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Babaoglu UT, Oymak Yalcin S, Calis AG, Ozgunaltay Ertugrul G, Erturk A. Effects of different occupational exposure factors on the respiratory system of farmers: the case of Central Anatolia. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Stoleski S, Minov J, Mijakoski D, Bislimovska D, Atanasovska A, Karadzinska-Bislimovska J. Lung Function Impairment in Construction Workers – Influence of Smoking and Exposure Duration. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The objective of the study was to assess the influence of exposure duration and smoking on ventilatory impairment among construction workers.
METHODS: A cross-sectional study was performed, including 83 construction workers aged 18–64 years, compared to equivalent number of office controls matched by age, workplace exposure duration, and smoking status. Data on chronic respiratory symptoms, work history, and smoking status were collected by standardized questionnaire, while lung functional testing of the examined subjects was performed by spirometry.
RESULTS: Mean values of spirometric parameters were lower in construction workers compared to controls with statistical significance registered for maximal expiratory flow (MEF25), MEF50, and MEF75. Lung functions of construction workers have been found to decrease in relation to exposure duration but reached significance only for small airways changes. There was a significant difference in detected ventilatory impairment between exposed workers and controls for any type of ventilatory impairment, as well as obstructive and combined ventilatory pattern and obstructive ventilatory pattern in small airways. Obstructive ventilatory impairment was significantly associated with life-time smoking in construction workers, while obstructive ventilatory pattern in small airways was significantly associated with life-time smoking. The combined effect of daily smoking, life-time smoking, and number of cigarettes smoked daily was shown to have a significant influence in their development. The risk for obstructive ventilatory pattern in small airways among exposed subjects was about 4 fold higher in those exposed more than 20 years (odds ratio [OR] = 3.68 [1.01–14.59] confidence interval [CI] 95%), and about 2.5 fold higher in smokers (OR = 2.57 [0.92-7.25] CI 95%). Exposure duration, smoking and age had independent effect only on small airways changes and force expiratory volume in the 1st s/force vital capacity %.
CONCLUSION: Our data suggest the importance of the joint effect of job exposure in construction and daily smoking on the development of lung function impairment and airflow limitation, being dominant, especially on small airways.
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Kim T, Cho HB, Kim WJ, Lee CH, Chae KJ, Choi SH, Lee KE, Bak SH, Kwon SO, Jin GY, Choi J, Park EK, Lin CL, Hoffman EA, Choi S. Quantitative CT-based structural alterations of segmental airways in cement dust-exposed subjects. Respir Res 2020; 21:133. [PMID: 32471435 PMCID: PMC7260806 DOI: 10.1186/s12931-020-01399-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background Dust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs. This study aims to investigate alterations of quantitative computed tomography (QCT)-based airway structural and functional metrics due to cement-dust exposure. Methods To reduce confounding factors, subjects with normal spirometry without fibrosis, asthma and pneumonia histories were only selected, and a propensity score matching was applied to match age, sex, height, smoking status, and pack-years. Thus, from a larger data set (N = 609), only 41 cement dust-exposed subjects were compared with 164 non-cement dust-exposed subjects. QCT imaging metrics of airway hydraulic diameter (Dh), wall thickness (WT), and bifurcation angle (θ) were extracted at total lung capacity (TLC) and functional residual capacity (FRC), along with their deformation ratios between TLC and FRC. Results In TLC scan, dust-exposed subjects showed a decrease of Dh (airway narrowing) especially at lower-lobes (p < 0.05), an increase of WT (wall thickening) at all segmental airways (p < 0.05), and an alteration of θ at most of the central airways (p < 0.001) compared with non-dust-exposed subjects. Furthermore, dust-exposed subjects had smaller deformation ratios of WT at the segmental airways (p < 0.05) and θ at the right main bronchi and left main bronchi (p < 0.01), indicating airway stiffness. Conclusions Dust-exposed subjects with normal spirometry demonstrated airway narrowing at lower-lobes, wall thickening at all segmental airways, a different bifurcation angle at central airways, and a loss of airway wall elasticity at lower-lobes. The airway structural alterations may indicate different airway pathophysiology due to cement dusts.
