1
|
Leru PM, Anton VF, Chovancova Z, Baros J, Socha K, Petkova V, Kurowski M. Evaluation of respiratory allergies burden and management in primary care and comparative analysis of health care data from Romania, Poland, Czech Republic and Bulgaria - preliminary study. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2024; 0:rjim-2024-0018. [PMID: 38656830 DOI: 10.2478/rjim-2024-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Respiratory allergies mostly allergic rhinitis and asthma represent an important and increasing public health problem and one of the priorities for the European health systems. There is an increasing public concern regarding the persistence and severity of allergic diseases and many difficulties of health systems in providing prompt specialized medical assistance. Our study aims to highlight the main results of the Alliance 4Life project focused on the evaluation of the burden and management of respiratory allergies in primary care from Romania and comparative health-related data from four Central and Eastern European countries. METHOD We developed a questionnaire focused on patients with allergic rhinitis and asthma directly addressed to general practitioner (GP) specialists from Romania who attended the annual national conference in Bucharest. RESULTS The main results showed that patients with respiratory allergies are frequently encountered in primary care practice, only a few patients are evaluated by allergists and there is a clear need for education in this field. CONCLUSIONS This preliminary study confirms that respiratory allergies represent a considerable burden in primary care and the questionnaire may be a useful tool in further studies considering the experience of other healthcare systems. More advanced studies integrating epidemiology with data on air pollution and environmental conditions should be envisaged.
Collapse
Affiliation(s)
- Polliana Mihaela Leru
- 1Clinical Department 5, Carol Davila University of Medicine and Pharmacy, 050474, Bucharest, Romania
- 2Allergology Department, Colentina Clinical Hospital, 020125, Bucharest, Romania
| | - Vlad Florin Anton
- 2Allergology Department, Colentina Clinical Hospital, 020125, Bucharest, Romania
| | - Zita Chovancova
- 3Department of Immunology and Allergy, St. Anne's University Hospital in Brno, Pekarska 53, 65691, Brno, Czechia
- 4Medical Faculty of Masaryk University, Kamenice 5, 62500, Brno, Czechia
| | - Jan Baros
- 3Department of Immunology and Allergy, St. Anne's University Hospital in Brno, Pekarska 53, 65691, Brno, Czechia
- 4Medical Faculty of Masaryk University, Kamenice 5, 62500, Brno, Czechia
| | - Konrad Socha
- 5Healthcare Systems Development Department, Medical University of Lodz, 90-419 Lodz, Poland
| | - Valentina Petkova
- 6Department of Organisation and Economics of Pharmacy, Medical University Sofia, 1431 Sofia, Bulgaria
| | - Marcin Kurowski
- 7Department of Immunology and Allergy, Medical University of Lodz, 90-419 Lodz, Poland
| |
Collapse
|
2
|
Kim J, Zaitchik B, Waugh D. How Does Climate Change Affect the Upper Airway? Otolaryngol Clin North Am 2024; 57:309-317. [PMID: 37923592 DOI: 10.1016/j.otc.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
There is mounting evidence that climate change is having a significant influence on exacerbations of airway disease. We herein explore the physical factors of carbon dioxide, temperature increases, and humidity on intensifying allergen and fungal growth, and worsening air quality. The direct influence of these factors on promoting allergic rhinitis, chronic rhinosinusitis, and allergic fungal rhinosinusitis is reviewed.
Collapse
Affiliation(s)
- Jean Kim
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, USA; Department of Medicine, Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, USA.
| | - Benjamin Zaitchik
- Department of Earth and Planetary Sciences, Kennedy Krieger School of Arts and Sciences, Johns Hopkins University, 3400 N Charles Street, Olin Hall 301, Baltimore, MD 21218, USA
| | - Darryn Waugh
- Department of Earth and Planetary Sciences, Kennedy Krieger School of Arts and Sciences, Johns Hopkins University, 3400 N Charles Street, Olin Hall 320, Baltimore, MD 21218, USA
| |
Collapse
|
3
|
Beller J, Safieddine B, Sperlich S, Tetzlaff J, Geyer S. Time trends in limited lung function among German middle-aged and older adults. Sci Rep 2024; 14:5036. [PMID: 38424128 PMCID: PMC10904379 DOI: 10.1038/s41598-024-55624-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
Limited lung function represents a serious health impairment. However, studies investigating changes in limited lung function over time are rare. Thus, the current study investigates time-related changes in limited lung function and potential social inequalities. Data from the 2008 and 2017 waves of the population-based German Aging Survey were used in a repeated cross-sectional study design (N = 8778), including participants aged 40 years and older. Lung function was assessed by the peak flow test. Socio-economic indicators included educational attainment, income and occupational group. Additionally, smoking history, occupational exposure to fumes and gases, and physical exercise were used as potentially explanatory variables for the observed changes. We found that the prevalence of limited lung function decreased strongly over time on a descriptive level from 9.0 to 5.4%. In line with these results, a decreasing trend emerged (OR = 0.48) when controlling for age and gender differences. When additionally controlling for changes in socio-economic indicators and explanatory variables there were still significant decreases over time, but the decline was slightly reduced (OR = 0.57). Moreover, similar significant relative decreases over time occurred for middle-aged and older participants, female and male participants, and those belonging to the different socio-economic groups. Thus, limited lung function generally decreased over time. This decrease could partially be explained by beneficial developments in socio-economic indicators, smoking, occupational exposures, and physical exercise. Future studies might investigate how changes in medicinal treatment and prevention efforts have contributed to the observed beneficial trends in lung health.
Collapse
Affiliation(s)
- Johannes Beller
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Batoul Safieddine
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stefanie Sperlich
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Juliane Tetzlaff
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Siegfried Geyer
- Hannover Medical School, Center for Public Health and Health Care, Medical Sociology Unit, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| |
Collapse
|
4
|
Bonomo S, Marchetti P, Fasola S, Vesentini R, Marcon A, Ferrante G, Antonicelli L, Battaglia S, Bono R, Squillacioti G, Murgia N, Pirina P, Villani S, La Grutta S, Verlato G, Viegi G. Asthma incidence can be influenced by climate change in Italy: findings from the GEIRD study-a climatological and epidemiological assessment. Sci Rep 2023; 13:19047. [PMID: 37923929 PMCID: PMC10624678 DOI: 10.1038/s41598-023-46423-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
An association between climatic conditions and asthma incidence has been widely assumed. However, it is unclear whether climatic variations have a fingerprint on asthma dynamics over long time intervals. The aim of this study is to detect a possible correlation of the Summer North Atlantic Oscillation (S-NAO) index and the self-calibrated palmer drought severity index (scPDSI) with asthma incidence over the period from 1957 to 2006 in Italy. To this aim, an analysis of non-stationary and non-linear signals was performed on the time series of the Italian databases on respiratory health (ISAYA and GEIRD) including 36,255 individuals overall, S-NAO, and scPDSI indices to search for characteristic periodicities. The ISAYA (Italian Study on Asthma in Young Adults) and GEIRD (Gene Environment Interactions in Respiratory Diseases) studies collected information on respiratory health in general population samples, born between 1925 and 1989 and aged 20-84 years at the time of the interview, from 13 Italian centres. We found that annual asthma total incidence shared the same periodicity throughout the 1957-2006 time interval. Asthma incidence turned out to be correlated with the dynamics of the scPDSI, modulated by the S-NAO, sharing the same averaged 6 year-periodicity. Since climate patterns appear to influence asthma incidence, future studies aimed at elucidating the complex relationships between climate and asthma incidence are warranted.
Collapse
Affiliation(s)
- S Bonomo
- CNR Institute of Environmental Geology and Geo-Engineering (CNR-IGAG), Montelibretti, Rome, Italy.
| | - P Marchetti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Fasola
- CNR Institute of Translational Pharmacology (CNR-IFT), Palermo, Italy
| | - R Vesentini
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Marcon
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | | | - S Battaglia
- Dipartimento PROMISE, University of Palermo, Palermo, Italy
| | - R Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - G Squillacioti
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - N Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - P Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | - S Villani
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - S La Grutta
- CNR Institute of Translational Pharmacology (CNR-IFT), Palermo, Italy
| | - G Verlato
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Viegi
- CNR Institute of Clinical Physiology (CNR-IFC), Pisa, Italy
| |
Collapse
|
5
|
Alyami MH, Naser AY, Alyami HS, Algahtani TS, Alyami AH, Alsalem SA, Almansour AH, Alswar HS, Alhareth AMA. Prevalence and Knowledge of Respiratory Symptoms Among the General Public in the Southern Area of Najran, Saudi Arabia: A Cross-Sectional Health Survey Study. Int J Gen Med 2023; 16:4077-4090. [PMID: 37700743 PMCID: PMC10495072 DOI: 10.2147/ijgm.s418152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Objective To investigate the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. Methods An online cross-sectional survey was carried out in Najran region, Saudi Arabia. A self-administered questionnaire was distributed among a random sample of the general population, aged 18 or above between March and December 2022. The survey instrument included questions regarding history and exposure, physician diagnosed-disorders, respiratory symptoms, allergy, use of medications and possible risk-related factors. Results This research had a total of 712 individuals. Nearly one-third of the participants in the survey (n = 218; 30.6%) said that they or a member of their family suffer from respiratory ailments. The majority of research participants (n = 167; 76.8%) identified asthma as their primary respiratory condition. A total of 32.0% of participants (n = 70) reported dealing with dust or chemicals such as paints, fertilizers, and cleaning products on a daily basis at work or at home. Around 62.0% of the participants (n = 134) said that exposure to gases, fragrances, and other such substances negatively impacts their health. Almost 78.0% (n = 169) of them indicated that summer weather affects their health, whereas 63.0% (n = 138) reported that winter cold affects their health. Participants aged 41-50 years were 38.0% less likely to have CRDs compared to others (p < 0.05). Conclusion This study is among the first few studies that explored the knowledge, prevalence of chronic respiratory disorders, and utilization of their medications among the adults at Najran region, Saudi Arabia. In the southern area of Najran, respiratory symptoms are frequent among the inhabitants of Saudi Arabia. More research is required to discover avoidable risk factors and create countermeasures for them. It is recommended that healthcare personnel increase their efforts to educate their patients about respiratory illness prevention methods.
Collapse
Affiliation(s)
- Mohammad H Alyami
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Abdallah Y Naser
- Department of Applied Pharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Hamad S Alyami
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Thamer S Algahtani
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Abdullah H Alyami
- Directorate of Health Affairs Najran, Ministry of Health, Najran, Saudi Arabia
| | - Saleh A Alsalem
- Directorate of Health Affairs Najran, Ministry of Health, Najran, Saudi Arabia
| | | | - Hadi S Alswar
- Directorate of Health Affairs Najran, Ministry of Health, Najran, Saudi Arabia
| | - Ali M Al Alhareth
- Directorate of Health Affairs Najran, Ministry of Health, Najran, Saudi Arabia
| |
Collapse
|
6
|
Candy S, Reeve J, Dobson R, Whittaker R, Garrett J, Warren J, Calder A, Tane T, Robertson T, Rashid U, Taylor D. The Impact of Patient Preference on Attendance and Completion Rates at Centre-Based and mHealth Pulmonary Rehabilitation: A Non-Inferiority Pragmatic Clinical Trial. Int J Chron Obstruct Pulmon Dis 2023; 18:1419-1429. [PMID: 37465821 PMCID: PMC10350416 DOI: 10.2147/copd.s408423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
Purpose Pulmonary rehabilitation (PR) is vital in the management of chronic respiratory disorders (CRDs) although uptake, attendance and completion are poor. Differing models of delivering PR are emerging in an attempt to increase the uptake and completion of this intervention. This study aimed to evaluate participant rate of attendance and completion of PR when given a preference regarding model of delivery (centre-based and mPR). Secondary aims were to evaluate the factors affecting patient preference for model of delivery and determine whether mPR is non-inferior to centre-based PR in health outcomes. Methods A multi-centre non-inferiority preference based clinical trial in Auckland, New Zealand. Participants with a CRD referred for PR were offered the choice of centre-based or mHealth PR (mPR). The primary outcome was completion rate of chosen intervention. Results A total of 105 participants were recruited to the study with 67 (64%) preferring centre-based and 38 (36%) mPR. The odds of completing the PR programme were higher in the centre-based group compared to mPR (odds ratio 1.90 95% CI [0.83-4.35]). Participants opting for mPR were significantly younger (p = 0.002) and significantly more likely to be working (p = 0.0001). Results showed that mPR was not inferior to centre-based regarding changes in symptom scores (CAT) or time spent in sedentary behaviour (SBQ). When services were forced to transition to telehealth services during COVID-19 restrictions, the attendance and completion rates were higher with telephone calls and video conferencing compared to mPR - suggesting that synchronous interpersonal interactions with clinicians may facilitate the best attendance and completion rates. Conclusion When offered the choice of PR delivery method, the majority of participants preferred centre-based PR and this facilitated the best completion rates. mPR was the preferred choice for younger, working participants suggesting that mPR may offer a viable alternative to centre-based PR for some participants, especially younger, employed participants.
