-18 in nasal washings of subjects diagnosed with OAA to flour allergens. The observed higher concentrations of IL-18 in nasal washings after ICHT as well as the increase in the proportion of basophils provide evidence for the important role of IL-18 in persistent allergic inflammation.
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[Psychological factors in allergic skin diseases]
Medycyna pracy. 02/2008; 59(4):279-85.
BACKGROUND: Over recent years, increasing attention has been given to the impact of psychological factors on the onset and course of many illnesses. MATERIALS AND METHODS: In total, 112 patients underwent psychological interview, including 37 with diagnosed urticaria, 50 with allergic contact dermat... [more] BACKGROUND: Over recent years, increasing attention has been given to the impact of psychological factors on the onset and course of many illnesses. MATERIALS AND METHODS: In total, 112 patients underwent psychological interview, including 37 with diagnosed urticaria, 50 with allergic contact dermatitis and 25 with atopic dermatitis. General Health Questionnaire (GHQ) was used to determine patients' mental condition and Profile of Mood States (POMS) to measure subjects' affective states. The level of self-acceptance was assessed with the Self-Assessment Scale (SAS). The dermatology Life Quality Index (DLQI) was employed to measure the effects of skin disease on patients' physical and social functioning. RESULTS AND CONCLUSION: Patients with skin diseases have significantly lower level of: self-acceptance, self-knowledge and feeling of self-effectiveness than healthy controls. Skin disorders such as urticaria, allergic contact dermatitis and atopic dermatitis reduced patients' quality of life, especially in professional activities. The most extensive disturbances in physical and psychosocial functioning were observed in subjects with allergic contact dermatitis and atopic dermatitis. Patients with skin diseases, especially those with allergic contact dermatitis and urticaria have a higher prevalence of psychiatric disorders than the general population.
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Occupational asthma due to manganese exposure: a case report.
International journal of occupational medicine and environmental health. 02/2008; 21(1):81-3.
Manganese belongs to a group of agents called "transitional metals" that are known to induce occupational asthma. However, well-documented cases of manganese-induced asthma have been lacking thus far. We have discussed a case of a 42-year-old non-smoking welder with work-related dyspnea. A... [more] Manganese belongs to a group of agents called "transitional metals" that are known to induce occupational asthma. However, well-documented cases of manganese-induced asthma have been lacking thus far. We have discussed a case of a 42-year-old non-smoking welder with work-related dyspnea. A number of clinical procedures were performed including clinical examination, routine laboratory tests, total serum IgE, skin prick tests to common aeroallergens and manganese nitrate, resting spirometry test, histamine challenge, and a single-blind, placebo-controlled specific inhalation challenge with 0.1% manganese chloride solution. Clinical findings and laboratory test results remained normal but a significant bronchial hyperreactivity was found. During the specific inhalation challenge, dyspnea and a significant decrease in forced expiratory volume (FEV1) were observed. An increased proportion of eosinophils and basophils in induced sputum could also be noted at 4 and 24 h after the challenge. The argument for recognizing the condition as occupational asthma was a positive clinical response to the specific challenge test as well as the morphological changes found in induced sputum. To our knowledge, this is the first well-documented case of manganese-induced occupational asthma.
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[The role of psychological factors and psychiatric disorders in skin diseases]
Medycyna pracy. 02/2006; 57(6):551-5.
In this paper, the relation between psychological factors and psychiatric disorders in patients with skin diseases is discussed. On the one hand psychological factors (stress, negative emotions) can influence the generation and aggravation of skin disorders (urticaria, atopic dermatitis, vitiligo), ... [more] In this paper, the relation between psychological factors and psychiatric disorders in patients with skin diseases is discussed. On the one hand psychological factors (stress, negative emotions) can influence the generation and aggravation of skin disorders (urticaria, atopic dermatitis, vitiligo), on the other hand psychological disorders can result in some skin diseases (psoriasis, atopic dermatitis). In the majority of cases the quality of life is poorly estimated by patients with skin problems. Psychodermatology is divided into three categories according to the relationship between skin diseases and mental disorders: 1) psychophysiologic disorders caused by skin diseases triggering different emotional states (stress), but not directly combined with mental disorders (psoriasis, eczema); 2) primary psychiatric disorders responsible for self-induced skin disorders (trichotillomania); and 3) secondary psychiatric disorders caused by disfiguring skin (ichthyosis, acne conglobata, vitiligo), which can lead to states of fear, depression or suicidal thoughts.
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[Sick building syndrome due to exposure to pentachlorophenol in the office: a case report]
Medycyna pracy. 02/2006; 57(1):21-4.
"Sick building syndrome" (SBS) is a group of symptoms experienced by people working in various buildings. This or another term "building-related illness" (BRI) is used to define illnesses related to modern buildings, mainly offices, in which people spend many working hours. SBS a... [more] "Sick building syndrome" (SBS) is a group of symptoms experienced by people working in various buildings. This or another term "building-related illness" (BRI) is used to define illnesses related to modern buildings, mainly offices, in which people spend many working hours. SBS applies to a group of diseases with a fairly homogenous clinical picture and etiology (specific - infectious, allergic and non-specific--for example irritant symptoms). A case of a 51-year-old non-smoking female office worker is reported. After having her working premise renovated, she started to suffer from irritation of mucous membrane of the throat, sore throat and dysphonia. She claimed that these symptoms were associated with exposure to pentachlorophenol (PCP) emitted by the elements of ceiling impregnated with PCP-containing varnish. The concentration of PCP was below the hygiene standards adopted for the work environment. There were no grounds for recognizing occupational intoxication, but the case met the criteria for the sick building syndrome.
