Exposure to Fumes of a Vegetable Margarine for Frying: Respiratory Effects in an Experimental Model.

Deep frying is one of the strongest emission sources into indoor air. A vegetable margarine has recently been used in commercial kitchens. This study investigated the respiratory effects of exposure to its fumes in an experimental model. A setup with glass chambers was constructed. A chamber housed a fryer. The fumes were transported to the other chamber where 24 Wistar albino rats were placed in four randomized groups: acute, subacute, chronic, and control for the exposure durations. PM10 concentration in the exposure chamber was monitored to ensure occupational levels were obtained. Sacrification was performed 24 h after exposure. Lung, trachea, and nasal concha specimens were evaluated by two blinded histologists under a light microscope with hematoxylin-eosin. Mild mononuclear cell infiltration, alveolar capillary membrane thickening, alveolar edema, and diffuse alveolar damage, along with diffuse hemorrhage, edema, and vascular congestion in the interstitium were observed in the acute and subacute groups, and were overexpressed in the chronic group, whereas normal lung histology was observed in the control group. The results indicate that exposure to fumes of vegetable margarine for frying in commercial kitchens may cause pulmonary inflammation that becomes severe as the duration of the exposure increases.

The Effect of Noise Exposure on Hearing Function and Vestibular Evoked Myogenic Potentials.

Purpose: Exposure to noise can cause damage to both auditory and vestibular systems. The objective of this study is to evaluate how noise exposure affects the hearing and vestibular systems in individuals with noise-induced hearing loss (NIHL). Methods: This study included 80 subjects (40 subjects with NIHL, and 40 controls), between 26 and 59 years old. For hearing assessment, pure-tone audiometry, extended high-frequency audiometry, tympanometry, acoustic reflex threshold, and distortion product otoacoustic emission tests were used; for vestibular assessment, the cervical and ocular vestibular evoked myogenic potentials tests were used. Results: Statistically significant differences were found between the two groups in 3 to 6 kHz frequency thresholds; in extended high-frequency audiometry tests, there were also significant differences between groups at all frequencies from 9.5 to 16 kHz. The cervical and ocular vestibular evoked myogenic potentials thresholds were significantly higher and N1-P1 amplitudes were significantly lower in the NIHL group. Conclusion: Noise can lead to damage to both auditory and vestibular functions. Therefore, audiological assessments and vestibular evoked myogenic potentials could be clinically useful for examining patients with NIHL.

How were Non-COVID pulmonary patients and diseases affected from COVID-19 pandemic period?

OBJECTIVE: This study aimed to focus on non-COVID-19 patients during the process when all physicians focused on COVID-19 patients. Patients with pulmonary diseases in the COVID-19 pandemic period were analyzed. MATERIAL AND METHODS: Non-COVID-19 cases who were hospitalized in the pulmonology clinic, outpatients, and patients who applied to the non-COVID-19 emergency service and requested a pulmonology consultation in the period from March 16, 2020 to May 15, 2020 and in the same period of the previous year (i.e., from March 16, 2019 to May 15, 2019) were included in this study. RESULTS: In the pandemic period, it was found that there was an 84% decrease in outpatient admissions, a 43% decrease in inpatients, and a 75% decrease in emergency services. During the pandemic period, in outpatient setting, male and younger case admissions increased, admissions with chronic obstructive pulmonary disease (COPD), and interstitial lung diseases decreased, whereas the frequency of admission to asthma, pneumonia, and pulmonary thromboembolism increased. In the period of the pandemic, patients with asthma, COPD, and lung cancer were less hospitalized, whereas patients with pulmonary thromboembolism, pneumonia, and pleural effusion were hospitalized more. In non-COVID-19 patient treatments during the pandemic period, usage of a metered dose inhaler increased. CONCLUSION: During the COVID-19 pandemic, non-COVID pulmonary pathologies decreased significantly, and there was a change in the profile of the patients. From now on, to be prepared for pandemic and similar extraordinary situations, to organize hospitals for the epidemic, to determine health institutions to which nonepidemic patients can apply, to make necessary plans in order not to neglect the nonepidemic patients, and to develop digital health service methods, especially telemedicine, would be appropriate.

