gms | German Medical Science

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V. (DGHNOKHC)

ISSN 1865-1011

Environmental and Occupational Health Disorders


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  • corresponding author Hans-Jürgen Schultz-Coulon - Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, plastische Operationen, Phoniatrie und Pädaudiologie, Städt. Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery 2004;3:Doc01

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Veröffentlicht: 28. Dezember 2004

© 2004 Schultz-Coulon.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



This volume treasures the main lectures of the 75th Annual Meeting of the German Association of Otorhinolaryngology, Head and Neck Surgery, which took place from May 19-23, 2004, in Bad Reichenhall and was held under the congress motto "Environmental and Occupational Health Disorders". When in Otorhinolaryngology such health disorders are discussed, mainly three medical realms are addressed: (1) the allergic and non-allergic inflammatory diseases of the respiratory tract, (2) the pathogenesis of cancer of the oropharynx and upper respiratory tract due to oncogenic inhalants and (3) noise induced hearing loss.

Since the trend-setting and still worth reading review articles on occupational hearing loss (E. Lehnhardt), occupational diseases of the upper respiratory and digestive tract (W. Schwab) and occupational diseases of the larynx (E. Nessel) almost 40 years ago (1965) our knowledge and with that our diagnostic and therapeutic capabilities in environmental medicine have considerably grown.

Concerning noxious inhalants our main interests should be dedicated to the cellular and molecular acting mechanism of pollutants as being more and more explained by modern research. This is the central issue of the first essay from H. Riechelmann (Ulm). On the one hand there are the specific molecular reaction cascades triggered by inhaled pollutants which finally lead to inflammatory reactions of the mucous membrane of the upper respiratory tract; on the other hand there are the oncogene lesions of the DNA caused by noxious inhalants. Only an exact knowledge on these mechanisms can offer a basis for the design of possible molecular therapy concepts.

Besides chemical structures and molecular acting mechanisms of noxious inhalants it is very important to know about the dosage of a specific inhalant required for any health damage. For this reason the basics of the toxicological assessment of occupational and environmental inhalants are reviewed by N. Kleinsasser (Regensburg). Modern tests for exact quantity measurements as well as relevant characteristic and limiting values of noxious compounds are explained.

The during the passed two decades considerably advanced knowledge on molecular mechanisms of allergic and non-allergic inflammatory reactions did have significant consequences for the development of new therapeutical strategies. Therefore it appeared to be necessary to review the actual therapy concepts for the treatment of allergic and non-allergic inflammatory diseases of the upper respiratory tract. Claudia Rudack (Münster) discusses in here essay not only the recent development of new drug groups such as antihistaminics or glucocorticosteroids but also the specific immune therapy as the only causal therapy of allergic rhinitis.

In the context with environmental health disturbances there is the curious phenomenon of the so-called Multiple Chemical Sensitivity (MCS), which scientifically has not been proved as a definite disease yet and possibly fails to be a nosological entity. As it is pointed out in the article from M. Schwenk (Tübingen) the term MCS refers to a general hypersensitivity of the patient against chemical substances, without being able to find out any pathophysiological basis for this individual hypersensitivity. Dealing with the MCS phenomenon is of special importance for the otorhinolaryngologist because in many cases the differentiation of a MCS from a non-allergic, hyperreactive inflammation of the respiratory mucosa as well as the treatment of MCS are very difficult.

The environmental noxa "noise" is still one of the most frequent causes for a chronic hearing loss in spite of all efforts to minimize noise emission in industrial and social environment. Whereas the occupational exposure to noise could be somewhat decreased at industrial working places during the passed decades, the exposure to noxious noise levels in the social environments has grown. Actual research data on the pathophysiogology of noise induced hearing loss with regard to molecular and genetic aspects and to obviously changed epidemiological facts were reason enough to review our present knowledge thoroughly on this field. This has been done by S. Plontke and H.P. Zenner (Tübingen) in the last article.

This third volume of "Current Topics in Otorhinolaryngology - Head and Neck Surgery" emphasizes the great importance of environmental medicine for the otorhinolaryngological specialty and points out, that all our scientific efforts on this field should not only be targeted at an improvement of diagnosis and therapy but also and mainly at an improvement of an effective prophylaxis.