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Madsen AM, White JK, Nielsen JL, Keskin ME, Tendal K, Frederiksen MW. A cross sectional study on airborne inhalable microorganisms, endotoxin, and particles in pigeon coops - Risk assessment of exposure. ENVIRONMENTAL RESEARCH 2022; 204:112404. [PMID: 34838572 DOI: 10.1016/j.envres.2021.112404] [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: 07/09/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
Pigeon breeding is associated with symptoms of the airways. The aim of this study is to illuminate the bacteriological and toxicological characteristics of airborne dust in pigeon coops. Airborne dust was sampled in 31 urban pigeon coops with homing and fancy pigeons, and following the dust was characterized. In total 141 different bacterial species were identified using MALDI-TOF MS, and of these 11 species are classified in risk group 2. Of the cultivable bacteria, Staphylococcus equorum was present in the highest concentration. Microorganisms in the dust were able to form biofilm, and the amount correlated positively with the number of bacteria. Next generation sequencing showed 180 genera with Acinetobacter in highest reads. On average 999 ± 225 ZOTUs were observed per sample with a Shannon-Wiener biodiversity index of 6.17 ± 0.24. Of the identified species the following have previously been suggested as causative agents of extrinsic allergic alveolitis: Alcaligenes faecalis, Bacillus subtilis, Pantoea agglomerans, Sphingobacterium spiritivorum, Thermoactinomyces sp., and Streptomyces albus. Staphylococcus was present on particles with sizes between 1.1 and > 7.0 μm with a geometric mean diameter of particles on 4.7 ± 1.1 μm. Concentrations of airborne endotoxin and dust were elevated compared to references, and the geometric mean concentrations were 102 EU/m3 and 1.07 mg dust/m3, respectively. Upon exposure to the airborne dust human granulocytes produced Reactive Oxidative Species during the first 5 min, and then no further reaction was observed. The concentrations of bacteria in general, Staphylococcus spp., and endotoxin and biodiversity were associated significantly with season, temperature and/or relative humidity, but not with type or density of pigeons. The bacterial composition and biodiversity indices were not affected by type of pigeon. In conclusion, the exposure to bacteria and endotoxin in pigeon houses should not be neglected in the evaluation of causative agents of airways symptoms among pigeon breeders.
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Affiliation(s)
- Anne Mette Madsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark.
| | - John Kerr White
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark; Department of Chemistry and Bioscience, Aalborg University, Fredrik Bajers Vej 7H, 9220, Aalborg Ø, Denmark; Department of Microbiology, Tumor and Cell Biology, Division of Clinical Microbiology, Karolinska Institute and Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Jeppe Lund Nielsen
- Department of Chemistry and Bioscience, Aalborg University, Fredrik Bajers Vej 7H, 9220, Aalborg Ø, Denmark
| | - Mehmet Emin Keskin
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | - Kira Tendal
- The National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
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2
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Kaur K, Bachus H, Lewis C, Papillion AM, Rosenberg AF, Ballesteros-Tato A, León B. GM-CSF production by non-classical monocytes controls antagonistic LPS-driven functions in allergic inflammation. Cell Rep 2021; 37:110178. [PMID: 34965421 PMCID: PMC8759241 DOI: 10.1016/j.celrep.2021.110178] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 10/25/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
Lipopolysaccharide (LPS) can either promote or prevent T helper 2 (Th2) cell allergic responses. However, the underlying mechanism remains unknown. We show here that LPS activity switches from pro-pathogenic to protective depending on the production of granulocyte-macrophage colony-stimulating factor (GM-CSF) by non-classical monocytes. In the absence of GM-CSF, LPS can favor pathogenic Th2 cell responses by supporting the trafficking of lung-migratory dendritic cells (mDC2s) into the lung-draining lymph node. However, when non-classical monocytes produce GM-CSF, LPS and GM-CSF synergize to differentiate monocyte-derived DCs from classical Ly6Chi monocytes that instruct mDC2s for Th2 cell suppression. Importantly, only allergens with cysteine protease activity trigger GM-CSF production by non-classical monocytes. Hence, the therapeutic effect of LPS is restricted to allergens with this enzymatic activity. Treatment with GM-CSF, however, restores the protective effects of LPS. Thus, GM-CSF produced by non-classical monocytes acts as a rheostat that fine-tunes the pathogenic and therapeutic functions of LPS.
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Affiliation(s)
- Kamaljeet Kaur
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Holly Bachus
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Crystal Lewis
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Amber M Papillion
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Alexander F Rosenberg
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - André Ballesteros-Tato
- Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Beatriz León
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Togawa K, Leon ME, Lebailly P, Beane Freeman LE, Nordby KC, Baldi I, MacFarlane E, Shin A, Park S, Greenlee RT, Sigsgaard T, Basinas I, Hofmann JN, Kjaerheim K, Douwes J, Denholm R, Ferro G, Sim MR, Kromhout H, Schüz J. Cancer incidence in agricultural workers: Findings from an international consortium of agricultural cohort studies (AGRICOH). ENVIRONMENT INTERNATIONAL 2021; 157:106825. [PMID: 34461377 PMCID: PMC8484858 DOI: 10.1016/j.envint.2021.106825] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/29/2021] [Accepted: 08/11/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations. METHODS The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis. RESULTS During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01-1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04-1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01-1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77-0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men. CONCLUSION The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.
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Affiliation(s)
- Kayo Togawa
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
| | - Maria E Leon
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Pierre Lebailly
- ANTICIPE, U1086 INSERM, Université de Caen Normandie, and Centre de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Bethesda, MD, USA
| | | | - Isabelle Baldi
- EPICENE, U1219 INSERM, Université de Bordeaux, and Service Santé Travail Environnement, CHU de Bordeaux, Bordeaux, France
| | - Ewan MacFarlane
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sue Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Robert T Greenlee
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Torben Sigsgaard
- Department of Public Health, Research Section for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Ioannis Basinas
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Bethesda, MD, USA
| | | | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Rachel Denholm
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Gilles Ferro
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Malcolm R Sim
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hans Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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Environmental Injustice and Industrial Chicken Farming in Maryland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111039. [PMID: 34769558 PMCID: PMC8582720 DOI: 10.3390/ijerph182111039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 12/01/2022]
Abstract
Maryland’s growing chicken industry, including concentrated animal feeding operations (CAFOs) and meat processing plants, raises a number of concerns regarding public health and environmental justice. Using hot spot analysis, we analyzed the totality of Maryland’s CAFOs and meat processing plants and those restricted to the Eastern Shore to assess whether communities of color and/or low socioeconomic status communities disproportionately hosted these types of facilities at the census tract level. We used zero-inflated regression modeling to determine the strength of the associations between environmental justice variables and the location of CAFOs and meatpacking facilities at the State level and on the Eastern Shore. Hot spot analyses demonstrated that CAFO hot spots on the Eastern Shore were located in counties with some of the lowest wealth in the State, including the lowest ranking county—Somerset. Zero-inflated regression models demonstrated that increases in median household income across the state were associated with a 0.04-unit reduction in CAFOs. For every unit increase in the percentage of people of color (POC), there was a 0.02-unit increase in meat processing facilities across the state. The distribution of CAFOs and meat processing plants across Maryland may contribute to poor health outcomes in areas affected by such production, and contribute to health disparities and health inequity.
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Lu C, Norbäck D, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Qian H, Sun Y, Wang J, Liu W, Sundell J, Deng Q. Furry pet-related wheeze and rhinitis in pre-school children across China: Associations with early life dampness and mould, furry pet keeping, outdoor temperature, PM 10 and PM 2.5. ENVIRONMENT INTERNATIONAL 2020; 144:106033. [PMID: 32795753 DOI: 10.1016/j.envint.2020.106033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Few Chinese population studies exist on early life risk factors for furry pet allergy. OBJECTIVES We studied childhood respiratory symptoms when in contact with furry pets in relation to early life exposure. Moreover, we studied similar environmental associations for rhinitis not related to furry pets. METHODS Children aged 3-6 y from day care centres in seven Chinese cities participated (N = 39,782). Parents answered a questionnaire on home environment and children's health, including rhinoconjunctivitis and wheeze when in contact with furry pets, and diagnosed rhinitis. Prenatal and postnatal outdoor temperature, PM2.5, PM10, and NO2 were calculated using data from monitoring stations. Associations were estimated by multilevel logistic regression. RESULTS Totally 2% had cats, 4% dogs, and 3.2% had rhinoconjunctivitis or wheeze when in contact with furry pets (FP symptoms). Moreover, 1.1% had furry pet related diagnosed rhinitis and 7.5% had diagnosed rhinitis not related to furry pets (other diagnosed rhinitis). Prenatal PM2.5 and PM10, especially in second trimester, and a colder climate were risk factors for FP symptoms. ETS, dampness and mould, condensation on windows in wintertime, and cats and dog keeping were associated with FP symptoms. Breast feeding and frequent window opening were protective. Similar indoor associations were found for furry pet related diagnosed rhinitis. ETS, dampness and mould, window condensation, urbanization and mechanical exhaust ventilation were risk factors for other diagnosed rhinitis. Cooking with an electric stove and early life exposure to animals (cats, dogs, farm environment during pregnancy) were protective for diagnosed rhinitis not related to furry pets. CONCLUSIONS Prenatal outdoor PM10 and PM2.5 can be risk factors for symptoms suggestive of furry pet allergy. Early life dampness and mould can be risk factors for rhinitis related and not related to furry pets. Exposure to animals (cats, dogs, farm environment) may reduce diagnosed rhinitis not related to furry pets.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China
| | - Dan Norbäck
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; School of Energy Science and Engineering, Central South University, Changsha, Hunan, China.
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Wei Liu
- School of Architecture, Tsinghua University, Beijing, China; Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China; School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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6
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Moshammer H, Khan AW, Wallner P, Poteser M, Kundi M, Hutter HP. Validity of reported indicators of pesticide exposure and relevance for cytotoxic and genotoxic effects on buccal cells. Mutagenesis 2020; 34:147-152. [PMID: 30590686 DOI: 10.1093/mutage/gey043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/10/2018] [Indexed: 11/13/2022] Open
Abstract
Higher rates of nuclear anomalies in buccal cells of coffee workers exposed to pesticides in comparison to their unexposed peers were detected in our field study. Here, we extend our findings by examining other exposure indicators in this sample. Occupational exposure of 38 exposed and 33 non-exposed farmworkers was assessed as exposure days in the last month (0-25 days) and as years of exposure (0-47 years). Genotoxic and cytotoxic markers in buccal cells were analysed following standard procedures for buccal micronucleus cytome assay. Both exposure markers were associated with a higher frequency of nuclear anomalies with odds ratios more than 1. After restricting the analysis to the exposed workers only, this association remained only with the marker of recent exposure. In a secondary analysis also environmental exposure defined as proximity of the home to the nearest sprayed field (distance <1000 m) was assessed. Proximity led to increased rates (with odds ratios more than 3) of genotoxic but not cytotoxic nuclear anomalies. Reported recent frequency and intensity of pesticide use and application are a valid exposure marker relevant for cytological pathologies in the buccal mucosa. The exposure metric for environmental exposure was rather crude and confounding by some unmeasured factor cannot be fully excluded. Nevertheless, simple exposure indicators that can even be obtained under rather difficult field conditions do provide health-relevant and valid information.
