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Loeb E, Zock JP, Miravitlles M, Rodríguez E, Soler-Cataluña JJ, Soriano JB, García-Río F, de Lucas P, Alfageme I, Casanova C, Rodríguez González-Moro JM, Ancochea J, Cosío BG, Ferrer Sancho J. Association between occupational exposure and chronic obstructive pulmonary disease and respiratory symptoms in the Spanish population. Arch Bronconeumol 2024; 60:16-22. [PMID: 38176851 DOI: 10.1016/j.arbres.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION The aim of this study was to analyze the impact of occupational exposure on chronic obstructive pulmonary disease (COPD) and respiratory symptoms in the general Spanish population. METHODS This was a study nested in the Spanish EPISCAN II cross-sectional epidemiological study that included participants who had completed a structured questionnaire on their occupational history, a questionnaire on respiratory symptoms, and forced spirometry. The data were analyzed using Chi-square and Student's t tests and adjusted models of multiple linear regression and logistic regression. RESULTS We studied 7502 subjects, 51.1% women, with a mean age of 60±11 years. Overall, 53.2% reported some respiratory symptoms, 7.9% had respiratory symptoms during their work activity, 54.2% were or had been smokers, and 11.3% (851 subjects) met COPD criteria on spirometry. A total of 3056 subjects (40.7%) reported exposure to vapors, gases, dust or fumes (VGDF); occupational exposure to VGDF was independently associated with the presence of COPD (OR 1.22, 95% CI: 1.03-1.44), respiratory symptoms (OR 1.45, 95%: CI 1.30-1.61), and respiratory symptoms at work (OR 4.69, 95% CI: 3.82-5.77), with a population attributable fraction for COPD of 8.2%. CONCLUSIONS Occupational exposure is associated with a higher risk of COPD and respiratory symptoms in the Spanish population. These results highlight the need to follow strict prevention measures to protect the respiratory health of workers.
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Affiliation(s)
- Eduardo Loeb
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Centro Médico Teknon, Grupo Quironsalud, Barcelona, Spain
| | - Jan-Paul Zock
- Instituto Nacional de Salud Pública y Medio Ambiente (RIVM), Bilthoven, The Netherlands
| | - Marc Miravitlles
- Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Esther Rodríguez
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Juan José Soler-Cataluña
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Departamento de Medicina, Universitat de Valencia, Valencia, Spain
| | - Joan B Soriano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Pilar de Lucas
- Servicio de Neumología, Hospital General Gregorio Marañon, Madrid, Spain
| | - Inmaculada Alfageme
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Sevilla, Spain
| | - Ciro Casanova
- Servicio de Neumología-Unidad de Investigación Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
| | | | - Julio Ancochea
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Borja G Cosío
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Departamento de Medicina, Universidad de las Islas Baleares, Palma de Mallorca, Spain
| | - Jaume Ferrer Sancho
- Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain; Servicio de Neumología, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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Nguyen TC, Tran HVT, Nguyen TH, Vo DC, Godin I, Michel O. Identification of Modifiable Risk Factors of Exacerbations Chronic Respiratory Diseases with Airways Obstruction, in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11088. [PMID: 36078802 PMCID: PMC9517880 DOI: 10.3390/ijerph191711088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES to determine modifiable risk factors of exacerbations in chronic respiratory diseases with airways obstruction (i.e., asthma and COPD) in southern Vietnam. METHODS an environmental and health-related behavioural questionnaire was submitted to patients with both chronic respiratory symptoms and airways obstruction. An exacerbation was defined as any acute worsening in clinical symptoms requiring a change in treatment, in a patient receiving prophylactic therapy. RESULTS 235 patients were evaluated, including 131 (56%) chronic obstructive pulmonary disease (COPD) and 104 (44%) asthmatics. There were 75% males and 69% smokers. Occupational exposure accounted for 66%, mainly among construction and industry workers. Smoking was associated with more severe airways obstruction. Respiratory exacerbations were reported in 56/235 patients (24%). The risk of exacerbation was increased in patients with a lower education level, exposure to occupational pollutants, cumulative smoking ≥ 20 pack year, housing space < 10 m2, and poorly ventilated housing. Based on multivariate analysis, the risk of exacerbation remained significantly higher among patients with occupational exposure and low housing space per person. CONCLUSIONS besides smoking cessation, more supportive policies, including improvement of occupational environment and housing design for better ventilation, are needed to prevent the severity of chronic respiratory diseases in Vietnam.