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Affiliation(s)
- Taewoo Kim
- School of Mechanical Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, South Korea
| | - Hyun Bin Cho
- School of Mechanical Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, South Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Chang Hyun Lee
- Department of Radiology, College of Medicine, Seoul National University, Seoul, South Korea.,Department of Radiology, College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Kum Ju Chae
- Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - So-Hyun Choi
- Department of Statistics, Kyungpook National University, Daegu, South Korea
| | - Kyeong Eun Lee
- Department of Statistics, Kyungpook National University, Daegu, South Korea
| | - So Hyeon Bak
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Sung Ok Kwon
- Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Gong Yong Jin
- Department of Radiology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea
| | - Jiwoong Choi
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
| | - Ching-Long Lin
- IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Eric A Hoffman
- Department of Radiology, College of Medicine, The University of Iowa, Iowa City, Iowa, USA
| | - Sanghun Choi
- School of Mechanical Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, South Korea.
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Cohort profile: the Saskatchewan Rural Health Study-adult component. BMC Res Notes 2017; 10:732. [PMID: 29228973 PMCID: PMC5725811 DOI: 10.1186/s13104-017-3047-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/30/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Less is known about the respiratory health of general farming and non-framing populations. A longitudinal Saskatchewan Rural Health Study (SRHS) was conducted to explore the association between individual and contextual factors with respiratory health outcomes in these populations. Hence, the objectives are to: (i) describe the updated methodology of longitudinal SRHS-an extension of baseline survey methodology published earlier; (ii) compare baseline characteristics and the prevalences of respiratory health outcomes between drops-outs and completers; and (iii) summarize key findings based on baseline survey data. RESULTS The SRHS was a prospective cohort study conducted in two phases: baseline survey in 2010 and a follow-up in 2014. Each survey consisted of two components, self-administered questionnaire and clinical assessments. At baseline, 8261 participants (≥ 18 years) (4624 households) and at follow-up, 4867 participants (2797 households) completed the questionnaires. Clinical assessments on lung functions and/or allergies were conducted among a sub-group of participants from both the surveys. To date, we published 15 peer-reviewed manuscripts and 40 abstracts in conference proceedings. Findings from the study will improve the knowledge of respiratory disease etiology and assist in the development and targeting of prevention programs for rural populations in Saskatchewan, Canada.
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Hamzah NA, Mohd Tamrin SB, Ismail NH. Metal dust exposure and lung function deterioration among steel workers: an exposure-response relationship. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2016; 22:224-232. [PMID: 27392157 PMCID: PMC5102237 DOI: 10.1080/10773525.2016.1207040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Metallic dust is a heterogeneous substance with respiratory sensitizing properties. Its long term exposure adversely affected lung function, thus may cause acute or chronic respiratory diseases. METHODS A cross-sectional study was conducted in a steel factory in Terengganu, Malaysia to assess the metal dust exposure and its relationship to lung function values among 184 workers. Metal dust concentrations values (Co, Cr, and Ni) for each worker were collected using air personal sampling. Lung function values (FEV1, FVC, and %FEV1/FVC) were determined using spirometer. RESULTS Exposure to cobalt and chromium were 1-3 times higher than permissible exposure limit (PEL) while nickel was not exceeding the PEL. Cumulative of chromium was the predictor to all lung function values (FEV1, FVC, and %FEV1/FVC). Frequency of using mask was positively associated with FVC (Adj b = 0.263, P = 0.011) while past respiratory illnesses were negatively associated with %FEV1/FVC (Adj b = -1.452, P = 0.026). Only few workers (36.4%) were found to wear their masks all times during the working hours. CONCLUSIONS There was an exposure-response relationship of cumulative metal dust exposure with the deterioration of lung function values. Improvement of control measures as well as proper and efficient use or personal protection equipment while at work could help to protect the respiratory health of workers.
