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Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome. Clin Chest Med 2021; 41:777-796. [PMID: 33153695 DOI: 10.1016/j.ccm.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.
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Shamsollahi HR, Ghoochani M, Jaafari J, Moosavi A, Sillanpää M, Alimohammadi M. Environmental exposure to endotoxin and its health outcomes: A systematic review. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 174:236-244. [PMID: 30831472 DOI: 10.1016/j.ecoenv.2019.02.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 06/09/2023]
Abstract
Exposure to endotoxin occurs environmentally and occupationally. There are several differences between them in terms of the variety and severity of health outcomes, possible exposed groups and type and route of exposure. Occupational exposures caused adverse health outcomes in almost all cases, but there is disparity in the incidence of significant health outcomes due to environmental exposure to endotoxin. This study has therefore endeavoured to investigate health outcomes from environmental exposure to endotoxin. A systematic review was conducted of three databases and non-occupational studies reporting the environmental concentration of endotoxin, and observed health outcomes in exposed groups were included in the review (n = 27). The studies showed that first exposure to endotoxin occurs in infancy by the inhalation route. Inhalation is the only exposure route that can induce inflammation as the main symptom of exposure to endotoxin. The studies included were conducted using four approaches: molecular immunology, measurement of lung volumes, clinical sensitisation test and diagnosis of asthmatic and respiratory symptoms such as wheezing. By the immunological approach, all the included studies reported that environmental exposure to endotoxin, especially at a younger age, has a protective effect on the incidence of asthma in adolescence. The main disparity observed was in studies using the approach of diagnosed asthma. Overall, however, they confirm the protective effect of exposure to endotoxin although, in the case of children with non-atopic asthma, the results could be different.
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Affiliation(s)
- Hamid Reza Shamsollahi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahboobeh Ghoochani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Jalil Jaafari
- Department of Environmental Health Engineering, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
| | - Azam Moosavi
- Department of Biochemistry, School of Medicine, Alborz University of Medical Sciences, Alborz, Iran.
| | - Mika Sillanpää
- Laboratory of Green Chemistry, School of Engineering Science, Lappeenranta University of Technology, Sammonkatu 12, Mikkeli, Finland.
| | - Mahmood Alimohammadi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Water Quality Research (CWQI), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran.
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Oluwole O, Rennie DC, Senthilselvan A, Dyck R, Afanasieva A, Kirychuk S, Katselis G, Lawson JA. The association between endotoxin and beta-(1 → 3)-D-glucan in house dust with asthma severity among schoolchildren. Respir Med 2018; 138:38-46. [PMID: 29724391 DOI: 10.1016/j.rmed.2018.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/13/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Asthma severity can be affected by microbial exposures. However, less is known about the specific indoor agents aggravating the disease in children. We examined the associations between indoor endotoxin and beta-(1 → 3)-D-glucan exposures and asthma severity in children with asthma. METHODS A clinical cross-sectional study of schoolchildren (aged 7-17 years) was conducted in the province of Saskatchewan, Canada. Children with asthma (n = 116) were identified from 335 participants using a combination of survey responses and objective clinical assessments. We then ascertained asthma severity based on recommended guidelines (continuous daytime asthma symptoms, frequent nighttime asthma symptoms, and ≤ 60% predicted FEV1). Levels of indoor endotoxin and beta-(1 → 3)-D-glucan were measured in dust samples obtained from play area floors and child's mattresses. RESULTS The study population of 116 children with asthma was comprised of 75.9% mild asthma and 24.1% moderate/severe asthma. Higher mattress endotoxin concentration was associated with increased odds of moderate/severe asthma [adjusted odds ratio (aOR) = 11.40, 95% confidence interval (CI): 1.45-89.43] while higher beta-(1 → 3)-D-glucan concentration (aOR = 0.16, 95% CI: 0.03-0.89) and load (aOR = 0.10, 95% CI: 0.02-0.72) in play areas were inversely associated with moderate/severe asthma. Furthermore, higher mattress endotoxin concentration was associated with lower FVC (p = 0.01) and FEV1 (p = 0.03). These associations were not seen for beta-(1 → 3)-D-glucan. CONCLUSION Our results showed differential effects of microbial exposures on childhood asthma severity and further highlight domestic endotoxin exposure effects on respiratory health outcomes in children with asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology, University of Saskatchewan, 104 Clinic Place Saskatoon, SK, S7N 2Z4, Canada; Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada.