Collapse
Affiliation(s)
- Sarah Candy
- Te Whatu Ora Counties Manukau Health, Auckland, New Zealand
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Julie Reeve
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Rosie Dobson
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Te Whatu Ora Waitematā, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Te Whatu Ora Waitematā, Auckland, New Zealand
| | | | - Jim Warren
- School of Computer Science, University of Auckland, Auckland, New Zealand
| | - Amanda Calder
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Taria Tane
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | | | - Usman Rashid
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Taylor
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
7
|
Maio S, Fasola S, Marcon A, Angino A, Baldacci S, Bilò MB, Bono R, La Grutta S, Marchetti P, Sarno G, Squillacioti G, Stanisci I, Pirina P, Tagliaferro S, Verlato G, Villani S, Gariazzo C, Stafoggia M, Viegi G. Relationship of long-term air pollution exposure with asthma and rhinitis in Italy: an innovative multipollutant approach. ENVIRONMENTAL RESEARCH 2023; 224:115455. [PMID: 36791835 DOI: 10.1016/j.envres.2023.115455] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND air pollution is a complex mixture; novel multipollutant approaches could help understanding the health effects of multiple concomitant exposures to air pollutants. AIM to assess the relationship of long-term air pollution exposure with the prevalence of respiratory/allergic symptoms and diseases in an Italian multicenter study using single and multipollutant approaches. METHODS 14420 adults living in 6 Italian cities (Ancona, Pavia, Pisa, Sassari, Turin, Verona) were investigated in 2005-2011 within 11 different study cohorts. Questionnaire information about risk factors and health outcomes was collected. Machine learning derived mean annual concentrations of PM10, PM2.5, NO2 and mean summer concentrations of O3 (μg/m3) at residential level (1-km resolution) were used for the period 2013-2015. The associations between the four pollutants and respiratory/allergic symptoms/diseases were assessed using two approaches: a) logistic regression models (single-pollutant models), b) principal component logistic regression models (multipollutant models). All the models were adjusted for age, sex, education level, smoking habits, season of interview, climatic index and included a random intercept for cohorts. RESULTS the three-year average (± standard deviation) pollutants concentrations at residential level were: 20.3 ± 6.8 μg/m3 for PM2.5, 29.2 ± 7.0 μg/m3 for PM10, 28.0 ± 11.2 μg/m3 for NO2, and 70.9 ± 4.3 μg/m3 for summer O3. Through the multipollutant models the following associations emerged: PM10 and PM2.5 were related to 14-25% increased odds of rhinitis, 23-34% of asthma and 30-33% of night awakening; NO2 was related to 6-9% increased odds of rhinitis, 7-8% of asthma and 12% of night awakening; O3 was associated with 37% increased odds of asthma attacks. Overall, the Odds Ratios estimated through the multipollutant models were attenuated when compared to those of the single-pollutant models. CONCLUSIONS this study enabled to obtain new information about the health effects of air pollution on respiratory/allergic outcomes in adults, applying innovative methods for exposure assessment and multipollutant analyses.
Collapse
Affiliation(s)
- Sara Maio
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.
| | - Salvatore Fasola
- Institute of Translational Pharmacology, National Research Council, Palermo, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Anna Angino
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Sandra Baldacci
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Maria Beatrice Bilò
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Stefania La Grutta
- Institute of Translational Pharmacology, National Research Council, Palermo, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giuseppe Sarno
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Ilaria Stanisci
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Pietro Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | - Sofia Tagliaferro
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Giovanni Viegi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| |
Collapse
|
8
|
Marchetti P, Miotti J, Locatelli F, Antonicelli L, Baldacci S, Battaglia S, Bono R, Corsico A, Gariazzo C, Maio S, Murgia N, Pirina P, Silibello C, Stafoggia M, Torroni L, Viegi G, Verlato G, Marcon A. Long-term residential exposure to air pollution and risk of chronic respiratory diseases in Italy: The BIGEPI study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 884:163802. [PMID: 37127163 DOI: 10.1016/j.scitotenv.2023.163802] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
Long-term exposure to air pollution has adverse respiratory health effects. We investigated the cross-sectional relationship between residential exposure to air pollutants and the risk of suffering from chronic respiratory diseases in some Italian cities. In the BIGEPI project, we harmonised questionnaire data from two population-based studies conducted in 2007-2014. By combining self-reported diagnoses, symptoms and medication use, we identified cases of rhinitis (n = 965), asthma (n = 328), chronic bronchitis/chronic obstructive pulmonary disease (CB/COPD, n = 469), and controls (n = 2380) belonging to 13 cohorts from 8 Italian cities (Pavia, Turin, Verona, Terni, Pisa, Ancona, Palermo, Sassari). We derived mean residential concentrations of fine particulate matter (PM10, PM2.5), nitrogen dioxide (NO2), and summer ozone (O3) for the period 2013-2015 using spatiotemporal models at a 1 km resolution. We fitted logistic regression models with controls as reference category, a random-intercept for cohort, and adjusting for sex, age, education, BMI, smoking, and climate. Mean ± SD exposures were 28.7 ± 6.0 μg/m3 (PM10), 20.1 ± 5.6 μg/m3 (PM2.5), 27.2 ± 9.7 μg/m3 (NO2), and 70.8 ± 4.2 μg/m3 (summer O3). The concentrations of PM10, PM2.5, and NO2 were higher in Northern Italian cities. We found associations between PM exposure and rhinitis (PM10: OR 1.62, 95%CI: 1.19-2.20 and PM2.5: OR 1.80, 95%CI: 1.16-2.81, per 10 μg/m3) and between NO2 exposure and CB/COPD (OR 1.22, 95%CI: 1.07-1.38 per 10 μg/m3), whereas asthma was not related to environmental exposures. Results remained consistent using different adjustment sets, including bi-pollutant models, and after excluding subjects who had changed residential address in the last 5 years. We found novel evidence of association between long-term PM exposure and increased risk of rhinitis, the chronic respiratory disease with the highest prevalence in the general population. Exposure to NO2, a pollutant characterised by strong oxidative properties, seems to affect mainly CB/COPD.
Collapse
Affiliation(s)
- Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jessica Miotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | | | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Torino, Italy
| | - Angelo Corsico
- Respiratory Diseases Division, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Italy
| | - Pietro Pirina
- Respiratory Unit, Sassari University, Sassari, Italy
| | | | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service ASL Roma 1, Roma, Italy
| | - Lorena Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| |
Collapse
|
9
|
Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, Luong A, Rodriguez K, Sedaghat AR, Toskala E, Villwock J, Abdullah B, Akdis C, Alt JA, Ansotegui IJ, Azar A, Baroody F, Benninger MS, Bernstein J, Brook C, Campbell R, Casale T, Chaaban MR, Chew FT, Chambliss J, Cianferoni A, Custovic A, Davis EM, DelGaudio JM, Ellis AK, Flanagan C, Fokkens WJ, Franzese C, Greenhawt M, Gill A, Halderman A, Hohlfeld JM, Incorvaia C, Joe SA, Joshi S, Kuruvilla ME, Kim J, Klein AM, Krouse HJ, Kuan EC, Lang D, Larenas-Linnemann D, Laury AM, Lechner M, Lee SE, Lee VS, Loftus P, Marcus S, Marzouk H, Mattos J, McCoul E, Melen E, Mims JW, Mullol J, Nayak JV, Oppenheimer J, Orlandi RR, Phillips K, Platt M, Ramanathan M, Raymond M, Rhee CS, Reitsma S, Ryan M, Sastre J, Schlosser RJ, Schuman TA, Shaker MS, Sheikh A, Smith KA, Soyka MB, Takashima M, Tang M, Tantilipikorn P, Taw MB, Tversky J, Tyler MA, Veling MC, Wallace D, Wang DY, White A, Zhang L. International consensus statement on allergy and rhinology: Allergic rhinitis - 2023. Int Forum Allergy Rhinol 2023; 13:293-859. [PMID: 36878860 DOI: 10.1002/alr.23090] [Citation(s) in RCA: 72] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/11/2022] [Accepted: 09/13/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document. METHODS ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. RESULTS ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. CONCLUSION The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.
Collapse
Affiliation(s)
- Sarah K Wise
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Cecelia Damask
- Otolaryngology-HNS, Private Practice, University of Central Florida, Lake Mary, Florida, USA
| | - Lauren T Roland
- Otolaryngology-HNS, Washington University, St. Louis, Missouri, USA
| | - Charles Ebert
- Otolaryngology-HNS, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joshua M Levy
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Sandra Lin
- Otolaryngology-HNS, University of Wisconsin, Madison, Wisconsin, USA
| | - Amber Luong
- Otolaryngology-HNS, McGovern Medical School of the University of Texas, Houston, Texas, USA
| | - Kenneth Rodriguez
- Otolaryngology-HNS, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ahmad R Sedaghat
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Elina Toskala
- Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Baharudin Abdullah
- Otolaryngology-HNS, Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia
| | - Cezmi Akdis
- Immunology, Infectious Diseases, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - Jeremiah A Alt
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | | | - Antoine Azar
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuad Baroody
- Otolaryngology-HNS, University of Chicago, Chicago, Illinois, USA
| | | | | | - Christopher Brook
- Otolaryngology-HNS, Harvard University, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Raewyn Campbell
- Otolaryngology-HNS, Macquarie University, Sydney, NSW, Australia
| | - Thomas Casale
- Allergy/Immunology, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Mohamad R Chaaban
- Otolaryngology-HNS, Cleveland Clinic, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fook Tim Chew
- Allergy/Immunology, Genetics, National University of Singapore, Singapore, Singapore
| | - Jeffrey Chambliss
- Allergy/Immunology, University of Texas Southwestern, Dallas, Texas, USA
| | - Antonella Cianferoni
- Allergy/Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | - Anne K Ellis
- Allergy/Immunology, Queens University, Kingston, ON, Canada
| | | | - Wytske J Fokkens
- Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | | | - Matthew Greenhawt
- Allergy/Immunology, Pediatrics, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Amarbir Gill
- Otolaryngology-HNS, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashleigh Halderman
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Jens M Hohlfeld
- Respiratory Medicine, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover Medical School, German Center for Lung Research, Hannover, Germany
| | | | - Stephanie A Joe
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Shyam Joshi
- Allergy/Immunology, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Jean Kim
- Otolaryngology-HNS, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adam M Klein
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Helene J Krouse
- Otorhinolaryngology Nursing, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Edward C Kuan
- Otolaryngology-HNS, University of California Irvine, Orange, California, USA
| | - David Lang
- Allergy/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Matt Lechner
- Otolaryngology-HNS, University College London, Barts Health NHS Trust, London, UK
| | - Stella E Lee
- Otolaryngology-HNS, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Victoria S Lee
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia Loftus
- Otolaryngology-HNS, University of California San Francisco, San Francisco, California, USA
| | - Sonya Marcus
- Otolaryngology-HNS, Stony Brook University, Stony Brook, New York, USA
| | - Haidy Marzouk
- Otolaryngology-HNS, State University of New York Upstate, Syracuse, New York, USA
| | - Jose Mattos
- Otolaryngology-HNS, University of Virginia, Charlottesville, Virginia, USA
| | - Edward McCoul
- Otolaryngology-HNS, Ochsner Clinic, New Orleans, Louisiana, USA
| | - Erik Melen
- Pediatric Allergy, Karolinska Institutet, Stockholm, Sweden
| | - James W Mims
- Otolaryngology-HNS, Wake Forest University, Winston Salem, North Carolina, USA
| | - Joaquim Mullol
- Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jayakar V Nayak
- Otolaryngology-HNS, Stanford University, Palo Alto, California, USA
| | - John Oppenheimer
- Allergy/Immunology, Rutgers, State University of New Jersey, Newark, New Jersey, USA
| | | | - Katie Phillips
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael Platt
- Otolaryngology-HNS, Boston University, Boston, Massachusetts, USA
| | | | | | - Chae-Seo Rhee
- Rhinology/Allergy, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Sietze Reitsma
- Otolaryngology-HNS, University of Amsterdam, Amsterdam, Netherlands
| | - Matthew Ryan
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Joaquin Sastre
- Allergy, Fundacion Jiminez Diaz, University Autonoma de Madrid, Madrid, Spain
| | - Rodney J Schlosser
- Otolaryngology-HNS, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Theodore A Schuman
- Otolaryngology-HNS, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Marcus S Shaker
- Allergy/Immunology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Aziz Sheikh
- Primary Care, University of Edinburgh, Edinburgh, Scotland
| | - Kristine A Smith
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | - Michael B Soyka
- Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
| | - Masayoshi Takashima
- Otolaryngology-HNS, Houston Methodist Academic Institute, Houston, Texas, USA
| | - Monica Tang
- Allergy/Immunology, University of California San Francisco, San Francisco, California, USA
| | | | - Malcolm B Taw
- Integrative East-West Medicine, University of California Los Angeles, Westlake Village, California, USA
| | - Jody Tversky
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Matthew A Tyler
- Otolaryngology-HNS, University of Minnesota, Minneapolis, Minnesota, USA
| | - Maria C Veling
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Dana Wallace
- Allergy/Immunology, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - De Yun Wang
- Otolaryngology-HNS, National University of Singapore, Singapore, Singapore
| | - Andrew White
- Allergy/Immunology, Scripps Clinic, San Diego, California, USA
| | - Luo Zhang
- Otolaryngology-HNS, Beijing Tongren Hospital, Beijing, China
| |
Collapse
|
10
|
Hong G, Han YK, Yeo MK, Lee BG, Na YC. Development of analytical methods for the determination of 3-hydroxy fatty acids and muramic acid as bacterial markers in airborne particles and settled dust. J Chromatogr A 2023; 1688:463708. [PMID: 36528898 DOI: 10.1016/j.chroma.2022.463708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Inhalation of airborne bacteria in indoor environments is known to be associated with respiratory diseases. Analytical methods for the determination of 3-hydroxy fatty acids (3-OHFAs) and muramic acid (MA) as chemical markers of gram-negative and gram-positive bacteria, respectively, were developed for airborne particle and dust samples in this study. 3-OHFAs as markers of endotoxin were released and esterified during the hydrolysis process under methanolic acid conditions, and their hydrolysates, i.e., 3-OHFA methyl esters, were cleaned up by solid-phase extraction using silica sorbent that provided more effective separation from interferents than polymeric sorbent through elution pattern. The SPE eluent was analyzed by GC-MS/MS measurement after the trimethylsilylation reaction. The recovery of the method ranged from 82.1 % to 103.2 %, with a limit of detection ranging from 0.5 to 1.1 ng/filter and good linearity (R2 > 0.991). For the analysis of MA, muramic acid methyl ester (MAME), a product formed during methanolic hydrolysis, was selected as a specific marker of peptidoglycan. It was the first proposed compound identified and confirmed with MS and MS/MS spectra using high-resolution measurement. In particular, the measurement of MAME providing 12.5 times greater sensitivity than MA with the application of the LC-MS/MS method is one of the notable findings of this study. The recovery by simple liquid extraction was 99.4 % following the removal of the hydrophobic matrix and neutralization with solvent reconstruction. The method displayed a LOD of 0.7 ng/filter and linearity (R2) of 0.997 through a simple pretreatment process. Both developed methods were applied and evaluated by determining 3-OHFAs and MA in airborne particles collected from multipurpose facilities and settled dust in the laboratory and office.
