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Päivinen M, Keskinen K, Putus T, Kujala UM, Kalliokoski P, Tikkanen HO. Asthma, allergies and respiratory symptoms in different activity groups of swimmers exercising in swimming halls. BMC Sports Sci Med Rehabil 2021; 13:119. [PMID: 34607605 PMCID: PMC8491406 DOI: 10.1186/s13102-021-00349-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 09/22/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Respiratory symptoms are common in competitive swimmers. However, among these and in swimmers at other activity levels the swimming distance, the total spent time in swimming halls and their medical background varies. Our objectives were, first, to assess their medical histories and the associations with respiratory symptoms among swimmers in different activity groups and then second, to study the pulmonary function findings and related medications in competitive swimmers who exercise in swimming hall environments the most. METHODS First, 1118 participants consisting of 133 competitive-, 734 fitness- and 251 occasional swimmers answered questionnaires concerning their medical background, their respiratory symptoms in connection to swimming distance and their amount of time spent in swimming halls. Secondly, in 130 competitive swimmers, pulmonary function was tested by spirometry and a specific questionnaire was used to assess respiratory symptoms, medical histories and prescribed medication. RESULTS Respiratory symptoms were reported by 18% of the studied swimmers. Competitive swimmers had significantly more symptoms than fitness- and occasional swimmers. Naturally competitive swimmers swum more than 2000 m and stayed by the pool more than 90 min, longer than the other activity groups of swimmers. Spirometry testing showed airway obstruction in 15 swimmers, which was 12% of the 130 competitive swimmers. 21 of them, had physician-diagnosed asthma and 16 of these individuals had prescribed medication for it. CONCLUSIONS Competitive swimmers had the highest swimming hall exposure and reported significantly more respiratory symptoms. A high prevalence of airway obstruction findings in competitive swimmers with asthma and allergies suggests a need for future recommendations for regular testing and special medical care for competitive swimmers.
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Affiliation(s)
- Marja Päivinen
- Department of Occupational Medicine, Faculty of Medicine, University of Turku, Turku, Finland.
- Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Kari Keskinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuula Putus
- Department of Occupational Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pentti Kalliokoski
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Heikki O Tikkanen
- School of Medicine, Institute of Biomedicine/Sports and Exercise Medicine, University of Eastern Finland, Kuopio, Finland
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Prapamontol T, Norbäck D, Thongjan N, Suwannarin N, Somsunun K, Ponsawansong P, Khuanpan T, Kawichai S, Naksen W. Fractional exhaled nitric oxide (FeNO) in students in Northern Thailand: associations with respiratory symptoms, diagnosed allergy and the home environment. J Asthma 2021; 59:1787-1795. [PMID: 34435554 DOI: 10.1080/02770903.2021.1968424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE There are few studies on fractional exhaled nitric oxide (FeNO) among children in subtropical areas. We studied associations between FeNO and respiratory symptoms, reported diagnosed allergies and indoor and outdoor environmental factors in first grade junior high school students (N = 270) in upper northern Thailand. METHODS Data on demographics, health and home environment were collected by a questionnaire distributed in dry season (February-March 2018). FeNO was measured when the research team visited the school. Daily outdoor pollution data (PM10 and ozone) were collected from the nearest monitoring station 3 days (lag 3) and 7 days (lag 7) before the FeNO measurements. Two-level (student, school) linear mixed models were used to analyze associations, adjusting for gender and family education level. RESULTS In total, 29.6% had elevated FeNO level (>20 ppb) and 7.8% reported any allergy diagnosed by a doctor. Male gender (p = 0.02), diagnosed allergy (p = 0.001), especially to cat (p = 0.001) and house dust mite (HDM) allergies (p = 0.001) were associated with FeNO. Eye symptoms (p = 0.01), rhinitis symptoms (p = 0.03) and dyspnea (p = 0.05) in the last 3 days were associated with FeNO. Household indoor mold (p = 0.03), gas cooking (p = 0.03) and PM10 (lag 3 and lag 7) were negatively (protective) associated with FeNO. CONCLUSIONS Diagnosed allergy, especially to cat and HDM, can be associated with increased FeNO. Indoor mold and gas cooking can be associated with lower FeNO. Ocular, nasal and dyspnea symptoms reported by students in dry season in northern Thailand can be associated with FeNO, a biomarker of Th2 driven airway inflammation.
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Affiliation(s)
- Tippawan Prapamontol
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Dan Norbäck
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Nathaporn Thongjan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Neeranuch Suwannarin
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kawinwut Somsunun
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Tosabhorn Khuanpan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sawaeng Kawichai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
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Ford AP, Dillon MP, Kitt MM, Gever JR. The discovery and development of gefapixant. Auton Neurosci 2021; 235:102859. [PMID: 34403981 DOI: 10.1016/j.autneu.2021.102859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/06/2021] [Accepted: 07/21/2021] [Indexed: 01/02/2023]
Abstract
Gefapixant is the approved generic name for a compound also known as MK-7264, and prior to that AF-219 and RO-4926219. It is the first-in-class clinically developed antagonist for the P2X3 subtype of trimeric ionotropic purinergic receptors, a family of ATP-gated excitatory ion channels, showing nanomolar potency for the human P2X3 homotrimeric channel and essentially no activity at related channels devoid of P2X3 subunits. As the first P2X3 antagonist to have progressed into clinical studies it has now progressed to the point of successful completion of Phase 3 investigations for the treatment of cough, and the NDA application is under review with US FDA for treatment of refractory chronic cough or unexplained chronic cough. The molecule was discovered in the laboratories of Roche Pharmaceuticals in Palo Alto, California, but clinical development then continued with the formation of Afferent Pharmaceuticals for the purpose of identifying the optimal therapeutic indication for this novel mechanism and establishing a clinical plan for development in the optimal patient populations selected. Geoff Burnstock was a close collaborator and advisor to the P2X3 program for close to two decades of discovery and development. Progression of gefapixant through later stage clinical studies has been conducted by the research laboratories of Merck & Co., Inc., Kenilworth, NJ, USA (MRL; following acquisition of Afferent in 2016), who may commercialize the product once authorization has been granted by regulatory authorities.
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Affiliation(s)
- Anthony P Ford
- CuraSen Therapeutics, 930 Brittan Avenue, Suite 306, San Carlos, CA 94070, USA.
| | - Michael P Dillon
- Ideaya Biosciences, 7000 Shoreline Court, Suite 350, South San Francisco, CA 94080, USA
| | - Michael M Kitt
- Axalbion LTD., C/O Medicines Evaluation Unit, The Langley Building, Southmoor Road, Wythenshawe, M23 9QZ Manchester, UK
| | - Joel R Gever
- CuraSen Therapeutics, 930 Brittan Avenue, Suite 306, San Carlos, CA 94070, USA
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Abstract
In food allergy, allergen avoidance and emergency treatment are still therapeutic hallmarks but, recently, allergen immunotherapy (AIT), with different application routes, has gained more attention. In primary food allergy, oral immunotherapy has been frequently used in clinical trials. This year, an oral immunotherapy preparation for treatment of peanut allergy was licensed in Europe. In secondary food allergy, sublingual and subcutaneous extracts have been used in clinical trials, mostly with cross-reactive pollen allergens. As there is no AIT preparation licensed for this indication, therapy should only be started when there also is a need for treating associated respiratory symptoms.
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Affiliation(s)
- Regina Treudler
- Klinik für Dermatologie, Venerologie und Allergologie, Leipziger Interdisziplinäres Centrum für Allergologie - LICA-CAC, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - Jan-Christoph Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Leipziger Interdisziplinäres Centrum für Allergologie - LICA-CAC, Universität Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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Fakunle AG, Jafta N, Naidoo RN, Smit LAM. Association of indoor microbial aerosols with respiratory symptoms among under-five children: a systematic review and meta-analysis. Environ Health 2021; 20:77. [PMID: 34210330 PMCID: PMC8252236 DOI: 10.1186/s12940-021-00759-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 06/18/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Despite the recognition of the importance of indoor microbial exposures on children's health, the role of different microbial agents in development and aggravation of respiratory symptoms and diseases is only poorly understood. This study aimed to assess whether exposure to microbial aerosols within the indoor environment are associated with respiratory symptoms among children under-5 years of age. METHODS A systematic literature search was conducted on PubMed, Web of Science, GreenFILE, ScienceDirect, EMBASE and Cochrane library through February 2020. Studies that investigated the exposure-response relationship between components of the indoor microbial communities and respiratory symptoms among under-five children were eligible for inclusion. A random-effect meta-analysis was applied to estimate pooled relative risk (RR) and 95% confidence interval (CI) for study specific high versus low microbial exposures. The potential effect of individual studies on the overall estimate was evaluated using leave-one-out analysis, while heterogeneity was evaluated by I2 statistics using RevMan 5.3. RESULTS Fifteen studies were eligible for inclusion in a meta-analysis. The pooled risk estimate suggested that increased microbial exposure was associated with an increased risk of respiratory symptoms [pooled relative risk (RR): 1.24 (1.09, 1.41), P = 0.001]. The association was strongest with exposure to a combination of Aspergillus, Penicillium, Cladosporium and Alternaria species [pooled RR: 1.73 (1.30, 2.31), P = 0.0002]. Stratified analysis revealed an increased risk of wheeze [pooled RR: 1.20 (1.05, 1.37), P = 0.007 and allergic rhinitis [RR: 1.18 (0.94, 1.98), P = 0.16] from any microbial exposure. CONCLUSIONS Microbial exposures are, in general, associated with risk of respiratory symptoms. Future studies are needed to study the indoor microbiome more comprehensively, and to investigate the mechanism of these associations.
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Affiliation(s)
- Adekunle Gregory Fakunle
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Medicine, University of Ibadan, Ibadan, 200284 Nigeria
| | - Nkosana Jafta
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Rajen N. Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Environmental Epidemiology Division (IRAS-EEPI), Utrecht University, Utrecht, The Netherlands
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Korten I, Oestreich MA, Frey U, Moeller A, Jung A, Spinas R, Mueller-Suter D, Trachsel D, Rochat I, Spycher B, Latzin P, Casaulta C, Ramsey K. Respiratory symptoms do not reflect functional impairment in early CF lung disease. J Cyst Fibros 2021; 20:957-964. [PMID: 34088612 DOI: 10.1016/j.jcf.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lung disease can develop within the first year of life in infants with cystic fibrosis (CF). However, the frequency and severity of respiratory symptoms in infancy are not known. METHODS We assessed respiratory symptoms in 50 infants with CF and 50 healthy matched controls from two prospective birth cohort studies. Respiratory symptoms and respiratory rate were documented by standardized weekly interviews throughout the first year. Infants performed multiple breath washout in the first weeks of life. RESULTS We analyzed 4552 data points (2217 in CF). Respiratory symptoms (either mild or severe) were not more frequent in infants with CF (OR:1.1;95% CI:[0.76, 1.59]; p=0.6). Higher lung clearance index and higher respiratory rate in infants with CF were not associated with respiratory symptoms. CONCLUSIONS We found no difference in respiratory symptoms between healthy and CF infants. These data indicate that early CF lung disease may not be captured by clinical presentation alone.
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Affiliation(s)
- Insa Korten
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland
| | - Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland
| | - Urs Frey
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | - Andreas Jung
- Division of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | - Renate Spinas
- Division of Respiratory Medicine, University Children's Hospital Zurich, Switzerland
| | | | - Daniel Trachsel
- University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Isabelle Rochat
- Department of Paediatrics, Respiratory Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Ben Spycher
- Institute for Social and Preventive Medicine, University of Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland
| | - Carmen Casaulta
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland
| | - Kathryn Ramsey
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern Unviersity Hospital, University of Bern, Switzerland.
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Ghorani V, Alavinezhad A, Rajabi O, Boskabady MH. Carvacrol improves pulmonary function tests, oxidant/antioxidant parameters and cytokine levels in asthmatic patients: A randomized, double-blind, clinical trial. Phytomedicine 2021; 85:153539. [PMID: 33773189 DOI: 10.1016/j.phymed.2021.153539] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Carvacrol effects on inflammatory mediators, lung pathology and tracheal responsiveness were indicated in animal models of pulmonary diseases. PURPOSE To evaluate carvacrol effects on respiratory symptoms, pulmonary function tests (PFT), oxidative stress markers and cytokine levels in asthmatic patients. STUDY DESIGN This study was a randomized, placebo-controlled double-blind, clinical trial. METHODS Thirty-three moderate asthmatic patients were divided to the two groups of: placebo group (n = 16) and carvacrol group (1.2 mg/kg/day, n = 17). Prepared capsules were taken for two months along, 3 times/day along with routine medications. Respiratory symptoms, PFT, and oxidative stress markers were evaluated before the treatment (step 0), and one (step I) and two months (step II) after the beginning of the treatment. However, cytokine levels in serum and supernatant of peripheral blood mononuclear cells (PBMC), and their gene expression were evaluated in step 0 and II. RESULTS In carvacrol-treated group, respiratory symptoms significantly decreased after one- and two-month treatment with carvacrol compared to pre-treatment values (p < 0.05 to p < 0.001). Compared to step 0, PFT values were significantly increased in step I and II, in treated group with carvacrol (p < 0.05 to p < 0.001). Most oxidative stress markers were improved following carvacrol treatment (p < 0.05 to p < 0.001). Treatment with carvacrol for two-month also significantly improved cytokine levels in serum and supernatant of PBMC, compared to step 0 (p < 0.05 to p < 0.001). However, no significant changes were observed in the above-noted parameters in the placebo group. CONCLUSION Due to anti-inflammatory and antioxidant effect, carvacrol could be suggested as a therapeutic agent for asthma.
