A thirty year follow-up survey was carried out to determine the prevalence of adult onset wheeze in a randomly selected community cohort of 2,056 adults who had had no childhood respiratory symptoms when they were originally studied in 1964. New onset wheezing symptoms developed at a steady rate of 0.5 per 100 person years between age 15 and 14; 11.5% of subjects reported having had an attack of wheezing for the first time during this period of their lives. Adult onset disease accounted for a greater proportion (62.9%) of current wheezing in middle age than child onset disease (37.1%). The risk of adult onset wheeze among all cases who had ever wheezed since age 15 increased with low socioeconomic status, current smoking, positive atopic status and positive family history of atopic disease. Gender was not related to risk of wheeze. Vitamin C and E consumption were inversely related to the risk of current wheeze (i.e. wheeze in the previous 12 months); analyses stratified by social class and smoking habit suggested that these inverse associations were stronger in the manual compared to the nonmanual class, and among smokers compared to nonsmokers. Childhood factors, including father's social class, sibship structure and common childhood infections were not related to adult onset wheeze. The pattern of significant independent risk factors differed between three distinct subgroups of cases who reported doctor-diagnosed asthma (n=24), chronic cough and phlegm (n=31) or other wheeze (n=47). Manual social class was associated with cough and phlegm and other wheeze. Smoking was only related to cough and phlegm. Atopy was associated with doctor-diagnosed asthma and with cough and phlegm. Family history of atopic disease was related to all subgroups, suggesting that despite apparent heterogeneity in diagnostic labelling, concurrent symptoms and other risk factors, the different forms of adult onset wheeze may share a common allergic basis.

Background: Wheezing is one of the most common respiratory illnesses in children worldwide. Severe wheeze can result in significant morbidity, caregiver burden and increased health care costs. In addition, early childhood wheeze may be associated with reduced lung function, diminished airway responsiveness, increased risk of asthma in late childhood and subsequent respiratory disease including asthma in adulthood. This is particularly true in those experiencing recurrent wheeze episodes, which in the presence of viral respiratory tract infections, are believed to lead to asthma diagnosis. Thus, it is imperative to understand the risk factors for early childhood wheeze to reduce the increasing burden of respiratory illness. Recent research has seen a shift to maternal psychosocial risk factors and the impact these have on child respiratory health outcomes, such as wheeze. Various studies, largely conducted in High Income Countries (HIC), have found associations between antenatal or postnatal psychosocial risk factors, such as depression, psychological distress, and Intimate Partner Violence (IPV), and child wheeze and/or asthma diagnosis in early stages of life. However, these studies predominantly considered those in low-income urban regions that were predisposed to respiratory illnesses, including wheeze and asthma. Utilising the techniques and knowledge gained from previous studies, this research considers the relationship between antenatal or postnatal maternal psychosocial exposures and the onset and recurrence of child wheeze in a South African setting. In the study population used for this research, the reported prevalence of antenatal psychological distress and depression was 23% and 20%, respectively, while 34% of the women were exposed to antenatal IPV. Often those suffering from poor mental health in these contexts are not recognised and therefore remain untreated. In addition, service provision in these settings is also generally poor. The combination of low levels of social and psychiatric support, with unique political and socio-economic risk factors, may result in more persistent and severe forms of psychosocial exposure in Low Middle Income Countries (LMIC). Given the high prevalence of psychosocial risk factors, as well as the high prevalence of child wheeze, South Africa provides an excellent platform to investigate the association between maternal antenatal or postnatal