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Affiliation(s)
- Hanns Moshammer
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse, Vienna, Austria
| | - Abdul Wali Khan
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse, Vienna, Austria.,Federal Govt. Polyclinic (PGMI), Islamabad, Pakistan
| | - Peter Wallner
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse, Vienna, Austria.,International Society of Doctors for the Environment Austria, Große Mohrengasse, Vienna, Austria
| | - Michael Poteser
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse, Vienna, Austria
| | - Michael Kundi
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse, Vienna, Austria
| | - Hans-Peter Hutter
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse, Vienna, Austria.,International Society of Doctors for the Environment Austria, Große Mohrengasse, Vienna, Austria
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Microbial Agents in the Indoor Environment: Associations with Health. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2020. [PMCID: PMC7122805 DOI: 10.1007/978-981-32-9182-9_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is international consensus that damp buildings and indoor mould can increase the risk of asthma, rhinitis, bronchitis and respiratory tract infections but we do not know which types of microbial agents that are causing the observed adverse health effects. Microbial indoor exposure is a broader concept than microbial growth in buildings. Other sources of indoor microbial exposure include the outdoor environment, humans (crowdedness) and furry pet keeping. Microbial exposure can have different health effects depending on the dose, different exposure route, genetic disposition and the timing of exposure. Microbial stimulation linked to large microbial diversity in early life can protect against disease development, especially for allergic asthma and atopy. Protective effects are more often reported for bacterial exposure and adverse health effects are more often linked to mould exposure. There are many studies on health associations for indoor exposure to endotoxin, mainly from homes. The risk of getting atopic asthma may be less if you are exposed to endotoxin in childhood but the risk of non-atopic asthma may increase if exposed to endotoxin especially in adulthood. Moreover, genetic disposition modifies health effects of endotoxin. Epidemiological studies on muramic acid (from gram-positive bacteria) or ergosterol (from mould) are few. Studies on health effects of indoor exposure to beta-1-3-glucan (from mould) have conflicting results (positive as well as negative associations). Epidemiological studies on health effects of indoor exposure to mycotoxins are very few. Some studies have reported health associations for MVOC, but it is unclear to what extent MVOC has microbial sources in indoor environments. Many studies have reported health associations for fungal DNA, especially as a risk factor for childhood asthma at home. Since most studies on health effects of indoor exposure to mould, bacteria and microbial agents are cross-sectional, it is difficult to draw conclusions on causality. More prospective studies on indoor microbial exposure are needed and studies should include other indoor environments than homes, such as day care centers, schools, hospitals and offices.
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Future Directions of Research on Indoor Environment, Indoor Air Quality (IAQ), and Health. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/978-981-32-9182-9_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Abramson MJ, Guo Y. Indoor Endotoxin Exposure and Ambient Air Pollutants Interact on Asthma Outcomes. Am J Respir Crit Care Med 2019; 200:652-654. [PMID: 31063402 PMCID: PMC6775880 DOI: 10.1164/rccm.201904-0842ed] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Michael J Abramson
- School of Public Health & Preventive MedicineMonash UniversityMelbourne, Australia
| | - Yuming Guo
- School of Public Health & Preventive MedicineMonash UniversityMelbourne, Australia
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Basu S, Poole J, Frost G, Fox D. Developing a questionnaire to assess the health effects of bioaerosols. Occup Med (Lond) 2019; 68:448-453. [PMID: 29982820 DOI: 10.1093/occmed/kqy094] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Bioaerosol exposure occurs in several industries including green waste recycling, poultry farming, grain, animal feed and cotton production. Whilst several studies have investigated exposure and health effects in compost workers, the best questions to ask about health are uncertain. Aims This study aimed to develop a questionnaire to assess health symptoms in compost workers. Methods A 46-item questionnaire to ascertain possible symptoms of occupational illness related to bioaerosol exposure in a cohort of UK industrial compost workers and delivery in an interviewer-led format. The reliability of the questionnaire was assessed using Cronbach's α. A principal component analysis (PCA) was conducted to condense the questionnaire for practical purposes. Results One hundred and eleven (89%) workers completed the questionnaire. All items showed very good reliability (Cronbach's α = 0.83). After removing perfectly correlated questions from the data set, the PCA was conducted on a reduced data set of 28 items to explore underlying themes. Nine components were identified that explained 77% of the total variation. Nine of the questions removed prior to PCA due to perfect correlation were reintroduced because they added clinical value. The final questionnaire therefore consisted of 37 items and retained very adequate reliability (Cronbach's α = 0.76). Conclusions Our health questionnaire has demonstrated adequate reliability when used within this industrial composting workforce. Further applications may include health surveillance, investigating outbreaks of occupational disease or research. Future work should examine the predictive validity of the questionnaire in these settings.
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Affiliation(s)
- S Basu
- Health and Safety Executive, Centre for Workplace Health, Harpur Hill, Buxton, UK.,Silverwood, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK
| | - J Poole
- Health and Safety Executive, Centre for Workplace Health, Harpur Hill, Buxton, UK
| | - G Frost
- Health and Safety Executive, Centre for Workplace Health, Harpur Hill, Buxton, UK
| | - D Fox
- Health and Safety Executive, Centre for Workplace Health, Harpur Hill, Buxton, UK
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Mendy A, Wilkerson J, Salo PM, Weir CH, Feinstein L, Zeldin DC, Thorne PS. Synergistic Association of House Endotoxin Exposure and Ambient Air Pollution with Asthma Outcomes. Am J Respir Crit Care Med 2019; 200:712-720. [PMID: 30965018 PMCID: PMC6775869 DOI: 10.1164/rccm.201809-1733oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 04/05/2019] [Indexed: 01/08/2023] Open
Abstract
Rationale: House endotoxin and ambient air pollution are risk factors for asthma; however, the effects of their coexposure on asthma are not well characterized.Objectives: To examine potential synergistic associations of coexposure to house dust endotoxin and ambient air pollutants with asthma outcomes.Methods: We analyzed data of 6,488 participants in the National Health and Nutrition Examination Survey 2005-2006. Dust from bedding and bedroom floor was analyzed for endotoxin content. The Community Multiscale Air Quality Modeling System (CMAQ) and Downscaler Model data were used to determine annual average particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) exposures at participants' residential locations. The associations of the coexposures with asthma outcomes were assessed and tested for synergistic interaction.Measurements and Main Results: In adjusted analysis, PM2.5 (CMAQ) (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.07-1.18), O3 (Downscaler Model) (OR, 1.07; 95% CI, 1.02-1.13), and log10 NO2 (CMAQ) (OR, 3.15; 95% CI, 1.33-7.45) were positively associated with emergency room visits for asthma in the past 12 months. Coexposure to elevated concentrations of house dust endotoxin and PM2.5 (CMAQ) was synergistically associated with the outcome, increasing the odds by fivefold (OR, 5.01; 95% CI, 2.54-9.87). A synergistic association was also found for coexposure to higher concentrations of endotoxin and NO2 in children (OR, 3.45; 95% CI, 1.65-7.18).Conclusions: Coexposure to elevated concentrations of residential endotoxin and ambient PM2.5 in all participants and NO2 in children is synergistically associated with increased emergency room visits for asthma. Therefore, decreasing exposure to both endotoxin and air pollution may help reduce asthma morbidity.
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Affiliation(s)
- Angelico Mendy
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
| | | | - Pӓivi M. Salo
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; and
| | - Charles H. Weir
- Office of Emergency Management, U.S. Department of Health and Human Services, Atlanta, Georgia
| | | | - Darryl C. Zeldin
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; and
| | - Peter S. Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
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12
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Schultz AA, Peppard P, Gangnon RE, Malecki KMC. Residential proximity to concentrated animal feeding operations and allergic and respiratory disease. ENVIRONMENT INTERNATIONAL 2019; 130:104911. [PMID: 31238264 DOI: 10.1016/j.envint.2019.104911] [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: 09/28/2018] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Air emissions from concentrated animal feeding operations (CAFO) have been associated with respiratory and allergic symptoms among farm workers, primarily on swine farms. Despite the increasing prevalence of CAFOs, few studies have assessed respiratory health implications among residents living near CAFOs and few have looked at the health impacts of dairy CAFOs. OBJECTIVES The goal of this study was to examine objective and subjective measures of respiratory and allergic health among rural residents living near dairy CAFOs in a general population living in the Upper Midwest of the United States. METHODS Data were from the 2008-2016 Survey of the Health of Wisconsin (SHOW) cohort (n = 5338), a representative, population based sample of rural adults (age 18+). The association between distance to the nearest CAFO and the prevalence of self-reported physician-diagnosed allergies, asthma, episodes of asthma in the last 12 months, and asthma medication use was examined using logistic regression, adjusting for covariates and sampling design. Similarly, the association between distance to the nearest CAFO and lung function, measured using spirometry, was examined using multivariate linear regression. Restricted cubic splines accounted for nonlinear relationships between distance to the nearest CAFO and the aforementioned outcomes. RESULTS Living 1.5 miles from a CAFO was associated with increased odds of self-reported nasal allergies (OR = 2.08; 95% CI: 1.38, 3.14), lung allergies (OR = 2.72; 95% CI: 1.59, 4.66), asthma (OR = 2.67; 95% CI: 1.39, 5.13), asthma medication (OR = 3.31; 95% CI: 1.65 6.62), and uncontrolled asthma, reported as an asthma episode in last 12 months (OR = 2.34; 95% CI: 1.11, 4.92) when compared to living 5 miles from a CAFO. Predicted FEV1 was 7.72% (95% CI: -14.63, -0.81) lower at a residential distance 1.5 miles from a CAFO when compared with a residence distance of 3 miles from a CAFO. CONCLUSIONS Results suggest CAFOs may be an important source of adverse air quality associated with reduced respiratory and allergic health among rural residents living in close proximity to a CAFO.
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Affiliation(s)
- Amy A Schultz
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America
| | - Paul Peppard
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America
| | - Ron E Gangnon
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America; Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, WI, United States of America
| | - Kristen M C Malecki
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America.
