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OBJECTIVES To determine the effect of long term inhaled corticosteroids on lung function, exacerbations, and health status in patients with moderate to severe chronic obstructive pulmonary disease. DESIGN Double blind, placebo controlled study. SETTING Eighteen UK hospitals. PARTICIPANTS 751 men and women aged between 40 and 75 years with mean forced(More)
Bronchial provocation studies on 15 workers occupationally exposed to formaldehyde are described. The results show that formaldehyde exposure can cause asthmatic reactions, and suggest that these are sometimes due to hypersensitivity and sometimes to a direct irritant effect. Three workers had classical occupational asthma caused by formaldehyde fumes,(More)
The first series of three workers who developed occupational asthma following exposure to airborne chloramines in indoor chlorinated swimming pools is reported. Health problems of swimmers in indoor pools have traditionally been attributed to the chlorine in the water. Chlorine reacts with bodily proteins to form chloramines; the most volatile and prevalent(More)
Nitrogen dioxide is a common indoor pollutant. In the light of suggestions that outdoor air pollution can harm people with asthma, we investigated the effect of 1 h exposures to domestic concentrations of nitrogen dioxide on the airway response to house-dust mite (HDM) allergen in ten patients with mild asthma. Each subject breathed air, 100 ppb nitrogen(More)
Serial peak expiratory flow records are recommended in the first-line investigation of suspected occupational asthma. The effects of sequentially reducing the numbers of working weeks, consecutive days at work and readings taken per day on diagnostic sensitivity and specificity were investigated, using good quality peak expiratory flow records from 81(More)
BACKGROUND Isocyanates are the most frequent cause of occupational asthma in industrialized countries. OBJECTIVE We sought to investigate the utility of specific IgE measurement in the diagnosis of isocyanate-induced asthma. METHODS Fifty-eight of 101 patients referred for investigation were diagnosed as having isocyanate-induced occupational asthma by(More)
Exacerbations of chronic obstuctive pulmonary disease (COPD) are associated with worse health status. The Inhaled Steroids in Obstructive Lung Disease in Europe (ISOLDE) study showed that treatment with fluticasone propionate (FP) reduced exacerbation frequency and the rate of deterioration in health status as compared with placebo. The present study(More)
Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with worse health and increased healthcare utilisation. The Inhaled Steroids in Obstructive Lung Disease in Europe (ISOLDE) study in COPD showed a 26% reduction in the yearly rate of exacerbations in patients treated with fluticasone propionate (FP) compared to placebo, but did not(More)
BACKGROUND Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown. METHODS A pooled analysis, based on intention to treat, of individual patient data from seven randomised trials (involving 5085 patients) was(More)