A Medscape article that might interest you.

[Guest guest]

I am having trouble pulling up this article, could someone copy this to this

message board?

In a message dated 8/30/2006 10:12:50 AM Central Standard Time,

madeskv@... writes:

I thought you might be interested in this. It is about asbestos but it might

have some relevance to inhaling particles and auto immunity problems-

_http://www.medscapehttp://www.medschttp://www.mht_

(http://www.medscape.com/viewarticle/542480?src=mp)

To access the article, click on this Web address, or cut and paste it into a

browser window.

[Guest guest]

Nested Case-Control Study of Autoimmune Disease in an

Asbestos-Exposed Population

Posted 08/21/2006

Curtis W. Noonan; C. Pfau; Theodore C. Larson; R.

Spence

Abstract and Introduction

Abstract

Objective: To explore the potential association between asbestos

exposure and risk of autoimmune disease, we conducted a case-control study among

a cohort of 7,307 current and former residents of Libby, Montana, a community

with historical occupational and environmental exposure to asbestos-contaminated

vermiculite.

Methods: Cases were defined as those who reported having one of

three systemic autoimmune diseases (SAIDs) : systemic lupus erythematosus,

scleroderma, or rheumatoid arthritis (RA) . Controls were randomly selected at a

3:1 ratio from among the remaining 6,813 screening participants using

frequency-matched age and sex groupings.

Results: The odds ratios (ORs) and 95% confidence intervals (CIs)

for SAIDs among those ? 65 years of age who had worked for the vermiculite

mining company were 2.14 (95% CI, 0.90-5.10) for all SAIDs and 3.23 (95% CI,

1.31-7.96) for RA. In this age group, exposure to asbestos while in the military

was also an independent risk factor, resulting in a tripling in risk. Other

measures of occupational exposure to vermiculite indicated 54% and 65% increased

risk for SAIDs and RA, respectively. Those who had reported frequent contact

with vermiculite through various exposure pathways also demonstrated elevated

risk for SAIDs and RA. We found increasing risk estimates for SAIDs with

increasing numbers of reported vermiculite exposure pathways (p < 0.001).

Conclusion: These preliminary findings support the hypothesis that

asbestos exposure is associated with autoimmune disease. Refined measurements of

asbestos exposure and SAID status among this cohort will help to further clarify

the relationship between these variables.

Introduction

An association between occupational exposures of inhaled

particulates and autoimmunity was postulated as early as 1914, when Bramwell

(1914) reported increased frequency of diffuse scleroderma (SSc) in stone

masons. Although genetic factors undoubtedly exist that affect the development

of systemic autoimmune diseases (SAIDs) in certain individuals, the concordance

of SAIDs among identical twins is only 25-40%, suggesting that environmental

factors play a substantial role ( et al. 1999). Indeed, several

environmental agents are implicated in triggering or accelerating SAIDs,

including mercury, iodine, vinyl chloride, certain pharmaceuticals, and

crystalline silica. However, much more research is needed to determine the

mechanisms and epidemiology linking exposures to development of SAIDs. There is

considerable epidemiologic evidence supporting the hypothesis that occupational

silica exposure is associated with a variety of SAIDs, including SSc, rheumatoid

arthritis (RA), systemic lupus erythematosus (SLE), glomerulonephritis, and

small vessel vasculitis (Koeger et al. 1995; Parks et al. 1999, 2002; et

al. 1999; Steenland and Goldsmith 1995). Research regarding asbestos exposure

and SAIDs has been much more limited.

Asbestos-related lung disease continues to be a serious and

significant problem worldwide despite increasing awareness of health hazards of

asbestos inhalation. Asbestos exposure is associated with various lung

conditions, including fibrosis, pleural plaques, and cancer. Although the exact

mechanisms leading to the progression of these conditions have not been fully

explained, there is evidence that some of the lung abnormalities seen with both

asbestos and silica exposures are immunologically mediated (Hamilton et al.

1996; Holian et al. 1997; Perkins et al. 1993). Nevertheless, it is unclear how

these innate immune responses might translate to specific humoral responses.

Increased serum immunoglobulins (Ig), positive antinuclear antibody (ANA) tests,

and immune complexes have been reported in small cohorts of individuals exposed

to asbestos (Lange 1980; Nigam et al. 1993; Pfau et al. 2005; Zerva et al.

1989), but no comprehensive study has been undertaken to assess the association

between asbestos exposure and autoimmune disease.

