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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Clarhed UKE, Johansson H, Veel Svendsen M, Toren K, Moller AK, Hellgren J. Occupational exposure and the risk of new-onset chronic rhinosinusitis â€" a prospective study 2013-2018. Rhinology 2020; 58:597-604. [PMID: 32645120 DOI: 10.4193/rhin20.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aetiology behind chronic rhinosinusitis (CRS) is still poorly understood. The aim of this study was to investigate the association between the onset of CRS and several common occupational exposures over time. METHODOLOGY An adult random population from Telemark, Norway, comprising 7,952 subjects, who answered a comprehensive respiratory questionnaire including questions on CRS and occupational exposure first in 2013 and again in 2018. RESULTS New-onset CRS during the five-year follow-up was independently associated with occupational exposure to hair-care products, cleaning agents among women, super glue, strong acids, cooking fumes and wood dust. CONCLUSION In this random population cohort from Norway, exposure to several common occupational agents, such as hair-care products, super glue and wood dust, was associated with the onset of CRS. It is important that physicians who see patients with CRS inquire about workplace exposure.
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Affiliation(s)
- U K E Clarhed
- Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - H Johansson
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - M Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - K Toren
- Occupational and Environmental Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - A K Moller
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - J Hellgren
- Department of Otorhinolaryngology, Head & Neck Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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3
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Aberg M, Robertson J, Waern M, Schaufelberger M, Kuhn HG, Aberg ND, Schioler L, Toren K, Rosengren A. P5297Body weight in adolescent men in Sweden and risk of an early acute coronary event. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
To improve cardiovascular disease (CVD) prevention, knowledge of early key risk factors, especially those that are modifiable such as overweight and obesity, is essential.
Purpose
We aimed to determine whether body mass index (BMI) at age 18 predicted early acute coronary events among men in Sweden.
Methods
Population-based Swedish cohort study of conscripts (n=1,668,921; mean age at baseline, 18.3 years) who enlisted during 1968–2005. Follow-up was done through linkage to the nationwide Swedish patient- and death registries. Risk of an acute coronary event (hospitalization for acute myocardial infarction or coronary death) during follow-up (5–46 years) was calculated with Cox proportional hazards models. Objective baseline measures of fitness and cognition were included in the models in a second set of analyses.
Results
During follow-up there were 22,412 acute coronary events (mean age at diagnosis, 50.2 (SD 7.4) years, maximum 64 years). Compared with men with BMI of 18.5 to 20.0 kg/m2, men with BMI 20 to <22.5 and 22.5 to <25.0 kg/m2 had hazard ratios (HR) of 1.17 (1.12–1.43) and 1.51 (1.44–1.59), respectively, for an acute coronary event, after adjustment for age, year of conscription, comorbidities at baseline, parental education, blood pressure, IQ, muscle strength, and fitness. Those with a BMI of ≥35 kg/m2 had an HR of 3.47 (2.75–4.39) for an event before the age of 65. The multiple-adjusted risk per 1-unit increase in BMI was 1.10 (95% CI, 1.09–1.10).
Conclusion
We found a rise in risk of an early acute coronary event detectable already at normal levels of body weight at age 18, and rising to more than 3-fold in the highest weight category. Given increasing levels of body weight, and prevalence of overweight and obesity in young adults, the current decrease in coronary heart disease incidence in Sweden may flatten or even reverse in the near future.
Acknowledgement/Funding
The Swedish Heart and Lung Foundation [2015-0438]; the Swedish Research Council [2013-5187,2013-4236]
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Affiliation(s)
- M Aberg
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - J Robertson
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - M Waern
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - M Schaufelberger
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - H G Kuhn
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - N D Aberg
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - L Schioler
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - K Toren
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - A Rosengren
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
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Aberg D, Adiels M, Lindgren M, Nyberg J, Kuhn G, Schaufelberger M, Toren K, Aberg M, Rosengren A. 4949Diverging secular trends in cardiovascular disease 21-year incidence in Swedish men born in 1950–1978. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiovascular disease (CVD) mortality is decreasing in Western countries, including Sweden. However, there are reports of increases in incidence in young people with respect to heart failure (HF) and atrial fibrillation (AF). The magnitude and causes of these changes are only partly known.
Aims
We investigated secular trends in incidence in CVD outcomes and their attenuation by changes in body mass index (BMI). The outcomes were risk of acute myocardial infarction (AMI), heart failure (HF) and atrial fibrillation (AF) as well as cardiovascular and all-cause death in a population of Swedish adolescents.
