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Murgia N, Akgun M, Blanc PD, Costa JT, Moitra S, Muñoz X, Toren K, Ferreira AJ. Issue 3-The occupational burden of respiratory diseases, an update. Pulmonology 2024:S2531-0437(24)00045-X. [PMID: 38704309 DOI: 10.1016/j.pulmoe.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION AND AIMS Workplace exposures are widely known to cause specific occupational diseases such as silicosis and asbestosis, but they also can contribute substantially to causation of common respiratory diseases. In 2019, the American Thoracic Society (ATS) and the European Respiratory Society (ERS) published a joint statement on the occupational burden of respiratory diseases. Our aim on this narrative review is to summarise the most recent evidence published after the ATS/ERS statement as well as to provide information on traditional occupational lung diseases that can be useful for clinicians and researchers. RESULTS Newer publications confirm the findings of the ATS/ERS statement on the role of workplace exposure in contributing to the aetiology of the respiratory diseases considered in this review (asthma, COPD, chronic bronchitis, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, infectious pneumonia). Except for COPD, chronic bronchitis and infectious pneumonia, the number of publications in the last 5 years for the other diseases is limited. For traditional occupational lung diseases such as silicosis and asbestosis, there are old as well as novel sources of exposure and their burden continues to be relevant, especially in developing countries. CONCLUSIONS Occupational exposure remains an important risk factor for airways and interstitial lung diseases, causing occupational lung diseases and contributing substantially in the aetiology of common respiratory diseases. This information is critical for public health professionals formulating effective preventive strategies but also for clinicians in patient care. Effective action requires shared knowledge among clinicians, researchers, public health professionals, and policy makers.
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Affiliation(s)
- N Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy.
| | - M Akgun
- Department of Chest Diseases, School of Medicine, Ağrı İbrahim Çeçen University, Ağrı, Turkey
| | - P D Blanc
- Division of Occupational, Environmental, and Climate Medicine, Department of Medicine, University of California San Francisco, California, USA
| | - J T Costa
- Faculdade de Medicina da Universidade do Porto, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
| | - S Moitra
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - X Muñoz
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - K Toren
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A J Ferreira
- Faculty of Medicine, University of Coimbra. Coimbra, Portugal
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Jestin-Guyon N, Raherison-Semjen C. [Pesticide exposure and chronic respiratory diseases]. Rev Mal Respir 2024; 41:343-371. [PMID: 38594123 DOI: 10.1016/j.rmr.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Pesticides are used worldwide, mainly in agriculture as a means of controlling pests and protecting crops. That said, the entire world population is ultimately subject to pesticide exposure (consumption of fruits and vegetables, living near treated fields…), with varying degrees of toxicity involved. STATE OF THE ART In recent decades, epidemiological studies have contributed to the identification of chemical pesticide families with detrimental effects on human health: cognitive disorders, Parkinson's disease, prostate cancer… and impairment in respiratory functioning. Current scientific evidence points to the implication of the active substances in insecticides, herbicides and fungicides in chronic respiratory diseases, two examples being chronic obstructive pulmonary disease (COPD) in exposed workers, and asthmatic wheezing in children during prenatal or postnatal exposure. PERSPECTIVES The safety of individuals exposed to pesticides is of key importance in public health. Further epidemiological investigations are needed to identify the chemical families affecting certain populations. CONCLUSIONS The scientific literature suggests strong links between pesticide exposure and respiratory health. Whether it be environmental or occupational, pesticide exposure can lead to respiratory disorders and symptoms of varying severity.
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Affiliation(s)
- N Jestin-Guyon
- UMR1219 Bordeaux Population Health Centre de Recherche, ISPED, université de Bordeaux, 146, rue Léo-Saignat, 33000 Bordeaux, France.