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13
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Mendy A, Wilkerson J, Salo PM, Cohn RD, Zeldin DC, Thorne PS. Exposure and Sensitization to Pets Modify Endotoxin Association with Asthma and Wheeze. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:2006-2013.e4. [PMID: 29684578 PMCID: PMC6524530 DOI: 10.1016/j.jaip.2018.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/02/2018] [Accepted: 04/03/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pets are major contributors of endotoxin in homes, but whether they influence endotoxin association with respiratory outcomes is unclear. OBJECTIVE To examine whether exposure and sensitization to dog and cat modify the relationship between endotoxin exposure and asthma and wheeze. METHODS We analyzed data from 6051 participants in the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES). House dust from bedroom floor and bedding was evaluated for endotoxin and for dog (Canis familiaris 1) and cat (Feline domesticus 1) allergens. The NHANES also collected data on respiratory outcomes and measured IgE specific to allergens. Associations of log-endotoxin and pet exposure with respiratory outcomes were examined, adjusting for covariates including pet avoidance. RESULTS Dog and cat ownership among participants was 48.3% and 37.5%, respectively. Endotoxin geometric mean (SE) was 15.49 (0.50) EU/mg. Endotoxin and pet allergen levels were significantly higher in households with a dog or cat. Overall, endotoxin was positively associated with wheeze (odds ratio [OR], 1.30; 95% CI, 1.04-1.62), but not with asthma. However, in participants nonsensitized to dog, the odds of endotoxin association with wheeze were higher with exposure to dog allergen (OR, 1.80; 95% CI, 1.27-2.53; Pinteraction = .048). In participants sensitized to cat and exposed to cat allergen, endotoxin became positively associated with asthma (OR, 1.92; 95% CI, 1.21-3.0; Pinteraction = .040). With coexposure to dog and cat allergens, endotoxin association with asthma and wheeze was exacerbated (OR, 2.00; 95% CI, 1.04-3.83; Pinteraction = .012 and OR, 1.88; 95% CI, 1.32-2.66; Pinteraction = .016, respectively). CONCLUSIONS Exposure to dog and cat allergens enhances the association of endotoxin with asthma and wheeze.
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Affiliation(s)
- Angelico Mendy
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
| | | | - Päivi M Salo
- Division of Intramural Research, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | | | - Darryl C Zeldin
- Division of Intramural Research, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC
| | - Peter S Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa.
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14
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Strassle PD, Smit LAM, Hoppin JA. Endotoxin enhances respiratory effects of phthalates in adults: Results from NHANES 2005-6. ENVIRONMENTAL RESEARCH 2018; 162:280-286. [PMID: 29407759 DOI: 10.1016/j.envres.2018.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/06/2017] [Accepted: 01/16/2018] [Indexed: 06/07/2023]
Abstract
Phthalates have been associated with respiratory symptoms in adults; they may enhance effects of inflammatory compounds. To assess the potential interactions of phthalates and endotoxin on respiratory and allergic symptoms in adults, we used cross-sectional information from the 1091 adults with complete data on urinary phthalates and house dust endotoxin from NHANES 2005-2006. We used multivariable logistic regression to assess whether endotoxin levels modified the association between nine phthalate metabolites and four current allergic symptoms (asthma, wheeze, hay fever, and rhinitis). Endotoxin was classified into tertiles (<10, 10-25, >25EU/mg dust). Urinary phthalate and dust endotoxin levels were not correlated (r < |0.02|). Under low endotoxin conditions, no associations between phthalates and respiratory outcomes were observed. Under medium or high endotoxin conditions, exposure-response relationships were observed between specific phthalates and wheeze and asthma. For wheeze, three phthalates (mono-benzyl phthalate (MBzP), mono(carboxyoctyl) phthalate (MCOP), and di-ethylhexyl phthalate (DEHP) had significant interactions with endotoxin); for asthma, two phthalates (MCOP and mono(carboxyoctyl) phthalate (MCNP)) had significant interactions. Endotoxin did not modify the associations between phthalates and hay fever or rhinitis. These results are consistent with the hypothesis that endotoxin enhances the respiratory toxicity of phthalates; however this cross-sectional study cannot address key temporal issues. The lack of an association between wheeze or asthma and phthalates when endotoxin exposure was low suggests that phthalates alone may not increase these symptoms.
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Affiliation(s)
- Paula D Strassle
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Jane A Hoppin
- Center for Human Health and the Environment, North Carolina State University, Campus Box 7633, Raleigh 27695-7633, NC, United States; Department of Biological Sciences, North Carolina State University, Raleigh, NC, United States.
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15
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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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Norbäck D, Lu C, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Qian H, Sundell J, Deng Q. Common cold among pre-school children in China - associations with ambient PM 10 and dampness, mould, cats, dogs, rats and cockroaches in the home environment. ENVIRONMENT INTERNATIONAL 2017; 103:13-22. [PMID: 28351766 DOI: 10.1016/j.envint.2017.03.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND There is some evidence that dampness, mould and cockroaches can increase the risk of respiratory infections in children but few studies exist from China on this topic. Aim To study associations between domestic early life exposure to biological indoor factors (dampness, mould, cats, dogs, rats, cockroaches), cleaning habits and common cold among pre-school children across China. METHODS Children aged 3-6years (n=39,782) were recruited from randomly selected day care centres in seven cities in China. Data on common cold and prenatal and postnatal exposure to dampness, mould, windowpane condensation in wintertime (WPC), cats, dogs, cockroaches and rats were assessed by a parentally administered questionnaire. Data on annual ambient temperature and PM10 was assessed on city level. Associations between high frequency (>5 colds per year) and long duration (≥2weeks) of common colds in the past year and exposure were calculated by multilevel logistic regression. RESULTS A total of 9.2% had a high frequency and 11.9% had long duration of common cold. Exposure to mould (OR=1.38, 95% CI 1.24-1.53) and WPC (OR 1.23, 95%CI 1.13-1.33) at birth was associated with frequent common cold. Exposure to dogs at birth was associated with long duration of common cold. (OR=1.22, 95% CI 1.06-1.41). Exposure to mould (OR=1.36, 95% CI 1.22-1.54), WPC (OR=1.27, 95%CI 1.17-1.39) and water leakage (OR 1.34, 95% CI 1.20-1.49) in the current home was associated with frequent common cold. Presence of cockroaches were positively (OR=1.12, 95% CI 1.02-1.24) and presence of rats (OR=0.86, 95% CI 0.77-0.96) negatively associated with high frequency of common cold. Daily cleaning was negatively associated with frequent common cold (OR=0.89, 95% CI 0.81-0.97). Similar associations for mould, WPC, cockroaches and rats were found for long duration. Ambient PM10 (OR=1.21, 95% CI 1.21-1.35 per 10μg/m3) and temperature (OR=1.13, 95% CI 1.06-1.35 °C) on city level were associated with high frequency of common cold. Associations between cat keeping and high frequency of common cold were found only in southern China. Associations with cockroaches were stronger in northern China. Associations with dampness and mould were the same in the north and south. CONCLUSIONS Indoor mould, water damage, windowpane condensation, cockroaches and keeping cats or dogs as pets can be risk factors for common cold while daily cleaning can be protective factor. PM10 and a warmer climate zone can be other risk factors for common cold.
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Affiliation(s)
- Dan Norbäck
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Jan Sundell
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Architecture, Tsinghua University, Beijing, China
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; XiangYa School of Public Health, Central South University, Changsha, Hunan, China.
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Mendy A, Cohn RD, Thorne PS. Endotoxin exposure, serum vitamin D, asthma and wheeze outcomes. Respir Med 2016; 114:61-6. [PMID: 27109812 DOI: 10.1016/j.rmed.2016.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/04/2016] [Accepted: 03/08/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Endotoxin has been shown to induce neutrophilic asthma and wheeze after binding toll-like receptor 4 to produce pro-inflammatory cytokines. Animal models have demonstrated that vitamin D might inhibit lipopolysaccharide-induced cytokines. However, whether endotoxin exposure and serum vitamin D deficiency interact to affect asthma and wheeze in humans has never been investigated in an epidemiological study. METHODS Joint associations of house dust endotoxin and vitamin D with asthma and wheeze were examined using logistic regression adjusted for covariates in 5924 US participants of the National Health and Nutrition Examination Survey (NHANES). Interactions were assessed on the multiplicative as well as additive scale using the relative excess risk, the attributable portion due to additive interaction, and the synergy index. RESULTS The median endotoxin concentration was 19.1 EU/mg. Prevalence of vitamin D inadequacy (20-30 ng/ml) and deficiency (<20 ng/ml) were respectively 42.9 and 33.4%. The combination of high endotoxin and low vitamin D was associated with current asthma (OR: 1.56, 95% CI: 1.09, 2.23), wheeze in the past 12 months (OR: 1.72, 95% CI: 1.10, 3.71), recurrent wheeze (OR: 1.97, 95% CI: 1.00, 4.00), asthma diagnosis or recurrent wheeze (OR: 1.88, 95% CI: 1.33, 2.66), and current asthma or recurrent wheeze (OR:1.81, 95% CI: 1.23, 2.68) when compared to low endotoxin and normal vitamin D. The interactions between the exposures were not significant on the multiplicative or additive scale for any of the outcomes. CONCLUSIONS Combination of high endotoxin exposure and low vitamin D increases the odds of asthma and wheeze, but the exposures do not interact or modify each other's effect in the NHANES cohort.
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Affiliation(s)
- Angelico Mendy
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA
| | | | - Peter S Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA.
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18
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Thorne PS, Mendy A, Metwali N, Salo P, Co C, Jaramillo R, Rose KM, Zeldin DC. Endotoxin Exposure: Predictors and Prevalence of Associated Asthma Outcomes in the United States. Am J Respir Crit Care Med 2015; 192:1287-97. [PMID: 26258643 PMCID: PMC4731700 DOI: 10.1164/rccm.201502-0251oc] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 08/07/2015] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Inhaled endotoxin induces airway inflammation and is an established risk factor for asthma. The 2005-2006 National Health and Nutrition Examination Survey included measures of endotoxin and allergens in homes as well as specific IgE to inhalant allergens. OBJECTIVES To understand the relationships between endotoxin exposure, asthma outcomes, and sensitization status for 15 aeroallergens in a nationally representative sample. METHODS Participants were administered questionnaires in their homes. Reservoir dust was vacuum sampled to generate composite bedding and bedroom floor samples. We analyzed 7,450 National Health and Nutrition Examination Survey dust and quality assurance samples for their endotoxin content using extreme quality assurance measures. Data for 6,963 subjects were available, making this the largest study of endotoxin exposure to date. Log-transformed endotoxin concentrations were analyzed using logistic models and forward stepwise linear regression. Analyses were weighted to provide national prevalence estimates and unbiased variances. MEASUREMENTS AND MAIN RESULTS Endotoxin exposure was significantly associated with wheeze in the past 12 months, wheeze during exercise, doctor and/or emergency room visits for wheeze, and use of prescription medications for wheeze. Models adjusted for age, sex, race and/or ethnicity, and poverty-to-income ratio and stratified by allergy status showed that these relationships were not dependent upon sensitization status but were worsened among those living in poverty. Significant predictors of higher endotoxin exposures were lower family income; Hispanic ethnicity; participant age; dog(s), cat(s), cockroaches, and/or smoker(s) in the home; and carpeted floors. CONCLUSIONS In this U.S. nationwide representative sample, higher endotoxin exposure was significantly associated with measures of wheeze, with no observed protective effect regardless of sensitization status.