Our major objective, therefore, is to establish whether such an

association exists, and the community of Libby, Montana, provides a unique

opportunity to investigate this question. Individuals in this population

experienced significant exposures that occurred as a result of

asbestos-contaminated vermiculite mining near the community. From the early

1920s to 1990, the world's largest vermiculite deposits, located near Libby,

were mined and processed. Vermiculite is a silicate mineral with unique

properties and numerous commercial applications (Lockey 1984). The fibrous

minerals contaminating Libby vermiculite have been characterized as both

regulated asbestos fibers (e.g., tremolite and other amphibole forms) and

unregulated fibers (e.g., winchite and richterite) (Meeker et al. 2003). The

various mining, transportation, and processing activities as well as the

personal and commercial use of vermiculite in the community have led to

widespread environmental exposures in the Libby area with this

asbestos-contaminated vermiculite. Potential asbestos exposures in this

community have been documented not only in the miners but also in their family

members as well as anyone who used the vermiculite or played near the mine

tailings (Dixon et al. 1985). A mortality study in this community found more

than 40-fold increases in standardized mortality ratios for asbestosis, and

elevated mortality also was observed for malignant neoplasm of respiratory and

intrathoracic organs (Horton et al., in press).

Recently, the Agency for Toxic Substances and Disease Registry

(ATSDR) conducted an extensive screening program of > 7,300 individuals from

this community (Peipins et al. 2003). The initial results of this screening

program identified various routes of exposure in the community and how those

routes of exposure were associated with abnormalities on chest radiographs

(Peipins et al. 2003). In addition, when the ATSDR performed its screening in

Libby during 2000-2001, 494 (6.7%) participants indicated that they had been

diagnosed with SLE, SSc, or RA (Noonan et al. 2005). By comparison, a prevalence

of < 1% for these three conditions combined would be expected based on pooled

estimates from 43 prevalence studies (son et al. 1997). In the present

study, we take these data a step further by exploring the association of these

systemic autoimmune conditions with various parameters of asbestos and/or

vermiculite exposure using a nested case-control approach.

--------------------------------------------------------------------

Section 1 of 4 Next Page: Materials and Methods

Curtis W. Noonan,1 C. Pfau,1 Theodore C. Larson,2 and

R. Spence3

1Center for Environmental Health Sciences, University of Montana,

Missoula, Montana, USA;

2Agency for Toxic Substances and Disease Registry, Centers for

Disease Control and Prevention, Atlanta, Georgia, USA;

3Montana Department of Health and Human Services, Helena, Montana,

USA

Disclosure: The authors declare they have no competing financial

interests.

Environ Health Perspect. 2006;114(8):1243-1247. ©2006 National

Institute of Environmental Health Sciences

Re: [] A Medscape article that might interest you.

I am having trouble pulling up this article, could someone copy this to this

message board?

In a message dated 8/30/2006 10:12:50 AM Central Standard Time,

madeskv@... writes:

I thought you might be interested in this. It is about asbestos but it might

have some relevance to inhaling particles and auto immunity problems-

_http://www.medscapehttp://www.medschttp://www.mht_

(http://www.medscape.com/viewarticle/542480?src=mp)

To access the article, click on this Web address, or cut and paste it into a

browser window.

[Guest guest]

--Thanks, I found a article the other day that helps seperate the lung

diseases by symptoms, dont know where my head was, will see if I can

find it again. I hyperventalate with exsertion, it started with my

exposure at some point in the first home with stachy exposure. I dont

think it has anything to do with asthma, but this article listed it as

a symptom of one of these lung diseases, thinking it was COPD, but will

have to check. does anyone else hyperventalate with exsertion? this is

somewhat hard to sort out, asthma includes coughing doesn't it? I only

cough with a mcs attack from a chemical exposure.- In

, madeskv@... wrote:

>

> I thought you might be interested in this. It describes COPD as a

disease occurring from inflammation of the lungs.

> http://www.medscape.com/viewarticle/542510?src=mp

> To access the article, click on this Web address, or cut and paste it

into a browser window.

>

> This article notification service provided by http://www.medscape.com

>

[Guest guest]

(http://faculty.cse.edu/ikessler/path/path10.html)

sorry its hypoventilation , COPD or COLD no.

1V.