psychosocial exposure and the development and recurrence of child wheeze in an LMIC context. Methods: The data used for this research was provided by the Drakenstein Child Health Study (DCHS), a prospective birth cohort study conducted in the Drakenstein region, a peri-urban region outside of Paarl in the Western Cape of South Africa. Pregnant women over 18 years old, between 20-28 weeks' gestation, living in the region were enrolled in a parent study, in order to investigate the epidemiology and aetiology of respiratory illnesses in children. The parent study considered various risk factors, including psychosocial risk factors such as maternal depression, psychological distress and IPV, which were measured antenatally and postnatally by validated questionnaires. In the context of this research, wheeze was considered to be present if it was identified during any routine study follow-up visit, as well as at an unscheduled lower respiratory tract infection (LRTI) episode visit during the first two years of life. Recurrent wheeze was defined as experiencing two or more episodes of wheeze in a 12-month period. Logistic regression was used to investigate the relationship between antenatal and postnatal psychosocial risk factors and child wheeze. Results: From the results, postnatal psychological distress and IPV were associated with experiencing at least one episode of child wheeze (adjusted OR = 2.10, 95% CI: 1.16-3.79 and 1.60, 95% CI: 1.11-2.29 respectively) and recurrent wheeze (adjusted OR = 2.33, 95% CI: 1.09- 4.95 and 2.22, 95% CI: 1.35-3.63 respectively), within the first two years of life. No associations were found between antenatal psychosocial risk factors and child wheeze. Of clinical covariates explored, maternal smoking and household smoke exposure, birth weight, gestational age, sex and population group were associated with the presence of wheeze. All of these clinical covariates, as well as alcohol consumption were associated with recurrent child wheeze. Conclusion: Maternal postnatal psychological distress and postnatal IPV had the strongest impact on predicting wheeze outcomes. These findings suggest that screening and treatment programs which address maternal postnatal psychosocial risk factors may lessen the burden of childhood wheeze in LMIC settings.

No description available.

No description available.

Per and polyfluorinated compounds (PFCs) include a large group of chemicals which are known to be toxic, bioaccumulative and resistant to hydrolysis, photolysis, microbial degradation and metabolism. However, human exposure pathways and toxic effects to humans are still widely unknown and more data is needed over time. The concentrations of 7 PFCs were measured in indoor air from homes in Winnipeg, Manitoba using gas chromatography-mass spectrometry. 16 PFCs were measured in house dust from Winnipeg, Manitoba using on-line solid phase extraction coupled with liquid chromatography mass spectrometry. For commonly detected PFCs in indoor air and dust, concentrations were found at pg/m3 and ng/g levels, respectively, similar to that observed in other recent studies. Appropriate statistical tests and principal component analysis were used to evaluate possible associations between PFC concentrations and home characteristics. PFCs in indoor air and dust were associated with each other and home characteristics but not with indoor ambient temperature nor type of room (child room or the most used room). Furthermore PFCs did not show significant association with infant wheezing. None of the neutral PFCs in indoor air showed an association with seasonal temperature variation, except 8:2 FTOH and MeFOSE that had significantly higher concentrations in winter than summer.

Objetivo: Avaliar a prevalência, a gravidade e os fatores de risco associados à sibilância recorrente em crianças nos primeiros dois anos de vida em uma coorte de nascimentos. Métodos: Estudo de coorte prospectivo de 3167 crianças nascidas em Ribeirão Preto, SP, no ano de 2010 e avaliadas para esse estudo entre 12 e 24 meses. Os responsáveis pelos lactentes participantes responderam a questionários padronizados com questões referentes às características maternas, condições gestacionais, perinatais e pós-natais, antecedentes pessoais e familiares de doenças alérgicas, ocorrência e número de episódios de sibilância, ida a serviços de emergência, uso de