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2011 (pdf, 4 MB) - Universitätsklinikum Hamburg-Eppendorf

2011 (pdf, 4 MB) - Universitätsklinikum Hamburg-Eppendorf

WHO-Projekte Target

WHO-Projekte Target group and/or beneficiaries Summary of the project Dissemination Impact (global or regional) Progress on Project List of major outcomes already achieved by this project List of additional major outcomes expected by 2012 Respective evidence tables based on literature search (2009) Formulate recommendations how to prevent and related to these key questions manage occupational asthma (2009/2010) The target group of the intended guideline are workers in all sectors of activity. The target audience are all health care practitioners, i.e. occupational physicians and primary care physicians for fostering education. Given legal differences in the different countries, addition to industrial physicians, workers representatives with specific responsibility for the safety and health of workers may benefit from the guideline. The objective is the substantial improvement of the prevention of occupational asthma in order to obtain a reduction of symptoms, morbidity, mortality and expenses. The proposed output will be: - Introduction with definitions (e.g., new onset work-related asthma, aggravation of pre-existing asthma) - Background chapter (including a summary of the current knowledge on causes, prevalence / incidence, dose-response relations, risk factors, primary prevention, and diagnostic tools) - Compilation of useful information, e.g. legal framework conditions for the management of work-related asthma in the European Union - Evidence-based recommendations on the prevention and management of work-related asthma, including treatment and interventions, such as stopping/reduction of causative exposure. The guidelines will be published as a long version as an internet file and as a short version in an international journal. Global The project asked the European Respiratory Society (ERS) to fund a task force for “Evidence-based guidelines for the prevention of occupational asthma in Europe”. In March 2007, the ERS approved a revised version focusing on the “Management of work-related asthma”. After meetings in Copenhagen and Munich, the entire group held further meetings in Stockholm, San Diego and Barcelona. Carrie Redlich (Yale School of Medicine, USA) and Paul Henneberger (National Institute for Occupational Safety and Health (NIOSH), USA) joined as collaborators - Two articles (diagnostics, management) have been submitted for publication. Evidence-based statements and recommendations have been finalized by the ERS working group. - A national German guideline on prevention of occupational asthma was recently published. - Six articles comprising the whole content of the guidelines which will be published in two international journals in 2012 (ERJ, ERR). Presentations of the guidelines at two international symposia, Amsterdam (8/2011) and San Francisco (05/2012), are planned in order to distribute the results and recommendations. This project herewith ends as a separate project as suggested by Evelyn Kortum and Rokho Kim. Respective further activities will be included in the new project 2.11f (“Prevention of occupational asthma”) from 2012 onwards. Describe the impact - Establishment of appropriate diagnostic methods and screening in 81

WHO-Projekte or influence of this project order to detected work-related asthma at an earely stage - World-wide reduction of the risk of work-related asthma by improved primary prevention - Significantly improved secondary prevention of endangered/affected workers by appropriate sensitive surveillance programs and exposure reduction. Detection of impaired lung function in early stages of asbestosis by means of gas diffusion parameters Priority Initiative (Objective 1) Priority 1.3: Develop and disseminate evidence-based prevention tools and raise awareness for the elimination of asbestos-related diseases Project leader Dr. Alexandra M. Preisser Network partners WHO Regions involved Country ministries involved Centre for Occupational Health at the National Institute of Public Health, Prague, Czech Republic Europe External partners Not at all Summary of the project Target group and/or beneficiaries Events opportunities for furthering the project Expected results of this project by 2012 (outcomes) Indicators of achievement (impact) Major Milestones Ministry of Health, Germany Lung fibrosis and pleural plaques are frequent findings in asbestos workers. Asbestosis results in a restrictive ventilation pattern with decreases of diffusion capacity and lung compliance. The effect of pleural plaques on the gas diffusion, measured as CO diffusion capacity (DL,CO) is controversially discussed. Our aim is to objectify functional impairment of pleural plaques and initial parenchymal fibrosis by means of DL,CO, the new analyzing method DL,NO, and the alveolar-arterial PO2 difference in the exercise test (spiroergometry). The data will be compared with results from spirometry, compliance, chest X-ray (CT, when available) and the estimated cumulative asbestos dose. Workers previously occupationally exposed to asbestos in shipyards, power plants and other industries Development of a sensitive diagnostic tool for asbestos-induced plaques and asbestosis at early stages Description of the best method for measurement of impaired gas diffusion in the lung already detecting initial changes in lung function Evidence-based recommendations for detecting early stages of asbestos-related benign lung disorders - Examination of 60 former asbestos-exposed workers with lung function analysis and chest x-ray (2009-10) - Statistical analysis of the data (2010-11) - Analysis and publication of the data and recommendations (2012) 82

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