Immunological methods for diagnosis and monitoring of IgE‐mediated allergy caused by industrial sensitizing agents
occupational asthma
Selected publications related to occupational asthma by Prof. Dr. med. Xaver Baur:
List of allergenic occupational asthmagens, JOMT modified
JOMT. Bronchial asthma and COPD due to irritants in the workplace - an evidence-based approach
List of irritants causing occupational asthma or COPD
Occupational COPD - Overview The chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality
worldwide. In addition to dominating causative smoking and environmental exposures (especially biomass smoke from cooking with open fire stoves), about 15% are due to occupational exposure. Occupational causes are frequently not recognised because a detailed occupational history has not been taken.
Int Arch Occup Environ Health. Allergens causing occupational asthma
Individual publications on allergens causing occupational asthma
Occupational agents with respiratory effects (H334)
Algorithm for occupational asthma
Guidelines for the management of work-related asthma
Management of work-related asthma: a broader perspective
Questionnaire Occupational asthma
Differential diagnosis: Allergic alveolitis - hypersensitivity pneumonitis
Questionnaire Fumigants, chemicals
Ethics
Integrity of Occup. and Environm. Reseach Because corporations provide "science for hire, period, and it is extremely lucrative", this editorial serves to bring attention to the undermining of occupational and environmental global public health through the insertion of “knowledge” through mechanisms of corporate malfeasance. Practices of corporate malfeasance include:Contamination of editorial boards of peer-reviewed scientific journals with industry apologists resulting in the publication of poorly-designed research studies that produce biased results that mislead readers and flood the literature with invalid science;
- Interference with the activities of national regulatory bodies (e.g. USEPA, EFSA) and international review panels (e.g. WHO/IARC) and other independent organizations engaged in safeguarding occupational and public health;
- Constructing roadblocks, e.g. by capitalizing on uncertainty to undermine scientific consensus for much-needed government regulation of carcinogenic, endocrine-disrupting and/or immunotoxic agents widely present in the workplace and the environment, including air toxics, pesticides and toxic metals;
- The promotion of “causation” criteria that lack foundation and effectively block workers’ access to legal remedies for harms from occupational exposures resulting in morbidity and premature mortality.
- Violating standards of professional conduct by seducing reputable scientists with financial incentives that make them beholden to serve the corporate agenda.
This well-orchestrated assault on science must be met head-on and could be achieved by promoting and protecting the integrity of research. Further, avoiding influence by conflicted corporate affiliates in occupational and public health regulations would be needed. In so doing, the welfare of patients and society through quality medical and public health education would be more assured.
See also most recent articles in Journal of Scientific Practice and Integrity https://www.jospi.org/articles
Abstracts from the Collegium Ramazzini
How Corporate Influence Continues to Undermine the Public’s Health
Massive Faculty Donations and Institutional Conflicts of Interest
Letter from the Editors: An Introduction to the Journal of Scientific Practice and Integrity
Publications by Prof. Dr. Xaver Baur:
Baur X, Budnik LT, Ruff K et al. Ethics, morality, and conflicting interests: how questionable professional integrity in some scientists supports global corporate influence in public health. Int J Occup Environ Health 2015; 21: 172-175 Abstract
Baur X. Ethik in der Arbeitsmedizin - Orientierungshilfe in ethischen Spannungsfeldern. Landsberg: ecomed Medizin; 2009
Das deutschsprachige Referenzwerk für ethische Fragen in der Arbeitsmedizin Das Buch macht die Spannungslinien deutlich, denen arbeitsmedizinisch Tätige ausgesetzt sind. Die authentischen Beiträge aus den unterschiedlichen Perspektiven bringen die Interessenverflechtungen und -gegensätze auf den Punkt, die es für Arbeitsmediziner in ihrer "Sandwich"-Position zwischen Arbeitgebern und Arbeitnehmern, Sozialbehörden und Betroffenen, Interessengruppen, in den verschiedenen Gremien und auch in der Forschungsförderung (Drittmittelvergabe) immer wieder gibt. Damit stößt es eine breite Diskussion über die Maßstäbe des rechten Handelns in der Arbeitsmedizin an. Ziel ist es, die Rolle der Arbeits- und Betriebsmedizin immer wieder kritisch zu reflektieren und einen eigenen Standpunkt sowie adäquate Strategien zur Wahrung der Unabhängigkeit in diffizilen Konstellationen zu entwickeln.