| | - C Raherison-Semjen
- UMR1219 Bordeaux Population Health Centre de Recherche, ISPED, université de Bordeaux, 146, rue Léo-Saignat, 33000 Bordeaux, France; Centre hospitalier universitaire de la Guadeloupe, 97159 Pointe-à-Pitre, Guadeloupe
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Zhang J, Wurzel DF, Perret JL, Lodge CJ, Walters EH, Dharmage SC. Chronic Bronchitis in Children and Adults: Definitions, Pathophysiology, Prevalence, Risk Factors, and Consequences. J Clin Med 2024; 13:2413. [PMID: 38673686 PMCID: PMC11051495 DOI: 10.3390/jcm13082413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
The complex nature of chronic bronchitis (CB) and changing definitions have contributed to challenges in understanding its aetiology and burden. In children, CB is characterised by persistent airway inflammation often linked to bacterial infections and is therefore termed "protracted bacterial bronchitis" (PBB). Longitudinal studies suggest that CB in childhood persists into adulthood in a subgroup. It can also be associated with future chronic respiratory diseases including asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD). Adult CB is traditionally associated with smoking, occupational exposures, and lower socioeconomic status. The interplay between risk factors, childhood CB, adult CB, and other chronic respiratory diseases is intricate, requiring comprehensive longitudinal studies for a clearer understanding of the natural history of CB across the lifespan. Such longitudinal studies have been scarce to date given the logistic challenges of maintaining them over time. In this review, we summarise current evidence on the evolution of the definitions, pathophysiology, risk factors, and consequences of childhood and adulthood chronic bronchitis.
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Affiliation(s)
- Jingwen Zhang
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
| | - Danielle F. Wurzel
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - Jennifer L. Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
- Institute for Breathing and Sleep (IBAS), Melbourne, VIC 3084, Australia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
| | - E. Haydn Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
- School of Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
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Wang H, Meng R, Wang X, Si Z, Zhao Z, Lu H, Wang H, Hu J, Zheng Y, Chen J, Zhao Z, Zhu H, Li X, Xue L, Yan S, Sun J, Su Y, Wu J. A nested case-control study of the effects of dust exposure, smoking on COPD in coal workers. BMC Public Health 2023; 23:2056. [PMID: 37864177 PMCID: PMC10588135 DOI: 10.1186/s12889-023-16944-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) represents a prevalent ailment, progressively surging within the ranks of coal mine laborers. The current study endeavors to elucidate the effects of dust exposure and smoking on COPD incidence amongst coal mine workers, while concurrently devising preventive strategies for this affliction. METHOD A nested case-control study was conducted encompassing 1,416 participants aged ≥ 18 years, spanning the duration from (2017-2018) until 2020. A meticulous matching process yielded a cohort of 708 COPD patients, each paired with a control subject, forming a harmonious 1:1 ratio. Multiple logistic regression analysis was employed to scrutinize the associations between smoking, dust exposure with COPD among coal workers. RESULTS The COPD prevalence within the cohort of coal workers under investigation amounted to 22.66%, with an accompanying incidence density of 0.09/person-year. Following meticulous adjustment for confounding variables, it was discerned that cumulative dust exposure within the range of 47.19 ~ (OR: 1.90, 95% CI: 1.05, 3.44), 101.27 ~ (OR: 1.99, 95% CI: 1.17, 3.39), as well as smoking indices of 72 ~ (OR: 1.85, 95% CI: 1.19, 2.88), 145 ~ (OR: 1.74, 95% CI: 1.17, 2.61), 310 ~ (OR: 1.85, 95% CI: 1.23, 2.77) engender an escalated vulnerability to COPD among coal workers. Furthermore, interaction analysis discerned an absence of both multiplicative and additive interactions between dust exposure, smoking, and COPD occurrence amidst coal workers. CONCLUSION Dust exposure and smoking were unequivocally identified as precipitating risk factors for COPD incidence within the population of coal workers, albeit devoid of any discernible interaction between these two causal agents.
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Affiliation(s)
- Hui Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Rui Meng
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Xuelin Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Zhikang Si
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Zekun Zhao
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Haipeng Lu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Huan Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Jiaqi Hu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Yizhan Zheng
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Jiaqi Chen
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Ziqi Zhao
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Hongmin Zhu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Xiaoming Li
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Ling Xue
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Shengguang Yan
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Jian Sun
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Yu Su
- Personnel Department, North China University of Science and Technology, Tangshan City, Hebei Province, China.
| | - Jianhui Wu
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China.
