Cezary Pałczyński

Publications of Cezary Pałczyński

• Contact blepharoconjunctivitis due to black henna - A case report.

  Authors: Alicja Pas-Wyroślak, Marta Wiszniewska, Beata Kręcisz, Dominika Swierczyńska-Machura, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  International journal of occupational medicine and environmental health. 04/2012;

  Para-phenylenediamine (PPD) can induce immediate or - more often - delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visitPara-phenylenediamine (PPD) can induce immediate or - more often - delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid.

• Occupational allergy to birds within the population of Polish bird keepers employed in zoo gardens.

  Authors: Sylwia Swiderska-Kiełbik, Anna Krakowiak, Marta Wiszniewska, Ewa Nowakowska-Świrta, Jolanta Walusiak-Skorupa, Konrad Sliwkiewicz, Cezary Pałczyński

  International journal of occupational medicine and environmental health. 09/2011; 24(3):292-303.

  To evaluate the risk factors for the development of occupational allergy to birds among Polish zoo garden keepers. A total of 200 bird zookeepers employed in the Polish zoo gardens in KLódź, Warsaw,To evaluate the risk factors for the development of occupational allergy to birds among Polish zoo garden keepers. A total of 200 bird zookeepers employed in the Polish zoo gardens in KLódź, Warsaw, Gdańsk, Chorzów and Płock and exposed occupationally to bird allergens were examined using a questionnaire, skin prick tests (SPTs) to common allergens and bird allergens, spirometry and cytograms of nasal swab. The level of total IgE in serum and serum-specific IgE to parrot, canary, pigeon feathers and serum were also evaluated. Eight percent of bird zookeepers were sensitized to at least one of the bird allergens. The most frequent allergens yielding positive SPT results were D. farinae - 32 cases (16%), D. pteronyssinus - 30 cases (15%) and grass pollens (16.5%). In the studied group, allergen-specific IgE against bird allergens occurred with the following frequency: 87 (43.5%) against canary feathers and/or serum, 80 (40%) against parrot feathers and/or serum and 82 (41%) against pigeon feathers and/or serum. Occupational allergy was diagnosed in 39 (26.5%) cases, occupational rhinitis was present in 22 (15%) cases, occupational asthma in 20 (13.6%) subjects, occupational conjunctivitis in 18 (12.2%) cases, whereas occupational skin diseases in 11 (7.5%) cases. More eosinophils were found in nose swab cytograms among bird zookeepers with occupational airway allergy. The findings indicate that occupational allergy to birds is an important health problem among zoo bird keepers in Poland.

• Occupational allergy to Limonium sinuatum: a case report.

  Authors: Marta Wiszniewska, Cezary Pałczyński, Patrycja Krawczyk-Szulc, Tomasz Wittczak, Aleksandra Cyran, Jolanta Walusiak-Skorupa

  International journal of occupational medicine and environmental health. 09/2011; 24(3):304-7.

  Decorative flowers are known to be a cause of occupational allergy in the floral industry. The allergic manifestations induced by flowers include asthma, rhinoconjunctivitis and urticaria. We presentDecorative flowers are known to be a cause of occupational allergy in the floral industry. The allergic manifestations induced by flowers include asthma, rhinoconjunctivitis and urticaria. We present a case of a 55-year-old woman, who has been working for the last 30 years as a gardener with various kinds of flowers, e.g., Limonium sinuatum (LS), chrysanthemum, sweet William (Dianthus barbatus) and Lilium. During the last 10 years she has developed nasal and eyes symptoms, dry cough, dyspnoea, chest tightness and wheezing. Clinical examination, routine laboratory testing, chest radiography, skin prick tests (SPT) involving common allergens, native plants pollens and leaves by the prick-prick technique, rest spirometry, methacholine challenge test and specific inhalation challenge test (SICT) were conducted. SPT results to common allergens were positive for grass pollens. SPT with native plants pollens and leaves showed a positive reaction only for LS. SICT induced an isolated early asthmatic reaction and significant increase in the number of eosinophils in the nasal lavage fluid. Additionally, significant increase in non-specific bronchial hyperreactivity was observed after SICT. To our knowledge, the presently described report is the first one of Limonium sinuatum induced occupational asthma and rhinitis in a Polish gardener.

• Diagnosing of bakers' respiratory allergy: is specific inhalation challenge test essential?

  Authors: Marta Wiszniewska, Ewa Nowakowska-Świrta, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  Allergy and asthma proceedings : the official journal of regional and state allergy societies. 03/2011; 32(2):111-8.