Collapse
Affiliation(s)
- Gieun Hong
- Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Republic of Korea
| | - Yoon-Kyung Han
- Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Republic of Korea
| | - Min-Kyeong Yeo
- Department of Applied Environmental Science, Graduate School Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Environmental Science and Engineering, College of Engineering, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Bong Gu Lee
- Department of Applied Environmental Science, Graduate School Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Yun-Cheol Na
- Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Republic of Korea.
| |
Collapse
|
11
|
Kim J, Waugh DW, Zaitchik BF, Luong A, Bergmark R, Lam K, Roland L, Levy J, Lee JT, Cho DY, Ramanathan M, Baroody F, Takashima M, O'Brien D, Lin SY, Joe S, Chaaban MR, Butrymowicz A, Smith S, Mullings W, Smith S, Mullings W. Climate change, the environment, and rhinologic disease. Int Forum Allergy Rhinol 2022; 13:865-876. [PMID: 36575965 DOI: 10.1002/alr.23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The escalating negative impact of climate change on our environment has the potential to result in significant morbidity of rhinologic diseases. METHODS Evidence based review of examples of rhinologic diseases including allergic and nonallergic rhinitis, chronic rhinosinusitis, and allergic fungal rhinosinusitis was performed. RESULTS The lower socioeconomic population, including historically oppressed groups, will be disproportionately affected. CONCLUSIONS We need a systematic approach to improve healthcare database infrastructure and funding to promote diverse scientific collaboration to address these healthcare needs.
Collapse
Affiliation(s)
- Jean Kim
- Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Darryn W Waugh
- Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Benjamin F Zaitchik
- Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Amber Luong
- Otolaryngology-Head and Neck Surgery, McGovern Medical School of University of Texas Health Science Center, Houston, Texas, USA
| | - Regan Bergmark
- Otolaryngology-Head and Neck Surgery, Harvard Medical School and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kent Lam
- Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Lauren Roland
- Otolaryngology-Head and Neck Surgery, Washington University, St. Louis, Missouri, USA
| | - Joshua Levy
- Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jivianne T Lee
- Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Do-Yeon Cho
- Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Murugappan Ramanathan
- Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuad Baroody
- Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, Illinois, USA
| | - Mas Takashima
- Otolaryngology-Head and Neck Surgery, Houston Methodist Research Institute, Houston, Texas, USA
| | - Daniel O'Brien
- Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Sandra Y Lin
- Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Stephanie Joe
- Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mohamad R Chaaban
- Otolaryngology-Head and Neck Surgery, Cleveland Clinic, Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA
| | - Anna Butrymowicz
- Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, USA
| | - Stephanie Smith
- Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Warren Mullings
- Otolaryngology-Head and Neck Surgery, Ear, Nose and Throat Department, Kingston Public Hospital, Kingston, Jamaica
| | - Stephanie Smith
- Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Warren Mullings
- Otolaryngology-Head and Neck Surgery, Ear, Nose and Throat Department, Kingston Public Hospital, Kingston, Jamaica
| |
Collapse
|
12
|
Häufigkeit von Sensibilisierungen und Allergien durch Hausstaubmilben. ALLERGO JOURNAL 2022. [DOI: 10.1007/s15007-022-5636-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
13
|
Airway Obstruction in Primary Care Patients: Need for Implementing Spirometry Use. Diagnostics (Basel) 2022; 12:diagnostics12112680. [PMID: 36359521 PMCID: PMC9689256 DOI: 10.3390/diagnostics12112680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/23/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
(1) Background: To detect early airway obstruction in an adult primary care setting. (2) Methods: Seventeen general practitioners (GP) were involved. A total of 912 patients consulting their GPs over 40 years were recruited: 583 of them (323M) agreed to perform/undergo all the procedures: respiratory questionnaire, mMRC questionnaire, and spirometry. We identified four subgroups: physician COPD patients; physician asthma patients; asthma-COPD overlap syndrome patients; and no respiratory diagnosis subjects, on the basis of physician diagnosis. For screening purposes, an FEV1/FVC < 70% was considered a marker of airway obstruction (AO). (3) Results: Prevalence rates of COPD, A, and ACOS were 12.5%, 7.8%, and 3.6%, respectively. In the overall sample 16.3% showed airway obstruction: 26% mild, 56% moderate, 17% severe, and 1% very severe. In obstructed subjects, those reporting neither respiratory symptoms nor a physician’s respiratory diagnosis were 60% level I; 43% level II; 44% level III; and none level IV. Wheezing (p < 0.001), sputum (p = 0.01), older age (p < 0.0001), and male gender (p = 0.002) were the best predictors of airway obstruction. (4) Conclusions: A high prevalence of AO was found. In AO we found a high prevalence of subjects without respiratory symptoms or respiratory chronic diagnosis. Airway obstruction was predicted by the presence of wheezing, sputum, older age, and male gender.
Collapse
|
14
|
|
15
|
Respiratory Symptoms among US Adults: a Cross-Sectional Health Survey Study. Pulm Ther 2022; 8:255-268. [PMID: 35794458 PMCID: PMC9458821 DOI: 10.1007/s41030-022-00194-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/23/2022] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Data collected through ongoing, state-based, cross-sectional health surveys could be used to better understand the contribution of respiratory symptoms to impaired health among the US adult population. METHODS We used the 2015 Behavioral Risk Factor Surveillance System telephone health survey in four states (Kentucky, Florida, South Carolina, Texas) to describe the relationship between symptoms, associated factors such as tobacco smoking, and health impairments. Self-reported productive cough, shortness of breath (SOB), and dyspnea on exertion (DOE) were categorized as minimal, moderate, or severe. Data were analyzed using multiple logistic regression models with age as a covariate to assess relationships of symptoms with other factors. RESULTS Among adults ≥ 18 years, respiratory impairment [current asthma, chronic obstructive pulmonary disease (COPD), or a current moderate or severe symptom] occurred in 39.1% of the population. More than half of adults reporting moderate or severe symptoms had not been diagnosed with asthma or COPD, particularly with DOE and productive cough. Subjects were at greater risk of moderate and severe SOB or productive cough with increasing age, prolonged smoking duration (≥ 20 years), being an ever-smoker, or if reporting COPD, current asthma, or any other comorbidity except cancer. Morbid obesity [body mass index (BMI) > 35 kg/m2] was associated with severe DOE at a rate similar to current asthma or COPD (25.6%, 95% CI 20.9-30.3%; 20.8%, 95% CI 16.4-25.1%; 21.3%, 95% CI 17.5-25.1%, respectively); it was the most common cause of DOE. SOB was associated with worse general health impairment and limited ambulation compared with other symptoms. Tobacco smoking prevalence and race varied among states, affecting symptom prevalence. CONCLUSION In the largest US survey in decades, we provide a current perspective of respiratory symptoms among adults of all ages. While known risk factors were apparent, low-risk persons also frequently reported symptoms and impairments.
Collapse
|
16
|
Novembre E, Giovannini M, Barni S, Mori F. From the Global Initiative for Asthma report and asthma guidelines to real-life asthma control: is there room for improvement? Ital J Pediatr 2022; 48:110. [PMID: 35790997 PMCID: PMC9258205 DOI: 10.1186/s13052-022-01304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/15/2022] [Indexed: 11/22/2022] Open
Abstract
Available guidelines for asthma management represent an important and suitable tool to make the entire medical process evidence-based, effective, and safe for patients. Their purpose is to help doctors and patients formulate the best decisions in regard to asthma management by choosing the most appropriate strategies in each specific clinical situation. The Global Initiative for Asthma (GINA) document, together with other national and international recommendations, is one of the main documents used for asthma prevention and management in Italy, but several studies reported that these recommendations are often not applied in real-life clinical practice, which consequently results in inadequate asthma control. In this context, a substantial simplification of the GINA document and asthma guidelines may represent a feasible strategy to be pursued to ameliorate the knowledge among GPs, primary care pediatricians, and specialists taking care of children and adults with asthma. On the other hand, another critical factor that may explain unsatisfactory control of asthma is the limited importance that all recommendations place on asthma heterogeneity. In the era of personalized medicine and target therapies, phenotype-driven asthma management may become a desirable approach for optimizing the management of asthmatic patients. In addition, digital health strategies have been investigated in the literature to improve asthma monitoring and may represent a promising tool in the future from this point of view. Relevant stakeholders should continue to investigate how to optimize real-life asthma control to propose novel solutions to translate into clinical practice.
Collapse
Affiliation(s)
- Elio Novembre
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Mattia Giovannini
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy.
| | - Simona Barni
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Francesca Mori
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| |
Collapse
|
17
|
Exposomic determinants of immune-mediated diseases. Environ Epidemiol 2022; 6:e212. [PMID: 35702504 PMCID: PMC9187189 DOI: 10.1097/ee9.0000000000000212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
|
18
|
Determinants in the Underdiagnosis of COPD in Spain-CONOCEPOC Study. J Clin Med 2022; 11:jcm11092670. [PMID: 35566796 PMCID: PMC9105961 DOI: 10.3390/jcm11092670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
Factors such as seeking medical attention for respiratory symptoms and health professionals ordering spirometry come into play in the underdiagnosis of chronic obstructive pulmonary disease (COPD). The objective of this study was to analyze seeking medical attention and the use of spirometry in individuals with chronic respiratory symptoms and to compare these results with those obtained in the 2005 and 2011 surveys. Material and Methods: A cross-sectional, observational, epidemiological study was conducted via phone interview in December 2020 in Spain, with a representative sample from 17 autonomous communities. The study design was identical to that of the studies carried out in 2005 and 2011 to evaluate the changes that have occurred in seeking medical attention and performing spirometry in Spain, as well as the variability between autonomous communities. Results: From 89,601 phone contacts, a total of 6534 respondents were obtained. A total of 24.8% reported having some chronic respiratory symptom, and 17.9% reported a respiratory disease. Only 51.6% of those who had some chronic respiratory symptom had seen their doctor, which was less likely among current smokers (OR: 0.599, 95% CI: 0.467−0.769, p < 0.001) and those living in a rural setting (OR: 0.797, 95% CI: 0.651−0.975, p = 0.027). A total of 68.7% of the individuals who saw a doctor reported having undergone spirometry, most frequently males (OR: 1.535, 95% CI: 2.074−1.136, p < 0.005), former smokers (OR: 1.696, 95% CI: 2.407−1.195, p < 0.003), and those seen by a pulmonologist (OR: 6.151, 95% CI: 8.869−4.265, p < 0.001). With respect to the 2005 survey, more frequent use of spirometry has been observed (42.6 vs. 68.7%), without any change in seeking medical attention for respiratory symptoms. There is a clear variability according to the autonomous community (p < 0.05). Conclusions: Many individuals with chronic respiratory symptoms do not seek medical attention and although the use of spirometry has increased in the past 15 years, it is still an important area that needs improving in the primary care setting, especially among women. Both of these factors can be determinants in the underdiagnosis of COPD and its variability between autonomous communities.
Collapse
|
19
|
Maio S, Baldacci S, Tagliaferro S, Angino A, Parmes E, Pärkkä J, Pesce G, Maesano CN, Annesi-Maesano I, Viegi G. Urban grey spaces are associated with increased allergy in the general population. ENVIRONMENTAL RESEARCH 2022; 206:112428. [PMID: 34838570 DOI: 10.1016/j.envres.2021.112428] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/27/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND the built environment in urban areas may have side effects on children's respiratory health, whilst less is known for adulthood. AIM to assess the association between increasing exposure to grey spaces and allergic status in an adult general population sample. METHODS 2070 subjects (age range 15-84 yrs), living in Pisa/Cascina, Italy, were investigated in 1991-93 through a questionnaire on health status and risk factors, skin prick test (SPT), serum Immunoglobulins E (IgE), and serum antibodies to benzo(a)pyrene diol epoxide (BPDE)-DNA adducts. Land-cover exposure within a 1000 m buffer from each subject's home address was assessed through the CORINE Land Cover program (CLC 1990) within the FP7/HEALS project (2013-2018). Participants' residential addresses were geocoded and the proportion of surrounding grey spaces was calculated. Through logistic regression models, adjusting for potential confounding factors, the effect of a 10% increase in grey spaces exposure on allergic biomarkers/conditions was assessed; the relationship with serum antibodies to BPDE-DNA adducts positivity was also analyzed. RESULTS A 10% increase in grey spaces coverage was associated with a higher probability of having SPT positivity (OR 1.07, 95% CI 1.02-1.13), seasonal SPT positivity (OR 1.12, 1.05-1.19), polysensitization (OR 1.11, 1.04-1.19), allergic rhinitis (OR 1.10, 1.04-1.17), co-presence of SPT positivity and asthma/allergic rhinitis (OR 1.16, 1.08-1.25), asthma/allergic rhinitis (OR 1.06, 1.00-1.12), presence of serum antibodies to BPDE-DNA adducts positivity (OR 1.07, 1.01-1.14). CONCLUSIONS grey spaces have adverse effects on allergic status and are related to a biomarker of polycyclic aromatic hydrocarbons exposure in adulthood. Thus, they may be used as a proxy of urban environmental exposure.
