No / Nanotechnology has preceded nanotoxicology and little is known of the effects of nanoparticles in human systems, let alone in diseased individuals. Therefore, the effects of titanium dioxide (TiO2) nanoparticles in peripheral blood lymphocytes from patients with respiratory diseases [lung cancer, chronic obstructive pulmonary disease (COPD) and asthma] were compared with those in healthy Individuals, to determine differences in sensitivity to nanochemical insult. The Comet assay was performed according to recommended guidelines. The micronucleus assay and ras oncoprotein detection were conducted according to published standard methods. The results showed statistically significant concentration-dependent genotoxic effects of TiO2 NPs in both respiratory patient and control groups in the Comet assay. The TiO2 NPs caused DNA damage in a concentration dependent manner in both groups (respiratory and healthy controls) with the exception of the lowest TiO2 concentration (10 µg/ml) which did not induce significant damage in healthy controls (ns). When OTM data were used to compare the whole patient group and the control group, the patient group had more DNA damage (p > 0.001) with the exception of 10 µg/ml of TiO2 that caused less significant damage to patient lymphocytes (p < 0.05). Similarly, there was an increase in the pattern of cytogenetic damage measured in the MN assay without statistical significance except when compared to the negative control of healthy individuals. Furthermore, when modulation of ras p21 expression was investigated, regardless of TiO2 treatment, only lung cancer and COPD patients expressed measurable ras p21 levels. All results were achieved in the absence of cytotoxicity.

Nasal AEC cultures were established from children (0.6-14.9 years) undergoing elective surgical procedures under general anaesthetic, categorised as atopic asthmatics (n=12), virus-induced wheezers (n=8) or healthy controls (n=32) using questionnaire and serum IgE levels. All subjects were free of current respiratory symptoms. Successful AEC cultures were maintained to passage 2 or 41 (79%) subjects. AEC from children with a history of wheeze produced significantly less IL-8, IL-6, MCP-1 and G-CSF than AEC from healthy controls. When the wheezing phenotypes were considered separately, AEC from atopic asthmatic children released significantly less IL-8, IL-6, MCP-1 and G-CSF than AEC from controls but there were no significant differences between AEC mediator release from children with virus-induced wheeze and either atopic asthmatics or controls. Similar results were found for cytokine-stimulated AEC. In non-wheezy subjects, there were no differences in AEC mediator release between atopic and non-atopic individuals. There were no differences between the study groups in the percentage increments in mediator release in response to stimulation. In multivariate analysis, taking into account age, gender, passive smoke exposure, use of inhaled corticosteroids, total serum IgE and specific responses to inhaled aeroallergens as possible confounders, wheeze was the only significant predictor of AEC mediator release. It was concluded that there are intrinsic differences in AEC from children with a history of wheeze compared to healthy controls and these are independent of atopic status. This study provides further evidence that the airway epithelium is implicated in the pathogenesis of childhood wheezing. It is hypothesised that different systemic factors, such as atopy and viral responsiveness, interact with common epithelial abnormalities to give rise to different wheezing phenotypes. Further work is required to establish whether these abnormalities are primary or secondary and to confirm these findings in well-differentiated AEC cultured with an air-liquid interface.

Background and Aims: The Sohar Industrial Zone (SIZ), Oman, which started to operate in 2006, contains many industries that possibly affect the health of the local population. This study was carried out to evaluate the health effects in a population living near SIZ. Methods: Retrospective health care visits for acute respiratory diseases (ARD), asthma, conjunctivitis and dermatitis were collected between 2006 and 2010 for 2 large provinces with geographic proximity to SIZ. Exposure of the surrounding villages was classified using proximity to SIZ. Three exposure zones were defined according to the distances from the SIZ: ≤5, >5-10, ≥20 km representing high, intermediate and control exposure zones respectively. Age and gender-adjusted monthly counts of visits for the selected diseases were modelled using generalised additive models controlling for time trends. The high and intermediate exposure zones were later merged together due to similarity of effects. Exposure effect modification by age, gender and socioeconomic status (SES) was also tested. Results: Living within 10 km from SIZ showed greater association for ARD (RR: 2.5; 95% CI: 2.3-2.7), asthma (RR: 3.7; 95% CI: 3.1-4.5), conjunctivitis (RR: 3.1; 95% CI: 2.9-3.5) and dermatitis (RR: 2.7; 95% CI: 2.5-3.0) when compared to the control zone, for the population of <20 years. For the population of ≥20 years, these risks were: (RR: 2.0; 95% CI: 1.9-2.2), (RR: 3.6; 95% CI: 3.0-4.4), (RR: 2.8; 95% CI: 2.5-3.2) and (RR: 2.1; 95% CI: 1.9-2.4), respectively. Greater exposure effects were observed amongst ages ≥50 years and lower SES groups in the ≥20 years group. Models showed no differences between the gender groups. Conclusion: This is the first study conducted in Oman examining the adverse health effects on the population living near SIZ. We hope that these findings will contribute to building up an evidence-based environmental and public health policy in Oman.