Validity and Reliability of the Assessment Tool for Asthma (ATA) Questionnaire: the ATA Study.

OBJECTIVES: A multicenter trial was designed to validate the "Assessment Tools for Asthma (ATA)" questionnaire, a newly developed questionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument. MATERIALS AND METHODS: This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100 randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assesses symptomatic control criteria, and the remaining section, queries the flare-up of asthma, control of comorbidities, treatment adherence, and inhaler technique. RESULTS: The mean scores for ATA1, ATA total, VAS, and ACT were 24.7±14.8, 53.8±19, 7.1±3, and 18.8±5.5, respectively. According to the ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flare-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthma treatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach's alpha coefficient=0.683). ACT, ATA1, and two specialists' evaluations using VAS correlated strongly with the ATA total scores (Spearman correlation coefficient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specificity=82.40%). CONCLUSION: The validated ATA questionnaire may be a practical tool for physicians in asthma management.

Demographic, Clinical and Management Characteristics of Newly Diagnosed COPD Patients in Turkey: A Real-Life Study.

Purpose: In order to determine the clinical and sociodemographic characteristics of newly diagnosed treatment-naïve asthma and COPD patients in Turkey, a multicenter study in 2012 was initiated . We aimed to investigate the characteristics and therapies of COPD patients in the original study in more detail. Patients and Methods: This nation-wide, multicentric, non-interventional, prospective, real-life observational cohort study was conducted in 122 centers. The newly diagnosed patients were not receiving any treatment before the recruitment. Their general characteristics, the combined GOLD 2011 COPD categories and exacerbation histories were noted. The patients were followed up with 3 voluntary visits for 1 year. Their adherence to the inhaled treatment according to GOLD 2011 was evaluated during follow-up visits. Results: The study included 776 COPD patients. Their mean age was 59.4±9.1 years, and 11.9% of the patients were female. 35.1% of the patients were in the GOLD 2011 C and D category. 12.6% are frequent exacerbators, and 52.8% had at least one comorbid condition. 71.8% overtreatment rate was detected. Their attendance rates for three follow-up visits became 55.9%, 32.9% and 18.7%, respectively. The adherence rate to the treatment was measured as 81.9%. Conclusion: Although these patients were diagnosed for the first time, the GOLD C and D categories and frequent exacerbator phenotype were found at a high rate. They were usually prescribed an overtreatment regimen. We think that newly diagnosed COPD patients should be evaluated carefully, and best effort should be made to treat these patients in accordance with the recommendations of the major COPD guidelines.

Asthma control and adherence in newly diagnosed young and elderly adult patients with asthma in Turkey.

OBJECTIVE: This study aimed to evaluate the factors that affect asthma control and adherence to treatment in newly diagnosed elderly asthmatics in Turkey compared with younger patients. METHODS: This real-life prospective observational cohort study was conducted at 136 centers. A web-based questionnaire was administered to the patients who were followed up for 12 months. RESULTS: Analysis included 1037 young adult asthma patients (age <65 years) and 79 elderly asthma patients (age ≥65 years). The percentage of patients with total control in the elderly and young groups were 33.9% and 37.1% at visit 1, 20.0% and 42.1% (p = 0.012) at visit 2, and 50.0% and 49.8% at visit 3, respectively. Adherence to treatment was similar for both groups. Visit compliance was better in the elderly group than in the young group at visit 1 (72.2% vs. 60.8%, p = 0.045), visit 2 (51.9% vs. 34.9%, p = 0.002), and visit 3 (32.9% vs. 19.4%, p = 0.004). Adherence to treatment increased with asthma control in both groups (both p < 0.001) but decreased with the presence of gastritis/ulcer, gastroesophageal reflux, and coronary artery disease in the elderly. CONCLUSIONS: Asthma control and adherence to treatment were similar for the elderly and young asthma patients, though the follow-up rate was lower in young patients. The presence of gastritis/ulcer, gastroesophageal reflux and coronary artery disease had negative impacts on the adherence to treatment in elderly adult patients.

