Respiratory disease widespread in Middle East, study shows

Desert climate, chemical warfare, water-pipe smoking contribute to lung diseases

Lung diseases in the Middle East range from the centuries-old pulmonary tuberculosis (TB) to modern manifestations caused by chemical warfare, according to a recent press release.

A new paper in Respirology, a journal of the Asian Pacific Society of Respirology, provides pulmonologists and patients with the first comprehensive review of respiratory illnesses specific to the Persian Gulf region, and the challenges in treating them.

Lung diseases affect many individuals
in Middle Eastern countries

A wide spectrum of pulmonary disorders affect individuals living in the Middle East, including bronchial and pleural diseases, respiratory tract infections and neoplasms (tumors), as well as chest traumas caused by traffic accidents.

According to the World Health Organization (WHO) Global Burden of Disease Report there were 114,000 deaths caused by TB; 407,000 from respiratory infection; 25,000 attributed to lung, trachea and bronchus cancers; and 160,000 associated with respiratory disease such as chronic obstructive pulmonary disorder (COPD) and asthma in the Eastern Mediterranean Region1 in 2008.

"The wealth of pulmonary pathologies encountered in the Middle East probably surpasses all other regions of the world," explains lead author Dr. Atul Mehta, Chief Medical Officer at Sheikh Khalifa Medical City in Abu Dhabi, United Arab Emirates.

"Our paper highlights the diverse conditions specific to this region that contribute to the variety of respiratory illnesses found among individuals living in Middle Eastern countries."

Study cites various causes of lung diseases

Major categories covered in the review include environmental factors, infections, genetic-idiopathic diseases, sleep disorders, lung malignancies, pleural diseases, and miscellaneous respiratory conditions.

For example, the vast desert area of the Middle East experience extreme temperature changes which can exacerbate chronic lung diseases such as asthma.

The frequent wars in the Middle East have included chemical ammunitions that can cause immediate lung damage and have potential long-term effects, ranging from bronchiolitis to "desert-storm pneumonitis."

Additionally, water-pipe smoking, which is unique to the Gulf region and on the rise, particularly in women and children, has been linked to pulmonary disease, coronary heart disease, and pregnancy-related complication in preliminary studies.

Cultural and environmental factors to blame

The authors suggest the broad array of lung disorders can be attributed to the large immigrant population and unique cultural and environmental conditions in the region.

"An integrated approach that involves public health, primary care, and pulmonary specialists is required to ensure effective management of the various lung diseases in the Persian Gulf," concluded Dr. Mehta.

"Consideration of the unique cultural and environmental factors will aid clinicians and public health officials in combating these health issues and ensuring compliance to medical care to improve patient outcomes."

Please note: WHO's Eastern Mediterranean Region includes health statistics from countries that include Afghanistan, Bahrain, Cyprus, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, The Occupied Territories, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, U.A.E., and Yemen Arab Republic. 

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Shop towels another health risk for auto body shop and garage workers

Working in an auto body shop or garage
is associated with many inhalation risks.

Mechanics and other auto body shop and garage workers are exposed to a variety of harmful substances such as the ones contained in brake fluids, detergents, lubricants, degreasers, paints, metal cleaners, diesel fumes, fuel, solvents and many other fluids.

Exposure to the heavy metals and airborne chemicals in auto body shops and garages can lead to long-term and short-term health effects.

Now a study described in a recent Huffington Post article names yet another occupational health and safety risk for mechanics and auto body workers:  Cleaned and laundered shop towels.

 
Study found lead, other toxins on shop towels 

A new study sponsored by Kimberly-Clark Professional, one of the largest makers of disposable towels in the US, suggests that workers using laundered towels are in fact exposing themselves to high levels of lead, cadmium and other heavy metals.

However, providers of laundered towels -- and even some independent toxicology experts -- viewed those claims with skepticism, the article adds.

According to the authors of the report, exposure to the metals, oil and grease that don't get removed in the wash can occur both directly and indirectly: a worker may graze their lips with a towel while wiping off sweat, or touch their fingers to their mouth after using a towel to remove grime from a hand or tool. (The average person subconsciously touches his or her face an estimated 16 times an hour.)


Metal exposure exceeds recommended guidelines

The study found that the average worker who uses 12 towels a day may be exposed to seven metals -- antimony, beryllium, cadmium, cobalt, copper, lead, and molybdenum -- at levels that exceed health-based exposure guidelines.

