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1. Allergic sensitization to common pets (cats/dogs) according to different possible modalities of exposure: an Italian Multicenter Study

Author

Liccardi, G., Calzetta, L., Baldi, G., Berra, A., Billeri, L., Caminati, M., Capano, P., Carpentieri, E., Ciccarelli, A., Crivellaro, M. A., Cutajar, M., D'Amato, M., Folletti, I., Gani, F., Gargano, D., Giannattasio, D., Giovannini, M., Lombardi, C., Schiavo, M. Lo, Madonna, F., Maniscalco, M., Meriggi, A., Micucci, C., Milanese, M., Montera, C., Paolocci, G., Parente, R., Pedicini, A., Pio, R., Puggioni, F., Russo, M., Salzillo, A., Scavalli, P., Scichilone, N., Sposato, B., Stanziola, A., Steinhilber, G., Vatrella, A., Rogliani, P., Passalacqua, G., Baiardini, Ilaria, Bucca, Caterina, Canonica, Giorgio Walter, Costantino, Maria Teresa, Giacco, Stefano Del, Heffler, Enrico, Grutta, Stefania La, Patella, Vincenzo, Ridolo, Erminia, Rolla, Giovanni, Rossi, Oliviero, Savi, Eleonora, Senna, Gianenrico, Tesi, Carlo Filippo, Viegi, Giovanni, Liccardi, G., Calzetta, L., Baldi, G., Berra, A., Billeri, L., Caminati, M., Capano, P., Carpentieri, E., Ciccarelli, A., Crivellaro, M.A., Cutajar, M., D'Amato, M., Folletti, I., Gani, F., Gargano, D., Giannattasio, D., Giovannini, M., Lombardi, C., Schiavo, M.Lo, Madonna, F., Maniscalco, M., Meriggi, A., Micucci, C., Milanese, M., Montera, C., Paolocci, G., Parente, R., Pedicini, A., Pio, R., Puggioni, F., Russo, M., Salzillo, A., Scavalli, P., Scichilone, N., Sposato, B., Stanziola, A., Steinhilber, G., Vatrella, A., Rogliani, P., Passalacqua, G., Baiardini, Ilaria, Bucca, Caterina, Canonica, Giorgio Walter, Costantino, Maria Teresa, Giacco, Stefano Del, Heffler, Enrico, Grutta, Stefania La, Patella, Vincenzo, Ridolo, Erminia, Rolla, Giovanni, Rossi, Oliviero, Savi, Eleonora, Senna, Gianenrico, Tesi, Carlo Filippo, and Viegi, Giovanni

Subjects
lcsh:Immunologic diseases. Allergy, Allergy, medicine.medical_specialty, Immunology, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Pets exposure, Allergic rhinitis, Allergic sensitization, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, Allergic rhiniti, Dog, Hypersensitivity, medicine, Immunology and Allergy, 030212 general & internal medicine, Allergic rhinitis, Allergic sensitization, Bronchial asthma, Cat, Dog, Hypersensitivity, Pets, Pets exposure, Immunology and Allergy, Immunology, Molecular Biology, Bronchial asthma, Molecular Biology, Cat, Pets, Anamnesis, CATS, Modalities, business.industry, Research, medicine.disease, Pet ownership, Pet, 030228 respiratory system, Multicenter study, lcsh:RC581-607, business
Abstract

Background The query “are there animals at home?” is usually administered for collecting information on anamnesis. This modality to consider exposure to pet allergens constitutes a potential bias in epidemiological studies and in clinical practice. The aim of our study was to evaluate/quantify different modalities of exposure to cat/dog in inducing allergic sensitization. Methods Thirty Italian Allergy units participated in this study. Each centre was required to collect the data of at least 20 consecutive outpatients sensitized to cat/dog allergens. A standardized form reported all demographic data and a particular attention was paid in relieving possible modalities of exposure to cat/dog. Results A total 723 patients sensitized to cat/dog were recorded, 359 (49.65%) reported direct pet contact, 213 patients (29.46%) were pet owners, and 146 subjects (20.19%) were exposed to pets in other settings. Other patients were sensitized by previous pet ownership (150–20.75%) or indirect contact (103–14.25%), in 111 subjects (15.35%) any contact was reported. Conclusions Only 213 patients (29.46%) would be classified as “exposed to animals” and 510 (70.54%) as “not exposed” according to usual query. Our classification has shown that many “not-exposed” subjects (399–55.19%) were “really exposed”. The magnitude of exposure to pet allergens at home is not related exclusively to pet ownership. These considerations should be taken into account during the planning of epidemiological studies and in clinical practice for the management of pet allergic individuals.