medicações, diagnóstico de pneumonia e internações. O estudo das associações entre os desfechos e as variáveis independentes de interesse foi feito por meio de análise univariada e por modelos log-binomiais ajustados, obtendose medidas de risco relativo (RR) e seus intervalos de confiança (IC). Resultados: A prevalência de pelo menos um episódio de sibilância nos dois primeiros anos de vida foi de 56,3% (1785/3167), sendo que 35,8% (1136/3167) lactentes apresentaram sibilância ocasional (até dois episódios) e 20,1% (639/3167) apresentaram sibilância recorrente (três ou mais episódios). Sibilância recorrente grave (mais de 6 episódios) foi relatada em 8,7% lactentes (277/3167). Os fatores de risco independentes para apresentar de 3 a 6 episódios de sibilância foram: prematuridade (RR=1,46), tabagismo passivo (RR= 1,72, se menos de 10 cigarros/dia e RR=2,04. se mais de 10 cigarros/dia), frequentar a creche após os 6 meses (RR= 1,31), diagnóstico médico de rinite alérgica (RR= 1,52) e presença de carpete no domicílio (RR= 1,59). Os principais fatores de risco associados à sibilância grave foram: tabagismo passivo (RR= 2,89 para mais de 10 cigarros/dia), frequentar creche (RR= 2,43, se início até os 6 meses e RR: 1,49, se início após os 6 meses), resfriados nos 3 primeiros meses de vida (RR= 2,17), asma (RR= 1,50) e dermatite atópica na família (RR= 1,49) e diagnóstico de rinite alérgica (RR= 1,93). Lactentes brancos apresentaram prevalência menor de sibilância recorrente não grave (RR=0,68). Não houve associação entre o tempo de aleitamento materno e sibilância recorrente. Conclusões: Crianças nascidas em Ribeirão Preto apresentam alta prevalência de sibilância recorrente nos dois primeiros anos de vida. Nessa fase precoce da vida, medidas ambientais visando a diminuição da exposição à fumaça do cigarro e a prevenção de infeções virais poderiam resultar na redução dos casos de sibilância recorrente grave nesta população. / Objective: To evaluate the prevalence, severity and risk factors associated with recurrent wheezing in children in early years of life. Methods: Prospective cohort study of 3167 children born in Ribeirão Preto, São Paulo, in 2010, and evaluated for this study at 12-24 months of age. A standardized questionnaire with questions regarding maternal characteristics, gestational, perinatal and postnatal conditions, family and children allergy, occurrence of wheezing, number of wheezing episodes, daycare attendance, visits to emergency, medication use, diagnosis of pneumonia and hospitalizations was applied to caregivers . Associations between outcomes and the independent variables of interest were done through univariate analysis and adjusted log-binomial models. Relative risks (RR) and confidence intervals (CI) were calculated. Results: The prevalence of at least one episode of wheezing in the first two years of life was 56.3% (1785/3167), 35.8% (1136/3167) infants had occasional wheezing (up to two episodes) and 20,1% (639/3167) had recurrent wheezing (three or more episodes). Severe recurrent wheeze (more than 6 episodes) was reported in 8.7% infants (277/3167). The independent risk factors for presenting 3 to 6 episodes of wheezing were prematurity (RR = 1.46), passive smoking (RR = 1.72 for less than 10 cigarettes / day, RR = 2.04 for more than 10 cigarettes / day), daycare attendance after 6 months (RR = 1.31), medical diagnosis of allergic rhinitis (RR = 1.52) and the presence of carpet at home (RR = 1.59). The main risk factors associated with severe wheezing were passive smoking (RR = 2.89 for more than 10 cigarettes / day), daycare attendance (RR = 2.43 if was started before 6 months and RR=1.49, if started after 6 months), acute upper respiratory infections during the first 3 months of life (RR = 2.17), asthma (RR = 1.50) and atopic dermatitis in the family (RR = 1.49) and diagnosis of allergic rhinitis (RR = 1.93). White infants have a lower prevalence of non-severe recurrent wheezing (RR = 0.68). There was no association between duration of breastfeeding and recurrent wheeze Conclusions: Children born in Ribeirão Preto have a high prevalence of recurrent wheezing in the first two years of life. In this early stage of life, environmental measures to reduce the exposure to cigarette smoke and prevention of viral infections could result in the reduction of severe recurrent wheezing in this population.

