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Article ; Online: Consensus study defining occupational asthma and confirming the diagnosis.

Niven, R McL / Burge, S / Fishwick, D / Francis, H C

2008 Volume 65, Issue 3, Page(s) 215–216

MeSH term(s)	Asthma/diagnosis ; Consensus ; Humans ; Occupational Diseases/diagnosis ; Respiratory Function Tests/standards
Language	English
Publishing date	2008-02-11
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oem.2007.036459
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Article: Evaluation of nebulised hypertonic saline (7%) as an adjunct to physiotherapy in patients with stable bronchiectasis.

Kellett, F / Redfern, J / Niven, R McL

Respiratory medicine

2004 Volume 99, Issue 1, Page(s) 27–31

Abstract: Sputum clearance is of prime importance in the management of patients with bronchiectasis. While nebulised normal isotonic saline (0.9%) (IS) has been anecdotally used to treat patients with tenacious sputum, the use of hypertonic saline (7%) (HS) could ... ...

Abstract	Sputum clearance is of prime importance in the management of patients with bronchiectasis. While nebulised normal isotonic saline (0.9%) (IS) has been anecdotally used to treat patients with tenacious sputum, the use of hypertonic saline (7%) (HS) could have potential muco-protective and clearance properties. 24 patients with bronchiectasis were randomised to receive four single treatment schedules in random order: (1) active cycle breathing technique (ACBT) alone, (2) nebulised terbutaline then ACBT, (3) nebulised terbutaline, nebulised IS then ACBT and (4) nebulised terbutaline, nebulised HS then ACBT. Sputum weights were significantly higher after HS than IS (P = 0.002). Ease of expectoration also differed overall (P < 0.0001) and was significantly lower with HS than with IS (P = 0.0005). Sputum viscosity differed between treatment phases, with a significant linear trend to reduced sputum viscosity with HS (P = 0.0002). These changes were associated with small but statistically significant differences in FEV1 (P = 0.043) and FVC (P = 0.011) between treatment phases. Nebulised hypertonic saline can be used safely and effectively as an adjunct to physiotherapy in selected patients. A long-term prospective trial is now indicated to determine its effectiveness on long-term infection rate, quality of life and lung function.
MeSH term(s)	Aged ; Breathing Exercises ; Bronchiectasis/physiopathology ; Bronchiectasis/rehabilitation ; Bronchiectasis/therapy ; Combined Modality Therapy ; Cross-Over Studies ; Expectorants/therapeutic use ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged ; Nebulizers and Vaporizers ; Physical Therapy Modalities ; Saline Solution, Hypertonic/therapeutic use ; Sputum/physiology ; Viscosity ; Vital Capacity
Chemical Substances	Expectorants ; Saline Solution, Hypertonic
Language	English
Publishing date	2004-09-03
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Randomized Controlled Trial
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2004.05.006
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Article: Occupational asthma induced by thiamine in a vitamin supplement for breakfast cereals.

Drought, V J / Francis, H C / McL Niven, R / Burge, P S

Allergy

2005 Volume 60, Issue 9, Page(s) 1213–1214

MeSH term(s)	Adult ; Asthma/chemically induced ; Dietary Supplements/adverse effects ; Food, Fortified/adverse effects ; Food-Processing Industry ; Humans ; Male ; Middle Aged ; Occupational Diseases/chemically induced ; Thiamine/adverse effects
Chemical Substances	Thiamine (X66NSO3N35)
Language	English
Publishing date	2005-09
Publishing country	Denmark
Document type	Case Reports ; Journal Article
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/j.1398-9995.2005.00848.x
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Article: Byssinosis: a review.

McL Niven, R / Pickering, C A

Thorax

1996 Volume 51, Issue 6, Page(s) 632–637

MeSH term(s)	Byssinosis/epidemiology ; Byssinosis/etiology ; Byssinosis/pathology ; Byssinosis/physiopathology ; Humans ; Lung/physiopathology
Language	English
Publishing date	1996-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thx.51.6.632
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Book: Comparative Personal Exposures to Organic Dusts and Endotoxin

Simpson, J.C.G. / Niven, R. McL. / Pickering, C. A.