Published
2018

2. Distribution and determinants of house dust mite allergens in Europe: The European Community Respiratory Health Survey II

Author

Jan Paul Zock, Joachim, Heinrich, Deborah, Jarvis, Giuseppe, Verlato, Dan, Norba¨, Estel, Plana, Jordi, Sunyer, Susan, Chinn, Mario, Olivieri, Argo, Soon, Simona, Villani, Michela, Ponzio, Anna Dahlman Hoglund, Cecilie, Svanes, Christina, Luczynska, Principal Investigators, for the Indoor Working Group of the European Community Respiratory Health Survey I. I., Senior Scientific Team Belgium: South Antwerp, France: Paris, Antwerp C. i. t. y. Estonia: T. a. r. t. u., Italy:turin, G. r. e. n. o. b. l. e. Germany: E. r. f. u. r. t. Iceland: R. e. y. k. j. a. v. i. k., Verona, Pavia Spain: Barcelona, Huelva, Albacete, Galdakao, Sweden:uppsala, O. v. i. e. d. o., Goteborg, United Kingdom: Norwich, U. m. e. a. Switzerland: B. a. s. e. l., Ipswich, Romano, Canzio, Dalmasso, Paola, Brussino, Luisa, Bucca, Caterina, and Rolla, Giovanni

Subjects
Veterinary medicine, European community, Cysteine Endopeptidases, Dermatophagoides pteronyssinus, Immunology, HOUSE DUST, MITE ALLERGENS, Distribution (economics), ECRHS, medicine.disease_cause, Arthropod Proteins, Epitopes, house dust mites, allergens, housing, risk factors, geographic, Allergen, immune system diseases, Environmental health, parasitic diseases, medicine, Mite, Animals, Immunology and Allergy, Antigens, Dermatophagoides, Longitudinal Studies, Respiratory health, House dust mite, Dermatophagoides farinae, biology, business.industry, Dust, biology.organism_classification, respiratory tract diseases, Europe, Allergens, Ecrhs, Geographic, House Dust Mites, Housing, Risk Factors, Multicenter study, business
Abstract

Background: Several studies in European homes have described allergen levels from the house dust mite species Dermatophagoides pteronyssinus and to a lesser extent Dermatophagoides farinae, but geographic comparisons of exposure levels and risk factors have been hampered by a lack of standardized methods. Objective: To study the distribution and determinants of the major house dust mite allergens Der p 1 and Der f 1 in 10 European countries using a common protocol. Methods: During home visits with 3580 participants of the European Community Respiratory Health Survey II from 22 study centers, mattress dust was sampled and analyzed for Der p 1, Der f 1, and Der 2 allergen. Information on housing characteristics was obtained by both observations and interview. Results: Der 1 and Der 2 allergens were detectable (≥0.1 μg/g) in 68% and 53% of the samples, respectively. Large differences in allergen levels between study centers were observed, and geographic patterns for Der p 1 and Der f 1 were different. Low winter temperatures reduced Der p 1 rather than Der f 1. Important risk factors for high allergen levels included an older mattress, a lower floor level of the bedroom, limited ventilation of the bedroom, and dampness for Der p 1 but not for Der f 1. Conclusion: There are large qualitative and quantitative differences of house dust mite allergen levels in Europe, which can partly be explained by geographic and housing characteristics. Clinical implications: Mite allergen exposure may be reduced by replacing the mattress regularly and increasing ventilation of the bedroom, particularly in winter. © 2006 American Academy of Allergy, Asthma and Immunology.

Published
2006

3. An international prospective general population based study of respiratory work disability

Author

Toren, K, Zock, Jp, Kogevinas, M, Plana, E, Sunyer, J, Radon, K, Jarvis, D, Kromhout, H, D’Errico, A, Payo, F, Anto´, Jm, List of Principal Investigators, Blanc P. D., Australia: Melbourne, Senior Scientific T. e. a. m., Belgium: South Antwerp, Antwerp, City, Estonia:, Tartu, France:, Paris, Grenoble, Germany:, Erfurt, Iceland, Italy:, Turin, Verona, Pavia, The, Netherlands, Norway:, Bergen, Spain:, Barcelona, Huelva, Albacete, Galdakao, Oviedo, Sweden: Uppsala, Goteborg, Umea, Switzerland:, Basel, United, Kingdom, Norwich, Ipswich, Usa:, Portland, Romano, Canzio, Brussino, Luisa, Bucca, Caterina, and Rolla, Giovanni

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Population, General Population Cohort, Occupational safety and health, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Occupational Exposure, Environmental health, medicine, Humans, Disabled Persons, RESPIRATORY WORK DISABILITY, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, education, education.field_of_study, business.industry, Incidence (epidemiology), Smoking, Hazard ratio, Dust, Respiration Disorders, Asthma, 3. Good health, Occupational Diseases, 030228 respiratory system, Cohort, Physical therapy, Female, business, Follow-Up Studies, Cohort study
Abstract