Rapid migration of people to the urban areas of developing countries resulted in a shortage of housing and the location of people in poor housing and unhealthy environments. Studies have shown that people who live in poor housing are at increased risk of exposure to the determinants of respiratory diseases. Objective: This study investigated the influence of housing conditions on respiratory disease in selected low cost housing settlements in Johannesburg, South Africa. Methodology: Secondary data analysis based on the Health, Environment and Development (HEAD) cross-sectional study were used to explore housing conditions in relation to respiratory health. Results: Black African households comprised (77%) the major population group in the study. The overall mean number of people per household was five with household size ranging from 1 to 22 people permanently living in the household. Most of the households (48%) had an average monthly income of R1001 to R2000. The self reported household prevalence of asthma was highest among households in Riverlea (21%). Households in Riverlea had reported higher levels of asthma 33% relative to households in Bertrams. Hairdressing activities within dwellings increased the risk of asthma (OR: 2.89, 95% CI 1.46-5.73). Tuberculosis was associated with household size (OR 0.9, 95% CI 0.79 – 0.99) and smoking (OR 0.4 CI 0.12 - 0.96) in the univariate analysis. However in the multivariate analysis there was no significant association between tuberculosis with household size (OR 0.92, 95% CI 0.80 - 1.05) or smoking (OR 0.03, 95% CI 0.12 – 1.00). Conclusion: In this study housing quality was an important determinant of respiratory health. More intervention strategies need to be employed to improve the living environment. These include increasing awareness and education to the public and other sectors, source reduction and more guidelines for healthy housing. Finally, more research on housing and health is needed to determine the effect of housing on health.

D'abord développées pour traiter les maladies respiratoires (asthme, BPCO...), les thérapies inhalées sont depuis peu l'objet d'un intérêt particulier pour délivrer des molécules dans le sang via la barrière alvéolo-capillaire. Quelle que soit la cible de ces thérapies, leur efficacité dépend de la quantité de médicament qui arrive sur la zone à traiter dans l'arbre respiratoire. La région extrathoracique (appelée "région ET" et comprenant la bouche, l'oropharynx, le larynx et le début de la trachée) se comporte alors comme un "filtre" où se dépose une certaine masse de médicament. Afin d'optimiser une telle administration, il est nécessaire de connaître au mieux l'influence des facteurs caractéristiques de l'inhalation (entre autres, le débit d'inhalation, les diamètres des particules inhalées, les propriétés physiques du gaz porteur). Pour cela, un modèle réaliste de région ET a été construit à partir des données issues de l'imagerie médicale. Après la définition d'un maillage et le choix d'un modèle de turbulence et de paramètres adéquats, les équations de Navier-Stokes ont été résolues numériquement pour (i) décrire l'écoulement dans ce modèle et (ii) pour déterminer les trajectoires des particules inhalées. En parallèle, deux études expérimentales ont été menées sur l'exacte reproduction physique du modèle : l'une pour estimer les pertes de pression provoquées par des écoulements d'air et d'oxhel (mélange hélium (78 %) - oxygène (22 %)), l'autre pour mesurer les vitesses par IRM d'un écoulement d'hélium-3 hyperpolarisé. Les résultats obtenus en terme d'écoulement et de quantité de particules déposées dans la région ET sont en accord avec les rares données expérimentales existantes. Ils montrent l'influence prépondérante de la géométrie tant sur l'écoulement (marqué par la présence, vérifiée expérimentalement, du jet laryngeal) que sur le dépôt. Les zones préférentielles de dépôt se situent là où des variations géométriques brusques surviennent (rétrécissement de section et courbures près de l'épiglotte et en amont de la glotte), et là où le caractère turbulent de l'écoulement est prononcé (en fin de larynx notamment). Ces constatations ont permis de caractériser avec précision le dépôt à l'aide de deux nombres adimensionnés : le nombre de Stokes, caractéristique de l'impaction inertielle et le nombre de Reynolds, caractéristique du régime de l'écoulement. L'étude a permis une meilleure appréhension des influences des divers paramètres à considérer pour modéliser une inhalation d'aérosol médicament et, de surcroît, une prévision des quantités de médicament déposée et transmise à l'arbre respiratoire, soit un outil précieux pour l'optimisation des thérapies inhalées. La méthodologie, ainsi développée, est applicable aux morphologies issues d'une étude clinique en cours et permettra d'affiner la caractérisation / Inhaled therapies were originally developed to treat respiratory diseases (e.g., asthma and COPD). They are now the subject of research to deliver medicine to the blood through the alveolar-capillary barrier. The efficacy of such therapies lies in the quantity of medicine that reaches the targeted area