1999 , Page(s) S.107–115

Keywords	Endotoxin
Language	English
Document type	Book
Database	OPAC and Environmental database (ULIDAT) of The Federal Environment Agency (UBA)

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Article: Functional upper airways obstruction: two patients with persistent symptoms.

Warburton, C J / McL Niven, R / Higgins, B G / Pickering, C A

Thorax

1996 Volume 51, Issue 9, Page(s) 965–966

Abstract: Functional upper airways obstruction is caused by vocal cord dysfunction and classically occurs in paroxysms closely resembling acute asthmatic attacks. We present two cases in which the symptoms and signs of the vocal cord dysfunction demonstrate very ... ...

Abstract	Functional upper airways obstruction is caused by vocal cord dysfunction and classically occurs in paroxysms closely resembling acute asthmatic attacks. We present two cases in which the symptoms and signs of the vocal cord dysfunction demonstrate very little variability with time. We suggest that as part of this disorder, a syndrome of chronic unremitting symptoms may occur.
MeSH term(s)	Adolescent ; Airway Obstruction/etiology ; Airway Obstruction/physiopathology ; Chronic Disease ; Female ; Humans ; Laryngeal Diseases/complications ; Middle Aged ; Vocal Cords/physiopathology
Language	English
Publishing date	1996-09
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thx.51.9.965
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Article ; Online: Predictors of early leaving from the cotton spinning mill environment in newly hired workers.

Bakirci, N / Kalaca, S / Fletcher, A M / Pickering, C A C / Tumerdem, N / Cali, S / Oldham, L / Francis, H / McL Niven, R

Occupational and environmental medicine

2006 Volume 63, Issue 2, Page(s) 126–130

Abstract: Objective: This longitudinal study aimed to identify the predictors of leaving during the first year of employment from the cotton spinning mill environment in newly hired workers.: Methods: One hundred and ninety eight consecutively appointed new ... ...

Abstract	Objective: This longitudinal study aimed to identify the predictors of leaving during the first year of employment from the cotton spinning mill environment in newly hired workers. Methods: One hundred and ninety eight consecutively appointed new employees were investigated by questionnaire, lung function test, and skin test. They were examined before employment and at the end of the 1st week, and the 1st, 3rd, 6th, and 12th month after starting work and when possible before leaving their job. 572 personal dust sampling and 191 endotoxin measurements were performed to assess the environmental exposure. For the univariate analysis chi2, Student t tests, ANOVA, and Kruskall Wallis tests were used. Cox proportional hazards analysis was used to identify factors associated with leaving the job. Results: Fifty three per cent of workers left the mill environment during their first working year. Work related lower respiratory tract symptoms reported at the third month were associated with an increase rate of leaving the industry compared to those remaining in the industry (25% v 4.8%; p<0.005). Having respiratory symptoms at the first month of work predicted those leaving the industry at some point in the next 11 months. According to the Cox model, increasing age and having work related lower respiratory tract symptoms were found to be predictors for leaving job at the first working year. Atopic status, dust and endotoxin levels, and lung function changes were not consistently predictive of workers who left the industry in the follow up period. Conclusion: This study demonstrated that work related respiratory symptoms can predict workers likely to leave the cotton mill environment during the first year of employment, but atopy or acute lung function changes do not.
MeSH term(s)	Adolescent ; Adult ; Cotton Fiber ; Dust/analysis ; Environmental Monitoring/methods ; Epidemiologic Methods ; Epidemiological Monitoring ; Female ; Healthy Worker Effect ; Humans ; Male ; Occupational Diseases/etiology ; Occupational Exposure/analysis ; Occupational Health ; Personnel Turnover/statistics & numerical data ; Respiration Disorders/etiology ; Respiratory Function Tests ; Skin Tests ; Textile Industry/statistics & numerical data ; Turkey
Chemical Substances	Dust
Language	English
Publishing date	2006-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oem.2005.021352
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Article: Lung function in Lancashire cotton and man made fibre spinning mill operatives.