Lead exposure, which has been linked to nervous system damage, may be of particular concern. Gradient's analysis found that the typical 12-towel-a-day worker may ingest up to 3,600 times more lead than is recommended by the EPA.

Industrial workers that don't use toxic materials themselves may be particularly unaware of the potential risk of contamination.

Shop towels from a food or beverage manufacturer, for example, could have been laundered in the same facility as those soiled by automotive and heavy equipment companies.

According to the article, most auto shops now use reusable towels and that trend is unlikely to change until there is a more evidence and independent research.

 
Experts suggest the following to minimize the risks:

• Choose a launderer that doesn't recycle rags across multiple industries
• Change the practice in order to minimize contacts with towels, such as adopting hand washing and decontamination protocols before going on break or before going home
• Make sure the laundering method is the right one for the industry
• Choose towels towels made of materials that would be less likely to trap particles, such as ones with flat surfaces rather than loops like a bath towel

Source: Huffington Post 


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Metal fume fever a persisting problem, toxicologists say

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“Monday morning fever” – metal fume fever – is a persisting problem, despite changes in modern-day work practices, researchers say. Workers in the home and also students doing metal work are at great risk.

First described in 1822, it is a disease which may have been forgotten by GPs and ED doctors but is well known to toxicologists.

Dr Anselm Wong and colleagues from the Emergency Department at Melbourne’s Austin Hospital and Victorian Poisons Information Center analyzed all metal fume fever-related calls to the Victorian Poisons Information Centre between June 2005 and December 2010.

Among the study's findings:

• They found 85 reported exposures, mostly in males (82 – 96% of cases).
• Almost all (84 – 99%) of these calls were about adults.
• Most (81 – 95%) of the callers reported symptoms occurring within 24 hours, and 53% of the exposures occurred in the workplace.
• The most frequent days of exposure with symptoms were Monday (20 – 24%) and Tuesday (18 – 21%).
• The most common symptoms were fever, headache, and chills.
• All of the calls were people involved in welding metal, zinc being the most common (38%).

The researchers concluded that metal fume fever may still be a public health issue and potentially an indicator of poor work place practices.

Chronic respiratory disease is the fourth leading cause of death of Australasians and this study is an indicator that further efforts are required to ensure safe workplace practice and minimise potentially harmful exposures.

“In the workplace, prevention is the key to this disease – such as avoidance of direct contact with toxic metal fumes, improved engineering controls including exhaust ventilation systems, personal protective equipment such as respirators, and education of workers on the features of the disease.

“However, people in the workshop at home or students doing metal work may not have access to all of these.”

Source: Australasian College for Emergency Medicine

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Working in an office? You could be exposed to banned toxins

Many office workers are exposed to a
banned flame retardant.

A US study evaluating 31 offices in Boston, Massachussetts has found that most office workers have concentrations of a banned flame retardant on their hands, which was directly linked to the amount of the toxin found in their blood.

The flame retardant called polybrominated dipheny ether (PBDE) was found in the dust in these offices. It was once widely used in computers and other electronics as well as the polyurethane foam padding in office chairs, furniture, and carpeting.

Even though PBDEs were banned under the Stockholm Convention, a treaty to control and phase out major pollutants, they are still widespread in many offices.

In previous studies, PBDEs have been linked to thyroid hormone imbalance, fatigue, depression, anxiety, unexplained weight gain, hair loss, low libido and infertility.

What to do to reduce exposure to toxins

While you likely can't avoid PBDEs altogether, researchers said the best way to cut your exposure is to wash your hands often with soap and water.

In the study, workers who reported washing their hands four or more times per day tended to have lower levels of PBDEs on their hands than those who washed their hands less often.

They also had, on average, three times lower concentrations of PBDEs in their blood.

When it comes to upgrading office furniture and electronics, opt for products that don’t contain brominated fire retardants and choose PBDE-free furniture.

Keep your office space as clean as possible and dust regularly with a damp cloth.

During lunch time, you can also try to reduce your exposure: According to Health Canada, PBDEs are also found in some fatty meats, fish, and dairy products.

PollutioninPeople.org, a project of the Toxic-Free Legacy Coalition, says avoid farmed fish, especially farmed salmon from the UK or US, and reduce animal fats from your diet.

Source: The Independent

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