in the respiratoy tree. The extrathoracic region (called "ET" and including the mouth, the oropharynx, the larynx and the beginning of the trachea) has the role of a "filter" limiting the amount of medicine that is deposited in the targeted area. In order to optimize the administration of aerosol medicine, it is necessary to know the influence of the various parameters of an inhalation (among others, the inhalation flow rate, the diameter of inhaled particles, the physical properties of the cariier gas). Therefore, a realistic model of the ET region has been constructed from data obtained from medical imaging. The Navier-Stokes equations were numerically solved (i) to describe the flow in the model and (ii) to determine the trajectories of inhaled particles. The numerical analysis required the development of an appropriate mesh and the choice of turbulence model and parameters. In parallel, two experimental studies were performed on an exact physical reproduction of the model : one to estimate the pressure losses in air and oxhel (a helium (78 %) - oxygen (22 %) mixture) flows and another to measure the velocity field using a MRI of a hyperpolarized helium-3 flow. The flow and deposition results that were obtained in the model of the ET region are in agreement with the few existing experimental data. They show the dominant effect of the geometry not only on the flow (marked by the experimentally verified presence of the laryngeal jet) but also on the particle deposition. The major areas of deposition are located where sudden geometrical changes are observed (like the constrictions and the bends near the epiglottis and upstream the glottis) and where the turbulent character of the flow is pronounced (particulary at the end of the larynx). These observations allowed for the accurate characterization of the deposition with non-dimensional numbers : the Stokes number, characteristic number of the inertial impaction, and the Reynolds number, characteristic number of the flow regime. The study allows for the improved comprehension of the influences of the various parameters that must be considered to model the inhalation of aerosol medicine. Furthermore, predictions in terms of the deposited and transmitted mass of medicine were possible. The methodology explained herein will be applicable to the morphologies that are to be obtained from an on-going clinical study

Introdução: Atribui-se à poluição atmosférica aproximadamente 800 mil mortes prematuras anualmente ao redor do mundo, sendo que diversos estudos têm mostrado que mesmo quando as emissões dos poluentes estiveram em conformidade com os padrões estabelecidos, mudanças dos níveis de poluição em curtos períodos, sazonalmente, ou em longo prazo produziram efeitos nocivos sobre a saúde das populações expostas. Dentre estas populações, idosos e crianças foram os mais sensíveis a esses efeitos. Vitória é uma cidade industrial que tem enfrentado um aumento da sua frota automotiva e, conseqüentemente, um aumento das concentrações dos poluentes atmosféricos. O presente trabalho comparou a prevalência de sintomas respiratórios em escolares expostos predominantemente aos poluentes atmosféricos emitidos por indústrias e por veículos automotores. Casuística e Métodos: Estudo transversal, exploratório, em uma amostra de 350 crianças em duas escolas localizadas em áreas com diferentes fontes predominantes de poluição atmosférica (industrial e automotiva). As fontes predominantes de poluição atmosférica em cada área foram identificadas através da análise de componentes principais, tendo como base os componentes químicos identificados em folhas de Tradescantia pallida expostas através da técnica de fluorescência de Raio-X. Foi aplicado o questionário International Study of Asthma and Allergies in Childhood (ISAAC) para investigar os sintomas respiratórios. Outros sintomas e condições de moradia foram avaliados através de um questionário complementar. A associação entre a freqüência dos sintomas entre as áreas foi investigada através do teste de Qui-quadrado. Modelos de regressão logística foram usados para os cálculos das razões de chances prevalentes (OR). Resultados: Não houve associação significativa nas prevalências dos sintomas pesquisados entre as áreas investigadas. Em relação às morbidades referidas, rinite mostrou uma associação significativa com local de moradia próxima à área industrial, OR= 2 (IC95%: 1,1; 3,7). Embora não tenham sido encontradas associações, asma, tosse e coriza também foram mais freqüentes nas crianças moradoras na área industrial. Conclusão: Os resultados encontrados na cidade de Vitória sugerem que o risco de exposição às emissões industriais pode ser maior que o da emissão por fontes automotivas / Introduction: Almost 800 thousand premature deaths have been attributed to the air pollution around the world, and several studies have showed that even when the established patterns for pollutants emissions were achieved, short and seasonal changes in the pollutant levels, or long term changes may lead to a different harmful health effects on the exposed population. The elderly and children have been identified the most susceptible groups in terms of air pollution health effects. Vitória is a seaboard Brazilian industrial city, which has faced an increase in the automotive fleet in the last decade, and, consequently, air pollution levels. Casuistic and methods: This study compared the prevalence of respiratory symptoms in school children exposed, mainly, to industrial or automotive sources. We carried out a cross sectional study with 350 children of two schools located in different areas. The main source of air pollution in each area was assessed by factor analysis based on components identified in Tradescantia pallid leafs through fluorescence x-ray technique. