The Asbestos Industry, being comparatively young, plays but a modest part in the Nation's activities as a whole. That would appear to be the only excuse for the even more modest position which it holds in the literature of Medicine. It is from the clinical aspect that I have perforce studied the effects of this industry on those employed in it, for it is in the course of General Practice alone that I have access to the subject. My attention once aroused by the frequent occurrence of intractable pulmonary disease amongst my patients working in a local asbestos factory, I soon found that not only do the workers regard their occupation as almost inevitably productive of Phthisis in the long run, but that the employers are so wide awake to the risks as to establish and enforce precautionary measures on a scale far beyond the requirements of the Factory and Work Shops Act. If I have been afforded some opportunity of observing the conditions under which my patients are employed, it has been entirely due to the courtesy and enthusiasm of the management at Leeds. I have no official status.

No description available.

Large quantities of asbestos are used in the building and repairing of ships. Much is used in easily recognisable form and some is incorporated into materials which bear little or no superficial resemblance to the crude fibre at all, but which may still give rise to highly dangerous dust when sawn or otherwise manipulated. The inhalation of this dust over a period of time gives rise to a very disabling and sometimes fatal form or pneumoconiosis known as asbestosis and it is the aim of this article to discuss the prevention of this disease in Dockyard workers .

Background and objective: Asbestos can cause various pulmonary diseases including asbestosis, pleural plaques and pleural thickening. Animal and in vitro studies suggest that the toxicity of asbestos is due to the iron content of the fibres which not only generate oxidants directly, but also activate the inflammatory cells in the lung that contribute to oxidative stress. This study therefore sought to establish data in man to corroborate the animal and in vitro evidence. Exhaled breath condensate (EBC) collection is a novel, non-invasive technique to collect samples from the lung for investigating inflammatory biomarkers of lung diseases. This technique is harmless, rapid and easily repeatable which leads itself to the investigation of lung diseases such as asbestos-related diseases and pulmonary fibrosis (PF) that are otherwise difficult to study. The hypothesis tested was that oxidative and nitrosylative stress markers will be elevated in the EBC of patients with asbestos-related diseases and PF compared to normal control subjects. Methods: The study design was a cross-sectional and observational in vivo study whereby EBC was collected and fractional exhaled nitric oxide (FeNO) and carbon monoxide (eCO) were measured. EBC markers including pH, hydrogen peroxide (H2O2), total nitrogen oxides (NOx), 3-nitrotyrosine (3-NT), 8-isoprostane (8-iso), total protein and transforming growth factor-β1 (TGFβ1) were measured by microelectrode analysis, colorimetric and enzyme immunoassays. 3-NT and 8-iso were further examined by immunohistochemical techniques in samples of lung tissue. Results: Subjects with asbestosis had significantly raised levels of EBC H2O2, 8-iso, total protein and FeNO compared with healthy individuals. The same markers except H2O2, but with 3-NT and eCO were again significantly increased in those with other causes of PF, compared with control subjects. Heavy nitrotyrosine staining was found on the lung sections from patients with asbestosis and PF. Conclusions: This study confirmed that increased production of reactive oxygen and nitrogen species is associated with asbestos exposure and pulmonary fibrosis in vivo confirming animal and in vitro studies. Analysis of EBC may prove a useful non-invasive tool in exploring the basic pathophysiology of lung diseases in clinical research and may in the future be used to monitor progress in asbestosis and pulmonary fibrosis.