Background: Previous cross-sectional studies have shown that job change due to breathing problems at the workplace (respiratory work disability) is common among adults of working age. That research indicated that occupational exposure to gases, dust and fumes was associated with job change due to breathing problems, although causal inferences have been tempered by the cross-sectional nature of previously available data. There is a need for general population-based prospective studies to assess the incidence of respiratory work disability and to delineate better the roles of potential predictors of respiratory work disability. Methods: A prospective general population cohort study was performed in 25 centres in 11 European countries and one centre in the USA. A longitudinal analysis was undertaken of the European Community Respiratory Health Survey including all participants employed at any point since the baseline survey, 6659 subjects randomly sampled and 779 subjects comprising all subjects reporting physician-diagnosed asthma. The main outcome measure was new-onset respiratory work disability, defined as a reported job change during follow-up attributed to breathing problems. Exposure to dusts (biological or mineral), gases or fumes during follow-up was recorded using a job-exposure matrix. Cox proportional hazard regression modelling was used to analyse such exposure as a predictor of time until job change due to breathing problems. Results: The incidence rate of respiratory work disability was 1.2/1000 person-years of observation in the random sample (95% CI 1.0 to 1.5) and 5.7/1000 person-years in the asthma cohort (95% CI 4.1 to 7.8). In the random population sample, as well as in the asthma cohort, high occupational exposure to biological dust, mineral dust or gases or fumes predicted increased risk of respiratory work disability. In the random sample, sex was not associated with increased risk of work disability while, in the asthma cohort, female sex was associated with an increased disability risk (hazard ratio 2.8, 95% CI 1.3 to 5.9). Conclusions: Respiratory work disability is common overall. It is associated with workplace exposures that could be controlled through preventive measures.

Published
2009

4. Domestic use of hypochlorite bleach, atopic sensitization, and respiratory symptoms in adults

Author

Zock, Jp, Plana, E, Anto´, Jm, Benke, G, Blanc, Pd, Carosso, A, Dahlman H€oglund, A, Heinrich, J, Jarvis, D, Kromhout, H, Lillienberg, L, Mirabelli, Mc, Norba, D, Olivieri, M, Ponzio, M, Radon, K, Soon, A, van Sprundel, A, Sunyer, Y, Svanes, C, Tore´, K, Verlato, G, Villani, S, PRINCIPAL INVESTIGATORS AND SENIOR SCIENTIFIC TEAM : Belgium: South Antwerp, Kogevinas M., France: Paris, Antwerp C. i. t. y. Estonia: T. a. r. t. u., Italy: Turin, G. r. e. n. o. b. l. e. Germany: E. r. f. u. r. t., Verona, Spain:barcelona, P. a. v. i. a. Norway: B. e. r. g. e. n., Huelva, Albacete, Galdakao, Sweden: Uppsala, O. v. i. e. d. o., G€oteborg, United Kingdom: Norwich, U. m. e. a. Switzerland: B. a. s. e. l., Ipswich, Romano, Canzio, Brussino, Luisa, Bucca, Caterina, Rolla, Giovanni, Risk Assessment of Toxic and Immunomodulatory Agents, and Dep IRAS

Subjects
Adult, Male, Allergy, Hypoclorite, Bleach, genetic structures, atopy, respiratory symptoms, Immunology, Respiratory Tract Diseases, Immunoglobulin E, hypochlorite bleach, household, allergy, respiratory, Atopy, Environmental health, Surveys and Questionnaires, medicine, Hypersensitivity, Immunology and Allergy, Animals, Humans, Sensitization, Environmental Restoration and Remediation, House dust mite, biology, business.industry, Household Products, Odds ratio, Allergens, biology.organism_classification, medicine.disease, Hypochlorous Acid, medicine.anatomical_structure, Logistic Models, Bronchial hyperresponsiveness, Air Pollution, Indoor, Multivariate Analysis, biology.protein, Cats, Female, Human medicine, business, Follow-Up Studies
Abstract

Background: Professional use of hypochlorite (bleach) has been associated with respiratory symptoms. Bleach is capable of inactivating allergens, and there are indications that its domestic use may reduce the risk of allergies in children. Objective: To study the associations between household use of bleach and atopic sensitization, allergic diseases, and respiratory health status in adults. Methods: We identified 3626 participants of the European Community Respiratory Health Survey 11 in 10 countries who did the cleaning in their homes and for whom data on specific serum IgE to 4 environmental allergens were available. Frequency of bleach use and information on respiratory symptoms were obtained in face-to-face interviews. House dust mite and cat allergens in mattress dust were measured in a subsample. Associations between the frequency of bleach use and health outcomes were evaluated by using multivariable mixed logistic regression analyses. Results: The use of bleach was associated with less atopic sensitization (odds ratio [OR], 0.75; 95% CI, 0.63-0.89). This association was apparent for specific IgE to both indoor (cat) and outdoor (grass) allergens, and was consistent in various subgroups, including those without any history of respiratory problems (OR, 0.85). Dose-response relationships (P