Collapse
Affiliation(s)
- S Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
| | - S Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
| | - S Tagliaferro
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
| | - A Angino
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy
| | - E Parmes
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - J Pärkkä
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - G Pesce
- INSERM, Paris-Saclay University, UVSQ, Center for Research in Epidemiology and Population Health (CESP), Villejuif, France
| | - C N Maesano
- INSERM, Montpellier University, Institut Desbrest d'Épidémiologie et de Santé Publique, Montpellier, France
| | - I Annesi-Maesano
- INSERM, Montpellier University, Institut Desbrest d'Épidémiologie et de Santé Publique, Montpellier, France
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy; CNR Institute for Research and Biomedical Innovation, Palermo, Italy
| |
Collapse
|
20
|
Derman W, Badenhorst M, Eken MM, Ezeiza-Gomez J, Fitzpatrick J, Gleeson M, Kunorozva L, Mjosund K, Mountjoy M, Sewry N, Schwellnus M. Incidence of acute respiratory illnesses in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'. Br J Sports Med 2022; 56:630-638. [PMID: 35260411 DOI: 10.1136/bjsports-2021-104737] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To determine the incidence of acute respiratory illness (ARill) in athletes and by method of diagnosis, anatomical classification, ages, levels of performance and seasons. DESIGN Systematic review and meta-analysis. DATA SOURCES Electronic databases: PubMed-Medline, EbscoHost and Web of Science. ELIGIBILITY CRITERIA Original research articles published between January 1990 and July 2020 in English reporting the incidence of ARill in athletes, at any level of performance (elite/non-elite), aged 15-65 years. RESULTS Across all 124 studies (n=1 28 360 athletes), the incidence of ARill, estimated by dividing the number of cases by the total number of athlete days, was 4.7 (95% CI 3.9 to 5.7) per 1000 athlete days. In studies reporting acute respiratory infections (ARinf; suspected and confirmed) the incidence was 4.9 (95% CI 4.0 to 6.0), which was similar in studies reporting undiagnosed ARill (3.7; 95% CI 2.1 to 6.7). Incidences of 5.9 (95% CI 4.8 to 7.2) and 2.8 (95% CI 1.8 to 4.5) were found for studies reporting upper ARinf and general ARinf (upper or lower), respectively. The incidence of ARinf was similar across the different methods to diagnose ARinf. A higher incidence of ARinf was found in non-elite (8.7; 95% CI 6.1 to 12.5) vs elite athletes (4.2; 95% CI 3.3 to 5.3). SUMMARY/CONCLUSIONS These findings suggest: (1) the incidence of ARill equates to approximately 4.7 per athlete per year; (2) the incidence of upper ARinf was significantly higher than general (upper/lower) ARinf; (3) elite athletes have a lower incidence of ARinf than non-elite athletes; (4) if pathogen identification is not available, physicians can confidently use validated questionnaires and checklists to screen athletes for suspected ARinf. For future studies, we recommend that a clear diagnosis of ARill is reported. PROSPERO REGISTRATION NUMBER CRD42020160472.
Collapse
Affiliation(s)
- Wayne Derman
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa .,International Olympic Committee Research Centre, Pretoria, South Africa
| | - Marelise Badenhorst
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Maaike Maria Eken
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Josu Ezeiza-Gomez
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,International Olympic Committee Research Centre, Pretoria, South Africa
| | - Jane Fitzpatrick
- Centre for Health and Exercise Sports Medicine, Faculty of Medicine Dentistry and Health Science, University of Melbourne, Parkville, Victoria, Australia
| | - Maree Gleeson
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Lovemore Kunorozva
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Katja Mjosund
- Paavo Nurmi Centre, Sport and Exercise Medicine Unit, University of Turku, Turku, Finland
| | - Margo Mountjoy
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nicola Sewry
- International Olympic Committee Research Centre, Pretoria, South Africa.,Sport, Exercise Medicine and Lifestyle Institute, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa
| | - Martin Schwellnus
- International Olympic Committee Research Centre, Pretoria, South Africa.,Sport, Exercise Medicine and Lifestyle Institute, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa
| |
Collapse
|
21
|
De Matteis S, Forastiere F, Baldacci S, Maio S, Tagliaferro S, Fasola S, Cilluffo G, La Grutta S, Viegi G. Issue 1 - “Update on adverse respiratory effects of outdoor air pollution”. Part 1): Outdoor air pollution and respiratory diseases: A general update and an Italian perspective. Pulmonology 2022; 28:284-296. [DOI: 10.1016/j.pulmoe.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022] Open
|
22
|
Yu Z, Ma Y, Zhang Y, Cheng B, Feng F, Ma B, Jiao H, Zhou J. A study on the short-term effect of particulate matter pollution on hospital visits for asthma in children in Shanghai, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:4123-4138. [PMID: 33774778 DOI: 10.1007/s10653-021-00888-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
Recently, particulate matter pollution has been worsening, which has been affecting the asthma visits in children. In this study, we assessed the short-term effects of PM10 and PM2.5 on asthma visits in children in Shanghai, China from January 1, 2009 and December 31, 2010, using a generalized additive model. We controlled the confounding factors, such as long-term trends, week day effect, and weather elements. The lag effects of different age subgroups (≤ 2 yr, 3-5 yr, and 6-18 yr subgroups) were performed. The results showed significant effects of PM10 and PM2.5 on asthma visits in children, though the seasonal lags varied for the three age subgroups. In general, the effect of PM2.5 on asthma visits in children was stronger and more acute than that of PM10. PM2.5 showed the highest relative risk of 1.192 at lag 0 day in summer; and PM10 showed the highest relative risk of 1.073 at lag 3 day in autumn. Overall, particulate matter pollution showed a greater effect on relatively younger children. In particular, the ≤ 2 yr subgroup showed the highest seasonal relative risk of PM10. Especially, seasonal relative risk of PM10 in autumn for the ≤ 2 yr subgroup was much higher than that for the other two subgroups. The 3-5 yr and 6-18 yr subgroups showed the highest seasonal relative risk of PM2.5 in summer and winter, respectively. But the pediatric visits data we obtained cannot reflect the true prevalence of asthma and multiple visits. Thus, selection bias may exist in our analysis.
Collapse
Affiliation(s)
- Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bingji Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Ji Zhou
- Key Laboratory of Meteorology and Health in Shanghai, Shanghai, 200030, China
| |
Collapse
|
23
|
Huang J, Zhang J, Wang F, Liang J, Chen Q, Lin Z. Association between comorbid asthma and prognosis of critically ill patients with severe sepsis: a cohort study. Sci Rep 2021; 11:15395. [PMID: 34321496 PMCID: PMC8319316 DOI: 10.1038/s41598-021-93907-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
Basic research suggests some contributing mechanisms underlying asthma might at the same time benefit patients with asthma against sepsis, while the potential protective effect of comorbid asthma on prognosis of sepsis has not been well studied in clinical research. The study aimed to assess the association between comorbid asthma and prognosis in a cohort of patients admitted to intensive care unit (ICU) with severe sepsis. Patients with severe sepsis admitted to ICUs were included from the MIMIC-III Critical Care Database, and categorized as patients without asthma, patients with stable asthma, and patients with acute exacerbation asthma. The primary study outcome was 28-day mortality since ICU admission. Difference in survival distributions among groups were evaluated by Kaplan–Meier estimator. Multivariable Cox regression was employed to examine the association between comorbid asthma and prognosis. A total of 2469 patients with severe sepsis were included, of which 2327 (94.25%) were without asthma, 125 (5.06%) with stable asthma, and 17 (0.69%) with acute exacerbation asthma. Compared with patients without asthma, patients with asthma (either stable or not) had a slightly younger age (66.73 ± 16.32 versus 64.77 ± 14.81 years), a lower proportion of male sex (56.81% versus 40.14%), and a lower median SAPS II score (46 versus 43). Patients with acute exacerbation asthma saw the highest 28-day mortality rate (35.29%), but patients with stable asthma had the lowest 28-day mortality rate (21.60%) when compared to that (34.42%) in patients without asthma. Consistent results were observed in Kaplan–Meier curves with a p-value for log-rank test of 0.016. After adjusting for potential confounding, compared to being without asthma, being with stable asthma was associated with a reduced risk of 28-day mortality (hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.44–0.97, p = 0.0335), but being with acute exacerbation asthma was toward an increased risk of 28-day mortality (HR 1.82, 95% 0.80–4.10, p = 0.1513). E-value analysis suggested robustness to unmeasured confounding. These findings suggest comorbid stable asthma is associated with a better prognosis in critically ill patients with severe sepsis, while acute exacerbation asthma is associated with worse prognosis.
Collapse
Affiliation(s)
- Jinju Huang
- Intensive Care Unit, Guangzhou Panyu Central Hospital, No. 8 Fuyu East Road, Qiaonan Street, Panyu District, Guangzhou, 511400, China
| | - Jurong Zhang
- Intensive Care Unit, Guangzhou Panyu Central Hospital, No. 8 Fuyu East Road, Qiaonan Street, Panyu District, Guangzhou, 511400, China
| | - Faxia Wang
- Intensive Care Unit, Guangzhou Panyu Central Hospital, No. 8 Fuyu East Road, Qiaonan Street, Panyu District, Guangzhou, 511400, China
| | - Jiezhu Liang
- Intensive Care Unit, Guangzhou Panyu Central Hospital, No. 8 Fuyu East Road, Qiaonan Street, Panyu District, Guangzhou, 511400, China
| | - Qinchang Chen
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Zhuandi Lin
- Intensive Care Unit, Guangzhou Panyu Central Hospital, No. 8 Fuyu East Road, Qiaonan Street, Panyu District, Guangzhou, 511400, China.
| |
Collapse
|
24
|
Abstract
Objective To summarize the main updated evidence about the health effects of air pollution, with a special focus on Southern Europe. Data sources Literature was obtained through PubMed Central and the official websites of European Agencies and Scientific Societies. Study selection Recent shreds of evidence about the health effects of air pollution coming from international reports and original research were collected and described in this review. Results Air pollution is an avoidable risk factor that causes a huge burden for society, in terms of death, health disorders, and huge socio-economic costs. The southern European countries face a more threatening problem because they experience the effects of both anthropogenic pollutants and natural dusts (particulate matter [PM]). The European Environment Agency reported the number of premature deaths in the 28 countries of the European Union attributable to air pollutant exposure in the year 2016: 374,000 for PM2.5, 68,000 for nitrogen dioxide, and 14,000 for ozone. In Italy, time series and analytical epidemiological studies showed increased cardio-respiratory hospital admissions and mortality, as well as increased risk of respiratory diseases in people living in urban areas. Conclusions Based on abundant evidence, the World Health Organization, which hosts the Global Alliance against Chronic Respiratory Diseases (GARD), the scientific respiratory societies, and the patients’ associations, as well as others in the health sector, must increase their engagement in advocacy for clean air policies.
Collapse
|
25
|
Nam JS, Ahn SH, Ha JG, Park JJ, Noh HE, Yoon JH, Kim CH, Cho HJ. Differential Correlations among Allergy Tests According to Indoor Allergens in Allergic Rhinitis. Ann Otol Rhinol Laryngol 2021; 131:71-77. [PMID: 33870717 DOI: 10.1177/00034894211008702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Several allergy tests are used for the diagnosis of allergic rhinitis; however, few studies have reported a direct comparison of the skin prick test (SPT), multiple allergen simultaneous test (MAST), and ImmunoCAP according to specific allergens. This study aimed to evaluate the correlations between each test and allergic rhinitis symptoms and to evaluate the correlations of the MAST and ImmunoCAP with the SPT for representative indoor allergens in Korea. METHODS Electronic medical charts were retrospectively reviewed, and 698 patients with allergic rhinitis who had performed SPT, MAST, and ImmunoCAP were enrolled. Correlations between each allergy test for 4 representative indoor allergens and the symptoms of allergic rhinitis were analyzed. Agreements of the MAST and ImmunoCAP with the SPT were compared according to each allergen. RESULTS The SPT showed higher correlations with allergic rhinitis symptoms for 4 indoor allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, and dog allergens) than the MAST or ImmunoCAP. In comparison between the MAST and SPT, the least correlation was observed for the dog allergen, whereas between the ImmunoCAP and SPT, the least correlation was observed for the cat allergen. The correlation between the ImmunoCAP and SPT was higher than that between the MAST and SPT for the dog allergen, whereas no significant differences were noted for other allergens. CONCLUSIONS Overall, the SPT showed a higher correlation with allergic rhinitis symptoms than the MAST or ImmunoCAP for 4 indoor allergens. ImmunoCAP showed similar reactivity to MAST; however, it showed better positivity with dog allergen in patients who were reactive to the allergen in the SPT. Care should be taken while evaluating dog allergen sensitization using the MAST.
Collapse
Affiliation(s)
- Jae-Sung Nam
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyeon Ahn
- Department of Otorhinolaryngology, Bundang Jesaeng Hospital, Seongnam, Korea.,Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea
| | - Jong-Gyun Ha
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong-Jin Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Hae Eun Noh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung-Ju Cho
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
26
|
Cait A, Messing M, Cait J, Canals Hernaez D, McNagny KM. Antibiotic Treatment in an Animal Model of Inflammatory Lung Disease. Methods Mol Biol 2021; 2223:281-293. [PMID: 33226601 DOI: 10.1007/978-1-0716-1001-5_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Allergic disease is on the rise and yet the underlying cause and risk factors are not fully understood. While lifesaving in many circumstances, the use of antibiotics and the subsequent disruption of the microbiome are positively correlated with the development of allergies. Here, we describe the use of the antibiotic vancomycin in combination with the papain-induced mouse model of allergic disease that allows for the assessment of microbiome perturbations and the impact on allergy development.