Orientador: Ericson Batagin / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T10:27:03Z (GMT). No. of bitstreams: 1 Lido_AlessandroVito_M.pdf: 591520 bytes, checksum: 2689b2b924e9a05658e2ce48f82eb0f6 (MD5) Previous issue date: 2004 / Resumo: Os dados brasileiros sobre a epidemiologia das pneumoconioses são limitados; ainda não dispomos de informações suficientes para o dimensionamento desse problema em nosso país. A consolidação dos dados, que permitem avaliar os agravos à saúde e seus fatores intervenientes, é uma ferramenta fundamental para seu controle e a avaliação e para a elaboração de políticas de saúde, através da vigilância epidemiológica. Com o objetivo de estudarmos a demanda ambulatorial das pneumoconioses no Hospital das Clínicas da UNICAMP, realizamos um estudo descritivo baseado na análise de prontuários. Os critérios básicos de inclusão foram: diagnóstico de pneumoconiose; histórico ocupacional compatível; e um radiograma do tórax. Através do registro hospitalar, dos relatórios médicos emitidos pela Área de Saúde Ocupacional (do Departamento de Medicina Preventiva e Social da Faculdade de Ciências Médicas da UNICAMP) e da análise dos prontuários, foram obtidas as informações necessárias para a consolidação de um banco de dados. Detectamos um universo de 1.147 casos de pneumoconiose, diagnosticados no período de 1978 a 2003, sendo 1.075 (93,72 %) do sexo masculino e 72 (6,28 %) do sexo feminino, com média de idade de 47,9 ± 10,14 anos (mediana em 46,86) e tempo médio de exposição aos agentes causadores das pneumoconioses de 17,1 ± 8,4 anos. Quanto ao tabagismo, 634 (65,43 %) eram fumantes (21,93 ± 17,53 anos-maço), 335 (34,57 %) não fumavam e em 178 a informação não estava disponível. Quanto às queixas respiratórias, a dispnéia foi o sintoma mais freqüente (560 pacientes, ou 48,82 %), seguido por tosse (261, ou 22,76 %), catarro (182, ou 15,87 %) e chiado (168, ou 14,65 %). Foram identificados 1.061 (92,50 %) casos de silicose, 51 (4,45 %) de pneumoconiose por poeira mista, 15 (1,31 %) de asbestose, 13 (1,13 %) de pneumoconiose por rocha fosfática e 7 (0,61 %) de outras pneumoconioses (por carvão, grafite e metais duros). Os radiogramas foram classificados quanto à qualidade; em 1, foram 330 (28,77 %); 2, foram 293 (25,54 %); 3, foram 401 (34,96 %). Quanto à profusão, em profusão 1 foram 657 (57,28 %); 2, foram 339 (29,56 %); 3, foram 145 (12,64 %). Os radiogramas apresentavam diversas combinações de forma e tamanho; 192 deles foram classificados com grandes opacidades: A, 58; B, 72; C, 62. Foram realizadas análises comparativas entre o primeiro e o último radiograma do tórax dos pacientes que fizeram seguimento, para avaliação da progressão radiológica. Também foram comparados os radiogramas com tomografias computadorizadas de alta resolução do tórax (TCAR), para o estudo comparativo no diagnóstico das pneumoconioses. A demanda ambulatorial de pacientes com pneumoconiose no Hospital das Clínicas da UNICAMP, nos 25 anos de atendimento que cobrem o período de 1978 a 2003, é uma das mais expressivas do país. A silicose foi a pneumoconiose de maior ocorrência, entre esses pacientes, seguido da pneumoconiose por poeira mista, da asbestose e da pneumoconiose por rocha fosfática. Os pacientes com pneumoconiose são predominantemente ceramistas fundidores de louças sanitárias e estampadores de louça doméstica, procedentes dos municípios de Jundiaí e Pedreira, ambos no estado de São Paulo. Encontramos uma maior freqüência (780 pacientes, ou 68 %) com tempo de exposição a poeiras maior que 10 anos, caracterizando a predominância da forma crônica da doença. As pneumoconioses foram diagnosticadas predominantemente em pacientes com faixa etária entre 40 e 54 anos, caracterizando o acometimento de adultos em plena idade produtiva. A categoria 1 da profusão das opacidades foi a mais freqüente (ocorre em 657 radiogramas, ou 57,28 %), caracterizando predominância da forma simples da doença. Foram observadas progressões radiológicas, com aumento da categoria da profusão das opacidades em 18,55 %, e surgimento ou aumento do tamanho das grandes opacidades em 18,12 %. A relação entre os exames de imagem mostrou discordância entre o radiograma do tórax (padrão OIT) e a tomografia computadorizada de alta resolução (TCAR) para a definição do diagnóstico. A atualização e o aprimoramento do banco de dados foram consolidados através