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Rous JS, Lees PSJ, Koehler K, Buckley JP, Quirós-Alcalá L, Han MK, Hoffman EA, Labaki W, Barr RG, Peters SP, Paine R, Pirozzi C, Cooper CB, Dransfield MT, Comellas AP, Kanner RE, Drummond MB, Putcha N, Hansel NN, Paulin LM. Association of Occupational Exposures and Chronic Obstructive Pulmonary Disease Morbidity. J Occup Environ Med 2023; 65:e443-e452. [PMID: 36977360 PMCID: PMC10330008 DOI: 10.1097/jom.0000000000002850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJECTIVE The aim of the study is to determine whether aggregate measures of occupational exposures are associated with chronic obstructive pulmonary disease (COPD) outcomes in the Subpopulations and Intermediate Outcome Measures in COPD study cohort. METHODS Individuals were assigned to six predetermined exposure hazard categories based on self-reported employment history. Multivariable regression, adjusted for age, sex, race, current smoking status, and smoking pack-years determined the association of such exposures to odds of COPD and morbidity measures. We compared these with the results of a single summary question regarding occupational exposure. RESULTS A total of 2772 individuals were included. Some exposure estimates, including "gases and vapors" and "dust and fumes" exposures resulted in associations with effect estimates over two times the estimated effect size when compared with a single summary question. CONCLUSIONS Use of occupational hazard categories can identify important associations with COPD morbidity while use of single-point measures may underestimate important differences in health risks.
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Affiliation(s)
- Jennifer S Rous
- From the Region VIII, Occupational Safety and Health Administration, Department of Labor, Denver, Colorado (J.S.R.); Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.S.R., P.S.J.L., K.K., J.P.B., L.Q.-A.); Department of Medicine, University of Michigan, Ann Arbor, Michigan (M.K.H., W.L.); Department of Radiology, University of Iowa, Iowa City, Iowa (E.A.H.); Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York (R.G.B.); Department of Medicine, Wake Forest University, Winston-Salem, North Carolina (S.P.P.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P., C.P., R.E.K.); Department of Medicine, University of California, Los Angeles, Los Angeles, California (C.B.C.); Department of Medicine, University of Alabama, Birmingham, Alabama (M.T.D..); Department of Medicine, University of Iowa, Iowa City, Iowa (A.P.C.); Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (M.B.D.); Department of Medicine, Johns Hopkins University, Baltimore, Maryland (N.P., N.N.H.); and Department of Medicine, Dartmouth-Hitchcock Medical Center/Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (L.M.P.)
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Bergqvist J, Bove M, Andersson A, Schiöler L, Klepaker G, Abrahamsen R, Fell AKM, Hellgren J. Chronic rhinosinusitis associated with chronic bronchitis in a five-year follow-up: the Telemark study. BMC Pulm Med 2022; 22:406. [PMID: 36348489 PMCID: PMC9644625 DOI: 10.1186/s12890-022-02203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic rhinosinusitis (CRS) is associated with generalised airway inflammation. Few studies have addressed the relationship between CRS and chronic bronchitis (CB). Methods This prospective study over a five-year period aims to investigate the risk of developing CB in subjects reporting CRS at the beginning of the study. A random sample of 7393 adult subjects from Telemark County, Norway, answered a comprehensive respiratory questionnaire in 2013 and then 5 years later in 2018. Subjects reporting CB in 2013 were excluded from the analyses. New cases of CB in 2018 were analysed in relation to having CRS in 2013 or not. Results The prevalence of new-onset CB in 2018 in the group that reported CRS in 2013 was 11.8%. There was a significant increase in the odds of having CB in 2018 in subjects who reported CRS in 2013 (OR 3.8, 95% CI 2.65–5.40), adjusted for age, sex, BMI, smoking and asthma. Conclusion In this large population sample, CRS was associated with increased odds of developing CB during a five-year follow-up. Physicians should be aware of chronic bronchitis in patients with CRS.
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Challenges in Diagnosing Occupational Chronic Obstructive Pulmonary Disease. MEDICINA-LITHUANIA 2021; 57:medicina57090911. [PMID: 34577834 PMCID: PMC8469547 DOI: 10.3390/medicina57090911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
Occupational chronic obstructive pulmonary disease (oCOPD) represents 15–20% of the global burden of this disease. Even if industrial bronchitis has long been known, new occupational hazards continue to emerge and enlarge the number of people exposed to risk. This review discusses the challenges related to the early detection of oCOPD, in the context of new exposures and of limited usage of methods for an efficient disease occupational screening. It underlines that a better translation into clinical practice of the new methods for lung function impairment measurements, imaging techniques, or the use of serum or exhaled breath inflammation biomarkers could add significant value in the early detection of oCOPD. Such an approach would increase the chance to stop exposure at an earlier moment and to prevent or at least slow down the further deterioration of the lung function as a result of exposure to occupational (inhaled) hazards.