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Affiliation(s)
- Nurul Ainun Hamzah
- Environmental and Occupational Health Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Shamsul Bahri Mohd Tamrin
- Faculty of Medicine and Health Sciences, Department of Environmental and Occupational Health, Universiti Putra Malaysia, Serdang, Malaysia
| | - Noor Hassim Ismail
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, Malaysia
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Marchetti N, Garshick E, Kinney GL, McKenzie A, Stinson D, Lutz SM, Lynch DA, Criner GJ, Silverman EK, Crapo JD. Association between occupational exposure and lung function, respiratory symptoms, and high-resolution computed tomography imaging in COPDGene. Am J Respir Crit Care Med 2015; 190:756-62. [PMID: 25133327 DOI: 10.1164/rccm.201403-0493oc] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Although occupational exposure to dust and fumes is considered a risk factor for chronic obstructive pulmonary disease, this determination has been limited by reliance on spirometry alone to assess disease severity in predominantly male populations. OBJECTIVES To determine the effect of occupational exposure on lung function, respiratory symptoms, and findings of emphysema and airway wall thickness measured using quantitative computed tomography in men and women. METHODS COPDGene is a multicenter study of current and former smokers that underwent standardized volumetric chest computed tomography scans to assess airways, % emphysema, and % gas trapping. Spirometry and a respiratory questionnaire including occupational history were also analyzed in 9,614 subjects (4,496 women). Logistic regression and analysis of covariance was used to assess associations with exposure. MEASUREMENTS AND MAIN RESULTS Occupational exposure to both dust and fumes was reported by 47.9% of men and 20.1% of women. Adjusting for age, race, body mass index, education, and current and lifetime smoking, the odds ratios for persons with dust and fume exposures for chronic cough, chronic phlegm, persistent wheeze, and Global Initiative for Chronic Obstructive Lung Disease stages 2 and higher chronic obstructive pulmonary disease were significantly elevated and similar for men (1.83, 1.84, 2.0, 1.61, respectively) and women (1.65, 1.82, 1.98, 1.90, respectively). The % predicted FEV1 was similarly lower in those with exposure in men (70.7 ± 0.8 vs. 76.0 ± 0.9; P < 0.001) and women (70.5 ± 0.8 vs. 77.2 ± 0.8; P < 0.001). Percent emphysema and gas trapping was greater in those exposed to dust and fumes in men and women. In men, but not in women, persons with exposure had a greater mean square root wall area of 10-mm internal perimeter airways. CONCLUSIONS Occupational exposure to dust and fumes in men and women is similarly associated with airflow obstruction, respiratory symptoms, more emphysema, and gas trapping in men and women.
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Affiliation(s)
- Nathaniel Marchetti
- 1 Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
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Mirabelli MC, Chatterjee AB, Mora DC, Arcury TA, Blocker JN, Chen H, Grzywacz JG, Marín AJ, Schulz MR, Quandt SA. Airway obstruction among Latino poultry processing workers in North Carolina. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2015; 70:63-66. [PMID: 24965321 PMCID: PMC4526130 DOI: 10.1080/19338244.2013.787965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This analysis was conducted to evaluate the prevalence of airway obstruction among Latino poultry processing workers. Data were collected from 279 poultry processing workers and 222 other manual laborers via spirometry and interviewer-administered questionnaires. Participants employed in poultry processing reported the activities they perform at work. Participants with forced expiratory volume in 1 second (FEV1) or FEV1/forced expiratory volume (FVC) below the lower limits of normal were categorized as having airway obstruction. Airway obstruction was identified in 13% of poultry processing workers and 12% of the comparison population. Among poultry processing workers, the highest prevalence of airway obstruction (21%) occurred among workers deboning chickens (prevalence ratio: 1.75; 95% confidence interval: 0.97, 3.15). These findings identify variations in the prevalence of airway obstruction across categories of work activities.
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Affiliation(s)
- Maria C Mirabelli
- a Division of Public Health Sciences, Department of Epidemiology and Prevention, School of Medicine , Wake Forest University , Winston-Salem , North Carolina , USA
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Johncy S S, G D, Samuel T V, K T A, Bondade SY. Acute lung function response to dust in street sweepers. J Clin Diagn Res 2013; 7:2126-9. [PMID: 24298455 DOI: 10.7860/jcdr/2013/5818.3449] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 07/01/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sweepers are chronically exposed to dust raised during sweeping. Dust is regarded as the most influential agent and it is perceived as a frequent cause of respiratory system illness and may cause acute and chronic lung function impairment. AIMS The aim of this study was to determine the acute lung function changes in sweepers exposed to dust generated from street sweeping. MATERIAL AND METHODS This study was conducted in central Karnataka, India, on 25 female sweepers and 25 healthy female control subjects who were comparable in age, height and weight. The pulmonary function test was performed in controls, sweepers before and after sweeping, by using RMS medspiror and results were compared by Student's unpaired 't' test. RESULTS The results showed a significant reduction in percent predicted values and mean values of FVC, FEV1, PEFR, FEF25-75% and FEF 200-1200 between sweepers and their matched controls. Pulmonary function after sweeping also showed a significant decrease. CONCLUSIONS On comparing the pulmonary functions of sweepers before and after sweeping, it was concluded that inhalation of dust acutely affected the lung function of sweepers in India and that sweepers were at a risk of developing occupation related lung function impairment. We recommend that the workers should use protective face masks and do wet sweeping instead of dry sweeping during sweeping activity.