da inclusão de casos e do acréscimo de novas variáreis para o estudo das pneumoconioses / Abstract: The Brazilian data on pneumoconiosis epidemiology are limited, and we have not enough information for the measurement of such problem in our country yet. The data consolidation that allows the evaluation of the health hazard and its interposing factors is a fundamental tool to control, evaluate, and elaborate health politics, through epidemiological surveillance. In order to assess its occurrence, we carried out a descriptive study whose basic criteria of admission were the preceding data of occupational exposure to pneumoconiosis causing agents and the chest radiography. Through medical register, and reports from the Área de Saúde Ocupacional do Departamento de Medicina Preventiva e Social of the Faculdade de Ciências Médicas da UNICAMP, it was possible to accomplish the identification of all patients with pneumoconiosis diagnoses in the Hospital das Clínicas da UNICAMP. The necessary information for this survey was obtained from medical records and the interpretation of the radiological exams that were collected in standardized form, composing a database. It includes 1,147 cases of pneumoconiosis diagnosed from 1978 to 2003. There are in it 1,075 (93.72 %) male and 72 (6.28 %) female workers, and their average age and standard deviation are 47.9 ± 10.14 years (median in 46.86). The average period of exposure for pneumoconiosis was 17.1 ± 8.4 years. With regard to smoking, there were 634 smokers (65.43 %) with an average consumption of 21.93 ± 17.53 packs-year; 335 (34.57 %) did not smoke, and the information was not available in 178 records. Concerning the respiratory symptoms, dyspnea was the most frequent, occurring in 560 cases (48.82 %), and then cough (261 cases; 22.76 %), sputum (182 cases; 15.87 %), and sizzle (168 cases; 14.65 %). We found 1,061 (92.50 %) cases of silicosis, 51 (4.45 %) of mixed dust pneumoconiosis (on abrasive industry), 15 (1.31 %) of asbestosis, 13 (1.13 %) of phosphorite pneumoconiosis, and 7 (0.6 %) of mineral dust pneumoconiosis (coal, graphite, and hard metals). The chest radiographs with predominant profusion-1 were 657 (57.28 %), with 2-profusion were 339 (29.55 %), and with profusion-3 were 145 (12.64 %), in several combinations of shapes and sizes. We found 192 radiographs with large opacities; the A type were 58; B, 72; and C, 62. From those patients who have undergone a radiological attendance, we carried out a comparative analysis between the first and the last chest radiograph, for the progression assessment. We also compared the high-resolution computer-assisted tomography (HRCT), when available, with the chest radiograph to study the pneumoconiosis diagnosis. The ambulatory medical demand of pneumoconiosis patients at the Hospital das Clínicas da UNICAMP from 1978 to 2003 is one of the most relevant in the country. The silicosis was the pneumoconiosis with the greatest frequency, followed by mixed dust pneumoconiosis, asbestosis, and phosphorite pneumoconiosis. The patients with pneumoconiosis are predominantly workers of the ceramics industries located in the cities of Jundiaí and Pedreira, both at São Paulo state. We found 780 patients (68 %) who have undergone a period of exposure to dust longer than 10 years. The pneumoconioses were diagnosed in patients whose age was predominantly between 40 and 54; the disease attacks the workers when they are in their best productive condition. The category profusion-1 of opacity was the most frequent (57.28 % of the cases), predominating the simple form of the disease. Radiological progression was found in 18.55 % of the cases, which had an increase in profusion of small opacities, and 18.12 % developed large opacities. The relation among the radiological exams showed divergence between chest radiograph (ILO standard) and high-resolution computer-assisted tomography (HRCT) for the diagnosis definition. The updating and improvement of database were compiled through the inclusion of new variables / Mestrado / Saude Coletiva / Mestre em Saude Coletiva

