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Wang H, Meng R, Wang X, Si Z, Zhao Z, Lu H, Wang H, Hu J, Zheng Y, Chen J, Zhao Z, Zhu H, Li X, Xue L, Yan S, Sun J, Su Y, Wu J. A nested case-control study of the effects of dust exposure, smoking on COPD in coal workers. BMC Public Health 2023; 23:2056. [PMID: 37864177 PMCID: PMC10588135 DOI: 10.1186/s12889-023-16944-6] [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: 05/17/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) represents a prevalent ailment, progressively surging within the ranks of coal mine laborers. The current study endeavors to elucidate the effects of dust exposure and smoking on COPD incidence amongst coal mine workers, while concurrently devising preventive strategies for this affliction. METHOD A nested case-control study was conducted encompassing 1,416 participants aged ≥ 18 years, spanning the duration from (2017-2018) until 2020. A meticulous matching process yielded a cohort of 708 COPD patients, each paired with a control subject, forming a harmonious 1:1 ratio. Multiple logistic regression analysis was employed to scrutinize the associations between smoking, dust exposure with COPD among coal workers. RESULTS The COPD prevalence within the cohort of coal workers under investigation amounted to 22.66%, with an accompanying incidence density of 0.09/person-year. Following meticulous adjustment for confounding variables, it was discerned that cumulative dust exposure within the range of 47.19 ~ (OR: 1.90, 95% CI: 1.05, 3.44), 101.27 ~ (OR: 1.99, 95% CI: 1.17, 3.39), as well as smoking indices of 72 ~ (OR: 1.85, 95% CI: 1.19, 2.88), 145 ~ (OR: 1.74, 95% CI: 1.17, 2.61), 310 ~ (OR: 1.85, 95% CI: 1.23, 2.77) engender an escalated vulnerability to COPD among coal workers. Furthermore, interaction analysis discerned an absence of both multiplicative and additive interactions between dust exposure, smoking, and COPD occurrence amidst coal workers. CONCLUSION Dust exposure and smoking were unequivocally identified as precipitating risk factors for COPD incidence within the population of coal workers, albeit devoid of any discernible interaction between these two causal agents.
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Affiliation(s)
- Hui Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Rui Meng
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Xuelin Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Zhikang Si
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Zekun Zhao
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Haipeng Lu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Huan Wang
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Jiaqi Hu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Yizhan Zheng
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Jiaqi Chen
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Ziqi Zhao
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Hongmin Zhu
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Xiaoming Li
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Ling Xue
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Shengguang Yan
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Jian Sun
- School of Public Health, Caofeidian New Town, North China University of Science and Technology, No.21 Bohai Avenue, Tangshan City, Hebei Province, 063210, People's Republic of China
| | - Yu Su
- Personnel Department, North China University of Science and Technology, Tangshan City, Hebei Province, China.
| | - Jianhui Wu
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China.
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López A, Benavides-Cordoba V, Palacios M. Effects of changing reference values on the interpretation of spirometry for rubber workers. Toxicol Rep 2023; 10:686-689. [PMID: 37324404 PMCID: PMC10265506 DOI: 10.1016/j.toxrep.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction The National Health and Nutrition Assessment Survey (NHANES) is being adopted for interpreting spirometry in occupational examinations. Rubber workers have an elevated risk of respiratory health issues due to industrial exposure, and changes in the equations would affect spirometry monitoring programs. Objective To determine the differences in the use of the Knudson and NHANES III equations in nonsmoking workers in the rubber industry. Method A cross-sectional study was conducted with 75 nonsmoking workers with occupational exposure to rubber for at least two years. The factory had engineered protection controls and provided respiratory protection to the workers. Spirometry was conducted according to Spirometry Testing in Occupational Health Programs and Standardization of Spirometry: American Thoracic Society/European Respiratory Society. Result Spirometric prediction differences were present in the restrictive pattern assessment based on forced vital capacity (FVC), in which three individuals (4%) classified as normal according to Knudson presented restrictive disease according to NHANES III; only in the record of one participant was there restrictive disease using both equations. There was an 8% discrepancy for small airway obstruction in which six workers classified as normal using NHANES III were classified as diseased (FEF 25-75 <50%) using the Knudson equation. Conclusion In the respiratory examination of workers exposed to rubber, the NHANES III equation is better able to detect restrictive diseases than is the Knudson equation; however, the Knudson equation is more sensitive to obstructive patterns.
