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Formaldehyde
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
William J. Rea, Kalpana D. Patel
In some individuals, sensitivity to “low concentrations” can cause a reaction, resulting in an exacerbation of the symptoms of the chemically sensitive. The health effects of acute exposure to gaseous formaldehyde at low or moderate concentrations include eye, nose, and throat irritation; olfactory fatigue; thirst; headaches; dizziness; lethargy; inability to concentrate; paranoia; irritability; disturbed sleep, moodiness; crying without cause; a crawling sensation of the skin; and hemicorporeal elevation of body temperature. Chronic exposure to formaldehyde can cause chronic rhinitis, chronic pharyngitis, hypertrophic or subatrophic nasal mucosa, and subatrophic or atrophic pharynx.125 “Toxicity” was reported in the Wisconsin Epidemiology Bulletin in February 1979.126 Eighty-seven cases were reported in 56 houses where the mean formaldehyde level was 0.88 ppm, with a range of 0.02–4.15 ppm. Symptoms were reported as eye irritation (69%), upper respiratory irritation (53%), lower respiratory difficulty (26%), headache (25%), and fatigue (20%). Harris125 reported similar symptoms in 48 occupants of UF-insulated homes. They pointed out that allergic or sensitized individuals may have severe reactions to formaldehyde levels below odor threshold, which has been our experience at the EHC-Dallas in over 5000 inhaled challenges.
How Much Diagnosis Can We Afford?
Published in Pat Croskerry, Karen S. Cosby, Mark L. Graber, Hardeep Singh, Diagnosis, 2017
Sometimes the likelihood of disease is high enough and the benefit of therapy clear enough (and the potential risk of adverse events with treatment small enough) that a treatment threshold is reached, and no formal diagnostic testing is needed. An exudative pharyngitis with fever and cervical adenopathy is often taken as sufficient proof that even a negative streptococcal screen would not change the decision to treat for streptococcal pharyngitis. Typical manifestations of a very likely condition (e.g., fever and myalgias during an influenza epidemic in an immunocompetent patient) may not require anything more than a history and exam to secure a reasonable diagnosis. At another extreme, there may be times when there is little to be gained by intervention, so testing may be deferred even when the likelihood of disease is significant. For instance, patients with limited life expectancy may forego cancer screening. The decision to test for all of these conditions requires a thoughtful assessment of the risks and benefits of testing and the potential benefit of intervention, and a consideration of the unique characteristics of the patient and his relationship with the clinician. These decisions involve some degree of diagnostic reasoning, but with little to no financial cost. They are examples of thoughtful, deliberate diagnoses that are both safe and cost-conscious.
Biological hazards
Published in Sue Reed, Dino Pisaniello, Geza Benke, Principles of Occupational Health & Hygiene, 2020
Margaret Davidson, Ryan Kift, Sue Reed
Certain bioaerosols can act as irritants, cause airway blockages or stimulate the innate immune system, even when they do not produce an allergic response in the worker. One of the most common symptoms, mucous membrane irritation (MMI), which may appear consistently during the work shift, may take the form of irritation and inflammation of the upper respiratory tract—conjunctivitis, sinusitis, rhinitis, pharyngitis, laryngitis and tracheitis. There may also be a chronic cough or bronchitis (Rusca et al., 2008; Schlosser et al., 2009). Important non-allergenic diseases include non-allergic asthma, inhalation fever and ODTS.
World Trade Center Health Program best practices for the diagnosis and treatment of gastroesophageal reflux disease
Published in Archives of Environmental & Occupational Health, 2023
Ruth A. Lin, Geoffrey M. Calvert, Iris G. Udasin
GERD is characterized by symptoms of heartburn (i.e., a substernal burning sensation starting in the epigastrium and moving upwards toward the neck), food regurgitation, chest pain, and dysphagia. Atypical or extra esophageal reflux symptoms include chronic dry cough, pharyngitis with or without dysphagia, hoarseness, and bronchospasm.13 A single unifying clinical definition of GERD is difficult, and instead requires a blend of definitions. A consensus document of The American College of Gastroenterology defines GERD as reflux of gastric contents into the esophagus resulting in symptoms and/or complication.13 GERD is objectively defined by the characteristic mucosal injury seen on reflux monitoring study (pH or impedance-pH) and/or abnormal esophageal acid exposure demonstrated on a reflux monitoring study.13 Importantly, the reflux disorders observed in WTC-exposed persons are heterogeneous, and sometimes cannot be objectively documented (e.g., when the disorder is consistent with hypersensitive esophagus syndrome or functional heartburn, or other disorders9) Note that the presence of GERD appears to adversely affect the quality of life. Among Japanese workers who received a routine checkup at a clinic in Osaka, Japan, patients with GERD were found to have a poorer quality of life compared to clinic patients who did not have GERD, functional dyspepsia nor irritable bowel syndrome.14
Biomonitoring of DNA damage in individuals exposed to brick kiln pollution from Peshawar, Khyber Pakhtunkhwa, Pakistan
Published in Archives of Environmental & Occupational Health, 2018
Muhammad Khisroon, Ajmal Khan, Muhammad Imran, Farrah Zaidi, Ahmadullah, Syeda Hira Fatima
Epidemiological studies performed in different regions of the world have found evidence that increased rates of asthma, bronchitis, decreased lung function, cough, pharyngitis, allergic rhinitis, emphysema, eye irritation, low birth weight, fibrosis, and cardiovascular diseases are associated with deteriorating ambient air quality from brick kilns.5 The brick kilns are a semi-tight environment with an average temperature ranging from 10°C to 25°C higher than the surrounding temperature. Long-time exposure to high dust density, raised temperature, and particulate material might lead to injurious effects such as DNA damage and occupational health complications, for example, lung cancer.7