See also:
Corporate Influence Threatens the Public Health
Vested interests, whose primary goal is to protect markets for products which frequently have hazardous potentials, are increasingly combined with distortion of science applied in legislation, policy-making, standard-setting and legal proceedings. The Collegium Ramazzini held a panel entitled “Corporate Influence Threatens the Public’s Health” on November 1, 2018, which drew attention to these hazardous malfeasances. Strategies to meet the related ongoing challenges by promoting and protecting the integrity of research, the welfare of patients and society, and the quality of medical/health education, were debated.
Reviewing own conflict of interests? Scientists working for product defence firms, such as Exponent, a scientist working for Bayer, as well, sadly, as scientists working for the U.S. Environmental Protection Agency and for the Canadian government's department of Environment and Climate Change suggest “how to improve research reproducibility, credibility, and transparency” (Mebane CA et al, 2019 in Integr Environ Assess Manag.).
Boffeta again left his conflict of interests undeclared: D. Consonni and C Mensi comment on paper “Boffetta et al. Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy. Ann Oncol 2018; 29(2): 484-489: ... “In conclusion, contrarily to what stated in the paper, a high quality of the RMRP emerges from the available data. Finally, we note that the Authors of the paper (on mesothelioma) have declared no conflict of interests. This is odd, given that two of the Authors in a recent paper (on mesothelioma) reported “Consulting or Advisory Roles” for 4 large companies and one Author declared “Other relationships” with law offices. These companies and law offices are currently involved in litigations regarding asbestos-related diseases” [D. Consonni and C. Mensi, Integr Environ Assess Manag. 2019 Jan 4. doi: 10.1002/ieam.4119. [Epub ahead of print]
Most interesting publications on this issue:
Egilman D, Wallace W, Hom C. Corporate corruption of medical literature: asbestos studies concealed by W.R. Grace & Co. Account Res 1998; 6: 127-147
Lemen RA. Role of government in occupational and environmental health. Int J Occup Environ Health 1999; 5: 283-286
Axelson O, Balbus JM, Cohen G et al. Re: Regulatory Toxicology and Pharmacology. Int J Occup Environ Health 2003; 9: 386-389; author reply 389-390
Bailar JC, 3rd, Ballal SG, Boback M et al. FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe. Int J Occup Environ Health 2006; 12: 254-258
Egilman D, Howe S. Against anti-health epidemiology: corporate obstruction of public health via manipulation of epidemiology. Int J Occup Environ Health 2007; 13: 118-124
Baur X, Soskolne CL, Lemen RA et al. How conflicted authors undermine the World Health Organization (WHO) campaign to stop all use of asbestos: spotlight on studies showing that chrysotile is carcinogenic and facilitates other non-cancer asbestos-related diseases. Int J Occup Environ Health 2015; 21: 176-179
Welch LS. Asbestos exposure causes mesothelioma, but not this asbestos exposure: an amicus brief to the Michigan Supreme Court. Int J Occup Environ Health 2007; 13: 318-327
Oreskes N, Conway EM. Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming. New York: Bloombury Press, 2011
Michaels D. Doubt Is Their Product How Industrys Assault On Science Threatens Your Health. New York: Oxford University Press; 2016
Conflict of interest disclosure
asbestos related diseases
Selected publications related to asbestos related diseases by Prof. Dr. med. Xaver Baur:
The German experience with asbestos-related diseases: a failure of compensation due to the manipulation of science
Ongoing downplaying of the carcinogenicity of chrysotile
The persisting strong influence of vested asbestos-related interests in workers and public health issues including regulations and compensation necessitate ongoing alertness, corrections and appropriate reactions in scientific as well as public media and policy advisory bodies. Industries that mine, manufacture and sell asbestos or asbestos-containing products have a long tradition of promoting the use of asbestos, while placing the burden of economic and health costs on workers and society. This has been successfully done in recent years and decades in spite of the overwhelming evidence that all asbestos types are carcinogenic and cause asbestosis. They continue to be extremely active by using slogans such as chrysotile can be used safely. Another approach of the asbestos industry and of some of its insurance agencies is to broadly defeat liability claims of asbestos victims. In doing so they systematically use inappropriate science produced by their own and/or by industry-affiliated researchers. Some of the latter were also engaged in producing defense material for other industries including the tobacco industry. Frequent examples of distributing such disinformation include questioning or denying established scientific knowledge about adverse health effects of asbestos. False evidence continues to be published in scientific journals and books.