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was applied to investigate respiratory symptoms. Referred respiratory morbidity was also investigated. Associations between areas and frequency of symptoms were tested with the chi-square test. Logistic regression models were used to calculate the prevalent odds ratio (OR) of the main respiratory symptoms. Results: There was no significant association between area and prevalence of respiratory symptoms. In terms of referred disease, rhinitis was associated with living in the industrial area, OR= 2 (CI95%:1.1; 3.7). Although without significant statistical association, asthma, cough and flue were also more frequent among those living in the industrial area. Conclusion: Despite the increase of automotive contribution to the pool of air pollutants in the city of Vitória, our results suggest that, in this specific situation, being exposed to industrial emissions may be more hazardous than being exposed to automotive emissions

Em uma amostra de 12 por cento da população urbana de Botucatu, São Paulo, constituída de 7.075 pessoas, foram identificados 525 indivíduos com sintomas sugestivos de doença respiratória crônica inespecífica (DRCI). Utilizando o questionário de sintomas respiratórios \"ATS-DLD-78\", aplicado por entrevistadores leigos, a autora determinou a prevalência de alguns sintomas e de associações sugestivas de asma brônquica, bronquite crônica e doença pulmonar obstrutiva crônica (DPOC). Os sintomas mais frequentes no sexo masculino, foram: tosse, expectoração e chiado, cuja prevalência foi de 6,2 por cento , 5,4 por cento e 5,3 por cento , respectivamente. No sexo feminino os sintomas mais frequentes foram: tosse, chiado, dispnéia e rinite alérgica cujas taxas de prevalência foram: 4,7 por cento , 4,7 por cento , 4,2 por cento e 4,0 por cento , respectivamente. Houve maior prevalência de sintomas respiratórios nos maiores de 50 anos de idade e nos menores de 15 anos. A prevalência média de sintomas sugestivos de asma brônquica foi de 5, 0 por cento , e de 1,9 por cento para bronquite crônica e de 0,1 por cento para DPOC. A influência do hábito de fumar, presente entre os sintomáticos respiratórios em 33,7 por cento dos homens e 23,4 por cento das mulheres, foi estudada em relação aos sintomas de tosse e expectoração pela manhã e aos sintomas sugestivos de bronquite crônica. Em vista dos resultados, a autora analisa e comenta a metodologia utilizada e a aplicabilidade do questionário \"ATS-DLD-78\" em nosso meio. Frente a escassez de dados relativos às DRCI, no Brasil, conclui sobre a necessidade de novos inquéritos epidemiológicos em regiões diferentes, realizados com metodologia adequada que possibilite a comparação dos resultados, complementados, quando possível, por estudos clínicos, tendo em vista o planejamento de medidas e programas de intervenção. / In a sample of 12 per cent of the urban population of Botucatu, São Paulo (7075 persons) submitted to a general health and life conditions survey, 525 people with symptoms of inespecific chronic respiratory diseases (ICRD) were detected. The \"ATS-DLD-78\" questionnaire for respiratory symptoms was applyed to these 525 people by non-medical interviewers, and from the collected data the prevalence of some symptoms and association of symptoms suggesting asthma, chronic bronchitis and chronic obstructive pulmonar disease (COPD) was determined. The most frequent symptoms in males were cough (6,2 per cent ), expectoration (5.4 per cent ) and wheezing (5.3 per cent ) and in females, cough (4.7 per cent ), wheezing (4.7 per cent ), dyspnea (4.2 per cent ) and allergic rhinitis (4.01). The prevalence os respiratory symptoms was greater before 15 after 50 years of age. The mean prevalence of symptoms suggesting asthma was 5.0 per cent , suggesting chronic bronchitis, 1.9 per cent and COPD 0,1 per cent . Tobacco smoking was presente in 33.7 per cent of symptomatic men and 23.4 per cent of the symptomatic women. There was a relation between smoking and the presence of morning cough and phlegm and symptoms of chronic bronchitis. The used metodology and the applicability of the \"ATS-DLD-78\" questionnaire to our population is analysed and commented. Taking into account the scarcity of data about ICRD in Brazil, the author concludes emphazising the need of another epidemiological surveys in different parts of the country, using tested and standardized methods that make possible a comparison of data, with the aim of planning intervention measures and programmes.