Three-year' experience of a tertiary level occupational diseases clinic.

INTRODUCTION: We aimed to evaluate the diagnosis of patients who applied on the first three years of our clinic, in order to contribute to the state of occupational diseases (OD) in Turkey. MATERIALS AND METHODS: The study is a cross-sectional study, between November 2013 and December 2016, 862 subjects were accepted for the evaluation. Gender, age, application ways, the reason of referral, workplace, exposure time and possible risks for the patients were evaluated through a file examination. RESULT: Total of 708 (82.1%) was male and 154 (17.9%) were female. The mean age of the subjects was 38.3 ± 7.7 years; the mean term of employment was 126.6 ± 87.3 (1-420) months. The most common cause of referral was the suspicion of occupational pulmonary diseases (64.3%) with 554 workers. 435 workers (50,6%) were diagnosed to have an OD, 78 workers (9.0%) were diagnosed with work-related diseases. The most common diagnoses of OD; 169 (38.9%) pneumoconiosis, 71 (16.3%) occupational asthma, 38 (8.7%) cervical disc hernia, 24 (5.5%) lumbar disc hernia, 24 (5.5%) hearing loss, 19 (4.3%) cubital/carpal tunnel, and 15 (3.4%) workers have lead intoxication. CONCLUSIONS: Dust, chemicals, ergonomic risks and noise still remain as important occupational health risks in Turkey. It is seen that the existing occupational diseases monitoring system is inadequate to identify and manage the health problems of the workers. An effective and comprehensive occupational disease monitoring system should be established and legal regulations should be planned.

Employment status changes of workers after referral to an occupational disease clinic.

OBJECTIVE: Occupational diseases (OD) are among the most significant issues of work life, with economic, medical, social, and ethical aspects. The majority of studies concerning OD focus on the causes or medical outcomes of OD. There are a limited number of studies investigating the social and economic impacts of being diagnosed with an OD. One of the important social aspects of OD is the employability of workers after an OD diagnosis. The aim of this study is to evaluate the changes in employment status after the OD diagnosis process. METHODS: This is a cross sectional study. There were 204 eligible cases, and 198 (97%) completed the study. The study data were obtained from patient files, including OD Committee reports and questionnaires applied via telephone interview. RESULTS: Among the 198 applicants, 170 (85.9%) were male and 146 (73.7%) were diagnosed with an OD. Of these workers, 106 (53.5%) had quit their current jobs. Of those workers, 89 out of 106 were in the OD group, and 17 were in the non-OD group. Diagnosis with OD (OR: 3.1 CI: 1.4-6.8) and non-union membership (OR: 11.1 CI: 5.2-23.5) increased the likelihood of quitting the job after an OD diagnosis. CONCLUSION: The short-term prognosis of OD was relatively poor. OD diagnosis or even referral to an outpatient clinic may cause quitting the job. Policies should account for the risk of unemployment after an OD diagnosis, and OD surveillance systems should obtain data on the employment status of workers following diagnosis.

Dental Technicians' Pneumoconiosis; Illness Behind a Healthy Smile - Case Series of a Reference Center in Turkey.