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Cumulative Occupational Exposures and Lung-Function Decline in Two Large General-Population Cohorts. Ann Am Thorac Soc 2021; 18:238-246. [PMID: 33090904 DOI: 10.1513/annalsats.202002-113oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: Few longitudinal studies have assessed the relationship between occupational exposures and lung-function decline in the general population with a sufficiently long follow-up.Objectives: To examine the potential association in two large cohorts: the ECRHS (European Community Respiratory Health Survey) and the SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults).Methods: General-population samples of individuals aged 18 to 62 were randomly selected in 1991-1993 and followed up approximately 10 and 20 years later. Spirometry (without bronchodilation) was performed at each visit. Coded complete job histories during follow-up visits were linked to a job-exposure matrix, generating cumulative exposure estimates for 12 occupational exposures. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were jointly modeled in linear mixed-effects models, fitted in a Bayesian framework, taking into account age and smoking.Results: A total of 40,024 lung-function measurements from 17,833 study participants were analyzed. We found accelerated declines in FEV1 and the FEV1/FVC ratio for exposure to biological dust, mineral dust, and metals (FEV1 = -15.1 ml, -14.4 ml, and -18.7 ml, respectively; and FEV1/FVC ratio = -0.52%, -0.43%, and -0.36%, respectively; per 25 intensity-years of exposure). These declines were comparable in magnitude with those associated with long-term smoking. No effect modification by sex or smoking status was identified. Findings were similar between the ECRHS and the SAPALDIA cohorts.Conclusions: Our results greatly strengthen the evidence base implicating occupation, independent of smoking, as a risk factor for lung-function decline. This highlights the need to prevent or control these exposures in the workplace.
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Alqudaihi KS, Aslam N, Khan IU, Almuhaideb AM, Alsunaidi SJ, Ibrahim NMAR, Alhaidari FA, Shaikh FS, Alsenbel YM, Alalharith DM, Alharthi HM, Alghamdi WM, Alshahrani MS. Cough Sound Detection and Diagnosis Using Artificial Intelligence Techniques: Challenges and Opportunities. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2021; 9:102327-102344. [PMID: 34786317 PMCID: PMC8545201 DOI: 10.1109/access.2021.3097559] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 06/02/2023]
Abstract
Coughing is a common symptom of several respiratory diseases. The sound and type of cough are useful features to consider when diagnosing a disease. Respiratory infections pose a significant risk to human lives worldwide as well as a significant economic downturn, particularly in countries with limited therapeutic resources. In this study we reviewed the latest proposed technologies that were used to control the impact of respiratory diseases. Artificial Intelligence (AI) is a promising technology that aids in data analysis and prediction of results, thereby ensuring people's well-being. We conveyed that the cough symptom can be reliably used by AI algorithms to detect and diagnose different types of known diseases including pneumonia, pulmonary edema, asthma, tuberculosis (TB), COVID19, pertussis, and other respiratory diseases. We also identified different techniques that produced the best results for diagnosing respiratory disease using cough samples. This study presents the most recent challenges, solutions, and opportunities in respiratory disease detection and diagnosis, allowing practitioners and researchers to develop better techniques.
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Affiliation(s)
- Kawther S. Alqudaihi
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Nida Aslam
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Irfan Ullah Khan
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Abdullah M. Almuhaideb
- Department of Networks and CommunicationsCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Shikah J. Alsunaidi
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Nehad M. Abdel Rahman Ibrahim
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Fahd A. Alhaidari
- Department of Networks and CommunicationsCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Fatema S. Shaikh
- Department of Computer Information SystemsCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Yasmine M. Alsenbel
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Dima M. Alalharith
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Hajar M. Alharthi
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Wejdan M. Alghamdi
- Department of Computer ScienceCollege of Computer Science and Information TechnologyImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
| | - Mohammed S. Alshahrani
- Department of Emergency MedicineCollege of MedicineImam Abdulrahman Bin Faisal UniversityDammam31441Saudi Arabia
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Marcon A, Locatelli F, Dharmage SC, Svanes C, Heinrich J, Leynaert B, Burney P, Corsico A, Caliskan G, Calciano L, Gislason T, Janson C, Jarvis D, Jõgi R, Lytras T, Malinovschi A, Probst-Hensch N, Toren K, Casas L, Verlato G, Garcia-Aymerich J, Accordini S. The coexistence of asthma and COPD: risk factors, clinical history and lung function trajectories. Eur Respir J 2021; 58:13993003.04656-2020. [PMID: 33863744 PMCID: PMC8613837 DOI: 10.1183/13993003.04656-2020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/06/2021] [Indexed: 11/05/2022]
