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Sousa AW, Barros Cabral AL, Arruda Martins M, Carvalho CRF. Risk factors for fixed airflow obstruction in children and adolescents with asthma: 4-Year follow-up. Pediatr Pulmonol 2020; 55:591-598. [PMID: 31909900 DOI: 10.1002/ppul.24625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/23/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Asthma is a disease with reversible bronchoconstriction; however, some patients develop fixed airflow obstruction (FAO). Previous studies have reported the incidence and risk factors of FAO in adults; however, the corresponding factors in children remain poorly understood. AIM To evaluate the incidence and risk factors of FAO in children and adolescents with asthma. METHOD Observational and prospective cohort study with a 4-year follow-up of clinically stable patients with asthma (from 6-8 years old). Anthropometric data, history of asthma, number of hospitalizations, frequent exacerbations, asthma severity, asthma control, inhaled corticosteroid dose, atopy, and lung function were analyzed as potential risk factors for FAO. FAO was defined by a ratio of the forced expiratory volume in the first second to the forced vital capacity below the lower limit of normal, even after inhaled and oral corticosteroid treatment. RESULTS Four hundred and twenty-eight patients were recruited, and 358 were analyzed. The FAO incidence in children and adolescents with asthma was 9.5% (n = 34), starting at 10 years of age. Age, body mass index, hospitalizations for asthma, bronchodilator response, frequent exacerbations, length of exacerbations, and asthma severity were associated with FAO. Frequent exacerbations (odds ratio [OR] = 4.0; 95% confidence interval [CI] = 1.3-11.7) and asthma severity categorized as steps 4 to 5 (OR = 3.5; 95% CI = 1.6-7.6) remained risk factors. CONCLUSIONS Frequent exacerbations and asthma severity are the risk factors for FAO in children and adolescents with asthma.
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Affiliation(s)
- Andrey W Sousa
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Milton Arruda Martins
- Department of Clinical Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
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Oluwole O, Rennie DC, Afanasieva A, Lawson JA. Personal and early life factors associated with new-onset asthma, remission, and persistence of asthma in a 2-year follow-up of schoolchildren. J Asthma 2020; 58:488-496. [PMID: 31906746 DOI: 10.1080/02770903.2019.1709865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The natural course of childhood asthma, after its onset, is characterized by periods of persistence, relapse and remission. To investigate personal and early life factors associated with new-onset asthma, persistence and remission among children. METHODS The study was conducted in the province of Saskatchewan, Canada. Children in grades Kindergarten to Grade 8 (ages 5-14 years) participated in a cross-sectional study in 2013. In 2015, we approached those who gave consent in 2013 to be re-contacted, creating a prospective cohort. Data were collected using questionnaires in both years. Participants in 2013 who also had data in 2015 (25%: n = 324/1,348) had their asthma status reclassified and longitudinal descriptors were applied: "no asthma", "new-onset asthma", "persistent" or "remission". Personal and early life factors associations with asthma outcomes in 2015 were evaluated. RESULTS Among those without asthma in 2013 (n = 245), the incidence of new-onset asthma in 2015 was 7.2%. Among those with asthma in 2013 (n = 79), 47.1% had remission and 52.9% had persistent asthma in 2015. Parental history of asthma (adjusted odds ratio (aOR): 4.99; 95% confidence interval (CI): 1.88-28.27), early life respiratory infection (aOR: 1.92; 95%CI: 1.47-7.88), early life allergy [aOR: 6.39; 95%CI: 1.34-30.58) and early life infection (aOR: 4.99; 95%CI: 1.19-20.93) were associated with new onset asthma. Similarly, while parental history of asthma (aOR: 1.13; 95%CI: 0.29-4.34), early life respiratory infection (aOR: 2.71; 95%CI: 0.70-10.45), and early life ear infection (aOR: 1.34; 95%CI: 0.36-5.05) were also positively association with persistent asthma, the associations were not statistically significant. CONCLUSION Parental history of asthma, early life respiratory infection and allergy might not only influence the onset of childhood asthma but also be associated with asthma persistence.
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Affiliation(s)
- Oluwafemi Oluwole
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.,Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna C Rennie
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.,Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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3
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Haines SR, Adams RI, Boor BE, Bruton TA, Downey J, Ferro AR, Gall E, Green BJ, Hegarty B, Horner E, Jacobs DE, Lemieux P, Misztal PK, Morrison G, Perzanowski M, Reponen T, Rush RE, Virgo T, Alkhayri C, Bope A, Cochran S, Cox J, Donohue A, May AA, Nastasi N, Nishioka M, Renninger N, Tian Y, Uebel-Niemeier C, Wilkinson D, Wu T, Zambrana J, Dannemiller KC. Ten questions concerning the implications of carpet on indoor chemistry and microbiology. BUILDING AND ENVIRONMENT 2019; 170:1-16. [PMID: 32055099 PMCID: PMC7017391 DOI: 10.1016/j.buildenv.2019.106589] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Carpet and rugs currently represent about half of the United States flooring market and offer many benefits as a flooring type. How carpets influence our exposure to both microorganisms and chemicals in indoor environments has important health implications but is not well understood. The goal of this manuscript is to consolidate what is known about how carpet impacts indoor chemistry and microbiology, as well as to identify the important research gaps that remain. After describing the current use of carpet indoors, questions focus on five specific areas: 1) indoor chemistry, 2) indoor microbiology, 3) resuspension and exposure, 4) current practices and future needs, and 5) sustainability. Overall, it is clear that carpet can influence our exposures to particles and volatile compounds in the indoor environment by acting as a direct source, as a reservoir of environmental contaminants, and as a surface supporting chemical and biological transformations. However, the health implications of these processes are not well known, nor how cleaning practices could be optimized to minimize potential negative impacts. Current standards and recommendations focus largely on carpets as a primary source of chemicals and on limiting moisture that would support microbial growth. Future research should consider enhancing knowledge related to the impact of carpet in the indoor environment and how we might improve the design and maintenance of this common material to reduce our exposure to harmful contaminants while retaining the benefits to consumers.