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Affiliation(s)
- Smilee Johncy S
- Associate Professors, Department of Physiology, J. J. M. Medical College , Davangere-577004, Karnataka, India
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Bala S, Tabaku A. Chronic Obstructive Pulmonary Disease in Iron-steel and Ferrochrome Industry Workers. Cent Eur J Public Health 2010; 18:93-8. [DOI: 10.21101/cejph.a3548] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Liu X, Salter A, Thomas P, Leigh J, Wang H. Exhaled nitric oxide levels and lung function changes of underground coal miners in Newcastle, Australia. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2010; 73:437-44. [PMID: 20155584 DOI: 10.1080/15287390903486592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The possibility of exhaled nitric oxide (eNO) in combination with lung function as a marker of airway inflammation produced by coal mining exposure was determined presuming that workers exposed to airborne hazards would possess different concentrations of eNO and decreased lung function indices, relative to control subjects recruited from the same area. The effect of smoking was also considered. A study (exposed) group comprising 186 male subjects (aged 19-58 yr) was recruited from Newcastle coal mining companies with 86 male subjects (aged 20-64 yr) from the same area, but working outside of the coal mining location, serving as controls. The parameters examined were eNO, lung function, and variables derived from an interview-administered questionnaire survey. After adjustment for age, body weight, and smoking status, no significant differences between exposed coal mining workers and controls were found for various lung function parameters. However, the exposed group was shown to have significantly lower concentrations of eNO. In the exposed group, forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), and FEV(1) (%) predicted were found to be significantly different between nonsmokers and smokers. The concentrations of eNO were not significantly different between smoking and nonsmokers within the exposed group. The consideration of nonsmokers alone showed that eNO was significantly lower in the exposed group compared to the control group. The consideration of smokers alone found that eNO was significantly lower in exposed subjects. In the exposed group, no significant association was detected between eNO levels and underground work duration but a significant negative association was shown between eNO and age. Data suggest that exposure to airborne hazards in coal mining is not significantly associated with lung function changes but is correlated with decreased eNO concentrations in exposed workers. While underground work duration was not found to be significantly associated with eNO concentrations in coal mining workers in this study, the potential for using eNO as a monitoring marker still exists and further studies are needed to establish its importance.
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Affiliation(s)
- Xiaohui Liu
- Discipline of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Hart JE, Laden F, Eisen EA, Smith TJ, Garshick E. Chronic obstructive pulmonary disease mortality in railroad workers. Occup Environ Med 2008; 66:221-6. [PMID: 19039098 DOI: 10.1136/oem.2008.040493] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is little information describing the risk of non-malignant respiratory disease and occupational exposure to diesel exhaust. METHODS US railroad workers have been exposed to diesel exhaust since diesel locomotives were introduced after World War II. In a retrospective cohort study we examined the association of chronic obstructive pulmonary disease (COPD) mortality with years of work in diesel-exposed jobs. To examine the possible confounding effects of smoking, multiple imputation was used to model smoking history. A Cox proportional hazards model was used to estimate an incidence rate ratio, adjusted for age, calendar year, and length of follow-up after leaving work (to reduce bias due to a healthy worker survivor effect). RESULTS Workers in jobs with diesel exhaust exposure had an increased risk of COPD mortality relative to those in unexposed jobs. Workers hired after the introduction of diesel locomotives had a 2.5% increase in COPD mortality risk for each additional year of work in a diesel-exposed job. This risk was only slightly attenuated after adjustment for imputed smoking history. CONCLUSIONS These results support an association between occupational exposure to diesel exhaust and COPD mortality.
