Ericson Bagatin

University of Campinas, Conceição de Campinas, São Paulo, Brazil

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Publications (40)63.44 Total impact

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    ABSTRACT: Objectives: The aim of this estudy was to investigate the influence of allergen exposure levels and other risk factors for allergic sensitization, asthma, and bronchial hyperresponsiveness (BHR) in workers exposed to laboratory animals. Methods: This was a cross-sectional study performed at two universities, 123 workplaces with 737 subjects. Dust samples were collected from laboratories and animal facilities housing rats, mice, guinea pigs, rabbits, or hamsters and analyzed by enzyme-linked immunosorbent assay (ELISA) to measure allergen concentrations. We also sampled workplaces without animals. Asthma was defined by both symptoms and BHR to mannitol. The concentrations of allergens were tested for association with a skin prick test, respiratory symptoms, spirometry data, and BHR. This multivariate analysis was performed by using Poisson regression to estimate the relative risk (RR) for the exposed group. Results: Our sample comprised students and workers, with 336 subjects in the nonexposed group and 401 subjects in the exposed group. Sixty-nine subjects (17%) had positive results in the skin prick test for animal allergens in the exposed group; in the nonexposed group, 10 subjects had positive results (3%) (p < 0.001). Exposure to laboratory animals over 2.8 years was associated with atopic sensitization (RR = 1.85; 95% confidence interval: 1.09-3.15; p = 0.02). Allergen concentration was not associated with sensitization, asthma, or BHR. Conclusion: Exposure to laboratory animals was associated with atopic sensitization. However, we did not find a cutoff allergen concentration that increased the risk for sensitization. Duration of exposure seems to be more relevant to sensitization than concentration of allergens in dust.
    No preview · Article · Oct 2015 · Journal of Occupational Health

  • No preview · Article · Sep 2015 · European Respiratory Journal
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    ABSTRACT: Chest radiography (CXR) is inferior to Thin-section computed tomography in the detection of asbestos related interstitial and pleural abnormalities. It remains unclear, however, whether these limitations are large enough to impair CXR´s ability in detecting the expected reduction in the frequency of these asbestos-related abnormalities (ARA) as exposure decreases. Clinical evaluation, CXR, Thin-section CT and spirometry were obtained in 1418 miners and millers who were exposed to progressively lower airborne concentrations of asbestos. They were separated into four groups according to the type, period and measurements of exposure and/or procedures for controlling exposure: Group I (1940-1966/tremolite and chrysotile, without measurements of exposure and procedures for controlling exposure); Group II (1967-1976/chrysotile only, without measurements of exposure and procedures for controlling exposure); Group III (1977-1980/chrysotile only, initiated measurements of exposure and procedures for controlling exposure) and Group IV (after 1981/chrysotile only, implemented measurements of exposure and a comprehensive procedures for controlling exposure). In all groups, CXR suggested more frequently interstitial abnormalities and less frequently pleural plaques than observed on Thin-section CT (p<0.050). The odds for asbestosis in groups of decreasing exposure diminished to greater extent at Thin-section CT than on CXR. Lung function was reduced in subjects who had pleural plaques evident only on Thin-section CT (p<0.050). In a longitudinal evaluation of 301 subjects without interstitial and pleural abnormalities on CXR and Thin-section CT in a previous evaluation, only Thin-section CT indicated that these ARA reduced as exposure decreased. CXR compared to Thin-section CT was associated with false-positives for interstitial abnormalities and false-negatives for pleural plaques, regardless of the intensity of asbestos exposure. Also, CXR led to a substantial misinformation of the effects of the progressively lower asbestos concentrations in the occurrence of asbestos-related diseases in miners and millers.
