Factors affecting the development of lung function in Tunisian children

Associations of PFASs and Pesticides with Lung Function Changes from Adolescence to Young Adulthood in the ESPINA study

Per- and polyfluoroalkyl substances (PFASs) and pesticides are ubiquitous environmental exposures with increasingly recognized adverse health outcomes; however, their impact on lung function, particularly in combination, remains poorly understood. We included 381 adolescent participants from a prospective cohort study in Ecuador who underwent measurements of serum PFAS (perfluorooctanoic acid [PFOA], perfluorooctanesulfonic acid [PFOS] and perfluorononanoic acid [PFNA]) and urinary herbicides (glyphosate, 2,4D) and fungicides (ethylene thiourea) and had spirometric measurements in either 2016 or 2022. We characterized the association between each PFAS or pesticide and each lung function measure in log-log models estimated via ordinary least squares regression. We used quantile g-computation to assess the association of the mixture of PFAS and pesticides with lung function outcomes. After accounting for multiple hypothesis testing, and in models adjusting for household income, parental education, and exposure to tobacco, we found that, individually, PFOA, glyphosate, and ETU were associated with slight increases in FEV1/FVC between 2016 and 2022. No other individual associations were significant. In mixtures analyses, a one quartile increase in all PFASs and pesticides simultaneously was also not associated with statistically significant changes in lung function outcomes after accounting for multiple hypothesis testing. In large part, we do not provide evidence for associations of PFAS and herbicide and fungicide pesticides with lung function among adolescents in moderate-to-high-altitude agricultural communities in Ecuador.

Physical Activity Predicts Better Lung Function in Children and Adolescents

PURPOSE

To investigate (1) whether physical activity is associated with lung function in children and adolescents, (2) whether this association is modified by the subjects' weight status, and (3) whether this association is mediated by the body mass index.

METHODS

This is a cross-sectional study including 460 participants aged 7-17 years, randomly selected from 13 public schools in southern Brazil. Collected data included anthropometric measures, physical activity, screen time, and spirometric measures expressed as percent predicted values. Data were analyzed using multiple linear regression and 2-way analysis of variance.

RESULTS

There were positive associations between physical activity and forced vital capacity (β = 3.897, P = .001) and forced expiratory volume in the first second (β = 2.931, P = .021). The effect modification by weight status was not statistically significant (forced vital capacity: Pinteraction = .296 and forced expiratory volume in the first second: Pinteraction = .057). Body mass index did not mediate the association between physical activity and spirometric outcomes (P > .05).

CONCLUSION

Regular physical activity was associated with higher forced vital capacity and forced expiratory volume in the first second in children and adolescents. The observed associations were not modified by weight status nor mediated by body mass index. Our results reinforce the importance of regular physical activity for the development of lung function during childhood and adolescence.

Binational survey using Mytilus galloprovincialis as a bioindicator of microplastic pollution: Insights into chemical analysis and potential risk on humans

Microplastic (MP) contamination in edible mussels has raised concerns due to their potential risk to human health. Aiming to provide valuable insights regarding the occurrence, physicochemical characteristics, and human health implications of MP contamination, in the present study, two nationwide surveys of MP contamination in mussels (Mytilus galloprovincialis) were conducted in Morocco and Tunisia. The results indicated that MP frequency ranged from 79 % to 100 % in all the analyzed samples. The highest MP density was detected in mussels from Morocco (gills "GI": 1.88 MPs/g ww^-1; digestive glands "DG": 0.92 MPs/g ww^-1) compared to mussels of Tunisia (GI: 1.47 MPs g^{- 1}; DG: 0.79 MPs g^{- 1}). No significant differences in MP density were found between the two organs (GI and DG) for both countries. MPs were predominantly blue and black fibers, and smaller than 1000 μm. Seven polymeric types were identified, of which PET, PP, and PE were the most abundant, accounting for >87 % of all samples. Scanning Electron Microscopy (SEM) coupled with Energy dispersive X-ray (EDX) showed that most MPs have noticeable signs of weathering and inorganic components on their surface. The highest MP daily intake was found in children, while the lowest was estimated in women and men. Moreover, the annual dietary exposure of MPs through mussel consumption was estimated to be 1262.17 MPs/year in Morocco and 78.18 MPs/year in Tunisia. The potential risk assessment of MPs in mussels based on the polymer hazard index (PHI) was estimated in the high-risk levels, implying that MPs may pose health risks to humans. Overall, this research suggests that the consumption of mussels represents a considerable MP exposure route for the Moroccan and Tunisian populations.

