Etiology and pathogenesis of airway disease in children and adults from rural communities

Environmental Health Perspectives

Volumn 107, Issue SUPPL. 3, 1999, Pages 393-401

  Schwartz, David A ^a,b  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b UNIVERSITY OF IOWA   (United States)

Author keywords

Agricultural; Asthma; Children; Endotoxin; Noxious gases; Organic dusts; Rural

Indexed keywords

ALLERGEN; ANTIINFLAMMATORY AGENT; IRRITANT AGENT; PROTEIN;

AGRICULTURE; AIRFLOW; ASTHMA; BRONCHUS HYPERREACTIVITY; CHILD; CHILDHOOD DISEASE; CHRONIC DISEASE; DISEASE SEVERITY; ENVIRONMENTAL EXPOSURE; ENVIRONMENTAL FACTOR; HEALTH CARE ACCESS; HEALTH INSURANCE; HEREDITY; HUMAN; INFANT; INFLAMMATION; MORBIDITY; MORTALITY; ORGANIC DUST; PATHOGENESIS; POVERTY; PRIORITY JOURNAL; RESPIRATORY TRACT DISEASE; REVIEW; RURAL AREA; URBAN RURAL DIFFERENCE; WHEEZING;

EID: 0032765425     PISSN: 00916765     EISSN: None     Source Type: Journal    
DOI: 10.1289/ehp.99107s3393     Document Type: Review

References (150)

1. MMWR. Asthma mortality and hospitalization among children and young adults - United States, 1980-1993. Morb Mortal Wkly Rep 45:350-353 (1996).
2. MMWR. Asthma - United States, 1982-1992. Morb Mortal Wkly Rep 43:952-956 (1995).
3. Weiss KB, Wagener DK. Chang ng patterns of asthma mortality: identifying target populations at high risk. JAMA 264:1683-1687 (1990).
4. National Institutes of Health. Executive Summary: Guidelines for the Diagnosis and Treatment of Asthma. Rpt No 91-3042. Washington:U.S. Department of Health and Human Services, 1991.
5. ATS. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis 136:225-244 (1987).
6. Evans R, Mulally DI, Wilson RW, Gergen PJ, Rosenberg HM, Gramman JS, Chevarley FM, Feinkib M. National trends in the morbidity and mortality of asthma in the United States. Chest 91(suppl):65S-74S (1987)
7. Chan-Yeung M, Malo JL. Occupational asthma. N Engl J Med 333:107-112 (1995).
8. Detels R, Sayre JW, Coulson AH, Rokaw SN, Massey FJ, Tashkin DP, Wu MM. The UCLA population studies of chronic obstructive respiratory disease. IV: Respiratory effect of long-term exposure to photochemical oxidants, nitrogen dioxide, and sulfates on current and never smokers. Am Rev Respir Dis 124:673-680 (1981).
9. Samet JM, Utell MJ. The environment and the lung: changing perspectives. JAMA 266: 670-675 (1991).
10. Samet JM, Speizer FE, Bishop Y, Spengler JD, Ferris BG. The relationship between air pollution and emergency room visits in an industrial community. J Air Pollut Control Assoc 31:236-240 (1981).
11. Bates DV, Sizto R. Air pollution and hospital admissions in Southern Ontario: the acid summer haze effect. Environ Res 43:317-331 (1987).
12. Speizer FE. Asthma and persistent wheeze in the Harvard six cities study. Chest 98: 191S-195S (1990).
13. Merchant JA. Agricultural exposures to organic dusts. In: Occupational Medicine: State of the Art Reviews (Rosenstock L, ed). Philadelphia: Hanley and Belfus, 1987;409-425.
14. Van Niekerk CH, Weinberg EG, Shore SC, Heese HV, Van Schalkwyk J. Prevalence of asthma: a comparative study of urban and rural Xhosa children. Clin Allergy 9:319-324 (1979).