Este trabalho é um estudo híbrido, prospectivo e transversal, de uma coorte de 280 mineiros de carvão de subsolo, selecionados por possuírem espirometrias aceitáveis nas investigações de 1984 e 1989. Em ambas as ocasiões, êles responderam a questionários de sintomas respiratórios e exposições ocupacionais, fizeram espirometrias, e foram submetidos a uma radiografia do torax. Em 1989, em adição, fizeram um teste de provocação brônquica inespecífica. Os métodos de análise empregados foram: análises descritivas, medidas de associação, análises de variância , e modelos de regressão logística e linear. Em 1989, as médias e os desvios-padrão de idade e de anos de subsolo era de 34,9± 5,1, e 10,4 ± 3,9, respectivamente. Todos os mineiros eram do sexo masculino e 252 (90 por cento ), brancos. A tosse, e o catarro foram os sintomas predominantes em ambas as ocasiões. No seguimento, 27,9 por cento dos mineiros apresentavam sintomas compatíveis com bronquite crônica. O chiado foi o único sintoma a evoluir significativamente durante o período de observação. A tosse, o catarro e a bronquite crônica, foram fundamentalmente dependentes do tabagismo e reversíveis com o abandono do hábito, ao passo que a dispnéia e o chiado associaram-se à exposição ocupacional. Dezoito por cento dos mineiros tinham sintomas compatíveis com asma, em 1989, enquanto 12,1 por cento referiram sintomas compatíveis com asma ocupacional. Destes últimos, 44,1 por cento apresentaram hiperreatividade brônquica. A prevalência de pneumoconiose foi de 5,4 por cento em 1984, e 7,9 por cento em 1989. A incidência anual de PMC foi de 11,4/1.000 mineiros expostos. A progressão radiológica associou-se significativamente à exposição ajustada, tabagismo, ao componente sinérgico entre exposição e tabagismo, e a um VEF1 mais baixo. Mineiros com opacidades irregulares ao Rx tenderam a apresentar uma pior função pulmonar. Houve um discreto crescimento da CVF média da coorte durante os 5 anos. O VEF1 e o IT declinaram no mesmo período. O VEF1 identificou apenas 2,5 por cento mineiros com valores anormais, enquanto que o IT identificou 15,7 por cento . O tabagismo foi o principal fator associado a alterações espirométricas. Em relação ao IT, houve ainda um efeito significante do componente sinérgico da exposição e do tabagismo. A hiperreatiVidade brônquica associou-se significativamente a resíduos negativos do VEF1 e do IT. O declínio longitudinal do VEF1 foi superior ao calculado transversalmente, em 1984 e 1989, e superior ao declínio previsto em indivíduos normais. A hiperreatividade brônquica associou-se, também, a um declínio acelerado do VEF1. Concluimos que os resultados aqui descritos são uma estimativa conservadora dos efeitos reais da exposição ocupacional, devido à seleção da coorte, e também a outros vieses. Há fortes indícios da presença de asma ocupacional neste grupo, assim como uma elevada incidência de PMC, e um declínio acelerado do VEF1. O tabagismo foi o principal fator de risco relacionado à deterioração funcional, em mineiros de carvão ativos, com uma média de 10 anos de subsolo, porém houve um efeito potencializador da exposição ocupacional. / This is a hybrid study in a cohort of 280 coalminers, with both prospective and cross sectional components. They were selected when they succeded in having acceptable spirometries and attended the 1984 and 1989 investigations. On both occasions they were submitted to a questionnaire of respiratory symptoms and occupational exposures, spirometry, and a chest x-ray. In addition, in 1989, they had a nonspecific bronchial challenge test. The statistical methods included, descriptive analysis, measures of association, analysis of variance, and logistic and linear regression models. In 1989, the mean age and the mean number of years of exposure were, 34.9 .±. 5.1, and 10.4 .±. 