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Affiliation(s)
- Thuy Chau Nguyen
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 740500, Vietnam
| | - Hoa Vi Thi Tran
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 740500, Vietnam
| | - Thanh Hiep Nguyen
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 740500, Vietnam
| | - Duc Chien Vo
- Nguyen Tri Phuong Hospital, Ho Chi Minh City 740500, Vietnam
| | - Isabelle Godin
- School of Public Health, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Olivier Michel
- Clinic of Immuno-Allergology, CHU Brugmann, Université Libre de Bruxelles (ULB), 4 Place A-Van Gehuchten, 1020 Brussels, Belgium
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Khan M, Muhmood K, Noureen S, Mahmood HZ, Amir-Ud-Din R. Epidemiology of respiratory diseases and associated factors among female textile workers in Pakistan. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022; 28:184-198. [PMID: 32602797 DOI: 10.1080/10803548.2020.1751973] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective. The study aimed to estimate the prevalence of byssinosis and other respiratory symptoms among women textile workers and the associated risk factors in 18 spinning mills of Faisalabad and Lahore districts of Punjab, Pakistan. Method. In this case-control study of 1054 female workers, we used the dose-response function to measure the association between dust level and respiratory disorders in cotton textile workers. Results. Working overtime and long working hours per week are significantly associated with self-reported symptoms of byssinosis. Women's age, marital status and wages were significantly associated with mitigating actions (seeing the doctor), while the education of the women was significantly associated with averting action (use of a mask). Conclusion. Regulating working hours and ensuring employees' compliance with the safety standards are expected to mitigate the health problems of female workers.
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Affiliation(s)
- Muhammad Khan
- Department of Economics, COMSATS University Islamabad, Pakistan
| | - Kashif Muhmood
- Department of Economics, COMSATS University Islamabad, Pakistan
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Abdel-Rasoul GM, El-Sayed Abu-Salem M, Abdel-Azeem Salem E, Younis FE, Abdel-Monaem AM, Allam HK. Respiratory health disorders among workers in some Egyptian welding enterprises. Toxicol Ind Health 2022; 38:53-62. [PMID: 35072568 DOI: 10.1177/07482337211064950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Welding fumes contain a complex mixture of metallic oxides that pose a risk to welders' respiratory systems. This study aimed to evaluate respiratory health disorders among workers in some Egyptian welding enterprises and their relationship to the workplace environment. This research was performed from January 1st, 2019 to February 28th, 2021 in welding enterprises in Birket El-Sabaa, a randomly selected district of Menoufia governorate, Egypt. A cross-sectional comparative study was conducted on 110 welders and 110 non-occupationally exposed subjects. Environmental studies were carried out for total welding fumes, respirable dust, and manganese air levels. Spirometric measures and manganese levels in whole blood were applied. Analysis of the personal air samples revealed that the mean values of welding fumes, respirable dust, and manganese air levels were higher than the international permissible levels. Welders had a higher significant prevalence of respiratory manifestations (rhinitis, cough, expectoration, wheezes, dyspnea, and chronic bronchitis) as well as decreased spirometric measures (FVC%, FEV1%, FEV1/FVC%, and FEF25-75%) than controls. The mean value of whole blood manganese level was statistically significantly higher among welders than that of the controls (3.35 ± 0.5 and 1.81 ± 0.79 ng/mL; respectively). A significant relationship was reported between longer work time and the prevalence of respiratory manifestations and decreased spirometric measurements. The use of masks/respirators was associated with a reduced prevalence of respiratory manifestations. Finally, welders that are exposed to welding fumes at concentrations higher than the permissible levels in welding establishments suffer from adverse respiratory problems, as shown by increased prevalence of respiratory manifestations and lower spirometric measurements. Regular use of high-quality personal protective equipment, especially masks, as well as periodic medical examinations for welders, is highly urged.