The Association of Self-Reported Birthweight with Lung Function and Respiratory Diseases: Results from a Multi-Centre, Multi-Case Control Study in Italy

Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW), however, is conflicting. We examined associations of self-reported BW with lung function and the development of respiratory and also non-respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) project, an Italian multi-centre, multi-case control study involving cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status as response variable; BW as main determinant; and adjusting for sex, age and smoking status. Of the 2287 participants reporting BW, 6.4% (n = 147) had low BW (<2500 g), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Both men and women with low BW were shorter than those with normal BW (mean ± SD: 160.2 ± 5.5 vs. 162.6 ± 6.5 cm in women, p = 0.009; 172.4 ± 6.1 vs. 174.8 ± 7.2 cm in men, p < 0.001). Although FEV1 and FVC were reduced in individuals with low BW, this was explained by associations with sex and height. In multivariable analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before the age of two (10.3% vs. 4.1%; p < 0.001), severe respiratory infection before the age of five (16.9% vs. 8.8%; p = 0.001) and hypertension in adulthood (29.9% vs. 23.7%; p = 0.001); however, they had a lower risk of arrhythmia (2.7% vs. 5.8%; p = 0.027).

Microplastics in fillets of Mediterranean seafood. A risk assessment study

Microplastics (MPs) are considered as emergent threat to human health. No complete data still exists on MPs presence in fish tissue and their transmission to humans. The present study aims to detect and quantify the presence of MPs (<3 μm) in several edible seafood (Sardina pilchardus, wild and farmed Sparus aurata, Mullus surmuletus, Solea solea and musselMytilus galloprovincialis) from the south coast of Mediterranean Sea. MPs were detected through an innovative extraction method coupled to the SEM-EDX technology. The Estimated Daily Intakes (EDIs) for adults and children for each species were calculated. The higher median level (IQR) of MPs (9.09E+04) was found inM. surmuletus. Conversely, the lower median (IQR) level was observed in S. pilchardus (7.04E+04). The smallest and biggest median (IQR)diameter of MPs (1.8 and 2.5 μm) were identified in M. galloprovincialisand S. solea, respectively. The highest EDIs (25.50E+03; 48.09E+03) arefor ingestion of farmedS. auratarespectively for adults and children. Instead, the lowest EDIs (2.37E+02; 4.48E+02) are due to M. galloprovincialisingestion for adults and children, respectively. Our data should be carefully considered in view of the direct exposure of humans to plastic particles under 3 μm through seafood consumption to better manage the related risks.

Physical-activity trajectories during childhood and lung function at 15 years: findings from the ALSPAC cohort

Background

Although physical activity has many known health benefits, its association with lung function in childhood/adolescence remains unclear. We examined the association of physical-activity trajectories between 11 and 15 years with lung function at 15 years in 2266 adolescents.

Methods

A population-based cohort of 14 305 singleton births alive at 1 year was recruited in the UK population-based Avon Longitudinal Study of Parents and Children cohort. Physical activity (counts/minute and moderate-to-vigorous physical activity) was assessed for 7 days using an accelerometer at 11, 13 and 15 years. We identified sex-specific physical-activity trajectories applying K-means for longitudinal data in children with at least two accelerometer measurements (n = 3584). We then estimated the sex-specific associations of these trajectories with post-bronchodilation lung-function parameters using multivariable linear-regression models (n = 2266, 45% boys).

Results

Fewer than 7% of participants met the WHO physical-activity recommendations (i.e. daily average of at least 60 minutes of moderate-to-vigorous physical activity). Boys were substantially more active than girls. In both sexes, we identified three distinct physical-activity trajectories (‘low’: 39.8% boys, 45.8% girls; ‘moderate’: 42.9% boys, 41.4% girls; and ‘high’ physical activity: 17.3% boys, 12.8% girls). Girls in the moderate and high physical-activity trajectories had 0.11 L [95% confidence interval (CI): 0.04–0.19] and 0.15 L (95% CI: 0.03–0.26) higher forced vital capacity than their less-active peers. No association was observed in boys.

Conclusions

Higher childhood physical activity relates to higher lung-function levels in adolescent girls. A better understanding of the mechanisms underlying this association should be pursued.

Socioeconomic circumstances and respiratory function from childhood to early adulthood: a systematic review and meta-analysis

OBJECTIVE

Disadvantaged socioeconomic circumstances in early life have the potential to impact lung function. Thus, this study aimed to summarise evidence on the association between socioeconomic circumstances and respiratory function from childhood to young adulthood.