Published
2009

5. Operational definitions of asthma in studies on its aetiology

Author

Pekkanen, J, Sunyer, J, Anto, Jm, Burney, Pl, Abramson, M, Kutin, J, Vermeire, P, van Bastelaer, F, Bousquet, J, Neukirch, F, Liard, R, Pin, I, Pison, C, Taytard, A, Magnussen, H, Nowak, D, Wichmann, He, Heinrich, J, Gislason, T, Gislason, D, Prichard, J, Allwright, S, Macleod, D, Bugiani, M, Bucca, Caterina, Romano, Canzio, de Marco, R, Lo Cascio, V, Campello, C, Marinoni, A, Cerveri, I, Casali, L, Rijcken, B, Kremer, A, Crane, J, Lewis, S, Gulsvik, A, Omenaas, E, Soriano, J, Tobías, A, Roca, J, Kogevinas, M, Muniozguren, N, Ramos González, J, Capelastegui, A, Martinez Moratalla, J, Almar, E, Maldonado, J, Pereira, A, Sánchez, J, Payo, F, Huerta, I, Boman, G, Janson, C, Bjornsson, E, Rosenhall, L, Norrman, E, Lundback, B, Lindholm, N, Plaschke, P, Ackermann Liebrich, U, Künzli, N, Perruchoud, A, Burr, M, Layzqll, J, Hall, R, Harrison, B, Stark, J, Chinn, S, Luczynska, C, Jarvis, D, Lai, E, Buist, S, Vollmer, W, and Osborne, M.

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Multivariate analysis, Cross-sectional study, International Cooperation, Asthma, definition, epidemiology, method, risk factor, Sensitivity and Specificity, Severity of Illness Index, Age Distribution, immune system diseases, Risk Factors, Surveys and Questionnaires, Severity of illness, Epidemiology, medicine, Confidence Intervals, Prevalence, Humans, Risk factor, Sex Distribution, Respiratory Sounds, business.industry, Airway Resistance, Odds ratio, Middle Aged, medicine.disease, Prognosis, respiratory tract diseases, Respiratory Function Tests, Cross-Sectional Studies, Dyspnea, Bronchial hyperresponsiveness, Multivariate Analysis, Physical therapy, Female, business, Clinical psychology
Abstract

The most popular way to define asthma based on questionnaires is to use definitions taken from cross-sectional international studies on asthma. These definitions may not, however, be optimal for future studies focusing on risk factors of asthma. The current authors, therefore, compared the performance of different operational definitions of asthma. The European Community Respiratory Health Study I was a cross-sectional study of 21,924 subjects aged between 25-44 yrs in 18 countries. Operational definitions of asthma compared included different combinations of symptoms of asthma and bronchial hyperresponsiveness. A continuous asthma score, ranging from 0-8, was defined as the sum of positive answers to eight main symptom questions. There was no threshold in the associations of asthma symptoms with severity or risk factors of asthma, which would have suggested a dichotomous definition of asthma. Using dichotomous definitions requiring the presence of several asthma symptoms strengthened associations with studied risk factors, and also increased the estimated specificity and positive predictive value. Using a continuous asthma score also improved the power of the analyses. In conclusion, dichotomous definitions of asthma yielding higher odds ratios are achieved by requiring positive responses to several questions on symptoms. However, symptoms of asthma are possibly best analysed as a continuous asthma score.

Published
2005

6. Is the prevalence of adult asthma and allergic rhinitis still increasing? Results of an Italian study

Author

Verlato, G, Corsico, A, Villani, S, Cerveri, I, Migliore, E, Accordini, S, Carolei, A, Piccioni, P, Bugiani, M, Lo Cascio, V, Marinoni, A, Poli, A, Ecrhs, de Marco R., Marinoni, ISAYA group Principal researchers: A., Carolei, A., Montomoli, C., Villani, S., Comelli, M., Ponzio, M., Grassi, M., Rezzani, C., Casali, L., Cerveri, I., Zoia, M. C., Corsico, A., Colato, S., Moscato, G., Perfetti, L., Alesina, R., Basso, O., Berrayah, L., Brusotti, R., Fanfulla, F., Moi, P., Frati, C., Karytinos, P., Bugiani, M., Piccioni, P., Carosso, A., Arossa, W., Caria, E., Castiglioni, G., Migliore, E., Romano, C., Fabbro, D., Ciccone, G., Magnani, C., Dalmasso, Paola, Bono, Roberto, Gigli, G., Giraudo, A., Brussino, Luisa, Bucca, Caterina, Rolla, Giovanni, Aime, M., Cerutti, A., Chiampo, F., Gallo, W., Sulotto, F., de Marco, R., Verlato, G., Accordini, S., Zanolin, M. E., Locatelli, F., Cazzoletti, L., Pattaro, C., Sartori, S., Poli, A., Dorigo, N., Cantarelli, S., Ciresola, D., Lo Cascio, V., Olivieri, M., Ferrari, M., Biasin, C., Campello, C., Rossi, F., Cannistrà, A., Cenci, B., Destefani, E., Girotto, M., Lampronti, G., Martini, C., Tardivo, S., Villani, A., Lauriola, P., Danielli, G., Sesti, D., Ghigli, E., Natale, P., Grosa, M., Tacconi, A., Frontero, P., and Salomoni, A.

