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Öğe Annual Changes in Forced Expiratory Flows in Toll Collectors: Results from a Four Years Observation(Natl Inst Occupational Safety & Health, Japan, 2009) Arbak, Peri Meram; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Bilgin, Cahit; Ozsahin, Sefa LeventDiesel exhaust (DE) has been accused for various health outcomes including exacerbation of asthma, chronic bronchitis. Exposure to DE has long-term effects on lung development in children and reductions in lung function have been reported. The aim of the study was to evaluate the annual changes in forced expiratory flows among toll collectors in Duzce city from 2002 to 2005. Annual FVC, FEV1 and MMF changes in smoker and nonsmoker 58 toll collectors and 37 controls selected among men who worked in the same company as officer have been followed up. No significant changes were seen in expiratory flows among smoker-nonsmoker toll collectors and controls (p>0.05). Annual FVC, FEV1 and MMF changes were not significantly different between smoker and nonsmoker toll collectors. Twelve toll collectors (20.7%) in the study group and 4 (10.8%) controls were found to have FEV1 and FVC below longitudinal lower limit of normal. The difference between groups did not reach statistically significance (p>0.05). Toll collectors (18/58) and controls (15/37) with spirometric measurements for three times showed no difference according to the rate of annual difference in either FEV1 (-21.3 +/- 133.1 ml/yr vs -44.3 +/- 166.6 (ml/yr) or FVC (13.2 +/- 202.9 ml/yr vs. -16.1 +/- 204.2 ml/yr). Further investigations including large groups with long term follow up are needed to observe annual FVC, FEV1 and MMF changes among toll collectors.Öğe Are serum eosinophilic cationic protein levels of toll collectors affected by diesel exhaust exposure?(Professional Medical Publications, 2016) Bilgin, Cahit; Arbak, Peri Meram; Yavuz, Özlem; Balbay, Ege Güleç; Balbay, Öner Abidin; Annakkaya, Ali NihatObjective: There are few studies on the diesel exhaust particulates (DEP) / eosinophilic cationic protein (ECP) level relationship. This study aimed to detect ECP levels in a highly DE exposed group, named as toll collectors. Methods: In a cross-sectional study, levels of serum ECP, rates of respiratory symptoms, mean levels of respiratory functions, smoking status, and variations in peak expiratory flow (PEF) during weekends and working days were compared for 68 toll collectors (TC) (range of age, 24-48 years) and 28 controls (range of age, 25-61 years). All subjects in the study group were men. Results: No significant difference was observed in terms of symptoms and smoking rates between the toll collectors and control group. The number of toll collectors [12/68 (17.7%) vs 1/28 (3.5%)] with diurnal PEF variability in the working period was higher than that of controls (p=0.058). Mean ECP level of toll collectors was higher than that of controls (32.8 vs 21.4 ng/L), but the difference was not significant. Mean ECP levels were higher in subjects experiencing diurnal PEF variability during work and off-work periods (34.9 vs 28.3 ng/L, p=0.410). Conclusions: Serial PEF measurements combined with serum ECP measurements did not add a new tool to detect the sensitivity of workers dealing with DE. Much more diesel exhaust exposed workers should be included to search for cheap and available methods when evaluating airway.Öğe Bronchial Wall Thickness in Toll Collectors(Natl Inst Occupational Safety & Health, Japan, 2010) Şafak, Alp Alper; Arbak, Peri Meram; Yazıcı, Burhan; Bilgin, Cahit; Erdoğmuş, Beşir; Annakkaya, Ali Nihat; Özşahin, Sefa LeventThere is an increasing concern about the possible adverse effects of diesel exhaust particulates on human health. In a diesel exposed occupational group composed of 120 toll collectors, a cross-sectional study was performed to evaluate the chest radiographs and 40 toll collectors were selected for computed tomography examination according to hyperinflation and linear markings. The wall thicknesses and luminal diameters of trachea, main bronchi, and