Publications
52 results found
Hopkinson N, Wallis C, Higgins B, et al., 2013, CIGARETTE PACKAGING Children must be protected from the tobacco industry's marketing tactics, BMJ-BRITISH MEDICAL JOURNAL, Vol: 347, ISSN: 1756-1833
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- Citations: 1
Szram J, Schofield SJ, Cosgrove MP, et al., 2013, Welding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studies, EUROPEAN RESPIRATORY JOURNAL, Vol: 42, Pages: 1186-1193, ISSN: 0903-1936
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- Citations: 46
Gordon H, Szram J, 2013, Paternity leave experiences of NHS doctors, CLINICAL MEDICINE, Vol: 13, Pages: 426-430, ISSN: 1470-2118
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- Citations: 6
Szram J, Cullinan P, 2013, Medical surveillance for prevention of occupational asthma, CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY, Vol: 13, Pages: 138-144, ISSN: 1528-4050
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- Citations: 15
Szram J, 2012, Occupational asthma. current practice: When to think of it, what to do?, Clinical Pulmonary Medicine, Vol: 19, Pages: 199-205, ISSN: 1068-0640
Exposures at work are an often overlooked but important cause of asthma and other airway diseases. Evidence from large population-based studies shows that 1 in 10 cases of asthma occurring, recurring, or worsening in adulthood can be related to occupational factors. The majority of cases are of pre-existing asthma made worse by employment [work-exacerbated asthma (WEA)]. Adults presenting with increased or new asthma symptoms should be carefully assessed so that WEA can be distinguished from true occupational asthma (OA), a disease that is directly caused by a workplace exposure. Airways disease may also arise from toxic exposures to respiratory irritants at work. In most cases, symptoms are self-limiting, but an asthma-like syndrome (irritant-induced asthma) occasionally results. OA and WEA require different diagnostic and management approaches. Key steps required to make a definitive diagnosis of either condition are an awareness of the disease with an associated low threshold of suspicion, time spent acquiring a full and detailed job history followed by carefully considered application of a few simple important diagnostic investigations. A satisfying part of managing OA is the opportunity for cure (provided that the necessary management advice can be implemented), although the socioeconomic consequences-mainly to the patient themselves-can be high. Copyright © 2012 by Lippincott Williams & Wilkins.
Szram J, 2012, Occupational airways disease, Medicine (United Kingdom), Vol: 40, Pages: 279-282, ISSN: 1357-3039
Airway disease can be either caused or exacerbated by occupational exposures; early recognition of work-related disease is crucial to achieving a successful outcome for the patient. It has been estimated from population research that 10% of adult asthma presentations (either new cases or exacerbation of existing disease) can be attributed to a work exposure. Work-exacerbated and occupational asthma have different causal pathways and therefore require different management by healthcare professionals as well as by employers. Obtaining a full, precise job history together with careful application of simple but powerful diagnostic investigations are the key processes in distinguishing successfully between the two conditions. Appropriate management may result in cure, although in most cases there is a significant socio-economic cost to the patient. Toxic exposures to workplace respiratory irritants can also result in airway disease; symptoms are generally short lived and self-limiting but can occasionally result in an asthma-like syndrome ('irritant-induced asthma'). A number of specific occupational exposures have been causally associated with chronic obstructive airways disease (COPD); diagnosis can be complicated due to the long latency period between exposure and clinically evident disease, and confounding by smoking. Other rare, occupationally induced airway diseases such as obliterative bronchiolitis require specialist consideration. © 2012 Elsevier Ltd. All rights reserved.
Cannon J, Szram J, Welch J, et al., 2011, SUPERMARKET BAKERS ASTHMA: A REPORT OF THREE SUCCESSIVE ROUNDS OF SURVEILLANCE, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A6-A7, ISSN: 0040-6376
Szram J, Schofield SJ, Woods APM, et al., 2011, WORK PERFORMANCE AND AIRFLOW OBSTRUCTION IN A GENERAL UK POPULATION OF OLDER WORKERS, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A5-A5, ISSN: 0040-6376
Pickles E, Szram J, Schofield SJ, et al., 2011, OCCUPATIONAL EXPOSURE, BREATHLESSNESS AND COPD IN A GENERAL POPULATION OF OLDER UK MEN, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A4-A5, ISSN: 0040-6376
Díaz Angulo S, Szram J, Welch J, et al., 2011, Occupational asthma in antibiotic manufacturing workers: case reports and systematic review., J Allergy (Cairo), Vol: 2011
Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5-8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required.
Szram J, Schofield SJ, Woods APM, et al., 2010, BREATHLESSNESS AND WORK PERFORMANCE IN OLDER ADULTS IN KENT, British-Thoracic-Society-Winter-Meeting 2010, Publisher: B M J PUBLISHING GROUP, Pages: A78-A79, ISSN: 0040-6376
Szram J, Schofield SJ, MacNeill SJ, et al., 2010, PREVALENCE OF ASTHMA RELATED TO EMPLOYMENT IN THE UK, British-Thoracic-Society-Winter-Meeting 2010, Publisher: B M J PUBLISHING GROUP, Pages: A71-A72, ISSN: 0040-6376
jones mg, 2009, Occupational Asthma, Occupational Asthma, Editors: Sigsgaard, Heederik, Publisher: Birkhauser, ISBN: 9783764385552
Epidemiology of laboratory animal allergy Hayley L. Jeal, Meinir G. Jones and Paul Cullinan Department of Occupational and Environmental Medicine, ...
Szram J, Upchurch S, MacNeill SJ, et al., 2008, WORKFORCE DEMOGRAPHICS OF PEOPLE WITH ASTHMA COMPARED WITH THE GENERAL POPULATION: A NATIONWIDE STUDY, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A7-A7, ISSN: 0040-6376
Szram J, Tucker L, Arbery J, et al., 2008, ASTHMA IN FIRE FIGHTERS AND RECRUITS, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A117-A117, ISSN: 0040-6376
Upchurch SJ, Szram J, Cosgrove M, et al., 2007, The effect of welding on lung function decline and respiratory symptoms: A systematic review, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A130-A131, ISSN: 0040-6376
Munshi M, Szram J, Macneill S, et al., 2007, The outcome of occupational asthma with continuing exposure: A systematic review, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A130-A130, ISSN: 0040-6376
Szram J, MacNeill S, Walker S, et al., 2006, Prevalence of asthma related to employment in the UK: A national survey through general practice, Winter Meeting of the British-Thoracic-Society/British-Lung-Foundation (BTS/BLF), Publisher: B M J PUBLISHING GROUP, Pages: II18-II18, ISSN: 0040-6376
Szram J, Cannon J, Hole AM, et al., 2005, Occupational asthma: Old agents in new (dis) guises, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: II72-II72, ISSN: 0040-6376
Szram J, Nicholson AG, Goldstraw P, et al., 2003, Left lower lobe collapse in an octogenarian., Age Ageing, Vol: 32, Pages: 463-464, ISSN: 0002-0729
Szram J, Nicholson AG, Goldstraw P, et al., 2003, Left lower lobe collapse in an octogenarian, AGE AND AGEING, Vol: 32, Pages: 463-U2, ISSN: 0002-0729
Hudsmith L, Weston V, Szram J, et al., 2001, Clinical picture, Rat bite fever., Lancet Infect Dis, Vol: 1, ISSN: 1473-3099
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