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Allergy, Rhinitis, Allergic, Perennial, temporal trend, Immunology, Logistic regression, asthma, allergic rhinitis, temporal trend, epidemiology, Epidemiology, Prevalence, Immunology and Allergy, Medicine, Humans, Non-response bias, Young adult, Asthma, Response rate (survey), allergic rhinitis, business.industry, Rhinitis, Allergic, Seasonal, Odds ratio, asthma, medicine.disease, Italy, Female, epidemiology, business
Abstract

The prevalence of asthma and allergic rhinitis has increased worldwide during the 1970s and 1980s.This study was aimed at evaluating whether the increasing trend in prevalence persisted during the 1990s in the young adult Italian population.In 1998 to 2000 a screening questionnaire was sent by mail to a general population sample aged 20 to 44 years; nonresponders were contacted again first by mail and then by phone, achieving a final response rate of 78.1% (6876 of 8800). Prevalence estimates, adjusted to correct for nonresponse bias, were compared with those recorded in Italy in 1991 to 1993 during the European Community Respiratory Health Survey, when response rate had been slightly higher (87.6%). Temporal variations in symptom prevalence were analyzed by a logistic regression model, controlling for sex, age, site of residence (urban vs suburban areas), season of response, response rate, and type of contact (mail vs phone).The prevalence of asthma attacks did not vary significantly from 1991 to 1993 (3.6%) to 1998 to 2000 (3.2%) (P =.188). The prevalence of asthma-like symptoms (wheezing, chest tightness, shortness of breath) tended to decrease in the age classes of 32.5 to 45 years, while increasing in the youngest age class (20 to 26 years). A clear-cut increase from 15.4% to 18.3% was observed for the prevalence of allergic rhinitis (P.001), whereas the proportion of people under antiasthmatic treatment increased in suburban areas but not in urban areas (interaction time-site of residence, P.001).Asthma prevalence has not increased during the last decade in Italy. The persistence of an increasing trend in allergic rhinitis prevalence deserves attention.

Published
2003

7. Asthma characteristics in cleaning workers, workers in other risk jobs and office workers

Author

Zock, J. P., Kogevinas, M., Sunyer, J., Jarvis, D., Tore´, K., Anto´, J. M., Z, Abramson, for the European Community Respiratory Health Survey Australia: M., Kutin, J., Belgium: P. Vermeire, F. van Bastelaer, Germany: H. Magnussen, D. Nowak, H. E. Wichmann, J. Heinrich, Gislason, Iceland: T. Gislason D., Prichard, Ireland: J., Allwright, S., Macleod, D., Bugiani, Italy: M., Bucca, Caterina, Romano, C., de Marco lo Cascio, R., Campello, C., Marinoni, A., Cerveri, I., Casali, L., Perfetti, L., Rijcken, The Netherlands: B., Schouten, J. P., Kerkhof, M., Boezen, H. M., Crane, New Zealand: J., Lewis, S., Pearce, N., Norway: A. Gulsvik, E. Omenaas, Anto´, Spain: J. M., Soriano, J., Tobı´as, A., Roca, J., Muniozguren, N., Ramos Gonza´ lez, J., Capelastegui, A., Martı´nez Moratalla, J., Maldonado Pe´rez, E. Almar J., Pereira, A., Sa´nchez, J., Quiro´s, J., Huerta, I., Boman, Sweden: G., Janson, C., Bjo¨ rnsson, E., Rosenhall, L., Lundba¨ck, E. Norrman B., Lindholm, N., Plaschke, P., Tore´n, K., Ku¨nzli, Switzerland: N., Hall, United Kingdom: R., Harrison, B., Stark, J., Buist, USA: S., Vollmer, W., The following grants helped to fund the local studies: Australia: Allen, M. O. s. b. o. r. n. e., H. a. n. b. u. r. y. 9. s. Belgium: Belgian Science Policy Office, National Fund for Scientific R. e. s. e. a. r. c. h. Germany: GSF, Forschung und Technologie, the Bundesminister fu¨ r., Tecnologica, B. o. n. n. Italy: Ministero dell9Universita e. della Ricerca Scientifica e., Cnr, and Regione Veneto grant RSF, n. 3. 8. 1. /. 0. 5. 9. 3.

Subjects
Adult, Male, Pulmonary and Respiratory Medicine, Chronic bronchitis, medicine.medical_specialty, SYMPTOMS, Vital Capacity, Population, cleaning, Peak Expiratory Flow Rate, RESPIRATORY-HEALTH-SURVEY, Bronchial Provocation Tests, DISEASE, Atopy, asthma risk cleaning workers, Risk Factors, Forced Expiratory Volume, Occupational Exposure, Surveys and Questionnaires, Environmental health, occupation, Humans, Medicine, EXPOSURE, Occupations, Risk factor, education, OCCUPATIONAL ASTHMA, POPULATION, Asthma, education.field_of_study, business.industry, VALUES, Absolute risk reduction, Immunoglobulin E, asthma, medicine.disease, respiratory tract diseases, Occupational Diseases, Bronchial hyperresponsiveness, CLEANERS, Physical therapy, Female, European Community Respiratory Health Survey, SENSITIVITY, business, Occupational asthma
Abstract