Abstract
RATIONALE Patients with concomitant features of asthma and chronic obstructive pulmonary disease (COPD) have a heavy disease burden. OBJECTIVES Using data collected prospectively in the European Community Respiratory Health Survey, we compared the risk factors, clinical history, and lung function trajectories from early adulthood to the late sixties of middle aged subjects having asthma+COPD (n=179), past (n=263) or current (n=808) asthma alone, COPD alone (n=111), or none of these (n=3477). METHODS Interview data and prebronchodilator FEV1 and FVC were obtained during three clinical examinations in 1991-1993, 1999-2002, and 2010-2013. Disease status was classified in 2010-2013, when the subjects were aged 40-68, according to the presence of fixed airflow obstruction (postbronchodilator FEV1/FVC below the lower limit of normal), a lifetime history of asthma, and cumulative exposure to tobacco or occupational inhalants. Previous lung function trajectories, clinical characteristics, and risk factors of these phenotypes were estimated. MAIN RESULTS Subjects with asthma+COPD reported maternal smoking (28.2%) and respiratory infections in childhood (19.1%) more frequently than subjects with COPD alone (20.9 and 14.0%, respectively). Subjects with asthma+COPD had an impairment of lung function at age 20 that tracked over adulthood, and more than half of them had asthma onset in childhood. Subjects with COPD alone had the highest lifelong exposure to tobacco smoking and occupational inhalants, and they showed accelerated lung function decline during adult life. CONCLUSIONS The coexistence between asthma and COPD seems to have its origins earlier in life compared to COPD alone. These findings suggest that prevention of this severe condition, which is typical at older ages, should start in childhood.
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Affiliation(s)
- Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Ludwig Maximilians University, Munich; Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany
| | - Bénédicte Leynaert
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP, , Villejuif, France
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation - Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland.,Medical Faculty, University of Iceland, Reykjavik, Iceland
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Theodore Lytras
- Institute for Global Health (ISGlobal), Barcelona, Spain.,Present institution: School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Nicole Probst-Hensch
- Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kjell Toren
- Occupational and Environmental Medicine, School of Public Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lidia Casas
- Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Judith Garcia-Aymerich
- Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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11
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Bhatt SP, Bodduluri S, Kizhakke Puliyakote AS, Oelsner EC, Nakhmani A, Lynch DA, Wilson CG, Fortis S, Kim V. Structural airway imaging metrics are differentially associated with persistent chronic bronchitis. Thorax 2021; 76:343-349. [PMID: 33408194 PMCID: PMC8225550 DOI: 10.1136/thoraxjnl-2020-215853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Chronic bronchitis (CB) is strongly associated with cigarette smoking, but not all smokers develop CB. We aimed to evaluate whether measures of structural airway disease on CT are differentially associated with CB. METHODS In smokers between ages 45 and 80 years, and with Global Initiative for Obstructive Lung Disease stages 0-4, CB was defined by the classic definition. Airway disease on CT was quantified by (i) wall area percent (WA%) of segmental airways; (ii) Pi10, the square root of the wall area of a hypothetical airway with 10 mm internal perimeter; (iii) total airway count (TAC) and (iv) airway fractal dimension (AFD), a measure of the complex branching pattern and remodelling of airways. CB was also assessed at the 5-year follow-up visit. MEASUREMENTS AND MAIN RESULTS Of 8917 participants, 1734 (19.4%) had CB at baseline. Airway measures were significantly worse in those with CB compared with those without CB: WA% 54.5 (8.8) versus 49.8 (8.3); Pi10 2.58 (0.67) versus 2.28 (0.59) mm; TAC 156.7 (81.6) versus 177.8 (91.1); AFD 1.477 (0.091) versus 1.497 (0.092) (all p<0.001). On follow-up of 5517 participants at 5 years, 399 (7.2%) had persistent CB. With adjustment for between-visits changes in smoking status and lung function, greater WA% and Pi10 were associated with significantly associated with persistent CB, adjusted OR per SD change 1.75, 95% CI 1.56 to 1.97; p<0.001 and 1.66, 95% CI 1.42 to 1.86; p<0.001, respectively. Higher AFD and TAC were associated with significantly lower odds of persistent CB, adjusted OR per SD change 0.76, 95% CI 0.67 to 0.86; p<0.001 and 0.69, 95% CI 0.60 to 0.80; p<0.001, respectively. CONCLUSIONS Higher baseline AFD and TAC are associated with a lower risk of persistent CB, irrespective of changes in smoking status, suggesting preserved airway structure can confer a reserve against CB.
