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1/13. tobacco allergy: demonstration of cross-reactivity with other members of solanaceae family and mugwort pollen.

    BACKGROUND: tobacco is a plant belonging to the solanaceae family. This plant is usually used as a contact insecticide for several infestations in some areas, such as the Canary islands. Allergy induced by inhalation of this plant is unusual. Identification of the potential allergen in growing areas is essential. OBJECTIVE: We report a patient with occupational sensitivity to an aqueous solution of cut tobacco whose clinical manifestations were rhinoconjunctivitis and urticaria. Past medical history was significant for seasonal allergic rhinoconjunctivitis to mugwort pollen and oral allergy syndrome with avocado. methods: Green tobacco and cured tobacco leaf extracts were prepared, skin prick tests were performed with green tobacco, cured tobacco leaf extracts, and certain aeroallergens. Conjunctival challenge test was carried out with green tobacco and cured tobacco leaf extract. serum-specific IgE against tobacco leaf was performed by commercial CAP. CAP inhibition experiments were carried out with tobacco and artemisia vulgaris. RESULTS: Skin prick tests and conjunctival challenge tests with green tobacco and cured tobacco leaf extracts were positive, as well as serum-specific IgE by CAP, indicating an IgE-mediated sensitization. CAP inhibition experiments were carried out and it was found that tobacco, mugwort pollen, and tomato extracts inhibited the binding of the patient's serum to solid-phase tobacco leaf. No inhibition was observed when alternaria, D. pteronyssinus, and potato were used as control inhibitors. Inhibition of immunoCAP to mugwort was obtained with mugwort and tobacco extracts and no cross-reactivity to D. pteronyssinus was shown. CONCLUSION: The results suggest that tobacco can induce IgE-mediated reactions that are mediated by the existence of common antigenic epitopes between tobacco and mugwort pollen. This allergy can be a hazard of employment in the agricultural areas.
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2/13. Phytophotodermatitis associated with parsnip picking.

    Phytophotodermatitis to certain plant groups is a well recognised entity. The combination of sunlight exposure and contact with plants of the umbelliferae family leads to the development of painful, erythematous, and bullous lesions and later to cutaneous hyperpigmentation. Agricultural workers and many clinicians often fail to make this link when patients present with these lesions. An incident involving 11 patients is presented to high-light this problem.
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3/13. Occupational contact dermatitis to phaseolus vulgaris in a farmer - a case report.

    A case of occupational contact dermatitis in a farmer is described, caused among others by phaseolus vulgaris. The patient's history of eczematous and vesicular and bullous skin reactions occurring after exposure to phaseolus was confirmed by skin tests with native leaves of the plant. To the best of our knowledge, this is the first description of occupational contact dermatitis caused by leaves of phaseolus plant.
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4/13. Contact dermatitis to Asparagus officinalis.

    A 53-year-old farm worker presented with a 3-year history of an occupational allergic contact dermatitis to asparagus. The dermatitis cleared quickly with courses of systemic corticosteroids but relapsed within days of further exposure to asparagus. The genera Asparagus is made up of some 300 species. It belongs to the family liliaceae which includes tulips, onions and garlic. Asparagus contains asparagin, coniferin and the glucoside vanillin. The allergen may be a plant growth inhibitor, 1,2,3-Trithiane-5-carboxylic acid, which is present in young shoots.
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5/13. Occupational airborne and hand dermatitis to hop (humulus lupulus) with non-occupational relapses.

    We report a case of a 57-years-old female farmer with occupational airborne dermatitis and hand dermatitis to hop (humulus lupulus). The disease appeared at the age of 46, after 30 years of working with hop without any health problems. The patient had skin erythema of the face, neck and decollete , oedema of the eyelids, conjunctivitis, as well as acute dermatitis of the hands. The symptoms were provoked both by fresh and dried hop, appeared after half-an-hour of working and persisted over 1-2 days. There were no other skin or allergic problems. Skin tests were carried out with hop leaves (saline extract: prick positive, patch negative; glycerol extract: prick positive, patch negative) and hop cones (saline extract: prick positive, patch negative; glycerol extract: prick negative, patch positive after 48 and 72 hours). Despite discontinuing work, the patient experienced several relapses of her dermatitis. We identified new sources of hop allergens: a beauty cream and a herbal sedative, both containing hop extract. During the next hop cultivation period it also turned out that sleeping in one bed with her husband was provoking relapses of the patient's dermatitis. The husband admitted that sometimes he felt too tired to wash thoroughly after working on the plantation. Our case shows that connubial contacts with husband working in the same workplace may cause relapses of occupational dermatitis. To our knowledge, this is the first report on the concurrent occupational and connubial dermatitis to hop.
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6/13. Pseudo-outbreak of tuberculosis in poultry plant workers, Sussex County, delaware.

    delaware is a leading US poultry-producing state, and foreign-born workers make up a significant percentage of those employed by delaware's poultry plants. In Sussex County, delaware, a high percentage of the poultry workers are from two countries with a high incidence of tuberculosis (TB), mexico and guatemala, and thus are at risk for TB infection and disease. Furthermore, their risk of TB may be increased because many of these workers live in crowded conditions and lack access to medical care.
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7/13. Allergic contact dermatitis in shiitake (Lentinus edodes (Berk) Sing) growers.