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Affiliation(s)
- Vahideh Ghorani
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Alavinezhad
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Rajabi
- Department of Drug and Food Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Meteran H, Thomsen SF, Miller MR, Hjelmborg J, Sigsgaard T, Backer V. Impact of the spirometric definition on comorbidities in chronic obstructive pulmonary disease. Respir Med 2021; 184:106399. [PMID: 34000574 DOI: 10.1016/j.rmed.2021.106399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/30/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Little is known about how the spirometric definition of airway obstruction affects the association between COPD and comorbidities and whether these associations might be due to genetic predisposition. AIM 1) To examine the impact of the spirometric definition on the associations between COPD and its comorbidities and 2) To examine whether these associations can be explained by shared genetic or environmental factors. METHODS 11,458 twins, aged 40-80 years, from the Danish Twin Registry were recruited who completed a questionnaire on medical history, life style factors and had a clinical examination. COPD was defined by respiratory symptoms (RS) plus airway obstruction according to either GOLD (FR-COPD) or ERS/ATS guidelines (LLN-COPD). Self-reported physician diagnoses were used to identify comorbidities. RESULTS The mean age of participants was 58.4 years ±SD 9.7, mean BMI was 26.6 kg/m2 ± SD 4.4, 52% were female and the prevalence of LLN2.5-COPD and FR-COPD was 2.5% and 6.3%, respectively. Among eight major comorbidities, multivariate logistic regression showed COPD was only associated with heart failure, whereas RS alone were associated with 6 out of 8 comorbidities after Bonferroni-correction. There was an increased risk of heart failure, ischemic heart disease, depression and pulmonary embolism in twin individuals with RS compared with the co-twin without RS. CONCLUSIONS COPD was only associated with an increased risk of heart failure. Discordant COPD-individuals (FR-COPD+/LLN5-COPD-) were at increased risk of heart failure. Sub-analyses showed that RS, but not airway obstruction were associated with an increased risk of comorbidities.
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Affiliation(s)
- Howraman Meteran
- Department of Internal Medicine, Respiratory Medicine Section, Copenhagen University Hospital-Herlev-Gentofte, Hellerup, Denmark; Department of Public Health, Section of Environment Occupation and Health, Danish Ramazzini Centre, University of Aarhus, Aarhus C, Denmark; Department of Microbiology and Immunology, University of Copenhagen, Denmark.
| | - Simon Francis Thomsen
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg-Frederiksberg, Copenhagen, Denmark; Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin R Miller
- Institute of Applied Health Sciences, University of Birmingham, Birmingham, UK
| | - Jacob Hjelmborg
- The Danish Twin Registry, Epidemiology and Biostatistics, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Section of Environment Occupation and Health, Danish Ramazzini Centre, University of Aarhus, Aarhus C, Denmark
| | - Vibeke Backer
- Centre of Inflammation and Metabolism, Centre for Physical Activity Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Oo TW, Thandar M, Htun YM, Soe PP, Lwin TZ, Tun KM, Han ZM. Assessment of respiratory dust exposure and lung functions among workers in textile mill (Thamine), Myanmar: a cross-sectional study. BMC Public Health 2021; 21:673. [PMID: 33827504 PMCID: PMC8028193 DOI: 10.1186/s12889-021-10712-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Airborne dusts are being potentially harmful for workers in occupational environment. Exposure to respirable dust is the most important concern in textile workers for the widespread of occupational lung diseases, especially more serious in developing countries. The aim of the study was to assess the respirable dust exposure and associated factors of lung functions among textile workers. METHODS A cross-sectional study was carried out at a textile mill (Thamine), Yangon Region, from April to December, 2018 and a total of 207 textile workers were randomly selected by using a multistage sampling procedure. Data were collected by using a structured questionnaire for respiratory symptoms, an air sampling pump for assessment of respirable dust exposure, and a spirometer for testing the lung functions. Logistic regression analysis was performed to assess the associated factors of lung functions. Odds ratios with a 95% confidence interval were computed for strength of associations at the significance level of α ≤ 0.05. RESULTS The mean (± standard deviation, SD) respirable dust exposure was 3.3 mg/m3 (± 0.69) and the prevalence of increased respirable dust exposure (> 3 mg/m3) was 50.7%. The level of respirable dust exposure was highest in the textile workers involving at twisting department. The means (± SD) spirometry values were FVC 82.8% (± 17.8), FEV1 83.6% (± 18.5), and FEV1/FVC 0.9 (± 0.1). Overall magnitude of reduced lung functions was 40.1%, and the prevalence of reduced FVC, FEV1, and FEV1/FVC were 36.7, 34.3 and 3.9% respectively. The current working at twisting department, > 5 years of service duration, respiratory symptoms and increased respirable dust exposure were associated with reduction in FVC and FEV1. CONCLUSIONS The current working department, service duration, respiratory symptoms and exposure to respirable dust were predictors of lung functions in textile workers. An adequate ventilation, good work practices, hygienic workplace, safety and health training regarding potential health effects, and periodically assessment of lung functions are the critical elements for control of respirable dust exposure and reduction of occupational lung diseases.
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Affiliation(s)
- Thet Wai Oo
- Special Operation Medical Research Department, Defence Services Medical Research Centre, Nay Pyi Taw, Myanmar
| | - Mya Thandar
- Department of Environmental and Occupational Health, University of Public Health, Yangon, Myanmar
| | - Ye Minn Htun
- Department of Prevention and Research Development of Hepatitis, AIDS and Other Viral Diseases, Health and Disease Control Unit, Nay Pyi Taw, Myanmar.
| | - Pa Pa Soe
- Department of Preventive and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Thant Zaw Lwin
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Kyaw Myo Tun
- Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar
| | - Zaw Myo Han
- Defence Services Liver Hospital, Yangon, Myanmar
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Abstract
PURPOSE Case series on respiratory features of Aerotoxic Syndrome (AS). The term AS has been coined to describe the spectrum of clinical manifestations after aircraft fume events. Among these manifestations, neurological and respiratory symptoms are the most frequently reported complaints. METHODS Three cases of AS with relevant respiratory features are presented. RESULTS Cough and shortness of breath for 6 to12 months were the predominant symptoms in the first two cases. The first case also developed neurological symptoms affecting his central nervous system. In the third case, the patient complained for nine years about an unbearable cough triggered by odors, smells, and a variety of indoor and outdoor irritants, among other symptoms of multiple chemical sensitivity. In all three cases, the respiratory symptoms resolved after appropriate treatment. CONCLUSION Our report aims at raising awareness on AS and calls for actions to improve the management of patients suffering from this syndrome.
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Affiliation(s)
- Jorge Roig
- Department of Pulmonary Medicine, Clínica Creu Blanca, Barcelona, Spain.
| | - Christian Domingo
- Department of Pulmonary Medicine, Corporació Sanitària Parc Taulí, Sabadell, Spain.,Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Jonathan Burdon
- Consultant Respiratory Physician, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Susan Michaelis
- Occupational and Environmental Health Research Group, School of Health Sciences, University of Stirling, Stirling, UK
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Pietersen PI, Mikkelsen S, Lassen AT, Helmerik S, Jørgensen G, Nadim G, Christensen HM, Wittrock D, Laursen CB. Quality of focused thoracic ultrasound performed by emergency medical technicians and paramedics in a prehospital setting: a feasibility study. Scand J Trauma Resusc Emerg Med 2021; 29:40. [PMID: 33632276 PMCID: PMC7908705 DOI: 10.1186/s13049-021-00856-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a prehospital setting, the severity of respiratory symptoms in patients calling for an ambulance differ. The initial evaluation, diagnosing, and thereby management can be challenging because respiratory symptoms can be caused by disease in many organs. Ultrasound examinations can contribute with important information and support the clinical decision-making. However, ultrasound is user-dependent and requires sufficient knowledge and training. The aim of this study was to explore the quality of thoracic ultrasound examinations performed on patients by emergency medical technicians and paramedics in a prehospital, clinical setting. METHODS From November 2018 - April 2020, Danish emergency medical technicians and paramedics (n = 100) performed thoracic ultrasound examinations on patients with respiratory symptoms using a portable ultrasound device. The ultrasound examinations were stored and retrospectively assessed by a reviewer blinded to the patients' symptoms and history, as well as the emergency medical technicians' and paramedics' findings. The image quality was scored from 1 to 5. The findings determined by the reviewer was then correlated with a questionnaire filled out by the emergency medical technicians and paramedics regarding ultrasonic findings and potential change in treatment or management of the patient. The agreement in percentage and as Cohen's kappa was explored. RESULTS A total of 590 ultrasound examinations were assessed, resulting in a median image quality score of 3 (IQ1 = 4, IQ3 = 3). The overall agreement in percentage between the emergency medical technicians and paramedics and reviewer was high (87.7% for a normal scan, 89.9% for interstitial syndrome, 97.3% for possible pneumothorax, and 96.3% for pleural effusion). Cohen's kappa varied from 0.01 for possible pneumothorax to 0.69 for pleural effusion. Based on the questionnaires (n = 406), the ultrasound examination entailed a change in treatment or visitation in 48 cases (11.7%) which in this study population encompasses a number-needed-to-scan of 8.5. CONCLUSION Emergency medical technicians and paramedics perform focused thoracic ultrasound examinations with adequate image quality sufficient to determine if pathology is present or not. The emergency medical technicians' and paramedics' assessment correlates to some extent with an experienced reviewer and their findings are most reliable for the inclusion of a normal scan or inclusion of pleural effusion. Implementation could possibly impact the number of patients receiving correct prehospital treatment and optimal choice of receiving facility.
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Affiliation(s)
- Pia Iben Pietersen
- Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, entrance 87, 1st floor, 5000, Odense C, Denmark.
- Regional Center for Technical Simulation, Odense University Hospital, 5000, Odense C, Denmark.
| | - Søren Mikkelsen
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, 5000, Odense C, Denmark
| | - Annmarie T Lassen
- Department of Emergency Medicine, Odense University Hospital, 5000, Odense C, Denmark
| | - Simon Helmerik
- Department of Quality & Education, Ambulance Syd, Region of Southern Denmark, 5220, Odense SØ, Denmark
| | - Gitte Jørgensen
- Ambulance Syd, Region of Southern Denmark, 5220, Odense SØ, Denmark
| | - Giti Nadim
- Department of Emergency Medicine, Odense University Hospital, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000, Odense C, Denmark
| | - Helle Marie Christensen
- Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, entrance 87, 1st floor, 5000, Odense C, Denmark
- Department of Respiratory Medicine, Odense University Hospital, 5000, Odense C, Denmark
| | - Daniel Wittrock
- Department of Quality & Education, Ambulance Syd, Region of Southern Denmark, 5220, Odense SØ, Denmark
| | - Christian B Laursen
- Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, entrance 87, 1st floor, 5000, Odense C, Denmark
- Department of Respiratory Medicine, Odense University Hospital, 5000, Odense C, Denmark
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Ly TDA, Hoang VT, Goumballa N, Louni M, Canard N, Dao TL, Medkour H, Borg A, Bardy K, Esteves-Vieira V, Filosa V, Davoust B, Mediannikov O, Fournier PE, Raoult D, Gautret P. Variations in respiratory pathogen carriage among a homeless population in a shelter for men in Marseille, France, March-July 2020: cross-sectional 1-day surveys. Eur J Clin Microbiol Infect Dis 2021; 40:1579-1582. [PMID: 33580843 PMCID: PMC7881748 DOI: 10.1007/s10096-020-04127-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/13/2020] [Indexed: 12/03/2022]
Abstract
We aimed to compare respiratory pathogen carriage by PCR during three different time periods in 2020 in sheltered homeless people in Marseille, France. The overall prevalence of respiratory pathogen carriage in late March–early April (69.9%) was significantly higher than in late April (42.3%) and mid-July (45.1%). Bacterial carriage significantly decreased between late March–early April and late April. SARS-CoV-2 was detected only in late March–early April samples (20.6%). Measures aiming at mitigating SARS-CoV-2 transmission were effective and also impacted bacterial carriage. Seasonal variations of bacterial carriage between winter and summer in this population were not marked.
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Affiliation(s)
- Tran Duc Anh Ly
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Van Thuan Hoang
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,Family Medicine Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Ndiaw Goumballa
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Senegal
| | - Meriem Louni
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Naomie Canard
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Thi Loi Dao
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,Pneumology Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Hacene Medkour
- IHU-Méditerranée Infection, Marseille, France.,IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Audrey Borg
- IHU-Méditerranée Infection, Marseille, France
| | - Kevin Bardy
- IHU-Méditerranée Infection, Marseille, France
| | | | | | - Bernard Davoust
- IHU-Méditerranée Infection, Marseille, France.,IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, Marseille, France.,IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Pierre-Edouard Fournier
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,IRD, AP-HM, SSA, MEPHI, Aix Marseille Univ, Marseille, France
| | - Philippe Gautret
- IRD, AP-HM, SSA, VITROME, Aix Marseille Univ, Marseille, France. .,IHU-Méditerranée Infection, Marseille, France.