BACKGROUND: Dental laboratories include many hazards and risks. Dental technicians working in an unfavorable work environment in Turkey and other parts of the world may develop pneumoconiosis as a result of exposure to dust, depending on exposure time. In this study, we aimed to investigate the clinical and laboratory findings of dental technicians. MATERIALS AND METHODS: The study consists of a case series. Between 2013 and 2016, a total of 70 who were working as a dental technician and referred to our clinic with suspicion of occupational disease were evaluated. Comprehensive work-history, physical examination complaints, functional status, chest X-ray, and high-resolution computed lung tomography (HRCT) findings were evaluated. RESULTS: In all, 46 (65.7%) of the 70 dental technicians were diagnosed with pneumoconiosis. About 45 (97.8%) subjects were male and 1 (2.2%) was female. The mean age of starting to work was 15.89 ± 2.79 (11-23) years. The mix dust exposure time was 176.13 ± 73.97 (18-384) months. Small round opacities were most common finding. In 16 patients, high profusion being 2/3 and above were identified, and large opacity was detected in 11 patients. The radiological profusion had a weak negative correlation with FEV 1 and FVC (correlation coefficient - 0.18, P = 0.210 and - 0.058, P = 0704) and moderate negative correlation between radiological profusion and FEV1/FVC (correlation coefficient - 0.377, P = 0.010). In addition, no correlation was observed between the age at start of work and the duration of exposure. CONCLUSION: The presence of pneumoconiosis continues in dental technicians in Turkey, especially because there is an early childhood apprenticeship culture and almost all workers in this period have the history of sandblasting.

Skydiving and the risk of cervical disc herniation.

The skydiving/parachuting sport which has recently gained popularity is also known for its accidents and injuries. However, there are a few studies related to its occupational ergonomic risks and occupational musculoskeletal diseases. It has been reported that the sudden hyperextension of the neck during the parachute opening, so called opening shock results in neck pain. It has been found that the jumpers are subjected to an average deceleration of 3-5 times the earth's gravitational acceleration (3-5 G) during parachute opening shock. It is considered that the spinal cord is destabilized by the impact of this force. This study presents the occupational cervical disc herniation occurring in the case of a subject who has been working as a skydiving/parachuting instructor for 25 years, and the ergonomic risks specific to the sports of skydiving. There is a requirement for systematic and representative studies related to the administrative measures to be taken in order to prevent the occupational diseases that may occur in the case of skydivers, the personal protective equipment to be used, and the employee. Int J Occup Med Environ Health 2018;31(2):243-249.

Assessment of work-related Asthma cases: Our three-year experience.

OBJECTIVE: Work-related asthma (WRA) is one of the most common occupational diseases. In this study, we aimed to review diagnosing procedures and the characteristics of patients who were diagnosed with WRA. METHODS: Between November 2013 and June 2016; 214 patients were referred to our clinic with WRA suspicion by an occupational health specialist, personal visit, chest disease specialists [61 (28%), 51 (23%), and 102 (47%) respectively]. Occupational history, functional and radiological assessment, skin prick test, PEF monitoring were done. RESULTS: Fifty-four patients (25%) were diagnosed with OA, and 24 (11%) with WEA, total 78 workers were diagnosed with WRA. Twenty-five (32.1%) had allergic rhinitis, 13 (16.7%) had allergic dermatitis, and 8 (10%) had both diseases. CONCLUSION: WRA can be seen in many areas. Complaints are the basic route for admission to physician, and the diagnosis can be delayed for a long time as one year. Lower rates of referral by occupational health physicians are the signs of limitations on management of cases. Non-specific BPT and skin prick test for selected cases would be sufficient besides occupational history and clinical examination for the diagnosis of WRA. PEF assessment, one of the most important tests for the diagnosis of WRA, must be performed.

Real life profile of asthma and chronic obstructive pulmonary disease patients in Turkey.

INTRODUCTION: Despite the presentation of similar symptoms, the airway diseases have different underlying pathophysiological processes and must be distinguished to enable the administration of appropriate treatment. In several studies the clinician- and patient-related causes of poor compliance to treatment in asthma/chronic obstructive pulmonary disease (COPD) patients have been evaluated. This study aimed to determine the clinical and sociodemographic characteristics of newly diagnosed treatment-naïve asthma and COPD patients in Turkey. MATERIALS AND METHODS: This national, multicentre, prospective, observational study was conducted in 122 centres. A questionnaire including items related to demographic, clinical, laboratory parameters was applied. All patients were intended to be followed-up for 12 months. RESULT: 1892 adult patients (1116 asthma and 776 COPD) from 122 centres were enrolled. Overall 95%, 86% and 65% of intermittent, mild persistent and moderate persistent asthma patients were over-treated. Among COPD patients, the percentages of over-treated patients were 66%, 79% and 82% for those with GOLD stage A, B and C. Physicians' adherence to guidelines was appropriate in 93% of severe persistent asthma patients and 89% of GOLD stage D COPD patients. Among patients with high compliance to treatment, proportion of asthma patients with total control was 44% and that of COPD patients at GOLD stage A was 41%. In consecutive two visits, this figure increased to 52% and 63% in asthma patients and 54% and 50% in COPD patients. CONCLUSIONS: The main findings are: (a) patients are frequently over-treated and (b) patients do not adhere to visits as expected, in both asthma and COPD.