Collapse
Affiliation(s)
- Alissa Cait
- Department of Microbiology and Immunology, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Melina Messing
- Division of Experimental Medicine, Faculty of Medicine, University of British Columbia, The Biomedical Research Centre, Vancouver, BC, Canada
| | - Jessica Cait
- Division of Experimental Medicine, Faculty of Medicine, University of British Columbia, The Biomedical Research Centre, Vancouver, BC, Canada
| | - Diana Canals Hernaez
- Departments of Biomedical Engineering and Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Kelly M McNagny
- Division of Experimental Medicine, Faculty of Medicine, University of British Columbia, The Biomedical Research Centre, Vancouver, BC, Canada. .,Departments of Biomedical Engineering and Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
27
|
Short-Term Effects of Air Pollution on Cardiovascular Hospitalizations in the Pisan Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031164. [PMID: 33525695 PMCID: PMC7908381 DOI: 10.3390/ijerph18031164] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 12/05/2022]
Abstract
Air pollution effects on cardiovascular hospitalizations in small urban/suburban areas have been scantly investigated. Such effects were assessed among the participants in the analytical epidemiological survey carried out in Pisa and Cascina, Tuscany, Italy (2009–2011). Cardiovascular hospitalizations from 1585 subjects were followed up (2011–2015). Daily mean pollutant concentrations were estimated through random forests at 1 km (particulate matter: PM10, 2011–2015; PM2.5, 2013–2015) and 200 m (PM10, PM2.5, NO2, O3, 2013–2015) resolutions. Exposure effects were estimated using the case-crossover design and conditional logistic regression (odds ratio—OR—and 95% confidence interval—CI—for 10 μg/m3 increase; lag 0–6). During the period 2011–2015 (137 hospitalizations), a significant effect at lag 0 was observed for PM10 (OR = 1.137, CI: 1.023–1.264) at 1 km resolution. During the period 2013–2015 (69 hospitalizations), significant effects at lag 0 were observed for PM10 (OR = 1.268, CI: 1.085–1.483) and PM2.5 (OR = 1.273, CI: 1.053–1.540) at 1 km resolution, as well as for PM10 (OR = 1.365, CI: 1.103–1.690), PM2.5 (OR = 1.264, CI: 1.006–1.589) and NO2 (OR = 1.477, CI: 1.058–2.061) at 200 m resolution; significant effects were observed up to lag 2. Larger ORs were observed in males and in subjects reporting pre-existent cardiovascular/respiratory diseases. Combining analytical and routine epidemiological data with high-resolution pollutant estimates provides new insights on acute cardiovascular effects in the general population and in potentially susceptible subgroups living in small urban/suburban areas.
Collapse
|
28
|
Models for Heart Failure Admissions and Admission Rates, 2016 through 2018. Healthcare (Basel) 2020; 9:healthcare9010022. [PMID: 33375483 PMCID: PMC7824516 DOI: 10.3390/healthcare9010022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Approximately 6.5 to 6.9 million individuals in the United States have heart failure, and the disease costs approximately $43.6 billion in 2020. This research provides geographical incidence and cost models of this disease in the U.S. and explanatory models to account for hospitals' number of heart failure DRGs using technical, workload, financial, geographical, and time-related variables. METHODS The number of diagnoses is forecast using regression (constrained and unconstrained) and ensemble (random forests, extra trees regressor, gradient boosting, and bagging) techniques at the hospital unit of analysis. Descriptive maps of heart failure diagnostic-related groups (DRGs) depict areas of high incidence. State- and county-level spatial and non-spatial regression models of heart failure admission rates are performed. Expenditure forecasts are estimated. RESULTS The incidence of heart failure has increased over time with the highest intensities in the East and center of the country; however, several Northern states have seen large increases since 2016. The best predictive model for the number of diagnoses (hospital unit of analysis) was an extremely randomized tree ensemble (predictive R2 = 0.86). The important variables in this model included workload metrics and hospital type. State-level spatial lag models using first-order Queen criteria were best at estimating heart failure admission rates (R2 = 0.816). At the county level, OLS was preferred over any GIS model based on Moran's I and resultant R2; however, none of the traditional models performed well (R2 = 0.169 for the OLS). Gradient-boosted tree models predicted 36% of the total sum of squares; the most important factors were facility workload, mean cash on hand of the hospitals in the county, and mean equity of those hospitals. Online interactive maps at the state and county levels are provided. CONCLUSIONS Heart failure and associated expenditures are increasing. Costs of DRGs in the study increased $61 billion from 2016 through 2018. The increase in the more expensive DRG 291 outpaced others with an associated increase of $92 billion. With the increase in demand and steady-state supply of cardiologists, the costs are likely to balloon over the next decade. Models such as the ones presented here are needed to inform healthcare leaders.
Collapse
|
29
|
Maio S, Baldacci S, Simoni M, Angino A, La Grutta S, Muggeo V, Fasola S, Viegi G. Longitudinal Asthma Patterns in Italian Adult General Population Samples: Host and Environmental Risk Factors. J Clin Med 2020; 9:jcm9113632. [PMID: 33187300 PMCID: PMC7696248 DOI: 10.3390/jcm9113632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Asthma patterns are not well established in epidemiological studies. Aim: To assess asthma patterns and risk factors in an adult general population sample. Methods: In total, 452 individuals reporting asthma symptoms/diagnosis in previous surveys participated in the AGAVE survey (2011–2014). Latent transition analysis (LTA) was performed to detect baseline and 12-month follow-up asthma phenotypes and longitudinal patterns. Risk factors associated with longitudinal patterns were assessed through multinomial logistic regression. Results: LTA detected four longitudinal patterns: persistent asthma diagnosis with symptoms, 27.2%; persistent asthma diagnosis without symptoms, 4.6%; persistent asthma symptoms without diagnosis, 44.0%; and ex -asthma, 24.1%. The longitudinal patterns were differently associated with asthma comorbidities. Persistent asthma diagnosis with symptoms showed associations with passive smoke (OR 2.64, 95% CI 1.10–6.33) and traffic exposure (OR 1.86, 95% CI 1.02–3.38), while persistent asthma symptoms (without diagnosis) with passive smoke (OR 3.28, 95% CI 1.41–7.66) and active smoke (OR 6.24, 95% CI 2.68–14.51). Conclusions: LTA identified three cross-sectional phenotypes and their four longitudinal patterns in a real-life setting. The results highlight the necessity of a careful monitoring of exposure to active/passive smoke and vehicular traffic, possible determinants of occurrence of asthma symptoms (with or without diagnosis). Such information could help affected patients and physicians in prevention and management strategies.
Collapse
Affiliation(s)
- Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), 56126 Pisa, Italy; (S.B.); (M.S.); (A.A.); (G.V.)
- Correspondence:
| | - Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), 56126 Pisa, Italy; (S.B.); (M.S.); (A.A.); (G.V.)
| | - Marzia Simoni
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), 56126 Pisa, Italy; (S.B.); (M.S.); (A.A.); (G.V.)
| | - Anna Angino
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), 56126 Pisa, Italy; (S.B.); (M.S.); (A.A.); (G.V.)
| | - Stefania La Grutta
- CNR Institute for Biomedical Research and Innovation (IRIB), 90146 Palermo, Italy; (S.L.G.); (S.F.)
| | - Vito Muggeo
- Department of Economics, Business and Statistics, University of Palermo, 90128 Palermo, Italy;
| | - Salvatore Fasola
- CNR Institute for Biomedical Research and Innovation (IRIB), 90146 Palermo, Italy; (S.L.G.); (S.F.)
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), 56126 Pisa, Italy; (S.B.); (M.S.); (A.A.); (G.V.)
- CNR Institute for Biomedical Research and Innovation (IRIB), 90146 Palermo, Italy; (S.L.G.); (S.F.)
| | | |
Collapse
|
30
|
Eguiluz‐Gracia I, Mathioudakis AG, Bartel S, Vijverberg SJH, Fuertes E, Comberiati P, Cai YS, Tomazic PV, Diamant Z, Vestbo J, Galan C, Hoffmann B. The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma. Allergy 2020; 75:2170-2184. [PMID: 31916265 DOI: 10.1111/all.14177] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/20/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023]
Abstract
Air pollution and climate change have a significant impact on human health and well-being and contribute to the onset and aggravation of allergic rhinitis and asthma among other chronic respiratory diseases. In Westernized countries, households have experienced a process of increasing insulation and individuals tend to spend most of their time indoors. These sequelae implicate a high exposure to indoor allergens (house dust mites, pets, molds, etc), tobacco smoke, and other pollutants, which have an impact on respiratory health. Outdoor air pollution derived from traffic and other human activities not only has a direct negative effect on human health but also enhances the allergenicity of some plants and contributes to global warming. Climate change modifies the availability and distribution of plant- and fungal-derived allergens and increases the frequency of extreme climate events. This review summarizes the effects of indoor air pollution, outdoor air pollution, and subsequent climate change on asthma and allergic rhinitis in children and adults and addresses the policy adjustments and lifestyle changes required to mitigate their deleterious effects.
Collapse
Affiliation(s)
- Ibon Eguiluz‐Gracia
- Allergy Unit IBIMA‐Hospital Regional Universitario de Malaga‐UMA Malaga Spain
| | - Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester Academic Health Science Centre UK
- North West Lung Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Southmoor Road Manchester UK
| | - Sabine Bartel
- Early Life Origins of Chronic Lung Disease, Research Center Borstel Leibniz Lung Center Member of the German Research Center for Lung Research (DZL) Borstel Germany
- Department of Pathology and Medical Biology University Medical Center Groningen GRIAC Research Institute University of Groningen Groningen The Netherlands
| | - Susanne J. H. Vijverberg
- Department of Respiratory Medicine Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Elaine Fuertes
- National Heart and Lung Institute Imperial College London London UK
| | - Pasquale Comberiati
- Section of Paediatrics Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
- Department of Clinical Immunology and Allergology Sechenov University Moscow Russia
| | - Yutong Samuel Cai
- Department of Epidemiology and Biostatistics MRC Centre for Environment and Health School of Public Health Imperial College London London UK
- The George Institute for Global Health University of Oxford Oxford UK
| | - Peter Valentin Tomazic
- Department of General ORL, Head and Neck Surgery Medical University of Graz Graz Austria
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Institute for Clinical Science Skane University Hospital Lund University Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester Academic Health Science Centre UK
- North West Lung Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Southmoor Road Manchester UK
| | - Carmen Galan
- Department of Botany, Ecology and Plant Physiology International Campus of Excellence on Agrifood (ceiA3) University of Córdoba Córdoba Spain
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine Medical Faculty University of Düsseldorf Düsseldorf Germany
| |
Collapse
|
31
|
Vlaski E, Stavrikj K, Kimovska M, Cholakovska VC, Lawson JA. Divergent trends in the prevalence of asthma-like symptoms and asthma in a developing country: three repeated surveys between 2002 and 2016. Allergol Immunopathol (Madr) 2020; 48:475-483. [PMID: 32284265 DOI: 10.1016/j.aller.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION AND OBJECTIVES There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence. SUBJECTS AND METHODS Data were obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors. RESULTS The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p=0.075). Statistically significant (p<0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.22, 95%CI=0.67-2.22; 2016: OR=2.45, 95%CI=1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared. CONCLUSIONS Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.
Collapse
Affiliation(s)
- E Vlaski
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia.
| | - K Stavrikj
- Department of Immunology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - M Kimovska
- Intensive Care Unit, University Children's Clinic, Skopje, Republic of North Macedonia
| | - V C Cholakovska
- Department of Pulmonology and Allergology, University Children's Clinic, Skopje, Republic of North Macedonia
| | - J A Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| |
Collapse
|
32
|
Axelsson M, Ilmarinen P, Backman H, Ekerljung L, Hedman L, Langhammer A, Lindberg A, Lindqvist A, Nwaru BI, Pallasaho P, Sovijärvi A, Vähätalo I, Kankaanranta H, Hisinger-Mölkänen H, Piirilä P, Rönmark E. Differences in diagnostic patterns of obstructive airway disease between areas and sex in Sweden and Finland - the Nordic EpiLung study. J Asthma 2020; 58:1196-1207. [PMID: 32475292 DOI: 10.1080/02770903.2020.1776727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate the current prevalence of physician-diagnosed obstructive airway diseases by respiratory symptoms and by sex in Sweden and Finland. METHOD In 2016, a postal questionnaire was answered by 34,072 randomly selected adults in four study areas: Västra Götaland and Norrbotten in Sweden, and Seinäjoki-Vaasa and Helsinki in Finland. RESULTS The prevalence of asthma symptoms was higher in Norrbotten (13.2%), Seinäjoki-Vaasa (14.8%) and Helsinki (14.4%) than in Västra Götaland (10.7%), and physician-diagnosed asthma was highest in Norrbotten (13.0%) and least in Västra Götaland (10.1%). Chronic productive cough was most common in the Finnish areas (7.7-8.2% versus 6.3-6.7%) while the prevalence of physician-diagnosed chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) varied between 1.7 and 2.7% in the four areas. Among individuals with respiratory symptoms, the prevalence of asthma was most common in Norrbotten, while a diagnosis of COPD or CB was most common in Västra Götaland and Seinäjoki-Vaasa. More women than men with respiratory symptoms reported a diagnosis of asthma in Sweden and Seinäjoki-Vaasa but there were no sex differences in Helsinki. In Sweden, more women than men with symptoms of cough or phlegm reported a diagnosis of CB or COPD, while in Finland the opposite was found. CONCLUSION The prevalence of respiratory symptoms and corresponding diagnoses varied between and within the countries. The proportion reporting a diagnosis of obstructive airway disease among individuals with respiratory symptoms varied, indicating differences in diagnostic patterns both between areas and by sex.