15. Odhiambo JA, Ng'ang'a LW, Mungai MW, Gicheha CM, Nyamwaya JK, Karimi F, Macklem PT, Becklake MR. Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children. Eur Respir J 12:1105-1112 (1998).
16. Crockett AJ, Cranston JM, Alpers JH. The changing prevalence of asthma-like respiratory symptoms in South Australian rural schoolchildren. J Paediatr Child Health 31:213-217 (1995).
17. Schembri DA, Crockett AJ, Alpers JH, Latimer KM. Bronchial hyperresponsiveness in two populations of South Australian rural schoolchildren. Med J Aust 152:578-582 (1990).
18. Asgari MM, DuBois A, Asgari M, Gent J, Beckett WS. Association of ambient air quality with children's lung function in urban and rural Iran. Arch Environ Health 53:222-230 (1998).
19. Anto JM, Sunyer J, Rodriguez-Roisin R. Suarex-Cervera M, Vazquez L, Committee T. Community outbreaks of asthma associated with inhalation of soybean dust. N Engl J Med 320:1097-1102 (1989).
20. Haber LD. Disabling effects of chronic disease and impairment. J Chron Dis 24:469-487 (1971).
21. Carlson ML, Petersen GR. Mortality of California agricultural workers. J Occup Med 20:30-32 (1978).
22. Milham S. Occupational Mortality in Washington State, 1950-1971. NIOSH Research Report. Cincinnati, OH:National Institute for Occupational Safety and Health, 1976.
23. Peterson G. Occupational Mortality in the State of California, 1959-1961. NIOSH Research Rpt. Cincinnati, OH:National Institute for Occupational Safety and Health, 1980.
24. Zejda JE, McDuffie HH, Dosman JA. Epidemiology of health and safety risks in agriculture and related industries. Practical applications for rural physicians. West J Med 158:56-63 (1993).
25. Senthilselvan A, Chen Y, Dosman JA. Predictors of asthma and wheezing in adults. Grain farming, sex, and smoking. Am Rev Respir Dis 148:667-670 (1993).
26. Cuthbert OD, Brostoff J, Wraith DG, Brighton WD. 'Barn allergy': asthma and rhinitis due to storage mites. Clin Allergy 9:229-236 (1979).
27. Pomrehn PR, Wallace RB, Burmeister LF. Ischemic heart disease mortality in Iowa farmers: the influence of life-style. JAMA 248:1073-1076 (1982).
28. Sterling TD, Weinkam JJ. Smoking patterns by occupation, industry, sex, and race. Arch Environ Health 33:313-317 (1978).
29. WHO. Recommended Health-based Occupational Exposure Limits for Selected Vegetable Dusts. WHO Tech Rpt Ser 684. Geneva:World Health Organization, 1983.
30. McCurdy SA, Ferguson TJ, Goldsmith DF, Parker JE, Schenker MB. Respiratory health of California rice farmers. Am J Respir Crit Care Med 153:1553-1559 (1996).
31. Iversen M, Dahl R, Korsgaard J, Hallas T, Jensen EJ. Respiratory symptoms in Danish farmers: an epidemiological study of risk factors. Thorax 43:872-877 (1988).
32. ATS. Respiratory health hazards in agriculture. Am J Respir Crit Care Med 158:S1-S76 (1998).
33. Kennedy SM, Christiani DC, Eisen EA, Wegman DH, Greaves IA, Olenchock SA, Ye TT, Lu PL. Cotton dust and endotoxin exposure-response relationships in cotton textile workers. Am Rev Respir Dis 135:194-200 (1987).
34. Haglind P, Rylander R. Exposure to cotton dust in an experimental cardroom. Br J Ind Med 41:340-345 (1984).
35. Rylander R, Haglind P, Lundholm M. Endotoxin in cotton dust and respiratory function decrement among cotton workers in an experimental cardroom. Am Rev Respir Dis 131:209-213 (1985).
36. Dorham K, Haglind P, Peterson Y, Rylander R, Belin L. Environmental and health studies of farm workers in Swedish swine confinement buildings. Br J Ind Med 46:31-37 (1989).
