Showing papers by "Frank E. Speizer published in 1974"

Questionnaire approaches and analysis of epidemiological data in organic dust lung diseases.

Abstract: Respiratory diseases associated with exposure to organic materials can be and are a potential hazard to workers in various occupations. In fact, it is almost incredible that the occupational organic dust disease described in 171 3 by Ramazzini as a “disease of sifters and measurers of grain” stood alone for over 300 years before Campbell’s classic description from England in 1932 of the acute stages of farmer’s lung.’, Farmer’s lung has since been reported in many parts of the world, particularly in those areas which tend to have a wet summer ~ e a s o n . ~ Epidemiological investigations in populations at risk are designed generally to test hypotheses which are developed from information gathered initially from a study of individual cases. This information is usually the result of astute observations by a clinician who reports an unusual finding. This is followed by the collection of a number of unusual cases by the academically oriented specialist in a variety of laboratory sciences. The findings described are those abnormalities which occur in a disease process which are appropriate to the particular specialist. With this information, the epidemiologist can identify thekind of information which needs to be gathered to define the levels of risk from these diseases, the natural history of these diseases, the factors which lead to susceptibility to these diseases, and how these diseases interact with other pathologic states. The specific aim of this paper is to describe some of the findings in organic dust lung disease which have been identified with the use of epidemiological approaches. I will also consider how these approaches might be further put to use in the study of industrial population groups to learn about pulmonary diseases associated with exposure to organic materials. TABLE 1 lists some of the diseases which can be considered to be associated with exposure to organic materials. For most of these conditions the information is rather sparse or .uninterpretable. For example, SO-90% of the patients with farmer’s lung have been found to have specific thermophillic actinomycetes antibodies. Nevertheless, there are no reliable United States figures on the proportion of farmers having antibodies for these specific actinomycete~.~ The study of approximately 1,000 farmers from 18 member clinics of the American Association of Medical Clinics, representing the major United States and