    Full-text · Article · Mar 2015 · PLoS ONE
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    ABSTRACT: Subjects exposed to laboratory animals are at a heightened risk of developing respiratory and allergic diseases. These diseases can be prevented by simple measures such as the use of personal protective equipment. We report here the primary findings of the Laboratory Animals and Respiratory Allergies Study regarding the prevalence of allergic diseases among laboratory animal workers, the routine use of preventive measures in laboratories and animal facilities, and the need for prevention programs. Animal handlers and non-animal handlers from 2 Brazilian universities (University of São Paulo and State University of Campinas) answered specific questionnaires to assess work conditions and symptoms. These subjects also underwent spirometry, a bronchial challenge test with mannitol, and skin prick tests for 11 common allergens and 5 occupational allergens (rat, mouse, guinea pig, hamster, and rabbit). Four hundred fifty-five animal handlers (32±10 years old [mean±SD], 209 men) and 387 non-animal handlers (33±11 years old, 121 men) were evaluated. Sensitization to occupational allergens was higher among animal handlers (16%) than non-animal handlers (3%, p<0.01). Accessibility to personal protective equipment was measured at 85% (median, considering 73 workplaces of the animal handler group). Nineteen percent of the animal handlers indicated that they wear a respirator at all times while handling animals or working in the animal room, and only 25% of the animal handlers had received an orientation about animal-induced allergies, asthma, or rhinitis. In conclusion, our data indicate that preventive programs are necessary. We suggest providing individual advice to workers associated with institutional programs to promote a safer work environment.
    Full-text · Article · Jun 2013 · Clinics (São Paulo, Brazil)
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    ABSTRACT: Exposure to silica dust has been examined as a possible risk factor for autoimmune diseases, including systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus and ANCA-associated vasculitis. However, the underlying cellular and molecular mechanisms resulting in the increased prevalence of autoimmunity remain elusive. To clarify these mechanisms, we studied various markers of immune activation in individuals occupationally exposed to silica dust, i.e., serum levels of soluble IL-2 receptor (sIL-2R), levels of IL-2, other pro- and anti-inflammatory cytokines and lymphoproliferation. Our results demonstrate that silica-exposed individuals present important alterations in their immune response when compared to controls, as shown by increased serum sIL-2R levels, decreased production of IL-2 and increased levels of the pro-inflammatory (IFN-γ, IL-1α, TNF-α, IL-6) as well as anti-inflammatory (IL-10 and TGF-β) cytokines. Furthermore, silica-exposed individuals presented enhanced lymphoproliferative responses. Our findings provide evidence that the maintenance of immune homeostasis may be disturbed in silica-exposed individuals, possibly resulting in autoimmune disorders.
    Full-text · Article · Jan 2013 · International journal of hygiene and environmental health

  • No preview · Conference Paper · May 2012
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    ABSTRACT: Exposure to silica dust has been examined as a possible risk factor for autoimmune diseases, including scleroderma, rheumatoid arthritis and systemic lupus erythematosus. Since CTLA-4 [CD152] and PD-1 [CD279] are important for the maintenance of peripheral tolerance by regulating T cell responsiveness, we evaluated the expression of these molecules on the surface of CD4 and CD8 T cells, as well as single nucleotide polymorphisms (SNP) in CTLA-4 and PDCD1 genes, of 70 silica-exposed workers and 30 non-exposed, age-, ethnically- and sex-matched controls. Expression of CTLA-4 was significantly (P<0.05) reduced in CD4 T cells of exposed individuals [median=0.1% and interquartile range, IQR 0.0-0.1% (exposed), median=0.20%, IQR 0.0-0.4% (control)]. Also the expression of PD-1 was significantly (P<0.0001) reduced in both CD4 [median=0.9%, IQR 0.4-2.3% (exposed), median=5.7%, IQR 1.4-13.3% (control)] and CD8 T cells [median=0.9%, IQR 0.3-1.9% (exposed), median=5.0%, IQR 3.4-8.9% (control)]. The study of polymorphisms demonstrated a lower frequency of the A allele in the analysis of the PD1.3 SNP in the exposed group, which might be associated with the lower expression of PD-1 on the surface of CD4 T cells. Our findings provide evidence for the association of silica exposure and the maintenance of self-tolerance, i.e., the susceptibility to autoimmune disorders.
    Full-text · Article · Dec 2011 · International journal of hygiene and environmental health
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    ABSTRACT: Pulmonary function tests (PFT), particularly spirometry and lung diffusing capacity for carbon monoxide (DL(CO) ), have been considered useful methods for the detection of the progression of interstitial asbestos abnormalities as indicated by high-resolution computed tomography (HRCT). However, it is currently unknown which of these two tests correlates best with anatomical changes over time. In this study, we contrasted longitudinal changes (3-9 years follow-up) in PFTs at rest and during exercise with interstitial abnormalities evaluated by HRCT in 63 ex-workers with mild-to-moderate asbestosis. At baseline, patients presented with low-grade asbestosis (Huuskonen classes I-II), and most PFT results were within the limits of normality. In the follow-up, most subjects had normal spirometry, static lung volumes and arterial blood gases. In contrast, frequency of DL(CO) abnormalities almost doubled (P < 0.05). Twenty-three (36.5%) subjects increased the interstitial marks on HRCT. These had significantly larger declines in DL(CO) compared to patients who remained stable (0.88 vs. 0.31 ml/min/mm Hg/year and 3.5 vs. 1.2%/year, respectively; P < 0.05). In contrast, no between-group differences were found for the other functional tests, including spirometry (P > 0.05). These data demonstrate that the functional consequences of progression of HRCT abnormalities in mild-to-moderate asbestosis are better reflected by decrements in DL(CO) than by spirometric changes. These results might have important practical implications for medico-legal evaluation of this patient population.