Methods
We followed a cohort of Swedish men enrolled for military service conscription in 1969–1996 (n=1,326,082; mean age=18.3) until December 2016, collected from the national inpatient (IPR) and outpatient registries (OPR). Cox-proportional hazard models were used to analyse the longitudinal change in incidence by with respect to early (0–21 years) of follow-up for subgroups with conscription 1968–1971, 1971–1976, 1976–1981, 1981–1986, 1986–1991, 1991–1996 (with the group born 1971–1976 as reference). Adjustments for potential confounders including BMI were performed.
Results
We found that CVD and all-cause mortality and MI decreased progressively during the follow-up with hazard ratios (HR) of 0.51, 95% confidence interval (CI) 0.43–0.62, HR 0.51 CI 0.57–0.62, and 0.60 CI 0.50–0.72, respectively. In contrast, we found increases in the incidence of HF (HR 1.86, CI 1.48–2.33], and AF (HR 8.26, CI 6.87–9.92). Adjustments for changes in BMI partly attenuated the changes in secular trends. Cubic spline models showed where the changes in secular trends were most prominent.
Conclusion
The incidences of cardiovascular outcomes show diverging secular changes. While MI and cardiovascular mortality are continually decreasing, there is an increase in HF and AF. The associations appear to be partly explained by changes in index BMI over time.
Acknowledgement/Funding
grants from the Swedish Government and the county councils, the ALF–GBG-719761, ALFGBG-751111, Swedish Stroke Association, Göteborg Medical Society
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Affiliation(s)
- D Aberg
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - M Adiels
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - M Lindgren
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - J Nyberg
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - G Kuhn
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - M Schaufelberger
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - K Toren
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - M Aberg
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
| | - A Rosengren
- Sahlgrenska Academy - University of Gothenburg, Goteborg, Sweden
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Lindgren M, Robertson J, Adiels M, Schaufelberger M, Aberg M, Toren K, Waern M, Aberg ND, Rosengren A. P1818Resting heart rate in late adolescence and long term risk of early heart failure in Swedish men. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Lindgren
- Sahlgrenska Academy, Institute of medicine, Dpt. of molecular and clinical Medicine, Gothenburg, Sweden
| | - J Robertson
- Sahlgrenska Academy, Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Gothenburg, Sweden
| | - M Adiels
- Sahlgrenska Academy, Institute of medicine, Dpt. of molecular and clinical Medicine, Gothenburg, Sweden
| | - M Schaufelberger
- Sahlgrenska Academy, Institute of medicine, Dpt. of molecular and clinical Medicine, Gothenburg, Sweden
| | - M Aberg
- Sahlgrenska Academy, Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Gothenburg, Sweden
| | - K Toren
- Sahlgrenska Academy, Public Health and Community Medicine, Section of Occupational and environmental medicine, Gothenburg, Sweden
| | - M Waern
- Sahlgrenska Academy, Section of Psychiatry and Neurochemistry, Gothenburg, Sweden
| | - N D Aberg
- Sahlgrenska Academy, Department of Internal Medicine, Institute of Medicine, Gothenburg, Sweden
| | - A Rosengren
- Sahlgrenska Academy, Institute of medicine, Dpt. of molecular and clinical Medicine, Gothenburg, Sweden
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Bergström G, Berglund G, Blomberg A, Brandberg J, Engström G, Engvall J, Eriksson M, de Faire U, Flinck A, Hansson MG, Hedblad B, Hjelmgren O, Janson C, Jernberg T, Johnsson Å, Johansson L, Lind L, Löfdahl CG, Melander O, Östgren CJ, Persson A, Persson M, Sandström A, Schmidt C, Söderberg S, Sundström J, Toren K, Waldenström A, Wedel H, Vikgren J, Fagerberg B, Rosengren A. The Swedish CArdioPulmonary BioImage Study: objectives and design. J Intern Med 2015; 278:645-59. [PMID: 26096600 PMCID: PMC4744991 DOI: 10.1111/joim.12384] [Citation(s) in RCA: 210] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.