Collapse
Affiliation(s)
- Malin Axelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Pinja Ilmarinen
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN unit, Umeå University, Umeå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Linda Ekerljung
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN unit, Umeå University, Umeå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
| | - Ari Lindqvist
- Clinical Research Unit of Pulmonary Diseases, Helsinki University Hospital, Helsinki University and Clinical Research Institute HUCH Ltd, Helsinki, Finland
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Anssi Sovijärvi
- Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Iida Vähätalo
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Hannu Kankaanranta
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.,Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | | | - Päivi Piirilä
- Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN unit, Umeå University, Umeå, Sweden
| |
Collapse
|
33
|
Viegi G, Maio S, Fasola S, Baldacci S. Global Burden of Chronic Respiratory Diseases. J Aerosol Med Pulm Drug Deliv 2020; 33:171-177. [PMID: 32423274 DOI: 10.1089/jamp.2019.1576] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Noncommunicable diseases (NCDs) and chronic respiratory diseases (CRDs) are the main causes of mortality and morbidity worldwide. Methods: The main evidences about the NCDs and CRDs burden and related risk factors, from updated international reports and results of original researches, were collected and described in this review. Results: Most recent evidence is available from the Global Burden of Diseases Study (GBD) 2017 reports. There were 3.2 million deaths due to chronic obstructive pulmonary disease (COPD) and 495,000 deaths due to asthma. COPD was the seventh leading cause of years of life lost (YLLs). Overall, prevalent cases of CRDs were 545 million: about 50% for COPD and 50% for asthma. Incident cases of CRDs were 62 million, mostly due to asthma (69%) and COPD (29%). COPD accounted for 81.6 million disability-adjusted life years, asthma for 22.8 million. COPD prevalence of 9.1% has been found in a recent general population sample of North-Eastern Italy, while in Central Italy a 25-year follow-up of a general population sample has shown an increased prevalence of COPD and asthma up to 6.8% and 7.8%, respectively. In Central Italy, a COPD incidence of 8% and an asthma incidence of 3.2% have been found in adult subjects at an 18-year follow-up. Among the risk factors, a relevant role is played by smoking and high body mass index for asthma, while smoking, particulate matter pollution, ambient ozone pollution, occupational exposure to particulate matter, gases and fumes, as well as second-hand smoke, play an important role for COPD. Forecasting the YLLs by 2040 indicates a rising toll from several NCDs due to population growth and aging, with COPD expected to reach the fourth leading cause. Conclusions: Several recent studies and international reports highlighted the huge global health burden of CRDs and other major NCDs, pointing out the need for implementing international collaborations to fight this epidemic trend.
Collapse
Affiliation(s)
- Giovanni Viegi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Palermo, Italy.,Institute of Clinical Physiology (IFC), National Research Council (CNR), Pisa, Italy
| | - Sara Maio
- Institute of Clinical Physiology (IFC), National Research Council (CNR), Pisa, Italy
| | - Salvatore Fasola
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Palermo, Italy
| | - Sandra Baldacci
- Institute of Clinical Physiology (IFC), National Research Council (CNR), Pisa, Italy
| |
Collapse
|
34
|
Fasola S, Maio S, Baldacci S, La Grutta S, Ferrante G, Forastiere F, Stafoggia M, Gariazzo C, Viegi G. Effects of Particulate Matter on the Incidence of Respiratory Diseases in the Pisan Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2540. [PMID: 32276330 PMCID: PMC7177905 DOI: 10.3390/ijerph17072540] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/27/2020] [Accepted: 04/06/2020] [Indexed: 12/17/2022]
Abstract
The current study aimed at assessing the effects of exposure to Particulate Matter (PM) on the incidence of respiratory diseases in a sub-sample of participants in the longitudinal analytical epidemiological study in Pisa, Italy. Three hundred and five subjects living at the same address from 1991 to 2011 were included. Individual risk factors recorded during the 1991 survey were considered, and new cases of respiratory diseases were ascertained until 2011. Average PM10 and PM2.5 exposures (µg/m3, year 2011) were estimated at the residential address (1-km2 resolution) through a random forest machine learning approach, using a combination of satellite data and land use variables. Multivariable logistic regression with Firth's correction was applied. The median (25th-75th percentile) exposure levels were 30.1 µg/m3 (29.9-30.7 µg/m3) for PM10 and 19.3 µg/m3 (18.9-19.4 µg/m3) for PM2.5. Incidences of rhinitis and chronic phlegm were associated with increasing PM2.5: OR = 2.25 (95% CI: 1.07, 4.98) per unit increase (p.u.i.) and OR = 4.17 (1.12, 18.71) p.u.i., respectively. Incidence of chronic obstructive pulmonary disease was associated with PM10: OR = 2.96 (1.50, 7.15) p.u.i. These results provide new insights into the long-term respiratory health effects of PM air pollution.
Collapse
Affiliation(s)
- Salvatore Fasola
- Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy; (S.L.G.); (F.F.); (G.V.)
| | - Sara Maio
- Institute of Clinical Physiology, National Research Council, 56126 Pisa, Italy; (S.M.); (S.B.)
| | - Sandra Baldacci
- Institute of Clinical Physiology, National Research Council, 56126 Pisa, Italy; (S.M.); (S.B.)
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy; (S.L.G.); (F.F.); (G.V.)
| | - Giuliana Ferrante
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialities, University of Palermo, 90127 Palermo, Italy;
| | - Francesco Forastiere
- Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy; (S.L.G.); (F.F.); (G.V.)
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service—ASL Roma 1, 00147 Rome, Italy;
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Monte Porzio Catone, 00144 Rome, Italy;
| | - Giovanni Viegi
- Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy; (S.L.G.); (F.F.); (G.V.)
- Institute of Clinical Physiology, National Research Council, 56126 Pisa, Italy; (S.M.); (S.B.)
| | | |
Collapse
|
35
|
Parmes E, Pesce G, Sabel CE, Baldacci S, Bono R, Brescianini S, D'Ippolito C, Hanke W, Horvat M, Liedes H, Maio S, Marchetti P, Marcon A, Medda E, Molinier M, Panunzi S, Pärkkä J, Polańska K, Prud'homme J, Ricci P, Snoj Tratnik J, Squillacioti G, Stazi MA, Maesano CN, Annesi-Maesano I. Influence of residential land cover on childhood allergic and respiratory symptoms and diseases: Evidence from 9 European cohorts. ENVIRONMENTAL RESEARCH 2020; 183:108953. [PMID: 31818476 DOI: 10.1016/j.envres.2019.108953] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/02/2019] [Accepted: 11/20/2019] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Recent research focused on the interaction between land cover and the development of allergic and respiratory disease has provided conflicting results and the underlying mechanisms are not fully understood. In particular, green space, which confers an overall positive impact on general health, may be significantly contributing to adverse respiratory health outcomes. This study evaluates associations between surrounding residential land cover (green, grey, agricultural and blue space), including type of forest cover (deciduous, coniferous and mixed), and childhood allergic and respiratory diseases. METHODS Data from 8063 children, aged 3-14 years, were obtained from nine European population-based studies participating in the HEALS project. Land-cover exposures within a 500 m buffer centred on each child's residential address were computed using data from the Coordination of Information on the Environment (CORINE) program. The associations of allergic and respiratory symptoms (wheeze, asthma, allergic rhinitis and eczema) with land coverage were estimated for each study using logistic regression models, adjusted for sex, age, body mass index, maternal education, parental smoking, and parental history of allergy. Finally, the pooled effects across studies were estimated using meta-analyses. RESULTS In the pooled analyses, a 10% increase in green space coverage was significantly associated with a 5.9%-13.0% increase in the odds of wheezing, asthma, and allergic rhinitis, but not eczema. A trend of an inverse relationship between agricultural space and respiratory symptoms was observed, but did not reach statistical significance. In secondary analyses, children living in areas with surrounding coniferous forests had significantly greater odds of reporting wheezing, asthma and allergic rhinitis. CONCLUSION Our results provide further evidence that exposure to green space is associated with increased respiratory disease in children. Additionally, our findings suggest that coniferous forests might be associated with wheezing, asthma and allergic rhinitis. Additional studies evaluating both the type of green space and its use in relation to respiratory conditions should be conducted in order to clarify the underlying mechanisms behind associated adverse impacts.
Collapse
Affiliation(s)
- Eija Parmes
- VTT Technical Research Centre of Finland Ltd, 02150 Espoo, Finland.
| | - Giancarlo Pesce
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Institut Pierre Louis D'Épidémiologie et de Santé Publique, F75012, Paris, France
| | - Clive E Sabel
- BERTHA, The Danish Big Data Centre for Environment and Health, Department of Environmental Science, Aarhus University, 4000, Roskilde, Denmark
| | - Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste No. 41, 56126, Pisa, Italy
| | - Roberto Bono
- Department of Public Health and Paediatrics, University of Turin, Italy. Via Santena 5 Bis Turin, Italy
| | - Sonia Brescianini
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina D'Ippolito
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Milena Horvat
- Jožef Stefan Institute, Department of Environmental Sciences, Jamova Cesta 39, Ljubljana, Slovenia
| | - Hilkka Liedes
- VTT Technical Research Centre of Finland Ltd, 02150 Espoo, Finland
| | - Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste No. 41, 56126, Pisa, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy
| | - Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Silvia Panunzi
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy
| | - Juha Pärkkä
- VTT Technical Research Centre of Finland Ltd, 02150 Espoo, Finland
| | - Kinga Polańska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Julie Prud'homme
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Institut Pierre Louis D'Épidémiologie et de Santé Publique, F75012, Paris, France
| | - Paolo Ricci
- Unità Operativa Complessa Osservatorio Epidemiologico, Agenzia Tutela Salute Della Val Padana, Mantova, Italy
| | - Janja Snoj Tratnik
- Jožef Stefan Institute, Department of Environmental Sciences, Jamova Cesta 39, Ljubljana, Slovenia
| | - Giulia Squillacioti
- Department of Public Health and Paediatrics, University of Turin, Italy. Via Santena 5 Bis Turin, Italy
| | - Maria Antonietta Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cara Nichole Maesano
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Institut Pierre Louis D'Épidémiologie et de Santé Publique, F75012, Paris, France
| | - Isabella Annesi-Maesano
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Institut Pierre Louis D'Épidémiologie et de Santé Publique, F75012, Paris, France
| |
Collapse
|
36
|
IgG4-related disease and allergen-specific immunotherapy. Ann Allergy Asthma Immunol 2020; 124:631-633. [PMID: 32240759 DOI: 10.1016/j.anai.2020.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 12/15/2022]
|
37
|
Impact of Tree Pollen Distribution on Allergic Diseases in Serbia: Evidence of Implementation of Allergen Immunotherapy to Betula verrucosa. ACTA ACUST UNITED AC 2020; 56:medicina56020059. [PMID: 32033101 PMCID: PMC7074275 DOI: 10.3390/medicina56020059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 01/17/2023]
Abstract
Background and objectives: The relationship between air pollen quantity and the sensitization of allergic patients is crucial for both the diagnosis and treatment of allergic diseases. Weather conditions influence the distribution of allergenic pollen and increases in pollen concentration may negatively affect the health of allergic patients. The aim of this study was to analyze the implementation of allergen immunotherapy with regard to air pollen concentration. Material and Methods: Here we examined the relationship between Betula air pollen concentration and the usage of Betula verrucosa allergen immunotherapy in Serbia. Examination covered the period from 2015 to 2018. Measurement of airborne pollen concentration was performed with Lanzoni volumetric pollen traps. The evidence of the usage of sublingual allergen immunotherapy (SLIT) was gathered from patients with documented sensitization to specific pollen. Results: During this period tree pollens were represented with 58% ± 21% of all measured air pollen species, while Betula pollen represented 15% ± 8% of all tree pollens. Betula pollination peaked in April. Allergen immunotherapy to Betula verrucosa in Serbia is entirely conducted as sublingual immunotherapy and represents 47.1% ± 1.4% of issued tree pollen SLIT. The use of pollen SLIT increased by 68% from 2015 to 2018, with an even greater increase in usage recorded for Betula SLIT—80%. Conclusions: This analysis shows a clear causative relationship between pollination and the type/prevalence of applied allergen immunotherapy. Information about the flowering seasons of allergenic plants is very important for people who suffer from allergy, for clinical allergologists, as well as for governing authorities. The presented data is of practical importance to the proper timing of immunotherapy initiation and of importance for urban landscaping. The obtained data can be the starting point for the instatement of a thorough epidemiological study and the inclusion of Serbia on the pollen map of Europe.
Collapse
|
38
|
Increase in Airway Obstruction between 1993 and 2012 in Switzerland. An Observational Study. Ann Am Thorac Soc 2020; 17:457-465. [PMID: 31991089 DOI: 10.1513/annalsats.201907-542oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rationale: Most studies determining the prevalence of airway obstruction are limited to short time periods.Objectives: Because temporal trends of obstruction in populations are largely unknown, we determined the prevalence of airway obstruction over 20 years in yearly general population samples in Switzerland between 1993 and 2012.Methods: We analyzed data of 85,789 participants aged 35 years and older who provided spirometric measurements as part of the LuftiBus lung function campaign. We linked data from the 2003-2012 period to the Swiss National Cohort to adjust for annual population differences. Spirometry was performed without bronchodilation, according to American Thoracic Society guidelines. We used Global Lung Initiative (GLI) and Hankinson reference equations to identify obstruction.Results: Obstruction prevalence increased between 1993 and 2012 from 6.1% (95% confidence interval [CI], 5.5 to 6.7) to 15.6% (95% CI, 13.8 to 17.3) based on GLI estimates and from 5.3% (95% CI, 4.7 to 5.9) to 15.4% (95% CI, 13.6 to 17.1) based on Hankinson estimates. When adjusted for participant demographics, air pollutant and occupational exposures, altitude, and season, the prevalence ratios of obstruction were 1.54 (95% CI, 1.22 to 1.93) and 1.65 (95% CI, 1.33 to 2.04) for GLI- and Hankinson-defined airway obstruction, respectively, for 2012 compared with 2003.Conclusions: Though prebronchodilator measurements likely overestimate the prevalence of airway obstruction in absolute terms compared with post-bronchodilator measurements, we found an increase in airway obstruction prevalence. Even with adjustment for several well-known risk factors for obstruction to make the populations across the years more comparable, we still saw a statistically significant increase in prevalence over this time period.