Several studies have demonstrated an excess risk for asthma among cleaning workers. The aim of this analysis was to compare clinical, immunological and functional characteristics associated with asthma in cleaners and other occupational groups.Cleaners, workers exposed to high molecular weight (MW) agents, workers exposed to low MW agents, and office workers were identified from an international community-based epidemiological study. Influence of sex, smoking, age and atopy on the relationships with asthma was investigated. Rates of respiratory symptoms, bronchial hyperresponsiveness, atopic sensitisation and lung function were compared between asthmatics from the four groups (case-case analysis).The risk for asthma in workers exposed to low MW agents was higher among nonatopics than among atopics. Case-case analysis showed no major differences in asthma characteristics between cleaners and workers exposed to high or low MW agents. Asthmatic cleaners had less atopy, more chronic bronchitis and a lower lung function as compared to office workers.Asthma in cleaning workers showed many similarities with that in workers known to be at risk for occupational asthma. Atopic sensitisation did not seem to play an important role in cleaning-related asthma.

Published
2002

8. Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life

Author

Diego Bagnasco, Massimiliano Povero, Lorenzo Pradelli, Luisa Brussino, Giovanni Rolla, Marco Caminati, Francesco Menzella, Enrico Heffler, Giorgio Walter Canonica, Pierluigi Paggiaro, Gianenrico Senna, Manlio Milanese, Carlo Lombardi, Caterina Bucca, Andrea Manfredi, Rikki Frank Canevari, Giovanni Passalacqua, Gabriella Guarnieri, Vincenzo Patella, Foschino Barbaro Maria Pia, Elisiana Carpagnano, Anna del Colle, Giulia Scioscia, Pelaia Gerolamo, Manuela Latorre, Francesca Puggioni, Francesca Racca, Elisabetta Favero, Sandra Iannacone, Eleonora Savi, Marcello Montagni, Gianna Camiciottoli, Chiara Allegrini, Giuseppe Spadaro, Caterina Detoraki, Carla Galeone, Patrizia Ruggiero, Monna Rita Yacoub, Alvise Berti, Gisella Colombo, Nicola Scichilone, Carmen Durante, Maria Teresa Costantino, Chiara Roncallo, Mariachiara Braschi, Francesco Blasi, Alice D'Adda, Erminia Ridolo, Massimo Triggiani, Roberta Parente, D'Amato Maria, Maria Vittoria Verrillo, Zappa Maria Cristina, Marianna Lilli, Nunzio Crimi, Marco Bonavia, Angelo Guido Corsico, Amelia Grosso, Stefano Del Giacco, Margherita Deidda, Luisa Ricciardi, Stefania Isola, Francesca Cicero, Giuliana Amato, Federica Vita, Antonio Spanevello, Patrizia Pignatti, Francesca Cherubino, Dina Visca, Eleonora Aletti, Fabio Luigi Massimo Ricciardolo, Vitina Maria Anna Carriero, Francesca Bertolini, Pierachille Santus, Roberta Barlassina, Andrea Airoldi, Giuseppe Guida, Nucera Eleonora, Arianna Aruanno, Angela Rizzi, Cristiano Caruso, Stefania Colantuono, Alessandra Arcolaci, Andrea Vianello, Fulvia Chieco Bianchi, Maria Rita Marchi, Stefano Centanni, Simone Luraschi, Silvia Ruggeri, Rocco Rinaldo, Elena Parazzini, Cecilia Calabrese, Martina Flora, Lorenzo Cosmi, Linda Di Pietro, Enrico Maggi, Laura Pini, Luigi Macchia, Danilo Di Bona, Luca Richeldi, Carola Condoluci, Leonello Fuso, Matteo Bonini, Alessandro Farsi, Giulia Carli, Paolo Montuschi, Giuseppe Santini, Maria Elisabetta Conte, Elisa Turchet, Carlo Barbetta, Francesco Mazza, Simona D'Alo, Stefano Pucci, Maria Filomena Caiaffa, Elena Minenna, Luciana D'Elia, Carlo Pasculli, Vittorio Viviano, Paolo Tarsia, Joyce Rolo, Mariacarmela Di Proietto, Salvatore Lo