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Affiliation(s)
- Gaafar M Abdel-Rasoul
- Public Health and Community Medicine Department, Faculty of Medicine, 68872Menoufia University, Shebin El-Kom, Egypt
| | - Mahmoud El-Sayed Abu-Salem
- Public Health and Community Medicine Department, Faculty of Medicine, 68872Menoufia University, Shebin El-Kom, Egypt
| | - Eman Abdel-Azeem Salem
- Public Health and Community Medicine Department, Faculty of Medicine, 68872Menoufia University, Shebin El-Kom, Egypt
| | - Faten E Younis
- Public Health and Community Medicine Department, Faculty of Medicine, 68872Menoufia University, Shebin El-Kom, Egypt
| | - Amira M Abdel-Monaem
- Public Health and Community Medicine Department, Faculty of Medicine, 68872Menoufia University, Shebin El-Kom, Egypt
| | - Heba K Allam
- Public Health and Community Medicine Department, Faculty of Medicine, 68872Menoufia University, Shebin El-Kom, Egypt
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Syamlal G, Doney B, Hendricks S, Mazurek JM. Chronic Obstructive Pulmonary Disease and U.S. Workers: Prevalence, Trends, and Attributable Cases Associated With Work. Am J Prev Med 2021; 61:e127-e137. [PMID: 34419236 PMCID: PMC8672326 DOI: 10.1016/j.amepre.2021.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease is the fourth leading cause of death in the U.S. Workplace exposures are important modifiable contributors to the burden of chronic obstructive pulmonary disease. Among U.S. workers, 19% of chronic obstructive pulmonary disease cases are attributable to workplace exposures. This study examines the trends in chronic obstructive pulmonary disease prevalence during 2012-2018 among workers and assesses the population attributable fraction for chronic obstructive pulmonary disease associated with work by smoking status, industry, and occupation. METHODS The 2012-2018 National Health Interview Survey data for workers aged ≥18 years employed during the 12 months before the interview were analyzed in 2019. Annual trends were examined using the Poisson regression model. Multivariate logistic regression was used to calculate adjusted prevalence ORs. RESULTS During 2012-2018, an estimated age-adjusted annual average of 4.1% of workers had chronic obstructive pulmonary disease, and prevalence varied by industry and occupation. Overall, chronic obstructive pulmonary disease prevalence increased by an estimated annual average of 1.5% (p<0.05). The prevalence trends increased significantly among workers in the merchant wholesale nondurable and the arts, entertainment, and recreation industries and among financial specialists; supervisors, other food services workers; supervisors, building grounds workers, and maintenance workers; personal care and services workers; supervisors and office and administrative support workers; and motor-vehicle operators and material moving workers. The proportion of chronic obstructive pulmonary disease cases attributable to work was 27.3% among all workers and 24.0% among never smokers. CONCLUSIONS Public health efforts to increase the awareness and understanding of chronic obstructive pulmonary disease associated with occupational risk factors are needed to prevent chronic obstructive pulmonary disease among workers, especially among those employed in industries and occupations with increasing prevalence trends.
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Affiliation(s)
- Girija Syamlal
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia.
| | - Brent Doney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Scott Hendricks
- Division of Safety Research, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Jacek M Mazurek
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
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Skaaby S, Flachs EM, Lange P, Schlünssen V, Marott JL, Brauer C, Nordestgaard BG, Sadhra S, Kurmi O, Bonde JPE. Chronic productive cough and inhalant occupational exposure-a study of the general population. Int Arch Occup Environ Health 2021; 94:1033-1040. [PMID: 33559749 DOI: 10.1007/s00420-020-01634-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Occupational inhalant exposures have been linked with a higher occurrence of chronic productive cough, but recent studies question the association. METHODS We included participants from two general population studies, the Copenhagen City General Population Study and the Copenhagen City Heart Study, to assess contemporary (year 2003-2017) and historical (1976-1983) occupational inhalant hazards. Job titles one year prior to study inclusion and an airborne chemical job-exposure matrix (ACE JEM) were used to estimate occupational exposure. The association between occupational exposures and self-reported chronic productive cough was studied using generalized estimating equations stratified by smoking status and cohort. RESULTS The population consisted of 5210 working individuals aged 20-65 from 1976 to 1983 and 64,279 from 2003 to 2017. In smokers, exposure to high levels of mineral dust, biological dust, gases & fumes and the composite variable vapours, gases, dusts or fumes (VGDF) were associated with chronic productive cough in both cohorts with odds ratios in the range of 1.2 (95% confidence interval, 1.0;1.4) to 1.6 (1.2;2.1). High levels of biological dust were only associated with an increased risk of a chronic productive cough in the 2003-2017 cohort (OR 1.5 (1.1;2.0)). In non-smokers, high levels of VGDF (OR 1.5 (1.0;2.3)) and low levels of mineral dust (OR 1.7 (1.1;2.4)) were associated with chronic productive cough in the 1976-1983 cohort, while no associations were seen in non-smokers in the 2003-2017 cohort. CONCLUSION Occupational inhalant exposure remains associated with a modestly increased risk of a chronic productive cough in smokers, despite declining exposure levels during the past four decades.