segmental bronchi of right apical and posterior basal segments were measured with manual tracing method. The walls of right upper bronchus in exsmoker toll collectors were significantly thicker than those of nonsmokers (p=0.011). A positive correlation was observed between age and the right upper bronchus wall thickness (r=0.577, p=0.000). An inverse correlation was found between the working duration and the diameter of right main bronchus (r=-0.366, p=0.020). A positive correlation was seen between smoking and the right upper bronchus wall thickness (r=0.457, p=0.005). Diesel exposure might have a role in increase of thickness of large airways wall and a decrease in the diameters of large airways. Studies in this area are needed to protect the population under the diesel exposure risk.Öğe Does periodic lung screening of films meets standards?(Professional Medical Publications, 2016) Binay, Songül; Arbak, Peri Meram; Şafak, Alp Alper; Balbay, Ege Güleç; Bilgin, Cahit; Karataş, NaciyeObjective: To determine whether the workers' periodic chest x-ray screening techniques in accordance with the quality standards is the responsibility of physicians. Evaluation of differences of interpretations by physicians in different levels of education and the importance of standardization of interpretation. Methods: Previously taken chest radiographs of 400 workers who are working in a factory producing the glass run channels were evaluated according to technical and quality standards by three observers (pulmonologist, radiologist, pulmonologist assistant). There was a perfect concordance between radiologist and pulmonologist for the underpenetrated films. Whereas there was perfect concordance between pulmonologist and pulmonologist assistant for over penetrated films. Results: Pulmonologist (52%) has interpreted the dose of the films as regular more than other observers (radiologist; 44.3%, pulmonologist assistant; 30.4%). The frequency of interpretation of the films as taken in inspiratory phase by the pulmonologist (81.7%) was less than other observers (radiologist; 92.1%, pulmonologist assistant; 92.6%). The rate of the pulmonologist (53.5%) was higher than the other observers (radiologist; 44.6%, pulmonologist assistant; 41.8%) for the assessment of the positioning of the patients as symmetrical. Pulmonologist assistant (15.3%) was the one who most commonly reported the parenchymal findings (radiologist; 2.2%, pulmonologist; 12.9%). Conclusion: It is necessary to reorganize the technical standards and exposure procedures for improving the quality of the chest radiographs. The reappraisal of all interpreters and continuous training of technicians is required.Öğe Effect of symptom-to-treatment interval on prognosis in lung cancer(Sage Publications Ltd, 2007) Annakkaya, All Nihat; Arbak, Peri Meram; Balbay, Öner Abidin; Bilgin, Cahit; Erbaş, Mete; Bulut, İsmetAims and background: To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods: One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results: The patients were followed up for a mean period ( SD) of 7.4 +/- 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 +/- 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 +/- 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-totreatment intervals were 41 +/- 82 days (median, 10) and 16 +/- 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions: The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.Öğe The effects of Two Sequential Earthquakes on Tuberculosis Patients: An Experience from Duzce Earthquake(Drunpp-Sarajevo, 2011) Balbay, Öner Abidin; Balbay, Ege Güleç; Arbak, Peri Meram; Annakkaya, Ali Nihat; Bilgin, CahitSetting: Duzce city, a rural area in the northwest part of Turkey. Objectives: To examine the effects of two sequential earthquakes on sociodemographic and disease related features of tuberculosis (TB) patients. Methods: The present study was conducted among newly diagnosed smear positive (from October 1998 to October 2002) 112 pulmonary TB patients based on a specific questionnaire. Patients were divided into 3 groups regarding