Collapse
|
39
|
Haahtela T, von Hertzen L, Anto JM, Bai C, Baigenzhin A, Bateman ED, Behera D, Bennoor K, Camargos P, Chavannes N, de Sousa JC, Cruz A, Do Céu Teixeira M, Erhola M, Furman E, Gemicioğlu B, Gonzalez Diaz S, Hellings PW, Jousilahti P, Khaltaev N, Kolek V, Kuna P, La Grutta S, Lan LTT, Maglakelidze T, Masjedi MR, Mihaltan F, Mohammad Y, Nunes E, Nyberg A, Quel J, Rosado-Pinto J, Sagara H, Samolinski B, Schraufnagel D, Sooronbaev T, Tag Eldin M, To T, Valiulis A, Varghese C, Vasankari T, Viegi G, Winders T, Yañez A, Yorgancioğlu A, Yusuf O, Bousquet J, Billo NE. Helsinki by nature: The Nature Step to Respiratory Health. Clin Transl Allergy 2019; 9:57. [PMID: 31695865 PMCID: PMC6822361 DOI: 10.1186/s13601-019-0295-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. Results The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking “nature” to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. Conclusions In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.
Collapse
Affiliation(s)
- Tari Haahtela
- 1Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Leena von Hertzen
- 2Department of Dermatology, Allergology and Venereology, Helsinki University Hospital, Helsinki, Finland
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Chunxue Bai
- Zhongshan Hospital, Fudan University, Shanghai Respiratory Research Institute, Shanghai, China
| | | | - Eric D Bateman
- 6Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Digambar Behera
- 7Dept. of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kazi Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Paulo Camargos
- 9Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Niels Chavannes
- 10Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaime Correia de Sousa
- 11Life and Health Sciences Research Institute, ICVS, School of Medicine, University of Minho, Braga, Portugal
| | - Alvaro Cruz
- 12ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória Da Conquista, Brazil
| | | | - Marina Erhola
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Eeva Furman
- 15Environmental Policy Centre, Finnish Environment Institute, Helsinki, Finland
| | - Bilun Gemicioğlu
- 16Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Peter W Hellings
- 18Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - Pekka Jousilahti
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Nikolai Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD), Geneva, Switzerland
| | - Vitezslav Kolek
- 20Department of Respiratory Diseases and Tuberculosis, University Hospital Olomouc, Olomouc, Czech Republic
| | - Piotr Kuna
- 21Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Stefania La Grutta
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy
| | - Le Thi Tuyet Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Vietnam
| | - Tamaz Maglakelidze
- 24Pulmonology Department, Ivane Javakhishvili Tbilisi State University, Chapidze Emergency Cardiology Center, Tbilisi, Georgia
| | | | - Florin Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - Yousser Mohammad
- 27National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - Elizabete Nunes
- 28Pulmonology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Arvid Nyberg
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland
| | - Jorge Quel
- Hispanic American Allergy Asthma & Immunology Association, Marina Del Rey, California USA
| | - Jose Rosado-Pinto
- 31Immunoallergology Department, Hospital da Luz Lisboa, Lisbon, Portugal
| | - Hironori Sagara
- 32Division of Allergology & Respiratory Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Boleslaw Samolinski
- 33Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Dean Schraufnagel
- 34Department of Medicine, University of Illinois at Chicago, Chicago, USA
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Mohamed Tag Eldin
- 36Department of Thoracic Diseases, Ain Shams Faculty of Medicine, Abbassia, Cairo, Egypt
| | - Teresa To
- 37The Hospital for Sick Children, Research Institute and Della Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Arunas Valiulis
- 38Clinic of Children's Diseases, Institute of Clinical Medicine, and Department of Public Health, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | | | | | - Giovanni Viegi
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy.,40Istituto di Fisiologia Clinica CNR, Pisa, Italy
| | - Tonya Winders
- Allergy & Asthma Network, Vienna, VA USA.,Global Allergy & Asthma Patient Platform, Vienna, Austria
| | - Anahi Yañez
- Investigaciones en Alergia y Enfermedades Respiratorias (INAER), Buenos Aires, Argentina
| | - Arzu Yorgancioğlu
- 44Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Osman Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, Montpellier, France
| | - Nils E Billo
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland.,Global Alliance Against Respiratory Diseases (GARD), Helsinki, Finland
| |
Collapse
|
40
|
Maio S, Baldacci S, Carrozzi L, Pistelli F, Simoni M, Angino A, La Grutta S, Muggeo V, Viegi G. 18-yr cumulative incidence of respiratory/allergic symptoms/diseases and risk factors in the Pisa epidemiological study. Respir Med 2019; 158:33-41. [PMID: 31585374 DOI: 10.1016/j.rmed.2019.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Few population-based studies on the effects of environmental exposure variation exist. AIM Assessing respiratory symptom/disease incidence related to risk factor exposure changes. METHODS A longitudinal general population sample from two surveys (PISA2:1991-1993; PISA3:2009-2011; no. = 970), aged ≥20 years at baseline, completed a questionnaire on respiratory symptoms/diseases, risk factor exposure and performed spirometry. 18-year follow-up cumulative incidence of respiratory symptoms/diseases and longitudinal changes (persistence, incidence, remittance) in risk factor exposure were computed. RESULTS Cumulative incidence values were: 3.2% (corresponding to a 1.8‰/year incidence rate), asthma; 6.6% (3.8‰/year), asthma attacks; 4.5% (2.6‰/year), wheeze; 31.7% (21.0‰/year), allergic rhinitis-AR; 7.6% (4.4‰/year), chronic obstructive pulmonary disease-COPD; 16.1% (9.7‰/year), usual cough; 18.5% (11.3‰/year), usual phlegm; 30.7% (20.1‰/year), dyspnoea 1+; 13.9% (8.3‰/year), airway obstruction. The following associations emerged among respiratory symptom/disease cumulative incidence and risk factor exposure changes: a two-to-five fold higher risk for COPD, phlegm, cough, dyspnoea, asthma attacks, airway obstruction in persistent smokers; a two-to-three fold higher risk for COPD in remittent smokers; a two-fold higher risk for AR, phlegm and a four-fold higher risk for asthma in subjects with persistent occupational exposure; a two-fold higher risk for cough, phlegm, dyspnoea, AR in subjects with incident occupational exposure; a two-fold higher risk for AR, asthma attacks, COPD in subjects with incident traffic exposure. CONCLUSIONS Our study showed noteworthy respiratory symptom/disease incidence values and indicated that life-style and environmental exposure changes can differently influence onset. This information could be useful for primary prevention strategies in order to reduce the chronic disease burden in the general population.
Collapse
Affiliation(s)
- Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy; University of Palermo, Department of Economics, Business and Statistic, Palermo, Italy.
| | - Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Laura Carrozzi
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Italy
| | - Francesco Pistelli
- Unit of Pulmonology, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Marzia Simoni
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Anna Angino
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Stefania La Grutta
- CNR Institute for Research and Biomedical Innovation (IRIB), Palermo, Italy
| | - Vito Muggeo
- University of Palermo, Department of Economics, Business and Statistic, Palermo, Italy
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology (IFC), Pisa, Italy; CNR Institute for Research and Biomedical Innovation (IRIB), Palermo, Italy
| |
Collapse
|
41
|
Ma Y, Yu Z, Jiao H, Zhang Y, Ma B, Wang F, Zhou J. Short-term effect of PM 2.5 on pediatric asthma incidence in Shanghai, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:27832-27841. [PMID: 31342347 DOI: 10.1007/s11356-019-05971-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
Recent epidemiological studies pointed out that air pollution has a significant impact on pediatric asthma. Shanghai is one of the biggest cities in China, and the short-term effect of atmospheric particulate matter on the incidence of pediatric asthma has become a hot topic. From January 1, 2009, to December 31, 2010, we used daily measurements of pollutant concentrations, daily weather data, and daily records of pediatric asthma hospital visits from local authorities to evaluate the short-term effect of air pollution on pediatric asthma incidence in Shanghai, China. We used a generalized additive model (GAM) in the analysis, and the controlled confounding factors include long-term trends, day-of-the-week effects, and weather elements. We divided the entire study group into different age-subgroups. In addition, we took a variety of lag models into consideration. The results showed a strong connection between concentrations of fine particulate matter (PM2.5) and pediatric asthma hospital visits from 2009 to 2010 in Shanghai, China. For the entire study group, the greatest relative risk (RR) of PM2.5 on pediatric asthma hospital visits was 1.060 on a lag of 4 days. As for the three different age-subgroups, the greatest RR of PM2.5 on pediatric asthma hospital visits was 1.061 (at a lag of 5 days), 1.071 (at a lag of 4 days), and 1.052 (at a lag of 2 days), for the under-2-year-olds, 3-to-5-year-olds, and the 6-to-18-year-olds, respectively. The overall short-term effect of PM2.5 on pediatric asthma hospital visits was relatively stronger in younger children. Within the year, we detected the strongest seasonal effect of PM2.5 on pediatric asthma hospital visits in Summer. When adding other air pollutants in the analysis model, RR of PM2.5 on pediatric asthma hospital visits would be increased.
Collapse
Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bingji Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fei Wang
- Tacheng Meteorological Bureau, Tacheng, 834700, China
| | - Ji Zhou
- Key Laboratory of Meteorology and Health in Shanghai, Shanghai, 200030, China.
| |
Collapse
|
42
|
Bonomo S, Ferrante G, Palazzi E, Pelosi N, Lirer F, Viegi G, La Grutta S. Evidence for a link between the Atlantic Multidecadal Oscillation and annual asthma mortality rates in the US. Sci Rep 2019; 9:11683. [PMID: 31406172 PMCID: PMC6690970 DOI: 10.1038/s41598-019-48178-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/16/2019] [Indexed: 11/13/2022] Open
Abstract
An association between climatic conditions and asthma mortality has been widely assumed. However, it is unclear whether climatic variations have a fingerprint on asthma dynamics over long time intervals. The aim of this study is to detect a possible correlation between climatic indices, namely the Atlantic Multidecadal Oscillation and Pacific Decadal Oscillation, and asthma mortality rates over the period from 1950 to 2015 in the contiguous US. To this aim, an analysis of non-stationary and non-linear signals was performed on time series of US annual asthma mortality rates, AMO and PDO indices to search for characteristic periodicities. Results revealed that asthma death rates evaluated for four different age groups (5-14 yr; 15-24 yr; 25-34 yr; 35-44 yr) share the same pattern of fluctuation throughout the 1950-2015 time interval, but different trends, i.e. a positive (negative) trend for the two youngest (oldest) categories. Annual asthma death rates turned out to be correlated with the dynamics of the AMO, and also modulated by the PDO, sharing the same averaged ∼44 year-periodicity. The results of the current study suggest that, since climate patterns have proved to influence asthma mortality rates, they could be advisable in future studies aimed at elucidating the complex relationships between climate and asthma mortality.
Collapse
Affiliation(s)
- Sergio Bonomo
- Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council (CNR-IRIB), Via Ugo La Malfa 153, 90146, Palermo, Italy
- Institute for Marine Sciences, National Research Council (CNR-ISMAR), Calata Porta di Massa, 80133, Napoli, Italy
- National Institute of Geophysics and Volcanology (INGV), Via della Faggiola 32, 52126, Pisa, Italy
| | - Giuliana Ferrante
- Dipartimento di Scienze per la Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Palermo, Italy.
| | - Elisa Palazzi
- Institute of Atmospheric Sciences and Climate, National Research Council (CNR-ISAC), Corso Fiume 4, I-10133, Torino, Italy
| | - Nicola Pelosi
- Institute for Marine Sciences, National Research Council (CNR-ISMAR), Calata Porta di Massa, 80133, Napoli, Italy
| | - Fabrizio Lirer
- Institute for Marine Sciences, National Research Council (CNR-ISMAR), Calata Porta di Massa, 80133, Napoli, Italy
| | - Giovanni Viegi
- Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council (CNR-IRIB), Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Stefania La Grutta
- Istituto per la Ricerca e l'Innovazione Biomedica, National Research Council (CNR-IRIB), Via Ugo La Malfa 153, 90146, Palermo, Italy
| |
Collapse
|
43
|
Church MK, Zuberbier T. Untreated allergic rhinitis is a major risk factor contributing to motorcar accidents. Allergy 2019; 74:1395-1397. [PMID: 30742716 DOI: 10.1111/all.13741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Martin K Church
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - Torsten Zuberbier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| |
Collapse
|
44
|
Leru PM, Eftimie AM, Anton VF, Thibaudon M. Five-Year Data on Pollen Monitoring, Distribution and Health Impact of Allergenic Plants in Bucharest and the Southeastern Region of Romania. ACTA ACUST UNITED AC 2019; 55:medicina55050140. [PMID: 31096707 PMCID: PMC6572317 DOI: 10.3390/medicina55050140] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/27/2019] [Accepted: 05/13/2019] [Indexed: 11/23/2022]
Abstract
Background and objectives: Respiratory allergies induced by allergenic pollen represent an important public health problem with increasing prevalence and severity in Europe. Romania has no aerobiology network and pollen measurements have been done for about ten years in the west region only. Materials and Methods: We established the first pollen monitoring center in the capital of Bucharest in 2013, based on collaboration with the Réseau National de Surveillance Aérobiologique (RNSA) from France. The aim of our paper is to present results from five years of pollen monitoring in the city center of Bucharest and preliminary data on distribution and health impact of some allergenic plants, mainly Ambrosia artemisiifolia, which is considered a real danger for the public health. Results: Our data show a significant atmospheric amount and a longer season than previously considered of grass (Gramineae) pollen and short period with a high level of Ambrosia pollen, while tree pollen looks less important in this area. The plant distribution data provided by specialists and information from affected persons showed the wide and increasing spread of Ambrosia in Bucharest and other cities from the south region. Preliminary health data from allergists confirmed that the number of patients with allergies to Ambrosia pollen is increasing from one year to another and almost all patients describe a high urban exposure from their living or working place. Conclusions: We consider that the recently implemented Law 62/2018 against Ambrosia may help reduce weed distribution and the atmospheric pollen load, but a more complex and coordinated strategy for controlling urban vegetation and reducing biologic pollution is needed.