3.9, respectively. All miners were male, and 252 (90 per cent ) white. Cough and phlegm were the most prevalent symptoms. In the follow up, 27.9 per cent had symptoms of chronic bronchitis. Wheezing was the only symptom that increased significantly during the observation period. Cough, phlegm and chronic bronchitis were basically associated with smoking, and reversible upon the cessation of the habit, whereas breathlessness and wheezing were associated with dust exposure. In 1989, 18 per cent of the miners had asthma symptoms, and 12.1 per cent had symptoms compatible with occupational asthma. Forty-four percent of thela ter had bronchial hyperresponsiveness. The prevalence of pneumoconiosis was 5.4 per cent in 1984, and 7.9 per cent in 1989. The annual incidence of CWP was 11.4/1,000 miners at risk. Radiological progression was significantly associated with adjusted exposure, smoking, an interacion term involving exposure and smoking, anda low FEV1 Irregular opacities on the x-ray were non-significantly associated with a worse pulmonary function. During those 5 years there was a discrete growth in the mean FVC. The FEV1 and the FEV1/FVC per cent declined in the same period. The FEV1 identified only 2.5 per cent miners with abnormal results, whereas the FEV1/FVC per cent identified 15.7 per cent . Smoking was the main variable associated with spirometric abnormalities. The interaction term of exposure and smoking was also significantly associated with an abnormal FEV1/FVC per cent . Bronchial hyperresponsiveness was significantly associated with negative FEV, and FEV1/FVC per cent residuais. The longitudinal decline of the FEV1 was greater than the cross-sectional decline, both in 1984 and 1989, and also greater than the predicted decline in normal adults. Bronchial hyperresponsiveness was also associated with a rapid decline in FEV1. We conclude that these findings are an underestimate of the real effects of the dust exposure, because of the cohort selection, and also because of other bias. There are strong evidences of the ocurrence of occupational asthma, of a high incidence of CWP, and of a rapid decline the FEV1 in this cohort. Smoking was the main factor linked to functional deterioration in active coalminers with a mean of 10 years of exposure, but there was a synergistic effect of dust exposure.

Introdução - Alguns tipos de fungos, como o mofo, são de fundamental importância médica, principalmente por produzirem toxinas nocivas à saúde dos humanos. São frequentemente encontrados no interior dos domicílios quando há condição favorável, como umidade e temperatura adequada. Vários estudos relataram associação entre mofo e doenças alérgicas ou respiratórias em crianças. Objetivos - Descrever as características dos domicílios dos recém-nascidos incluídos em um estudo de coorte na cidade de São Paulo e identificar as possíveis associações com o desenvolvimento de mofo visível nas superfícies (paredes, piso e teto). Métodos - Este trabalho faz parte de uma coorte de recém-nascidos com início em 2003 e término em 2007, denominada PROJETO CHIADO. Participaram do estudo 378 domicílios. Entrevistadores fizeram visitas nestas residências para coletar dados referentes às características dos domicílios (tipo de cobertura, tipo de forro, idade da construção) e condições intra-domiciliares (ventilação, aglomeração, incidência solar, temperatura, presença de umidade, presença de mofo). Foram realizadas análises descritivas e análises bivariável e multivariável (regressão logística) para identificar possíveis associações entre as características dos domicílios e a presença de mofo. Resultados Foi encontrado mofo visível na maioria dos domicílios visitados (66 por cento), sendo 28 por cento no quarto da criança e 38 por cento em outros cômodos. Foi relatada umidade em aproximadamente metade dos domicílios (47 por cento) e ventilação regular, ruim ou péssima em 42 por cento. Foram identificadas associações positivas entre a presença de mofo no quarto da criança e ventilação ruim ou péssima (OR=2,14; IC95 por cento:1,05-4,38), falta de incidência solar no verão (OR=3,84; IC95 por cento:1,59-9,28) e aglomeração de quatro ou mais pessoas no quarto da criança (OR=2,09; IC95 por cento:1,24-3,50). Por outro lado, os tipos construtivos apresentaram associação inversa com o mofo (OR=0,41; IC95 por cento: 0,17-1,01) para cobertura com telha de cerâmica e forro de madeira ou cobertura com fibrocimento e forro de concreto e OR=0,40; IC95 por cento: 0,18-0,90 para cobertura com telha de cerâmica e forro de concreto. Conclusão Ventilação precária, falta de incidência solar no domicílio durante o verão e aglomeração de pessoas no domicílio propiciam o desenvolvimento de mofo enquanto que os tipos construtivos com coberturas feitas com materiais de maior densidade protegem os domicílios contra o desenvolvimento de