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Hussein H, Shamsipour M, Yunesian M, Hasanvand MS, Mahamudu T, Fotouhi A. Fuel type use and risk of respiratory symptoms: A cohort study of infants in the Northern region of Ghana. Sci Total Environ 2021; 755:142501. [PMID: 33038841 DOI: 10.1016/j.scitotenv.2020.142501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Little evidence exists about the association between fuel type use and risk of respiratory symptoms among infants; we aimed to evaluate this hypothesis through a cohort study in the Northern Region of Ghana. The study was carried out from April 2018 to May 2019. We recruited 28 weeks old pregnant women at selected hospitals and prospectively followed them at birth in the hospital ward to register their newborns and at homes when the baby had attained 3 to 7 months to collect data on respiratory symptoms of infants. A logistic regression model was used to investigate the odds of respiratory symptoms in infants. Exactly 1270 infants completed the study; the average age of women was 27.1 years and standard deviation of 5.1. The study found that infants of mothers who cooked with charcoal and those with firewood had increased odds of having cough with cold 4.10 (95% CI, 2.21-7.61) and 3.95 (95% CI, 2.06-7.58), increased odds of congestion, phlegm with cold by 3.89 (95% CI, 1.73-8.79) and 3.45 (95% CI, 1.44-8.26), increased odds of wheezing 4-14 days or nights by 1.68 (95% CI, 0.72-3.91) and 3.37 (95% CI, 1.41-8.04) and increased odds of seeking medical treatments in a health facility for chest illness by 3.97 (95% CI, 1.31-12.02) and 6.67 (95% CI, 2.14-20.77) in comparison with liquid petroleum gas respectively. Some significant predictors of respiratory infections were maternal malaria, hospitalisations of an infant after birth, residence, cooking location, composite breastfeeding, sharing of a bedroom with infant and air-conditioner or fan in the living room. Our findings indicate increased odds of infant respiratory symptoms in households using solid fuel in Ghana. Although our observational design precludes ascribing any causal relationships, our results are consistent with other studies suggesting clean fuel use during pregnancy and infancy may benefit this vulnerable age group.
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Affiliation(s)
- Hawawu Hussein
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; African Union Scientific Technical and Research Commission, Abuja, Nigeria; Tamale Teaching Hospital, Research Department, Tamale, Ghana
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad S Hasanvand
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Gashi V, Ahmetaj L. The Prevalence of Self-reported Respiratory Symptoms, Asthma and use of Asthma Medication Among Young Adolescents from Southeast Kosovo. Med Arch 2021; 74:19-23. [PMID: 32317829 PMCID: PMC7164728 DOI: 10.5455/medarh.2020.74.19-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction: Asthma is a chronic inflammatory airway disease characterized by episodes of airway narrowing leading to manifestations of symptoms such as wheeze, shortness of breath, chest tightness and cough, that may resolve spontaneously or following treatment. Aim: The aim of this paper was to present the collected data related to the prevalence of self-reported respiratory symptoms, asthma, and use of asthma medication among school children aged 13-14 years from the city of Gjilan, a municipality located in southeast Kosovo. Methods: This was a cross-sectional study realized during the year 2018 as a part of the Project of Global Asthma Network (GAN) Phase I. The study elaborated randomly selected sample of 1200 school children from the city of Gjilan, in the southeast of Kosovo. The mean age was 13.4±0.51 with median IQR=13 (13-14). About 618 (51.5%) were male and 582 (48.5%) were female with the relation between the genders of 1:1.1. The percentage difference between the genders was not statistically significant (Difference test: Difference 3% [(-0.99-6.99) CI 95%]; Chi-square=2.159; df=1 p=0.1417). The prevalence of wheezing/ whistling in the chest EVER and the last 12 months was 12.7% vs. 6.4% respectively with no significant association between gender and symptoms (p>0.05) (Table 1). About 1132 (94.3%) had no attacks of wheezing in the last 12 MONTHS, 59 (4.9%) had 1-3 attacks, 7 (0.6%) had 4-12 attacks and 2 (0.2%) had>12 attacks. The analysis did not indicate a significant association between gender and the frequency of wheezing attacks (none / 1-3 / ≥ 4) for Pearson Chi-square: 2.5501; df=2; p=0.2801. Conclusion: This study has found moderately low asthma prevalence among adolescents in the southeast region of Kosovo, with no significant association between genders. Although, should be considered as an urgent need the proper examination, because asthma seems to be under-diagnosed and also untreated. It’s possible that doctors in our country hesitate to diagnose asthma or the parents themselves and the children deny it.
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Affiliation(s)
- Valbona Gashi
- Department of Allergology and Clinical Immunology, School of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Luljeta Ahmetaj
- Department of Allergology and Clinical Immunology, University of Prishtina, University of Prishtina, Prishtina, Kosovo
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Hashimoto S, Sorimachi R, Jinnai T, Ichinose M. Asthma and Chronic Obstructive Pulmonary Disease Overlap According to the Japanese Respiratory Society Diagnostic Criteria: The Prospective, Observational ACO Japan Cohort Study. Adv Ther 2021; 38:1168-1184. [PMID: 33355907 PMCID: PMC7889677 DOI: 10.1007/s12325-020-01573-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/12/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) present with chronic respiratory symptoms with features of both asthma and COPD. New ACO diagnostic criteria (2018) were suggested by the Japanese Respiratory Society (JRS). This prospective, multicenter, observational cohort study was conducted to investigate the proportion of patients who meet the JRS ACO diagnostic criteria among COPD patients in clinical practice. METHODS This 2-year ongoing study enrolled consecutive outpatients aged ≥ 40 years with COPD who visited one of 27 Japanese centers at which the medical examinations/tests required for ACO diagnosis were routinely conducted. At registration, the proportion of ACO or non-ACO patients was determined using the JRS diagnostic criteria, and the characteristics of the two groups were compared using analysis of variance and chi-square test. RESULTS Of 708 COPD patients analyzed at registration, 396 (55.9%) had the data necessary for ACO diagnosis to be conducted, and 312 (44.1%) were lacking these data. Of the 396 patients who had the data necessary for ACO diagnosis, 101 (25.5%) met the diagnostic criteria for ACO, and 295 (74.5%) did not (non-ACO patients). ACO patients were younger, had a greater rate of asthma based on a physician's diagnosis, and used more medications, including inhaled corticosteroids (p < 0.05), compared with non-ACO patients. CONCLUSIONS We have determined the proportion of patients with the data necessary to diagnose ACO using the JRS criteria, and the proportion of these who met the ACO criteria among the COPD population at the time of registration. Patients, including those lacking necessary examination/test data at registration, will continue to undergo follow-up to explore changes in their testing and ACO diagnostic status over time. Analyses of study data over 2 years will provide relevant information on the ACO symptoms, clinical course, and real-world treatment patterns. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT03577795.
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Affiliation(s)
- Shu Hashimoto
- Nihon University, Itabashi-ku, Tokyo, Japan.
- Hibiya Kokusai Clinic, Chiyoda-ku, Tokyo, Japan.
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Heibati B, Jaakkola MS, Lajunen TK, Ducatman A, Bamshad Z, Eslamizad S, Shafee F, Karimi A, Jaakkola JJK. Occupational exposures and respiratory symptoms and lung function among hairdressers in Iran: a cross-sectional study. Int Arch Occup Environ Health 2021; 94:877-87. [PMID: 33459872 DOI: 10.1007/s00420-020-01645-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/24/2020] [Indexed: 01/09/2023]
Abstract
Objective Exposures at hairdressers’ work have been reported to lead to an increased risk of several health outcomes. The present study aimed to investigate the relations between occupational exposures and respiratory symptoms and lung function among hairdressers in Iran. Methods We conducted a cross-sectional study to compare potential respiratory effects among 140 women working as hairdressers to such effects among 140 women working as office workers (administrative personnel). Both groups worked in Shiraz, Iran. Respiratory symptoms were assessed by a standard respiratory questionnaire. The questionnaire also inquired about substances used and workspace conditions, including ventilation type. Lung function levels were measured by spirometry. Results Respiratory symptoms, including cough, wheezing, shortness of breath, and chest tightness were significantly more frequent in hairdressers compared to the reference group (p < 0.05). After controlling for potential confounders, hairdressers had a prevalence ratio (PR) of 2.18 (95% CI 1.26–3.77) for cough, 9.59 (95% CI 1.004–91.73) for wheezing, 2.06 (95% CI 1.25–3.39) for shortness of breath, and 3.31 (95% CI 1.84–5.97) for chest tightness compared to the reference group. Lung function parameters (including VC, FVC, and FEV1) were significantly reduced in hairdressers (p < 0.001). Absence of air conditioning predicted greater reduction in lung function (p < 0.05) in the exposed. Decrease in FVC with normal FEV1/FVC in the exposed group suggested existence of restrictive lung function. Conclusions This study provides evidence of increased prevalence of respiratory symptoms and restrictive lung function impairment among hairdressers in Iran. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-020-01645-z.
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Gaisberger M, Wass RE, Dobias H, Grabcanovic-Musija F, Weiss G, Lamprecht B, Kaiser B, Studnicka M, Hartl A. Acute Exposure to Environmental Tobacco Smoke: A Controlled Study in Adults with Asthma. Respiration 2020; 99:1-8. [PMID: 33296904 DOI: 10.1159/000508397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 05/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Short-term, indoor exposure to environmental tobacco smoke (ETS) is still highly prevalent; however, little is known about the acute lung response in adult asthma. OBJECTIVES We investigated whether acute, experimental ETS exposure influences symptoms, lung function, and inflammatory parameters. METHODS Human subjects with asthma (n = 23) were exposed for 180 min to either room air or ETS at 250, 450, or 850 µg/m3. Respiratory symptoms, lung function, and exhaled nitric oxide (FeNO) were measured. Additionally, blood samples were analyzed for pro- and anti-inflammatory cytokines. RESULTS Humans with asthma demonstrate an increase in respiratory symptoms at all levels of ETS exposure, while the forced expiratory volume in 1 s (FEV1) and FeNO decrease with increasing ETS. The anti-inflammatory cytokine interleukin (IL)-10 increases at intermediate ETS concentrations, whereas tumor necrosis factor (TNF)-α and IL-8 increase only at the highest ETS concentration. CONCLUSION Following 180 min of acute, experimental ETS exposure, we observed a significant increase in respiratory symptoms, a decrease in lung function, and an increase in inflammatory cytokines, indicating an acute lung response in asthma.
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Affiliation(s)
- Martin Gaisberger
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | - Romana Elisabeth Wass
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
- Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria
| | - Heidemarie Dobias
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | | | - Gertraud Weiss
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | - Bernd Lamprecht
- Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria
| | - Bernhard Kaiser
- Department for Statistics, University of Linz, Linz, Austria
| | - Michael Studnicka
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria,
| | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
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Perna G, Cuniberti F, Daccò S, Nobile M, Caldirola D. Impact of respiratory protective devices on respiration: Implications for panic vulnerability during the COVID-19 pandemic. J Affect Disord 2020; 277:772-778. [PMID: 33065816 PMCID: PMC7476564 DOI: 10.1016/j.jad.2020.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The wearing of respiratory protective devices (RPDs) correctly and continually in situations where people are at risk of respiratory infections is crucial for infection prevention. Certain people are poorly compliant with RPDs due to RPD-related annoyance, including respiratory discomfort. We hypothesized that individuals vulnerable to panic attacks are included in this group. No published studies on this topic are available. The evidence for our hypothesis was reviewed in this study as a starting point for future research. METHODS We selected a set of experimental studies that measured the respiratory physiological burden in RPD wearers through objective and validated methods. We conducted a bibliographic search of publications in the PubMed database (January 2000-May 2020) to identify representative studies that may be of interest for panic respiratory pathophysiology. RESULTS Five studies were included. Wearing RPDs exerted significant respiratory effects, including increased breathing resistance, CO2 rebreathing due to CO2 accumulation in the RPD cavity, and decreased inhaled O2 concentration. We discussed the implications of these effects on the respiratory pathophysiology of panic. LIMITATIONS Most studies had a small sample size, with a preponderance of young participants. Different methodologies were used across the studies. Furthermore, differences in physical responses between wearing RPDs in experimental settings or daily life cannot be excluded. CONCLUSIONS This research supports the idea that panic-prone individuals may be at higher risk of respiratory discomfort when wearing RPDs, thereby reducing their tolerance for these devices. Strategies to decrease discomfort should be identified to overcome the risk of poor compliance.
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Affiliation(s)
- Giampaolo Perna
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy.
| | - Francesco Cuniberti
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Silvia Daccò
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
| | - Maria Nobile
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini 23842, Lecco, Italy
| | - Daniela Caldirola
- Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Via Roma 16, 22032 Albese con Cassano, Como, Italy
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Alnajem A, Redha A, Alroumi D, Alshammasi A, Ali M, Alhussaini M, Almutairi W, Esmaeil A, Ziyab AH. Use of electronic cigarettes and secondhand exposure to their aerosols are associated with asthma symptoms among adolescents: a cross-sectional study. Respir Res 2020; 21:300. [PMID: 33198741 PMCID: PMC7670675 DOI: 10.1186/s12931-020-01569-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 11/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background Globally, a surge in electronic cigarette (e-cigarette) use has been observed in recent years, with youth being the most susceptible group. Given their recent emergence, studies assessing the health consequences of using e-cigarettes and exposure to their secondhand aerosols (SHA) are limited. Hence, this study sought to assess associations between e-cigarette use and household exposure to SHA from e-cigarettes with asthma symptoms among adolescents. Methods A school-based cross-sectional study was conducted by enrolling high school students (n = 1565; aged 16–19 years) in Kuwait. Participants self-completed a questionnaire on tobacco products use (e-cigarettes and cigarettes) and asthma symptoms. Current e-cigarette use and cigarette smoking were defined as any use in the past 30 days. Household exposure to SHA from e-cigarettes in the past 7 days was reported as none (0 days), infrequent (1–2 days), and frequent (≥ 3 days). Asthma symptoms included current (past 12 months) wheeze, current asthma (history of clinical diagnosis and current wheeze and/or medication use), and current symptoms of uncontrolled asthma (≥ 4 attacks of wheeze, ≥ 1 night per week sleep disturbance from wheeze, and/or wheeze affecting speech). Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. Results Among the analytical study sample (n = 1345), current e-cigarette use and cigarette smoking was reported by 369 (27.4%) and 358 (26.6%) participants, respectively. Compared to never e-cigarette users and never cigarette smokers, current e-cigarette users with no history of cigarette smoking had increased prevalence of current wheeze (aPR = 1.54, 95% CI 1.01–2.45) and current asthma (aPR = 1.85, 95% CI 1.03–3.41). Moreover, the frequency of exposure to household SHA from e-cigarettes was associated with asthma symptoms. For example, compared to those with no exposure to household SHA, frequent exposure to household SHA was associated with current wheeze (aPR = 1.30, 95% CI 1.04–1.59), current asthma (aPR = 1.56, 95% CI 1.13–2.16), and current uncontrolled asthma symptoms (aPR = 1.88, 95% CI 1.35–2.62). Conclusions E-cigarette use and their household SHA exposure were independently associated with asthma symptoms among adolescents. Hence, such observations indicate that e-cigarette use and passive exposure to their aerosols negatively impact respiratory health among adolescents.