-- In , " who " <jeaninem660@...>

wrote:

>

> --Thanks, I found a article the other day that helps seperate the

lung

> diseases by symptoms, dont know where my head was, will see if I

can

> find it again. I hyperventalate with exsertion, it started with my

> exposure at some point in the first home with stachy exposure. I

dont

> think it has anything to do with asthma, but this article listed it

as

> a symptom of one of these lung diseases, thinking it was COPD, but

will

> have to check. does anyone else hyperventalate with exsertion? this

is

> somewhat hard to sort out, asthma includes coughing doesn't it? I

only

> cough with a mcs attack from a chemical exposure.- In

> , madeskv@ wrote:

> >

> > I thought you might be interested in this. It describes COPD as a

> disease occurring from inflammation of the lungs.

> > http://www.medscape.com/viewarticle/542510?src=mp

> > To access the article, click on this Web address, or cut and

paste it

> into a browser window.

> >

> > This article notification service provided by

http://www.medscape.com

> >

>

[Guest guest]

There is a special running right now on the Discovery Times Channel

that was done by the New York Times about the survivors of 9-11 and

the health nightmare they have been facing..

(which all of the payers, like their employers, insurers, etc, seem to

be trying to get out of helping them pay for! Bear in mind that these

people are in many cases, the very same firefighters, public safety

workers, etc, who were lauded as heroes after 9-11!!! )

Anyway, watch this special and/or the segments on the New York Times

website, and I think you will see that whatever disease seems to be

striking the 9-11 workers down, it looks VERY much like mold illness.

They are weak in exactly the same way.. They have the same fears..

(with some extra ones thrown in for good measure..)

And most striking, is the TERRIFYING fact that DESPITE ALL THE

POLITICAL EXPLOITATION OF THE TRAGEDY - they are dealing with the same

kinds of denial we get..

Despite the fact that nobody would understandably want to be seen (I

would hope) as contributing to their pain, after all that has

happened.. STILL, THEY ARE OUT IN THE COLD WHEN IT COMES TO THE SYSTEM

WORKING FOR THEM..

If you ask me, that means that the system is profoundly broken..

[Guest guest]

Hi who -

I cough when I am in a bad mold spot- don't cough

other wise-

Val

[Guest guest]

Hi Who-

Please post the lung article if you can find it. I

have asked the doctors and they don't seem to know-

thank you,

Val

[Guest guest]

--have you been diagnosed with mcs? or think you may have it?- In

, Madeska <madeskv@...> wrote:

>

> Hi who -

>

> I cough when I am in a bad mold spot- don't cough

> other wise-

>

> Val

>

[Guest guest]

Hi Who,

I think that I have it - only my symptoms have calmed

down considerably. I have been in the sick building

since 1983. (I know, I know) The first ten years or

so - I had severe mcs symptoms. Now, I have much

milder ones to the point that my occupational doctor

did not believe that I had ever had them severely. I

did though - couldn't walk through soap aisles,

perfume areas, perfumed people, etc.

Not as bothered by those things any more- don't know

why I have gotten less reactive in that way.

[Guest guest]

I just remembered one thing that has changed since

that ten year mark - I no longer had to work with

formaldehyde and solvents like xylene. I am sure that

helped -

[Guest guest]

--Val, it is kind of strange, it seams some of my reactions have

mellowed out a little, but some still knock my socks off, but I'm

wondering if maybe the difference in the lesser ones is that I often

hold my breath when I detect them and exit,while the worse ones dont

give me that chance.- In ,

Madeska <madeskv@...> wrote:

>

> Hi Who,

>

> I think that I have it - only my symptoms have calmed

> down considerably. I have been in the sick building

> since 1983. (I know, I know) The first ten years or

> so - I had severe mcs symptoms. Now, I have much

> milder ones to the point that my occupational doctor

> did not believe that I had ever had them severely. I

> did though - couldn't walk through soap aisles,

> perfume areas, perfumed people, etc.

>

> Not as bothered by those things any more- don't know

> why I have gotten less reactive in that way.

>

>

>

[Guest guest]

that job change reduced your total load so according to dr. rea , your barrel so

to speak is not as full. you were exposed to some heavy duty chemicals in that

enviornment.

Madeska <madeskv@...> wrote: I just remembered one thing

that has changed since

that ten year mark - I no longer had to work with

formaldehyde and solvents like xylene. I am sure that

helped -

[Guest guest]

--ok, yea, that would make a difference, glad you dont have to be

around that nasty stuff anymore. problem is we can't aviod everything.-

In , Madeska <madeskv@...> wrote:

>

> I just remembered one thing that has changed since

> that ten year mark - I no longer had to work with

> formaldehyde and solvents like xylene. I am sure that

> helped -

>

[Guest guest]

SOunds like typical rebound effect to me.