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Affiliation(s)
- Surya P Bhatt
- Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sandeep Bodduluri
- Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Arie Nakhmani
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, USA
- Electrical Engineering, University of Alabama At Birmingham, Birmingham, Alabama, USA
| | - David A Lynch
- Radiology, National Jewish Health, Denver, Colorado, USA
| | - Carla G Wilson
- Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colorado, USA
| | - Spyridon Fortis
- Pulmonary, Critical Care and Occupation Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Victor Kim
- Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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12
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Faruque MO, Boezen HM, Kromhout H, Vermeulen R, Bültmann U, Vonk JM. Airborne occupational exposures and the risk of developing respiratory symptoms and airway obstruction in the Lifelines Cohort Study. Thorax 2021; 76:thoraxjnl-2020-216721. [PMID: 33653936 PMCID: PMC8311115 DOI: 10.1136/thoraxjnl-2020-216721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/27/2021] [Accepted: 02/05/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To date, only a few studies have investigated the associations between occupational exposures and respiratory outcomes longitudinally in the general population. We investigated the associations between occupational exposures and the development of respiratory symptoms and airway obstruction in the Lifelines Cohort Study. METHODS We included 35 739 occupationally active subjects with data on chronic cough, chronic phlegm, chronic bronchitis or airway obstruction at baseline and approximately 4.5 years follow-up. Exposures to biological dust, mineral dust, gases/fumes, pesticides, solvents and metals in the current job at baseline were estimated with the ALOHA+job-exposure matrix (JEM). Airway obstruction was defined as FEV1/FVC below the lower limit of normal. Logistic regression analysis adjusted for baseline covariates was used to investigate the associations. RESULTS At follow-up, 1888 (6.0%), 1495 (4.7%), 710 (2.5%) and 508 (4.5%) subjects had developed chronic cough, chronic phlegm, chronic bronchitis and airway obstruction, respectively. High exposure to biological dust was associated with a higher odds to develop chronic cough and chronic bronchitis. High exposure to pesticides was associated with a higher odds for the development of all respiratory symptoms and airway obstruction. In the multiple exposures analyses, only the association between pesticides exposure and respiratory symptoms remained. CONCLUSIONS Subjects exposed to high pesticides had a higher odds to develop respiratory symptoms on average 4.5 years later. Control measures should be taken to reduce pesticides exposure among the working population to prevent respiratory symptoms and airway obstruction.
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Affiliation(s)
- Md Omar Faruque
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, Netherlands
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, Netherlands
| | - H Marike Boezen
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, Netherlands
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, Netherlands
| | - Hans Kromhout
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, Netherlands
| | - Ute Bültmann
- University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, Netherlands
| | - Judith M Vonk
- University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen, Netherlands
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, Netherlands
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13
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Skaaby S, Flachs EM, Lange P, Schlünssen V, Marott JL, Brauer C, Nordestgaard BG, Sadhra S, Kurmi O, Bonde JPE. Chronic productive cough and inhalant occupational exposure-a study of the general population. Int Arch Occup Environ Health 2021; 94:1033-1040. [PMID: 33559749 DOI: 10.1007/s00420-020-01634-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Occupational inhalant exposures have been linked with a higher occurrence of chronic productive cough, but recent studies question the association. METHODS We included participants from two general population studies, the Copenhagen City General Population Study and the Copenhagen City Heart Study, to assess contemporary (year 2003-2017) and historical (1976-1983) occupational inhalant hazards. Job titles one year prior to study inclusion and an airborne chemical job-exposure matrix (ACE JEM) were used to estimate occupational exposure. The association between occupational exposures and self-reported chronic productive cough was studied using generalized estimating equations stratified by smoking status and cohort. RESULTS The population consisted of 5210 working individuals aged 20-65 from 1976 to 1983 and 64,279 from 2003 to 2017. In smokers, exposure to high levels of mineral dust, biological dust, gases & fumes and the composite variable vapours, gases, dusts or fumes (VGDF) were associated with chronic productive cough in both cohorts with odds ratios in the range of 1.2 (95% confidence interval, 1.0;1.4) to 1.6 (1.2;2.1). High levels of biological dust were only associated with an increased risk of a chronic productive cough in the 2003-2017 cohort (OR 1.5 (1.1;2.0)). In non-smokers, high levels of VGDF (OR 1.5 (1.0;2.3)) and low levels of mineral dust (OR 1.7 (1.1;2.4)) were associated with chronic productive cough in the 1976-1983 cohort, while no associations were seen in non-smokers in the 2003-2017 cohort. CONCLUSION Occupational inhalant exposure remains associated with a modestly increased risk of a chronic productive cough in smokers, despite declining exposure levels during the past four decades.