Cicero, Bagnasco, D., Povero, M., Pradelli, L., Brussino, L., Rolla, G., Caminati, M., Menzella, F., Heffler, E., Canonica, G. W., Paggiaro, P., Senna, G., Milanese, M., Lombardi, C., Bucca, C., Manfredi, A., Canevari, R. F., Passalacqua, G., Guarnieri, G., Patella, V., Maria Pia, F. B., Carpagnano, E., Colle, A. D., Scioscia, G., Gerolamo, P., Latorre, M., Puggioni, F., Racca, F., Favero, E., Iannacone, S., Savi, E., Montagni, M., Camiciottoli, G., Allegrini, C., Spadaro, G., Detoraki, C., Galeone, C., Ruggiero, P., Yacoub, M. R., Berti, A., Colombo, G., Scichilone, N., Durante, C., Costantino, M. T., Roncallo, C., Braschi, M., Blasi, F., D'Adda, A., Ridolo, E., Triggiani, M., Parente, R., Maria, D. A., Verrillo, M. V., Cristina, Z. M., Lilli, M., Crimi, N., Bonavia, M., Corsico, A. G., Grosso, A., Del Giacco, S., Deidda, M., Ricciardi, L., Isola, S., Cicero, F., Amato, G., Vita, F., Spanevello, A., Pignatti, P., Cherubino, F., Visca, D., Aletti, E., Massimo Ricciardolo, F. L., Anna Carriero, V. M., Bertolini, F., Santus, P., Barlassina, R., Airoldi, A., Guida, G., Eleonora, N., Aruanno, A., Rizzi, A., Caruso, C., Colantuono, S., Arcolaci, A., Vianello, A., Bianchi, F. C., Marchi, M. R., Centanni, S., Luraschi, S., Ruggeri, S., Rinaldo, R., Parazzini, E., Calabrese, C., Flora, M., Cosmi, L., Di Pietro, L., Maggi, E., Pini, L., Macchia, L., Di Bona, D., Richeldi, L., Condoluci, C., Fuso, L., Bonini, M., Farsi, A., Carli, G., Montuschi, P., Santini, G., Conte, M. E., Turchet, E., Barbetta, C., Mazza, F., D'Alo, S., Pucci, S., Caiaffa, M. F., Minenna, E., D'Elia, L., Pasculli, C., Viviano, V., Tarsia, P., Rolo, J., Di Proietto, M., Lo Cicero, S., Bagnasco, Diego, Povero, Massimiliano, Pradelli, Lorenzo, Brussino, Luisa, Rolla, Giovanni, Caminati, Marco, Menzella, Francesco, Heffler, Enrico, Canonica, Giorgio Walter, Paggiaro, Pierluigi, Senna, Gianenrico, Milanese, Manlio, Lombardi, Carlo, Bucca, Caterina, Manfredi, Andrea, Canevari, Rikki Frank, Passalacqua, Giovanni, Guarnieri, Gabriella, Patella, Vincenzo, Foschino Barbaro, Maria Pia, Carpagnano, Elisiana, D' Amato, Maria, Verrillo, Mariavittoria, Zappa, Maria Cristina, Lo Cicero, Salvatore, Di Proietto, Maria Carmela, Walter Canonica, Giorgio, Frank Canevari, Rikki, Spadaro, Giuseppe, Bagnasco D., Povero M., Pradelli L., Brussino L., Rolla G., Caminati M., Menzella F., Heffler E., Canonica G.W., Paggiaro P., Senna G., Milanese M., Lombardi C., Bucca C., Manfredi A., Canevari R.F., Passalacqua G., Guarnieri G., Patella V., Maria Pia F.B., Carpagnano E., Colle A.D., Scioscia G., Gerolamo P., Latorre M., Puggioni F., Racca F., Favero E., Iannacone S., Savi E., Montagni M., Camiciottoli G., Allegrini C., Spadaro G., Detoraki C., Galeone C., Ruggiero P., Yacoub M.R., Berti A., Colombo G., Scichilone N., Durante C., Costantino M.T., Roncallo C., Braschi M., Blasi F., D'Adda A., Ridolo E., Triggiani M., Parente R., Maria D.A., Verrillo M.V., Cristina Z.M., Lilli M., Crimi N., Bonavia M., Corsico A.G., Grosso A., Del Giacco S., Deidda M., Ricciardi L., Isola S., Cicero F., Amato G., Vita F., Spanevello A., Pignatti P., Cherubino F., Visca D., Aletti E., Massimo Ricciardolo F.L., Anna Carriero V.M., Bertolini F., Santus P., Barlassina R., Airoldi A., Guida G., Eleonora N., Aruanno A., Rizzi A., Caruso C., Colantuono S., Arcolaci A., Vianello A., Bianchi F.C., Marchi M.R., Centanni S., Luraschi S., Ruggeri S., Rinaldo R., Parazzini E., Calabrese C., Flora M., Cosmi L., Di Pietro L., Maggi E., Pini L., Macchia L., Di Bona D., Richeldi L., Condoluci C., Fuso L., Bonini M., Farsi A., Carli G., Montuschi P., Santini G., Conte M.E., Turchet E., Barbetta C., Mazza F., D'Alo S., Pucci S., Caiaffa M.F., Minenna E., D'Elia L., Pasculli C., Viviano V., Tarsia P., Rolo J., Di Proietto M., and Lo Cicero S.