On Wed, 13 Sep 2006 madeskv@... wrote:

> Date: Wed, 13 Sep 2006 10:26:54 -0400 (EDT)

> From: madeskv@...

> Reply-

>

> Subject: [] A Medscape article that might interest you.

>

> I thought you might be interested in this. advair increasing asthma

exacerbations in children

> http://www.medscape.com/viewarticle/542728?src=mp

> To access the article, click on this Web address, or cut and paste it into a

browser window.

>

> This article notification service provided by http://www.medscape.com

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

No, not exactly. there is a black box warning on advair that it can make an

asthma attack worse.

Angel!! <jap2bemc@...> wrote:

SOunds like typical rebound effect to me.

On Wed, 13 Sep 2006 madeskv@... wrote:

> Date: Wed, 13 Sep 2006 10:26:54 -0400 (EDT)

> From: madeskv@...

> Reply-

>

> Subject: [] A Medscape article that might interest you.

>

> I thought you might be interested in this. advair increasing asthma

exacerbations in children

> http://www.medscape.com/viewarticle/542728?src=mp

> To access the article, click on this Web address, or cut and paste it into a

browser window.

>

> This article notification service provided by http://www.medscape.com

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

Actually that article is not about Advair, it is about a component of Advair

called salmeterol which is Serevent. It has long been known that Serevent can

cause asthma exacerbations, this is not news. However, in this study they are

finding out that it may be only children with certain genetic factors that

predispose to exacerbations from salmeterol.

I think it's important to be accurate about this.

Lori

[] A Medscape article that might interest you.

>

> I thought you might be interested in this. advair increasing asthma

exacerbations in children

> http://www.medscape.com/viewarticle/542728?src=mp

> To access the article, click on this Web address, or cut and paste it into a

browser window.

>

> This article notification service provided by http://www.medscape.com

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

No wonder--I can't take that either.

Lori Baur <lori@...> wrote: Actually that article is not about

Advair, it is about a component of Advair called salmeterol which is Serevent.

It has long been known that Serevent can cause asthma exacerbations, this is not

news. However, in this study they are finding out that it may be only children

with certain genetic factors that predispose to exacerbations from salmeterol.

I think it's important to be accurate about this.

Lori

[] A Medscape article that might interest you.

>

> I thought you might be interested in this. advair increasing asthma

exacerbations in children

> http://www.medscape.com/viewarticle/542728?src=mp

> To access the article, click on this Web address, or cut and paste it into a

browser window.

>

> This article notification service provided by http://www.medscape.com

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

No wonder--I can't take that either.

Lori Baur <lori@...> wrote: Actually that article is not about

Advair, it is about a component of Advair called salmeterol which is Serevent.

It has long been known that Serevent can cause asthma exacerbations, this is not

news. However, in this study they are finding out that it may be only children

with certain genetic factors that predispose to exacerbations from salmeterol.

I think it's important to be accurate about this.

Lori

[] A Medscape article that might interest you.

>

> I thought you might be interested in this. advair increasing asthma

exacerbations in children

> http://www.medscape.com/viewarticle/542728?src=mp

> To access the article, click on this Web address, or cut and paste it into a

browser window.

>

> This article notification service provided by http://www.medscape.com

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

I do not think the other component of Advair causes exacerbations of asthma.

That second component is fluticasone, which is the steroid component. The

salmeterol or brand name Serevent in the US is the beta agonist component. The

drug by the brand name of Flovent is fluticasone by itself and there have been

no studies I am aware of which show that this component causes exacerbations.

So yes Advair can cause the exacerbations in certain groups of people, but it's

only because of the salmeterol component in it ...

Flovent is available in the diskus form as well as puffer forms. I have had

asthma in a severe form for about 20 years now and I believe the

puffers/inhalers also include other chemicals that may contribute to long-term

problems and short-term exacerbations. I did not do well on the inhalers, but

the powdered discus form has greatly helped me and I think it is purer form of

the meds.

Lori

[Guest guest]

All I know is that the pulmonologist and the immunologist at National Jewish

both saw something on the back of my throat which they said was from Advair. It

was not Candida. They would not say what it was but it could come after a few

days of use. Sort of had an air of mystery about it. I could not push them to

tell me what it was either.

Lori Baur <lori@...> wrote: I do not think the other component

of Advair causes exacerbations of asthma. That second component is fluticasone,

which is the steroid component. The salmeterol or brand name Serevent in the US

is the beta agonist component. The drug by the brand name of Flovent is

fluticasone by itself and there have been no studies I am aware of which show

that this component causes exacerbations. So yes Advair can cause the

exacerbations in certain groups of people, but it's only because of the

salmeterol component in it ...

