Objectives-To find the nature and incidence of symptoms experienced by a large sample of hospital endoscopy nurses. To find whether nurses in endoscopy units develop asthma under current working conditions in endoscopy units. To obtain analytically reliable data on exposure concentrations of glutaraldehyde (GA) vapour in endoscopy units, and to relate them to individual hygiene and work practices. To characterise any exposureresponse relations between airborne GA and the occurrence of work related symptoms (WRSs). Due to the growing concern about the perceived increase in WRSs among workers regularly exposed to biocides, all of whom work within a complex multiexposure environment, a cross sectional study was designed. Methods-Current endoscopy nurses (n=348) from 59 endoscopy units within the United Kingdom and ex-employees (who had left their job for health reasons (n=18) were surveyed. Symptom questionnaires, end of session spirometry, peak flow diaries, skin prick tests (SPTs) to latex and common aeroallergens, and measurements of total immunoglobulin E (IgE) and IgE specific to GA and latex were performed. Exposure measurements included personal airborne biocide sampling for peak (during biocide changeover) and background (endoscopy room, excluding biocide changeover) concentrations. Results-All 18 ex-employees and 91.4% of the current nurses were primarily exposed to GA, the rest were exposed to a succinaldehyde-formaldehyde (SF) composite. Work related contact dermatitis was reported by 44% of current workers exposed to GA, 56.7% of those exposed to SF composite, and 44.4% of ex-employees. The prevalence of WRSs of the eyes, nose, and lower respiratory tract in current workers exposed to GA was 13.5%, 19.8%, and 8.5% respectively and 50%, 61.1%, and 66.6% in the ex-employees. The mean percentage predicted forced expired volume in 1 second (ppFEV 1 ) for ex-employees (93.82, 95% confidence interval (95% CI) 88.53 to 99.11) was significantly lower (p<0.01) than that of current workers exposed to GA ( Ex-employees and current workers with WRSs warrant further study to elucidate the cause and mechanisms for their symptoms. Ventilation systems used for the extraction of aldehydes from the work area may be less eVective than expected and due to poor design may even contribute to high peak exposures. (Occup Environ Med 2000;57:752-759)

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A questionnaire survey of over 400 workers handling reactive dyes showed that over 15% had work related respiratory or nasal symptoms. Forty nine employees with symptoms were referred to chest clinics for detailed assessment attributed to reactive dyes. He had been advised by his trade union to consult his local Employment Medical Adviser. Two and a half years previously a colleague from the same dyehouse had been investigated for occupational asthma. Inhalation testing with a Levafix orange reactive dye provoked an asthmatic response; the dye was subsequently withdrawn from his place of work. This man's death at work with asthma gave urgency to this study.The first phase of the study was to identify, by means of a questionnaire administered by a physician, those dyehouse operatives with work related upper and lower respiratory tract symptoms. Symptomatic employees identified by the questionnaire were referred to one of two chest physicians who investigated the nature of their symptoms, their severity, relation with work, and the possible causative agents. The study included an estimate of the prevalence of specific IgE to dye-human serum albumin conjugates (dye-HSA) as a measure of immunological response in employees exposed to reactive dyes, and to relate this to symptoms, atopy, and smoking.In the present paper we report the clinical and immunological findings on the employees referred to 534 on 11 May 2018 by guest. Protected by copyright.

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