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | | | - Roland Dyck
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - George Katselis
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK, S7N 2Z4, Canada; Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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Beridze V, Abuladze L, Partenadze N, Bakhtadze T, Lawson J, Zejda JE. Childhood asthma in Batumi, Georgia: Prevalence and environmental correlates. J Asthma 2017; 55:43-49. [PMID: 27901622 DOI: 10.1080/02770903.2016.1247169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A relative lack of data for Eastern Europe and unknown epidemiology of childhood asthma in Batumi (Georgia) justified a study aimed at determining the prevalence of physician-diagnosed asthma and related respiratory conditions, a comparison of the prevalence of these conditions between urban and rural children, and identification of their environmental correlates. METHODS Subjects of the cross-sectional population-based study were 3238 urban and 2081 rural children aged 5-17 years whose respiratory status was assessed using the ISAAC questionnaire. RESULTS The overall prevalence of asthma was larger in rural children than in urban children (2.8% vs. 1.8%, respectively; p = 0.01). Spastic bronchitis occurred with similar frequency in urban (7.8%) and rural children (6.5%). Compared with urban children, rural subjects had dry cough at night (13.1 vs 8.2%, p < 0.001) and attacks of dyspnea (4.7 vs 2.4%, p < 0.001) more often. The prevalence of other symptoms did not differ significantly between urban and rural subjects. Results of multivariate analyses showed that both asthma and spastic bronchitis were associated (p < 0.05) with parental history of asthma, dampness in the house, and poor financial standing of the family. In addition, asthma was related to coal/wood-based heating whereas spastic bronchitis was associated with passive smoking and lower parental education. CONCLUSIONS The findings show a low prevalence of ever-diagnosed asthma in the examined population. Nosological tradition and similar correlates of asthma and spastic bronchitis suggest that some cases of asthma might be included in the diagnostic category of spastic bronchitis.
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Affiliation(s)
- Vakhtang Beridze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Lia Abuladze
- b Maternity and Child Health Center , Batumi , Georgia
| | | | - Tamar Bakhtadze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Joshua Lawson
- c Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon , Canada
| | - Jan E Zejda
- d Department of Epidemiology , School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
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Lawson JA, Rennie DC, Cockcroft DW, Dyck R, Afanasieva A, Oluwole O, Afsana J. Childhood asthma, asthma severity indicators, and related conditions along an urban-rural gradient: a cross-sectional study. BMC Pulm Med 2017; 17:4. [PMID: 28056923 PMCID: PMC5216545 DOI: 10.1186/s12890-016-0355-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/16/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Asthma prevalence is generally lower in rural locations with some indication of an urban-rural gradient. However, among children with asthma, certain rural exposures thought to protect against the development of asthma could aggravate the condition. We examined childhood asthma prevalence and related conditions along an urban-rural gradient and also examined the characteristics of those with asthma along the urban-rural gradient. METHODS In 2013 we completed a cross-sectional survey of 3509 children aged 5-14 years living in various population densities of Saskatchewan, Canada. Location of dwelling was identified as belonging to one of the following population densities: large urban region (approximately 200,000), small urban (approximately 35,000), or rural (small town of <1,500 or farm dweller). Physician-diagnosed asthma and asthma-related symptoms were ascertained from responses in the parental-completed questionnaires. RESULTS Of the study population, 69% lived in a large urban region, 11% lived in a small urban centre and 20% were rural dwellers. Overall, asthma prevalence was 19.6% with differences in asthma prevalence with differences between locations (large urban = 20.7%; small urban = 21.5%; rural = 15.1%; p = 0.003). After adjustment for potential confounders, the association between location of dwelling and asthma remained significant. Despite a lower prevalence of asthma in the rural area, the prevalence and risk of ever wheeze and having more than 3 wheezing episodes in the past 12 months among those who reported asthma, was higher in rural locations after adjustment for potential confounders. CONCLUSIONS The results of this study support the evidence of a difference in childhood asthma prevalence between urban and rural locations and that once a child has asthma, certain rural exposures may aggravate the disease.