  The diagnosis of occupational asthma (OA) and/or rhinitis needs to be confirmed by means of objective methods, because it is followed by important social and financial consequences. The aim of theThe diagnosis of occupational asthma (OA) and/or rhinitis needs to be confirmed by means of objective methods, because it is followed by important social and financial consequences. The aim of the study was to evaluate sensitivity and specificity of diagnostic methods as skin-prick tests (SPTs) to occupational allergens, evaluation of allergen-specific serum IgE, and nonspecific bronchial hyperreactivity with reference to a specific inhalation challenge test in diagnosing bakers' respiratory allergy due to wheat flour. The study group included 358 bakers suspected of having OA due to wheat flour. They underwent physical examination, SPTs to common and occupational allergens, allergen-specific IgE determination, spirometry, nonspecific bronchial challenge, and specific inhalation test. The sensitivity of SPTs to occupational allergens in recognition of baker's rhinitis was low (47.9%) unlike the estimation of allergen-specific IgE (76.4%), with relatively high specificity (77.4 and 68.3%, respectively). Bronchial hyperreactivity (PC(20) < 8 mg/mL) was the most sensitive method, whereas high degree of bronchial hyperreactivity (PC(20) < 1 mg/m(3)) alone or bronchial hyperreactivity (PC(20) < 8 mg/m(3)) combined with the skin reactivity to wheat flour was the most specific method of recognizing OA. Neither SPTs to occupational allergens nor evaluation of serum allergen-specific IgE alone or combined with nonspecific bronchial hyperreactivity are characterized by sufficient diagnostic accuracy to replace the specific inhalation challenge test. For the establishment of a definite diagnosis of baker's asthma, specific challenge testing with occupational allergens should be performed.

• [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].

  Authors: Dominika Swierczyńska-Machura, Jolanta Walusiak-Skorupa, Marta Wiszniewska, Agnieszka Lipińska-Ojrzanowska, Tomasz Wittczak, Wojciech Dudek, Cezary Pałczyński

  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 occupationalThe 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.

• [Occupational allergy in transport workers--underestimated hazard].

  Authors: Diana Tymoszuk, Tomasz Wittczak, Jolanta Walusiak-Skorupa, Cezary Pałczyński

  Medycyna pracy. 01/2011; 62(6):633-41.

  Transport workers, subjected to variable direct exposure to allergens in the workplace, are an occupational group at risk of developing occupational allergic diseases of the respiratory system asTransport workers, subjected to variable direct exposure to allergens in the workplace, are an occupational group at risk of developing occupational allergic diseases of the respiratory system as well as the skin. Their work environment is characterized by considerable diversity of both chemical and biological sensitizers. Sensitization occurs due to occupational exposure to allergens mainly by inhalation or direct skin contact. Therefore, it is necessary to be aware of the presence of strong allergens in the work environment to introduce appropriate preventive measures and to reduce the adverse health effects resulting from the exposure. This publication presents the most important allergens described as causal factors of occupational allergy among transport workers and the basic principles of diagnostics and medical certification of these diseases.

• [Coexistence of two occupational infectious diseases in one patient--borreliosis and tick-borne encephalitis--a case report].

  Authors: Dariusz Krzyczmanik, Marcin Rybacki, Tomasz Wittczak, Wojciech Dudek, Dominika Swierczyńska-Machura, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  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.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.

• [Prophylactic care of apprentices occupationally exposed to allergens].

  Authors: Agnieszka Lipińska-Ojrzanowska, Marcin Rybacki, Marta Wiszniewska, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  Medycyna pracy. 01/2011; 62(4):403-13.

  An increase in the frequency of allergic diseases, including bronchial asthma, in the children population has been observed over several last decades. This trend is reflected in the increasing numberAn increase in the frequency of allergic diseases, including bronchial asthma, in the children population has been observed over several last decades. This trend is reflected in the increasing number of young workers who suffer from allergy and asthma. The problem determines a new challenge to physicians responsible for medical prophylactic care of this group of patients. Active occupational counseling should be performed especially by general practitioners and occupational medicine specialists in in cooperation with allergologists. Apprenticeship is a period of increased risk of work-related respiratory allergic diseases, particularly in the case of occupational exposure to high molecular weight agents. An adequate prophylactic care of apprentices exposed to aeroallergens at workplace may help to reduce work-related allergic health problems, mainly by supporting adolescents in choosing their jobs.

• [Cleaners'asthma--etiology, diagnostics, prophylaxis and medical certification].

  Authors: Agnieszka Lipińska-Ojrzanowska, Tomasz Wittczak, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  Medycyna pracy. 01/2011; 62(2):163-73.