mofo. A partir do conhecimento das características dos domicílios, é possível realizar intervenções para evitar o crescimento do mofo / Introduction Some kind of fungi, such as mold, has fundamental medical importance, especially by producing toxins harmful to human health. They are often found inside the homes when there are favorable conditions, such as appropriated humidity and temperature. Several studies have reported associations between mold and respiratory and allergic diseases in children. Objectives To describe the household characteristics of the newborns included in a cohort study in the city of São Paulo and to identify possible associations with the visible mold development on the surfaces (walls, floors and ceiling). Methods This study is part of a newborns cohort study that started in 2003 and finished in 2007, called WHEEZING PROJECT. 378 households participated in the study. Interviewers visited the homes to collect data from households characteristics (type of roof, type of ceiling, building age) and indoor conditions (ventilation, crowding, solar incidence, temperature, presence of moisture, presence of mold). Descriptive analyses and bivariate and multivariate analyses (logistic regression) were performed to identify associations between households characteristics and the presence of mold. Results Visible mold was found in most households visited (66 per cent), 28 per cent in the child´s room and 38 per cent in the other rooms. Moisture was reported in 47 per cent of the houses, and regular, bad or very bad ventilation in 42 per cent. Positive associations were found between the presence of mold in the homes and bad or very bad ventilation (OR=2,14; 95 per centCI: 1,05-4,38), no solar incidence in the summer (OR=3,84; 95 per centCI: 1,59-9,28) and crowding of at least four people in the child´s room (OR=2,09, 95 per centCI: 1,24-3,50). On the other hand, the type of construction showed inverse association with the mold (OR=0,41; 95 per centCI: 0,17-1,01) to ceramic tile roof and wood ceiling or cement-fibre roof and concrete ceiling and OR=0,40; CI IC95 per cent: 0,18-0,90 to ceramic tile and concrete ceiling. Conclusion Poor ventilation, no solar incidence in the home during the summer and crowding in the child´s room facilitate the development of mold, while the type of construction with high density materials protects the homes against the mold development. From the knowledge of the households characteristics, it is possible to perform interventions to prevent mold growth

Este trabalho é um estudo híbrido, prospectivo e transversal, de uma coorte de 280 mineiros de carvão de subsolo, selecionados por possuírem espirometrias aceitáveis nas investigações de 1984 e 1989. Em ambas as ocasiões, êles responderam a questionários de sintomas respiratórios e exposições ocupacionais, fizeram espirometrias, e foram submetidos a uma radiografia do torax. Em 1989, em adição, fizeram um teste de provocação brônquica inespecífica. Os métodos de análise empregados foram: análises descritivas, medidas de associação, análises de variância , e modelos de regressão logística e linear. Em 1989, as médias e os desvios-padrão de idade e de anos de subsolo era de 34,9± 5,1, e 10,4 ± 3,9, respectivamente. Todos os mineiros eram do sexo masculino e 252 (90 por cento ), brancos. A tosse, e o catarro foram os sintomas predominantes em ambas as ocasiões. No seguimento, 27,9 por cento dos mineiros apresentavam sintomas compatíveis com bronquite crônica. O chiado foi o único sintoma a evoluir significativamente durante o período de observação. A tosse, o catarro e a bronquite crônica, foram fundamentalmente dependentes do tabagismo e reversíveis com o abandono do hábito, ao passo que a dispnéia e o chiado associaram-se à exposição ocupacional. Dezoito por cento dos mineiros tinham sintomas compatíveis com asma, em 1989, enquanto 12,1 por cento referiram sintomas compatíveis com asma ocupacional. Destes últimos, 44,1 por cento apresentaram hiperreatividade brônquica. A prevalência de pneumoconiose foi de 5,4 por cento em 1984, e 7,9 por cento em 1989. A incidência anual de PMC foi de 11,4/1.000 mineiros expostos. A progressão radiológica associou-se significativamente à exposição ajustada, tabagismo, ao componente sinérgico entre exposição e tabagismo, e a um VEF1 mais baixo. Mineiros com