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Affiliation(s)
- Stinna Skaaby
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Peter Lange
- Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.,Department of Medicine, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Copenhagen City Heart Study, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark.,National Research Center for the Working Environment, Copenhagen, Denmark
| | - Jacob Louis Marott
- Copenhagen City Heart Study, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Børge G Nordestgaard
- Copenhagen City Heart Study, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Biochemistry, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Steven Sadhra
- Institute of Occupational and Environmental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Om Kurmi
- Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.,Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
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14
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Vlahovich KP, Sood A. A 2019 Update on Occupational Lung Diseases: A Narrative Review. Pulm Ther 2020; 7:75-87. [PMID: 33385174 PMCID: PMC8137769 DOI: 10.1007/s41030-020-00143-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/02/2020] [Indexed: 12/04/2022] Open
Abstract
Occupational lung diseases (OLDs) are caused, aggravated or exacerbated by exposures at the workplace. OLDs encompass a wide range of respiratory diseases similar to that found outside the work environment. Occupational asthma is the most commonly diagnosed OLD. Other OLDs may include acute and chronic conditions, ranging from hypersensitivity pneumonitis to chronic obstructive pulmonary disease (COPD) to pulmonary fibrosis. Historically, research into OLDs has centered on diseases resulting from exposures relevant to high-income countries and more obvious hazardous occupations, such as silicosis in coal miners. Peer-reviewed publications in 2019 have broadened the focus to include low- and middle-income countries and once-overlooked occupations such as dry cleaning and animal husbandry. Technological advances and greater understanding of disease etiology have allowed researchers and clinicians to implement improved risk analysis, screening and mitigation strategies to not only treat disease once it occurs, but to identify at-risk populations and institute protections to prevent or limit the negative impacts of workplace hazards. As recognition of OLDs as a worldwide threat in a variety of occupations increases, research is allowing for the development of better treatments and preventive measures that advance workers’ rights and ensure their continued good health.
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Affiliation(s)
- Kevin P Vlahovich
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Akshay Sood
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.
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15
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Kim V, Wang W, Mannino D, Diaz A. Association of birthplace and occupational exposures with chronic bronchitis in US Hispanics/Latinos, 2008-2011. Occup Environ Med 2020; 77:344-350. [PMID: 32165546 DOI: 10.1136/oemed-2019-106081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 01/27/2020] [Accepted: 02/21/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In the US, chronic bronchitis (CB) is common and is associated with substantial morbidity and mortality. Data on CB in the Hispanic/Latino population-a large, diverse US minority-are scarce. We aimed to test whether the prevalence of CB varies across Hispanic/Latino heritages and to identify CB risk factors, including occupational exposures, in this population. METHODS We analysed data from the Hispanic Community Health Study/Study of Latinos, a US population-based probability sample of participants aged 18-74 years (n=16 415) including those with Mexican, Puerto Rican, Dominican, Cuban, Central American and South American heritages. Participants who had a completed respiratory questionnaire and valid spirometric data were included in the analysis (n=13 259). CB, place of birth, heritage, occupational exposures and other risk factors were based on standardised questionnaires. The prevalence of CB was estimated using survey logistic regression-conditional marginal analysis. RESULTS The estimated (mean (95% CI)) overall adjusted prevalence of CB was 12.1% (9.3 to 15.6), with a large variation across heritages. Dominican heritage had a fivefold higher prevalence than South American heritage. US-born participants had a higher adjusted prevalence than their non-US-born counterparts (16.8% (12.5 to 22.1) vs 11.0% (8.5 to 14.10); p=0.022). Compared with non-exposed participants, those exposed to cleaning or disinfecting solutions had a higher adjusted prevalence of CB (12.6% (9.1 to 17.1) vs 11.8% (9.2 to 15.1); p=0.024). CONCLUSIONS The prevalence of CB was higher among Dominicans than other Hispanic/Latino heritages. CB was more prevalent among US-born participants and those exposed to cleaning and disinfecting solutions.