37. Thelin A, Tegler O, Rylander R. Lung reactions during poultry handling related to dust and bacterial endotoxin levels. Eur J Respir Dis 65:266-271 (1984).
38. Rylander R, Bake B, Fischer JJ, Helander IM. Pulmonary function and symptoms after inhalation of endotoxin. Am Rev Respir Dis 140:981-986 (1989).
39. Schwanz DA, Thorne PS, Yagla SJ, Burmeister LF, Olenchock SA, Watt JL, Quinn TJ. The role of endotoxin in grain dust-induced lung disease. Am J Respir Crit Care Med 152:603-608 (1995).
40. Schwartz DA, Donham KJ, Olenchock SA, Popendorf W, van Fossen SD, Burmeister LF, Merchant JA. Determinants of longitudinal changes in spirometric functions among swine confinement operators and farmers. Am J Respir Crit Care Med 151:47-53 (1995).
41. Cavagna G, Foa V, Vigliani EC. Effects in man and rabbits of inhalation of cotton dust or extracts and purified endotoxins. Br J Ind Med 26:314-321 (1969).
42. Herbert A, Carvalheiro M, Rubenowitz E, Bake B, Rylander R. Reduction of alveolar-capillary diffusion after inhalation of endotoxin in normal subjects. Chest 102:1095-1098 (1992).
43. Michel O, Ginanni R, Le Bon B, Content J, Duchateau J, Sergysels R. Inflammatory response to acute inhalation of endotoxin in asthmatic patients Am Rev Respir Dis 146:352-357 (1992).
44. Michel O, Duchateau J, Sergysels R. Effect of inhaled endotoxin on bronchial reactivity in asthmatic and normal subjects. J Appl Physiol 66:1059-1064 (1989).
45. doPico GA, Flaherty D, Bhaansali P, Chavaje N. Grain fever syndrome induced by inhalation of airborne grain dust. J Allergy Clin Immunol 69:435-443 (1982).
46. Clapp WD, Thorne PS, Frees KL, Zhang X, Lux CR, Schwartz DA. The effects of inhalation of grain dust extract and endotoxin on upper and lower airways. Chest 104:825-830 (1993).
47. Clapp WD, Becker S, Quay J, Watt JL, Thorne PS, Frees KL, Zhang X, Lux CR, Schwartz DA. Grain dust-induced airflow obstruction and inflammation of the lower respiratory tract. Am J Respir Crit Care Med 150:611-617 (1994).
48. Boehlecke B, Cocke J, Bragg K, Hancock J, Petsonk E, Piccirillo R, Merchant J. Pulmonary function response to dust from standard and closed boll harvested cotton. Chest 79:77S-81S (1981).
49. Castellan RM, Olenchock SA, Hankinson JL, Millner PD, Cocke JB, Bragg CK, Perkins HH, Jacobs RR. Acute bronchoconstriction induced by cotton dust: dose-related responses to endotoxin and other dust factors. Ann Int Med 101:157-163 (1984).
50. Castellan RM, Olenchock SA, Kinsely KB, Hankinson JL. Inhaled endotoxin and decreased spirometric values. N Engl J Med 317:605-610 (1987).
51. Zhiping W, Malmberg P, Larsson B-M, Larsson K, Larsson L, Saraf A. Exposure to bacteria in swine-house dust and acute inflammatory reactions in humans. Am J Respir Crit Care Med 154:1261-1266 (1996).
52. Jagielo PJ, Thorne PS, Watt JL, Frees KL, Quinn TJ, Schwartz DA. Grain dust and endotoxin inhalation produced similar inflammatory responses in normal subjects. Chest 110:263-270 (1996).
53. Deetz DC, Jagielo PJ, Quinn TJ, Thorne PS, Bleuer SA, Schwartz DA. The kinetics of grain dust-induced inflammation of the lower respiratory tract. Am J Respir Crit Care Med 155:254-259 (1997).