opacidades irregulares ao Rx tenderam a apresentar uma pior função pulmonar. Houve um discreto crescimento da CVF média da coorte durante os 5 anos. O VEF1 e o IT declinaram no mesmo período. O VEF1 identificou apenas 2,5 por cento mineiros com valores anormais, enquanto que o IT identificou 15,7 por cento . O tabagismo foi o principal fator associado a alterações espirométricas. Em relação ao IT, houve ainda um efeito significante do componente sinérgico da exposição e do tabagismo. A hiperreatiVidade brônquica associou-se significativamente a resíduos negativos do VEF1 e do IT. O declínio longitudinal do VEF1 foi superior ao calculado transversalmente, em 1984 e 1989, e superior ao declínio previsto em indivíduos normais. A hiperreatividade brônquica associou-se, também, a um declínio acelerado do VEF1. Concluimos que os resultados aqui descritos são uma estimativa conservadora dos efeitos reais da exposição ocupacional, devido à seleção da coorte, e também a outros vieses. Há fortes indícios da presença de asma ocupacional neste grupo, assim como uma elevada incidência de PMC, e um declínio acelerado do VEF1. O tabagismo foi o principal fator de risco relacionado à deterioração funcional, em mineiros de carvão ativos, com uma média de 10 anos de subsolo, porém houve um efeito potencializador da exposição ocupacional. / This is a hybrid study in a cohort of 280 coalminers, with both prospective and cross sectional components. They were selected when they succeded in having acceptable spirometries and attended the 1984 and 1989 investigations. On both occasions they were submitted to a questionnaire of respiratory symptoms and occupational exposures, spirometry, and a chest x-ray. In addition, in 1989, they had a nonspecific bronchial challenge test. The statistical methods included, descriptive analysis, measures of association, analysis of variance, and logistic and linear regression models. In 1989, the mean age and the mean number of years of exposure were, 34.9 .±. 5.1, and 10.4 .±. 3.9, respectively. All miners were male, and 252 (90 per cent ) white. Cough and phlegm were the most prevalent symptoms. In the follow up, 27.9 per cent had symptoms of chronic bronchitis. Wheezing was the only symptom that increased significantly during the observation period. Cough, phlegm and chronic bronchitis were basically associated with smoking, and reversible upon the cessation of the habit, whereas breathlessness and wheezing were associated with dust exposure. In 1989, 18 per cent of the miners had asthma symptoms, and 12.1 per cent had symptoms compatible with occupational asthma. Forty-four percent of thela ter had bronchial hyperresponsiveness. The prevalence of pneumoconiosis was 5.4 per cent in 1984, and 7.9 per cent in 1989. The annual incidence of CWP was 11.4/1,000 miners at risk. Radiological progression was significantly associated with adjusted exposure, smoking, an interacion term involving exposure and smoking, anda low FEV1 Irregular opacities on the x-ray were non-significantly associated with a worse pulmonary function. During those 5 years there was a discrete growth in the mean FVC. The FEV1 and the FEV1/FVC per cent declined in the same period. The FEV1 identified only 2.5 per cent miners with abnormal results, whereas the FEV1/FVC per cent identified 15.7 per cent . Smoking was the main variable associated with spirometric abnormalities. The interaction term of exposure and smoking was also significantly associated with an abnormal FEV1/FVC per cent . Bronchial hyperresponsiveness was significantly associated with negative FEV, and FEV1/FVC per cent residuais. The longitudinal decline of the FEV1 was greater than the cross-sectional decline, both in 1984 and 1989, and also greater than the predicted decline in normal adults. Bronchial hyperresponsiveness was also associated with a rapid decline in FEV1. We conclude that these findings are an underestimate of the real effects of the dust exposure, because of the cohort selection, and also because of other bias. There are strong evidences of the ocurrence of occupational asthma, of a high incidence of CWP, and of a rapid decline the FEV1 in this cohort. Smoking was the main factor linked to functional deterioration in active coalminers with a mean of 10 years of exposure, but there was a synergistic effect of dust exposure.