the time of diagnosis and the period from the initiation to the end of the treatment (pre, peri and post-earthquake periods). Results: Although the present study has not focused on the factors that influence the adherence of patients to TB therapy, no major changes were observed regarding socio-economical parameters that have an effect on the fate of TB. Patients were frequently hospitalized in pre-earthquake period while patients were ambulatory in peri and post-earthquake period (p<0.005). Patients were significantly controlled once a month in peri-earthquake period (p<0.001). Patients were mostly followed by the same doctor in post-earthquake period. Conclusion: It can be stated that the earthquakes had very little impact on the TB during and after earthquakes in Duzce. Further studies including whole Marmara region are needed to interpret the effect of earthquake on TB control.Öğe High serum homocysteine levels correlate with a decrease in the blood flow velocity of the ophthalmic artery in highway toll collectors(Tohoku Univ Medical Press, 2007) Memişoğulları, Ramazan; Yüksel, Harun; Coşkun, Abdurrahman; Yüksel, Hatice Kurt; Yazgan, Ömer; Bilgin, CahitHighway workers, such as policemen, automotive service companies, and toll collectors, are placed at risk of the accelerated atherosclerotic process, since recent studies have suggested that exposure to exhaust particles and ambient air pollution increases carotid intima-media thickness and reduces ocular blood flow velocity. Therefore, we assessed the relationship between serum homocysteine, a potential parameter for atherosclerosis, and the ocular blood flow velocity and the resistivity index in highway toll collectors. The peak systolic and end diastolic flow velocities and the resistivity index were measured in 22 toll collectors and 24 control subjects by color Doppler ultrasonography. The resistivity index, which is an indirect measure of the atherosclerotic process, was calculated: resistivity index = (peak systolic velocity - end diastolic velocity)/peak systolic velocity. Serum homocysteine levels were determined by fluorometric high-performance liquid chromatography. In the highway toll collectors, the serum homocysteine level (14.4 +/- 4.8 mu mol/l; p < 0.005) and the resistivity index of the ophthalmic artery (0.741 +/- 0.015; p < 0.05) were higher and the ophthalmic blood flow velocity (33.0 < 3.0 cm/s; p < 0.001) was lower than those in the controls (10.6 +/- 3.1,mu mol/l; 0.728 +/- 0.023; 36.8 +/- 2.2 cm/s; respectively). There were significant correlations between the serum homocysteine level and ophthalmic artery resistivity index in both highway toll collectors (p < 0.001) and controls (p < 0.005). Exposure to exhaust particles might increase the serum homocysteine level, which in turn could lead to the decreased ocular blood flow and the increased resistivity index.Öğe Intima-media thickness of the common carotid artery in highway toll collectors(John Wiley & Sons Inc, 2006) Erdoğmuş, Beşir; Yazıcı, Burhan; Annakkaya, Ali Nihat; Bilgin, Cahit; Şafak, Alp Alper; Arbak, Peri Meram; Tugay, AliPurpose. To assess the effects of exposure to exhaust particles on intima-media thickness of the common carotid artery in highway toll collectors, Methods. Sixty-one highway toll collectors (HTCs) between 24 and 56 years of age (mean, 36.2 +/- 7.3) and 48 controls between 24 and 64 years of age (mean, 42.6 +/- 10.6) were evaluated with gray-scale sonography to measure intima-media thickness (IMT) of the common carotid artery (CCA). Subgroups were categorized according to duration of exhaust exposure and further divided according to tobacco use. Results. CCA IMT was higher (0.8 +/- 0.2 mm) in HTCs than in the control group (0.6 +/- 0.1 mm; p < 0.001) and remained higher when subgroups with similar smoking habits were compared. In HTCs, IMT was greater when the number of years working in tollbooths was greater (p = 0.023). IMT was lower in HTCs with an exposure duration of < 10 years compared with a duration of 10-20years (p = 0.017) or > 20years (p value not significant). Conclusion. Air pollution has a widely acknowledged negative effect on humans. This study confirms that exposure to exhaust particles might cause wall thickening of carotid arteries. (c) 2006 Wiley Periodicals, Inc.