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Affiliation(s)
- G Bergström
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G Berglund
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - A Blomberg
- Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden
| | - J Brandberg
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Radiology, University of Gothenburg, Gothenburg, Sweden
| | - G Engström
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - J Engvall
- Department of Clinical Physiology, County Council of Östergötland, Linköping, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - M Eriksson
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - U de Faire
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - A Flinck
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Radiology, University of Gothenburg, Gothenburg, Sweden
| | - M G Hansson
- Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - B Hedblad
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - O Hjelmgren
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - T Jernberg
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Å Johnsson
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Radiology, University of Gothenburg, Gothenburg, Sweden
| | - L Johansson
- Department of Radiology, Oncology and Radiation Science, Unit of Radiology, Uppsala, Sweden
| | - L Lind
- Department of Clinical Sciences, Uppsala University, Uppsala, Sweden
| | - C-G Löfdahl
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Respiratory Medicine and Allergology, Lund University Hospital, Lund, Sweden
| | - O Melander
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - C J Östgren
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - A Persson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Radiology in Linkoping, County Council of Östergötland, Linköping, Sweden
| | - M Persson
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - A Sandström
- Department of Public Health and Clinical Medicine, Medicine and Heart Centre, Umeå University, Umeå, Sweden
| | - C Schmidt
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - S Söderberg
- Department of Public Health and Clinical Medicine, Medicine and Heart Centre, Umeå University, Umeå, Sweden
| | - J Sundström
- Department of Clinical Sciences, Uppsala University, Uppsala, Sweden.,Uppsala Clinical Research Centre, Uppsala, Sweden
| | - K Toren
- Section of Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - A Waldenström
- Department of Public Health and Clinical Medicine Thoracic Center, Umeå University Hospital, Umeå University, Umeå, Sweden
| | - H Wedel
- Epidemiology and Biostatistics, Nordic School of Public Health, Gothenburg, Sweden
| | - J Vikgren
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Radiology, University of Gothenburg, Gothenburg, Sweden
| | - B Fagerberg
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - A Rosengren
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
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7
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Obaseki D, Potts J, Joos G, Baelum J, Haahtela T, Ahlström M, Matricardi P, Kramer U, Gjomarkaj M, Fokkens W, Makowska J, Todo‐Bom A, Toren K, Janson C, Dahlen S, Forsberg B, Jarvis D, Howarth P, Brozek G, Minov J, Bachert C, Burney P. The relation of airway obstruction to asthma, chronic rhinosinusitis and age: results from a population survey of adults. Allergy 2014; 69:1205-14. [PMID: 24841074 PMCID: PMC4233404 DOI: 10.1111/all.12447] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2014] [Indexed: 11/27/2022]
Abstract
RATIONALE There is conflicting evidence on whether patients with asthma experience an accelerated decline in lung function with age. We examined the association between postbronchodilator lung function, asthma, chronic rhinosinusitis (CRS), and atopy with age using a large European sample. METHODS In 17 centers in 11 European countries, case-control studies were nested within representative cross-sectional surveys of adults aged less than 75 years. Representative samples of participants with asthma, CRS or both and controls were assessed for postbronchodilator ventilatory function, smoking history, atopy, and treatment. Multiple regression was used to assess the interactive effects of age and diagnostic group on decline in postbronchodilator ventilatory function. RESULTS A total of 3337 participants provided adequate data (778 with asthma, 399 with CRS, 244 with both asthma and CRS and 1916 controls who had neither asthma nor CRS). Participants with asthma had lower FEV1 /FVC (-4.09% (95% CI: -5.02, -3.15, P < 0.001) and a steeper slope of FEV1 /FVC against age (-0.14%/annum [95%CI: -0.19, -0.08]) equivalent to smoking 1-2 packs of cigarettes per day. Those with atopy had a slope equivalent to controls. CONCLUSIONS People with asthma have a steeper decline in postbronchodilator lung function with age, but neither CRS nor atopy alone were associated with such decline.