    Full-text · Article · Mar 2011 · American Journal of Industrial Medicine
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    ABSTRACT: To evaluate the changes over time in the pattern and extent of parenchymal abnormalities in asbestos-exposed workers after cessation of exposure and to compare 3 proposed semiquantitative methods with a careful side-by-side comparison of the initial and the follow-up computed tomography (CT) images. The study included 52 male asbestos workers (mean age+/-SD, 62.2 y+/-8.2) who had baseline high-resolution CT after cessation of exposure and follow-up CT 3 to 5 years later. Two independent thoracic radiologists quantified the findings according to the scoring systems proposed by Huuskonen, Gamsu, and Sette and then did a side-by-side comparison of the 2 sets of scans without awareness of the dates of the CT scans. There was no difference in the prevalence of the 2 most common parenchymal abnormalities (centrilobular small dotlike or branching opacities and interstitial lines) between the initial and follow-up CT scans. Honeycombing (20%) and traction bronchiectasis and bronchiolectasis (50%) were seen more commonly on the follow-up CT than on the initial examination (10% and 33%, respectively) (P=0.01). Increased extent of parenchymal abnormalities was evident on side-by-side comparison in 42 (81%) patients but resulted in an increase in score in at least 1 semiquantitative system in only 16 (31%) patients (all P>0.01, signed test). The majority of patients with previous asbestos exposure show evidence of progression of disease on CT at 3 to 5 years follow-up but this progression is usually not detected by the 3 proposed semiquantitative scoring schemes.
    No preview · Article · Dec 2008 · Journal of thoracic imaging
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    ABSTRACT: To develop and consolidate a comprehensive database on the occurrence of pneumoconioses in an industrialized region of Brazil, with a special focus on the activities most frequently related to these diseases. A retrospective, observational study was conducted in order to gather data on cases of pneumoconioses treated at the outpatient clinic of the State University at Campinas Hospital das Clínicas between 1978 and 2003. Individuals diagnosed with pneumoconiosis, based on their occupational history and on chest X-ray findings of abnormalities consistent with interstitial lung disease involving the parenchyma, in accordance with the 1980 and 2000 recommendations of the International Labour Organization, were included in the study. A total of 1147 cases of pneumoconiosis were identified (1075 in males and 72 in females): 1061 cases of silicosis (92.5%); 51 cases of mixed-dust pneumoconiosis (4.45%); 15 cases of asbestosis (1.31%); 13 cases of phosphate rock-related pneumoconiosis (1.13%); and 7 cases of other types of pneumoconiosis (0.6%), including those related to exposure to coal, graphite and hard metals. The most common chest X-ray findings were 1/0, 1/1 or 1/2 profusion and small regular opacities (p, q or r), although 192 patients (16.74%) presented large opacities. There has been a substantial decline in the occurrence of the disease since the 1990s, and the duration of exposure was typically shorter than that observed in a study conducted in the United States. Our findings have been compiled into a comprehensive database for the investigation of pneumoconiosis in an industrialized area of Brazil. These data make it possible to conduct follow-up studies and develop health policies related to occupational respiratory disorders.