Malignant mesothelioma: Controversies about its etiology in females
Malignant mesothelioma (MM) is one of the most aggressive cancers with the poorest of outcomes. There is no doubt that mesothelioma in males is related to asbestos exposure, but some authors suggest that most of the cases diagnosed in females are "idiopathic." In this assessment of the science, it is demonstrated that the "low risk" of mesothelioma in females is because of the nonsystematic recording of exposure histories among females. Detailed analysis of the literature shows the risk of MM among females to be close to that in males. The absence of detailed exposure histories should be rectified in future studies involving women. As a matter of social justice, the ongoing failure to recognize asbestos as the cause of a majority of cases of MM in females does them, and their kin, a profound disservice.
Oliver, Baur-letter-to-Feder et al In a recent publication Feder, Theile and Tannapfel claim an ongoing debate about the hazardous nature of chrysotile. Publications cited by Feder et al (Quinn, LaDou, IARC, WHO), and other professional bodies and government agencies contradict this claim, concluding that chrysotile asbestos exposure increases risk for asbestosis, mesothelioma, lung and other cancers. There is grave risk that the publication by Feder et al. will unfairly and unjustly influence outcomes in the adjudication of asbestos-related disease in the legal system and that, as a result, the injured worker will suffer. This risk would apply to those with a history of occupational exposure to chrysotile asbestos and in whom few or no asbestos fibres are found in the lung years later. The claim by Feder et al. that chrysotile fibres are biopersistent in the lung could be used in courts of law to deny justice to asbestos-harmed victims.
see also letter of the Collegium Ramazzini
Misleading fiber analysis in chrysotile workers The silicate mineral asbestos is categorized into two main groups based on fiber structure: serpentine asbestos (chrysotile) and amphibole asbestos (crocidolite, amosite, anthophyllite, tremolite, and actinolite). All forms of asbestos are capable of inducing mesothelioma, lung cancer, asbestosis, and other diseases. However, unlike other forms of asbestos, chrysotile asbestos, the predominant form of asbestos in world markets today and in the past is well documented to have only a short residence time in lung tissue.
See also full text by Woitowitz and Baur re the "New Insights"
Response to letter of Merget, Tannapfel In their letter Merget, Feder and Tannapfel ignore the cited publication of leading pneumoconiosis pathologists, namely Hammar and Abraham, who convincingly reject the “modification” of the asbestosis definition from CAP-NIOSH by a group of pathologists headed by V. Roggli. Another concern refers to their differential diagnosis of asbestosis and idiopathic pulmonary fibrosis. According to the annual report of the Deutsche Mesotheliomregister in 2014, the authors diagnosed in only 11% of the subjects (suspected to suffer from asbestosis and/or asbestos-related plaques/fibrosis asbestosis) grade 1 and in only c. 6% of the cases asbestosis of higher grades. No details are presented for the overwhelming majority of the patients which were obviously not diagnosed as asbestosis or an asbestos-related non-malignant pleural disorder. The diagnosis of asbestosis is of highly significant relevance in compensation issues because of the German medical legal definition of asbestos-related lung cancer, asbestosis is requires as a precondition for acceptance of the disorder as an occupational disease in the absence of the 25 fibre years or of asbestos-related non-malignant pleural disorders. Contrary to what the authors of the letter assert, it is obvious from the figures mentioned that non-acceptance of lung cancer as an occupational disease is frequently due to application of this restrictive and unsound definition of asbestosis.
Asbestos diseases in Germany This article belongs to the special issue theme “Global Panorama of National Experiences in Public Health Actions to Ban Asbestos”. It was published in the International Journal of Environmental Research and Public Health (IJERPH) with Ken Takahashi, Jukka Takala and Annette David as guest editors. The major topic is the German experience in hazardous exposures during industrial application of asbestos, the war in initiating respective health regulations, an asbestos ban, and compensation of victims. In addition to the tragedy of thousands of former workers annually affected by asbestos-related diseases the related economic burden on the society including forthcoming clean-up of contaminated sites is also shortly covered.