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Affiliation(s)
- Joshua A. Lawson
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 5E5 Canada
| | - Donna C. Rennie
- College of Nursing and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
| | - Don W. Cockcroft
- Department of Medicine, University of Saskatchewan, Saskatoon, SK Canada
| | - Roland Dyck
- Department of Medicine and Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 5E5 Canada
| | - Anna Afanasieva
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
| | - Oluwafemi Oluwole
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
| | - Jinnat Afsana
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK Canada
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Abstract
Asthma is the most common chronic disease among children. It cannot be prevented but can be controlled. Industrialized countries experience high lifetime asthma prevalence that has increased over recent decades. Asthma has a complex interplay of genetic and environmental triggers. Studies have revealed complex interactions of lung structure and function genes with environmental exposures such as environmental tobacco smoke and vitamin D. Home environmental strategies can reduce asthma morbidity in children but should be tailored to specific allergens. Coupled with education and severity-specific asthma therapy, tailored interventions may be the most effective strategy to manage childhood asthma.
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Affiliation(s)
- Jessica P Hollenbach
- Department of Pediatrics, Asthma Center, The Children's Center for Community Research, CT Children's Medical Center, University of Connecticut School of Medicine, 282 Washington Street, Hartford, CT 06106, USA
| | - Michelle M Cloutier
- Department of Pediatrics, Asthma Center, The Children's Center for Community Research, Connecticut Children's Medical Center, University of Connecticut Health Center, 282 Washington Street, Hartford, CT 06106, USA.
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Kanchongkittiphon W, Mendell MJ, Gaffin JM, Wang G, Phipatanakul W. Indoor environmental exposures and exacerbation of asthma: an update to the 2000 review by the Institute of Medicine. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:6-20. [PMID: 25303775 PMCID: PMC4286274 DOI: 10.1289/ehp.1307922] [Citation(s) in RCA: 241] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 10/09/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Previous research has found relationships between specific indoor environmental exposures and exacerbation of asthma. OBJECTIVES In this review we provide an updated summary of knowledge from the scientific literature on indoor exposures and exacerbation of asthma. METHODS Peer-reviewed articles published from 2000 to 2013 on indoor exposures and exacerbation of asthma were identified through PubMed, from reference lists, and from authors' files. Articles that focused on modifiable indoor exposures in relation to frequency or severity of exacerbation of asthma were selected for review. Research findings were reviewed and summarized with consideration of the strength of the evidence. RESULTS Sixty-nine eligible articles were included. Major changed conclusions include a causal relationship with exacerbation for indoor dampness or dampness-related agents (in children); associations with exacerbation for dampness or dampness-related agents (in adults), endotoxin, and environmental tobacco smoke (in preschool children); and limited or suggestive evidence for association with exacerbation for indoor culturable Penicillium or total fungi, nitrogen dioxide, rodents (nonoccupational), feather/down pillows (protective relative to synthetic bedding), and (regardless of specific sensitization) dust mite, cockroach, dog, and dampness-related agents. DISCUSSION This review, incorporating evidence reported since 2000, increases the strength of evidence linking many indoor factors to the exacerbation of asthma. Conclusions should be considered provisional until all available evidence is examined more thoroughly. CONCLUSION Multiple indoor exposures, especially dampness-related agents, merit increased attention to prevent exacerbation of asthma, possibly even in nonsensitized individuals. Additional research to establish causality and evaluate interventions is needed for these and other indoor exposures.