Call centers and noise-induced hearing loss.

Noise is defined as unwelcome sound. It has been estimated that 16% of adult hearing loss in the world is due to noise exposure at the workplace. This report offers a case that diagnosed with hearing loss of whom working as a call center operator at home. Home agent operators should be explored.

Pneumoconiosis in different sectors and their differences in Turkey.

INTRODUCTION: Pneumoconiosis which is one of the ancient diseases, still affects many workers throughout the world despite "existing" control programs. We add data from a single center reviewing risk factors for pneumoconiosis; evaluate functional and radiological findings in different sectors. MATERIALS AND METHODS: We reviewed medical records of patients diagnosed with pneumoconiosis who were admitted to our center between the years 2013 and 2015. Several personal and occupational features, together with functional and radiologic data, were collected. RESULT: 60 were young males. Twenty-four of the cases (39.3%) worked at dental technician, 24 cases (39.3%) were ceramic workers, 5 cases (8.2%) were sandblasters, 2 cases (3.3%) were welders, 3 cases (4.9%) were miners, and 3 cases (4.9%) were marble cutters. The sectors in which the exposure started at the earliest ages were dental technicians and sandblasters, while the shortest working time was in sandblasting. The dental technicians were younger than the ceramic workers at the age of diagnosis (Kruskall-Wallis p= 0.003). The exposure time of the sandblasters was significantly shorter, especially than the ceramic workers (Kruskall-Wallis p= 0.002). The cases have been referred to us with pneumoconiosis suspicion based on the radiographic findings in the PA chest roentgenogram performed during the periodic examinations at their work place; but unlike other studies, in our study, following the HRCT assessment, cases which did not present any visible pathology in the re-evaluation of their PA chest roentgenogram, but had HRCT findings have been diagnosed as pneumoconiosis. Among the 44 cases in which micro-nodules had been detected at their HRCT, 15 of them had been previously classified as profusion of small opacities 0/1 according to their PA chest roentgenogram findings. It has been seen that the HRCT findings differ among sectors. Ceramics workers and sandblasters had significantly more micro-nodules, while dental technicians had significantly more mediastinal lymphadenopathies (Chi square, p= 0.004 and p= 0.007 respectively). When the relationship between the existence of big opacities and complaints was studied, statistically significant weight loss was detected in cases which had C opacities (chi square p= 0.01). Statistically significant FEV1 decrease was observed in cases which had weight loss (independent samples t-test p= 0.046). It has been observed that when the profusion of small opacities increased, while there was no statistically significant functional status change in non-smokers, a significant functional impairment was observed in smokers. CONCLUSIONS: Pneumoconiosis still exists in Turkey. Even a short exposure time as 2 years can cause pneumoconiosis. Workers in different sectors had different functional, radiological properties and smoking can affect the diseases' course. There are serious limitations related to the surveillance of both the workplace environment and the employees' health in Turkey. Without institutional preventive measures, personal protection and surveillance examinations, occupational hazards will continue to cause premature deaths. Pneumoconiosis in different sectors is a prototype of uncontrolled industry in the developing world.

Indoor air quality in a restaurant kitchen using margarine for deep-frying.