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Affiliation(s)
- Alex López
- Maestría en Salud Ocupacional, Universidad del Valle, Cali, Colombia
| | | | - Mauricio Palacios
- Farmacología, Universidad del Valle, Cali, Colombia
- Facultad de Salud, Universidad del Valle, Cali, Colombia
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Bashir MBA, Basna R, Hedman L, Backman H, Ekerljung L, Andersén H, Wennergren G, Bhatta L, Lindberg A, Lundbäck B, Kankaanranta H, Rönmark E, Nwaru BI. Interaction of smoking and social status on the risk of respiratory outcomes in a Swedish adult population: A Nordic Epilung study. Respir Med 2023; 211:107192. [PMID: 36906185 DOI: 10.1016/j.rmed.2023.107192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/19/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Evidence abounds on the independent roles of social class and smoking in relation to obstructive airway diseases, but data are sparse on the impact of their interaction. We evaluated whether and to what extent social class and smoking interact in relation to risk of respiratory diseases in adults. METHODS Data from the population-based studies, West Sweden Asthma Study (WSAS, n = 23,753) and Obstructive Lung Disease in Northern Sweden studies (OLIN, n = 6519), were used, constituting randomly selected adults aged 20-75 years. Bayesian network analysis was used to estimate the probability for the interaction between smoking and socioeconomic status in relation to respiratory outcomes. RESULTS Occupational and educational SES modified the association between smoking and the probability of allergic and non-allergic asthma. Former smokers who were at intermediate non manual employees and manual workers in service had higher probability of allergic asthma compared to professionals and executives. Furthermore, former smokers with primary education had higher probability of non-allergic asthma than those with secondary and tertiary education. Similarly, former smokers among professionals and executives had higher probability of non-allergic asthma than manual and home workers and primary educated. Likewise, allergic asthma due to former smoking was higher among highly educated compared to low educated. CONCLUSIONS Beyond their independent roles, socioeconomic status and smoking interact in defining the risk of respiratory diseases. Clearer understanding of this interaction can help to identify population subgroups at most need of public health interventions.
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Affiliation(s)
| | - Rani Basna
- Krefting Research Centre, 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
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN Unit, Umeå University, Umeå, Sweden
| | - Linda Ekerljung
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Heidi Andersén
- Faculty of Medicine and Health Technology, Tampere University Respiratory Research Group, Tampere University, Tampere, Finland; Oncology Unit, Vaasa Keskussairaala, Vaasa, Finland
| | - Göran Wennergren
- Department of Paediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Laxmi Bhatta
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Section of Medicine/the OLIN Unit, Umeå University, Umeå, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - Hannu Kankaanranta
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/ the OLIN Unit, Umeå University, Umeå, Sweden
| | - Bright I Nwaru
- Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Barnes PJ. Oxidative Stress in Chronic Obstructive Pulmonary Disease. Antioxidants (Basel) 2022; 11:antiox11050965. [PMID: 35624831 PMCID: PMC9138026 DOI: 10.3390/antiox11050965] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 12/16/2022] Open
Abstract
There is a marked increase in oxidative stress in the lungs of patients with COPD, as measured by increased exhaled 8-isoprostane, ethane, and hydrogen peroxide in the breath. The lung may be exposed to exogenous oxidative stress from cigarette smoking and indoor or outdoor air pollution and to endogenous oxidative stress from reactive oxygen species released from activated inflammatory cells, particularly neutrophils and macrophages, in the lungs. Oxidative stress in COPD may be amplified by a reduction in endogenous antioxidants and poor intake of dietary antioxidants. Oxidative stress is a major driving mechanism of COPD through the induction of chronic inflammation, induction of cellular senescence and impaired autophagy, reduced DNA repair, increased autoimmunity, increased mucus secretion, and impaired anti-inflammatory response to corticosteroids. Oxidative stress, therefore, drives the pathology of COPD and may increase disease progression, amplify exacerbations, and increase comorbidities through systemic oxidative stress. This suggests that antioxidants may be effective as disease-modifying treatments. Unfortunately, thiol-based antioxidants, such as N-acetylcysteine, have been poorly effective, as they are inactivated by oxidative stress in the lungs, so there is a search for more effective and safer antioxidants. New antioxidants in development include mitochondria-targeted antioxidants, NOX inhibitors, and activators of the transcription factor Nrf2, which regulates several antioxidant genes.
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Affiliation(s)
- Peter J Barnes
- National Heart and Lung Institute, Imperial College London, London SW5 9LH, UK
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