  Asthma is the most common occupational allergic respiratory disease. The results of several current studies reveal also high risk of work-related asthma among cleaners. This kind of work may increaseAsthma is the most common occupational allergic respiratory disease. The results of several current studies reveal also high risk of work-related asthma among cleaners. This kind of work may increase the risk of allergic as well as non-allergic asthma. However, the mechanism by which inflammation in respiratory airways is induced by cleaning chemicals is still unknown. This paper shows the results of numerous studies regarding exposure and respiratory symptoms among cleaning personnel. The increased risk of respiratory diseases among cleaners suggests the need to educate workers and to devise safety methods during multiuse cleaning both in occupational settings and in private households.

• [Invasion by trichinae in the patient hospitalized with suspicion of occupational borreliosis: a case report].

  Authors: Agnieszka Lipińiska-Ojrzanowska, Tomasz Wittczak, Dariusz Krzyczmanik, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  Medycyna pracy. 01/2011; 62(1):73-6.

  Diagnosis of occupational infectious diseases gives rise to a number of problems in the practice of occupational medicine. Similar symptoms of many infections, including parasitic diseases, can limitDiagnosis of occupational infectious diseases gives rise to a number of problems in the practice of occupational medicine. Similar symptoms of many infections, including parasitic diseases, can limit the range of applied diagnostic and certification procedures only to diseases induced by pathogenic agents or exposures occurring in the occupational environment. In some cases this makes difficult or even impossible to explain a real cause of patients' complaints. We present a case report on the patient with suspected occupational borreliosis. Due to many diagnostic doubts during hospitalization, including long term presence of some clinical manifestations reported by the patient, which could occur in the course of borreliosis and also suggest earlier infection by trichinae, a wider span of specialist examinations was applied. Finally, the invasion of trichinae was diagnosed and later confirmed by serologic tests.

• [Health hazards associated with occupational exposure to birds].

  Authors: Sylwia Swiderska-Kiełbik, Anna Krakowiak, Marta Wiszniewska, Wojciech Dudek, Jolanta Walusiak-Skorupa, Patrycja Krawczyk-Szulc, Aleksandra Michowicz, Cezary Pałczyński

  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 birdsThe 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.

• [Cross-reactive carbohydrate determinants in diagnostics of occupational allergy].

  Authors: Joanna Zgorzelska-Kowalik, Marta Wiszniewska, Damian Kowalik, Patrycja Krawczyk-Szulc, Ewa Nowakowska-Swirta, Cezary Pałczyński, Jolanta Walusiak-Skorupa

  Medycyna pracy. 01/2010; 61(1):79-89.

  In most cases diagnosis of immediate-type occupational allergy is very complex. Mainly it is caused by diversity of occupational allergens and lack of standardized diagnostic methods. The content ofIn most cases diagnosis of immediate-type occupational allergy is very complex. Mainly it is caused by diversity of occupational allergens and lack of standardized diagnostic methods. The content of allergic proteins in commercially available skin prick test reagents differs between companies and in some the most important allergens are not named. Also the evaluation of serum specific IgE (asIgE) is characterized by different diagnostic accuracy. In some cases, false-positive results of asIgE detection are the consequence of cross-reaction to common environmental allergens. In those cases it is helpful to determine asIgE for cross-reacting carbohydrate determinants (CCDs) to exclude cross-hypersensitivity. The presented paper reviews the structure of carbohydrate determinants, their prevalence and possible impact on laboratory in vitro tests used in allergy diagnostics, as well as the methods of their identification. Possible applications of CCDs in occupational allergy diagnostics are also discussed.

• Occupational asthma due to turpentine in art painter - case report.

  Authors: Wojciech Dudek, Tomasz Wittczak, Dominika Swierczyńska-Machura, Jolanta Walusiak-Skorupa, Cezary Pałczyński

  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 turpentineTurpentine 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.

• [Welding-related respiratory diseases]

  Authors: Tomasz Wittczak, Jolanta Walusiak, Cezary Pałczyński

  Medycyna pracy. 01/2009; 60(3):201-8.

  Welders are exposed to fumes containing different gases, fumes and particles, depending on the composition of the welding electrodes, welded material and the welding method used. Welders are workersWelders are exposed to fumes containing different gases, fumes and particles, depending on the composition of the welding electrodes, welded material and the welding method used. Welders are workers at risk of developing various respiratory signs and symptoms. Health effects associated with welding include different lung function abnormalities, including metal fume fever, bronchial asthma, chronic obstructive pulmonary disease, pneumoconiosis and other pulmonary fibrosis (chronic beryllium disease, cobalt lung), and lung cancer. The authors describe some aspects of etiology, pathogenesis, diagnostics, prophylaxis, and medical certification of welding-related respiratory diseases.