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Affiliation(s)
- D. Obaseki
- Department of Medicine Obafemi Awolowo University Ile‐Ife Nigeria
- Respiratory Epidemiology and Public Health Group National Heart and Lung Institute Imperial College London London UK
| | - J. Potts
- Respiratory Epidemiology and Public Health Group National Heart and Lung Institute Imperial College London London UK
| | - G. Joos
- Department of Respiratory Medicine Ghent University Hospital Ghent Belgium
| | - J. Baelum
- Odense University Hospital Odense University Odense Denmark
| | - T. Haahtela
- Skin and Allergy Hospital Helsinki University Helsinki Finland
| | - M. Ahlström
- Skin and Allergy Hospital Helsinki University Helsinki Finland
| | - P. Matricardi
- Department of Pediatric Pneumonology and Immunology Charité‐Universitätsmedizin Berlin Berlin Germany
| | - U. Kramer
- IUF – Leibniz Research Institute for Environmental Medicine Düsseldorf Germany
- Department of Dermatology and Allergy am Biederstein Technical University Munich Munich Germany
| | - M. Gjomarkaj
- Institute of Biomedicine and Molecular Immunology National Research Council Palermo Italy
| | - W. Fokkens
- Department of Otorhinolaryngology Academic Medical Center Amsterdam the Netherlands
| | - J. Makowska
- Department of Immunology Rheumatology and Allergy Medical University of Lodz Lodz Poland
| | - A. Todo‐Bom
- Faculty of Medicine University of Coimbra Coimbra Portugal
| | - K. Toren
- Section of Occupational and Environmental Medicine University of Gothenburg Gothenburg Sweden
| | - C. Janson
- Department of Medical Sciences: Respiratory Medicine and Allergology University of Uppsala Uppsala Sweden
| | - S.‐E. Dahlen
- CfA ‐ The Centre for Allergy Research Karolinska Institute Stockholm Sweden
| | - B. Forsberg
- Occupational and Environmental Medicine Umeå University Umeå Sweden
| | - D. Jarvis
- Respiratory Epidemiology and Public Health Group National Heart and Lung Institute Imperial College London London UK
| | - P. Howarth
- Clinical and Experimental Sciences Faculty of Medicine Southampton General Hospital Southampton UK
| | - G. Brozek
- Department of Epidemiology Medical University of Silesia in Katowice Katowice Poland
| | - J. Minov
- Institute for Occupational Health of Republic of Macedonia Skopje Republic of Macedonia
| | - C. Bachert
- Upper Airway Research Laboratory University of Ghent Ghent Belgium
- Division of Ear, Nose, and Throat Diseases Clintec Karolinska Institute Stockholm Sweden
| | - P. Burney
- Respiratory Epidemiology and Public Health Group National Heart and Lung Institute Imperial College London London UK
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8
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Nyberg J, Aberg MAI, Toren K, Nilsson M, Ben-Menachem E, Kuhn HG. Cardiovascular fitness and later risk of epilepsy: A Swedish population-based cohort study. Neurology 2013; 81:1051-7. [DOI: 10.1212/wnl.0b013e3182a4a4c0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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9
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Omenaas E, Svanes C, Janson C, Toren K, Jogi R, Gislason T, Franklin KA, Gulsvik A. What can we learn about asthma and allergy from the follow-up of the RHINE and the ECRHS studies? Clin Respir J 2010; 2 Suppl 1:45-52. [PMID: 20298349 DOI: 10.1111/j.1752-699x.2008.00083.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECT The international population-based studies RHINE and ECRHS have provided new insight in the epidemiology and management of asthma, allergy and rhinitis in young adults. The aim of the present review is to focus on longitudinal results with regard incidence and net change of asthma and asthma-like symptoms, risk factors and management of asthma, with special reference to the Nordic-Baltic countries. RESULTS Asthma and rhinitis are common conditions that are important in a public health perspective. There are gender differences in incidence and remission. A socio-economic gradient that non-atopic asthma is more strongly related to poverty seems to have developed in the last decade. These findings will challenge our welfare states in the future. In addition, occupational, as well as indoor and outdoor environmental exposures, influenced the onset of asthma. The population-attributable risk for adult asthma because of occupational exposures is equivalent to an incidence of new-onset asthma of 250-300 cases per million per year. Genetic factors, allergic sensitisation, gastro-oesophageal reflux, habitual snoring, diet and other factors may also contribute to the onset of asthma and rhinitis. Even though management of asthma has improved, there are still great variations throughout Europe. These findings highlight the key role doctors and nurses play in educating and reviewing management of patients.
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Affiliation(s)
- E Omenaas
- Respiratory Research Group, Institute of Medicine, University of Bergen, Bergen, Norway.