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Kulhankova K, George CL, Kline JN, Darling M, Thorne PS. Endotoxin inhalation alters lung development in neonatal mice. Am J Ind Med 2012; 55:1146-58. [PMID: 22576659 PMCID: PMC3549999 DOI: 10.1002/ajim.22061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Childhood asthma is a significant public health problem. Epidemiologic evidence suggests an association between childhood asthma exacerbations and early life exposure to environmental endotoxin. Although the pathogenesis of endotoxin-induced adult asthma is well studied, questions remain about the impact of environmental endotoxin on pulmonary responsiveness in early life. METHODS We developed a murine model of neonatal/juvenile endotoxin exposures approximating those in young children and evaluated the lungs inflammatory and remodeling responses. RESULTS Persistent lung inflammation induced by the inhalation of endotoxin in early life was demonstrated by the influx of inflammatory cells and pro-inflammatory mediators to the airways and resulted in abnormal alveolarization. CONCLUSIONS Results of this study advance the understanding of the impact early life endotoxin inhalation has on the lower airways, and demonstrates the importance of an experimental design that approximates environmental exposures as they occur in young children.
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Affiliation(s)
- Katarina Kulhankova
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA, USA
- Department of Pathology, University of Iowa, Iowa City, IA, USA
| | | | - Joel N. Kline
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Peter S. Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA
- Environmental Health Sciences Research Center, University of Iowa, Iowa City, IA, USA
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Lawson JA, Dosman JA, Rennie DC, Beach JR, Newman SC, Crowe T, Senthilselvan A. Endotoxin as a determinant of asthma and wheeze among rural dwelling children and adolescents: a case-control study. BMC Pulm Med 2012; 12:56. [PMID: 22966977 PMCID: PMC3545854 DOI: 10.1186/1471-2466-12-56] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 08/31/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The association between endotoxin exposure and asthma is complex and has been associated with rural living. We examined the relationship between domestic endotoxin and asthma or wheeze among rural school-aged children (6-18 years) and assessed the interaction between endotoxin and other characteristics with these outcomes. METHODS Between 2005 and 2007 we conducted a case-control study of children 6-18 years in the rural region of Humboldt, Canada. Cases (n = 102) reported doctor-diagnosed asthma or wheeze in the past year. Controls (n = 208) were randomly selected from children without asthma or wheeze. Data were collected to ascertain symptoms, asthma history and indoor environmental exposures (questionnaire), endotoxin (dust collection from the play area floor and child's mattress), and tobacco smoke exposure (saliva collection). Statistical testing was completed using multiple logistic regression to account for potential confounders and to assess interaction between risk factors. A stratified analysis was also completed to examine the effect of personal history of allergy. RESULTS Among children aged 6-12 years, mattress endotoxin concentration (EU/mg) and load (EU/m2) were inversely associated with being a case [odds ratio (OR) = 0.44, 95% confidence interval (CI) = 0.20-0.98; and OR = 0.38, 95% CI = 0.20-0.75, respectively]. These associations were not observed in older children or with play area endotoxin. CONCLUSIONS Our results suggest that endotoxin exposure might be protective for asthma or wheeze. The protective effect is found in younger school-aged, non-allergic children. These results may help explain the inconsistencies in previous studies and suggest that the protective effects of endotoxin in the prevention of atopy and asthma or wheeze are most effective earlier in life.
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Affiliation(s)
- Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture & Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Canadian Centre for Health and Safety in Agriculture Royal University Hospital University of Saskatchewan, 3641-103 Hospital Drive, Saskatoon, SK S7N 0 W8, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna C Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, and the College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jeremy R Beach
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Stephen C Newman
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Trever Crowe
- College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ambikaipakan Senthilselvan
- Department of Public Health Sciences, School of Public Health Sciences, University of Alberta, Edmonton, AB, Canada
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Knight DA, Yang IA, Ko FWS, Lim TK. Year in review 2011: asthma, chronic obstructive pulmonary disease and airway biology. Respirology 2012; 17:563-72. [PMID: 22248232 DOI: 10.1111/j.1440-1843.2012.02126.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Darryl A Knight
- UBC James Hogg Research Centre, Institute for Heart + Lung Health, Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