Öğe Investigation of the effect of exhaust particles on ocular blood flow in highway toll collectors using color Doppler ultrasonography(Taylor & Francis Ltd, 2007) Erdoğmuş, Beşir; Yazıcı, Burhan; Önder, Halil İbrahim; Bilgin, Cahit; Tugay, Ali; Büyükkaya, RamazanPurpose: To investigate the effect of exhaust particles on orbital blood flow velocity of the ophthalmic artery, central retinal artery, and posterior ciliary artery by color Doppler ultrasonography in highway toll collectors. Material and Methods: Color Doppler imaging was used to measure the peak-systolic and end-diastolic flow velocities and resistivity indices of the ophthalmic artery, central retinal artery, and posterior ciliary artery in 20 toll collectors and 20 controls. Results: Both the peak-systolic and the end-diastolic flow velocities were decreased in the ophthalmic artery, central retinal artery, and posterior ciliary artery, and the resistivity index was increased in the central retinal artery in toll collectors when compared with control groups. Results were considered statistically significant if P < 0.05. Conclusion: It was determined that the effect of exhaust particles reduced ocular blood flow velocity in toll collectors as measured by color duplex Doppler ultrasonography.Öğe Respiratory symptoms and peak expiratory flow rates among furniture-decoration students(Inst Agricultural Medicine, 2004) Arbak, Peri Meram; Bilgin, Cahit; Balbay, Öner; Yeşildal, Nuray; Annakkaya, Ali Nihat; Ülger, FüsunThis study was designed to evaluate the effects of furniture production, mainly including fir tree (aberia mulleriana), on respiratory health of young workers and to compare the results with those obtained from previous Studies. Sixty-four furniture-decoration students (57 males and 7 females) and 62 controls (54 male, 8 female) from different departments in the same school were included into the Study. All participants were assessed with a questionnaire (concerning history of occupational exposure, work-related respiratory and other symptoms, smoking history, previous asthma history), full physical examination, spirometric evaluation and chest radiograph. Participants then performed serial monitoring of peak expiratory flow rates (PEER) at work and away from work within a month. Mean age of students was 20.9 +/- 3.7 years, 20.5 +/- 2.6 years in controls. There was no difference between study and control groups with regard to age, gender, smoking status and previous asthma history. Reported cough (23.4% vs. 8.1%) and shortness of breath (18.8% vs. 6.5%) were significantly higher in furniture-decoration students than in controls (p = 0.016 and p = 0.034, respectively). Furniture-decoration students had higher conjunctivitis (34.4% vs. 9.7%, p = 0.001) and rhinitis (34.4% vs. 19.4%, p = 0.044) history when compared with controls. Both students and controls were normal in terms of respiratory examination. PEF recordings were performed for approximately one month. Diurnal variability greater than 20% was seen in 12/64 (18.7%) of students at work, whereas it was detected in 4/62 (6.4%) of controls (p = 0,034). When comparing for the presence of diurnal variability greater than 20% in weekends, no difference was found between groups (p = 0.457). In conclusion, early detection of work-related respiratory changes by serial monitoring of peak expiratory flows should save the workers from hazardous respiratory effects of the furniture production, especially in young population.