    Full-text · Article · Jul 2008 · Jornal brasileiro de pneumologia: publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia
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    ABSTRACT: Asbestosis is associated with lung cellular and immunological abnormalities. Induced sputum cytology and local and systemic markers of inflammation may be helpful to characterize disease status and progression in these patients. Thirty-nine ex-workers with asbestosis on high-resolution CT (HRCT) and 21 non-exposed controls were evaluated. Sputum cytology and IL-8 in serum and sputum were related to lung function impairment. Subjects with asbestosis had reduced sputum cellularity but higher macrophage/neutrophil ratio and % macrophage as compared with controls. Sputum and serum IL-8 were also higher in patients with asbestosis (P < 0.05). In addition, evidence of lung architectural distorption on HRCT was associated with increased levels of serum IL-8. Interestingly, absolute macrophage number was negatively correlated with total lung capacity (r = -0.40; P = 0.04) and serum IL-8 to lung diffusing capacity (r = -0.45; P = 0.01). Occupationally exposed subjects with asbestosis on HRCT have cytologic abnormalities in induced sputum and increased local and systemic pro-inflammatory status which are correlated to functional impairment.
    Full-text · Article · Mar 2008 · American Journal of Industrial Medicine
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    M R Becklake · E Bagatin · JA Neder
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    ABSTRACT: Asbestos is a descriptive term for a group of naturally occurring minerals known to mankind since ancient times. The main types of asbestos (chrysotile, and the amphiboles crocidolite and amosite) differ in chemical structure, biopersistence in human tissue and toxicity. Commercial exploitation, with little thought for environmental controls, increased over the twentieth century, particularly after World War II, to accommodate globalisation and the demands of the world's burgeoning cities. As its ill-health effects, both non-malignant (fibrosis of the lungs or asbestosis; pleural effusion, plaques and thickening) and malignant (mesothelioma, lung and other cancers), became evident, public pressure rose to control its use. The last decades of the last century saw decreases in exposure and rates of asbestosis in industrialised and in some less-industrialised countries, where pleural plaques and malignant mesothelioma are currently the most frequent manifestations of asbestos exposure. Longer follow-up of asbestos-exposed cohorts in mining and manufacturing has also strengthened the evidence of a fibre gradient in toxicity, with chrysotile exhibiting lower toxicity than the amphiboles, and amosite lower toxicity than crocidolite. The last decades of the twentieth century saw stabilisation and/or declines in mesothelioma rates in several industrialised countries. In less-industrialised countries, data on disease are sparse, exposure generally high and rates may peak in the future. Management of asbestos-related disease in the workplace requires collaboration between workers and unions (responsible for monitoring workplace dust levels, to which they must have access) and companies (responsible for engineering controls), reinforced by appropriate government regulations and by community support.
    Full-text · Article · Apr 2007 · The International Journal of Tuberculosis and Lung Disease
  • M.R. Becklake · E. Bagatin · J.A. Neder
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    ABSTRACT: Asbestos is a descriptive term for a group of naturally occurring minerals known to mankind since ancient times. The main types of asbestos (chrysotile, and the amphiboles crocidolite and amosite) differ in chemical structure, biopersistence in human tissue and toxicity. Commercial exploitation, with little thought for environmental controls, increased over the twentieth century, particularly after World War II, to accommodate globalisation and the demands of the world's burgeoning cities. As its ill-health effects, both non-malignant (fibrosis of the lungs or asbestosis; pleural effusion, plaques and thickening) and malignant (mesothelioma, lung and other cancers), became evident, public pressure rose to control its use. The last decades of the last century saw decreases in exposure and rates of asbestosis in industrialised and in some less-industrialised countries, where pleural plaques and malignant mesothelioma are currently the most frequent manifestations of asbestos exposure. Longer follow-up of asbestos-exposed cohorts in mining and manufacturing has also strengthened the evidence of a fibre gradient in toxicity, with chrysotile exhibiting lower toxicity than the amphiboles, and amosite lower toxicity than crocidolite. The last decades of the twentieth century saw stabilisation and/or declines in mesothelioma rates in several industrialised countries. In less-industrialised countries, data on disease are sparse, exposure generally high and rates may peak in the future. Management of asbestos-related disease in the workplace requires collaboration between workers and unions (responsible for monitoring workplace dust levels, to which they must have access) and companies (responsible for engineering controls), reinforced by appropriate government regulations and by community support.
    No preview · Article · Mar 2007 · The International Journal of Tuberculosis and Lung Disease
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    ABSTRACT: A doença pulmonar obstrutiva crônica ocupacional, apesar de ampla discussão há quase meio século, ainda é muito pouco abordada em nosso meio. Diversos estudos, especialmente os de base populacional, revelaram a associação entre as exposições ocupacionais aos aerodispersóides e o comprometimento das vias aéreas. Este capítulo objetiva alertar para o diagnóstico da doença pulmonar obstrutiva crônica de origem ocupacional apresentando uma revisão suscinta sobre o tema que deverá ser incorporado ao projeto Global Initiative for Chronic Obstructive Lung Disease, tanto no seu escopo de fundamentação diagnóstica quanto em seu questionário específico. O detalhamento da história ocupacional e a caracterização da exposição a agentes inalatórios, de reconhecida ação deletéria para o aparelho respiratório, seguramente proporcionarão uma melhor abordagem para o reconhecimento, prognóstico e controle dessa doença.