54. Schwartz DA, Thorne PS, Jagielo PJ, White GE, Bleuer SA, Frees KL. Endotoxin responsiveness and grain dust-induced inflammation in the lower respiratory tract. Am J Physiol 267:L609-L617 (1994).
55. Jagielo PJ, Thorne PS, Kern JA, Quinn TJ, Schwartz DA. The role of endotoxin in grain dust-induced inflammation in mice. Am J Physiol: Lung Cell Mol Physiol 207:L1052-L1059 (1996).
56. Jagielo PJ, Quinn TJ, Qureshi N, Schwartz DA. Grain dust induced lung inflammation is reduced by Rhodobacter sphaeroides disphosphoryl lipid A. Am J Physiol 274:L26-L31 (1998).
57. Olenchock SA, Lewis DM, Mull JC. Composition of extracts of airborne grain dusts: lectins and lymphocite mitogens. Environ Health Perspect 66:119-123 (1986).
58. Vogelzang PF, van der Gulden JW, Folgering H, van Schayck CP. Longitudinal changes in lung function associated with aspects of swine-confinement exposure. J Occup Environ Med 40:1048-1052 (1998).
59. Von Essen SG, O'Neill DP, Robbins RA, Rennard SI. Neutrophil chemotaxis to extracts of grain plant components. Am J Ind Med 25:85-88 (1994).
60. Von Essen SG, Robbins RA, Thompson AB, Ertl RF, Linder J, Rennard S. Mechanisms of neutrophil recruitment to the lung by grain dust exposure. Am Rev Respir Dis 138:921-927 (1988).
61. Skea D, Broder I. Methanol extract of grain dust shows complement fixing activity and other characteristics similar to tannic acid. Environ Health Perspect 66:155-158 (1986).
62. Lauque D, Prevost MC, Carles P, Chap H. Signal transducing mechanisms in human platelets stimulated by cotton bract tannin. Am J Respir Cell Mol Biol 4:65-71 (1991).
63. Rask-Andersen A, Malmberg P, Lundholm M. Endotoxin levels in farming: absence of symptoms despite high exposure level. Br J Ind Med 46:412-416 (1989).
64. Buck MG, H WJ, Schachter EN. Airway constrictor response to cotton bract extracts in the absence of endotoxin. Br J Ind Med 43:220-226 (1986).
65. Keskinen H. Causes of occupational asthma. Allergia 4:17-33 (1989).
66. Garcia DP, Corbett ML, Sublett JL, Pollard SJ, Meiners JF, Karibo JM, Pence HL, Petrosko JM. Cockroach allergy in Kentucky: a comparison of inner city, suburban, and rural small town populations. Ann Allergy 72:203-208 (1994).
67. Ray D, Abel R, Selvaraj KG. A 5-year epidemiological study of chronic obstructive pulmonary disease in rural south India. Indian J Med Res 101:238-244 (1995).
68. Winer A. Bronchial asthma due to the organic phosphate insecticides. Ann Allergy 19:397-401 (1961).
69. Hoek G, Fischer P, Brunekreef B, Lebret E, Hofschreuder P, Mennen MG. Acute effects of ambient ozone on pulmonary function of children in The Netherlands. Am Rev Respir Dis 147:111-117 (1993).
70. Hosein HR, Mitchell CA, Bouhuys A. Evaluation of outdoor air quality in rural and urban communities. Arch Environ Health 32:4-13 (1977).
71. Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest 88:376-384 (1985).
72. National Heart, Lung and Blood Institite. National Asthma Education and Prevention Program, 1997.
73. Busse WW, Banks-Schlegel SP, Larsen GL. Effects of growth and development on lung function: models for study of childhood asthma. Am J Respir Crit Care Med 156:314-319 (1997).
74. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. N Engl J Med 332:133-138 (1995).
75. Lombardi E, Morgan WJ, Wright AL, Stein RT, Holberg CJ, Martinez FD. Cold air challenge at age 6 and subsequent incidence of asthma: a longitudinal study. Am J Respir Crit Care Med 156:1863-1869 (1997).
