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Gandhi SA, Heinzerling A, Flattery J, Cummings KJ. Occupational Contributions to Respiratory Health Disparities. Clin Chest Med 2023; 44:635-649. [PMID: 37517841 PMCID: PMC10861114 DOI: 10.1016/j.ccm.2023.03.016] [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: 08/01/2023]
Abstract
Occupation is an important contributor to disparities in respiratory disease, affecting financial status, health-care access, and exposure to hazardous substances. Although occupation and associated exposures are included in the socioecological models, work exposures remain persistently absent from research on health inequities and their contribution to health. This article focuses on the occupational contribution to disparities in asthma, chronic obstructive pulmonary disease, silicosis, coronavirus disease 2019, and lung cancer. Because occupational exposures are largely preventable through proper workplace controls, the recognition of occupational causes of disease can provide an opportunity for interventions to bring about health equity.
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Affiliation(s)
- Sheiphali A Gandhi
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, 2330 Post St Ste 460, San Francisco, CA 94115, USA
| | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway P-3, Richmond, CA 94804, USA
| | - Jennifer Flattery
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway P-3, Richmond, CA 94804, USA
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway P-3, Richmond, CA 94804, USA.
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de Almeida GC, Mizutani RF, Terra-Filho M, Santos UDP. Constrictive bronchiolitis secondary to exposure to flavoring agents: a little known occupational hazard. J Bras Pneumol 2023; 49:e20220328. [PMID: 36700574 PMCID: PMC9970363 DOI: 10.36416/1806-3756/e20220328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Gustavo Corrêa de Almeida
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clinicas Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rafael Futoshi Mizutani
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clinicas Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Mario Terra-Filho
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clinicas Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Ubiratan de Paula Santos
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clinicas Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Gutor SS, Richmond BW, Du RH, Wu P, Lee JW, Ware LB, Shaver CM, Novitskiy SV, Johnson JE, Newman JH, Rennard SI, Miller RF, Blackwell TS, Polosukhin VV. Characterization of Immunopathology and Small Airway Remodeling in Constrictive Bronchiolitis. Am J Respir Crit Care Med 2022; 206:260-270. [PMID: 35550018 PMCID: PMC9890264 DOI: 10.1164/rccm.202109-2133oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Rationale: Constrictive bronchiolitis (ConB) is a relatively rare and understudied form of lung disease whose underlying immunopathology remains incompletely defined. Objectives: Our objectives were to quantify specific pathological features that differentiate ConB from other diseases that affect the small airways and to investigate the underlying immune and inflammatory phenotype present in ConB. Methods: We performed a comparative histomorphometric analysis of small airways in lung biopsy samples collected from 50 soldiers with postdeployment ConB, 8 patients with sporadic ConB, 55 patients with chronic obstructive pulmonary disease, and 25 nondiseased control subjects. We measured immune and inflammatory gene expression in lung tissue using the NanoString nCounter Immunology Panel from six control subjects, six soldiers with ConB, and six patients with sporadic ConB. Measurements and Main Results: Compared with control subjects, we found shared pathological changes in small airways from soldiers with postdeployment ConB and patients with sporadic ConB, including increased thickness of the smooth muscle layer, increased collagen deposition in the subepithelium, and lymphocyte infiltration. Using principal-component analysis, we showed that ConB pathology was clearly separable both from control lungs and from small airway disease associated with chronic obstructive pulmonary disease. NanoString gene expression analysis from lung tissue revealed T-cell activation in both groups of patients with ConB with upregulation of proinflammatory pathways, including cytokine-cytokine receptor interactions, NF-κB (nuclear factor-κB) signaling, TLR (Toll-like receptor) signaling, T-cell receptor signaling, and antigen processing and presentation. Conclusions: These findings indicate shared immunopathology among different forms of ConB and suggest that an ongoing T-helper cell type 1-type adaptive immune response underlies airway wall remodeling in ConB.
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Affiliation(s)
- Sergey S. Gutor
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Bradley W. Richmond
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Veterans Affairs Medical Center, Nashville, Tennessee
| | - Rui-Hong Du
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Pingsheng Wu
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Jae Woo Lee
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California; and
| | - Lorraine B. Ware
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ciara M. Shaver
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Sergey V. Novitskiy
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Joyce E. Johnson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John H. Newman
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Stephen I. Rennard
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Robert F. Miller
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Timothy S. Blackwell
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Veterans Affairs Medical Center, Nashville, Tennessee
| | - Vasiliy V. Polosukhin
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
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Affiliation(s)
- Alexander S Rabin
- From the Division of Pulmonary and Critical Care, Department of Medicine, Veterans Affairs Ann Arbor Healthcare System, and the Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan - both in Ann Arbor (A.S.R., C.W.D., J.J.O.); and the Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, East Orange (A.M.S., M.J.F.), and the Division of Pulmonary and Critical Care, Department of Medicine (A.M.S.), and the Departments of Pharmacology, Physiology and Neuroscience, and Physical Medicine and Rehabilitation (M.J.F.), Rutgers New Jersey Medical School, Newark
| | - Caroline W Davis
- From the Division of Pulmonary and Critical Care, Department of Medicine, Veterans Affairs Ann Arbor Healthcare System, and the Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan - both in Ann Arbor (A.S.R., C.W.D., J.J.O.); and the Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, East Orange (A.M.S., M.J.F.), and the Division of Pulmonary and Critical Care, Department of Medicine (A.M.S.), and the Departments of Pharmacology, Physiology and Neuroscience, and Physical Medicine and Rehabilitation (M.J.F.), Rutgers New Jersey Medical School, Newark
| | - Anays M Sotolongo
- From the Division of Pulmonary and Critical Care, Department of Medicine, Veterans Affairs Ann Arbor Healthcare System, and the Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan - both in Ann Arbor (A.S.R., C.W.D., J.J.O.); and the Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, East Orange (A.M.S., M.J.F.), and the Division of Pulmonary and Critical Care, Department of Medicine (A.M.S.), and the Departments of Pharmacology, Physiology and Neuroscience, and Physical Medicine and Rehabilitation (M.J.F.), Rutgers New Jersey Medical School, Newark
| | - Michael J Falvo
- From the Division of Pulmonary and Critical Care, Department of Medicine, Veterans Affairs Ann Arbor Healthcare System, and the Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan - both in Ann Arbor (A.S.R., C.W.D., J.J.O.); and the Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, East Orange (A.M.S., M.J.F.), and the Division of Pulmonary and Critical Care, Department of Medicine (A.M.S.), and the Departments of Pharmacology, Physiology and Neuroscience, and Physical Medicine and Rehabilitation (M.J.F.), Rutgers New Jersey Medical School, Newark
| | - John J Osterholzer
- From the Division of Pulmonary and Critical Care, Department of Medicine, Veterans Affairs Ann Arbor Healthcare System, and the Division of Pulmonary and Critical Care, Department of Medicine, University of Michigan - both in Ann Arbor (A.S.R., C.W.D., J.J.O.); and the Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, East Orange (A.M.S., M.J.F.), and the Division of Pulmonary and Critical Care, Department of Medicine (A.M.S.), and the Departments of Pharmacology, Physiology and Neuroscience, and Physical Medicine and Rehabilitation (M.J.F.), Rutgers New Jersey Medical School, Newark
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