    A 42-year-old female shiitake grower was investigated to clarify the etiology of skin lesions which developed during the planting of shiitake hyphae into bed logs. She complained of repeated eczematous skin lesions during the planting season, from March to July, for 10 years. She handled 7,000 pieces of small conic blocks made of beech, with shiitake hyphae attached to their surface, per day, and 300,000 pieces altogether per season. She was positive on patch testing with extracts of shiitake hyphae. In contrast, female shiitake growers with skin lesions associated with work other than planting, and without skin lesions, were negative on patch testing to the hyphae. Moderate allergenicity was observed to extracts of shiitake hyphae in a guinea pig maximization test. These findings indicated the etiology of skin lesions in shiitake growers to be allergic contact dermatitis induced by shiitake hyphae.
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8/13. Green tobacco sickness in children and adolescents.

    tobacco (Nicotiana tabacum) is cultivated in more than 100 countries, and in 2004, some 5.73 million metric tons dry weight of tobacco were grown worldwide. The top five tobacco producers forecast for 2004 are china (2.01 million metric tons; 35.1%), brazil (757 thousand metric tons; 13.2%), india (598 thousand metric tons; 10.4%), united states (358 thousand metric tons; 6.2%), and malawi (138 thousand metric tons; 2.4%). Together, these five countries account for two-thirds of worldwide tobacco production. tobacco farming presents several hazards to those who cultivate and harvest the plant. Although some of these hazards, such as pesticide exposure and musculoskeletal trauma, are faced by workers in other types of agricultural production, tobacco production presents some unique hazards, most notably acute nicotine poisoning, a condition also known as green tobacco sickness (GTS). GTS is an occupational poisoning that can affect workers who cultivate and harvest tobacco. It occurs when workers absorb nicotine through the skin as they come into contact with leaves of the mature tobacco plant. GTS is characterized largely by nausea, vomiting, headache, muscle weakness, and dizziness. Historically, children have played a role in agricultural production in the united states, and they continue to do so today. This includes tobacco farming. The North American Guidelines for Children's Agricultural Tasks, a set of injury prevention guidelines prepared by the National Children's Center for Rural and Agricultural Health and safety, lists GTS as one of several hazards children face when working on tobacco farms. Children 17 years of age and younger who work on U.S. tobacco farms come from three main groups: members of farm families, migrant youth laborers (primarily Latinos), and other hired local children. All three groups are at risk for GTS. Beyond the U.S., tobacco production using child labor is an emerging topic of concern in developing nations. An international movement, advocated by the Eliminating child Labor in tobacco Foundation, is underway to restrict child labor in tobacco production. GTS is a unique occupational poisoning associated with tobacco farming. We suspect that many public health practitioners, clinicians, advocates, and researchers are unaware of GTS among children and adolescents. In this article, we provide an overview of GTS among young people who work in tobacco, summarize reports documenting pediatric GTS cases, explain GTS etiology, and present three case studies of pediatric GTS in kentucky. In addition, we discuss the need for expanded surveillance and prevention of GTS, both in the united states and globally.
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9/13. Pseudo-delusory syndrome caused by Limothrips cerealium.

    BACKGROUND: Limothrips cerealium (or "grain thrips") is an insect of the phylum Arthropoda, known as parasite of plants of the family Gramineae; human infestation is not frequently described in literature. MATERIALS AND methods: We report the case of a 59-year-old female farmer, come to observation because of intense itching and sensation of "walking insects" on her head, with no objective cutaneous signs except lesions due to scratching. After repeated visits, in which negative results of clinical and laboratory tests suggested the diagnosis of "delusory syndrome" (Ekbom's syndrome), we finally isolated on her head some insects, identified by stereomicroscopy as L. cerealium. Careful inspection of the house of our patient allowed us to identify, as possible source of parasites, a wheat field and a deposit of grains used for animal feeding. Temporarily removing the patient from her usual environment resulted in complete clinical resolution. RESULTS: Peculiarity of symptoms caused by this parasite and consequent problems for a correct diagnosis are discussed, as well as possible solutions.
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10/13. Occupational respiratory allergy to cyclamen pollen: a case report.

    A case of cyclamen (cyclamen persicum) pollen allergy is described on a flower cultivator. The diagnosis was assessed by skin test, methacoline test, nasal provocation test and RAST. SDS-PAGE and immunoblotting have shown an intense response against a 18 kDa component and a weaker one at 100 Kda. A RAST inhibition against cupressus sempervirens and acacia floribundia showed no identity with cyclamen. This case confirm the cyclamen allergenity, in professional exposure. The nasal challenge prove to be very useful to confirm allergic sensitizations an we emphasize the necessity of preventive measures of protection for those florists who cultivate cyclamen plants.
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