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Affiliation(s)
- J E Hart
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
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Abstract
OBJECTIVE To examine the association between occupation and chronic bronchitis among a cross section of Chinese women who participated in the Shanghai Women's Health Study. METHODS Cases were 4873 women who self-reported a physician-diagnosed bronchitis during adulthood. Controls were 9746 women randomly selected from Shanghai Women's Health Study participants and matched with the cases by year of birth and age at diagnosis. Lifetime occupational histories were obtained. Logistic regressions were used to evaluate the association between chronic bronchitis and occupation, adjusting for smoking, education, family income, and concurrent asthma. RESULTS We observed excess prevalence of bronchitis for textile occupation (odds ratio, OR = 1.09; 95% CI = 1.00-1.18) and industry (OR = 1.11; 95% CI = 1.03-1.19), welders (OR = 1.40; 95% CI = 1.01-1.92), packing and baling workers (OR = 1.39; 95% CI = 1.15-1.68), and warehousing industry (OR = 1.58; 95% CI = 1.08-2.30) We also identified several new associations that may warrant further exploration and confirmation, including employment in some metal fabrication industries, postal and telecommunication industry, and a few white-collar occupations and industries. CONCLUSIONS Our study indicates that the risk of chronic bronchitis among women may be increased in some occupations and industries.
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Firlei N, Lamprecht B, Schirnhofer L, Kaiser B, Studnicka M. Die Prävalenz der COPD in Österreich – die erwartete Entwicklung bis 2020. Wien Klin Wochenschr 2007; 119:513-8. [DOI: 10.1007/s00508-007-0867-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Accepted: 08/20/2007] [Indexed: 11/24/2022]
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Hart JE, Laden F, Schenker MB, Garshick E. Chronic obstructive pulmonary disease mortality in diesel-exposed railroad workers. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:1013-7. [PMID: 16835052 PMCID: PMC1513327 DOI: 10.1289/ehp.8743] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Diesel exhaust is a mixture of combustion gases and ultrafine particles coated with organic compounds. There is concern whether exposure can result in or worsen obstructive airway diseases, but there is only limited information to assess this risk. U.S. railroad workers have been exposed to diesel exhaust since diesel locomotives were introduced after World War II, and by 1959, 95% of the locomotives were diesel. We conducted a case-control study of railroad worker deaths between 1981 and 1982 using U.S. Railroad Retirement Board job records and next-of-kin smoking, residential, and vitamin use histories. There were 536 cases with chronic obstructive pulmonary disease (COPD) and 1,525 controls with causes of death not related to diesel exhaust or fine particle exposure. After adjustment for age, race, smoking, U.S. Census region of death, vitamin use, and total years off work, engineers and conductors with diesel-exhaust exposure from operating trains had an increased risk of COPD mortality. The odds of COPD mortality increased with years of work in these jobs, and those who had worked >/= 16 years as an engineer or conductor after 1959 had an odds ratio of 1.61 (95% confidence interval, 1.12-2.30) . These results suggest that diesel-exhaust exposure contributed to COPD mortality in these workers. Further study is needed to assess whether this risk is observed after exposure to exhaust from later-generation diesel engines with modern emission controls.
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Affiliation(s)
- Jaime E Hart
- Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Garshick E, Laden F, Hart JE, Rosner B, Smith TJ, Dockery DW, Speizer FE. Lung cancer in railroad workers exposed to diesel exhaust. ENVIRONMENTAL HEALTH PERSPECTIVES 2004; 112:1539-43. [PMID: 15531439 PMCID: PMC1247618 DOI: 10.1289/ehp.7195] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Diesel exhaust has been suspected to be a lung carcinogen. The assessment of this lung cancer risk has been limited by lack of studies of exposed workers followed for many years. In this study, we assessed lung cancer mortality in 54,973 U.S. railroad workers between 1959 and 1996 (38 years). By 1959, the U.S. railroad industry had largely converted from coal-fired to diesel-powered locomotives. We obtained work histories from the U.S. Railroad Retirement Board, and ascertained mortality using Railroad Retirement Board, Social Security, and Health Care Financing Administration records. Cause of death was obtained from the National Death Index and death certificates. There were 43,593 total deaths including 4,351 lung cancer deaths. Adjusting for a healthy worker survivor effect and age, railroad workers in jobs associated with operating trains had a relative risk of lung cancer mortality of 1.40 (95% confidence interval, 1.30-1.51). Lung cancer mortality did not increase with increasing years of work in these jobs. Lung cancer mortality was elevated in jobs associated with work on trains powered by diesel locomotives. Although a contribution from exposure to coal combustion products before 1959 cannot be excluded, these results suggest that exposure to diesel exhaust contributed to lung cancer mortality in this cohort. Key words: diesel exhaust, lung cancer, occupational exposure.
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Affiliation(s)
- Eric Garshick
- Pulmonary and Critical Care Medicine Section, Medical Service, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.