The asbestos cancer epidemic by J. LaDou
Antigorite is an asbestiform material occuring in tunnelling. Obviously, it comprises the same adverse helath effects as asbestos. Respective precousious measures and regulations are needed: https://link.springer.com/article/10.1007/s00501-017-0686-4
Asbestiform antigorite: adverse health effects
Mixed-dust pneumoconiosis Environmental aerosolized particulates pose a potential risk to human health worldwide. Among others, high amounts of contaminants are generated especially in newly industrializing countries in the vicinity of industrial manufacturing, mining operations, but also during agricultural and natural processes. As an example of the needed multi-disciplinary diagnostic and differential diagnostic approach, we report a case of a 59-year old industrial worker who has suffered from chronic bronchitis and progressive dyspnea on exertion for 8 years.
Further publications and commtents:
Asbestos secretariat global-asbestos-mortality
Editorial oemed-2017 Mesothelioma mortality
Odgerel et al. Mesothelioma oemed-2017-104688
Mesothelioma from Asbestos Exposure in Brake Mechanics: Epidemiology in Context by Marty S. Kanarek and Henry A. Anderson Epidemiology has been applied to the study of automobile repair workers who have been exposed to asbestos from the replacement and installation of brakes containing asbestos. In spite of the limits of epidemiology methods there is an abundance of evidence that performing brake installation or repair releases substantial amounts of asbestos into workers’ breathing zones. The documentation of such exposures supports the weight of evidence epidemiologic conclusion that asbestos from brakes can and does cause mesothelioma in workers handling asbestos containing brake materials Mesothelioma due to chrysotile in brake mechanics
AWMF-Leitlinie zur Diagnostik und Begutachtung asbestbedingter Berufskrankheiten
A Systematic Policy of Misinformation on the Toxicity of Asbestos: Lobbying
Ausgewählte Publikationen von Prof. Dr. med. Xaver Baur:
Originalartikel
The German experience with asbestos-related diseases: a failure of compensation due to the manipulation of science
Asbest-bedingte BK: Schneider, Baur Becker
Bei Berufskrankheiten handelt es sich um bestimmte durch Rechtsverordnung bezeichnete Krankheiten. Während die
Krankheitsbilder medizinisch in Leitlinien beschrieben sind, beruht deren Anerkennung auf justiziablen Verwaltungsverfahren.
Die Kausalitätsprüfungen sind an sozialjuristische Vorgaben gebunden. Es werden die für die Begutachtung
grundlegenden sozialjuristischen Begriffe genannt und die Kausalitätsgrundsätze bei asbestbedingten Berufskrankheiten
aufgeführt sowie beispielhaft rechtskräftige Sozialgerichtsurteile zitiert. Hieraus resultieren teilweise
von der medizinischen Ansicht nicht selten abweichende Beurteilungen. Ziel ist die korrekte Anwendung sozialmedizinischer
Kenntnisse, um eine adäquate Begutachtung im Berufskrankheitenfall vorzunehmen, die die rechtlichen Vorgaben umsetzt.
Pneumologie 2020; 74: 603–610 DOI 10.1055/a-1201-3840
Miss-Interpretation und Verharmlosung der Asbestgefahren
Die Asbestindustrie verharmlost und negiert bis heute die Gesundheitsgefahren, die von Asbest ausgehen, z.B mit dem Slogan "Chrysotile can be used safely". Auf diese falschen Behauptungen, die mit der Verweigerung der Anerkennung und Entschädigungen asbestbedingter Berufskrankheiten einhergehen, wird in dieser Veröffentlichung unter Verweis auf die medizinisch-wissenschaftliche Literatur eingegangen.
Siehe auch:
Chrysotil-Asbest
Malignant mesothelioma: Ongoing controversies about its etiology in females
https://pubmed.ncbi.nlm.nih.gov/34036634/
Ongoing downplaying of the carcinogenicity of chrysotile
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901213/pdf/12995_2021_Article_295.pdf
Oliver et al to Feder, Theile, Tannapfel
In a recent publication Feder, Theile and Tannapfel claim an ongoing debate about the hazardous nature of chrysotile. Publications cited by Feder et al (Quinn, LaDou, IARC, WHO), and other professional bodies and government agencies contradict this claim, concluding that chrysotile asbestos exposure increases risk for asbestosis, mesothelioma, lung and other cancers. There is grave risk that the publication by Feder et al. will unfairly and unjustly influence outcomes in the adjudication of asbestos-related disease in the legal system and that, as a result, the injured worker will suffer. This risk would apply to those with a history of occupational exposure to chrysotile asbestos and in whom few or no asbestos fibres are found in the lung years later. The claim by Feder et al. that chrysotile fibres are biopersistent in the lung could be used in courts of law to deny justice to asbestos-harmed victims.