• Is the risk of allergic hypersensitivity to fungi increased by indoor exposure to moulds?

  Authors: Marta Wiszniewska, Jolanta Walusiak-Skorupa, Beata Gutarowska, Anna Krakowiak, Cezary Pałczyński

  International journal of occupational medicine and environmental health. 01/2009; 22(4):343-54.

  Moulds are frequently found in the indoor environment of residential houses. An association between domestic mould contamination and respiratory symptoms has been reported, but mould exposure as aMoulds are frequently found in the indoor environment of residential houses. An association between domestic mould contamination and respiratory symptoms has been reported, but mould exposure as a risk factor for allergy to moulds is not well documented. The aim of the study was to evaluate the prevalence and associated factors of allergic hypersensitivity to moulds. A group of 243 participants was examined. Of these 118 lived in dwellings with evident signs of fungal contamination (study group) and 125 in non-contaminated sites (controls). An interview, skin prick tests to common and fungal allergens, evaluation of total serum IgE and specific IgE to moulds, resting spirometry as well as mycological analysis in building were performed for each participant. 19.8% subjects were sensitized to at least one mould allergen. Logistic regression analysis revealed that the history of respiratory and skin symptoms, smoking cigarettes in the past and positive skin prick tests (SPT) to common allergens (dust mite and grass pollens) or the presence of a cat as a pet animal were the significant associated factors of hypersensitivity to moulds. The association between indoor fungal exposure and the development of fungal allergy was not confirmed in our study.

• Work-related respiratory symptoms in bird zoo keepers--questionnaire data.

  Authors: Sylwia Swiderska-Kiełbik, Anna Krakowiak, Marta Wiszniewska, Wojciech Dudek, Monika Kowalczyk, Jolanta Walusiak-Skorupa, Konrad Sliwkiewicz, Cezary Pałczyński

  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 respondedTo 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.

• Exhaled Nitric Oxide Levels After Specific Inahalatory Challenge Test in Subjects with Diagnosed Occupational Asthma.

  Authors: Dominika Swierczyńska-Machura, Anna Krakowiak, Marta Wiszniewska, Wojciech Dudek, Jolanta Walusiak, Cezary Pałczyński

  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 levelObjectives: 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.

• [Psychological factors in allergic skin diseases]

  Authors: Marta Kieć-Swierczyńska, Beata Krecisz, Adrianna Potocka, Dominika Swierczyńska-Machura, Wojciech Dudek, Cezary Pałczyński

  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 patientsBACKGROUND: 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.

• Occupational asthma due to manganese exposure: a case report.

  Authors: Tomasz Wittczak, Wojciech Dudek, Anna Krakowiak, Jolanta Walusiak, Cezary Pałczyński

  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 thusManganese 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.

• Prevalence and host determinants of occupational bronchial asthma in animal shelter workers.

  Authors: Anna Krakowiak, Patrycja Krawczyk, Bogdan Szulc, Marta Wiszniewska, Monika Kowalczyk, Jolanta Walusiak, Cezary Pałczyński

  International archives of occupational and environmental health. 05/2007; 80(5):423-32.

  OBJECTIVE: We examined the risk factors for the development of airway allergy in animal shelter workers. METHODS: The study population comprised 88 animal shelter workers occupationally exposed toOBJECTIVE: We examined the risk factors for the development of airway allergy in animal shelter workers. METHODS: The study population comprised 88 animal shelter workers occupationally exposed to cats and dogs. They responded to a questionnaire concerning the history of exposure to animal allergens and job characteristics and were subjected to skin prick test (SPT) to common and occupational allergens (cat and dog), and determination of total serum IgE level and specific IgE. In addition, SPT with rat and mouse allergens were performed. Bronchial hyperreactivity and peak expiratory flow rate were measured at work and off work only in workers with work-related symptoms suggestive of occupational asthma (OA). RESULTS: The prevalence of OA was 9.1%. Sensitization to dog allergens was higher than to cats. The multivariate logistic regression analysis revealed a significant role of positive family history of atopy and having a dog as pet in the past for the development of occupational airway allergy (OR 5.9; 95% CI 1.76, 20.00; P = 0.003; OR 6.47; 95% CI 1.90, 22.02; P = 0.002, respectively). In the multivariate logistic regression analysis, the risk for developing OA was most clearly associated with growing up in the country (OR 7.59; 95% CI 1.25, 45.9; P = 0.025). CONCLUSIONS: Allergic disease is a serious occupational health concern for subjects who have occupational contact with cats and dogs.