Objetivo: Avaliar a prevalência, a gravidade e os fatores de risco associados à sibilância recorrente em crianças nos primeiros dois anos de vida em uma coorte de nascimentos. Métodos: Estudo de coorte prospectivo de 3167 crianças nascidas em Ribeirão Preto, SP, no ano de 2010 e avaliadas para esse estudo entre 12 e 24 meses. Os responsáveis pelos lactentes participantes responderam a questionários padronizados com questões referentes às características maternas, condições gestacionais, perinatais e pós-natais, antecedentes pessoais e familiares de doenças alérgicas, ocorrência e número de episódios de sibilância, ida a serviços de emergência, uso de medicações, diagnóstico de pneumonia e internações. O estudo das associações entre os desfechos e as variáveis independentes de interesse foi feito por meio de análise univariada e por modelos log-binomiais ajustados, obtendose medidas de risco relativo (RR) e seus intervalos de confiança (IC). Resultados: A prevalência de pelo menos um episódio de sibilância nos dois primeiros anos de vida foi de 56,3% (1785/3167), sendo que 35,8% (1136/3167) lactentes apresentaram sibilância ocasional (até dois episódios) e 20,1% (639/3167) apresentaram sibilância recorrente (três ou mais episódios). Sibilância recorrente grave (mais de 6 episódios) foi relatada em 8,7% lactentes (277/3167). Os fatores de risco independentes para apresentar de 3 a 6 episódios de sibilância foram: prematuridade (RR=1,46), tabagismo passivo (RR= 1,72, se menos de 10 cigarros/dia e RR=2,04. se mais de 10 cigarros/dia), frequentar a creche após os 6 meses (RR= 1,31), diagnóstico médico de rinite alérgica (RR= 1,52) e presença de carpete no domicílio (RR= 1,59). Os principais fatores de risco associados à sibilância grave foram: tabagismo passivo (RR= 2,89 para mais de 10 cigarros/dia), frequentar creche (RR= 2,43, se início até os 6 meses e RR: 1,49, se início após os 6 meses), resfriados nos 3 primeiros meses de vida (RR= 2,17), asma (RR= 1,50) e dermatite atópica na família (RR= 1,49) e diagnóstico de rinite alérgica (RR= 1,93). Lactentes brancos apresentaram prevalência menor de sibilância recorrente não grave (RR=0,68). Não houve associação entre o tempo de aleitamento materno e sibilância recorrente. Conclusões: Crianças nascidas em Ribeirão Preto apresentam alta prevalência de sibilância recorrente nos dois primeiros anos de vida. Nessa fase precoce da vida, medidas ambientais visando a diminuição da exposição à fumaça do cigarro e a prevenção de infeções virais poderiam resultar na redução dos casos de sibilância recorrente grave nesta população. / Objective: To evaluate the prevalence, severity and risk factors associated with recurrent wheezing in children in early years of life. Methods: Prospective cohort study of 3167 children born in Ribeirão Preto, São Paulo, in 2010, and evaluated for this study at 12-24 months of age. A standardized questionnaire with questions regarding maternal characteristics, gestational, perinatal and postnatal conditions, family and children allergy, occurrence of wheezing, number of wheezing episodes, daycare attendance, visits to emergency, medication use, diagnosis of pneumonia and hospitalizations was applied to caregivers . Associations between outcomes and the independent variables of interest were done through univariate analysis and adjusted log-binomial models. Relative risks (RR) and confidence intervals (CI) were calculated. Results: The prevalence of at least one episode of wheezing in the first two years of life was 56.3% (1785/3167), 35.8% (1136/3167) infants had occasional wheezing (up to two episodes) and 20,1% (639/3167) had recurrent wheezing (three or more episodes). Severe recurrent wheeze (more than 6 episodes) was reported in 8.7% infants (277/3167). The independent risk factors for presenting 3 to 6 episodes of wheezing were prematurity (RR = 1.46), passive smoking (RR = 1.72 for less than 10 cigarettes / day, RR = 2.04 for more than 10 cigarettes / day), daycare attendance after 6 months (RR = 1.31), medical diagnosis of allergic rhinitis (RR = 1.52) and the presence of carpet at home (RR = 1.59). The main risk factors associated with severe wheezing were passive smoking (RR = 2.89 for more than 10 cigarettes / day), daycare attendance (RR = 2.43 if was started before 6 months and RR=1.49, if started after 6 months), acute upper respiratory infections during the first 3 months of life (RR = 2.17), asthma (RR = 1.50) and atopic dermatitis in the family (RR = 1.49) and diagnosis of allergic rhinitis (RR = 1.93). White infants have a lower prevalence of non-severe recurrent wheezing (RR = 0.68). There was no association between duration of breastfeeding and recurrent wheeze Conclusions: Children born in Ribeirão Preto have a high prevalence of recurrent wheezing in the first two years of life. In this early stage of life, environmental measures to reduce the exposure to cigarette smoke and prevention of viral infections could result in the reduction of severe recurrent wheezing in this population.