Subjects
OR, Odds Ratio, Pediatrics, Severe asthma, Exacerbation, Anti IL-5, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, gastroesophageal reflux disease, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, ICS, inhaled corticosteroid, Rate ratio, OCS, Oral Corticosteroids, law.invention, LAMA, long acting muscarinic antagonist, 0302 clinical medicine, Randomized controlled trial, fractional nitric oxide, Interquartile range, law, long acting beta 2 agonist, Odds Ratio, Immunology and Allergy, RR, Rate Ratio, 030223 otorhinolaryngology, Pharmacoeconomic, LOS, Length of stay, LOS, IQR, LAMA, MEP, Mepolizumab, OR, CI, SD, Standard Deviation, MEP, ACT, Asthma Control Test, Comorbiditie, CI, Confidence Intervals, medicine.drug, lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, interquartile range, long acting muscarinic antagonist, Immunology, LABA, LABA, long acting beta 2 agonist, Comorbidities, Mepolizumab, OCS, Pharmacoeconomics, Severe asthma, Anti IL-5, RR, Article, Rate Ratio, chronic obstructive pulmonary disease, 03 medical and health sciences, OCS, Oral Corticosteroid, Asthma Control Test, Confidence Intervals, FeNO, fractional nitric oxide, RCTs, Randomized Controlled Trial, medicine, COPD, GERD, gastroesophageal reflux disease, FeNO, IQR, interquartile range, SD, Asthma, RCTs, Oral Corticosteroids, business.industry, GERD, medicine.disease, ICS, inhaled corticosteroids, ACT, Comorbidity, Randomized Controlled Trials, CI, Confidence Interval, RCTs, Randomized Controlled Trials, COPD, chronic obstructive pulmonary disease, 030228 respiratory system, ICS, Standard Deviation, Length of stay, inhaled corticosteroids, lcsh:RC581-607, business
Abstract

Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of working days lost due to the disease. The primary objective was to compare the annual total cost per patient pre- and post-MEP. Secondary outcomes included rates of exacerbations and number of OCS-dependent patients. Results 106 patients were enrolled in the study: 46 male, median age 58 years. Mean annual cost pre- and post-MEP (cost of biologic excluded) was €3996 and €1,527, respectively. Total savings due to MEP resulted in €2469 (95%CI 1945–2993), 62% due to exacerbations reduction and 33% due to productivity increase. Such savings could fund about 22% of the total cost of MEP for one year. The introduction of MEP induced a clinical benefit by reducing both OCS-dependent patients (OR = 0.12, 95%CI 0.06–0.23) and exacerbation rate (RR = 0.19, 95%CI 0.15–0.24). Conclusions Patients with severe eosinophilic asthma experienced a clinical benefit in asthma control adding MEP to standard therapy. Biologic therapy can be, partially, funded by the savings produced by patients’ improvement.

Published
2021

9. Asthma management in a specialist setting: Results of an Italian Respiratory Society survey

Author

Giorgio Walter Canonica, Fulvio Braido, Angelo Corsico, Elena Bacci, Paola Rogliani, Giuseppe Girbino, Pierluigi Paggiaro, Fabiano Di Marco, Pierachille Santus, Michela Bellocchia, Maria D'Amato, Amelia Grosso, Ilaria Baiardini, Pietro Pirina, Manuela Latorre, Alfio Proietto, Stefano Centanni, Paolo Solidoro, Maria Teresa Busceti, Garuti Silvia, Maria Cristina Colanardi, Girolamo Pelaia, Umberto Zuccon, Nicola Scichilone, Giorgia Molinengo, Maria Pia Foschino Barbaro, Francesco Blasi, Silvia Terraneo, Josuel Ora, Caterina Bucca, Carlo Mereu, Pietro Alleri, Alida Benfante, Marta Ferrari, Carlo Barbetta, Alessandro G. Fois, Giovanni Florio, Sara Maniscalco, Marco Contoli, Francesco Mazza, Francesca Simioli, Dottorini Marco, Vincenzo Patella, Braido, Fulvio, Baiardini, Ilaria, Alleri, Pietro, Bacci, Elena, Barbetta, Carlo, Bellocchia, Michela, Benfante, Alida, Blasi, Francesco, Bucca, Caterina, Busceti, Maria Teresa, Centanni, Stefano, Colanardi, Maria Cristina, Contoli, Marco, Corsico, Angelo, D'Amato, Maria, Di Marco, Fabiano, Marco, Dottorini, Ferrari, Marta, Florio, Giovanni, Fois, Alessandro Giuseppe, Foschino Barbaro, Maria Pia, Silvia, Garuti, Girbino, Giuseppe, Grosso, Amelia, Latorre, Manuela, Maniscalco, Sara, Mazza, Francesco, Mereu, Carlo, Molinengo, Giorgia, Ora, Josuel, Paggiaro, Pierluigi, Patella, Vincenzo, Pelaia, Girolamo, Pirina, Pietro, Proietto, Alfio, Rogliani, Paola, Santus, Pierachille, Scichilone, Nicola, Simioli, Francesca, Solidoro, Paolo, Terraneo, Silvia, Zuccon, Umberto, and Canonica, Giorgio Walter

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Concordance, Socio-culturale, Practice Patterns, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Retrospective Studie, Surveys and Questionnaires, Severity of illness, Health care, medicine, Surveys and Questionnaire, Humans, Pharmacology (medical), 030212 general & internal medicine, Practice Patterns, Physicians', Aged, Asthma, Female, Italy, Middle Aged, Retrospective Studies, Quality of Life, Specialization, Modalities, Physicians', business.industry, Biochemistry (medical), Retrospective cohort study, medicine.disease, 030228 respiratory system, Test score, Family medicine, Physical therapy, business, Human
Abstract

Background Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. Aim to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. Method: A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. Results The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). Conclusions The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately.

Published
2017

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