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Affiliation(s)
| | - Abdullah Redha
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Dalal Alroumi
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Mohamad Ali
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Waad Almutairi
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ali Esmaeil
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
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Drop BRH, Zemel D, Wokke BHA, van Oosten BW, Dik S, Martins Jarnalo CO, Westerweel PE, de Beukelaar JWK. Diffuse alveolar hemorrhage as an early complication of alemtuzumab treatment: A case report of a multiple sclerosis patient and an overview of 14 cases. Mult Scler Relat Disord 2020; 47:102614. [PMID: 33249378 DOI: 10.1016/j.msard.2020.102614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/18/2020] [Accepted: 11/02/2020] [Indexed: 11/15/2022]
Abstract
Alemtuzumab is effective in relapsing remitting multiple sclerosis (RRMS). Serious adverse events have led to a renewed safety reassessment by the European Medicines Agency (EMA), leading to an approval under strict conditions. We report a RRMS patient experiencing diffuse alveolar hemorrhage (DAH) on day 4 of her first alemtuzumab cycle. In addition, we present an overview of the cases of alemtuzumab-induced DAH that were included in EMA's review procedure, additional well documented cases reported to the EMA and those cases reported in the literature. Combining these cases revealed striking similarities. Importantly, DAH was an early complication. All RRMS patients with known outcome showed complete recovery.
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Affiliation(s)
- B R H Drop
- Department of Neurology, Albert Schweitzer hospital, post office box 444, 3300AK, Dordrecht, Netherlands
| | - D Zemel
- Department of Neurology, Albert Schweitzer hospital, post office box 444, 3300AK, Dordrecht, Netherlands
| | - B H A Wokke
- Department of Neurology, Erasmus Medical Center, post office box 2040, 3000CA, Rotterdam, Netherlands
| | - B W van Oosten
- Department of Neurology, Amsterdam UMC, location VUmc, post office box 7057, 1007 MB, Amsterdam, Netherlands
| | - S Dik
- Department of Pulmonology, Albert Schweitzer hospital, post office box 444, 3300AK, Dordrecht, Netherlands
| | - C O Martins Jarnalo
- Department of Radiology, Albert Schweitzer hospital, post office box 444, 3300AK, Dordrecht, Netherlands
| | - P E Westerweel
- Department of Hematology, Albert Schweitzer hospital, post office box 444, 3300AK, Dordrecht, Netherlands
| | - J W K de Beukelaar
- Department of Neurology, Albert Schweitzer hospital, post office box 444, 3300AK, Dordrecht, Netherlands.
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Blatteau JE, Morin J, Roffi R, Druelle A, Sbardella F, Castagna O. Clinical problem solving: Mental confusion and hypoxaemia after scuba diving. Diving Hyperb Med 2020; 50:181-184. [PMID: 32557423 DOI: 10.28920/dhm50.2.181-184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/29/2019] [Indexed: 01/10/2023]
Abstract
INTRODUCTION We report a case of a diving accident associating both cerebral symptoms and signs of respiratory impairment after two dives. The objective is to describe the process for obtaining the diagnosis. CASE REPORT A 52-year-old man experienced mental confusion associated with hypoxaemia after surfacing. All decompression procedures were fully respected. The diver had a spatio-temporal disorientation accompanied by a marked tendency to fall asleep spontaneously. He had no dyspnoea and no cough, but crepitations at both lung bases were found with oxygen saturation at 80%. CONCLUSIONS In this clinical case, cerebral magnetic resonance imaging and chest computed tomography scan helped to exclude other pathology that would have necessitated urgent transfer rather than urgent hyperbaric treatment. The imaging is particularly useful in case of cerebral and respiratory symptoms following scuba diving.
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Affiliation(s)
- Jean-Eric Blatteau
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France.,Corresponding author: Professor Jean-Eric Blatteau, Service de Médecine Hyperbare et d'Expertise Plongée (SMHEP), Hôpital d'Instruction des Armées (HIA) Sainte-Anne, BP 600, 83800 Toulon cedex 9, France,
| | - Jean Morin
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Romain Roffi
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Arnaud Druelle
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Fabrice Sbardella
- Department of Radiology, Sainte-Anne Military hospital, Toulon, France
| | - Olivier Castagna
- Military Institute of Biomedical Research (ERRSO), Toulon, France
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Handaya AY, Andrew J, Hanif AS, Fauzi AR. Covid-19 mimicking symptoms in emergency gastrointestinal surgery cases during pandemic: A case series. Int J Surg Case Rep 2020; 77:22-27. [PMID: 33137666 PMCID: PMC7585363 DOI: 10.1016/j.ijscr.2020.10.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/17/2020] [Indexed: 01/01/2023] Open
Abstract
Digestive surgery emergency cases can present with COVID-19 mimicking symptoms. Indications of emergency surgery are the same in during pandemic compared to non-pandemic settings. Strict screening, examination, and protocol are necessary during pandemic.
Background The COVID-19 pandemic has changed patient management in all sectors. All patients need to be examined for COVID-19, including in digestive surgery emergency cases. In this paper, we report four digestive surgery emergency cases with clinical and radiological findings similar to COVID-19. Case presentation We report four digestive surgery emergency cases admitted with fever and cough symptoms. Case 1 is a 75-year-old male with gastric perforation and pneumonia, case 2 is a 32-year-old female with intestinal and pulmonal tuberculosis, case 3 is a 30-year-old female with acute pancreatitis with pleuritis and pleural effusion, and the last case is a 56-year-old female with rectosigmoid cancer with pulmonal metastases. All the patients underwent emergency laparotomy, were hospitalized for therapy, and discharged from the hospital. After 1-month follow-up after surgery, 1 patient had no complaints, 2 patients had surgical site infection, and 1 patient died because of ARDS due to lung metastases. Discussion For all four cases, the surgeries were done with strict COVID-19 protocol which included patient screening, examination, laboratory assessment, rapid test screening, and RT-PCR testing. There were no intrahospital mortalities and all the patients were discharged from the hospital. Three patients were followed-up and recovered well with 2 patients having surgical site infection which recovered within a week. However, 1 patient did not show up for the scheduled follow-up and was reported dead 2 weeks after surgery because of ARDS due to lung metastases. Conclusions Emergency surgery, especially digestive surgery cases, can be done in the COVID-19 pandemic era with strict prior screening and examination, and safety protocol.
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Affiliation(s)
- Adeodatus Yuda Handaya
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
| | - Joshua Andrew
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
| | - Ahmad Shafa Hanif
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
| | - Aditya Rifqi Fauzi
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
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CHOTIPHAN C, AUTTANATE N, MARUO SJ, NÄYHÄ S, JUSSILA K, RISSANEN S, SRIPAIBOONKIJ P, IKÄHEIMO TM, JAAKKOLA JJK, PHANPRASIT W. Prevalence of cold-related symptoms among Thai chicken meat industry workers: association with workplace temperature and thermal insulation of clothing. Ind Health 2020; 58:460-466. [PMID: 32554937 PMCID: PMC7557415 DOI: 10.2486/indhealth.2019-0214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/21/2020] [Indexed: 05/18/2023]
Abstract
This study determined the association of cold-related symptoms with workplace temperature and thermal insulation of clothing among Thai chicken industry workers. Three hundred workers were interviewed regarding cold-related symptoms, which were regressed on worksite temperature and protective clothing. In total, 80% of workers reported respiratory symptoms; 23%, cardiac symptoms; 62%, circulation disturbances; 42%, thirst; 56%, drying of the mouth; and 82%, degradation of their performance. When adjusted for personal characteristics, respiratory symptoms were 1.1‒2.2 times more prevalent at -22‒10°C than at 10‒23°C. At -22‒10°C, cardiac symptoms increased by 45%, chest pain by 91%, peripheral circulation disturbances by 25%, and drying of the mouth by 57%. Wearing protective clothing with at least 1.1 clo units was associated with marked reductions in symptom prevalence. Therefore, temperatures lower than 10°C increased prevalence of cold-related symptoms, which are largely preventable by appropriate clothing use.
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Affiliation(s)
- Chotirot CHOTIPHAN
- Department of Occupational Health and Safety, Faculty of
Public Health, Mahidol University, Thailand
| | - Nipaporn AUTTANATE
- Department of Occupational Health and Safety, Faculty of
Public Health, Mahidol University, Thailand
| | - Suchinda Jarupat MARUO
- Department of Occupational Health and Safety, Faculty of
Public Health, Mahidol University, Thailand
| | - Simo NÄYHÄ
- Center for Environmental and Respiratory Health Research,
University of Oulu, Finland
- *To whom correspondence should be addressed. E-mail:
| | | | | | - Penpatra SRIPAIBOONKIJ
- School of Public Health, Physiotherapy and Sports Science,
Woodview House, University College Dublin, Ireland
| | - Tiina M IKÄHEIMO
- Center for Environmental and Respiratory Health Research,
University of Oulu, Finland
| | - Jouni JK JAAKKOLA
- Center for Environmental and Respiratory Health Research,
University of Oulu, Finland
| | - Wantanee PHANPRASIT
- Department of Occupational Health and Safety, Faculty of
Public Health, Mahidol University, Thailand
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Aghaei M, Yaghmaeian K, Hassanvand MS, Hedayati MH, Yousefian F, Janjani H, Nabizadeh R, Yunesian M. Exposure to endotoxins and respiratory health in composting facilities. Ecotoxicol Environ Saf 2020; 202:110907. [PMID: 32800242 DOI: 10.1016/j.ecoenv.2020.110907] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 05/21/2023]
Abstract
The impact of bioaerosols in municipal solid waste management is nowadays identified as a growing health concern worldwide. In this study, exposure to endotoxin in composting facilities and its association with lung function and clinical symptoms was investigated in Tehran municipal solid waste management complex (Aradkooh) as one of the largest solid waste management facilities in the Middle East. Airborne endotoxins were collected between June and July 2019 and the concentrations were determined by Limulus Amebocyte Lysate (LAL) method. Healthy workers with no history of respiratory disease were recruited and data on clinical symptoms (cough, phlegm, wheezing, dyspnea, fatigue, headache, eye irritation, runny nose, runny eyes, and sore throat) was obtained by the modified American Thoracic Society questionnaire, and spirometric measurement was performed by an expert. The binary logistic regression test was used and adjusted for confounding variables. The results didn't show any difference in lung function parameters (FEV1, FVC, FEV1/FVC, PEF, FEF25-75%), and most of the respiratory symptoms despite a relatively high difference in the concentration of endotoxin observed in air samples of different locations. Only the increased risk of cough (OR 10.5, 95% CI: 2.4 to 44.8 in the moderately exposed group and 7.8, 95% CI: 1.6 to 39.1 in highly exposed ones), fatigue (OR 3.7, 95% CI: 1.2 to 11.7), and headache (OR 6.02, 95% CI: 1.4 to 24.5) were found in the exposed groups compared to controls after adjusting for age, active and passive smoking. However, findings of the study might be underestimated due to some issues including healthy worker effect, intra and intersubject variability, and self-reporting bias, thereby the results should be interpreted with caution. Although we did not find any relationship, due to the high concentrations of endotoxins observed in some sites, it is recommended to consider some possible prevention measures such as using personal protective equipment to reduce the exposure of workers at an acceptable level.
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Affiliation(s)
- Mina Aghaei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Yaghmaeian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Solid Waste Management (CSWM), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Yousefian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosna Janjani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. http://yunesian.tums.ac.ir
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Calle Rubio M, Rodríguez Hermosa JL, Miravitlles M, López-Campos JL. Knowledge of Chronic Obstructive Pulmonary Disease, Presence of Chronic Respiratory Symptoms and Use of Spirometry Among the Spanish Population: CONOCEPOC 2019 study. Arch Bronconeumol 2020; 57:S0300-2896(20)30271-4. [PMID: 32950312 DOI: 10.1016/j.arbres.2020.07.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/30/2020] [Accepted: 07/20/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to analyze current data on the population's level of knowledge about COPD and to evaluate certain diagnostic interventions, such as the use of spirometry. MATERIAL AND METHODS An epidemiological, observational, cross-sectional study by telephone interview, with random dialing of landline telephone numbers, was conducted in November 2019, in a nationally representative sample of adults over 40 years of age. RESULTS From a total of 51,079 telephone calls, a total of 1,920 individuals responded. Mean age was 61.9 years and 31.6% were men. Overall, 19.4% were current smokers and 13.4% reported respiratory disease (5% reported COPD). In total, 27.9% had spontaneous knowledge of COPD, which is a relative increase from the 17% observed in 2011. The most frequent information channel was the media (35.5%), with a significant presence of social networks and the Internet (25.7%). Almost one fifth (18.1%) had chronic respiratory symptoms. Of these, 59.3% had requested medical care, and 66.2% had undergone spirometry. Spirometry was performed less frequently in subjects treated in primary care compared to respiratory medicine departments (51.9% versus 79.1%; P<.001). CONCLUSIONS Knowledge of COPD is still scarce, and strategies are needed to increase awareness and the importance of assessing respiratory symptoms and increased use of spirometry.