Em países industrializados, as doenças pulmonares são as que mais se destacam quando o assunto é doença ocupacional. Entre os técnicos, cuidadores de animais, médicos e cientistas, as doenças respiratórias e alérgicas a animais de laboratório representam a principal doença ocupacional. Entre os agentes presentes na sujeira orgânica, as endotoxinas são as mais relacionadas às respostas inflamatórias e causadoras de uma série de doenças respiratórias. As endotoxinas, componentes externos das bactérias gram-negativas, são encontradas em várias concentrações em suspensão no ar ou depositadas na poeira do chão, em materiais e equipamentos, no ambiente domiciliar, urbano, rural e em alguns estabelecimentos. É inevitável a exposição à endotoxina, no entanto, o nível de exposição das vias aéreas pode ser muito variado. Alguns estudos mostraram a correlação dos sintomas apresentados pelos trabalhadores de laboratórios ou biotérios com o nível de exposição às endotoxinas. OBJETIVOS: Avaliar a exposição às endotoxinas, presentes na poeira de laboratórios e biotérios e a sua relação com asma, rinite e atopia apresentadas pelos trabalhadores. MÉTODOS: Trata-se de um estudo transversal, realizado na Universidade de São Paulo, campus Ribeirão Preto (USP-RP) e na Universidade Estadual de Campinas (UNICAMP). Foram coletadas amostras de poeira do chão de laboratórios e biotérios que continham rato, camundongo, cobaia, coelho ou hamster; e em laboratórios e salas administrativas que não tinham contato algum com esses animais. As amostras de poeira foram analisadas e a quantidade de endotoxina foi dosada pelo método Limulus amebocyte lysate (LAL). Esta quantidade foi relacionada com variáveis clínicas dos trabalhadores destes locais (sintomas, reatividade brônquica, espirometria e testes alérgicos). RESULTADOS: Foram coletadas amostras de poeira de 145 locais de trabalho. Destes, 74 (51%) da USP-RP e 71 (49%) da UNICAMP. Noventa e dois (63%) locais de trabalho continham animais de laboratório (57 da USP-RP e 35 da UNICAMP) e 53 não os continham (17 da USP-RP e 36 da UNICAMP). Foram utilizados os dados de 751 trabalhadores, 412 formaram o grupo exposto a animais de laboratório e 339 o grupo não exposto. O grupo exposto a animais de laboratório apresentou maior quantidade de endotoxina, 55 ± 79 UE por mg de poeira, quando comparado com o grupo não exposto, 19 ± 27 UE/mg (p < 0,001 pelo teste t de Student). Quando estratificada, a quantidade de endotoxina em elevada e baixa quantidade, a alta concentração (acima de 20,4 UE/mg) de endotoxina se associou ao relato de sibilos nos últimos 12 meses. Ou seja, 27% dos trabalhores expostos a elevadas concentrações relataram sibilos (p < 0,01 pelo teste do qui-quadrado). Porém, a quantidade de endotoxina não se associou com sintomas de rinite, com atopia, com o teste de hiperreatividade brônquica positiva. CONCLUSÃO: A exposição à endotoxina apresenta efeito no sistema respiratório dos trabalhadores mesmo não tendo se associado à asma. A alta concentração de endotoxina se associou com a presença de sibilos, ou seja, os trabalhadores de biotérios e de laboratórios que tem contato direto com animais de laboratório estão mais susceptíveis a apresentarem sibilos ao longo do ano, sendo necessárias medidas de prevenção para estes trabalhadores. / Respiratory diseases are the most common occupational illnesses in industrialized countries and, among them, asthma and allergies are highly prevalent. Respiratory diseases and laboratory animal allergies represent a major occupational illness among technicians, animal caretakers, doctors and scientists whose work requires such exposure. Among particles present on organic dust, endotoxin is the most related to the inflammation witch cause a numerous respiratory diseases. Endotoxin from gram-negative bacterias are airborne and found in different concentrations in dust and on the ground of home and rural environment, indoor or outdoor living areas. Exposure to endotoxin is unpreventable, but the degree of exposure may vary. Some studies have shown