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Affiliation(s)
- Stinna Skaaby
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Peter Lange
- Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.,Department of Medicine, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Copenhagen City Heart Study, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark.,National Research Center for the Working Environment, Copenhagen, Denmark
| | - Jacob Louis Marott
- Copenhagen City Heart Study, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Børge G Nordestgaard
- Copenhagen City Heart Study, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Copenhagen General Population Study, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Biochemistry, Herlev Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Steven Sadhra
- Institute of Occupational and Environmental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Om Kurmi
- Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.,Institute of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
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Zayed HA, Salah N, Hassan NM, Elmagid DA. Assessment of respiratory health and environmental safety measures in phosphate fertilizer industry in the middle region of the Nile Delta, Egypt. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:35008-35016. [PMID: 32583121 DOI: 10.1007/s11356-020-09817-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/19/2020] [Indexed: 06/11/2023]
Abstract
Phosphate fertilizer industry is one of the most environmental polluting industries in Egypt. To identity the prevalence of abnormal ventilatory functions and to assess environmental safety measures in phosphate fertilizer industry in the middle region of the Nile Delta, Egypt. The study included 180 exposed male workers in phosphate fertilizer factory at Kafr El-Zayat City. An interview questionnaire was used to collect data related to socio-demographic, occupational history, and work-related respiratory manifestations. Spirometer was used for measuring ventilatory functions tests. Assessment of workplace safety measures was done by using Occupational Safety and Health (OSH) Inspection Checklist, and environmental measures of total dust and sulfur dioxides (SOx) were obtained from records. Self-reported respiratory manifestations were found in 74/180 workers (41.11%), with rhinitis (49.3%), cough (38.9%), and expectoration (38.3%) were the most frequent. Abnormal ventilatory functions were confirmed and reported in about one-fourth of workers (43/180, 23.9%) with prominence of obstructive pattern. Significant negative correlation was found between age and MVV values (r = - 0.449, p = 0.001) and between duration of work and values of both FEV1(r = - 0.248, p = 0.033) and MVV (r = - 0.473, p = 0.001). The mean percent of applied safety practices and measures in workplace was 53.39% ± 16.4. The mean of sulfur dioxides values in English acid unit exceeded the permissible exposure level (PEL). Preventive medical and environmental safety measures were inadequate with a relatively high prevalence of abnormal ventilatory functions among workers. Sulfur dioxides measurements exceeded PEL.