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Affiliation(s)
- Myriam Calle Rubio
- Servicio de Neumología, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Juan Luis Rodríguez Hermosa
- Servicio de Neumología, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.
| | - Marc Miravitlles
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, España
| | - José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid
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76
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Dao TL, Canard N, Hoang VT, Ly TDA, Drali T, Ninove L, Fenollar F, Raoult D, Parola P, Marty P, Gautret P. Risk factors for symptoms of infection and microbial carriage among French medical students abroad. Int J Infect Dis 2020; 100:104-111. [PMID: 32890724 PMCID: PMC7467057 DOI: 10.1016/j.ijid.2020.08.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives To investigate symptoms of infections and their risk factors among French medical students undertaking an internship abroad. Methods Clinical follow up, and qPCR-based respiratory, gastrointestinal, and vaginal pathogen carriages were prospectively assessed pre-travel and post-travel, in a cohort of medical students departing from Marseille, France. Results 293 students were included. 63.5%, 35.8%, and 3.6% of students reported gastrointestinal, respiratory, and vaginal symptoms, respectively. The acquisition rate of Enteroaggregative Escherichia coli and Enteropathogenic E. coli was 40.9% and 18.6%, respectively. A significant increase was observed for rhinovirus and Streptococcus pneumoniae by comparing the prevalence of pathogens in pre-travel and post-travel samples. Gardnerella vaginalis and Atopobium vaginae acquisition rates were 12.9% and 13.9%, respectively. Being female, primarily traveling to Vietnam, and living in basic accommodation conditions were independent risk factors for reporting respiratory symptoms. Students reporting respiratory symptoms were three times more likely to acquire S. pneumoniae. Traveling primarily to north India and Senegal were independent risk factors for diarrhea. Conclusion This study makes it possible to identify the leading infectious diseases linked to travel in a group of French medical students undertaking an internship abroad and the risk factors on which to base targeting students for reinforced pre-travel advice.
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Affiliation(s)
- Thi Loi Dao
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Naomie Canard
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Van Thuan Hoang
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Tran Duc Anh Ly
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Tassadit Drali
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Laetitia Ninove
- IHU-Méditerranée Infection, Marseille, France; Unité des Virus Émergents (UVE: Aix-Marseille University - IRD 190 - Inserm 1207), Marseille, France
| | - Florence Fenollar
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Parola
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Pierre Marty
- Université Côte d'Azur, Inserm, C3M, Nice Cedex 3, France; Parasitologie-Mycologie, Centre Hospitalier Universitaire l'Archet, Nice Cedex 3, France
| | - Philippe Gautret
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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Prenzel F, Vogel M, Siekmeyer W, Körner A, Kiess W, Vom Hove M. Exercise capacity in children with bronchopulmonary dysplasia at school age. Respir Med 2020; 171:106102. [PMID: 32823240 DOI: 10.1016/j.rmed.2020.106102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the exercise capacity, exercise habits, and lung function of preterm born children with bronchopulmonary dysplasia (BPD) compared to term born controls at school age. METHODS Cardiopulmonary exercise test (CPET) by cycle ergometer and pulmonary function test were performed in children with BPD (n = 42) and compared with a term born control group (n = 42). Daily activity, participation in sports and respiratory symptoms were assessed by questionnaire. RESULTS Children with BPD versus controls had significantly lower values for oxygen consumption (V̇O2 [mL/min] 1442 ± 417 vs. 1766 ± 541), minute ventilation (VE [L/min] 48 ± 14.92 vs. 60 ± 18.33), and workload (W [watt] 96.1 ± 16.7 vs. 110.6 ± 17.2) at peak exercise and a lower anaerobic threshold (VO2 AT [mL/min] 1183 ± 345 vs. 1382 ± 398). When corrected for weight, only for the workload (2.7 ± 0.5 vs. 3.1 ± 0.5, p = 0.0013) did significant differences persist. The forced expiratory volume in 1 s and forced expiratory flow between 25 and 75% of expired forced vital capacity were significantly reduced in the BPD group (p < 0.0001). Children with BPD have a higher risk of reporting difficulties in physical activity (OR 2.5) and of suffering from wheezing or shortness of breath while exercising (OR 2.5). CONCLUSION Compared to term born controls, children with BPD at school age show airflow obstruction, a lower workload in CPET, and more respiratory symptoms related to physical activity. The comparable oxygen consumption based on weight suggests a functionally normal alveolar compartment.
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Affiliation(s)
- Freerk Prenzel
- University of Leipzig Medical Center, Department of Pediatrics and Center for Pediatric Research Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Straße 2704103 Leipzig, Germany.
| | - Werner Siekmeyer
- University of Leipzig Medical Center, Department of Pediatrics and Center for Pediatric Research Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Antje Körner
- University of Leipzig Medical Center, Department of Pediatrics and Center for Pediatric Research Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Wieland Kiess
- University of Leipzig Medical Center, Department of Pediatrics and Center for Pediatric Research Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany; LIFE Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Straße 2704103 Leipzig, Germany.
| | - Maike Vom Hove
- University of Leipzig Medical Center, Department of Pediatrics and Center for Pediatric Research Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
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Salepci E, Turk B, Ozcan SN, Bektas ME, Aybal A, Dokmetas I, Turgut S. Symptomatology of COVID-19 from the otorhinolaryngology perspective: a survey of 223 SARS-CoV-2 RNA-positive patients. Eur Arch Otorhinolaryngol 2020; 278:525-535. [PMID: 32794002 PMCID: PMC7426010 DOI: 10.1007/s00405-020-06284-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/10/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE To determine prevalence, severity, duration, and time from onset to diagnosis of general and Otorhinolaryngologic symptoms related to COVID-19 in whole disease spectrum: from mild to critical patients. METHODS All adult patients with positive SARS-CoV-2 RNA found in nasopharyngeal and oropharyngeal swabs between March 10 and April 21, 2020 were surveyed by the authors for new onset symptoms during disease course. Demographic features, general symptoms, and Otorhinolaryngological symptoms were evaluated and compared by disease severity. RESULTS Of 223 included patients, 18.4% had mild, 61.4%; moderate, 14.3%; severe, and 5.8%; critical disease. Median age was 51 (range 20-93), 113 (50.7%) were male and 110 (49.3%) were female. The most common general symptoms were fatigue, cough, and fever with respective frequencies of 71.3%, 54.3%, and 50.7%. The most common Otorhinolaryngologic symptoms were taste loss, smell loss, and sore throat with respective frequencies of 34.5%, 31.8%, and 26%. Fatigue, fever, and dyspnea were more common in severe-critical patients compared to mild-moderate patients (p = 0.029, p = 0.016, and p < 0.001, respectively). Only smell loss was more common in mild-moderate group (p = 0.003). Prevalence of other symptoms did not differ between groups. Symptom durations and onset time to diagnosis varied. CONCLUSION When compared to the previous studies, while general symptoms were less common, Otorhinolaryngologic symptoms were more common in our study population. Considering high infection risks, Otorhinolaryngologists should be aware of COVID-19 patients presenting with Otorhinolaryngologic complaints.
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Affiliation(s)
- Egehan Salepci
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey.
| | - Bilge Turk
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
| | - Safiye Nur Ozcan
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, 34371, Sisli, Istanbul, Turkey
| | - Merve Ekici Bektas
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
| | - Alperen Aybal
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
| | - Ilyas Dokmetas
- Department of Clinical Microbiology and Infectious Diseases, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, 34371, Sisli, Istanbul, Turkey
| | - Suat Turgut
- Department of Otorhinolaryngology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Etfal Sk. No: 1, 34371, Sisli, Istanbul, Turkey
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Gulsvik A, Bakke PS, Brøgger J, Nielsen R, Stavem K. Respiratory symptoms and mortality in four general population cohorts over 45 years. Respir Med 2020; 170:106060. [PMID: 32843179 DOI: 10.1016/j.rmed.2020.106060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study assessed the association between respiratory symptoms and mortality in four cohorts of the general population in Norway aged 15-75 years and in selected subgroups in the pooled sample. METHODS The study comprised 158,702 persons, who were drawn randomly from the Norwegian population register. All subjects received a standardized, self-administered questionnaire on 11 respiratory symptoms between 1972 and 1998, with follow-up of death until December 31, 2017. Analyses were performed on 114,380 respondents. RESULTS The hazard of death was closely associated with sex, age, and education. The hazard ratios (HR) for death and the 95% confidence intervals (CI) by risk factors were similar in the four cohorts. After adjustment for demographic and environmental, modifiable factors, the HR for death was 1.90 (95% CI 1.80-2.00) for breathlessness score 3, 1.28 (1.21-1.37) for cough/phlegm score 5 and 1.09 (1.05-1.14) for attack of breathlessness/wheeze score 2 compared to the referent (no symptom), respectively. The cough/phlegm score was associated with death in current smokers but not in never smokers or ex-smokers. Breathlessness score was associated with death in men and women. CONCLUSION Among persons aged 45-75 years, respiratory symptoms were significant predictors of all cause mortality. Education and smoking habits influenced only the associations between coughing and mortality. The associations were independent of study sites.
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Andualem Z, Azene ZN, Azanaw J, Taddese AA, Dagne H. Acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in northwest, Ethiopia. Environ Health Prev Med 2020; 25:20. [PMID: 32539699 PMCID: PMC7296770 DOI: 10.1186/s12199-020-00859-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Background Poor air quality of the household is likely to be the largest public health concern in resource-constrained countries. Exposure to household air pollution, poor working environment, and fuel type used at household level have been associated with respiratory symptoms. This study aimed to assess acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in Gondar city, northwest Ethiopia. Method A cross-sectional study was carried out from February 15, 2019 to June 20, 2019. Study participants were selected using simple random sampling, and data were collected via face-to-face interviews. Binary logistic regression analysis was used to test the association of explanatory and outcome variables. Variables with p < 0.05 were considered as significantly associated with the outcome variable. Results The prevalence of respiratory symptoms among mothers of under-five years-old children in this study was 46.1%. Education (vocational training compared to cannot read and write) (adjusted odd ratio (AOR) = 0.26 at 95% confidence interval (CI): 0.08–0.82), working in dusty environment (AOR = 2.90 at 95% CI: 1.39–6.08), wood fire use (AOR = 0.37 at 95% CI: 0.16–0.85), living in mud- and wood-walled houses (AOR = 0.53 at CI: 0.32–0.89), recent house painting (AOR = 1.95 at 95% CI: 1.03–3.69), new carpet (AOR = 2.02 at 95% CI: 1.08–3.77), pesticide use (AOR = 1.71 at 95% CI: 1.03–2.84), damp stain (AOR = 2.45 at 95% CI: 1.04–5.75), spending longer time in house for 6 to 11 h (AOR = 2.59 at 95% CI: 1.53–4.37) and 11 to 15 h (AOR = 3.47 at 95% CI: 1.87–6.43), and living less than 100 m from unpaved roads/streets (AOR = 4.35 at 95% CI: 2.64–7.18) were significantly associated with respiratory symptoms among mothers of under-five years-old children. Conclusion Respiratory symptoms were common among mothers who have under five-years-old children. Air quality improvement, fuel selection, and residential planning will help to reduce respiratory symptoms.
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Affiliation(s)
- Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zelalem Nigussie Azene
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Lagiso ZA, Mekonnen WT, Abaya SW, Takele AK, Workneh HM. Chronic respiratory symptoms, lung function and associated factors among flour mill factory workers in Hawassa city, southern Ethiopia: "comparative cross-sectional study". BMC Public Health 2020; 20:909. [PMID: 32527249 PMCID: PMC7291423 DOI: 10.1186/s12889-020-08950-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 05/18/2020] [Indexed: 11/25/2022] Open
Abstract
Background Occupational related respiratory diseases arise as a result of the deposition of dust particles in the lungs. Flour milling industries; generate organic dust during industrial processes, such as cleaning, milling, packaging, and loading which release dust into the air and later inhaled by workers. Flour mill workers are at risk of developing respiratory health problems because of exposure in their working environment, but existing data were few. The aim of this study was to assess the prevalence of chronic respiratory symptoms, lung function and associated factors among flour mill factory workers. Methods A comparative cross-sectional study was conducted among 196 flour mill factory workers and 210 soft drinks factory workers. We selected study participants using a systematic sampling technique. We assessed the chronic respiratory symptoms using the questionnaire adopted from the British Medical Research Council. Binary logistic regression analysis with 95% CI and p < 0.05 was used to identify the factors. Lung function parameters; Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and ratio FEV1/FVC was measured by using spirometer and analyzed by using an independent t-test. Results We included 406 (96.7%) workers in this study. The prevalence of chronic respiratory symptoms was higher among flour mill workers as compared to soft-drinks factory workers (56.6% vs.12.9%). Primary education (AOR = 5.8, 95% CI, 1.3–23.2), mixing department (AOR = 5.3, 95% CI = 1.68–16.56), work experience 6–9 years (AOR = 5.1, 95% CI = 2.05–12.48), work experience ≥10 years (AOR = 2.5, 95% CI = 1.01–6.11) and working over eight hours (AOR = 2.4, 95% CI, 1.16–5.10) were factors that significantly associated with chronic respiratory symptoms among flour mill workers. FVC (p < 0.002), FEV1 (p < 0.001) and FEV1/FVC (p < 0.012) were significantly reduced among flour mill workers. Conclusions We found chronic respiratory symptoms to be high among flour mill workers. Lower education level, mixing department, increased work experience, and longer working hours were identified factors. The flour mill dust exposed worker’s lung function parameters were highly reduced. This study suggested that workers’ dust exposure reduction and control methods in flour mill factories need to be implemented.