correlation between workers symptoms with degree of exposure. AIMS: Our aim was to evaluate amount of endotoxin exposure in laboratories and animal facilities and to test its association with asthma, rhinitis, and atopy presented by workers. METHODS: This is a cross-sectional study performed in the University of São Paulo, campus of Ribeirão Preto (USP-RP) and in the State University of Campinas (Unicamp). Dust samples were collected from laboratories and animal facilities with rat, mouse, guinea pig, rabbit or hamster. We also sampled workplaces without animals. These samples were analyzed by the method of Limulus amebocyte lysate (LAL). The concentration of endotoxin detected in those workplaces were tested for association with symptoms, bronchial hyperresponsiveness, spirometry data and skin prick test results. RESULTS: One hundred, forty-five workplaces had their dust sampled: 74 (51%) in USP-RP and 71 (49%) in Unicamp. Among those, 92 (63%) workplaces had laboratory animals (57 in USP-RP and 35 in UNICAMP) and 53 (37%) did not have animals. These workplaces had 751 workers or students, 412 were animal handlers and 339 were nonhandlers. Animal handlers workplaces were exposed to higher concentrations of endotoxin 55 ± 79 UE/mg as compared with the non-handlers group 19 ± 27 UE/mg (p < 0.001, Studentst test). We divided endotoxin concentration into two leves: high (> 20.4 UE/mg) and low concentration. The high concentration associated with wheezing prevalence, i.e. 27% of animal handlers exposed to high concentration reported wheezing in the last 12 months (p < 001, chi-squared test). The concentration of endotoxin was not associated with symptoms of rhinitis, atopy or bronchial hyperresponsiveness. CONCLUSION: Exposure to endotoxin has effect on workers respiratory system, although it is not associated with asthma. Higher endotoxin concentration is associated with wheezing. Therefore, animal handlers are prone to present wheezing and preventive measures are necessary for these workers.

Em países industrializados, as doenças pulmonares são as que mais se destacam quando o assunto é doença ocupacional. Entre os técnicos, cuidadores de animais, médicos e cientistas, as doenças respiratórias e alérgicas a animais de laboratório representam a principal doença ocupacional. Entre os agentes presentes na sujeira orgânica, as endotoxinas são as mais relacionadas às respostas inflamatórias e causadoras de uma série de doenças respiratórias. As endotoxinas, componentes externos das bactérias gram-negativas, são encontradas em várias concentrações em suspensão no ar ou depositadas na poeira do chão, em materiais e equipamentos, no ambiente domiciliar, urbano, rural e em alguns estabelecimentos. É inevitável a exposição à endotoxina, no entanto, o nível de exposição das vias aéreas pode ser muito variado. Alguns estudos mostraram a correlação dos sintomas apresentados pelos trabalhadores de laboratórios ou biotérios com o nível de exposição às endotoxinas. OBJETIVOS: Avaliar a exposição às endotoxinas, presentes na poeira de laboratórios e biotérios e a sua relação com asma, rinite e atopia apresentadas pelos trabalhadores. MÉTODOS: Trata-se de um estudo transversal, realizado na Universidade de São Paulo, campus Ribeirão Preto (USP-RP) e na Universidade Estadual de Campinas (UNICAMP). Foram coletadas amostras de poeira do chão de laboratórios e biotérios que continham rato, camundongo, cobaia, coelho ou hamster; e em laboratórios e salas administrativas que não tinham contato algum com esses animais. As amostras de poeira foram analisadas e a quantidade de endotoxina foi dosada pelo método Limulus amebocyte lysate (LAL). Esta quantidade foi relacionada com variáveis clínicas dos trabalhadores destes locais (sintomas, reatividade brônquica, espirometria e testes alérgicos). RESULTADOS: Foram coletadas amostras de poeira de 145 locais de trabalho. Destes, 74 (51%) da USP-RP e 71 (49%) da UNICAMP. Noventa e dois (63%) locais de trabalho continham animais de laboratório (57 da USP-RP e 35 da UNICAMP) e 53 não os