76. Weiss ST, Tosteson TD, Segal MR, Tager IB, Redline S, Speizer FE. Effects of asthma on pulmonary function in children. A longitudinal population-based study. Am Rev Respir Dis 145:58-64 (1992).
77. Redline S, Tager IB, Segal MR, Gold D, Speizer FE, Weiss ST. The relationship between longitudinal change in pulmonary function and nonspecific airway responsiveness in children and young adults. Am Rev Respir Dis 140:179-184 (1989).
78. Laitinen T, Rasanen M, Kaprio J, Koskenvuo M, Laitinen LA. Importance of genetic factors in adolescent asthma: a population-based twin-family study. Am J Respir Crit Care Med 157:1073-1078 (1998).
79. White MV, Kaliner MA. Regulation by histamine. In: The Lung Scientific Foundations. Philadelphia: Hanley and Belfus, 1991; 927-939.
80. Davies RJ, Green M, Schofield NM. Recurrent nocturnal asthma after exposure to grain dust. Am Rev Respir Dis 114:1011-1019 (1976).
81. Bush RK, Schroeckenstein D, Meier-Davis S, Balmes J, Rempel D. Soybean flour asthma: detection of allergens by immunoblotting. J Allergy Clin Immunol 82:251-255 (1988).
82. Blainey AD, Topping MD, Ollier S, Davies RJ. Allergic respiratory disease in grain workers: the role of storage mites. J Allergy Clin Immunol:296-303 (1989).
83. Chan-Yeung M, Wong R, MacLean L. Respiratory abnormalities among grain elevator workers. Chest 75:461-457 (1979).
84. doPico GA, Jacobs S, Flaherty D, Rankin J. Pulmonary reaction to durum wheat. Chest 81:55-61 (1982).
85. Broder I, McAvoy D. Characterization of precipitation reaction between grain dust and normal human serum and comparison of reactive and nonreactive grain handlers. Clin Immunol Immunopathol 21:141-153 (1981).
86. Blaski CA, Frees KL, Watt JL, Quinn TJ, Yagla SJ, Thorne PS, Schwartz DA. Nasal lavage cellularity, grain dust, and airflow obstruction. Chest 109:1086-1092 (1996).
87. Chan-Yeung M, Schulzer M, Maclean L, Dorken E, Tan F, Lam S, Enarson D, Grzybowski S. Follow-up study of the grain elevator workers in the Port of Vancouver. Arch Environ Health 36:75-81 (1981).
88. Tabona M, Chan-Yeung M, Enarson D, MacLean L, Dorken E, Schulzer M. Host factors affecting longitudinal decline in lung spirometry among grain elevator workers. Chest 85:782-786 (1984).
89. Gerrard JW, Mink J, Cheung SSC, Tan LKT, Dosman JA. Nonsmoking grain handlers in Saskatchewan: airways reactivity and allergic status. J Occup Med 21:342-346 (1979).
90. Mink JT, Gerrard JW, Cockcroft DW, Cotton DJ, Dosman JA. Increased bronchial reactivity to inhaled histamine in nonsmoking grain workers with normal lung function. Chest 77:28-31 (1980).
91. Lewis DM, Mentnech MS. Extracts of airborne grain dusts simulate interleukin-1 (IL-1) production by alveolar macrophages [Abstract]. Am Rev Respir Dis 129:A161 (1984).
92. Keller GE, Lewis DM, Olenchock SA. Demonstration of inflammatory cell population changes in rat lungs in response to intratracheal instillation of spring wheat dust using lung enzymatic digestion and centrifugal elutriation. Comp Immun Microbiol Infect Dis 10:219-226 (1987).
93. Von Essen SG, McGranaghan S, Cirian D, O'Neill D, Spurzem JR, Rennard SI. Inhalation of grain sorghum dust extract causes respiratory tract inflammation in human volunteers [Abstract]. Am Rev Respir Dis 143:A105 (1991).