DESIGN

Systematic review and meta-analysis.

METHODS

Following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, Medline, ISI-Web of Science and Scopus were searched from inception up to January 2018. Original studies on the association between socioeconomic circumstances and respiratory function in early ages (ie, participants younger than 25 years of age) were investigated. Two investigators independently evaluated articles, applied the exclusion criteria, extracted data and assessed the risk of bias using the Newcastle-Ottawa Scale. A meta-analysis of the standardised mean difference and 95% CI in respiratory function between participants from different socioeconomic circumstances was conducted, using a random-effects model.

RESULTS

Thirty-three papers were included in this review and 23 showed that disadvantaged socioeconomic circumstances were significantly associated with reduced respiratory function. The meta-analysis including seven papers showed a significant difference of -0.31 (95% CI -0.42 to -0.21) litres in forced expiratory volume in the first second between children, adolescents and young adults from disadvantaged versus advantaged socioeconomic circumstances. Specifically a difference of -0.31 (95% CI -0.51 to -0.10) litres in girls and -0.43 (95% CI -0.51 to -0.35) litres in boys was observed.

CONCLUSIONS

Children, adolescents and young adults from disadvantaged socioeconomic circumstances had lower respiratory function, and boys presented higher respiratory health inequalities. This information contributes to explain the social patterning of respiratory diseases, and might enable health policy makers to tackle respiratory health inequalities at early ages.

Does physical fitness enhance lung function in children and young adults?

Although physical activity is important for lung health, it is unclear whether physical fitness influences lung function. We investigated associations between lung function and fitness in two population-based cohort studies of children and young adults.Aerobic fitness was measured using a maximal cycle ergometer test at ages 9, 15, 21 and 29 years in Odense, Denmark and using a submaximal cycle test at ages 15, 26, 32 and 38 years in Dunedin, New Zealand.Aerobic fitness was positively associated with forced expiratory volume in 1 s (FEV₁) and forced vital capacity (FVC) in cross-sectional analyses at all ages in both cohorts, independently of height, weight, sex, asthma and smoking. Each standard deviation difference in fitness was associated with 2-3% predicted higher values of FEV₁ and FVC. Improvements in fitness during childhood and adolescence were associated with growth in lung volumes in longitudinal analyses. These associations tended to be stronger in males than females. No longitudinal associations were found after peak adult lung function had been attained. Fitness was not significantly associated with FEV₁/FVC ratios.Aerobic fitness is positively associated with lung volumes. Improving fitness during childhood and adolescence is associated with greater adult lung volumes, but not with airway calibre.

Which early life events or current environmental and lifestyle factors influence lung function in adolescents? - results from the GINIplus & LISAplus studies

BACKGROUND

Various factors may affect lung function at different stages in life. Since investigations that simultaneously consider several factors are rare, we examined the relative importance of early life, current environmental/lifestyle factors and allergic diseases on lung function in 15-year-olds.

METHODS

Best subset selection was performed for linear regression models to investigate associations between 21 diverse early life events and current factors with spirometric parameters (forced vital capacity, forced expiratory volume in 1 s and maximal mid-expiratory flow (FEF_25-75)) in 1326 participants of the German GINIplus and LISAplus birth cohorts. To reduce model complexity, one model for each spirometric parameter was replicated 1000 times in random subpopulations (N = 884). Only those factors that were included in >70% of the replication models were retained in the final analysis.

RESULTS

A higher peak weight velocity and early lung infections were the early life events prevalently associated with airflow limitation and FEF_25-75. Current environmental/lifestyle factors at age 15 years and allergic diseases that were associated with lung function were: indoor second-hand smoke exposure, vitamin D concentration, body mass index (BMI) and asthma status. Sex and height captured the majority of the explained variance (>75%), followed by BMI (≤23.7%). The variance explained by early life events was comparatively low (median: 4.8%; range: 0.2-22.4%), but these events were consistently negatively associated with airway function.

CONCLUSIONS

Although the explained variance was mainly captured by well-known factors included in lung function prediction equations, our findings indicate early life and current factors that should be considered in studies on lung health among adolescents.