Flovent is available in the diskus form as well as puffer forms. I have had

asthma in a severe form for about 20 years now and I believe the

puffers/inhalers also include other chemicals that may contribute to long-term

problems and short-term exacerbations. I did not do well on the inhalers, but

the powdered discus form has greatly helped me and I think it is purer form of

the meds.

Lori

[Guest guest]

Leigh,

Certainly you can get fungal infections from any steroid including inhaled

steroids. Additionally, the powder in the discus can stick to the throat and

mouth, so it is very important to gargle very well and rinse well with water

immediately after each Advair use. I don't know if you were doing this. I have

heard of some getting fungal type of infections even after rinsing, but I think

it is less likely in people who gargle and rinse fully after each and every use

and never skip this step.

Some doctors don't tell their patients this, and it's very unfortunate that

patients are not informed. As an extra step I also use probiotic powder in

water after each use, first swishing it around in my mouth and then swallowing.

I have been on Advair since it came on the market and I have never gotten any

fungal infections from it. But like I said it is possible. For me the benefits

far outweigh the risks, but this is not true for everyone.

I don't know why the doctors at National Jewish wouldn't tell you what it is.

That is very strange. How do you know it was not Candida albicans, did they

tell you that much? Anyway I'm not saying you should try it again but just for

others who may be using it it's very important not to skip this hygienic step.

But also this is not related to the exacerbations the Medscape article talked

about, as the fungal infections would not come from beta agonist use but only

from the steroid use, and salmeterol is not the steroid component.

Lori

[Guest guest]

I tried just about all of the inhalers. I didn't see any difference.

In fact sometimes I would get more mucus after using the inhalers. I

used the preventitive ones and the emergency ones. It says right on

the directions of most of them to rinse because it can cause yeast

infection in the mouth. It might have said thrush but that is the

same thing on your tongue. I kept telling the doctors I had yeast on

my tongue, and most of them said it was not yeast. Even Dr.

Johanning was going to test my tongue but then he didn't. Finally I

asked my ENT to test my tongue, and it was candida albicans. I am

allergic to candida albicans but was never allergic to it before the

mold. One of my mold samples that I had tested came back yeasts.

Plus all the antibiotics, prendizone, and the inhalers and of course

I got yeast. I spent almost a year trying to get someone to give me

yeast medication, and finally I took Diflican for about 8 months but

it is very expensive and lost insurance so had to stop. It was

starting to work. Plus did the diet for a long time but got very

thin, 95 lbs. so I had to start eating. Now I just try to eat what I

can but try to be careful with sugar, carbs, etc. but I still do eat

some. I lost my car in a mold battle with a landlord and have not

driven since around the 9/11 incident. So I lost health, and the

freedom to drive. After several moldy places and the loss of

belongings, health, and now having to live with relatives that do not

live chemical free. The only thing I did't lose was my husband and I

almost lost him. He had seizures, blood clot and it took a toll on

marriage. We got through the marriage part but are just hanging on

for our lives. Mold illness is life altering.

>

> Leigh,

>

> Certainly you can get fungal infections from any steroid including

inhaled steroids. Additionally, the powder in the discus can stick

to the throat and mouth, so it is very important to gargle very well

and rinse well with water immediately after each Advair use. I don't

know if you were doing this. I have heard of some getting fungal

type of infections even after rinsing, but I think it is less likely

in people who gargle and rinse fully after each and every use and

never skip this step.

>

> Some doctors don't tell their patients this, and it's very

unfortunate that patients are not informed. As an extra step I also

use probiotic powder in water after each use, first swishing it

around in my mouth and then swallowing. I have been on Advair since

it came on the market and I have never gotten any fungal infections

from it. But like I said it is possible. For me the benefits far

outweigh the risks, but this is not true for everyone.

>

> I don't know why the doctors at National Jewish wouldn't tell you

what it is. That is very strange. How do you know it was not

Candida albicans, did they tell you that much? Anyway I'm not saying

you should try it again but just for others who may be using it it's

very important not to skip this hygienic step. But also this is not

related to the exacerbations the Medscape article talked about, as

the fungal infections would not come from beta agonist use but only

from the steroid use, and salmeterol is not the steroid component.

>

> Lori

>

>

>

[Guest guest]

I thought you might be interested in this.

http://www.medscape.com/viewarticle/564359?src=mp

To access the article, click on this Web address, or cut and paste it into a

browser window.

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