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Natural rubber latex allergy: antigen specific IgE in Polish blood donors, prevalence and risk factors--preliminary data.
International journal of occupational medicine and environmental health. 02/2005; 18(1):35-42.
OBJECTIVES: There is insufficient data on the prevalence of latex allergy in the general population in Poland. The aim of the study was to evaluate natural rubber latex (NRL) sensitization and its risk factors among Polish blood donors. MATERIALS AND METHODS: The study group comprised 1000 consecuti... [more] OBJECTIVES: There is insufficient data on the prevalence of latex allergy in the general population in Poland. The aim of the study was to evaluate natural rubber latex (NRL) sensitization and its risk factors among Polish blood donors. MATERIALS AND METHODS: The study group comprised 1000 consecutive blood donors attending the Regional Centre for Transfusion Medicine. Total IgE and allergen specific IgE to NRL (asNRL-IgE) were assayed using the EIA (enzyme immunoassay) test. In the subjects with asNRL-IgE equal to or above Class II further surveys were performed: questionnaire, skin prick tests (SPT) to common allergens, NRL and food allergens cross reactive to NRL, asNRL-IgE with FDA (Food and Drug Administration) approved FEIA (fluorescent enzyme immunoassay) test and antigen profile of asNRL-IgE. RESULTS: asNRL-IgE (EIA) was observed in 17.9% of blood donors. Only 10% of positive results equal to or above Class II were confirmed with the FEIA test. The positive FEIA results were confirmed with SPT to NRL in 60% and the negative FEIA results in 5.4% of cases. The specific IgE to Hev b 3, 5, 6 and 13 were observed in the subjects with occupational exposure to NRL. The highest concentration of Hev b 8 was observed in the subjects not symptomatic to NRL with positive SPT to grass and tree pollens. CONCLUSION: The EIA test showed the high prevalence of antigen specific IgE to NRL among Polish blood donors. There was low concordance between EIA and FEIA tests. Therefore, the EIA test should be used only for screening purposes along with the establishment of sensitivity and specificity of the method. Elevated total IgE level, active tobacco smoking, and history of atopic disease symptoms were revealed to be risk factors for the presence of asNRL-IgE.
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Occupational asthma caused by cobalt chloride in a diamond polisher after cessation of occupational exposure: a case report.
International journal of occupational medicine and environmental health. 02/2005; 18(2):151-8.
OBJECTIVES: The inspiration of cobalt containing dust leads to various respiratory symptoms, including asthma and interstitial lung disease. Occupational asthma caused by cobalt chloride has been diagnosed in a 35-year-old patient, who worked as a diamond polishing disc former. The patient presented... [more] OBJECTIVES: The inspiration of cobalt containing dust leads to various respiratory symptoms, including asthma and interstitial lung disease. Occupational asthma caused by cobalt chloride has been diagnosed in a 35-year-old patient, who worked as a diamond polishing disc former. The patient presented a 2-year history of dyspnea, cough and symptoms of rhinitis. MATERIALS AND METHODS: The patient underwent a medical history interview, skin prick tests with common and occupational allergens (cobalt and nickel chloride), and pulmonary function testing both before and after the nasal provocation with 0.05% cobalt chloride. Additionally, the authors analyzed morphological and biochemical changes before and after the specific nasal challenge test. Cell proliferation analysis was also carried out. RESULTS: Skin prick tests (SPTs) with common environmental allergens were found to be negative, while SPTs with cobalt chloride were positive for all applied solutions. The provocation with cobalt chloride caused a significant increase in the proportion of eosinophils, basophils and albumin during the late allergic reaction. The positive lymphocyte transformation caused by cobalt was also observed. CONCLUSIONS: Cobalt salts may induce occupational asthma. The mechanism of this asthma may be IgE-mediated. The cobalt-sensitized lymphocytes may play an important role in this disease.
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[Allergen-specific IgE antibody in the diagnosis of occupational asthma and occupational rhinitis]
Medycyna pracy. 02/2004; 55(5):379-87.
BACKGROUND: The aim of the study was to evaluate the usefulness of skin prick tests and serum allergen-specific IgE determination in diagnosis of occupational airway allergies. MATERIALS AND METHODS: The study group comprised 152 patients with suspected occupational asthma and occupational allergic ... [more] BACKGROUND: The aim of the study was to evaluate the usefulness of skin prick tests and serum allergen-specific IgE determination in diagnosis of occupational airway allergies. MATERIALS AND METHODS: The study group comprised 152 patients with suspected occupational asthma and occupational allergic rhinitis. In all subjects, skin prick tests (SPT) to occupational allergens and specific challenge test were performed, and serum allergen-specific IgE (as-IgE) was determined. The sensitivity, specificity and predictive values of SPT and serum as-IgE were evaluated for different types of allergens (flour, grain, natural rubber latex and cotton). RESULTS: SPT sensitivity ranged from 22.2 to 68.2%, and specificity from 74.1 to 88.2%, depending on the allergen. Positive predictive values for SPT ranged from 30 to 68.2% and negative predictive values from 74 to 82.4%. As-IgE sensitivity was evaluated from 42.8 to 83.3%, and specificity from 57.1 to 81.5%. Positive predictive values for as-IgE ranged from 35.7 to 76.2% and negative predictive values from 72.4 to 92.3%. Conclusions: The results showed that neither SPT nor serum as-IgE determination indicated sufficient sensitivity and specificity to play a key role in diagnosis of occupational asthma and rhinitis. The sensitivity, specificity and predictive values varied depending on the type of allergen. During the diagnostic process of occupational asthma and rhinitis the specific inhalant challenge test should be taken into consideration to confirm the final diagnosis.
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Anna Krakowiak
Nofer Institute of Occupational Medicine
Topics (1)