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Affiliation(s)
- Sarah R. Haines
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Environmental Health Sciences, College of Public Health, and Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, 43210, USA
| | - Rachel I. Adams
- Plant & Microbial Biology, University of California, Berkeley, CA, 94720, USA
| | - Brandon E. Boor
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | | | - John Downey
- Cleaning Industry Research Institute, Granville, OH, 43023, USA
| | - Andrea R. Ferro
- Department of Civil and Environmental Engineering, Clarkson University, Potsdam, NY, 13699, USA
| | - Elliott Gall
- Department of Mechanical and Materials Engineering, Portland State University, Portland, OR, 97201, USA
| | - Brett J. Green
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
| | - Bridget Hegarty
- Civil and Environmental Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Elliott Horner
- UL Environment and Sustainability, Marietta, GA, 30067, USA
| | - David E. Jacobs
- National Center for Healthy Housing, Columbia, MD, 21044, USA
| | - Paul Lemieux
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Pawel K. Misztal
- Department of Civil, Architectural and Environmental Engineering, University of Texas at Austin, Austin, TX, 78712, USA
| | - Glenn Morrison
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Matthew Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Tiina Reponen
- Division of Environmental and Industrial Hygiene, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, 45220, USA
| | - Rachael E. Rush
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, 26505, USA
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, 26506, USA
| | - Troy Virgo
- Shaw Industries, Inc., Dalton, GA, 30722-2128, USA
| | - Celine Alkhayri
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Ashleigh Bope
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Environmental Health Sciences, College of Public Health, and Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, 43210, USA
| | - Samuel Cochran
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Environmental Health Sciences, College of Public Health, and Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, 43210, USA
| | - Jennie Cox
- Division of Environmental and Industrial Hygiene, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, 45220, USA
| | - Allie Donohue
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Andrew A. May
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Nicholas Nastasi
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, Environmental Health Sciences, College of Public Health, and Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, 43210, USA
| | - Marcia Nishioka
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Nicole Renninger
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Yilin Tian
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, 94720, USA
| | - Christina Uebel-Niemeier
- Division of Environmental and Industrial Hygiene, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, 45220, USA
| | | | - Tianren Wu
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Jordan Zambrana
- Indoor Environments Division, Office of Air and Radiation, U.S. Environmental Protection Agency, Washington, DC, 20460, USA
| | - Karen C. Dannemiller
- Department of Civil, Environmental & Geodetic Engineering, College of Engineering, and Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
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Al-Ghamdi BR, Koshak EA, Omer FM, Awadalla NJ, Mahfouz AA, Ageely HM. Immunological Factors Associated with Adult Asthma in the Aseer Region, Southwestern Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142495. [PMID: 31336954 PMCID: PMC6678431 DOI: 10.3390/ijerph16142495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 01/09/2023]
Abstract
Background: The prevalence of asthma is on the rise in Saudi Arabia. Data regarding the immunological profile of asthma in adults in the Aseer region, in southwestern Saudi Arabia, have not been well studied. Objectives: Our aim was to study the immunological factors associated with sensitization to asthma among adults in the Aseer region. Methods: A cross-sectional study with a nested case control design in a 1:1 ratio was conducted on a sample of adults attending primary health care centers in the Aseer region. The study used a validated Arabic version of the International study of asthma and allergies in childhood (ISAAC) questionnaire. The presence of wheezing in the past 12 months was used as a proxy for bronchial asthma. Matched age and sex controls were selected. Both groups were tested for complete blood count (CBC), total and differential white blood cell (WBC) count including eosinophils, total immunoglobulin E (IgE) measurement, allergen-specific immunoglobulin E (IgE), and cytokine levels. Results: The present study included 110 cases and 157 age- and sex-matched controls. Rye wheat was found to be a significant outdoor sensitizing agent ((odds ratio) OR = 5.23, 95% CI: 1.06–25.69). Indoors, house dust mites Dermatophagoides petronyssinus (OR = 2.04, 95% CI: 1.04–3.99) and Dermatophagoides farinae (OR = 2.50, 95% CI: 1.09–5.75) were significant. Higher total IgE (OR = 1.84, 95% CI: 1.10–3.06) and eosinophil levels (OR = 2.85, 95% CI: 1.14–7.15) were significantly associated with adult bronchial asthma in Aseer. On the other hand, the role of cytokines was not significant. Conclusions: In the present study, certain environmental agents were found to be important with regards to sensitization to bronchial asthma in adults. Knowledge about these sensitization agents should be disseminated to health providers and treating physicians in order to enhance preventive environmental control measures and asthma management. Asthma-treating physicians in the region should be alerted to the use of targeted biological therapies in selected asthmatics with difficult-to-control courses.
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Affiliation(s)
- Badr R Al-Ghamdi
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia.
| | - Emad A Koshak
- Department of Internal Medicine, College of Medicine, King Abdul Aziz University, Jeddah 21589, Saudi Arabia
| | - Fakhreldin M Omer
- Department of Clinical Microbiology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Nabil J Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Department of Community Medicine, College of Medicine Mansoura University, Mansoura 35516, Egypt
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt
| | - Hussein M Ageely
- Department of Internal Medicine, College of Medicine, Jazan University, Jazan 45142, Saudi Arabia
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