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Affiliation(s)
- Zemachu Ashuro Lagiso
- College of Health Science and Medicine, Dilla University, P.O. Box 419, Dilla, Ethiopia.
| | - Worku Tefera Mekonnen
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, P.O. Box 90861000, Addis Ababa, Ethiopia
| | - Samson Wakuma Abaya
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, P.O. Box 90861000, Addis Ababa, Ethiopia
| | - Abera Kumie Takele
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, P.O. Box 90861000, Addis Ababa, Ethiopia
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van Zoest V, Hoek G, Osei F, Stein A. Bayesian analysis of the short-term association of NO 2 exposure with local burden of asthmatic symptoms in children. Sci Total Environ 2020; 720:137544. [PMID: 32145626 DOI: 10.1016/j.scitotenv.2020.137544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
Short-term exposure to air pollution has been associated with exacerbation of respiratory diseases such as asthma. Substantial heterogeneity in effect estimates has been observed between previous studies. This study aims to quantify the local burden of daily asthma symptoms in asthmatic children in a medium-sized city. Air pollution exposure was estimated using the nearest sensor in a fine resolution urban air quality sensor network in the city of Eindhoven, the Netherlands. Bayesian estimates of the exposure response function were obtained by updating a priori information from a meta-analysis with data from a panel study using a daily diary. Five children participated in the panel study, resulting in a total of 400 daily diary records. Positive associations between NO2 and lower respiratory symptoms and medication use were observed. The odds ratio for any lower respiratory symptoms was 1.07 (95% C.I. 0.92, 1.28) expressed per 10 μg m-3 for current day NO2 concentration, using data from the panel study only (uninformative prior). Odds ratios for dry cough and phlegm were close to unity. The pattern of associations agreed well with the updated meta-analysis. The meta-analytic random effects summary estimate was 1.05 (1.02, 1.07) for LRS. Credible intervals substantially narrowed when adding prior information from the meta-analysis. The odds ratio for lower respiratory symptoms with an informative prior was 1.06 (0.99, 1.14). Burden of disease maps showed a strong spatial variability in the number of asthmatic symptoms associated with ambient NO2 derived from a regression kriging model. In total, 70 cases of asthmatic symptoms can daily be associated with NO2 exposure in the city of Eindhoven. We conclude that Bayesian estimates are useful in estimation of specific local air pollution effect estimates and subsequent local burden of disease calculations. With the fine resolution air quality network, neighborhood-specific burden of asthmatic symptoms was assessed.
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Affiliation(s)
- Vera van Zoest
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, the Netherlands.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands
| | - Frank Osei
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, the Netherlands
| | - Alfred Stein
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, PO Box 217, 7500 AE Enschede, the Netherlands
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Gholami A, Tajik R, Atif K, Zarei AA, Abbaspour S, Teimori-Boghsani G, Attar M. Respiratory Symptoms and Diminished Lung Functions Associated with Occupational Dust Exposure Among Iron Ore Mine Workers in Iran. Open Respir Med J 2020; 14:1-7. [PMID: 32509034 PMCID: PMC7254822 DOI: 10.2174/1874306402014010001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/14/2019] [Accepted: 01/10/2020] [Indexed: 01/10/2023] Open
Abstract
Background: Dust exposure at quarry mines is inevitable and can result in poor air quality. This research aimed to assess pulmonary symptoms and lung functions of dust-exposed workers at an iron-ore mine in eastern Iran. Methods: An environmental cross-sectional study sampled 174 dust-exposed mine workers and 93 unexposed administrative employees as the reference group. A standardized questionnaire on respiratory symptoms was completed in accordance with recommendations of the American Thoracic Society(ATS). Calibrated spirometer measured Pulmonary Function Tests (PFTs). Data were analyzed via SPSS-21, integrating independent samples t-test, Chi-square and linear or logistic-regression models. Results: There was no significant variation between dust-exposed and reference groups in terms of age, weight, height, work experience and the number of smokers (P>0.05). Mean levels of exposure to inhalable and respirable mineral-dust were 15.09±2.34 and 3.45±2.57 mg/m3 respectively. Pulmonary capacities of dust-exposed group were considerably decreased as compared to others (Forced Vital Capacity [FVC] 86.55±13.77 vs. 105.05±21.5; Forced Expiratory Volume in 1 second [FEV1] 88.06±16.8 vs. 105.81±21.55; FEV1/FVC 103.03±18.17 vs. 93.3±12.49; and Peak Expiratory Flow [PEF] 89.82±22.58 vs. 98.09±20.60) (P<0.001); with a higher prevalence of cough (P=0.041), wheezing (P=0.032), and dyspnea (P=0.035) among formers. Age along with exposure to respirable-dust significantly reduced FVC, FEV1 and FEV1/FVC. Cigarette consumption attenuated FVC and FEV1 on an average of 5 to 9 units. Conclusion: Controlled occupational dust-exposure is a definitive pre-requisite to reduce respiratory problems among quarry workers, with an explicit consideration towards mineral- mine workers. Modifiable accomplices like smoking and non-compliance of PPEs usage should be amicably resolved.
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Affiliation(s)
- Abdollah Gholami
- Social Determinants of Health Research Center, Faculty of Health, Department of Occupational Health Engineering, Birjand University of Medical Sciences, Birjand, Iran
| | - Reza Tajik
- Department of Occupational Health Engineering, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Khaula Atif
- Health Care Administrator, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Amin Allah Zarei
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Sedigheh Abbaspour
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Gholamheidar Teimori-Boghsani
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohsen Attar
- Vice Chancellery of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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84
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Khazdair MR, Rezaeetalab F, Rafatpanah H, Boskabady MH. The effect of Zataria multiflora on inflammatory cytokine and respiratory symptoms in veterans exposed to sulfur mustard. Environ Sci Pollut Res Int 2020; 27:22451-22460. [PMID: 32314290 DOI: 10.1007/s11356-020-08855-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
The effect of Zataria multiflora (Z. multiflora) on serum cytokine, chemokines, and respiratory symptoms in the veterans exposed to sulfur mustard (SM) more than two decades (27-30 years) ago was conducted in 2018. Thirty-four patients were randomly assigned to the placebo group (P, mean age (54.40 ± 5.51)) and two treated groups with Z. multiflora extract 5 and 10 mg/kg/day (Z5 and 10; mean age, 58.50 ± 3.60 and 55.18 ± 4.11, respectively). Serum levels of tumor necrosis factor (TNF-α), monocyte chemotactic protein 1 (MCP-1), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), forced expiratory volume-one second (FEV1), and respiratory symptoms including chest wheeze (CW), night wheeze (NW), night cough (NC), and cough and wheeze during exercise (ECW) were assessed at the baseline (phase 0), 1 and 2 months after starting treatment (phase I and II, respectively). The value of FEV1 was significantly increased in Z10 in phase I and II compared with that in phase 0 (p < 0.01 for both) and in Z5 in phase II compared with phase I and 0 (p < 0.001for both). All respiratory symptoms significantly decreased in Z5 and 10 in phase I and II compared with those in phase 0 (p < 0.05 to p < 0.001). Serum levels of TNF-α and VEGF were decreased in Z5 and 10 in phase I and II compared with those in phase 0 (p < 0.05 to p < 0.001). Serum levels of MCP-1 and EGF were decreased in Z10 in phase I and II compared with those in phase 0 (p < 0.05 to p < 0.001). The percent change of respiratory symptoms, serum levels of cytokines during the treatment period, was significantly improved in the treated groups compared with that in the placebo group. Two months' of treatment with Z. multiflora improved cytokine levels, respiratory symptom, and FEV1 values in SM-exposed patients.
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Affiliation(s)
- Mohammad Reza Khazdair
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fariba Rezaeetalab
- COPD Research Center, Department of Internal Medicine, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Houshang Rafatpanah
- Department of Immunology, Immunology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran.
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85
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Ghosh AJ, Moll M, Hayden LP, Bon J, Regan E, Hersh CP. Vitamin D deficiency is associated with respiratory symptoms and airway wall thickening in smokers with and without COPD: a prospective cohort study. BMC Pulm Med 2020; 20:123. [PMID: 32366316 PMCID: PMC7199369 DOI: 10.1186/s12890-020-1148-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/13/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Previous studies have established a higher prevalence of vitamin D deficiency in patients with COPD, but the relationship between vitamin D levels and COPD exacerbations remains controversial. In addition, the effect of vitamin D levels on imaging characteristics remains mostly unexplored. Using cross-sectional and longitudinal follow up data from the COPDGene Study, we assessed the association between vitamin D levels on respiratory symptoms, exacerbations, and imaging characteristics. We hypothesized that vitamin D deficiency will be associated with worse respiratory-related outcomes. METHODS Current and former smokers between ages 45-80 were enrolled the COPDGene Study. Subjects completed questionnaires, spirometry, six-minute walk test, and chest computed tomography scans. A subset of subjects had measurement of serum concentration of 25-hydroxyvitamin D (25(OH)D). Vitamin D deficiency was defined as serum concentration less than 20 ng/mL. Longitudinal follow up was conducted via a web-based or telephone questionnaire. RESULTS Vitamin D levels were measured on 1544 current and former smokers, of which 981 subjects had sufficient vitamin D levels and 563 subjects had vitamin D deficiency. Subjects with vitamin D deficiency were younger with increased likelihood of being African American, being current smokers, having a lower percent predicted FEV1, and having COPD. Vitamin D deficiency was associated with worse quality of life, increased dyspnea, decreased exercise tolerance, and increased frequency of severe exacerbations. Vitamin D deficiency was also associated with increased segmental airway wall thickness on chest CT scans. CONCLUSION Vitamin D deficiency was associated with increased respiratory symptoms, decreased functional status, increased frequency of severe exacerbations, as well as airway wall thickening on chest CT scans. Further research is needed to determine the potential impact of vitamin D supplementation to improve disease outcomes.
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Affiliation(s)
- Auyon J Ghosh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew Moll
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Lystra P Hayden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA
- Division of Respiratory Diseases, Children's Hospital, Boston, MA, USA
| | - Jessica Bon
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh Medical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Elizabeth Regan
- Division of Rheumatology, Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Craig P Hersh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA.
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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86
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Sadeghi-Yarandi M, Golbabaei F, Karimi A. Evaluation of pulmonary function and respiratory symptoms among workers exposed to 1,3-Butadiene in a petrochemical industry in Iran. Arch Environ Occup Health 2020; 75:483-490. [PMID: 32338162 DOI: 10.1080/19338244.2020.1749018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study aimed to evaluate pulmonary function among workers exposed to 1,3-butadiene and was carried out in a petrochemical industry in Iran. The study participants consisted of fifty male workers with current respiratory exposure to 1,3-butadiene and fifty non-exposed workers as the control group. Exposure to 1,3-butadiene was measured according to the NIOSH 1024 method. Respiratory symptom histories were collected through the American Thoracic Society respiratory symptom questionnaire. Lung functions were evaluated using spirometry method. The results showed that exposed participants had significantly higher prevalence rates of all respiratory symptoms compared to the control group. Statistical tests demonstrated a significant difference between pulmonary function tests of exposed and non-exposed personnel. Ultimately, the results of the present study indicate that respiratory exposure to 1,3-butadiene can lead to negative effects on pulmonary functions.
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Affiliation(s)
- Mohsen Sadeghi-Yarandi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Golbabaei
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Karimi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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87
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Pindus M, Orru H, Jõgi R. Change in the symptom profile treated as asthma - two cross-sectional studies twenty years apart. Respir Res 2020; 21:41. [PMID: 32013984 PMCID: PMC6998351 DOI: 10.1186/s12931-020-1308-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/29/2020] [Indexed: 11/10/2022] Open
Abstract
AIMS The aims of the study were to investigate prevalence trends of respiratory symptoms, asthma and asthma treatment among young adults in Estonia and to estimate changes in symptom profile among subjects who self-report asthma attacks or use asthma medications. METHODS Two similar questionnaires on respiratory health were sent to subjects in Tartu, Estonia, aged between 20 and 44 years; first in 1993/94, and then in 2014/15. To study the impact of different respiratory symptoms on asthma diagnosis and treatment, the log-binomial regression was used to estimate the association between 'attack of asthma' (as a proxy for current asthma) and respiratory symptoms as well as asthma treatment and respiratory symptoms, adjusted for age, sex and smoking history. RESULTS Self-reported prevalence of asthma attack, asthma medication use and nasal allergies increased over the twenty years between studies, whereas there was no change in prevalence of asthma-related symptoms, and the prevalence of most respiratory symptoms either decreased, or remained unchanged. For women experiencing asthma attacks, the prevalence of nasal allergies increased and waking with chest tightness decreased. For men using asthma medication, the prevalence of a wheeze without a cold decreased. Women using asthma medication reported decreased prevalence of waking with chest tightness. CONCLUSION Self-reported asthma attacks and asthma medication use has increased in last 20 years, while the prevalence of most respiratory symptoms either decreased or did not change. It is likely that changes in asthma symptom profile have had an impact on the prevalence of asthma and asthma treatment.
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Affiliation(s)
- Mihkel Pindus
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia. .,Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, SE-901 87, Umeå, Sweden.
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Riia 167, 51014, Tartu, Estonia
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88
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Mitsuhashi T. Effects of indium exposure on respiratory symptoms: a retrospective cohort study in Japanese workers using health checkup data. PeerJ 2020; 8:e8413. [PMID: 31988812 PMCID: PMC6969551 DOI: 10.7717/peerj.8413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/16/2019] [Indexed: 12/01/2022] Open
Abstract
Background Indium compounds are known health hazards for lung cancer and interstitial pneumonia. Furthermore, they are related to emphysema, alveolar proteinosis, and cholesterol granuloma. In Japan, laws were revised in 2013 to tighten regulations on indium exposure in workplaces. However, its impact on the health of workers who handle indium has not been evaluated. This study aimed to investigate whether subjective respiratory symptoms in these workers have reduced after the 2013 amendment in the regulations. Methods The subjects were workers from certain areas of Japan who had undergone health checkups between January 1, 2013, and June 30, 2015. Indium-handling and non-handling workers were categorized into the exposed and less-exposed groups, respectively. Based on the findings of health checkups during this period, the hazard ratio of subjective respiratory symptoms (cough, sputum production, shortness of breath, and palpitation) and its 95% confidence intervals (CIs) were calculated with the less-exposed group as the reference. The Prentice-Williams-Peterson model was used for calculation, and a model that adjusted for coarse analysis and potential confounding factors was adopted. Results Overall, 2,561 workers (from 22 companies) who underwent 6,033 health checkups were included. The total person-years were 2,562.8 years, and 162 outcome events occurred. The hazard ratios of the exposed group were 1.65 (95% CI [1.14–2.39]: p = 0.008) and 1.61 (95% CI [1.04–2.50]: p = 0.032) in the crude and adjusted models, respectively. Conclusion Indium-handling workers had a high hazard of the subjective respiratory symptoms than non-indium -handling workers despite stricter regulations on indium exposure in workplaces. This indicates the need for further changes to the legislation to protect the health of workers exposed to harmful substances in workplaces. Further studies including larger diverse cohorts are needed to validate our findings.