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10
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Blanc PD, Menezes AMB, Plana E, Mannino DM, Hallal PC, Toren K, Eisner MD, Zock JP. Occupational exposures and COPD: an ecological analysis of international data. Eur Respir J 2009; 33:298-304. [PMID: 19010980 DOI: 10.1183/09031936.00118808] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The occupational contribution to chronic obstructive pulmonary disease (COPD) has yet to be put in a global perspective. In the present study, an ecological approach to this question was used, analysing group-level data from 90 sex-specific strata from 45 sites of the Burden of Obstructive Lung Disease study, the Latin American Project for the Investigation of Obstructive Lung Disease and the European Community Respiratory Health Survey follow-up. These data were used to study the association between occupational exposures and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II or above. Regression analysis of the sex-specific group-level prevalence rates of COPD at each site against the prevalence of occupational exposure and ever-smoking was performed, taking into account mean smoking pack-yrs and mean age by site, sex, study cohort and sample size. For the entire data set, the prevalence of exposures predicted COPD prevalence (0.8% increase in COPD prevalence per 10% increase in exposure prevalence). By comparison, for every 10% increase in the proportion of the ever-smoking population, the prevalence of COPD GOLD stage II or above increased by 1.3%. Given the observed median population COPD prevalence of 3.4%, the model predicted that a 20% relative reduction in the disease burden (i.e. to a COPD prevalence of 2.7%) could be achieved by a 5.4% reduction in overall smoking rates or an 8.8% reduction in the prevalence of occupational exposures. When the data set was analysed by sex-specific site data, among males, the occupational effect was a 0.8% COPD prevalence increase per 10% change in exposure prevalence; among females, a 1.0% increase in COPD per 10% change in exposure prevalence was observed. Within the limitations of an ecological analysis, these findings support a worldwide association between dusty trades and chronic obstructive pulmonary disease for both females and males, placing this within the context of the dominant role of cigarette smoking in chronic obstructive pulmonary disease causation.
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Affiliation(s)
- P D Blanc
- Division of Occupational and Environmental Medicine, University of California San Francisco, 350 Parnassus Ave., Suite 609, San Francisco, CA 94117, USA.
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Jacquemin B, Sunyer J, Forsberg B, Aguilera I, Briggs D, Gotschi T, Heinrich J, Toren K, Vienneau D, Kunzli N. Association between annoyance and individuals' values of nitrogen dioxide in a European setting. J Epidemiol Community Health 2008; 62:e12. [DOI: 10.1136/jech.2007.066340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Radon K, Gerhardinger U, Schulze A, Zock JP, Norback D, Toren K, Jarvis D, Held L, Heinrich J, Leynaert B, Nowak D, Kogevinas M. Occupation and adult onset of rhinitis in the general population. Occup Environ Med 2008; 65:38-43. [PMID: 17664253 DOI: 10.1136/oem.2006.031542] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Occupational exposures have been associated with an increased risk of new-onset rhinitis in apprentices. However, population-based prospective data are scarce and do not cover new onset of rhinitis later in life. The authors studied the association between occupational exposure and adult onset of rhinitis prospectively. METHODS The data of 4994 participants (age at follow-up 28-57 years) from 27 centres of the European Community Respiratory Health Survey II who were symptom-free at baseline were analysed. As outcome at follow-up self-reported (a) nasal allergies ("allergic rhinitis") and (b) runny, blocked nose for 12 months a year ("perennial rhinitis") were used. Occupational exposures at any time during follow-up were defined by job title. RESULTS The cumulative incidence of allergic rhinitis, perennial rhinitis and both conditions was 12%, 11% and 3%, respectively. Compared to office workers, male medical professionals were at increased risk of new onset of allergic rhinitis (OR 3.0; 95% CI 1.4 to 6.4). Odds ratios were reduced in metal workers not involved in metal making or treating (0.3; 95% CI 0.1 to 0.7). For perennial rhinitis ORs were significantly increased in cleaners (1.4; 95% CI 1.0 to 2.1). CONCLUSIONS Cleaners and medical professionals may be at increased risk for adult-onset rhinitis.
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Affiliation(s)
- K Radon
- Unit for Occupational and Environmental Epidemiology & Net Teaching, Institute and Outpatient Clinic for Occupational and Environmental Medicine, Ziemssenstr 1, D-80336 Munich, Germany.