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Affiliation(s)
- Peter S. Thorne
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Angelico Mendy
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Nervana Metwali
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Päivi Salo
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; and
| | - Caroll Co
- Social & Scientific Systems, Inc., Durham, North Carolina
| | | | | | - Darryl C. Zeldin
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina; and
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Particulate matter, endotoxin, and worker respiratory health on large Californian dairies. J Occup Environ Med 2015; 57:79-87. [PMID: 25563544 DOI: 10.1097/jom.0000000000000304] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess respiratory exposures and lung function in a cross-sectional study of California dairy workers. METHODS Exposure of 205 dairy and 45 control (vegetable processing) workers to particulate matter and endotoxin was monitored. Pre- and postshift spirometry and interviews were conducted. RESULTS Geometric mean inhalable and PM2.5 concentrations were 812 and 35.3 μg/m3 versus 481.9 and 19.6 μg/m3, respectively, for dairy and control workers. Endotoxin concentrations were 329 EU/m3 or 1122 pmol/m3 and 13.5 EU/m3 or 110 pmol/m3, respectively, for dairy and control workers. In a mixed-effects model, forced vital capacity decreased across a work shift by 24.5 mL (95% confidence interval, -44.7 to -4.3; P = 0.018) with log10 (total endotoxin) and by 22.0 mL (95% confidence interval, -43.2 to -0.08; P = 0.042) per hour worked. CONCLUSIONS Modern California dairy endotoxin exposures and shift length were associated with a mild acute decrease in forced vital capacity.
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20
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Lampi J, Koskela H, Hartikainen AL, Ramasamy A, Couto Alves A, Järvelin MR, Pekkanen J. Farm environment during infancy and lung function at the age of 31: a prospective birth cohort study in Finland. BMJ Open 2015. [PMID: 26201721 PMCID: PMC4513452 DOI: 10.1136/bmjopen-2014-007350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Farming as an occupation is considered a risk factor for asthma and reduced lung function. By contrast, living on a farm during infancy has been reported to be associated with lower risk of asthma in adulthood. However, little is known about the association between farming environment during infancy and lung function in adulthood. We aimed to study the prospective longitudinal association between farming environment during infancy and lung function in adulthood. DESIGN A prospective birth cohort study. SETTING Northern Finland. PARTICIPANTS 5666 participants born in 1966 were followed up at the age of 31 years. PRIMARY OUTCOME MEASURES Spirometry at the age of 31 years. RESULTS To be born into a farmer's family was associated with higher forced expiratory volume in 1 s (FEV1) (36 mL; 95% CI 6 to 67 mL) and forced vital capacity (FVC) (40 mL; 95% CI 5 to 75 mL) at the age of 31 years. Contact with farm animals during infancy was associated with higher FEV1. No associations were seen with FEV1/FVC (FEV1/FVC ratio). Having dogs in childhood revealed similar associations. There was a suggestive dose-dependent association with the number of animal species during childhood and higher FEV1 and FVC at adulthood, especially among women. CONCLUSIONS Farming environment in early life may have a positive impact on lung function in adulthood.
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Affiliation(s)
- Jussi Lampi
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
- Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Heikki Koskela
- Center for Medicine and Clinical Research, Division of Pulmonary Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Anna-Liisa Hartikainen
- Department of Obstetrics and Gynecology and MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Adaikalavan Ramasamy
- Respiratory Epidemiology and Public Health, Imperial College London, London, UK
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Department of Medical and Molecular Genetics, King's College London, London, UK
| | - Alexessander Couto Alves
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Juha Pekkanen
- Department of Health Protection, National Institute for Health and Welfare, Kuopio, Finland
- Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Tischer C, Zock JP, Valkonen M, Doekes G, Guerra S, Heederik D, Jarvis D, Norbäck D, Olivieri M, Sunyer J, Svanes C, Täubel M, Thiering E, Verlato G, Hyvärinen A, Heinrich J. Predictors of microbial agents in dust and respiratory health in the Ecrhs. BMC Pulm Med 2015; 15:48. [PMID: 25929252 PMCID: PMC4425915 DOI: 10.1186/s12890-015-0042-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 04/17/2015] [Indexed: 01/05/2023] Open
Abstract
Background Dampness and mould exposure have been repeatedly associated with respiratory health. However, less is known about the specific agents provoking or arresting health effects in adult populations. We aimed to assess predictors of microbial agents in mattress dust throughout Europe and to investigate associations between microbial exposures, home characteristics and respiratory health. Methods Seven different fungal and bacterial parameters were assessed in mattress dust from 956 adult ECRHS II participants in addition to interview based home characteristics. Associations between microbial parameters and the asthma score and lung function were examined using mixed negative binomial regression and linear mixed models, respectively. Results Indoor dampness and pet keeping were significant predictors for higher microbial agent concentrations in mattress dust. Current mould and condensation in the bedroom were significantly associated with lung function decline and current mould at home was positively associated with the asthma score. Higher concentrations of muramic acid were associated with higher mean ratios of the asthma score (aMR 1.37, 95%CI 1.17-1.61). There was no evidence for any association between fungal and bacterial components and lung function. Conclusion Indoor dampness was associated with microbial levels in mattress dust which in turn was positively associated with asthma symptoms. Electronic supplementary material The online version of this article (doi:10.1186/s12890-015-0042-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christina Tischer
- Institute of Epidemiology I, Helmholtz Zentrum München, Ingolstädter Landstrasse 1,German Research Centre for Environmental Health, D-85764, Neuherberg, Germany. .,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
| | - Jan-Paul Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
| | - Maria Valkonen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.
| | - Gert Doekes
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands.
| | - Stefano Guerra
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA.
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands.
| | - Deborah Jarvis
- Respiratory Epidemiology and Public Health Group, Imperial College London, London, UK. .,MRC-HPA Centre for Environment Health, King's College London, London, UK.
| | - Dan Norbäck
- The Department of Medical Science, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Mario Olivieri
- Department of Occupational Medicine, University of Verona, Verona, Italy.
| | - Jordi Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Cecilie Svanes
- Department of Occupational Medicine, Centre for International Health, University of Bergen and , Haukeland University Hospital, Bergen, Norway.
| | - Martin Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.
| | - Elisabeth Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München, Ingolstädter Landstrasse 1,German Research Centre for Environmental Health, D-85764, Neuherberg, Germany. .,Division of Metabolic Diseases and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany.
| | - Giuseppe Verlato
- Epidemiology and Medical Statistics, University of Verona, Verona, Italy.
| | - Anne Hyvärinen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, Ingolstädter Landstrasse 1,German Research Centre for Environmental Health, D-85764, Neuherberg, Germany.
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Norbäck D, Cai G. Dampness, indoor mould, fungal DNA and respiratory health - molecular methods in indoor epidemiology. Clin Exp Allergy 2015; 45:840-843. [PMID: 25881855 PMCID: PMC7162140 DOI: 10.1111/cea.12524] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- D. Norbäck
- Department of Medical Science, Occupational and Environmental MedicineUppsala University and Uppsala University HospitalUppsalaSweden
| | - G.‐H. Cai
- Department of Medical Science, Occupational and Environmental MedicineUppsala University and Uppsala University HospitalUppsalaSweden
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Donovan C, Royce SG, Vlahos R, Bourke JE. Lipopolysaccharide does not alter small airway reactivity in mouse lung slices. PLoS One 2015; 10:e0122069. [PMID: 25822969 PMCID: PMC4379153 DOI: 10.1371/journal.pone.0122069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/13/2015] [Indexed: 11/19/2022] Open
Abstract
The bacterial endotoxin, lipopolysaccharide (LPS) has been associated with occupational airway diseases with asthma-like symptoms and in acute exacerbations of COPD. The direct and indirect effects of LPS on small airway reactivity have not been fully elucidated. We tested the hypothesis that both in vitro and in vivo LPS treatment would increase contraction and impair relaxation of mouse small airways. Lung slices were prepared from naïve Balb/C mice and cultured in the absence or presence of LPS (10 μg/ml) for up to 48 h for measurement of TNFα levels in conditioned media. Alternatively, mice were challenged with PBS or LPS in vivo once a day for 4 days for preparation of lung slices or for harvest of lungs for Q-PCR analysis of gene expression of pro-inflammatory cytokines and receptors involved in airway contraction. Reactivity of small airways to contractile agonists, methacholine and serotonin, and bronchodilator agents, salbutamol, isoprenaline and rosiglitazone, were assessed using phase-contrast microscopy. In vitro LPS treatment of slices increased TNFα release 6-fold but did not alter contraction or relaxation to any agonists tested. In vivo LPS treatment increased lung gene expression of TNFα, IL-1β and ryanodine receptor isoform 2 more than 5-fold. However there were no changes in reactivity in lung slices from these mice, even when also incubated with LPS ex vivo. Despite evidence of LPS-induced inflammation, neither airway hyperresponsiveness or impaired dilator reactivity were evident. The increase in ryanodine receptor isoform 2, known to regulate calcium signaling in vascular smooth muscle, warrants investigation. Since LPS failed to elicit changes in small airway reactivity in mouse lung slices following in vitro or in vivo treatment, alternative approaches are required to define the potential contribution of this endotoxin to altered small airway reactivity in human lung diseases.
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Affiliation(s)
- Chantal Donovan
- Lung Health Research Centre, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
| | - Simon G. Royce
- Lung Health Research Centre, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
- Department of Pharmacology, Monash University, Clayton, Victoria, Australia
| | - Ross Vlahos
- Lung Health Research Centre, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
- School of Health Sciences, Health Innovations Research Institute, RMIT University Bundoora, Victoria, Australia
| | - Jane E. Bourke
- Lung Health Research Centre, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
- Department of Pharmacology, Monash University, Clayton, Victoria, Australia
- * E-mail:
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24
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Khan AW, Nersesyan A, Knasmüller S, Moshammer H, Kundi M. Nuclear anomalies in exfoliated buccal cells in Pakistani cotton weavers. Mutagenesis 2015; 30:613-9. [DOI: 10.1093/mutage/gev022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Norbäck D, Lampa E, Engvall K. Asthma, allergy and eczema among adults in multifamily houses in Stockholm (3-HE study)--associations with building characteristics, home environment and energy use for heating. PLoS One 2014; 9:e112960. [PMID: 25479551 PMCID: PMC4257552 DOI: 10.1371/journal.pone.0112960] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/16/2014] [Indexed: 11/18/2022] Open
Abstract
Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings) were invited (one subject/dwelling) and 7,554 participated (73%). Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR = 1.74) and mould odour (OR = 1.79). Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR = 1.45) and was associated with redecoration (OR = 1.48) and mould odour (OR = 2.35). Pollen allergy was less common in buildings using more energy for heating (OR = 0.75) and was associated with humid air (OR = 1.76) and mould odour (OR = 2.36). Eczema was more common in larger buildings (OR 1.07) and less common in buildings using more energy for heating (OR = 0.85) and was associated with water damage (OR = 1.47), humid air (OR = 1.73) and mould odour (OR = 2.01). Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR = 0.49; 95% CI 0.29-0.82). Pollen allergy was less common if the building maintenance was outsourced (OR = 0.67; 95% CI 0.51-0.88). Eczema was more common when management accessibility was only at the division level (OR = 1.49; 95% CI 1.06-2.11). In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness. Energy saving may have consequences for allergy and eczema. More epidemiological studies are needed on building management organization.
