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• Objective: To investigate the frequency of work related asthma in garbage collectors. • Material and Method Garbage collector landfill centers in Istanbul in two different regions that run a total of 150 people were recruited in February 2009 to May 2009. • Results: Employees work environment threats to the health work accidents and occupational diseases. Work related asthma exacerbations in the environment plays a very significant effect is thought to be over. At least 3 days more than 20% peak expiratory flow (PEF) variability showing 13 people (11.5%) were found in recruited 113 people. 9 of 13 people (69.2%) were active smokers. And 9 other people who smoke showing variability within 8 patients with asthma, I person that was clinically healthy. PEE variability in the observed group of smokers with asthma, PEE variability is not significant, while the non- smoking asthmatic patients with PEF variability in a statistically significant percentage were higher ~88.9%~. As a result work environment and active smoking interaction is one of the most important indicators. Ambient air in the first place mainly in the Aspergillius sp, Coccidioides immitis sp. and Cladosporium sp the different rates were isolated. At different points at different rates in different micro- organisms to be isolated work environments is one of the most important indicator of pollution. These factors and PEF variability in all group was not statistically significant. • Conclusion: PEF variability in asthmatic patients who smoke were found istatistically significantly. This finding is one of the most important indicator of work environment and smoking interaction. [ABSTRACT FROM AUTHOR]

Objectives: To examine asthma control in conjunction with medication use in asthma patients from general practice. To determine features of patients with inadequately controlled asthma.Methods: A cross-sectional study was performed among 661 adult asthma patients recruited from general practice. Disease control was defined by: (1) respiratory symptoms; (2) forced expiratory volume in 1 s (FEV1)% predicted; (3) PEF variability; and (4) the use of β2-agonists. Medical treatment was categorised according to the step-care therapy rules following the 1997 guideline of the Dutch College of General Practitioners (DDGP).Results: Of the 661 asthma patients studied, 262 (40%) had a good disease control, 84 (13%) a mildly reduced, 235 (36%) a moderately reduced, and 80 (12%) had a poor disease control. Of the 399 patients (60%) inadequately controlled, in 292 patients (44%) adequate control might be achieved by changing treatment, in 99 patients (15%) adequate control might not completely be achieved by changing treatment, and 8 (1%) were already maximally treated. Compared to patients with a good disease control, patients inadequately controlled were usually older, less educated, younger at onset of pulmonary complaints, and in addition had more severe dyspnea and poorer health-related quality of life (HRQoL).Conclusion: Using our criteria, a substantial proportion of asthma patients primarily treated in general practice is not adequately controlled. Assessing patients’ disease control together with the level of medical treatment may help to gain insight into the effectiveness of current disease management. [Copyright &y& Elsevier]

Background: Peak expiratory flow (PEF) is an important measure of airway function in asthma. PEF variability (PEFvar) assessment is described in asthma treatment guidelines as another means of evaluating patient status and response to therapy.Objective: The goal of this study was to determine the clinical effect of oral montelukast, a leukotriene receptor antagonist, on PEFvar in asthmatic patients and to assess the relationship of PEFvar with other clinical measures.Methods: This was a retrospective analysis of data from a multicenter, randomized, double-blind, placebo-controlled, parallel-group study, details of which have been published previously. Eligible patients had chronic stable asthma, had a forced expiratory volume in 1 second (FEV1) that was 50% to 85% of the predicted value, used inhaled beta-agonists, had at least 15% improvement in absolute FEV1 after inhaled beta-agonist administration, and showed a minimal predefined level of daytime asthma symptoms. Treatment consisted of a 2-week, single-blind, placebo run-in period followed by a 12-week, double-blind treatment period (montelukast 10 mg or matching placebo once daily at bedtime).Results: Six hundred eighty-one patients (age range, 15–79 years) were randomized to treatment at 50 centers. Baseline PEFvar was 11.44% ± 6.55% and 10.62% ± 6.48% in the montelukast and placebo groups, respectively. PEFvar decreased 20.1% and 7.5% from baseline in the montelukast and placebo groups, respectively. The between-group difference was significant (P < 0.001). PEFvar had low correlation with other clinical measures.Conclusions: Over 12 weeks of treatment, montelukast significantly reduced PEFvar compared with placebo, indicating improved asthma control. The relative reduction in PEFvar was similar in patients with different degrees of variability at baseline. PEFvar did not correlate highly with other outcome variables and may measure different aspects of the disease. [Copyright &y& Elsevier]

Objective: There are few studies on the diesel exhaust particulates (DEP) / eosinophilic cationic protein (ECP) level relationship. This study aimed to detect ECP levels in a highly DE exposed group, named as toll collectors., Methods: In a cross-sectional study, levels of serum ECP, rates of respiratory symptoms, mean levels of respiratory functions, smoking status, and variations in peak expiratory flow (PEF) during weekends and working days were compared for 68 toll collectors (TC) (range of age, 24-48 years) and 28 controls (range of age, 25-61 years). All subjects in the study group were men., Results: No significant difference was observed in terms of symptoms and smoking rates between the toll collectors and control group. The number of toll collectors [12/68 (17.7%) vs 1/28 (3.5%)] with diurnal PEF variability in the working period was higher than that of controls (p=0.058). Mean ECP level of toll collectors was higher than that of controls (32.8 vs 21.4 ng/L), but the difference was not significant. Mean ECP levels were higher in subjects experiencing diurnal PEF variability during work and off-work periods (34.9 vs 28.3 ng/L, p=0.410)., Conclusions: Serial PEF measurements combined with serum ECP measurements did not add a new tool to detect the sensitivity of workers dealing with DE. Much more diesel exhaust exposed workers should be included to search for cheap and available methods when evaluating airway.