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Affiliation(s)
- Victor Kim
- Thoracic Medicine and Surgery, Temple University, Philadelphia, Pennsylvania, US
| | - Wei Wang
- Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts, US
| | - David Mannino
- US Medical Affairs, GlaxoSmithKline, Lexington, Kentucky, US.,Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY, US
| | - Alejandro Diaz
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, US
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16
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Marcon A, Marchetti P, Antó JM, Cazzoletti L, Cerveri I, Corsico A, Ferreira DS, Garcia-Aymerich J, Gislason D, Heinrich J, Jõgi R, Johannessen A, Leynaert B, Malinovschi A, Pin I, Probst-Hensch N, Weyler J, Janson C, Jarvis D, Accordini S. Atopy Modifies the Association Between Inhaled Corticosteroid Use and Lung Function Decline in Patients with Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:980-988.e10. [PMID: 31704441 DOI: 10.1016/j.jaip.2019.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Inhaled corticosteroids (ICSs) are the mainstay of asthma treatment, but response to medication is variable. Patients with allergic inflammation generally show a better short-term response to ICSs; however, studies on predictors of long-term response are few. OBJECTIVE To assess whether allergic sensitization can modify the association between ICS use and lung function decline over 20 years in adult asthma. METHODS We used data from the 3 clinical examinations of the European Community Respiratory Health Survey. We measured ICS use (no use, and use for <1.3, 1.3-8, and >8 years) and FEV1 decline among subjects with asthma over the 2 periods between consecutive examinations. We conducted a cohort study combining data of the 2 periods (906 observations from 745 subjects) to assess whether the association between ICS use and FEV1 decline was modified by allergic sensitization (IgE > 0.35 kU/L for any of house-dust mite, timothy grass, cat, or Cladosporium). RESULTS FEV1 decline was similar for non-ICS users, as well as ICS users for less than 1.3 years, with and without allergic sensitization. However, among subjects on ICSs for a longer period, sensitization was associated with an attenuated decline (Pinteraction = .006): in the group treated for more than 8 years, FEV1 decline was on average 27 mL/y (95% CIBonferroni-adjusted, 11-42) lower for subjects with sensitization compared with nonsensitized subjects. CONCLUSIONS Our study suggests that biomarkers of atopy can predict a more favorable long-term response to ICSs. Randomized controlled studies are needed to confirm these findings.
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Affiliation(s)
- Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Josep M Antó
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isa Cerveri
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Diogenes Seraphim Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Parana, Curitiba, Brazil
| | - Judith Garcia-Aymerich
- Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - David Gislason
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Ludwig, Maximilians University, Munich, Germany; Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Rain Jõgi
- Department of Pneumology, University of Tartu, Tartu, Estonia
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bénédicte Leynaert
- Inserm-U1168, VIMA (Aging and Chronic Diseases. Epidemiological and Public Health Approaches), Villejuif, France; UMR-S 1168, UVSQ, Univ Versailles St-Quentin-en-Yvelines, St-Quentin-en-Yvelines, France
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Isabelle Pin
- Pediatrics, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France; INSERM, Institut for Advanced Biosciences, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Joost Weyler
- Epidemiology and Social Medicine, StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep research, Uppsala University, Uppsala, Sweden
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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17
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Abstract
Cough is a physiological defense reflex for protecting the airways from aspiration and irritation. Thus, roles of environmental triggers are postulated in the pathogenesis of chronic cough. There are several lines of epidemiological evidence demonstrating the relationships between environmental irritant and pollutant exposure and chronic cough. However, positive findings from cross-sectional studies just reflect the protective nature of cough but may not properly address the true impact of environmental triggers. If harmful inhalation is repeated, cough may be seen as chronic but indeed is protective in nature. Therefore, long-term residual outcomes would be the key for understanding the effects of environmental triggers on chronic cough. The present review aims to summarize the associations between chronic cough and environmental pollutants or irritant exposure, with a focus on the long-term residual effects of (1) chronic persistent exposure and (2) acute high-intensity exposure on chronic cough, and also to examine (3) whether childhood irritant/pollutant exposure may increase the risk of chronic cough in adulthood.
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Affiliation(s)
- Eun-Jung Jo
- Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Woo-Jung Song
- Airway Sensation and Cough Research Laboratory, Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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