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Affiliation(s)
- Dan Norbäck
- Department of Medical Science, Uppsala University, 75185 Uppsala, Sweden
- * E-mail:
| | - Erik Lampa
- Department of Medical Science, Uppsala University, 75185 Uppsala, Sweden
| | - Karin Engvall
- Department of Medical Science, Uppsala University, 75185 Uppsala, Sweden
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26
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Ivester KM, Couëtil LL, Zimmerman NJ. Investigating the link between particulate exposure and airway inflammation in the horse. J Vet Intern Med 2014; 28:1653-65. [PMID: 25273818 PMCID: PMC4895611 DOI: 10.1111/jvim.12458] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/25/2014] [Accepted: 08/20/2014] [Indexed: 01/30/2023] Open
Abstract
Inhalant exposure to airborne irritants commonly encountered in horse stables is implicated in the pathogenesis of inflammatory airway disease (IAD) and recurrent airway obstruction (RAO), non‐infectious, inflammatory pulmonary disorders that impact the health and performance of horses across all equine disciplines. IAD and RAO have overlapping clinical, cytological, and functional manifestations of the pulmonary response to organic dust and noxious gases encountered in the barn environment. Study of these diseases has provided important but incomplete understanding of the effect of air quality upon the respiratory health of horses. In this review, the principles of particulate exposure assessment, including health‐related aerosol size fractions and size‐selective sampling, the factors influencing air quality in equine environments, and the effect of air quality on the equine respiratory tract are discussed. The objective of this review is to provide the reader with a summary of the most common chronic inflammatory airway diseases in the horse and the principles of air sampling that are essential to the planning, interpretation, and assessment of equine respiratory health‐related exposure studies.
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Affiliation(s)
- K M Ivester
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN
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27
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Hoppin JA, Umbach DM, Long S, Rinsky JL, Henneberger PK, Salo PM, Zeldin DC, London SJ, Alavanja MCR, Blair A, Beane Freeman LE, Sandler DP. Respiratory disease in United States farmers. Occup Environ Med 2014; 71:484-91. [PMID: 24913223 DOI: 10.1136/oemed-2013-101983] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Farmers may be at increased risk for adverse respiratory outcomes compared with the general population due to their regular exposures to dusts, animals and chemicals. However, early life farm exposures to microbial agents may result in reduced risk. Understanding respiratory disease risk among farmers and identifying differences between farmers and other populations may lead to better understanding of the contribution of environmental exposures to respiratory disease risk in the general population. METHODS We compared the prevalence of self-reported respiratory outcomes in 43548 participants from the Agricultural Health Study (AHS), a prospective cohort of farmers and their spouses from Iowa and North Carolina, with data from adult participants in the National Health and Nutrition Examination Survey (NHANES) over the same period (2005-2010). RESULTS AHS participants had lower prevalences of respiratory diseases (asthma, adult-onset asthma, chronic bronchitis and emphysema), but higher prevalences of current respiratory symptoms (wheeze, cough and phlegm) even after controlling for smoking, body mass index and population characteristics. The overall prevalence of asthma in the AHS (7.2%, 95% CI 6.9 to 7.4) was 52% of that in NHANES (13.8%, 95% CI 13.3 to 14.3), although the prevalence of adult-onset asthma among men did not differ (3.6% for AHS, 3.7% for NHANES). Conversely, many respiratory symptoms were more common in the AHS than NHANES, particularly among men. CONCLUSIONS These findings suggest that farmers and their spouses have lower risk for adult-onset respiratory diseases compared with the general population, and potentially higher respiratory irritation as evidenced by increased respiratory symptoms.
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Affiliation(s)
- Jane A Hoppin
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - David M Umbach
- Biostatistics Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
| | | | - Jessica L Rinsky
- Department of Epidemiology, UNC Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul K Henneberger
- Division of Respiratory Disease Studies, NIOSH, CDC, DHHS, Morgantown, West Virginia, USA
| | - Paivi M Salo
- Laboratory of Respiratory Biology, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
| | - Darryl C Zeldin
- Laboratory of Respiratory Biology, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
| | - Michael C R Alavanja
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, NIH/DHHS, Rockville, Maryland, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, NIH/DHHS, Rockville, Maryland, USA
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, NIH/DHHS, Rockville, Maryland, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
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Varga A, Budai MM, Milesz S, Bácsi A, Tőzsér J, Benkő S. Ragweed pollen extract intensifies lipopolysaccharide-induced priming of NLRP3 inflammasome in human macrophages. Immunology 2013; 138:392-401. [PMID: 23278511 DOI: 10.1111/imm.12052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 12/04/2012] [Accepted: 12/12/2012] [Indexed: 12/24/2022] Open
Abstract
Ragweed pollen extract (RWE) possesses intrinsic NADPH oxidase activity that induces oxidative stress by initiating the production of intracellular reactive oxygen species (ROS). The ROS are important contributors to the manifestation of allergic inflammation; furthermore, concomitant exposure to an allergen and an endotoxin trigger a stronger inflammatory response. One of the main pro-inflammatory cytokines produced in inflammatory responses is interleukin-1β (IL-1β), and its production is associated with caspase-1-containing inflammasome complexes. Intracellular ROS have been implicated in NLRP3 inflammasome-mediated IL-1β production, therefore, we aimed to study whether RWE influences the function of NLRP3 inflammasome. Here we describe that, in the presence of NADPH, RWE significantly elevates lipopolysaccharide-induced IL-1β production of THP-1 cells as well as human primary macrophages and dendritic cells. We also demonstrate that increased IL-1β production is mediated through NLRP3 inflammasome in THP-1 macrophages. We provide evidence that RWE elevates cytosolic ROS level in these cells, and ROS inhibitors abolish IL-1β production. Furthermore, we show that RWE enhances lipopolysaccharide-induced gene transcription/expression of pro-IL-1β and key components of the inflammasome via a ROS-dependent mechanism.
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Affiliation(s)
- Aliz Varga
- Department of Immunology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary
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29
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Lieder R, Petersen PH, Sigurjónsson ÓE. Endotoxins-the invisible companion in biomaterials research. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:391-402. [PMID: 23350734 DOI: 10.1089/ten.teb.2012.0636] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Metal implants and polymeric devices for the application in the clinical treatment of orthopedic tissue injuries are increasingly coated with bioactive biomaterials derived from natural substances to induce desirable biological effects. Many metals and polymers used in biomaterials research show high affinity for endotoxins, which are abundant in the environment. Endotoxin contamination is indicated in the pathology of periodontitis and aseptic implant loosening, but may also affect the evaluation of a biomaterial's bioactivity by inducing strong inflammatory reactions. In this review, we discuss the high affinity of three commonly used implant biomaterials for endotoxins and how the contamination can affect the outcome of the orthopedic fixation. The chemical nature of bacterial endotoxins and some of the clinical health implications are described, as this knowledge is critically important to tackle the issues associated with the measurement and removal of endotoxins from medical devices. Commonly used methods for endotoxin testing and removal from natural substances are examined and the lack of standard guidelines for the in vitro evaluation of biomaterials is discussed.
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Affiliation(s)
- Ramona Lieder
- The Blood Bank, Landspitali University Hospital, Reykjavik, Iceland
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Paba E, Tranfo G, Corsetti F, Marcelloni AM, Iavicoli S. Indoor exposure to airborne endotoxin: a review of the literature on sampling and analysis methods. INDUSTRIAL HEALTH 2013; 51:237-55. [PMID: 23385433 DOI: 10.2486/indhealth.ms1325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Assessment of exposure to airborne endotoxins has been studied for several years, especially in occupational environments, but a large number of procedures are used for sampling and analysis. This lack of standardization makes it very difficult to compare results and set internationally accepted threshold limit values (TLVs) or occupational exposure limits (OELs) for endotoxin exposure. This paper reviews the methods reported, using advanced bibliographical search techniques: 82 papers published from 2004 to the present were selected to analyze methods for the assessment of human exposure to airborne endotoxins, with particular reference to occupational settings, and to examine their performance and critical points. Only few studies have focused on the standardization of sampling and analysis methods. The European Committee for Standardization Guidelines coincide with the procedures most frequently applied, but this does not guarantee the best results in terms of recovery and reproducibility. The factor that mainly affects endotoxin measurements is the extraction method, the main concern being the presence in the samples of a fraction insoluble in aqueous media. If substantial differences in the proportions of this fraction in different environments are confirmed in the future, the contribution of insoluble endotoxins cannot be neglected.
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Affiliation(s)
- Emilia Paba
- Occupational Hygiene Department, INAIL Research, Italy
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Ljubičić Ćalušić A, Varnai VM, Cavlović AO, Segvić Klarić M, Beljo R, Prester L, Macan J. Respiratory health and breath condensate acidity in sawmill workers. Int Arch Occup Environ Health 2012; 86:815-25. [PMID: 23007314 DOI: 10.1007/s00420-012-0817-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/12/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of the study was to evaluate exhaled breath condensate acidity (EBC pH) as a biomarker of airway response to occupational respiratory hazards present in sawmill. METHODS Sixty-one sawmill workers in total (26 from Sawmill 1 and 35 from Sawmill 2) provided EBC samples at the beginning and at the end of the working week. Respiratory symptoms, lung function, bronchodilator test and atopy status were assessed. Occupational environment was checked for the levels of respiratory hazards. RESULTS Airborne dust concentrations were below threshold limit value. Endotoxin in Sawmill 1 and Sawmill 2, and moulds in Sawmill 1 were at the levels able to induce inflammatory response in the airways. Mould levels were 2.5 times higher in Sawmill 1 than in Sawmill 2. Compared to Sawmill 2 workers, lower spirometry values, higher prevalence of dry cough and positive bronchodilator test were found in Sawmill 1 workers. Monday EBC pH values did not differ between sawmills, but declined after one working week in Sawmill 1 workers (from 7.88 to 7.49, P = 0.012) and not in Sawmill 2 workers. Similar results were obtained when only respiratory healthy non-smokers were analysed. Monday-to-Friday change of other respiratory parameters was not observed. CONCLUSION The results suggest EBC pH as a biomarker of acute respiratory effects related to occupational exposure to respiratory hazards in sawmills, presumably increased mould levels. The effect was present even at subclinical level, namely in respiratory healthy subjects. The long-term health implications remain unclear and should be evaluated in a follow-up study.