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Affiliation(s)
- Hanaa A Zayed
- Occupational Health and Industrial Medicine at Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Nihal Salah
- Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nadira M Hassan
- Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dalia Abd Elmagid
- Occupational Health and Industrial Medicine at Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Sumit AF, Das A, Miraj IH, Bhowmick D. Association between chronic obstructive pulmonary disease (COPD) and occupational exposures: A hospital based quantitative cross-sectional study among the Bangladeshi population. PLoS One 2020; 15:e0239602. [PMID: 32966342 PMCID: PMC7510960 DOI: 10.1371/journal.pone.0239602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022] Open
Abstract
The association between chronic obstructive pulmonary disease (COPD) and occupational exposures are less studied in Bangladeshi context, despite the fact that occupational exposures are serious public health concerns in Bangladesh. Therefore, this study aimed to evaluate this association considering demographic, health and smoking characteristics of Bangladeshi population. This was a hospital-based quantitative study including 373 participants who were assessed for COPD through spirometry testing. Assessment of occupational exposures was based on both self-reporting by respondents and ALOHA based job exposure matrix (JEM). Here, among the self-reported exposed group (n = 189), 104 participants (55%) were found with COPD compared to 23 participants (12.5%) in unexposed group (n = 184) that differed significantly (p = 0.00). Similarly, among the JEM measured low (n = 103) and high exposed group (n = 236), 23.3% and 41.5% of the participants were found with COPD respectively; compared to unexposed group (14.7%; n = 34), that differed significantly also (p = 0.00). Likewise, participants with longer self-reported occupational exposures (>8 years) showed significantly (p = 0.00) higher proportions of COPD (79.5%) compared to 40.4% in shorter exposure group (1-8 years). Similarly, significant (p = 0.00) higher cases of COPD were observed among the longer cumulative exposure years (>9 years) group than the shorter cumulative exposure years (1-9 years) group in JEM. While combining smoking and occupational exposure, the chance of developing COPD among the current, former and non-smokers of exposed group were 7.4, 7.2 and 12.7 times higher respectively than unexposed group. Furthermore, logistic analysis revealed that after adjustments for confounding risk factors, the chance of developing COPD among the self-reported exposure group was 6.3 times higher (ORs: 6.3, p = 0.00) than unexposed group; and JEM exposure group has odds of 2.8 and 1.1 respectively (p<0.05) for high and low exposures. Further studies are needed to reinforce this association between COPD and occupational exposure in Bangladesh.
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Affiliation(s)
- Ahmed Faisal Sumit
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
- * E-mail:
| | - Anindya Das
- Department of Genetic Engineering and Biotechnology, University of Dhaka, Dhaka, Bangladesh
| | | | - Debasish Bhowmick
- Department of Respiratory Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh
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Kitjakrancharoensin P, Yasan K, Hongyantarachai K, Ratanachokthorani K, Thammasarn J, Kuwuttiwai D, Ekanaprach T, Jittakarm R, Nuntapravechpun R, Hotarapavanon S, Kulrattanarak S, Tongkaew S, Deemeechai S, Mungthin M, Rangsin R, Wongsrichanalai V, Sakboonyarat B. Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand. Int J Chron Obstruct Pulmon Dis 2020; 15:2189-2198. [PMID: 32982211 PMCID: PMC7501975 DOI: 10.2147/copd.s262050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose The present study aimed to determine the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among agriculturists in a remote rural community in central Thailand. Methods A cross-sectional study was conducted in January 2020. Face-to-face interviews were conducted using standardized questionnaires to determine demographic characteristics and risk behaviors. COPD was defined by the spirometric criterion for airflow limitation constituting a postbronchodilator fixed ratio of FEV1/FVC <0.70 following the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2019. Multivariable logistic regression analysis was used to determine the risk factors for COPD, and the magnitude of association was presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). Results A total of 546 agriculturists were enrolled in the study. The overall prevalence of COPD was 5.5% (95% CI: 3.6–7.4). The prevalence of COPD among males was 8.0% (95% CI: 4.7–11.3), and 3.2% (95% CI: 1.1–5.2) among females. The risk factors of COPD included age ≥60 years old (AOR 2.7, 95% CI: 1.1–7.0), higher intensity of smoking (AOR 1.1, 95% CI: 1.0–1.1), swine farm worker (AOR 4.1, 95% CI: 1.7–10.3), cattle farm worker (AOR 3.3, 95% CI: 1.4–8.2) and home cooking (AOR 2.7, 95% CI: 0.8–9.7). Conclusion Our data emphasized that COPD was one of the significant health problems among agriculturists in a rural community. Agricultural jobs such as animal farmers and behavioral factors such as smoking were associated with COPD. Effective public health interventions, especially, modifying risk behaviors, should be promoted in remote rural areas to prevent the disease and reduce its morbidity and mortality.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mathirut Mungthin
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
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Blanc PD, Annesi-Maesano I, Balmes JR, Cummings KJ, Fishwick D, Miedinger D, Murgia N, Naidoo RN, Reynolds CJ, Sigsgaard T, Torén K, Vinnikov D, Redlich CA. The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement. Am J Respir Crit Care Med 2020; 199:1312-1334. [PMID: 31149852 PMCID: PMC6543721 DOI: 10.1164/rccm.201904-0717st] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.
