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  • 1
    ISSN: 1399-3038
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The PREVASC study addresses the primary prevention of asthma in infants and small children. The objective of this study is to investigate whether a multifaceted prenatally started intervention strategy in high-risk infants leads to a decrease in the occurrence of (severe) asthma and whether a refinement of the prevention strategy leads to an increase in the adherence to the prevention program. The primary prevention program includes house dust mite impermeable bed coverings, education on breast feeding, hypoallergenic feeding, timing of introduction of solid food and smoking cessation. A total of 888 infants were prenatally included. By the time of inclusion the mothers were 3–7 months pregnant. About 27 infants were excluded from the study and 18 dropped out. Of the remaining 843 infants 535 had a first-degree familial predisposition of asthma (high-risk group), whereas a reference group of 308 (162 boys) infants was not predisposed for asthma in the first-degree (low-risk group). To evaluate the (cost-)effectiveness of the preventive intervention, 222 (118 boys) infants of the high-risk group allocated to the intervention group and 221 (112 boys) allocated to a control group are followed up. The low-risk infants served as controls to evaluate the predictive value of high risk (first-degree familial predisposition of asthma). The infants are followed from the prenatal stage until they reach the age of 6 yr. The remaining 92 high-risk infants were included in an optimized randomized-clinical adherence trial (RCAT). Of these 92 infants, 45 (20 boys) were allocated to an intervention group and 47 (24 boys) to a control group. Until now all infants have been followed for at least 1 yr.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    International archives of occupational and environmental health 70 (1997), S. 327-333 
    ISSN: 1432-1246
    Keywords: Key words Occupational exposure ; Confinement farming ; Quaternary ammonium compounds ; Lung function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To study the effect of exposure on bronchial responsiveness in pig farmers. Method: A group of 196 pig farmers were tested for lung function and bronchial responsiveness to histamine in the summer of 1992. To achieve sufficient contrast in respiratory morbidity and exposure, 96 of the farmers were selected because they had chronic respiratory symptoms and the remaining 100 because they were free from any respiratory symptoms. Personal exposure to dust, endotoxins and ammonia was measured during 1 working day in the summer of 1991 and 1 day in the winter of 1992. Data on farm characteristics were gathered in the same period. Results: After adjusting for age and smoking behaviour, mild bronchial responsiveness, defined as PC10≤ 16 mg/ml, was associated with the use of quaternary ammonium compounds as disinfectant [prevalence odds ratio (POR) 6.7, 95% confidence interval (CI) 1.4–32.8], use of wood-shavings as bedding (POR 13.3, CI 1.3–136.7), use of automated dry feeding (POR 2.8, CI 1.0–7.8), use of pellets as feeding material (POR 4.8, CI 1.1–21.1) and location of air exhaust via pit or roof in the confinement units (POR 2.7, CI 1.2–6.3). The association with the use of disinfectants other than quaternary ammonium compounds was not significant (POR 2.4, CI 0.7–8.4). No associations between bronchial responsiveness and measured exposure to dust, endotoxins or ammonia were discernible. Conclusion: Protective measures, designed to prevent airway disease in confinement farming, should be based on information about the operational and other characteristics of farms that are related to high exposure and health effects. Specifically, the use of quaternary ammonium compounds as disinfectant, the use of wood-shavings as bedding and the use of automated dry feeding should be discouraged.
    Type of Medium: Electronic Resource
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