Introdução Trata-se de um estudo descritivo das sentenças de segunda instância do Poder Judiciário que envolva o problema do trabalhador exposto ao risco do amianto como uma questão de saúde pública. Objetivo Avaliar as decisões judiciais a respeito da exposição dos trabalhadores ao risco do amianto como causa de doença do trabalho a partir da análise de acórdãos judiciais de 1999 até 2009. Métodos Os objetivos foram alcançados mediante pesquisa em acórdãos judiciais publicados no TRT (Tribunal Regional do Trabalho) da 2ª Região, TRT (Tribunal Regional do Trabalho) da 15ª Região e TST (Tribunal Superior do Trabalho), que são tribunais pertencentes à Justiça do Trabalho, bem como no TJSP (Tribunal de Justiça de São Paulo), STJ (Superior Tribunal de Justiça) e STF (Supremo Tribunal Federal), pertencentes à Justiça Comum, a partir do momento histórico em que houve a promulgação da Constituição Federal de 1988, considerando-se o ano da publicação ou do registro dos acórdãos de 1999 a 2009. Os acórdãos foram selecionados por meio da internet nos sites dos Tribunais em referência, que disponibilizam a busca on line. Resultados Os resultados indicam que de um total de 119 decisões judiciais analisadas, considerando-se todos os critérios de inclusão e exclusão, apenas em 42 casos houve a comprovação do nexo de causalidade entre a exposição do trabalhador ao risco do amianto e a doença adquirida no trabalho, o que evidencia que o trabalhador desincumbiuse de seu ônus probatório em pequena parte dos acórdãos. Conclusões Pela avaliação dos acórdãos judiciais de 1999 até 2009 a respeito da exposição dos trabalhadores ao risco do amianto como causa de acidente do trabalho, doença profissional ou morte, somente em 35,3 por cento das decisões foram declarados procedentes os pedidos dos trabalhadores / Introduction - This is a descriptive study of Judiciary second appeal decisions involving the problem of the risk of workers when exposed to asbestos as a public health issue. Objective - To evaluate judicial decisions regarding the exposure of workers to the risk of asbestos as a cause of occupational disease from the analysis of Judicial Decisions from 1999 to 2009. Methods - The objectives have been achieved by researching judicial decisions published by the TRT (Regional Court of Labor) of the 2nd Region, by the TRT (Regional Court of Labor) of the 15th Region and by the TST (Superior Labor Court), which are courts of the Labor Justice Department, as well as the ones by the TJSP (Court of Justice of São Paulo), by the STJ (Higher Justice Court) and by the STF (Supreme Federal Court), of the Common Justice, from the historical moment in which the 1988 Constitution was promulgated, considering the year of publication or record of the Judiciary Decisions from 1999 to 2009. The judicial decisions were selected with the use of the internet in the sites of the Courts previously mentioned, which made possible to make this search on line. Results - The results indicate that from a total of 119 judicial decisions, which were analyzed, and also taking in consideration all the inclusion and exclusion criteria, only in 42 cases there was proof of a causal link between the worker\'s risky exposure to asbestos and the disease acquired at work, which shows that the employee is discharged of the evidential burden on a small portion of the decisions. Conclusions - For the evaluation of the judicial decisions from 1999 to 2009 regarding the exposure of workers to the risk of asbestos as a cause of work accidents, and occupational disease or death, only 35.3 per cent of decisions were in favor of the workers claim

Introdução Trata-se de um estudo descritivo das sentenças de segunda instância do Poder Judiciário que envolva o problema do trabalhador exposto ao risco do amianto como uma questão de saúde pública. Objetivo Avaliar as decisões judiciais a respeito da exposição dos trabalhadores ao risco do amianto como causa de doença do trabalho a partir da análise de acórdãos judiciais de 1999 até 2009. Métodos Os objetivos foram alcançados mediante pesquisa em acórdãos judiciais publicados no TRT (Tribunal Regional do Trabalho) da 2ª Região, TRT (Tribunal Regional do Trabalho) da 15ª Região e TST (Tribunal Superior do Trabalho), que são tribunais pertencentes à Justiça do Trabalho, bem como no TJSP (Tribunal de Justiça de São Paulo), STJ (Superior Tribunal de Justiça) e STF (Supremo Tribunal Federal), pertencentes à Justiça Comum, a partir do momento histórico em que houve a promulgação da Constituição Federal de 1988, considerando-se o ano da publicação ou do registro dos acórdãos de 1999 a 2009. Os acórdãos foram selecionados por meio da internet nos sites