Indoor air quality has a great impact on human health. Cooking, in particular frying, is one of the most important sources of indoor air pollution. Indoor air CO, CO2, particulate matter (PM), and volatile organic compound (VOC) concentrations, including aldehydes, were measured in the kitchen of a small establishment where a special deep-frying margarine was used. The objective was to assess occupational exposure concentrations for cooks of such restaurants. While individual VOC and PM2.5 concentrations were measured before, during, and after frying events using active sampling, TVOC, PM10, CO, CO2, temperature, and relative humidity were continuously monitored through the whole period. VOC and aldehyde concentrations did not increase to considerable levels with deep-frying compared to the background and public indoor environment levels, whereas PM10 increased significantly (1.85 to 6.6 folds). The average PM2.5 concentration of the whole period ranged between 76 and 249 µg/m(3). Hence, considerable PM exposures could occur during deep-frying with the special margarine, which might be sufficiently high to cause health effects on cooks considering their chronic occupational exposures.

The effect of beclometasone dipropionate/formoterol extra-fine fixed combination on the peripheral airway inflammation in controlled asthma.

BACKGROUND: Suppression of small airway inflammation may contribute to achieving asthma control. We aimed to evaluate the additional effect of beclometasone dipropionate/formoterol (BDP/F) hydrofluoroalkane (HFA) pressurized metered dose inhaler (pMDI) (BDP/F-HFA 100/6 µg pMDI) on airway inflammation and functional parameters in asthma cases, who were optimally controlled by maintenance therapy. METHODS: Ninety-five controlled asthmatic patients were included. They were grouped as Group 1 [budesonide/formoterol 320/9 µg dry powder inhaler (DPI)] and Group 2 (fluticasone/salmeterol 500/50 µg DPI) according to the combination they used. Then Group 3 was established by random selection from these two groups, and BDP/F-HFA 100/6 µg pMDI treatment was prescribed. All patients were evaluated in the beginning of the study and were re-evaluated at the end of a 3-week treatment period by spirometry, exhaled nitric oxide (eNO) levels, and small airway functional indices, namely, Sacin and Scond values. RESULTS: There was no significant statistical difference in terms of age, height, weight, disease duration, symptoms, and spirometric parameters between the groups. There was a significant decrease in eNO levels in asthma cases who were on BDP/F-HFA therapy (p=0.001). A significant improvement in Sacin values at the end of the treatment period was observed in cases treated with BDP/F-HFA (p=0.001), indicating that inflammation was suppressed in peripheral airways. CONCLUSIONS: These results emphasize that asthma treatment has mainly focused on the strategy to keep the disease under control; maintaining optimal functional level might be underestimated. BDP/F-HFA may have an additional favorable effect on the peripheral airway inflammation in the controlled asthma.

The role of molds in the relation between indoor environment and atopy in asthma patients.

BACKGROUND: The effect of mold fungi to allergic sensitization is not well-known. We aimed to evaluate the role of molds in the relation between indoor environment and atopy in asthmatics. MATERIALS AND METHODS: The air samples obtained from 66 stable asthmatics and 35 control subject's houses were sprayed into Sabouraud dextrose agar. Allergy skin testing were performed in both groups. The temperature and humidity of each house were measured. RESULTS: The incidence of atopy was similar in cases (59.1%) and controls (51.4%). The average amount of mold was 35.9 CFU/m(3) and 34.3 CFU/m(3), respectively. The number of household residents was positively correlated with the amount of molds. There was no difference in the amount of mold with respect to dosage of inhaler corticosteroids as well as symptom levels in asthmatics. The most frequently encountered allergens were Dermatophagoides farinae/Dermatophagoides pteronyssinus, grass/weeds and molds. Spending childhood in a village was more common among atopics. CONCLUSION: Living environment during the childhood might affect atopy and asthma. Based on the identification of molds as the second most frequent allergen after mites in our study population, assessment of mold sensitization as well as in forming patients about ways to avoid them seem likely to contribute to the effective management of uncontrolled asthma.