siehe ferner letter of the Collegium Ramazzini
siehe hierzu außerdem Woitowitz, Baur The silicate mineral asbestos is categorized into two main groups based on fiber structure: serpentine asbestos (chrysotile) and amphibole asbestos (crocidolite, amosite, anthophyllite, tremolite, and actinolite). All forms of asbestos are capable of inducing mesothelioma, lung cancer, asbestosis, and other diseases. However, unlike other forms of asbestos, chrysotile asbestos, the predominant form of asbestos in world markets today and in the past is well documented to have only a short residence time in lung tissue.
https://www.ncbi.nlm.nih.gov/pubmed/29775975
Response to Merget, Tannapfel In their letter Merget, Feder and Tannapfel ignore the cited publication of leading pneumoconiosis pathologists, namely Hammar and Abraham, who convincingly reject the “modification” of the asbestosis definition from CAP-NIOSH by a group of pathologists headed by V. Roggli. Another concern refers to their differential diagnosis of asbestosis and idiopathic pulmonary fibrosis. According to the annual report of the Deutsche Mesotheliomregister in 2014, the authors diagnosed in only 11% of the subjects (suspected to suffer from asbestosis and/or asbestos-related plaques/fibrosis asbestosis) grade 1 and in only c. 6% of the cases asbestosis of higher grades. No details are presented for the overwhelming majority of the patients which were obviously not diagnosed as asbestosis or an asbestos-related non-malignant pleural disorder. The diagnosis of asbestosis is of highly significant relevance in compensation issues because of the German medical legal definition of asbestos-related lung cancer, asbestosis is requires as a precondition for acceptance of the disorder as an occupational disease in the absence of the 25 fibre years or of asbestos-related non-malignant pleural disorders. Contrary to what the authors of the letter assert, it is obvious from the figures mentioned that non-acceptance of lung cancer as an occupational disease is frequently due to application of this restrictive and unsound definition of asbestosis.
Die Asbestkörper-Hypothese ist tot (Woitowitz)
Leserbrief zu Auswirkungen der Asbestbelastung auf die Lungenfunktion (Wilken und Baur)
Sozialmedizinische Aspekte Deutsch
Asbestos-related diseases: Sociallegal aspects
Asbest-Berufskrankheiten in Deutschland This article belongs to the special issue theme “Global Panorama of National Experiences in Public Health Actions to Ban Asbestos”. It was published in the International Journal of Environmental Research and Public Health c Health (IJERPH) with Ken Takahashi, Jukka Takala and Annette David as guest editors. The major topic is the German experience in hazardous exposures during industrial application of asbestos, the war in initiating respective health regulations, an asbestos ban, and compensation of victims. In addition to the tragedy of thousands of former workers annually affected by asbestos-related diseases the related economic burden on the society including forthcoming clean-up of contaminated sites is also shortly covered.
Antigorit faserförmiges Gestein
Mischstaub-Pneumokoniose Viele Arbeitnehmer sind im Rahmen ihrer beruflichen Tätigkeiten gleichzeitig oder aufeinanderfolgend verschiedenen anorganischen Stäuben ausgesetzt. Diese können zu einer Lungenfibrose (Pneumokoniose) führen, welche von den klassischen Formen (Silikose, Asbestose etc.) mehr oder weniger abweicht. Nicht selten wird irrtümlich eine idiopathischen Lungenfibrose und nicht eine berufsbedingte Lungenkrankheit diagnostiziert. Das Fallbeispiel weist auf die Bedeutung der detaillierten Arbeitsanamnese hin und zeigt zielführende diagnostische Schritte auf.
Leitlinie Silikose
Weitere Veröffentlichungen, Hilfsmittel und Kommentare:
Lymphknotenvergrößerung: berufliche und nichtberufliche Ursachen
Asbestos secretariat global-asbestos-mortality
Editorial oemed-2017 Mesotheliom-Mortalität