Collapse
Affiliation(s)
- Polliana Mihaela Leru
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
- Colentina Clinical Hospital, 020125 Bucharest, Romania.
| | | | | | - Michel Thibaudon
- Réseau National de Surveillance Aérobiologique, 69690 Brussieu, France.
| |
Collapse
|
45
|
Milanzi EB, Koppelman GH, Oldenwening M, Augustijn S, Aalders-de Ruijter B, Farenhorst M, Vonk JM, Tewis M, Brunekreef B, Gehring U. Considerations in the use of different spirometers in epidemiological studies. Environ Health 2019; 18:39. [PMID: 31023382 PMCID: PMC6485068 DOI: 10.1186/s12940-019-0478-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/11/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Spirometric lung function measurements have been proven to be excellent objective markers of respiratory morbidity. The use of different types of spirometers in epidemiological and clinical studies may present systematically different results affecting interpretation and implication of results. We aimed to explore considerations in the use of different spirometers in epidemiological studies by comparing forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) measurements between the Masterscreen pneumotachograph and EasyOne spirometers. We also provide a correction equation for correcting systematic differences using regression calibration. METHODS Forty-nine volunteers had lung function measured on two different spirometers in random order with at least three attempts on each spirometer. Data were analysed using correlation plots, Bland and Altman plots and formal paired t-tests. We used regression calibration to provide a correction equation. RESULTS The mean (SD) FEV1 and FVC was 3.78 (0.63) L and 4.78 (0.63) L for the Masterscreen pneumotachograph and 3.54 (0.60) L and 4.41 (0.83) L for the EasyOne spirometer. The mean FEV1 difference of 0.24 L and mean FVC difference of 0.37 L between the spirometers (corresponding to 6.3 and 8.4% difference, respectively) were statistically significant and consistent between younger (< 30 years) and older volunteers (> 30 years) and between males and females. Regression calibration indicated that an increase of 1 L in the EasyOne measurements corresponded to an average increase of 1.032 L in FEV1 and 1.005 L in FVC in the Masterscreen measurements. CONCLUSION Use of different types of spirometers may result in significant systematic differences in lung function values. Epidemiological researchers need to be aware of these potential systematic differences and correct for them in analyses using methods such as regression calibration.
Collapse
Affiliation(s)
- Edith B. Milanzi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Gerard H. Koppelman
- University Medical Center Groningen, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, University of Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Marieke Oldenwening
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Sonja Augustijn
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | | | - Martijn Farenhorst
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - Judith M. Vonk
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Marjan Tewis
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| |
Collapse
|
46
|
Cui Y, Dai Z, Luo L, Chen P, Chen Y. Classification and treatment of chronic obstructive pulmonary disease outpatients in China according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017: comparison with GOLD 2014. J Thorac Dis 2019; 11:1303-1315. [PMID: 31179072 DOI: 10.21037/jtd.2019.03.99] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background In 2017, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) proposed new classification criteria for patients with chronic obstructive pulmonary disease (COPD), which categorizes them into groups A-D based on risk of exacerbations and symptoms. The impact of the 2017 revisions on categorization and subsequent drug selection has been insufficiently studied in China. Methods This observational, multicenter, cross-sectional study recruited patients attending the outpatient clinics of 12 tertiary hospitals in China between April 2016 and July 2018. Patients were classified according to the GOLD 2014 and 2017 classification criteria and profiled based on categorization, demographics, clinical characteristics, and treatment regimens. Results In total, 1,278 COPD patients [mean age (±SD), 62.4±8.4 years; body mass index (BMI), 22.3±3.4 kg/m2] were included. According to the GOLD 2014 and 2017 classification criteria, the distribution in groups A-D was 58 (4.5%), 288 (22.5%), 28 (2.2%), 904 (70.7%) and 71 (5.6%), 573 (44.8%), 15 (1.2%), 619 (48.4%), respectively. Overall, 32% of patients in groups C-D were reclassified to groups A-B. Based on both GOLD 2014 and 2017, low BMI and education level were independent risk factors for high risk of exacerbation (i.e., being in groups C-D) (P<0.05). The patients who were reclassified from group D to B were younger and had fewer symptoms than those who remained in group D. The most frequently prescribed regimen was triple inhaled treatment (39.4%). Inhaled corticosteroids (ICS) were prescribed across all groups, and 205 (71.9%) of the 285 patients who were reclassified from group D to B were treated with ICS. Conclusions GOLD 2017 reclassified COPD patients to low-risk groups. The risk of exacerbation increased with decreased BMI or education levels. Overtreatment was observed in many patients, and physicians should reexamine treatment patterns for patients reclassified into low-risk groups.
Collapse
Affiliation(s)
- Yanan Cui
- Department of Respiratory Medicine, the Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Zhongshang Dai
- Department of Respiratory Medicine, the Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Lijuan Luo
- Department of Respiratory Medicine, the Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Ping Chen
- Department of Respiratory Medicine, the Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Yan Chen
- Department of Respiratory Medicine, the Second Xiangya Hospital of Central South University, Changsha 410000, China
| |
Collapse
|
47
|
Dėdelė A, Miškinytė A, Gražulevičienė R. The impact of particulate matter on allergy risk among adults: integrated exposure assessment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:10070-10082. [PMID: 30756350 DOI: 10.1007/s11356-019-04442-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
Exposure assessment is an important part in environmental epidemiology for determining the associations of environmental factors with health effects. One of the greatest challenges for personal exposure assessment is associated with peoples' mobility during the day and spatial and temporal dynamics of air pollution. In this study, the impact of PM10 (particulate matter less than 10 μm) on allergy risk among adults was assessed using objective methods of exposure assessment. The primary objective of the present study was to estimate personal exposure to PM10 based on individual daily movement patterns. Significant differences between the concentration of PM10 in different microenvironments (MEs) and personal exposure to PM10 were determined. Home exposure accounted for the largest part of PM10 exposure. Thirty-five percent of PM10 exposure was received in other non-home MEs. Allergy risk increased significantly with increasing exposure to PM10. Adults exposed to the highest levels of PM10 exposure had a twice-higher risk of allergies than adults exposed to the lowest levels of PM10 exposure. The study results have practical relevance for exposure assessment to environmental factors and its impact on health effects.
Collapse
Affiliation(s)
- Audrius Dėdelė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404, Kaunas, Lithuania.
| | - Auksė Miškinytė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404, Kaunas, Lithuania
| | - Regina Gražulevičienė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404, Kaunas, Lithuania
| |
Collapse
|
48
|
Zanasi A, Morselli-Labate AM, Mazzolini M, Mastroroberto M, Dal Negro RW, Poliacek I, Morice AH, Maio S, Viegi G, Koufman J, Torresan F, Ioannou A, Mandolesi D, Liverani E, Montale A, Bazzoli F, Baldi F, Zompatori M, Fontana GA, Kantar A, Dicpinigaitis P, Page C, Birring SS, Tursi F. XII AIST 2018 Conference: “The thousand faces of cough: clinical and therapeutic updates”. Multidiscip Respir Med 2018. [PMCID: PMC6027558 DOI: 10.1186/s40248-018-0130-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This paper summarizes the presentations submitted for publication of the 12th AIST National Congress (Associazione Italiana Studio Tosse/Italian Association for Cough Study) entitled “The thousand facets of cough. A clinical and therapeutic update”, which occurred last February 2nd-3rd, 2018 in Bologna (Italy). It summarizes the contributions from leading experts of the sector, who, as in the previous editions, also this year have analyzed a problem too often underestimated which still has many dark sides as regards both the diagnosis and the therapy of cough. The Scientific Committee has chosen topics that had less space in previous editions and these are topical subjects representing a concrete opportunity for learning and comparison of opinions, as well as indispensable elements for the correct management of the symptoms. Hereby we report the abstracts of the works submitted for publication in this Meeting report. The main topics have covered Cough relationship with nerve vagus, ATP, air pollution, GERD, imaging, COPD, pediatric and therapy. Of particular interest it is the preliminary data on cough hydration ratio that shows a highly significant correlation between dehydration and cough.
Collapse
|
49
|
Baldacci S, Simoni M, Maio S, Angino A, Martini F, Sarno G, Cerrai S, Silvi P, Pala AP, Bresciani M, Paggiaro P, Viegi G. Prescriptive adherence to GINA guidelines and asthma control: An Italian cross sectional study in general practice. Respir Med 2018; 146:10-17. [PMID: 30665506 DOI: 10.1016/j.rmed.2018.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Although general practitioners (GPs) are frequently the first healthcare professionals whom asthma patients refer to for their symptoms, few studies have explored the extent of adherence to guidelines for asthma management based on data provided directly by GPs. Aims of the present study were to assess drug prescriptions for asthma by GPs and to evaluate prescriptive adherence to GINA guidelines (GL) and its relationship with disease control in real life. METHODS 995 asthmatic patients (45% males, mean age 43.3 ± 17.7 yrs) were enrolled by 107 Italian GPs distributed throughout the country. Data on diagnosis, disease severity, prescribed anti-asthmatic drugs and control were collected through questionnaires filled out by GPs taking into consideration the 2009 GINA Guidelines. Data on drug use and chronic sinusitis, nasal polyposis, chronic bronchitis, emphysema were reported by patients through a self-administered questionnaire. RESULTS The large majority of patients were classified by GPs as having intermittent (48.4%) or mild persistent asthma (25.3%); 61% had co-morbid allergic rhinitis (AR). The prevalent therapeutic regimen used by patients was a combination of inhaled corticosteroids (ICS) plus long-acting β2-agonists (LABA) (54.1%), even in the intermittent/mild persistent group. ICS as mono-therapy or in combination with other drugs but LABA, was the second most frequently adopted treatment (14.4%). In general, the GPs adherence to GL treatment indications was 28.8%, with a significant association with a good asthma control (OR 1.85, 95% CI 1.18-2.92). On the other hand, comorbidity (OR 0.52, 95% CI 0.32-0.84), moderate (0.44, 0.28-0.69) and severe (0.06, 0.02-0.20) persistent asthma showed significant negative effects on asthma control. CONCLUSIONS Our results show that over-treatment of intermittent/mild persistent asthma is frequent in the GPs setting while therapeutic regimens are more appropriately applied for moderate/severe asthma. In general, we found low adherence to GINA GL treatment recommendations even if its relevance in asthma control was confirmed.
Collapse
Affiliation(s)
- Sandra Baldacci
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Marzia Simoni
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Sara Maio
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Anna Angino
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Franca Martini
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Giuseppe Sarno
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Sonia Cerrai
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Patrizia Silvi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Anna Paola Pala
- Technoscience Unit, CNR Institute of Clinical Physiology, Via G. Moruzzi no. 1, 56124, Pisa, Italy
| | - Megon Bresciani
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy
| | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Via Paradisa no. 2, 56124, Pisa, Italy
| | - Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste no. 41, 56126, Pisa, Italy; CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa no. 153, 90146, Palermo, Italy
| | | |
Collapse
|
50
|
Hyrkäs-Palmu H, Ikäheimo TM, Laatikainen T, Jousilahti P, Jaakkola MS, Jaakkola JJK. Cold weather increases respiratory symptoms and functional disability especially among patients with asthma and allergic rhinitis. Sci Rep 2018; 8:10131. [PMID: 29973669 PMCID: PMC6031646 DOI: 10.1038/s41598-018-28466-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 06/20/2018] [Indexed: 12/18/2022] Open
Abstract
Cold weather affects the respiratory epithelium and induces bronchial hyperresponsiveness. We hypothesized that individuals with allergic rhinitis or/and asthma experience cold weather-related functional disability (FD) and exacerbation of health problems (EH) more commonly than individuals without these. This was a population-based study of 7330 adults aged 25–74 years. The determinants of interest, including doctor-diagnosed asthma and allergic rhinitis, and the outcomes, including cold weather-related FD and EH, were measured using a self-administered questionnaire. The prevalences of cold-related FD and EH were 20.3% and 10.3%, respectively. In Poisson regression, the risk of FD increased in relation to both allergic rhinitis (adjusted prevalence ratio (PR) 1.19, 95% CI 1.04–1.37 among men; 1.26, 95% CI 1.08–1.46 among women), asthma (1.29, 0.93–1.80; 1.36, 0.92–2.02, respectively) and their combination (1.16, 0.90–1.50; 1.40, 1.12–1.76, respectively). Also the risk of cold weather-related EH was related to both allergic rhinitis (1.53, 1.15,−2.04 among men; 1.78, 1.43–2.21 among women), asthma (4.28, 2.88–6.36; 3.77, 2.67–5.34, respectively) and their combination (4.02, 2.89–5.59; 4.60, 3.69–5.73, respectively). We provide new evidence that subjects with allergic rhinitis or/and asthma are more susceptible to cold weather-related FD and EH than those without pre-existing respiratory diseases.
Collapse
Affiliation(s)
- Henna Hyrkäs-Palmu
- Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Tiina M Ikäheimo
- Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Public Health Solutions, FI-00271, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, FI-70211, Kuopio, Finland.,Joint municipal authority for North Karelia social and health services (Siun sote), FI-80210, Joensuu, Finland
| | - Pekka Jousilahti
- National Institute for Health and Welfare, Public Health Solutions, FI-00271, Helsinki, Finland
| | - Maritta S Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland. .,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
| |
Collapse
|