[Prevalence of silicosis among employees in feldspat and quartz mills and associated factors with silicosis]. / Kuartz ve feldspat degirmenlerinde çalisanlarda silikoz sikligi ve silikoz ile iliskili faktörler.

INTRODUCTION: Problems in legal definition and diagnosis of occupational diseases in Turkey makes the diagnosis of these diseases and informing the parties important. For this purpose, this study was planned to elicit the frequency of silicosis in quartz mill workers in Cine which is one of the largest quartz and feldspat areas, and to detect the working conditions, to inform the workers to improve the working conditions. The aim was to evaluate 592 workers in 10 quartz mill and mines around Cine in 2004. MATERIALS AND METHODS: A structured questionnaire including personal information and work-related questions was applied. Standards chest X-rays taken in the last six months were evaluated according to International Labour Organization (ILO) 1980 standards. Dust concentration and respirable dust concentration in the work place were measured in enterprises. RESULTS: The mean age of the workers was 31.8 ± 8.26 years and 71.7% was smoker. Duration of working was ≤ 5 years in 80.5% and ≥ 10 years in only 4.2%. According to the results of dust measurements, threshold value was found to be exceeded in chopping, packaging and bagging parts of three workplaces. Frequency of silicosis was calculated to be 23.7%. CONCLUSION: Frequency of pneumoconiosis was found to be high like previous studies carried out in similar workplaces in this study. Although it was impossible to put forward the cumulative effect of dust exposure because of frequent altering in workplace, the high frequency of working in similar workplaces among the cases supported the significant risk of silicosis in these enterprises. The workplaces were observed after the workers and persons responsible from occupational health and safety.

[Mortality and factors affecting mortality in chronic obstructive pulmonary disease]. / Kronik obstrüktif akciger hastaliginda mortalite ve mortaliteyi etkileyen faktörler.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the major causes of mortality and morbidity in the world. Mortality rates vary between 15-54% in investigations. There is a limited number of studies evaluating factors associated with mortality and morbidity in our country. The aim of this study is to detect the mortality rate and to investigate the factors affecting mortality. PATIENTS AND METHODS: 427 patients with COPD between July 2004-November 2005 were evaluated. RESULTS: Mortality rate was found to be 17.3% at the end of four years. Deaths were most frequently due to pulmonary causes and secondly cardiac factors. Deaths due to lung cancer were 31%. Age, amount of smoking, COPD stage, FEV1 (L), FEV1% predicted, FVC (L), FVC% predicted, FEV1/FVC, PEF (L/sn), PEF% predicted, FEF25-75 (L) and FEF25-75% predicted values, presence of comorbid diseases, Modified Borg Scale and dyspnea severity according to MMRC, six minutes walking test and oxygen saturation following the test, BODE index, SF-36 quality of life questionnaire, physical function, physical role, emotional role and energy scores parameters and all parameters of SGRQ questionnaire were found to be significantly associated with mortality. CONCLUSION: COPD is a disease with high mortality and is one of the problems related with the public health. In the follow up of COPD, the usage of other measures like exercise capacity and quality of life besides spirometric measures should be encouraged. To make the patients and cases in the risky group conscious of their disease is important since the risk factors are preventable. This method may also contribute to the prevention of comorbid diseases.

Quality of life, depression and anxiety in young male patients with silicosis due to denim sandblasting.

The aim of this study was to estimate the quality of life, depression and anxiety in patients with silicosis due to denim sandblasting. This study was conducted on 50 young male patients with silicosis and 30 controls. A socio-demographic data form, Short Form-36 (SF-36), the Beck depression inventory (BDI) and the Beck anxiety inventory (BAI) were used to determine quality of life, depression and anxiety. The mean scores of SF-36, BDI and BAI were higher in the patients than in the controls. Correlation analysis revealed a strong negative correlation between all scales of SF-36 and BDI scores. Additionally, there was strong negative correlation between five scales of SF-36 and BAI scores. We suggest that silicosis might be detrimental to the quality of life and increase depression and anxiety in patients with silicosis due to denim sandblasting.