Predictive models and spatial variations of vital capacity in healthy people from 6 to 84 years old in China based on geographical factors

The aim of this study was to provide a scientific basic for a unified standard of the reference value of vital capacity (VC) of healthy subjects from 6 and 84 years old in China. The normal reference value of VC was correlated to seven geographical factors, including altitude (X1), annual duration of sunshine (X2), annual mean air temperature (X3), annual mean relative humidity (X4), annual precipitation amount (X5), annual air temperature range (X6) and annual mean wind speed (X7). Predictive models were established by five different linear and nonlinear methods. The best models were selected by t-test. The geographical distribution map of VC in different age groups can be interpolated by Kriging's method using ArcGIS software. It was found that the correlation of VC and geographical factors in China was quite significant, especially for both males and females aged from 6 to 45. The best models were built for different age groups. The geographical distribution map shows the spatial variations of VC in China precisely. The VC of healthy subjects can be simulated by the best model or acquired from the geographical distribution map provided the geographical factors for that city or county of China are known.

Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations

The aim of the Task Force was to derive continuous prediction equations and their lower limits of normal for spirometric indices, which are applicable globally. Over 160,000 data points from 72 centres in 33 countries were shared with the European Respiratory Society Global Lung Function Initiative. Eliminating data that could not be used (mostly missing ethnic group, some outliers) left 97,759 records of healthy nonsmokers (55.3% females) aged 2.5-95 yrs. Lung function data were collated and prediction equations derived using the LMS method, which allows simultaneous modelling of the mean (mu), the coefficient of variation (sigma) and skewness (lambda) of a distribution family. After discarding 23,572 records, mostly because they could not be combined with other ethnic or geographic groups, reference equations were derived for healthy individuals aged 3-95 yrs for Caucasians (n=57,395), African-Americans (n=3,545), and North (n=4,992) and South East Asians (n=8,255). Forced expiratory value in 1 s (FEV(1)) and forced vital capacity (FVC) between ethnic groups differed proportionally from that in Caucasians, such that FEV(1)/FVC remained virtually independent of ethnic group. For individuals not represented by these four groups, or of mixed ethnic origins, a composite equation taken as the average of the above equations is provided to facilitate interpretation until a more appropriate solution is developed. Spirometric prediction equations for the 3-95-age range are now available that include appropriate age-dependent lower limits of normal. They can be applied globally to different ethnic groups. Additional data from the Indian subcontinent and Arabic, Polynesian and Latin American countries, as well as Africa will further improve these equations in the future.

Physical activity and lung function in adolescents: the 1993 Pelotas (Brazil) birth cohort study

PURPOSE

To evaluate the association between physical activity changes in those aged 11 to 15 years and lung function at age 15 years.

METHODS

The original cohort comprised 5,249 hospital-born children during the calendar year of 1993 in Pelotas, Brazil. In 2004-2005 and 2008-2009, all cohort members were sought for follow-up visits. Self-reported physical activity was measured at ages 11 and 15 years. At the 2008-2009 visit, when participants were 15 years old, spirometry was performed. Linear regression was used, and all analyses were stratified by sex.

RESULTS

Of the 5,249 original members of the cohort, 4,325 were located at 15 years of age, and spirometry was performed on 4,010 members. Forced expiratory volume in 1 second was not associated with physical activity. In girls, those who were active in leisure time in both periods have better percent-predicted forced vital capacity (β = 3.573 [95% confidence interval {CI}: 1.015, 6.130]) and forced expiratory volume in the 6 seconds (β = .095 [95% CI: .021, .168]) than those who were inactive in the two periods. Also in girls, those who became active at 15 years of age had higher peak expiratory flow than those who were inactive at 11 and 15 years of age. In boys, only those who became inactive in leisure time had worse peak expiratory flow (β = -.180 [95% CI: -.339, -.021]) than boys who were inactive at ages 11 and 15 years.

CONCLUSIONS

Self-reported leisure-time physical activity was associated with better effort-dependent lung function parameters, particularly among girls.

Relationship between the lung function and anthropometric measures and indexes in adolescents from Córdoba, Argentina

OBJECTIVES

The objectives of this study were to determine the degrees of association between the Forced Vital Capacity (FVC) with four anthropometric variables: height, sitting height, surface, and body volume, and two somatometrics indexes: Body Mass Index (BMI) and Cormic index, and to confront the values of FVC obtained with the predicted ones by the method of Polgar.

METHODS

One sample of 54 boys and 31 girls was selected. All of them were 11-18 years of age, and were students of the National School of Monserrat (Cordoba, Argentina). The FVC was determined through computerized spirometer and the data were analyzed applying General Linear Models. The values of FVC were confronted with the predicted ones by the method of Polgar.

RESULTS

The results indicate the existence of direct relation, with different values from the regression coefficient, between the FVC and the somatometrics variables, with statistically significant differences between sexes. The association of the FVC with the sitting height and the Cormic index demonstrates an increased differential based on sex. The values obtained from FVC in women, similar to those predicted by the method of Polgar; do not occur in masculine sex.