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Affiliation(s)
- Anita Ljubičić Ćalušić
- Institute for Medical Research and Occupational Health, Ksaverska cesta 2, 10001, Zagreb, Croatia,
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Sheehan WJ, Hoffman EB, Fu C, Baxi SN, Bailey A, King EM, Chapman MD, Lane JP, Gaffin JM, Permaul P, Gold DR, Phipatanakul W. Endotoxin exposure in inner-city schools and homes of children with asthma. Ann Allergy Asthma Immunol 2012; 108:418-22. [PMID: 22626594 DOI: 10.1016/j.anai.2012.04.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/30/2012] [Accepted: 04/02/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Endotoxins are stimulators of the immune system and, despite their potential to protect against allergy, have been associated with early wheezing and asthma morbidity. OBJECTIVE To compare inner-city school endotoxin exposure with home endotoxin exposure in children with asthma. METHODS Students with asthma were recruited from 12 urban elementary schools. Settled and airborne dust samples, linked to enrolled students, were collected from school classrooms, gymnasiums, and cafeterias twice during the academic year. For comparison, settled dust was collected once from the bedrooms of students with asthma. RESULTS Two hundred twenty-nine school settled dust samples and 118 bedroom settled dust samples were collected and analyzed for endotoxin. The median endotoxin concentration for school samples was 13.4 EU/mg (range, 0.7-360.7 EU/mg) and for home samples was 7.0 EU/mg (range = LLOD-843.0 EU/mg). The median concentration within each individual school varied from 6.6 EU/mg to 24.0 EU/mg. One hundred four students with asthma had matched classroom and bedroom endotoxin exposure measurements performed in the same season and demonstrated significantly higher concentrations of endotoxin in the students' classrooms (mean log value, 1.13 vs 0.99, P = .04). The median of the classrooms was 12.5 EU/mg compared with their bedrooms, with a median of 7.0 EU/mg. Within the school environment, no significant difference was seen between the fall and spring samples (mean log value 1.14 vs 1.09; P = .35). CONCLUSION Inner-city children with asthma were exposed to higher concentrations of endotoxin in their classrooms as compared with their bedrooms. Further studies are needed to evaluate school endotoxin exposure as a factor in asthma morbidity.
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Affiliation(s)
- William J Sheehan
- Department of Pediatrics, Division of Allergy and Immunology, Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA
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Casas L, Tiesler C, Thiering E, Brüske I, Koletzko S, Bauer CP, Wichmann HE, von Berg A, Berdel D, Krämer U, Schaaf B, Lehmann I, Herbarth O, Sunyer J, Heinrich J. Indoor factors and behavioural problems in children: the GINIplus and LISAplus birth cohort studies. Int J Hyg Environ Health 2012; 216:146-54. [PMID: 22487276 DOI: 10.1016/j.ijheh.2012.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 03/02/2012] [Accepted: 03/08/2012] [Indexed: 01/04/2023]
Abstract
Indoor microbial agents exposure is associated to depressive symptoms in adults and persistent exposure to indoor mould is associated to poorer cognitive function in children. In our study, we aimed to assess the effects of the exposure to indoor factors associated with increased microbial exposure (mould, dampness and pets) on behavioural problems in children aged 10 years, participating in two German birth cohorts. A total of 4860 children were followed until the age of 10 years, and the strengths and difficulties questionnaire (SDQ) was administered to the parents. Indoor factors were assessed through parental reported questionnaires in periodical surveys. Logistic and multinomial regressions adjusting for potential confounders were performed. Prevalences of borderline/abnormal total scores in the SDQ at 10 years of age were higher in children exposed to mould (aOR=1.23, 95%CI=1.00-1.56), dampness (aOR=1.51, 95%CI=1.10-2.07), and pets (aOR=1.48, 95%CI=1.20-1.94). The dimension "emotional symptoms" showed statistically significant risk estimates for mould and pets, meanwhile "conduct problems" and "hyperactivity/inattention" dimensions only did for pets. No significant associations were found for the "peer relationship problems" dimension. We found a significant strong interaction between dampness and pet, the risk of borderline/abnormal scores in the "total difficulties" scale and the "emotional symptoms" dimension for pets' was at least twice the risk in children with reported dampness than in children without. Our findings point to a potential effect of microbial exposure on children's behavioural problems, especially on emotional disorders, probably mediated through neurotoxicity and immune system activation.
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Affiliation(s)
- Lidia Casas
- Centre for Research in Environmental Epidemiology, Spain
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Boneberger A, Hangl C, Schierl R, Koletzko S, von Kries R, Kabesch M, Radon K. Endotoxin levels in house dust samples and juvenile inflammatory bowel disease − a case−control study. J Crohns Colitis 2011; 5:525-30. [PMID: 22115370 DOI: 10.1016/j.crohns.2011.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 04/01/2011] [Accepted: 04/12/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Animal contact may reduce the risk not only for allergic diseases but also for inflammatory bowel diseases (IBD). We aimed to clarify the association between endotoxin levels in the home environment and IBD. METHODS A case-control study including 85 IBD cases (aged: 8-29 years) and 91 controls undergoing strabismus surgery (aged: 11-23 years) was conducted in Southern Germany. A questionnaire and a dust sampling sock were mailed to the parents (Response: 71% among cases, 58% among controls). Endotoxin levels were determined using Limulus Amoebocyte Lysate assay tests. Logistic regression models adjusting for age, sex, high parental school education, family history of IBD, environmental factors in the first year of life (urban place of living, farm animal or pet contact), and presence of cats or dogs in the room were performed. RESULTS Geometric mean levels of endotoxin were lower among cases (50.67 Endotoxin Units (EU)/mg; geometric standard deviation (GSD); 2.32) than controls (60.25 EU/mg; GSD: 2.22). Endotoxin levels were inversely, but not statistically significantly, related to case status in the multivariate logistic regression analysis (OR for the interquartile range increase: 0.70; 95%CI: 0.46-1.04). CONCLUSION In our study sample, high endotoxin levels were inversely related to case status. Whether endotoxin is a marker of hygiene or causal needs further investigation.
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Affiliation(s)
- Anja Boneberger
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit for Occupational and Environmental Epidemiology & NetTeaching, University Hospital of Munich (LMU), Germany
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Zhang X, Zhao Z, Nordquist T, Larsson L, Sebastian A, Norback D. A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 409:5253-5259. [PMID: 21943723 DOI: 10.1016/j.scitotenv.2011.08.059] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 08/23/2011] [Accepted: 08/25/2011] [Indexed: 05/31/2023]
Abstract
There are few longitudinal studies on sick building syndrome (SBS), which include ocular, nasal, throat, and dermal symptoms, headache, and fatigue. We studied the associations between selected microbial components, fungal DNA, furry pet allergens, and incidence and remission of SBS symptoms in schools in Taiyuan, China. The study was based on a two-year prospective analysis in pupils (N=1143) in a random sample of schools in China. Settled dust in the classrooms was collected by vacuum cleaning and analyzed for lipopolysaccharide (LPS), muramic acid (MuA), and ergosterol (Erg). Airborne dust was collected in Petri dishes and analyzed for cat and dog allergens and fungal DNA. The relationship between the concentration of allergens and microbial compounds and new onset of SBS was analyzed by multi-level logistic regression. The prevalence of mucosal and general symptoms was 33% and 28%, respectively, at baseline, and increased during follow-up. At baseline, 27% reported at least one symptom that improved when away from school (school-related symptoms). New onset of mucosal symptoms was negatively associated with concentration of MuA, total LPS, and shorter lengths of 3-hydroxy fatty acids from LPS, C14, C16, and C18. Onset of general symptoms was negatively associated with C18 LPS. Onset of school-related symptoms was negatively associated with C16 LPS, but positively associated with total fungal DNA. In general, bacterial compounds (LPS and MuA) seem to protect against the development of mucosal and general symptoms, but fungal exposure measured as fungal DNA could increase the incidence of school-related symptoms.
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Affiliation(s)
- Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, 030006 Taiyuan, China.
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Renström A, Olsson M, Hedrén M, Johansson SGO, van Hage M. Pet shop workers: exposure, sensitization, and work-related symptoms. Allergy 2011; 66:1081-7. [PMID: 21463332 DOI: 10.1111/j.1398-9995.2011.02591.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Allergy to laboratory animals is a well-known occupational hazard. The aim was to investigate the frequency of allergic sensitization and respiratory symptoms among pet shop staff and to document their work environment. METHODS Subjects (n = 59) from 24 pet shops were investigated with a questionnaire and lung function tests and skin prick tests against a panel of common inhalant and pet shop allergens. Blood samples were taken for immunoglobulin E (IgE) and IgE antibodies against Phadiatop and specific pet shop allergens. Personal airborne rodent allergen (n = 40) and endotoxin exposure (n = 40) was measured during work. Airborne rodent allergens were also collected using petri dishes at work (n = 40) and at home (n = 45). RESULTS Fifty-three percent reported nasal symptoms, 34% eye symptoms, and 22% had experienced symptoms indicating asthma. However, only four workers (7%) were previously diagnosed with asthma. One-third reported respiratory symptoms at work, mostly against rodents, birds, insects, and hay, and 29% were sensitized to work-related allergens, mainly rodents and fodder insects, e.g., Zophobas. Atopy and total IgE > 100 kU/l increased prevalence of pet shop sensitization [prevalence ratio (PR) 17 and 5.5, respectively], and atopy increased work-related symptoms (PR 3.2). Endotoxin levels were similar between shops with and without rodents. Exposure to animals outside of work was extensive. CONCLUSIONS A third of the pet shop workers reported airway symptoms at work or were sensitized, sometimes to unusual pet shop allergens, especially among atopics. The findings stress the importance of improving the knowledge of health risks and allergen avoidance measures among pet shop staff.
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Affiliation(s)
- A Renström
- National Institute of Environmental Medicine, Lung and Allergy Research, Karolinska Institutet, Stockholm, Sweden.