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Affiliation(s)
- Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
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89
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Téllez-Rojo MM, Rothenberg SJ, Texcalac-Sangrador JL, Just AC, Kloog I, Rojas-Saunero LP, Gutiérrez-Avila I, Bautista-Arredondo LF, Tamayo-Ortiz M, Romero M, Hurtado-Díaz M, Schwartz JD, Wright R, Riojas-Rodríguez H. Children's acute respiratory symptoms associated with PM 2.5 estimates in two sequential representative surveys from the Mexico City Metropolitan Area. Environ Res 2020; 180:108868. [PMID: 31711659 DOI: 10.1016/j.envres.2019.108868] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/26/2019] [Accepted: 10/27/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Respiratory diseases are a major component of morbidity in children and their symptoms may be spatially and temporally exacerbated by exposure gradients of fine particulate matter (PM2.5) in large polluted urban areas, like the Mexico City Metropolitan Area (MCMA). OBJECTIVES To analyze the association between satellite-derived and interpolated PM2.5 estimates with children's (≤9 years old) acute respiratory symptoms (ARS) in two probabilistic samples representing the MCMA. METHODS We obtained ARS data from the 2006 and 2012 National Surveys for Health and Nutrition (ENSaNut). Two week average exposure to PM2.5 was assessed for each household with spatial estimates from a hybrid model with satellite measurements of aerosol optical depth (AOD-PM2.5) and also with interpolated PM2.5 measurements from ground stations, from the Mexico City monitoring network (MNW-PM2.5). We used survey-adjusted logistic regressions to analyze the association between PM2.5 estimates and ARS reported on children. RESULTS A total of 1,005 and 1,233 children were surveyed in 2006 and 2012 representing 3.1 and 3.5 million children, respectively. For the same years and over the periods of study, the estimated prevalence of ARS decreased from 49.4% (95% CI: 44.9,53.9%) to 37.8% (95% CI: 34,41.7%). AOD-PM2.5 and MNW-PM2.5 estimates were associated with significantly higher reports of ARS in children 0-4 years old [OR2006 = 1.29 (95% (CI): 0.99,1.68) and OR2006 = 1.24 (95% CI: 1.08,1.42), respectively]. We observed positive non-significant associations in 2012 in both age groups and in 2006 for children 5-9 years old. No statistically significant differences in health effect estimates of PM2.5 were found comparing AOD-PM2.5 or MNW-PM2.5 for exposure assessment. CONCLUSIONS Our findings suggest that PM2.5 is a risk factor for the prevalence of ARS in children and expand the growing evidence of the utility of new satellite AOD-based methods for estimating health effects from acute exposure to PM2.5.
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Affiliation(s)
- Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Stephen J Rothenberg
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - José Luis Texcalac-Sangrador
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Iván Gutiérrez-Avila
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Luis F Bautista-Arredondo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; National Council of Science and Technology Fellowship, Mexico City, Mexico
| | - Martín Romero
- Center for Research in Surveys and Evaluation, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Magali Hurtado-Díaz
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joel D Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Horacio Riojas-Rodríguez
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Lawrence WR, Lin S, Lin Z, Gurram N, Neamtiu IA, Csobod E, Gurzau E. Interactions between dietary habits and home environmental exposures on respiratory symptoms in Romanian school children: an analysis of data from the SINPHONIE project. Environ Sci Pollut Res Int 2020; 27:2647-2657. [PMID: 31836974 DOI: 10.1007/s11356-019-07129-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 11/19/2019] [Indexed: 06/10/2023]
Abstract
In this study, we investigated the interactions between household pollutants and dietary habits on children's respiratory health. Our cross-sectional study collected self-reported information including health symptoms (allergy-like, asthma-like, and flu-like symptoms), home characteristics, dietary habits, and demographic information from questionnaires administered to parents of 280 school children in Romania. Unconditional logistic regression and stratified analyses were used to assess the interactions between dietary factors and environmental exposures on health symptoms among children, controlling for sociodemographic characteristics and co-exposures. We found that frequency of fruit consumption had significant interaction with residing near heavy traffic on allergy-like symptoms among children (p = 0.036). However, no association was observed by frequency of fruit consumption. Although no significant interaction was observed, we found that students with infrequent fruit consumption and residing near heavy traffic roads had elevated odds of asthma-like (POR 6.37; 95% CI 1.22, 33.29) and flu-like symptoms (POR 3.75; 95% CI 1.12, 11.86) than those who frequently consumed fruits. Likewise, low vegetable consumption was associated with increased asthma-like symptoms (POR 2.93; 95% CI 1.04, 8.24). Increased odds of asthma-like symptoms were observed among school children that resided near heavy traffic roads and frequently consumed milk (POR 2.80; 95% CI 1.24, 6.31) and yoghurt (POR 2.86; 95% CI 1.05, 7.75) compared to those that infrequently consumed dairy. Our findings suggest that frequent fruit and vegetable consumption may mitigate the negative effects of exposure to heavy traffic near dwelling on respiratory symptoms in Romanian children.
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Affiliation(s)
- Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA
| | - Ziqiang Lin
- Department of Mathematics and Statistics, College of Arts and Sciences, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | - Namratha Gurram
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA
| | - Iulia A Neamtiu
- Health Department, Environmental Health Center, 58 Busuiocului Street, Cluj-Napoca, Romania.
- Faculty of Environmental Science and Engineering, Babes-Bolyai University, 30 Fantanele Street, Cluj-Napoca, Romania.
| | - Eva Csobod
- Regional Environmental Center for Central and Eastern Europe (REC), Ady Endre ut 9-11, Szentendre, 2000, Hungary
| | - Eugen Gurzau
- Health Department, Environmental Health Center, 58 Busuiocului Street, Cluj-Napoca, Romania
- Faculty of Environmental Science and Engineering, Babes-Bolyai University, 30 Fantanele Street, Cluj-Napoca, Romania
- Cluj School of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor Street, Cluj-Napoca, Romania
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91
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Savelieva K, Marttila T, Lampi J, Ung-Lanki S, Elovainio M, Pekkanen J. Associations between indoor environmental quality in schools and symptom reporting in pupil-administered questionnaires. Environ Health 2019; 18:115. [PMID: 31881894 PMCID: PMC6935098 DOI: 10.1186/s12940-019-0555-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/18/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND The associations between indoor environmental quality (IEQ) in homes and symptom reporting of children have been extensively studied, but only few large-scale studies have been done in schools. We examined associations between expert-assessed IEQ in schools and pupils' reporting of different symptoms, and whether associations were stronger if participants relate symptoms to the school environment. METHODS The questionnaire survey was done in all primary and secondary schools in two areas of Helsinki, Finland. Primary school pupils (grade 3-6, n = 8775, 99 school-buildings) and secondary school pupils (grade 7-9, n = 3410, 30 school-buildings) reported their symptoms. Symptoms were combined into respiratory, lower respiratory, eye, skin, and general symptom groups. Surveys were also done among the parents of the primary school pupils (grade 1-6, n = 3540, 88 school buildings), but results are reported only in the supplement due to the low response rate (20% in 2017 and 13% in 2018). The associations between IEQ and symptoms were analyzed using multilevel logistic regression analysis. RESULTS Several of the IEQ indicators were highly correlated and indicators were therefore mainly analyzed by combining them into a summary score and into latent classes. Dose-response associations were found between IEQ problems and higher reporting of respiratory and general symptoms among both primary and secondary school pupils. Some associations were also observed with lower respiratory and skin symptoms, but not with eye symptoms. The associations were somewhat stronger with symptoms related to the school environment compared to symptoms reported without such relation: for a unit change in IEQ summary score and respiratory symptoms in primary schools, odds ratios were 1.07 (95% CI 1.02-1.06) and 1.04 (95% CI 1.04-1.10), and in secondary schools 1.09 (95% CI 1.01-1.09) and 1.05 (95% CI 1.02-1.17), respectively. CONCLUSIONS Expert-assessed IEQ problems in schools were associated with increased reporting of especially respiratory and general symptoms. The associations were only somewhat stronger in magnitude for symptoms reported in relation to the school environment compared to symptoms reported without such relation.
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Affiliation(s)
- Kateryna Savelieva
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Tero Marttila
- Unit of Civil Engineering, Faculty of Built Environment, Tampere University, 33014 Tampere, Finland
| | - Jussi Lampi
- Department of Health Security, Environmental Health, National Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Sari Ung-Lanki
- Department of Health Security, Environmental Health, National Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Juha Pekkanen
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Department of Health Security, Environmental Health, National Institute for Health and Welfare, 70701 Kuopio, Finland
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92
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Hikone M, Ainoda Y, Sakamoto N, Ohnishi K. Clinical characteristics of elderly pulmonary tuberculosis in an acute-care general hospital in Tokyo, Japan: A 12-year retrospective study. J Infect Chemother 2019; 26:245-250. [PMID: 31822452 DOI: 10.1016/j.jiac.2019.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/04/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A significant feature of tuberculosis (TB) in Japan is the fact that a high proportion of cases belong to the elderly population. Furthermore, previous reports have pointed out the delayed diagnosis of pulmonary TB in acute-care settings. We aimed to examine the clinical characteristics of pulmonary TB patients in an acute-care general hospital, particularly focusing on the elderly population. METHODS We retrospectively reviewed the medical records of patients with pulmonary TB who presented at our institution between May 2005 and December 2016. We described the overall clinical characteristics of these patients and compared them according to age. RESULTS Overall, 289 patients were eligible for the analysis, with a median age of 58 [42-73] years, and 29.4% being older than 70 years. Among the elderly patients, 42.4% were characterized by atypical presentation. CONCLUSION Our findings suggest that the elderly population tends to present as atypical cases lacking respiratory complaints, thereby being at a risk of misdiagnosis.
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Affiliation(s)
- Mayu Hikone
- Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan; Department of Emergency and Critical Care Center, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan.
| | | | - Naoya Sakamoto
- Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan
| | - Kenji Ohnishi
- Department of Infectious Diseases, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan
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93
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Hasan M, Tasfina S, Haque SMR, Saif-Ur-Rahman KM, Khalequzzaman M, Bari W, Islam SS. Association of biomass fuel smoke with respiratory symptoms among children under 5 years of age in urban areas: results from Bangladesh Urban Health Survey, 2013. Environ Health Prev Med 2019; 24:65. [PMID: 31775610 PMCID: PMC6882069 DOI: 10.1186/s12199-019-0827-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/06/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known regarding the effect of exposure to biomass fuel smoke inhalation on respiratory symptoms in the Bangladeshi population which is a major health hazard in most of the developing countries. This study aims to explore the association between respiratory symptoms and biomass fuel smoke exposure among children under 5 years of age. METHODS Data were extracted from the Bangladesh Urban Health Survey conducted in 2013. A total of 10,575 mothers with at least one surviving children were selected. Respiratory symptoms among children under 5 years of age were considered as the primary outcome. Sequential multiple logistic regression models were used to observe the association between respiratory symptoms and biomass fuel smoke exposure adjusting the effect of residential factors and mother and child characteristics. RESULTS Around 40% of the mothers exclusively used biomass fuel irrespective of the kitchen location and 54% of them were habituated in indoor cooking. The prevalence of respiratory symptoms of under-five children among in-house and outdoor biomass fuel users was 23.0% and 21.9%, respectively. Results of fitted multiple logistic regression models showed that the odds of having respiratory symptoms among children under 5 years of age were increased due to in-house biomass fuel use [OR = 1.18; 95% CI, 1.04-1.36] compared with the non-biomass user. An increased risk of respiratory symptoms was also significantly associated with mother's birth complication [OR = 1.51; 95% CI, 1.36-1.67], non-government organization (NGO) membership of mothers [OR = 1.32; 95% CI, 1.16-1.51], age of the child (6-23m) [OR = 1.29; 95% CI, 1.10-1.52], and nutritional status (stunting) [OR = 1.18; 95% CI, 1.06-1.31]. CONCLUSION This study found the use of in-house biomass fuel as a significant risk factor associated with respiratory symptoms of children under 5 years of age. More longitudinal studies should be designed to establish a causal relationship between HAP (household air pollution) and respiratory symptoms among children with more direct measures of HAP and clinical procedure.