CONCLUSIONS

we emphasize the observed intersexual difference when we used the Cormic index and sitting height for predicting the FVC; in contrast with the BMI, which has little explanatory power for the FVC. Finally, we also want to emphasize the necessity of counting on local reference tables for spirometric values.

[Lung function prediction equations in Tunisian children: taking into consideration pubertal stage]

OBJECTIVE

The purpose of this study was to set lung function prediction equations in Tunisian children with standing height and pubertal stage as the independent variables.

METHODS

Spirometric values were measured with a Minato portable Spirometer in 684 asymptomatic Tunisian children (351 boys and 333 girls), 8 to 16 years of age. The specific parameters of pulmonary function that were measured included Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV(1)), Peak Expiratory Flow (PEF), Maximal Expiratory Flow at 50% of the vital capacity (MEF(50)), and Maximum Mild Expiratory Flow between 25 and 75% (MMEF(25-75)). The pubertal status was assessed for males and females according to the Tanner method.

RESULTS

A large variation was observed in the distribution of children's age and height by pubertal stages in both sexes. Multiple regression equations for FVC, FEV(1), MEF(50), MEF(25-75), and PEF for both sexes are presented with standing height and pubertal stage as the independent variables.

CONCLUSION

The establishment of validated reference values relevant to the ethnic group of the local population should significantly improve medical surveillance of respiratory diseases in Tunisian children.

Changes in child exposure to secondhand smoke after implementation of smoke-free legislation in Wales: a repeated cross-sectional study

Background

Smoke-free legislation was introduced in Wales in April 2007. In response to concerns regarding potential displacement of smoking into the home following legislation, this study assessed changes in secondhand smoke (SHS) exposure amongst non-smoking children.

Methods

Approximately 1,750 year 6 (aged 10-11) children from 75 Welsh primary schools were included in cross-sectional surveys immediately pre-legislation and one year later. Participants completed self-report questionnaires and provided saliva samples for cotinine assay. Regression analyses assessed the impact of legislation on children's SHS exposure at the population level, and amongst subgroups defined by parental figures who smoke within the home.

Results

Geometric mean salivary cotinine concentrations were 0.17 ng/ml (95% CI 0.15,0.20) pre-legislation and 0.15 ng/ml (95% CI 0.13,0.17), post-legislation, although this change was not statistically significant. Significant movement was however observed from the middle (0.10-0.50 ng/ml) to lower tertile, though not from the higher end (>0.51 ng/ml) to the middle.

Reported exposure to SHS was greatest within the home. Home-based exposure did not change significantly post-legislation. Reported exposure in cafés or restaurants, buses and trains, and indoor leisure facilities fell significantly.

The proportion of children reporting that parent figures smoked in the home declined (P = 0.03), with children with no parent figures who smoke in the home significantly more likely to provide saliva with cotinine concentrations of <0.10 ng/ml post-legislation.

Amongst children with no parent figures who smoke in the home, the likelihood of 'not knowing' or 'never' being in a place where people were smoking increased post-legislation.

Conclusion

Smoke-free legislation in Wales did not increase SHS exposure in homes of children aged 10-11. Reported SHS exposure in public places fell significantly. The home remained the main source of children's SHS exposure. The legislation was associated with an unexpected reduction in cotinine levels among children with lower SHS exposure pre-legislation. The findings indicate positive rather than harmful effects of legislation on children's SHS exposure, but highlight the need for further action to protect those children most exposed to SHS.

[Determining factors of pulmonary function in healthy Tunisian children]

Introduction Pulmonary function parameters are known to vary with age, sex, height and ethnic extraction. No normal values have been reported for pulmonary function in Tunisian children. Moreover, little attention has been paid to the factors affecting the development of lung function in Tunisian healthy children. State of art Birth weight and height, physical activity level, anthropometric, socioeconomic and environmental factors could influence the development of lung function in healthy children. Perspectives The studies conducted by our group have allowed us 1) to set reference values for spirometry in healthy Tunisian children; 2) to indicate that, in Tunisian adolescents, the use of only one morphological parameter such as height, is not sufficient, but the pubertal status could be taken into account to standardize the lung function and 3) to show the main predictive factors for pulmonary development to be the anthropometric factors such as height, weight, maximal inspiratory and expiratory thoracic perimeter, sex and age, and the environmental conditions (type of heating) in our population of healthy Tunisian children. Conclusion These findings should improve medical surveillance of respiratory diseases, stipulation of preventive and therapeutic measures in Tunisian children.