Fishwick, D / Fletcher, A M / Pickering, C A / McL Niven, R / Faragher, E B

Occupational and environmental medicine

1996 Volume 53, Issue 1, Page(s) 46–50

Abstract: Objectives: This survey was conducted to investigate current lung function levels in operatives working with cotton and man made fibres. Dust concentrations, smoking history, and occupational details were recorded so that factors influencing lung ... ...

Abstract	Objectives: This survey was conducted to investigate current lung function levels in operatives working with cotton and man made fibres. Dust concentrations, smoking history, and occupational details were recorded so that factors influencing lung function could be identified. Methods: A cross sectional study of respiratory symptoms and lung function was made in 1057 textile spinning operatives of white caucasian extraction. This represented 96.9% of the total available working population to be studied. Most (713) worked currently with cotton. The remainder worked with man made fibre. Lung function was assessed by measuring forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Exposure to cotton dust was measured in the work area and personal breathing zones, and retrospective exposure to cotton dust over a working life was estimated with accurate work history and best available hygiene data. Results: 3.5% of all operatives had byssinosis, 55 (5.3%) chronic bronchitis, 36 (3.5%) work related persistent cough, 55 (5.3%) non-byssinotic work related chest tightness, and 56 (5.3%) work related wheeze. A total of 212 static work area dust samples (range 0.04-3.23 mg/m3) and 213 personal breathing zone samples (range 0.14-24.95 mg/m3) were collected. Percentage of predicted FEV1 was reduced in current smokers (mean 89.5, 95% confidence interval (95% CI) 88-91) in comparison with non-smokers (93.1, 90.5-94.1) and FVC was reduced in operatives currently working with man made fibre (95.3, 93.8-96.9) in comparison with cotton (97.8, 96.6-99.0). Regression analysis identified smoking (P < 0.01), increasing age (P < 0.01), increasing time worked in the waste room (P < 0.01), and male sex (P < 0.05) as being associated with a lower FEV1 and FVC. Current and retrospective cotton dust exposures did not appear as predictor variables in the regression analysis although in a univariate analysis, FEV1 was reduced in those operatives exposed to high dust concentrations assessed by personal and work area sampling. Discussion: This study has documented loss of lung function in association with exposure to cotton dust. Those operatives with work related symptoms had significantly lower FEV1 and FVC than asymptomatic workers. Although lung function seemed to be affected by high dust exposures when operatives were stratified into high and low exposure groups, regression analysis did not identify current dust concentrations as an independent factor influencing loss. Smoking habit was found to explain most of the measured change in FEV1 and FVC. It is likely that smoking and dust exposure interact to cause loss of lung function in cotton textile workers.
MeSH term(s)	Adult ; Byssinosis/epidemiology ; Byssinosis/physiopathology ; Cross-Sectional Studies ; Dust/adverse effects ; England/epidemiology ; Female ; Humans ; Lung Diseases/epidemiology ; Lung Diseases/physiopathology ; Male ; Occupational Diseases/epidemiology ; Occupational Diseases/physiopathology ; Respiratory Function Tests ; Textile Industry ; Textiles/adverse effects
Chemical Substances	Dust
Language	English
Publishing date	1996-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oem.53.1.46
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Article ; Online: Defining and investigating occupational asthma: a consensus approach.

Francis, H C / Prys-Picard, C O / Fishwick, D / Stenton, C / Burge, P S / Bradshaw, L M / Ayres, J G / Campbell, S M / Niven, R McL

Occupational and environmental medicine

2007 Volume 64, Issue 6, Page(s) 361–365

Abstract: Background: At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services.: Aims: ...