    Preview · Article · May 2006 · Jornal Brasileiro de Pneumologia
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    Preview · Article · May 2006 · Jornal Brasileiro de Pneumologia
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    José Alberto Neder · Ericson Bagatin · Luiz Eduardo Nery
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    ABSTRACT: The determination of functional consequences (dysfunction) and their impact on daily life (incapacitation) is central to the evaluation of patients with occupational respiratory diseases. The present review addresses the fundamentals underlying the instruments used to determine the degree of dysfunction, including clinical aspects, as well as those related to pulmonary function and, in some circumstances, exercise tolerance. In particular, a multifactorial system of classifying the degree of dysfunction is presented, with the objective of informing decisions related to the awarding of retirement benefits in Brazil.
    Full-text · Article · May 2006 · Jornal Brasileiro de Pneumologia
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    Ericson Bagatin · Satoshi Kitamura
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    ABSTRACT: Da mesma forma que uma boa anamnese é fundamental para o diagnóstico em geral, a história de exposição ambiental e ocupacional é informação basilar para o entendimento das doenças respiratórias ocupacionais. Estima-se que até 20% das doenças intersticiais e das vias aéreas são decorrentes dessas exposições. Por outro lado, raramente encontramos na anamnese informações sobre eventuais exposições ambientais ou sobre o trabalho/ocupação/função dos nossos pacientes. Assim, esse tema torna-se imprescindível à discussão entre os profissionais de saúde envolvidos nesse campo da atuação médica, se realmente almejamos avaliar a estimativa da magnitude desse problema em nosso meio.
    Full-text · Article · May 2006 · Jornal Brasileiro de Pneumologia
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    Ericson Bagatin · José Alberto Neder

    Full-text · Article · May 2006 · Jornal Brasileiro de Pneumologia
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    ABSTRACT: To assess the reproducibility of a new high-resolution computed tomography (CT) visual semiquantitative method for pleural plaques in asbestos-exposed workers. We performed thin-section CT in 752 chrysotile asbestos mining workers and ex-workers. Institutional review board approval and signed written informed consent from subjects were obtained. Two readers independently evaluated the 752 CT scans and identified 57 workers (mean age +/- SD, 61.8 years +/- 8.1; range, 37 to 81 years) who had pleural plaques and no other pleural or parenchymal abnormality. Three independent radiologists then quantified the plaque burden in these 57 workers using a scoring system based on the evaluation of the maximum thickness of parietal pleural plaques and percentage of parietal pleural surface involvement. We also calculated the proportion between the number of CT slices with diaphragmatic plaques and the total number of slices in which the diaphragm was seen (pdiaph). The intraobserver and interobserver agreements were analyzed using weighted Kappa coefficient. Interobserver agreements were good for the pleural plaque score (k = 0.61, 0.75, and 0.79) and ranged from good (k = 0.61) to excellent (k = 0.86) for the pdiaph. Intraobserver agreements ranged from good to excellent for the pleural plaque score (k = 0.79 and 1.00) and for the pdiaph (k = 0.79 and 0.93). The method proposed for high-resolution CT pleural plaque quantification in asbestos-exposed workers has a high reproducibility.
    No preview · Article · Apr 2006 · Journal of Thoracic Imaging
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    José Alberto Neder · Ericson Bagatin · Luiz Eduardo Nery
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    ABSTRACT: The determination of functional consequences (dysfunction) and their impact on daily life (incapacitation) is central to the evaluation of patients with occupational respiratory diseases. The present review addresses the fundamentals underlying the instruments used to determine the degree of dysfunction, including clinical aspects, as well as those related to pulmonary function and, in some circumstances, exercise tolerance. In particular, a multifactorial system of classifying the degree of dysfunction is presented, with the objective of informing decisions related to the awarding of retirement benefits in Brazil.
    Full-text · Article · Feb 2006 · Jornal brasileiro de pneumologia: publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia