Background: Asbestos exposure is related to serious adverse health effects. However, there is disagreement about the relationship between chrysotile exposure and mesothelioma or lung cancer. Objectives: Our aim was to investigate the mortality rate among workers exposed to relatively pure chrysotile in an asbestos cement factory. Patients and Methods: In an asbestos cement plant opened in 1968, we prospectively studied all 317 workers. A quantity of 2,000 tons of chrysotile, with minimal amphibole contamination, was used annually until 1 January 2005. Asbestos fiber concentration was measured regularly. Date and cause of death were recorded among active and retired workers. Results: Asbestos fiber concentration was always below permissible levels. Fifty-two workers died during the study. The cause was cancer in 28 subjects; lung cancer was diagnosed in 16 of them. No case of mesothelioma was reported. Death was attributed to cardiovascular diseases in 23 subjects and to liver cirrhosis in 1. Overall mortality rate was significantly lower than that of the Greek general population, standardized mortality ratio (SMR) was 0.71 (95% CI 0.53–0.93). Mortality due to cancer was increased (SMR 1.15, 95% CI 0.77–1.67), mainly due to lung cancer mortality (SMR 1.71, 95% CI 0.98–2.78), but not significantly. Conclusions: Occupational exposure to relatively pure chrysotile within permissible levels was not associated with a significant increase in lung cancer or with mesothelioma. Decreased overall mortality of workers indicates a healthy worker effect, which – together with the relatively small cohort size – could have prevented small risks to be detected.

Radiological appearance of pleural plaques and respiratory function of people previously exposed to asbestos environmental pollution worsens over the years. Prevalence of mesothelioma was found to be higher than expected.

No abstract

No abstract

SUMMARYWe studied 27 patients with stable chronic obstuctive pulmonary disease (COPD) in a randomised, single‐blind, within‐patient, placebo‐controlled clinical study. Each patient was assigned on six separate days to receive one of the following drug regimens in random order: A. 40 μg ipratropium bromide (Atrovent MDI, 20 μg/puff) plus 2 puffs placebo; B. 12 μg formoterol fumarate (Foradil MDI,12 μg/puff) plus 3 puffs placebo; C. 80 μg ipratropium; D. 24 μg formoterol plus 2 puffs placebo; E. 12 μg formoterol plus 40 μg ipratropium plus 1 puff placebo; F. 4 puffs placebo. On each study day, Spirometric indices and vital signs were measured at 5, 10, 15 and 60 minutes, and hourly thereafter up to and including 12 hours after study drug administration. Mean peak FEV1 change (primary endpoint) was maximum with the administration of the combination of ipratropium and formoterol (335.2 ml, SE 24.6), and it differed significantly from the observed peak changes following single administration of the two tested doses of ipratropium (p<0.05 and p<0.05 respectively). Safety and tolerability were satisfactory throughout the study.