Abstract	Background: At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services. Aims: To agree a working definition of occupational asthma and to develop a framework of resources necessary to run a specialist occupational asthma clinic. Method: A modified RAND appropriateness method was used to gain a consensus of opinion from an expert panel of clinicians running specialist occupational asthma clinics in the UK. Results: Consensus was reached over 10 terms defining occupational asthma including: occupational asthma is defined as asthma induced by exposure in the working environment to airborne dusts vapours or fumes, with or without pre-existing asthma; occupational asthma encompasses the terms "sensitiser-induced asthma" and "acute irritant-induced asthma" (reactive airways dysfunction syndrome (RADS)); acute irritant-induced asthma is a type of occupational asthma where there is no latency and no immunological sensitisation and should only be used when a single high exposure has occurred; and the term "work-related asthma" can be used to include occupational asthma, acute irritant-induced asthma (RADS) and aggravation of pre-existing asthma. Disagreement arose on whether low dose irritant-induced asthma existed, but the panel agreed that if it did exist they would include it in the definition of "work-related asthma". The panel agreed on a set of 18 resources which should be available to a specialist occupational asthma service. These included pre-bronchodilator FEV1 and FVC (% predicted); peak flow monitoring (and plotting of results, OASYS II analysis); non-specific provocation challenge in the laboratory and specific IgE to a wide variety of occupational agents. Conclusion: It is hoped that the outcome of this process will improve uniformity of definition and investigation of occupational asthma across the UK.
MeSH term(s)	Asthma/diagnosis ; Humans ; Occupational Diseases/diagnosis ; Professional Practice ; Surveys and Questionnaires
Language	English
Publishing date	2007-06
Publishing country	England
Document type	Consensus Development Conference ; Journal Article
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oem.2006.028902
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Article: Monocyte CD14 response following endotoxin exposure in cotton spinners and office workers.

Fishwick, D / Raza, S N / Beckett, P / Swan, J R M / Pickering, C A C / Fletcher, A M / Niven, R McL / Francis, H / Rawbone, R / Curran, A D

American journal of industrial medicine

2002 Volume 42, Issue 5, Page(s) 437–442

Abstract: Background: Monocyte cell surface CD14 acts as the major lipopolysaccharide (LPS) binding structure, and as such is of interest in the etiology of LPS induced disease.: Methods: The objective was to assess change in monocyte cell surface CD14 and CD4+ ...

Abstract	Background: Monocyte cell surface CD14 acts as the major lipopolysaccharide (LPS) binding structure, and as such is of interest in the etiology of LPS induced disease. Methods: The objective was to assess change in monocyte cell surface CD14 and CD4+ CD25+ lymphocytes in a group of cotton workers exposed to LPS over a working week, and to compare this to changes in office workers. Twenty-five cotton workers and nine office workers were studied. Monocyte CD14 fluorescence was measured by flow cytometry, on samples taken pre-shift on a Monday morning (baseline/pre-exposure), and subsequently after 6 and 72 hr. The majority of cotton workers were exposed to at least 1 EU/m(3) of endotoxin over a working shift, and some highly exposed (between 100 and 400 EU/m(3)). Results: After 6 hr of work in the mill, cotton workers developed a significant upregulation in CD14 in comparison to office workers (P = 0.016), whereas CD14 expression had returned to levels not significantly differing from the office workers at 72 hr after first work exposure (P = 0.426). Conclusions: We propose that CD14 expression on monocytes may help to determine the mechanism of action of lipopolysaccharide in producing respiratory ill health, and may ultimately play a role in monitoring the health effect associated with LPS exposure in the workplace.
MeSH term(s)	Adult ; Biomarkers ; CD4-Positive T-Lymphocytes/metabolism ; Cell Separation ; Dust ; Endotoxins/adverse effects ; Endotoxins/metabolism ; Female ; Flow Cytometry ; Gossypium/adverse effects ; Gossypium/metabolism ; Humans ; Lipopolysaccharide Receptors/metabolism ; Lipopolysaccharides/metabolism ; Male ; Monocytes/metabolism ; Occupational Exposure ; Receptors, Interleukin-2/metabolism ; Textile Industry ; Time Factors ; Up-Regulation/physiology
Chemical Substances	Biomarkers ; Dust ; Endotoxins ; Lipopolysaccharide Receptors ; Lipopolysaccharides ; Receptors, Interleukin-2
Language	English
Publishing date	2002-11
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	604538-8
ISSN	1097-0274 ; 0271-3586
ISSN (online)	1097-0274
ISSN	0271-3586
DOI	10.1002/ajim.10132
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