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. AC, . VB, . HH. Assessment of Chest and Postural Alignment in Healthy Turkish Coal Miners. JOURNAL OF MEDICAL SCIENCES 2004. [DOI: 10.3923/jms.2004.240.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Snider GL. Nosology for our day: its application to chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003; 167:678-83. [PMID: 12598211 DOI: 10.1164/rccm.200203-204pp] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Gordon L Snider
- Boston University School of Medicine, Veterans Affairs Boston Healthcare System, Boston, Massachusetts 02130, USA.
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Abstract
OBJECTIVE To estimate the number of annual deaths, as well as the direct and indirect costs of occupational COPD and asthma, in the United States in 1996. DESIGN Aggregation and analysis of national data sets collected by the National Center for Health Statistics, the Health Care Financing Administration, and other government bureaus and private firms. To assess mortality, we reviewed data from national surveys and applied a population attributable risk (PAR) of 15% for both asthma and COPD. We use a lower age limit of 35 years for occupational COPD and 20 years for occupational asthma. To calculate costs, we use the human capital method that decomposes costs into direct categories, such as medical expenses, as well as indirect categories, such as lost earnings and lost home production. We calculated proportionately adjusted costs for other plausible PARs. RESULTS The 15% PARs result in costs of $5.0 billion for COPD and $1.6 billion for asthma. For COPD, 56% of costs were direct and 44% were indirect; for asthma, 74% were direct and 26% indirect. These estimates are conservative since we ignored costs associated with pain and suffering as well as the value of care rendered by family members. The proportionately adjusted costs for 10 to 20% PARs are $3.3 to $6.6 billion for COPD and $1.1 to $2.1 billion for asthma. CONCLUSIONS The estimated $6.6 billion cost of occupational COPD and asthma in 1996 is likely to rise with the increasing prevalence of these diseases and warrants preventive intervention.
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Affiliation(s)
- J Paul Leigh
- Department of Epidemiology and Preventive Medicine, School of Medicine, University of California at Davis, Davis, CA 95616-8638, USA
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Ulvestad B, Lund MB, Bakke B, Djupesland PG, Kongerud J, Boe J. Gas and dust exposure in underground construction is associated with signs of airway inflammation. Eur Respir J 2001; 17:416-21. [PMID: 11405519 DOI: 10.1183/09031936.01.17304160] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Exposure to gases and dust may induce airway inflammation. It was hypothesized that heavy construction workers who had been exposed to dust and gases in underground construction work for 1 yr, would have early signs of upper and lower airway inflammation, as compared to outdoor workers. A study group comprising 29 nonsmoking underground concrete workers (mean +/- SD age 44+/-12 yrs), and a reference group of 26 outdoor concrete workers (39+/-12 yrs) were examined by acoustic rhinometry, nasal and exhaled nitric oxide spirometry and a questionnaire on respiratory symptoms. Exposure measurements were carried out. The underground workers had higher exposure to total and respirable dust, alpha-quartz and nitrogen dioxide than the references (p<0.001). The occurrence of respiratory symptoms was higher in the underground workers than in the references (p<0.05). Exhaled nitric oxide (NO) (geometric mean+/-SEM) was higher in the underground workers than in the references (8.4+/-1.09 versus 5.6+/-1.07 parts per billion (ppb), p = 0.001), whereas spirometric values were comparable. The underground workers had smaller nasal cross-sectional area and volume than the references, and more pronounced increases after decongestion (p<0.001). To conclude the exposure in underground construction may cause nasal mucosal swelling and increased levels of exhaled nitric oxide, indicating signs of upper and lower airway inflammation.