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Affiliation(s)
- Md Hasan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
| | - Sadia Tasfina
- School of Public Health, Independent University, Dhaka, Bangladesh
| | - S M Raysul Haque
- School of Public Health, Independent University, Dhaka, Bangladesh
| | - K M Saif-Ur-Rahman
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
- Department of Public Health and Health Systems, University of Nagoya, Nagoya, Japan
| | - Md Khalequzzaman
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Syed Shariful Islam
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Enkh-Undraa D, Kanda S, Shima M, Shimono T, Miyake M, Yoda Y, Nagnii S, Nishiyama T. Coal burning-derived SO 2 and traffic-derived NO 2 are associated with persistent cough and current wheezing symptoms among schoolchildren in Ulaanbaatar, Mongolia. Environ Health Prev Med 2019; 24:66. [PMID: 31775603 PMCID: PMC6882210 DOI: 10.1186/s12199-019-0817-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/23/2019] [Indexed: 11/25/2022] Open
Abstract
Background Children in Ulaanbaatar are exposed to air pollution, but few epidemiological studies have been conducted on the effects of environmental risk factors on children’s health. Also, no studies have yet examined the prevalence of respiratory symptoms in children in suburban areas, where air quality-monitoring stations have not yet been installed. This cross-sectional study evaluated the associations between outdoor air pollution and respiratory symptoms among schoolchildren in urban and suburban districts of Ulaanbaatar. Methods The ATS-DLD-78 C questionnaire was used to investigate the respiratory symptoms of schoolchildren aged 6–12 years (n = 1190) who lived in one of three urban districts or a suburban district of Ulaanbaatar. In each district, the outdoor concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) were measured at two sites (at ≤100 m and > 100 m from the nearest major road) in the 2-year period from 2015 to 2016. The associations between health outcomes and exposure to air pollutants were estimated using the multinomial logistic regression method. Results The outdoor concentration of SO2 was significantly associated with persistent cough symptom (OR = 1.12, 95% CI 1.04–1.22). Furthermore, the outdoor concentration of NO2 was significantly associated with the current wheezing symptom (OR = 1.33, 95% CI 1.01–1.75) among children in urban and suburban. Conclusions The prevalence of persistent cough symptom was markedly high among the schoolchildren in urban/suburban districts of Ulaanbaatar. Overall, the increases in the prevalence of respiratory symptoms among children might be associated with ambient air pollution in Ulaanbaatar.
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Affiliation(s)
- Dambajamts Enkh-Undraa
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka Prefecture, Japan
| | - Seiji Kanda
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka Prefecture, Japan.
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomya, Hyogo Prefecture, Japan
| | - Takaki Shimono
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka Prefecture, Japan
| | - Mari Miyake
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka Prefecture, Japan
| | - Yoshiko Yoda
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomya, Hyogo Prefecture, Japan
| | - Saijaa Nagnii
- Environmental Health Research Center, Public Health Institute, Enkhtaiwan Avenue 17, 3rd Khoroo Bayanzurkh, Ulaanbaatar, Mongolia
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka Prefecture, Japan
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95
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Wolkoff P. Comments to "Assessment of formaldehyde levels in relation to respiratory and allergic symptoms in children from Alba County schools, Romania" by Neamtiu et al. (2019). Environ Monit Assess 2019; 191:682. [PMID: 31659491 DOI: 10.1007/s10661-019-7897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Peder Wolkoff
- National Research Centre for the Working Environment, NRCWE, Lersø Parkallé 105, 2920, Copenhagen Ø, Denmark.
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96
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Svedahl SR, Hilt B, Svendsen K. Work environment factors and respiratory complaints in Norwegian cooks. Int Arch Occup Environ Health 2019; 93:205-212. [PMID: 31531780 DOI: 10.1007/s00420-019-01473-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Norwegian cooks exhibit relatively high mortality, particularly from respiratory diseases. Both occupational hazards and lifestyle factors have been suggested as possible explanations. Negative health effects from exposure to cooking fumes are well documented in non-Western populations, and it has been claimed that cooking fumes in Western style cooking might be substantially different. We hypothesise that exposure to cooking fumes contributes to respiratory diseases also in professional cooks in Western countries. The aim of this study was to elucidate if specific work environment factors related to cooking fume exposure are determinants for respiratory morbidity in Norwegian cooks. METHODS We surveyed specific work environment factors and respiratory complaints in 553 subjects that were currently working as skilled cooks. Inclusion was based on the register of people that had graduated as skilled cooks in central Norway between 1988 and 2008. Determinants for the occurrence of respiratory complaints were explored by logistic regression. RESULTS Overall, 17.2% of subjects reported respiratory complaints at work, while 8.1% had chronic bronchitis. Those who performed frying for over half of their workday exhibited an increased odds ratio for having chronic bronchitis of 2.5 (95% CI 1.2-5.3). Using gas for frying and using a fryer in the kitchen were also related to the occurrence of respiratory complaints. CONCLUSIONS This study in Norwegian cooks demonstrates a relationship between the extent of frying and the occurrence of work-related respiratory complaints. Therefore, reducing exposure to cooking fumes could reduce respiratory complaints in cooks, and potentially help alleviate excess morbidity and mortality in this occupation.
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Affiliation(s)
- Sindre Rabben Svedahl
- Department of Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. .,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Bjørn Hilt
- Department of Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristin Svendsen
- Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway
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Klepaker G, Svendsen MV, Hertel JK, Holla ØL, Henneberger PK, Kongerud J, Fell AKM. Influence of Obesity on Work Ability, Respiratory Symptoms, and Lung Function in Adults with Asthma. Respiration 2019; 98:473-481. [PMID: 31461714 DOI: 10.1159/000502154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/16/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Asthma is defined by variable respiratory symptoms and lung function, and may influence work ability. Similarly, obesity may contribute to respiratory symptoms, affect lung function, and reduce work ability. Thus, assessment of the influence of obesity on work ability, respiratory symptoms, and lung function in adults with asthma is needed. OBJECTIVES We hypothesized that patients with obesity and asthma have more respiratory symptoms and reduced work ability and lung function compared with normal-weight patients with asthma. METHODS We examined 626 participants with physician-diagnosed asthma, aged 18-52 years, recruited from a cross-sectional general population study using a comprehensive questionnaire including work ability score, the asthma control test (ACT), height and weight, and spirometry with reversibility testing. RESULTS Participants with a body mass index (BMI) ≥30 kg/m2 (i.e., obese) had a higher symptom score (OR 1.78, 95% CI 1.14-2.80), current use of asthma medication (1.60, 1.05-2.46), and incidence of ACT scores ≤19 (poor asthma control) (1.81, 1.03-3.18) than participants with BMI ≤24.9 kg/m2 (i.e., normal weight). Post-bronchodilator forced vital capacity (FVC) as a percentage of predicted (β coefficient -4.5) and pre-bronchodilator forced expiratory volume in 1 s as a percentage of predicted (FEV1) (β coefficient -4.6) were negatively associated with BMI ≥30 kg/m2. We found no statistically significant association of BMI >30 kg/m2 (compared to BMI <24.9 kg/m2) with sick leave (1.21, 0.75-1.70) or reduced work ability (1.23, 0.74-2.04). CONCLUSIONS There were indications that patients with obesity had a higher symptom burden, poorer asthma control, higher consumption of asthma medication, and reduced lung function, in particular for FVC, compared with normal-weight patients.
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Affiliation(s)
- Geir Klepaker
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway, .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway,
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | | | - Øystein Lunde Holla
- Department of Laboratory Medicine, Section of Medical Genetics, Telemark Hospital, Skien, Norway
| | - Paul Keefer Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Johny Kongerud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
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98
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Dalju I, Dessie A, Bogale L, Mekonnen TH. Occupational risk factors associated with respiratory symptoms among tannery workers in Mojo town, Southeast Ethiopia, 2018: a comparative cross-sectional study. Multidiscip Respir Med 2019; 14:27. [PMID: 31391941 PMCID: PMC6681476 DOI: 10.1186/s40248-019-0188-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction Work-related respiratory diseases (WRDs) account for 10-20% of all chronic respiratory illnesses affecting hundreds of millions of people of all ages. Tannery industries are often associated with hazardous working conditions favourable for respiratory conditions. However, information about the prevalence and occupational factors that predispose to respiratory symptoms is meagre in Ethiopia. This study aimed to investigate the magnitude and risk factors associated with work-related respiratory symptoms among tannery industry workers in Mojo town, Ethiopia. Methods A comparative cross-sectional study was conducted from March to May 2018. A total of 602 (299 exposed to tannery factories) and 303 unexposed (civil servants) were included using the stratified sampling method. The British Medical Research Council (BMRC) questionnaire was pretested and interviewer-administered for data collection. A binary logistic regression analysis was performed to identify the factors associated with respiratory symptoms. The significance of associations was ascertained at a < 0.05 p and adjusted odds ratio with a 95% CI was computed to evaluate the strength of associations. Results The prevalence of respiratory symptoms among exposed workers was 27.1% [95% CI (21.7, 32.1)] and 8.3% [95% CI (5.3, 11.6)] among unexposed workers in the previous 12 months and the prevalence was significantly different (X2 = 36.82; p < 0. 00001). The odds of developing respiratory symptoms was 3.37 times higher among tannery workers than unexposed workers [AOR: 3.37; 95% CI (1.71, 6.46)]. Female sex [AOR:1.80; 95% CI (1.24, 3.34)], temporarily workers [AOR = 3.43; 95% CI (2.63, 7.95)], working in a poorly ventilated working unit [AOR = 1.88; 95% CI (1.22, 3.98)], absence of occupational health and safety training [AOR = 2.37; 95% CI (1.14, 4.92)], and not using personal protective equipment [AOR = 2.30; 95% CI (1.25, 3.46)] were significant factors. Conclusion The prevalence of respiratory symptoms was higher among exposed workers compared to unexposed ones. Sex, employment status, ventilation of working units, absence of occupational health and safety training, and not using personal protective equipment were the factors associated with occupational-related respiratory symptoms. Strategies targeting health and safety training, creating awareness on the use of personal protective equipment, and improving workplace conditions, like the provision of adequate ventilation are useful means for assuaging the condition.
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Affiliation(s)
- Innawu Dalju
- Oromia Labour and Social Affairs Bureau, Oromia Regional State, Addis Ababa, Ethiopia
| | - Awrajaw Dessie
- 2Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Laekemariame Bogale
- 2Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Hambisa Mekonnen
- 2Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D, Atanasovska A, Bislimovska D. Asthma and Chronic Obstructive Pulmonary Disease Associated With Occupational Exposure in Dairy Farmers - Importance of Job Exposure Matrices. Open Access Maced J Med Sci 2019; 7:2350-2359. [PMID: 31592062 PMCID: PMC6765081 DOI: 10.3889/oamjms.2019.630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/21/2022] Open
Abstract
AIM To evaluate the prevalence of chronic respiratory symptoms, lung function impairment, and chronic obstructive respiratory diseases in dairy farmers. Our objective is to then examine their relation to exposure duration and to explore the usefulness of job exposure matrices as tools for exposure assessment, and predictors for respiratory health impairment. METHODS A cross-sectional study was performed, including 83 dairy farmers (mean age: 52.6 ± 8.7 years; mean exposure duration: 23.7 ± 7.6 years) and 80 office workers as a control group (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Methods of evaluating examined subjects included a questionnaire on respiratory symptoms in the last 12 months, spirometry and histamine challenge, as well as the use of job exposure matrices (JEM). RESULTS Dairy farmers had a significantly higher prevalence of cough (38.5), phlegm (27.7%), and wheezing (21.7%), than controls (p < 0.05). All mean baseline spirometric parameters were lower in dairy farmers compared to the controls, but statistical significance was confirmed only for MEF25, MEF50, and MEF75% (p = 0.010, p = 0.001, and p = 0.004, respectively). The prevalence of bronchial hyperresponsiveness, asthma, and chronic obstructive pulmonary disease was higher in dairy farmers but without statistical significance. JEM were useful tools for exposure assessment and predictors of factors for asthma and COPD development. CONCLUSION The results suggest that occupational exposure among crop farmers is associated with a higher prevalence of respiratory symptoms, lung function impairment, and a higher prevalence of chronic respiratory diseases. JEM showed good potential for farming exposure evaluation and promoted their applicability within the diagnostic algorithm focused on respiratory health assessment.
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Affiliation(s)
- Saso Stoleski
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Jordan Minov
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Jovanka Karadzinska-Bislimovska
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Dragan Mijakoski
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Aneta Atanasovska
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Dragana Bislimovska
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
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Nakamura T, Hatanaka D, Kashima K, Kusakari M, Takahashi H, Kamohara T, Takahashi N. A male preterm infant with cow's milk allergy to human milk fortifier showing only severe respiratory symptoms. Fukushima J Med Sci 2019; 65:50-54. [PMID: 31327804 DOI: 10.5387/fms.2019-10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We report a male infant with a birthweight of 1,400 g at 29 weeks 2 days gestation diagnosed as having cow's milk allergy (CMA) due to human milk fortifier, who developed severe respiratory symptoms. The infant had no gastrointestinal symptoms; rather, the initial symptoms were apnea attacks and wheezing with a prolonged expiratory phase that progressed to severe ventilatory insufficiency requiring mechanical ventilation. Aggravation of his general condition, which appeared to be due to sepsis, was improved by temporary starvation and respiratory care, but he relapsed on the resumption of enteral feeding of his mother's milk with a human milk fortifier. As a result, this event was interpreted as a positive oral food challenge test. The infant resumed complete breastfeeding without the fortifier and has not relapsed since. Examination of his serial cytokine profiles from residual serum revealed that although interleukin-5 was not increased, interferon (IFN)-γ was increased, suggesting some relation between the time course of IFN-γ and the infant's eosinophil count. These findings may indicate that the involvement of IFN-γ is one cause of the onset of this disease.
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Affiliation(s)
| | - Daisuke Hatanaka
- Department of Neonatology, Japanese Red Cross Musashino Hospital
| | - Kohei Kashima
- Department of Pediatric and Neonatal Intensive Care, The University of Tokyo Hospital
| | - Michiko Kusakari
- Department of Neonatology, Japanese Red Cross Musashino Hospital
| | | | - Takashi Kamohara
- Department of Neonatology, Japanese Red Cross Musashino Hospital
| | - Naoto Takahashi
- Department of Pediatric and Neonatal Intensive Care, The University of Tokyo Hospital
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