94. Schwartz DA. Grain dust, endotoxin, and airflow obstruction. Chest 109:57S-63S (1996).
95. Wohlford-Lenane CL, Deetz DC, Schwartz DA. Cytokine gene expression following inhalation of grain dust and lipopolysaccharide. Am J Physiol (in press).
96. Kips JC, Tavernier J, Pauwels RA. Tumor necrosis factor causes bronchial hyperresponsiveness in rats. Am Rev Respir Dis 145:332-336 (1992).
97. Beutler B, Milsark IW, Cerami AC. Passive immunization against cachectin/tumor necrosis factor protects mice from lethal effect of endotoxin. Science 229:869-871 (1965).
98. Strieter RM. Interleukin-8 In: Cytokines of the Lung (Kelley J, ed). New York:Marcel Dekker, 1993:281-305.
99. Standiford TJ, Strieter RM, Lukacs NW, Kunkel SL. Neutralization of IL-10 increases lethality in endotoxemia: cooperative effects of macrophage inflammatory protein-2 and tumor necrosis factor. J Immunol 155:2222-2229 (1995).
100. Nakamura H. IL-8 gene expression in human bronchial epithelial cells. J Biol Chem 266:19611-19617 (1991).
101. Massion PP, Inoue H, Richman-Eisenstat J, Grunberger D, Wiener-Kronish JP, Nadel JA. Novel pseudomonas product stimulates interleukin-8 production in airway epithelial cells in vitro. J Clin Invest 93:26-32 (1994).
102. Redl H, Schlag G, Ceska M, Davies J, Buurman WA. Interleukin-8 release in baboon septicemia is partially dependent on tumor necrosis factor. J Infect Dis 167:1464-1466 (1993).
103. Rose CE, Juliano CA, Tracey DE, Yoshimura T, Fu SM. Role of interleukin-1 in endotoxin-induced lung injury in the rat. Am J Respir Cell Mol Biol 10:214-221 (1994).
104. Wolpe SD, Sherry B, Juers D, Davatelis G, Yurt RW, Cerami A. Identification and characterization of macrophage inflammatory protein 2. Proc Natl Acad Sci USA 86:612-616 (1989).
105. Schwartz DA, Landas SK, Lassise DL, Burnmeister LF, Hunninghake GW, Merchant JA. Airway injury in swine confinement workers. Ann Intern Med 116:630-635 (1992).
106. Jeffrey PK, Wardlaw AJ, Nelson FC, Collins JV, Kay AB. Bronchial biopsiesin asthma: an ultrastructural, quantitative study and correlation with hyperreactivity. Am Rev Respir Dis 140:1745-1753 (1989).
107. Dunnill MS. The pathology of asthma, with special reference to changes in the broncial mucosa. J Clin Pathol 13:27-33 (1960).
108. Roche WR, Williams JH, Beasley R, Holgate ST. Subepithelial fibrosis in the bronchi of asthmatics. Lancet 1:520-524 (1989).
109. Paggiaro P, Bacci E, Paoletti P, Bernard P, Dente FL, Marchetti G, Talini D, Menconi GF, Giutini C. Bronchoalveolar lavage and morphology of the airways after cessation of exposure in asthmatic subjects sensitized to toluene diisocyanate. Chest 98:536-542 (1990).
110. Bousquet J, Chanez P, Lacoste JY, Barneon G, Ghavanian N, Enander I, Per V, Ahlstedt S, Simony-Lafontaine J, Godard P, Michel F-B. Eosinophilic inflammation in asthma. N Engl J Med 323:1033-1039 (1990).
111. 1 mRNA expression and airways fibrosis in bronchial asthma. Am J Respir Cell Mol Biol 17:326-333 (1997).
112. Chetta A, Forest A, Del Donno M, Bertorelli G, Pesci A, Olivieri D. Airways remodeling is a distinctive feature of asthma and is related to severity of disease. Chest 111:852-857 (1997).