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Suadicani P, Hein HO, Meyer HW, Gyntelberg F. Exposure to cold and draught, alcohol consumption, and the NS-phenotype are associated with chronic bronchitis: an epidemiological investigation of 3387 men aged 53-75 years: the Copenhagen Male Study. Occup Environ Med 2001; 58:160-4. [PMID: 11171928 PMCID: PMC1740108 DOI: 10.1136/oem.58.3.160] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study was performed to estimate the strength of association between chronic bronchitis and lifetime exposure to occupational factors, current lifestyle, and the NS-phenotype in the MNS blood group among middle aged and elderly men. METHODS The study was carried out within the frameworks of the Copenhagen Male Study. Of 3387 men 3331 men with a mean age of 63 (range 53-75) years could be classified by prevalence of chronic bronchitis. As well as the completion of a large questionnaire on health, lifestyle, and working conditions, all participants had a thorough examination, including measurements of height and weight and blood pressure and a venous blood sample was taken for the measurement of serum cotinine and MNS typing; 16.5% of the men had the NS-phenotype. Chronic bronchitis was defined as cough and phlegm lasting 3 months or more for at least 2 years; 14.6% had chronic bronchitis. RESULTS Smoking and smoke inhalation were the factors most strongly associated with prevalence of chronic bronchitis. There were three major new findings: (a) long term (>5 years) occupational exposure to cold and draught was associated with a significantly increased prevalence of chronic bronchitis; compared with others, and adjusted for confounders, the odds ratio (OR) with 95% confidence interval (95% CI) was 1.4 (1.1 to 1.7), p=0.004; (b) a significant J shaped association existed between alcohol use and bronchitis, p<0.001, with the lowest prevalence found among moderate users; (c) a significant gene by environment association existed between smoking and the NS-phenotype in the MNS blood group; only among smokers was the NS-phenotype associated with a significantly decreased risk of chronic bronchitis, OR 0.67 (0.47-0.97), p=0.02. Other well known associations between dust, fumes, and even exposure to solvents and bronchitis were confirmed. CONCLUSION The results emphasise the multifactorial nature of chronic bronchitis, and show some hitherto unrecognised associations between cold and draught exposure, alcohol consumption, and the NS-phenotype and chronic bronchitis.
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Affiliation(s)
- P Suadicani
- H:S Bispebjerg Hospital, University of Copenhagen, Epidemiological Research Unit, Clinic of Occupational and Environmental Medicine, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
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Sobradillo Peña V. [Is the country-side harmless?]. Med Clin (Barc) 2000; 114:696-7. [PMID: 10916791 DOI: 10.1016/s0025-7753(00)71406-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dalphin JC, Dubiez A, Monnet E, Gora D, Westeel V, Pernet D, Polio JC, Gibey R, Laplante JJ, Depierre A. Prevalence of asthma and respiratory symptoms in dairy farmers in the French province of the Doubs. Am J Respir Crit Care Med 1998; 158:1493-8. [PMID: 9817698 DOI: 10.1164/ajrccm.158.5.9709108] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
With the aim of determining whether dairy farming is associated with an excess of asthma and respiratory symptoms, we compared the respiratory status in a sample of dairy farmers (n = 265) and a control group of nonexposed subjects (n = 149). The study protocol comprised a questionnaire, spirometry, and a bronchodilatation test (400 micrograms salbutamol powder), and an allergological evaluation: serum total IgE level, Phadiatop test, and skin prick tests (SPT) for seven inhalant allergens. Cumulative prevalences of self-reported asthma and of current asthma were respectively 5.3% and 1.5% in farmers, and respectively 3.4% and 1.3% in control subjects (both NS). Prevalences of all the respiratory symptoms studied were higher in farmers, with statistically significant differences after adjusting for age, sex, and smoking, for wheezing ever (OR: 2.7, p < 0.05), wheezing within the last year (OR: 5.2, p < 0.025), usual morning cough (OR: 5, p < 10(-)3), usual morning phlegm (OR: 11.3, p < 10(-)4), and chronic bronchitis (OR: 11.8, p < 0.01). The effect of exposure on these symptoms was more pronounced than, or of the same magnitude as that of smoking. Smoking and exposure had an additive effect except for chronic cough for which a positive interaction was observed (p = 0.05). Mean FEV1/VC (percentage of predicted) was statistically negatively correlated to dairy farming (p < 0.025) after adjusting for confounders. Bronchial obstruction was reversible in about 10% of subjects in both groups. In conclusion, this study mainly demonstrated an excess of respiratory symptoms in dairy farmers which is weak and nonsignificant for asthma, and high for cough, phlegm, and chronic bronchitis. It also suggested that the combined effect of farming and smoking was synergistic on chronic cough.
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Affiliation(s)
- J C Dalphin
- Departments of Respiratory Disease, Public Health, and Biochemistry, University Hospital of Besançon, Medical Department of the Mutualité Sociale Agricole of the Doubs, Besançon, France
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Affiliation(s)
- S Murin
- Division of Pulmonary and Critical Care Medicine, University of California, Davis, School of Medicine, Sacramento, USA
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