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May S, Romberger DJ, Poole JA. Respiratory health effects of large animal farming environments. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2012; 15:524-41. [PMID: 23199220 PMCID: PMC4001716 DOI: 10.1080/10937404.2012.744288] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
With increases in large animal-feeding operations to meet consumer demand, adverse upper and lower respiratory health effects in exposed agriculture workers are a concern. The aim of this study was to review large animal confinement feeding operational exposures associated with respiratory disease with a focus on recent advances in the knowledge of causative factors and cellular and immunological mechanisms. A PubMed search was conducted with the keywords airway, farm, swine, dairy, horse, cattle inflammation, organic dust, endotoxin, and peptidoglycan, among items were published between 1980 and now. Articles were selected based on their relevance to environmental exposure and reference to airway diseases. Airway diseases included rhinitis, sinusitis, mucus membrane inflammation syndrome, asthma, chronic bronchitis, chronic obstructive pulmonary disease, hypersensitivity pneumonitis, and organic dust toxic syndrome. There is lower prevalence of immunoglobulin (Ig) E-mediated asthma and atopy in farmers and their children, but organic dust worsens existing asthma. Multiple etiologic factors are linked to disease, including allergens, organic dusts, endotoxins, peptidoglycans, and gases. Large animal confinement feeding operations contain a wide diversity of microbes with increasing focus on gram-positive bacteria and archaebacteria as opposed to gram-negative bacteria in mediating disease. Toll-like receptors (TLR) and nucleotide oligomerization domain (NOD)-like innate immune pathways respond to these exposures. Finally, a chronic inflammatory adaptation, tolerance-like response in chronically exposed workers occurs. Large animal confinement farming exposures produce a wide spectrum of upper and lower respiratory tract diseases due to the complex diversity of organic dust, particulates, microbial cell wall components, and gases and resultant activation of various innate immune receptor signaling pathways.
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Affiliation(s)
- Sara May
- Pulmonary, Critical Care, Sleep & Allergy Division; Department of Internal Medicine,; University of Nebraska Medical Center, 985300 The Nebraska Medical Center, Omaha, NE 68198-5300
| | - Debra J. Romberger
- Pulmonary, Critical Care, Sleep & Allergy Division; Department of Internal Medicine,; University of Nebraska Medical Center, 985300 The Nebraska Medical Center, Omaha, NE 68198-5300
- Veterans Administration Nebraska Western Iowa Healthcare System, Omaha, NE, 4101 Woolworth Ave., 68105
| | - Jill A. Poole
- Pulmonary, Critical Care, Sleep & Allergy Division; Department of Internal Medicine,; University of Nebraska Medical Center, 985300 The Nebraska Medical Center, Omaha, NE 68198-5300
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Lawson JA, Dosman JA, Rennie DC, Beach J, Newman SC, Senthilselvan A. The association between endotoxin and lung function among children and adolescents living in a rural area. Can Respir J 2011; 18:e89-94. [PMID: 22187693 PMCID: PMC3267627 DOI: 10.1155/2011/290261] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED BACKGROUND⁄ OBJECTIVES Knowledge of the effects of domestic endotoxin on children's lung function is limited. The association between domestic endotoxin and asthma or wheeze and lung function among school-age children (six to 18 years of age) was examined. The interaction between endotoxin and other personal and environmental characteristics and lung function was also assessed. METHODS A case-control study was conducted in and around the rural community of Humboldt, Saskatchewan, between 2005 and 2007. Parents of cases reported either doctor-diagnosed asthma or wheeze in the previous year. Controls were randomly selected from those not reporting these conditions. Data were collected by questionnaire to ascertain symptoms and conditions, while spirometry was used to measure lung function including forced vital capacity and forced expiratory volume in 1 s. Dust collected from the child's play area floor and the child's mattress was used to quantify endotoxin, and saliva was collected to quantify cotinine levels and assess tobacco smoke exposure. RESULTS There were 102 cases and 207 controls included in the present study. Lower forced expiratory volume in 1 s was associated with higher mattress endotoxin load among female cases (beta=-0.25, SE=0.07 [P<0.01]). There was a trend toward lower forced vital capacity, which was associated with higher play area endotoxin load among cases with high tobacco smoke exposure (beta=-0.17, SE=0.09 [P<0.10]). CONCLUSIONS Findings indicated that high endotoxin levels present in common household areas of rural children with asthma or wheeze may also affect their lung function. These associations may be potentiated by tobacco smoke exposure and female sex.
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Affiliation(s)
- Joshua A Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada.
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