dos Tribunais em referência, que disponibilizam a busca on line. Resultados Os resultados indicam que de um total de 119 decisões judiciais analisadas, considerando-se todos os critérios de inclusão e exclusão, apenas em 42 casos houve a comprovação do nexo de causalidade entre a exposição do trabalhador ao risco do amianto e a doença adquirida no trabalho, o que evidencia que o trabalhador desincumbiuse de seu ônus probatório em pequena parte dos acórdãos. Conclusões Pela avaliação dos acórdãos judiciais de 1999 até 2009 a respeito da exposição dos trabalhadores ao risco do amianto como causa de acidente do trabalho, doença profissional ou morte, somente em 35,3 por cento das decisões foram declarados procedentes os pedidos dos trabalhadores / Introduction - This is a descriptive study of Judiciary second appeal decisions involving the problem of the risk of workers when exposed to asbestos as a public health issue. Objective - To evaluate judicial decisions regarding the exposure of workers to the risk of asbestos as a cause of occupational disease from the analysis of Judicial Decisions from 1999 to 2009. Methods - The objectives have been achieved by researching judicial decisions published by the TRT (Regional Court of Labor) of the 2nd Region, by the TRT (Regional Court of Labor) of the 15th Region and by the TST (Superior Labor Court), which are courts of the Labor Justice Department, as well as the ones by the TJSP (Court of Justice of São Paulo), by the STJ (Higher Justice Court) and by the STF (Supreme Federal Court), of the Common Justice, from the historical moment in which the 1988 Constitution was promulgated, considering the year of publication or record of the Judiciary Decisions from 1999 to 2009. The judicial decisions were selected with the use of the internet in the sites of the Courts previously mentioned, which made possible to make this search on line. Results - The results indicate that from a total of 119 judicial decisions, which were analyzed, and also taking in consideration all the inclusion and exclusion criteria, only in 42 cases there was proof of a causal link between the worker\'s risky exposure to asbestos and the disease acquired at work, which shows that the employee is discharged of the evidential burden on a small portion of the decisions. Conclusions - For the evaluation of the judicial decisions from 1999 to 2009 regarding the exposure of workers to the risk of asbestos as a cause of work accidents, and occupational disease or death, only 35.3 per cent of decisions were in favor of the workers claim

[Truncated abstract] Previous studies in the field of tumour immunology had identified regulatory T (Treg) cells as important suppressors of the anti-tumour immune response as the presence of Treg cells in the peripheral blood of cancer patients was correlated with worse disease outcomes. Other studies had identified Treg cells to be active at sites of immune regulation such as the gut of colitis patients. It was therefore hypothesised that Treg cells would be present and active within tumours to suppress the cellular antitumour immune response. ... This treatment targeting multiple pathways of Treg cell mediated immuno-suppression and resulted in tumour regression in 50% of treated animals. Finally, the anti-tumour immune response is complex and a potentially synergistic multi-modality treatment designed to inactivate intra-tumoural Treg cells but to also induce apoptosis in tumour cells themselves was investigated. Alpha-tocopheryl succinate (α-TOS), an analogue of vitamin E, had previously been shown to induce apoptosis in human MM xenografts implanted into immuno-deficient (nude) mice. Administration of α-TOS was therefore examined as a potentially synergistic treatment to be coupled with Treg cell inactivation. At the previously published doses used to treat immuno-deficient mice, α-TOS was found to be toxic to the immuno-competent mice used in this study. A marked depleting effect on total T cells was seen in the treated animals. The results of this thesis demonstrated the high potential for an adjunct immunotherapy of MM. They did however also highlight the importance of future studies into anticancer therapies to be conducted using clinically relevant tumour models and clinically relevant treatment regimes. The need to consider synergistic multi-modal therapies was also emphasised.