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Mendy A, Gasana J, Vieira ER, Forno E, Patel J, Kadam P, Ramirez G. Endotoxin exposure and childhood wheeze and asthma: a meta-analysis of observational studies. J Asthma 2011; 48:685-93. [PMID: 21732750 DOI: 10.3109/02770903.2011.594140] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Exposure to endotoxin has been widely investigated as a potential factor for asthma and associated symptoms in children with different results. To clarify a potential relationship, we performed the present meta-analysis to integrate the results of studies examining the association of endotoxin exposure with wheeze and asthma in children. METHODS A search for relevant studies and reviews was conducted in MEDLINE, Highwire, CINAHL, and The Cochrane Library databases. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) for endotoxin exposure and wheeze or asthma were retrieved and pooled to generate summary effect estimates in STATA 11.1. RESULTS Nineteen studies were included in the meta-analysis. The summary estimates suggested that endotoxin was positively associated with wheeze in infants and toddlers (meta-OR: 1.48, 95% CI: 1.10-1.98), but negatively related to asthma in school-aged children (meta-OR: 0.82, 95% CI: 0.69-0.97 for endotoxin concentration and 0.68, 95% CI: 0.50-0.93 for endotoxin load). CONCLUSIONS Based on the studies evaluated, endotoxin is a risk factor for wheeze in younger children, but a protective factor for asthma in older children. Thus, this study supports the "hygiene hypothesis."
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Affiliation(s)
- Angelico Mendy
- Robert Stempel School of Public Health, Florida International University, Miami, FL 33199, USA
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Vandenplas O. Occupational asthma: etiologies and risk factors. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2011; 3:157-67. [PMID: 21738881 PMCID: PMC3121057 DOI: 10.4168/aair.2011.3.3.157] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 04/19/2011] [Indexed: 01/10/2023]
Abstract
The purpose of this article is to critically review the available evidence pertaining to occupational, environmental, and individual factors that can affect the development of occupational asthma (OA). Increasing evidence suggests that exploration of the intrinsic characteristics of OA-causing agents and associated structure-activity relationships offers promising avenues for quantifying the sensitizing potential of agents that are introduced in the workplace. The intensity of exposure to sensitizing agents has been identified as the most important environmental risk factor for OA and should remain the cornerstone for primary prevention strategies. The role of other environmental co-factors (e.g., non-respiratory routes of exposure and concomitant exposure to cigarette smoke and other pollutants) remains to be further delineated. There is convincing evidence that atopy is an important individual risk factor for OA induced by high-molecular-weight agents. There is some evidence that genetic factors, such as leukocyte antigen class II alleles, are associated with an increased risk of OA; however, the role of genetic susceptibility factors is likely to be obscured by complex gene-environment interactions. OA, as well as asthma in general, is a complex disease that results from multiple interactions between environmental factors and host susceptibilities. Determining these interactions is a crucial step towards implementing optimal prevention policies.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine, Mont-Godinne Hospital, Université Catholique de Louvain, Yvoir, Belgium
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Cai GH, Hashim JH, Hashim Z, Ali F, Bloom E, Larsson L, Lampa E, Norbäck D. Fungal DNA, allergens, mycotoxins and associations with asthmatic symptoms among pupils in schools from Johor Bahru, Malaysia. Pediatr Allergy Immunol 2011; 22:290-7. [PMID: 21457336 DOI: 10.1111/j.1399-3038.2010.01127.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
While there is a large variation of prevalence of asthma symptoms worldwide, what we do know is that it is on the rise in developing countries. However, there are few studies on allergens, moulds and mycotoxin exposure in schools in tropical countries. The aims were to measure selected fungal DNA, furry pet allergens and mycotoxins in dust samples from schools in Malaysia and to study associations with pupils' respiratory health effects. Eight secondary schools and 32 classrooms in Johor Bahru, Malaysia were randomly selected. A questionnaire with standardized questions was used for health assessment in 15 randomly selected pupils from each class. The school buildings were inspected and both indoor and outdoor climate were measured. Dust samples were collected by cotton swabs and Petri dishes for fungal DNA, mycotoxins and allergens analysis. The participation rate was 96% (462/480 invited pupils), with a mean age of 14 yr (range 14-16). The pupils mostly reported daytime breathlessness (41%), parental asthma or allergy (22%), pollen or pet allergy (21%) and doctor-diagnosed asthma (13%) but rarely reported night-time breathlessness (7%), asthma in the last 12 months (3%), medication for asthma (4%) or smoking (5%). The inspection showed that no school had any mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures. The mean building age was 16 yr (range 3-40) and the mean indoor and outdoor CO(2) levels were 492 ppm and 408 ppm, respectively. The mean values of indoor and outdoor temperature and relative humidity were the same, 29°C and 70% respectively. In cotton swab dust samples, the Geometric Mean (GM) value for total fungal DNA and Aspergillus/Penicillium (Asp/Pen) DNA in swab samples (Cell Equivalents (CE)/m(2)) was 5.7*10(8) and 0.5*10(8), respectively. The arithmetic mean (CE/m(2)) for Aspergillus versicolor DNA was 8780, Stachybotrys chartarum DNA was 26 and Streptomyces DNA was 893. The arithmetic means (pg/m(2)) for the mycotoxins sterigmatocystin and verrucarol were 2547 and 17, respectively. In Petri dish dust samples, the GM value for total fungal DNA and Asp/Pen DNA (CE/m(2) per day) was 9.2*10(6) and 1.6*10(6), respectively. The arithmetic mean (CE/m(2) per day) for A. versicolor DNA was 1478, S. chartarum DNA was 105 and Streptomyces DNA was 1271, respectively. The GM value for cat (Fel d1) allergen was 5.9 ng/m(2) per day. There were positive associations between A. versicolor DNA, wheeze and daytime breathlessness and between Streptomyces DNA and doctor-diagnosed asthma. However, the associations were inverse between S. chartarum DNA and daytime breathlessness and between verrucarol and daytime breathlessness. In conclusion, fungal DNA and cat allergen contamination were common in schools from Malaysia and there was a high prevalence of respiratory symptoms among pupils. Moreover, there were associations between levels of some fungal DNA and reported respiratory health in the pupils.
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Affiliation(s)
- Gui-Hong Cai
- Deparment of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala University, Uppsala, Sweden.
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Dillon MA, Harris B, Hernandez ML, Zou B, Reed W, Bromberg PA, Devlin RB, Diaz-Sanchez D, Kleeberger S, Zhou H, Lay JC, Alexis NE, Peden DB. Enhancement of systemic and sputum granulocyte response to inhaled endotoxin in people with the GSTM1 null genotype. Occup Environ Med 2011; 68:783-5. [PMID: 21441173 DOI: 10.1136/oem.2010.061747] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine if the GSTM1 null genotype is a risk factor for increased inflammatory response to inhaled endotoxin. METHODS 35 volunteers who had undergone inhalation challenge with a 20 000 endotoxin unit dose of Clinical Center Reference Endotoxin (CCRE) were genotyped for the GSTM1 null polymorphism. Parameters of airway and systemic inflammation observed before and after challenge were compared in GSTM1 null (n=17) and GSTM1 (n=18) sufficient volunteers. RESULTS GSTM1 null volunteers had significantly increased circulating white blood cells (WBCs), polymorphonuclear neutrophils (PMNs), platelets and sputum PMNs (% sputum PMNs and PMNs/mg sputum) after CCRE challenge. GSTM1 sufficient volunteers had significant, but lower increases in circulating WBCs, PMNs and % sputum PMNs, and no increase in platelets or PMNs/mg sputum. Linear regression analysis adjusted for baseline values of the entire cohort revealed that the GSTM1 null genotype significantly increased circulating WBCs, platelets and % sputum PMNs after challenge. CONCLUSION These data support the hypothesis that the GSTM1 null genotype is a risk factor for increased acute respiratory and systemic inflammatory response to inhaled CCRE. These data are consistent with other observations that the GSTM1 null genotype is associated with increased respiratory, systemic and cardiovascular effects linked to ambient air particulate matter exposure and indicate that the GSTM1 null genotype should be considered a risk factor for adverse health effects associated with exposure to environmental endotoxin.
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Affiliation(s)
- Madeline A Dillon
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7310, USA
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Schulze A, Römmelt H, Ehrenstein V, van Strien R, Praml G, Küchenhoff H, Nowak D, Radon K. Effects on pulmonary health of neighboring residents of concentrated animal feeding operations: exposure assessed using optimized estimation technique. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2011; 66:146-54. [PMID: 21864103 DOI: 10.1080/19338244.2010.539635] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Potential adverse health effects of concentrated animal feeding operations (CAFOs), which were also shown in the authors' Lower Saxony Lung Study, are of public concern. The authors aimed to investigate pulmonary health effect of neighboring residents assessed using optimized estimation technique. Annual ammonia emission was measured to assess the emission from CAFO and from surrounding fields. Location of sampling points was optimized using cluster analysis. Individual exposure of 457 nonfarm subjects was interpolated by weighting method. Mean estimated annual ammonia levels varied between 16 and 24 μg/m³. Higher exposed participants were more likely to be sensitized against ubiquitous allergens as compared to lower exposed subjects (adjusted odds ratio [OR] 4.2; 95% confidence interval [CI] 1.2-13.2). In addition, they showed a significantly lower forced expiratory volume in 1 second (FEV₁) (adjusted mean difference in % of predicted -8%; 95% CI -13% to -3%). The authors' previous findings that CAFOs may contribute to burden of respiratory diseases were confirmed by this study.
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Affiliation(s)
- Anja Schulze
- Unit for Occupational and Environmental Epidemiology, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the Ludwig-Maximilians-University Munich, Munich, Germany
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Parks CG, Biagini RE, Cooper GS, Gilkeson GS, Dooley MA. Total serum IgE levels in systemic lupus erythematosus and associations with childhood onset allergies. Lupus 2010; 19:1614-22. [PMID: 20937624 DOI: 10.1177/0961203310379870] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Elevated serum IgE has been described in systemic lupus erythematosus (SLE), but associations with disease risk and characteristics remain unresolved. We assessed total serum IgE levels and atopy (IgE > 100 IU/ml) in recently diagnosed SLE patients (n = 228) compared with population controls (n = 293) and in relation to disease activity, autoantibodies, clinical features, total immunoglobulins, C-reactive protein, and allergy history. Multivariate models estimated determinants of IgE and atopy in patients and controls, and associations of SLE with allergy and atopy. Total IgE levels were higher in patients than controls (median = 42 vs. 29 IU/ml); 32% of patients and 25% of controls were atopic (p = 0.06). IgE levels were significantly higher in non-Whites and patients reporting childhood onset (<18 years) asthma and hives, and in controls reporting childhood asthma, hay fever, eczema, and adult onset hives. After accounting for racial differences, atopy was not associated with SLE, nephritis, or other clinical and laboratory parameters. In sum, our findings provide limited evidence of a direct association between total serum IgE and SLE overall or with other disease characteristics after adjusting for demographic characteristics and allergy history. Future studies may want to explore potentially shared risk factors for development of allergy, atopy, and SLE.
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Affiliation(s)
- C G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC 27599, USA.