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Horváth I, Hunt J, Barnes PJ, Alving K, Antczak A, Baraldi E, Becher G, van Beurden WJC, Corradi M, Dekhuijzen R, Dweik RA, Dwyer T, Effros R, Erzurum S, Gaston B, Gessner C, Greening A, Ho LP, Hohlfeld J, Jöbsis Q, Laskowski D, Loukides S, Marlin D, Montuschi P, Olin AC, Redington AE, Reinhold P, van Rensen ELJ, Rubinstein I, Silkoff P, Toren K, Vass G, Vogelberg C, Wirtz H. Exhaled breath condensate: methodological recommendations and unresolved questions. Eur Respir J 2005; 26:523-48. [PMID: 16135737 DOI: 10.1183/09031936.05.00029705] [Citation(s) in RCA: 835] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Collection of exhaled breath condensate (EBC) is a noninvasive method for obtaining samples from the lungs. EBC contains large number of mediators including adenosine, ammonia, hydrogen peroxide, isoprostanes, leukotrienes, nitrogen oxides, peptides and cytokines. Concentrations of these mediators are influenced by lung diseases and modulated by therapeutic interventions. Similarly EBC pH also changes in respiratory diseases. The aim of the American Thoracic Society/European Respiratory Society Task Force on EBC was to identify the important methodological issues surrounding EBC collection and assay, to provide recommendations for the measurements and to highlight areas where further research is required. Based on the currently available evidence and the consensus of the expert panel for EBC collection, the following general recommendations were put together for oral sample collection: collect during tidal breathing using a noseclip and a saliva trap; define cooling temperature and collection time (10 min is generally sufficient to obtain 1-2 mL of sample and well tolerated by patients); use inert material for condenser; do not use resistor and do not use filter between the subject and the condenser. These are only general recommendations and certain circumstances may dictate variation from them. Important areas for future research involve: ascertaining mechanisms and site of exhaled breath condensate particle formation; determination of dilution markers; improving reproducibility; employment of EBC in longitudinal studies; and determining the utility of exhaled breath condensate measures for the management of individual patients. These studies are required before recommending this technique for use in clinical practice.
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Affiliation(s)
- I Horváth
- National Korányi Institute for Pulmonology, Dept of Pathophysiology, Budapest PO Box 1, Piheno u. 1. H-1529, Hungary.
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Abstract
There is accumulating evidence that the workplace environment contributes significantly to the general burden of asthma. The purpose of this review is to explore the respiratory health and socioeconomic consequences of work-related asthma by addressing a series of controversial issues: 1) what is the natural history of occupational asthma and in what ways does ongoing exposure to the causal agent impact clinical outcomes?; 2) how does the natural history of irritant-induced asthma differ in its health outcomes from immunologically-mediated occupational asthma?; 3) do working conditions have a significant impact on asthma regardless of the aetiology of the disease?; 4) what is the scope of work disability from work-related-asthma in social and economic terms?; 5) what is the clinician's role in reducing the respiratory health consequences of work-related asthma? 6) to what extent do existing compensation and other social insurance schemes successfully address occupational asthma and work-aggravated asthma?
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Affiliation(s)
- O Vandenplas
- Service de Pneumologie, Cliniques de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium.
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Abstract
PURPOSE Many occupational factors can cause asthma or reactivate preexisting disease. We carried out a critical review and synthesis of the available literature to estimate the proportion of adult asthma that is attributable to workplace factors. METHODS We reviewed published citations from 1966 through May 1999 as well as recent abstracts of studies providing risk estimates for asthma among various occupations. We extracted published attributable risk estimates, derived others from published data, and extrapolated estimates from the incidence rates of occupational asthma. We used a semiquantitative score to rank studies based on their characteristics. RESULTS We obtained 43 attributable risk estimates from 19 different countries: 23 were published estimates, 8 were derived from published data, and 12 were extrapolated from incidence data. The median value for the attributable risk of occupationally associated asthma was 9%(25th to 75th interquartile range: 5% to 19%). The derived estimates (median attributable risk = 25%) were significantly greater than published values (median = 9%, P = 0.002), whereas the extrapolated estimates were significantly lower (median = 5%, P = 0.04). The 12 highest scored studies based on their characteristics yielded a median risk estimate of 15%. CONCLUSION Occupational factors are associated with about 1 in 10 cases of adult asthma, including new onset disease and reactivation of preexisting asthma.
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Affiliation(s)
- P D Blanc
- Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, 94143-0924, USA
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Jarvholm B, Larsson S, Hagberg S, Olling S, Ryd W, Toren K. Quantitative importance of asbestos as a cause of lung cancer in a Swedish industrial city: a case-referent study. Eur Respir J 1993. [DOI: 10.1183/09031936.93.06091271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We wanted to assess the quantitative importance of asbestos as a cause of lung cancer. In a case-referent study, the exposure to asbestos, tobacco smoke and some other occupational exposures were compared between 147 cases of lung cancer (100 men, 47 women), 111 hospital referents, and 109 population referents, all below the age of 75 yrs and living in an industrial city. The attributable risk of lung cancer due to asbestos exposure was 16% in men (95% confidence interval 1-31%). No woman had occupational exposure to asbestos. We conclude that in the mid 1980's tobacco smoking was the major attributable risk, being 95% for men and 78% for women, but that in men asbestos was an appreciable contributing factor in the general population of a Swedish industrial city.
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