113. Brewster CEP, Howarth PH, Djukanovic R, Wilson J, Holgate ST, Roche WF. Myofibroblasts and subepithelial fibrosis in bronchial asthma. Am J Respir Crit Care Med 3:507-511 (1990).
114. Holgate ST, Djukanovic R, Howarth PH, Montefort S, Roche W. The T cell and the airway's fibrotic response in asthma. Chest 103:125S-128S (1993).
115. Border WA, Noble NA. Transforming growth factor β in tissue fibrosis. N Engl J Med 331:1286-1292(1994).
116. Phan SH, Gharee-Kermani M, Wolber F, Ryan US. Stimulation of rat endothelial cell transforming growth factor-β production by bleomycin. J Clin Invest 87:148-154 (1991).
117. James AL, Cookson WOCM, Buters G, Lewis S, Ryan G, Hockey R, Musk AW. Symptoms and longitudinal changes in lung function in young seasonal grain handlers. Br J Ind Med 43: 587-591 (1986).
118. 1, and five-year change in lung function. Am J Respir Crit Care Med 150: 1250-1255 (1994).
119. Becklake MR. Relationship of acute obstructive airway change to chronic (fixed) obstruction. Am J Respir Crit Care Med 149:584-590 (1995).
120. 1. Am J Respir Crit Care Med 149:584-590 (1994).
121. Armanious M, Cotton D, Wright J, Dosman J, Carr I. Grain dust and alveolar macrophages: an experimental study of the effects of grain dust on the mouse lung. J Pathol 136:265-272 (1982).
122. Friborsky V, Ulrich L, Tesik L, Malik E. Morphological changes of rat lung after exposure to plant dust. Acta Morphol Acad Sci Hung 20:191-197 (1972).
123. Alarie Y, Ellakkani M, Wayel D, Karol M. Respiratory parameters which characterize the response of guinea pigs to inhalation of cotton dust. Tenth Cotton Dust Research Conference, 1986.
124. Ellakkani M, Cockrell B, Thorne P, Karol MH. In: Tenth Cotton Dust Research Conference (Wakelyn PJ, Jacobs RR, eds), 1986.
125. Coulombe PA, Filion PR, Cote MG. Histomorphometric study of the pulmonary response of guinea pigs to chronic cotton dust inhalation. Toxicol Appl Pharmacol 85: 437-449 (1986).
126. Milton DK, Godleski JJ, Feldman HA, Greaves IA. Toxicity of intratracheally instilled cotton dust, cellulose, and endotoxin. Am Rev Respir Dis 142:184-192 (1990).
127. Chan-Yeung M. Occupational asthma. Chest 98:148S-161S (1990).
128. Paggiaro PL, Loi AM, Rossi O, Ferrante B, Padri F, Roselli MG, Baschieri L. Follow-up study of patients with respiratory disease due to toluene diisocyanate (TDI). Clin Allergy 14:463-469 (1984).
129. Cote J, Kennedy SM, Chan-Yeung M. Outcome of patients with cedar asthma with continuous exposure [Abstract], Am Rev Respir Dis 139:A388 (1989).
130. Djukanovic R, Roche WR, Wilson JW, Mucosal inflammation in asthma. Am Rev Respir Dis 142:434-457 (1990).
131. Laitinen LA, Heino M, Laitinen A, Kava T, Haahtela T. Damage of the airway epithelium and bronchial reactivity in patients with asthma. Am Rev Respir Dis 131:599-606 (1985).
132. Holgate ST, Beasely R, Twentymen OP. The pathogenesis and significance of bronchial hyperresponsiveness in airways disease. Clin Sci 73:561-572 (1987).
133. Bleecker ER. Airways reactivity and asthma: Significance and treatment. J Allergy Clin 75:21-24 (1985).
134. Cockroft DW. Airway hyperresponsiveness: therapeutic implications. Ann Allergy 59:405-414 (1987).
135. Beasley R, Roche WR, Roberts JA, Holgate ST. Cellular events in the bronchi in mild asthma and after bronchial provocation. Am Rev Respir Dis 139:806-817 (1989).