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Sikkeland LIB, Eduard W, Stangeland AM, Thorgersen EB, Haug T, Aukrust P, Halvorsen B, Mollnes TE, Kongerud J. Occupational exposure to bacterial single cell protein induces inflammation in lung and blood. Inhal Toxicol 2010; 21:674-81. [PMID: 19558225 DOI: 10.1080/08958370802491425] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Bacterial single cell protein (BSCP) is used as a protein enrichment in livestock and fish feed, and is extracted from dried bacterial mass. In the production of BSCP, workers are exposed to organic dust containing high levels of endotoxins that may induce acute airway inflammation. However, the long term effect on the airways of such exposure is not known, and we have examined inflammatory markers in induced sputum and blood among BSCP exposed workers. We included 21 non-smoking production workers (age 31-42 (range; mean 35)) without respiratory symptoms and 21 healthy non-exposed references (age 21-52 (range; mean 34)). Airborne endotoxin concentrations were measured, and induced sputum samples and blood samples were collected from the workers and non-exposed references. The airborne endotoxin concentration measured in inhaled air during the work shift was 430 EU/m(3) (50-2000) (median (range)). The percentage of neutrophils in induced sputum was 79% (66-93) (median (25th-75th percentiles)) and 31% (25-45) (p < 0.001) for operators and references, respectively. Protein analysis in induced sputum supernatant showed significantly elevated levels of interleukins IL-1beta and IL-12 (p < 0.05), while blood analysis showed significantly elevated levels of PDGF-BB (platelet-derived growth factor-BB) and RANTES (regulated upon activation normally T cell expressed and secreted) (p < 0.05). Workers exposed to BSCP had an airway inflammation characterized by a high level of neutrophils. However, only a few cytokines were elevated in lung and blood, which could imply low inflammatory activity suggestive of possible adaptation mechanisms due to daily exposure to BSCP, or that the inflammation reaction was a dose-related response occurring at higher levels.
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Affiliation(s)
- L I B Sikkeland
- Centre for Occupational and Environmental Medicine, Rikshospitalet University Hospital, Oslo, Norway.
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von Mutius E. 99th Dahlem conference on infection, inflammation and chronic inflammatory disorders: farm lifestyles and the hygiene hypothesis. Clin Exp Immunol 2010; 160:130-5. [PMID: 20415863 DOI: 10.1111/j.1365-2249.2010.04138.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
About 15 years have gone by since Strachan first proposed the idea that infections and unhygienic contact may confer protection from the development of allergic illnesses. The so-called 'hygiene hypothesis' has since undergone numerous modifications in the field of epidemiology, clinical science and immunology. Three main areas of research have been brought forward: to explore the role of overt viral and bacterial infections for the inception of allergic diseases; to investigate the significance of environmental exposure to microbial compounds on the development of allergies; and to study the effect of both exposures on underlying innate and adaptive immune responses. A concept unifying these various aspects has not been found, but various pieces of a complex interplay between immune responses of the host, characteristics of the invading microorganism, the level and variety of the environmental exposure and the interactions between an exposed subject's genetic background and the environmental exposures becomes apparent. A natural experiment relating to the hygiene hypothesis is the recurrent observation of a protective effect of growing up on a farm for asthma and allergies. This has been shown in a large number of epidemiological studies across the world among children and adults. The timing and duration of exposure are likely to play a critical role. The largest reduction in risk has been demonstrated for those exposed prenatally and continuously thereafter until adulthood. The protective factors in these farming environments have not been unravelled completely. Findings from various studies suggest that the contact with farm animals, at least in childhood, confers protection. Also the consumption of unprocessed cow's milk directly from the farm has been shown to protect from childhood asthma and allergies. Increased levels of microbial substances may, at least in part, contribute to the 'farm effect'. However, only few studies have measured microbial exposures in these environments and the results obtained so far suggest that the underlying protective microbial exposure(s) have not been identified, but a number of studies using metagenomic approaches are currently under way. The mechanisms by which such environmental exposures confer protection from respiratory allergies are also not well understood. There is good evidence for the involvement of innate immune responses, but translation into protective mechanisms for asthma and allergies is lacking. Furthermore, a number of gene x environment interactions have been observed.
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Affiliation(s)
- E von Mutius
- University Children's Hospital, Munich, Germany.
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45
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Surfactant protein-D and exposure to bioaerosols in wastewater and garbage workers. Int Arch Occup Environ Health 2010; 83:879-86. [DOI: 10.1007/s00420-010-0525-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Accepted: 02/23/2010] [Indexed: 10/19/2022]
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46
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Allergien und traditioneller Lebensstil. J Verbrauch Lebensm 2009. [DOI: 10.1007/s00003-009-0511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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47
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Parks CG, Cooper GS, Dooley MA, Park MM, Treadwell EL, Gilkeson GS. Childhood agricultural and adult occupational exposures to organic dusts in a population-based case-control study of systemic lupus erythematosus. Lupus 2008; 17:711-9. [PMID: 18625648 DOI: 10.1177/0961203308089436] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Organic dust exposure can influence the development and symptoms of immune-related diseases such as atopy and asthma, but has rarely been examined in relation to systemic autoimmunity. The present analyses explore the association of lifetime farm and occupational organic dust exposures with systemic lupus erythematosus (SLE) in recently diagnosed patients (n = 265) compared with controls (n = 355) frequency matched by age, sex and state. Questionnaire data included childhood farm residence, childhood and adult experience with specific crops, and adult work in textiles, hog or poultry processing and paper or furniture manufacture. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression models including age, sex, state, race, education and silica exposure. Overall childhood or adult farm contact and childhood farm residence were not associated with SLE. Farm contact with livestock was inversely associated with SLE (OR = 0.55, 95% CI 0.35, 0.88). This effect was most pronounced among those with childhood farm residence and both childhood and adult livestock exposure (OR = 0.19; 95% CI 0.06, 0.63), but was difficult to separate from adult exposure to grains or corn. Other adult occupational exposures were not associated with SLE risk overall, regardless of childhood farm residence or livestock exposure, although an inverse association was seen among non-smokers (OR = 0.59; 95% CI 0.33, 1.1), particularly for textile work (OR = 0.34; 95% CI 0.19, 0.64). These exploratory findings support the development of studies to specifically investigate the effects of organic dust exposure on SLE risk, with particular attention to exposure assessment and characterization of demographics, smoking and other occupational exposures.
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Affiliation(s)
- C G Parks
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
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Radon K, Schulze A, Schierl R, Dietrich-Gümperlein G, Nowak D, Jörres RA. Serum leptin and adiponectin levels and their association with allergic sensitization. Allergy 2008; 63:1448-54. [PMID: 18925881 DOI: 10.1111/j.1398-9995.2008.01714.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Obesity and respiratory allergies have increased in parallel in industrialized countries. We have recently shown an association between obesity and allergic sensitization whereby obesity diminished the protective effect of childhood farm contact. OBJECTIVE To assess whether taking obesity into account allergic sensitization is associated with adipokine levels in blood and whether this effect is modified by childhood farm contact. METHODS Serum samples of 231 adult participants (age 18-45 years) of the Lower Saxony Lung Study were analysed for leptin and adiponectin by ELISA. Subjects were elected to represent equal-sized groups with respect to obesity (<30 vs> or =30 kg/m(2)), childhood farm contact, specific IgE to ubiquitous allergens and sex. Multiple logistic regression models were adjusted for potential confounders. RESULTS Leptin levels were positively related to the prevalence of sensitization (highest vs lowest quartile odds ratio 6.7, 95% confidence interval 2.0-22.4). For adiponectin levels, a weak, not statistically significant inverse association with sensitization was shown (highest vs lowest quartile 0.4, 0.2-1.1). The association between leptin and sensitization appeared to be more pronounced in subjects with farm contact; however, the effect modification was not statistically significant. CONCLUSION These findings suggest that adipokines might be involved in the causal pathway between obesity and allergic sensitization.
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Affiliation(s)
- K Radon
- Institute for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
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49
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von Mutius E, Radon K. Living on a farm: impact on asthma induction and clinical course. Immunol Allergy Clin North Am 2008; 28:631-47, ix-x. [PMID: 18572111 DOI: 10.1016/j.iac.2008.03.010] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Exposure to a farming environment protects individuals from respiratory allergy. The timing and duration of exposure seem to play critical roles. The largest reduction in risk of developing respiratory allergies is seen among those who are exposed prenatally and continuously thereafter. Contact with farm animals, at least in childhood, likely confers protection; other factors have not been completely identified. Also, the consumption of milk directly from the farm during childhood has been shown to be beneficial with respect to childhood asthma and allergies. Increased levels of microbial substances may contribute to the protective effects. The mechanisms by which such environmental exposures confer protection from respiratory allergies are not well understood. A number of gene-by-environment interactions have been observed with polymorphisms in genes of innate immunity receptors and exposure to farming environments. Increased levels of microbial exposures recognized by innate immune responses may affect adaptive immune responses resulting in decreased levels of atopic sensitization and asthma.
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Affiliation(s)
- Erika von Mutius
- University Children's Hospital, Lindwurmstr 4, D 80337 Munich, Germany.
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50
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Zhao Z, Sebastian A, Larsson L, Wang Z, Zhang Z, Norbäck D. Asthmatic symptoms among pupils in relation to microbial dust exposure in schools in Taiyuan, China. Pediatr Allergy Immunol 2008; 19:455-65. [PMID: 18221461 DOI: 10.1111/j.1399-3038.2007.00664.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Microbial exposure has been indicated as significant in the development of asthma and allergy among children. The aim of the study was to test whether microbial exposure and allergens in the school environment are associated with asthmatic symptoms in pupils. Data on asthmatic symptoms and respiratory infections were collected through a questionnaire survey among 1993 pupils aged 11-15 yr in 10 randomly selected schools in Taiyuan, China. Settled dust in classrooms was analysed using tandem gas chromatography-mass spectrometry for 3-hydroxy fatty acids, marker of lipopolysaccharide (LPS) from endotoxin, muramic acid (MuA), marker of bacteria and ergosterol (Erg) for fungi, quantifying both culturable and non-culturable microbes. A total of 29.8% reported daytime attacks of breathlessness, 8.4% wheeze and 1.2% had doctor's diagnosed asthma. Generally, MuA was negatively associated with wheeze and daytime attacks of breathlessness, the latter of which was negatively associated with Erg to a weaker extent. Total concentration of LPS was positively associated with daytime attacks of breathlessness, but shorter lengths of LPS, C10, C12 and C14 LPS were negatively associated with either wheezing or daytime attacks of breathlessness. For MuA and C10 and C12 of LPS, the associations were independent of airborne allergens and classroom crowdedness, and even independent of the other two microbial markers for MuA. Microbial exposure indicated by certain chemical markers (e.g. MuA) could be protective for asthmatic symptoms, but for LPS (endotoxin), the picture is more complex, varying by different lengths of fatty acids of LPS.
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Affiliation(s)
- Zhuohui Zhao
- Department of Occupational and Environmental Medicine, University Hospital and Uppsala University, Uppsala, Sweden.
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