Öğe Serum homacysteine levels in highway toll collectors and the relationship with intima-media thickness of the carotid artery(2008) Memişoğulları, Ramazan; Erdoğmuş, Beşir; Alp, Hamit Hakan; Bilgin, Cahit; Arbak, Peri Meram; Yavuz, ÖzlemAmaç: Son zamanlarda hava kirliliği ve artmış intima-media kalınlığı (IMT) arasında bir ilişki olduğu rapor edilmiş, ancak etyolojisi tam olarak anlaşılamamıştır. Biz bu çalışmada önemli hava kirleticiler olan egsoz partiküllerine maruziyetin artmış homosistein (Hey) düzeyleriyle ilişkisi olup olmadığını ve artmış homosistein düzeylerinin artmış intima-media kalınlığı ile ilişkili olup olmadığını araştırdık. Yöntem ve Gereç: Altmışbeş erkek otoyol gişe memuru ve 43 sağlıklı erkek gönüllüde yüksek performanslı sıvı kromatografısi ile serum Hey düzeyleri ölçüldü. IMT ise Doppler Sonografi kullanılarak deneyimli bir radyolog tarafından ölçüldü. Bulgular: Otoyol gişe memurlarında serum Hey düzeyleri (14.5 4.9 mmol/1, P 0.005) ve IMT (0.757 0.18 mm, P 0.001) kontrollerden daha yüksekti (sırasıyla; 12.0 2.8 mmol/1 ve 0.612 0.11 mm). Hem otoyol gişe memurları grubunda (r 0.36; P 0.005) ve hem de kontrol grubunda (r 0.36; P 0.05) Hey ve IMT arasında pozitif bir korelasyon bulundu. Sonuç: Egsoz partiküllerine maruziyet, sonuçta bir IMT artışına yol açabiîen Hey düzeyinde bir artıştan dolayı, oksidatif stres artışına neden olabilir. Ancak son karara varmadan önce hala daha ileri çalışmalara ihtiyaç vardır.Öğe Serum homocysteine levels in highway toll collectors and the relationship with intima-media thickness of the carotid artery(Tubitak Scientific & Technical Research Council Turkey, 2008) Memişoğulları, Ramazan; Erdoğmuş, Beşir; Alp, Hamit Hakan; Bilgin, Cahit; Arbak, Peri Meram; Yavuz, ÖzlemAim: A relationship between air pollution and increased intima-media thickness (IMT) has been recently reported, but its etiology is not yet well understood. We aimed to determine whether exposure to exhaust particles, which are important air pollutants, is associated with increased serum homocysteine (Hcy) levels and whether elevated Hcy levels are associated with increased IMT. Materials and Methods: Serum Hcy levels were measured by fluorometric high performance liquid chromatography in 65 male highway toll collectors (HTCs) and 43 healthy male volunteers. IMT was measured with Doppler sonography by an experienced radiologist. Results: Serum Hcy levels (14.5 +/- 4.9 mmol/L, P < 0.005) and IMT (0.757 +/- 0.18 mm, P < 0.001) were higher in the HTC group than in controls (12.0 +/- 2.8 mmol/L and 0.612 +/- 0.11 mm, respectively). A positive correlation was found between Hcy level and IMT both in the HTC group (r = 0.36; P < 0.005) and in the control group (r = 0.36; P < 0.05). Conclusions: Exposure to exhaust particles may cause an increase in oxidative stress because of an increase in serum Hcy levels, which consequently may lead to an increase in IMT. Nevertheless, further studies on the subject are needed before drawing a firm conclusion.Öğe Use of a portable monitoring device (Somnocheck Micro) for the investigation and diagnosis of obstructive sleep apnoea in comparison with polysomnography(Professional Medical Publications, 2016) Bilgin, Cahit; Erkorkmaz, Ünal; Uçar, Muhammed Kürşad; Akın, Neşe; Nalbant, Ahmet; Annakkaya, Ali NihatObjective: Polysomnography (PSG) remains the gold standard for the diagnosis of obstructive sleep apnoea syndrome (OSAS). While PSG is essential for OSAS, this technique is not suitable for epidemiological investigation due to its high cost. This study aimed to compare a portable monitoring device with PSG for the measurement of parameters related to the diagnosis of OSAS in rural areas. Methods: We conducted a descriptive study of 155 patients (30 women and 125 men; mean age, 52 +/- 12 years) who visited to the Hendek Government Hospital Sleep Laboratory between February 2011 and January 2013 Apnoea hypopnea index (AHI), mean levels of O-2 (meanO(2)), desaturation index (DI), and minimum oxygen saturation (minO(2)) variations as measured using both PSG and a portable Somnocheck Micro (SM) device were compared. Results: Differences were found between the meanO(2) and DI, but not between AHI and minO(2). Differences between the methods were not desired, but the relationship between the methods was distinct and supported our hypothesis. Conclusions: The results of our study have shown that the SM portable device can be used as an alternative diagnostic tool in this population either at home or in sleep clinic.