136. Djukanovic R, Wilson J, Britten K, Wilson SJ, Walls AF, Roche WR, Hewarth PH, Holgate ST. Quantitation of mast cells and eosinophils in the bronchial mucosa of symptomatic atopic asthmatics and health control subjects using immunohistochemistry. Am Rev Respir Dis 142:863-871 (1990).
137. Wardlaw AJ, Dunnette S, Gleich GJ, Collins JV, Kay AB. Eosinophils and mast cells in bronchoalveolar lavage in subjects with mild asthma: relationship to branchial hyperreactivity. Am Rev Respir Dis 137:62-69 (1988).
138. Liu MC, Bleecker ER, Lichtenstein LM, Kagey-Sobotka A, Niv Y, McLemore TL, Permutt S, Proud D, Hubbard WC. Evidence for elevated levels of histamine, prostaglandin D2, and other bronchoconstricting prostaglandins in the airways of subjects with mild asthma. Am Rev Respir Dis 142:126-132 (1990).
139. Metzger WJ, Zavala D, Richerson HB, Moseley P, Iwamota P, Monick M, Sjoerdsma K, Hunninghake GW. Local allergen challenge and bronchoalveolar lavage of allergic asthmatic lungs. Am Rev Respir Dis 135:433-440 (1987).
140. Haahtela T, Jarvinen M, Kava T, Kiviranta D, Koskinen S, Lehtonen K, Nikander K, Persson T, Selroos O, Sovijarvi A, et al. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. N Engl J Med 331:700-705 (1994).
141. Juniper EF, Kline PA, Vanzieleghem MA, Ramsdale EH, O'Byrne PM, Hargreave FE. Effect of long-term treatment with an inhaled corticosteroid (Budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroid-dependent asthmatics. Am Rev Respir Dis 142:832-836 (1990).
142. Dutoit J, Salome CM, Woolcock AJ. Inhaled corticosteroids reduce the severity of bronchial hyperresponsiveness in asthma but oral theophylline does not. Am Rev Respir Dis 136:1174-1178 (1987).
143. Jeffery PK, Godfrey RW, Adelroth E, Nelson R, Rogers A, Johansson S-A. Effects of treatment on airway inflammation and thickening of basement membrane reticular collagen in asthma. Am Rev Respir Dis 145:890-899 (1992).
144. Robinson D, Hamid Q, Ying S, Bentley A, Assoufi B, Durham S, Kay AB. Prednisolone treatment in asthma is associated with modulation of bronchoalveolar lavage cell interleukin-4, interleukin-5, and interferon-γ cytokine gene expression. Am Rev Respir Dis 148:401-406 (1993).
145. Lundgren R, Soderberg M, Horstedt P, Stenling R. Morphological studies of bronchial mucosal biopsies from asthmatics before and after ten years of treatment with inhaled steroids. Eur Respir J 1:883-889 (1988).
146. Lee P. U.S. Senate Testimony on Rural Health before the Senate Subcommittee on Labor, Health, and Education Appropriations. Washington, DC, 1993.
147. Jones AP, Bentham G. Health service accessibility and deaths from asthma in 401 local authority districts in England and Wales, 1988-92. Thorax 52:216-222 (1997).
148. Gordon RJ, Meister JS, Hughes RG. In: Health in Rural North America - The Geography of Health Care Services and Delivery (Gesler WM, Ricketts TC, eds). New Brunswick, NJ:Rutgers University Press, 1992.
149. Crago S, Coors L, Lapidus JA, Sapien R, Murphy SJ. Prehospital treatment of acute asthma in a rural state. Ann Allergy Asthma Immunol 81:322-325 (1998).
150. Madge P, McColl J, Paton J. Impact of a nurseled home management training programme in children admitted to hospital with acute asthma: a randomised controlled study. Thorax 52:223-228 (1997).