continham (17 da USP-RP e 36 da UNICAMP). Foram utilizados os dados de 751 trabalhadores, 412 formaram o grupo exposto a animais de laboratório e 339 o grupo não exposto. O grupo exposto a animais de laboratório apresentou maior quantidade de endotoxina, 55 ± 79 UE por mg de poeira, quando comparado com o grupo não exposto, 19 ± 27 UE/mg (p < 0,001 pelo teste t de Student). Quando estratificada, a quantidade de endotoxina em elevada e baixa quantidade, a alta concentração (acima de 20,4 UE/mg) de endotoxina se associou ao relato de sibilos nos últimos 12 meses. Ou seja, 27% dos trabalhores expostos a elevadas concentrações relataram sibilos (p < 0,01 pelo teste do qui-quadrado). Porém, a quantidade de endotoxina não se associou com sintomas de rinite, com atopia, com o teste de hiperreatividade brônquica positiva. CONCLUSÃO: A exposição à endotoxina apresenta efeito no sistema respiratório dos trabalhadores mesmo não tendo se associado à asma. A alta concentração de endotoxina se associou com a presença de sibilos, ou seja, os trabalhadores de biotérios e de laboratórios que tem contato direto com animais de laboratório estão mais susceptíveis a apresentarem sibilos ao longo do ano, sendo necessárias medidas de prevenção para estes trabalhadores. / Respiratory diseases are the most common occupational illnesses in industrialized countries and, among them, asthma and allergies are highly prevalent. Respiratory diseases and laboratory animal allergies represent a major occupational illness among technicians, animal caretakers, doctors and scientists whose work requires such exposure. Among particles present on organic dust, endotoxin is the most related to the inflammation witch cause a numerous respiratory diseases. Endotoxin from gram-negative bacterias are airborne and found in different concentrations in dust and on the ground of home and rural environment, indoor or outdoor living areas. Exposure to endotoxin is unpreventable, but the degree of exposure may vary. Some studies have shown correlation between workers symptoms with degree of exposure. AIMS: Our aim was to evaluate amount of endotoxin exposure in laboratories and animal facilities and to test its association with asthma, rhinitis, and atopy presented by workers. METHODS: This is a cross-sectional study performed in the University of São Paulo, campus of Ribeirão Preto (USP-RP) and in the State University of Campinas (Unicamp). Dust samples were collected from laboratories and animal facilities with rat, mouse, guinea pig, rabbit or hamster. We also sampled workplaces without animals. These samples were analyzed by the method of Limulus amebocyte lysate (LAL). The concentration of endotoxin detected in those workplaces were tested for association with symptoms, bronchial hyperresponsiveness, spirometry data and skin prick test results. RESULTS: One hundred, forty-five workplaces had their dust sampled: 74 (51%) in USP-RP and 71 (49%) in Unicamp. Among those, 92 (63%) workplaces had laboratory animals (57 in USP-RP and 35 in UNICAMP) and 53 (37%) did not have animals. These workplaces had 751 workers or students, 412 were animal handlers and 339 were nonhandlers. Animal handlers workplaces were exposed to higher concentrations of endotoxin 55 ± 79 UE/mg as compared with the non-handlers group 19 ± 27 UE/mg (p < 0.001, Studentst test). We divided endotoxin concentration into two leves: high (> 20.4 UE/mg) and low concentration. The high concentration associated with wheezing prevalence, i.e. 27% of animal handlers exposed to high concentration reported wheezing in the last 12 months (p < 001, chi-squared test). The concentration of endotoxin was not associated with symptoms of rhinitis, atopy or bronchial hyperresponsiveness. CONCLUSION: Exposure to endotoxin has effect on workers respiratory system, although it is not associated with asthma. Higher endotoxin concentration is associated with wheezing. Therefore, animal handlers are prone to present wheezing and preventive measures are necessary for these workers.

No description available.