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11
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Soumagne T, Caillaud D, Degano B, Dalphin JC. [Differences and similarities between occupational and tobacco induced COPD]. Rev Mal Respir 2017; 34:607-617. [PMID: 28506727 DOI: 10.1016/j.rmr.2016.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/02/2016] [Indexed: 10/19/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) most often results from the inhalation of toxic agents. Cigarette smoking still remains the principal cause but the pertinence of occupational COPD is now clearly established. After a brief overview of the epidemiology of this "other COPD", the clinical and functional characteristics are summarized, taking into account recent advances in this field. The combined effects of occupational exposure and tobacco are also considered, providing evidence of the need to continuously reinforce campaigns of education and prevention in occupational COPD.
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Affiliation(s)
- T Soumagne
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; Service de physiologie-explorations fonctionnelles, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France.
| | - D Caillaud
- Service de pneumologie, université d'Auvergne, CHU Gabriel-Montpied, rue Montalembert, 63003 Clermont-Ferrand, France
| | - B Degano
- Service de physiologie-explorations fonctionnelles, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; EA 3920, université de Franche-Comté, 25000 Besançon, France
| | - J-C Dalphin
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; UMR CNRS 6249, chrono-environnement, université de Franche-Comté, 25000 Besançon, France
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12
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Würtz ET, Schlünssen V, Malling TH, Hansen JG, Omland Ø. Occupational Chronic Obstructive Pulmonary Disease in a Danish Population-Based Study. COPD 2016; 12:435-43. [PMID: 25415831 DOI: 10.3109/15412555.2014.974739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim was to explore the impact of occupation on chronic obstructive pulmonary disease (COPD) in a cross-sectional population-based study among subjects aged 45 to 84 years. In a stratified sampling 89 general practitioners practices (GPP) in Denmark recruited 3106 males and 1636 females through the Danish Civil Registration System. COPD was defined by spirometry by the 2.5(th)-centile Lower Limit of Normal of FEV1 and FEV1/FVC. Information about smoking, occupational exposure and the respective occupations were obtained from questionnaires. Occupations followed the Danish adaptation of The International Standard Classification of Occupations, revision 1988 (DISCO-88). Exposure to vapour, gas, dust (organic and inorganic), and fume (VGDF) in each occupation (yes/no) was evaluated by two independent specialist in occupational medicine. Exposures were divided in no, low, medium, and high exposure as 0, < 5, 5-14, and ≥ 15 years in the job, respectively. Data was analysed by a mixed random effect logistic regression model. The age-standardised COPD study prevalence was 5.0%. Of 372 DISCO-88 codes 72 were identified with relevant exposure to VGDF. 46% of the participants reported at least one occupation with VGDF exposure. Adjusted for smoking, age, sex, and GPP a dose-dependent association of COPD was found among workers in jobs with high organic dust exposure, with OR 1.56 (95% CI 1.09-2.24). Restricted to agriculture the OR was 1.59 (95% CI: 1.08-2.33). No association was observed for workers in jobs with inorganic dust, fume/gas, or vapour exposures. In summary, occupational organic dust exposure was associated to the prevalence of COPD.
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Affiliation(s)
- Else Toft Würtz
- a Department of Occupational Medicine, Danish Ramazzini Centre , Aalborg University Hospital , Aalborg , Denmark
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Song WJ, Chang YS, Faruqi S, Kang MK, Kim JY, Kang MG, Kim S, Jo EJ, Lee SE, Kim MH, Plevkova J, Park HW, Cho SH, Morice AH. Defining Chronic Cough: A Systematic Review of the Epidemiological Literature. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 8:146-55. [PMID: 26739408 PMCID: PMC4713878 DOI: 10.4168/aair.2016.8.2.146] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 07/09/2015] [Indexed: 01/29/2023]
Abstract
Purpose Recent evidence suggests a global burden of chronic cough in general populations. However, the definitions vary greatly among epidemiological studies, and none have been validated for clinical relevance. We aimed to examine previous epidemiological definitions in detail and explore the operational characteristics. Methods A systematic review was conducted for epidemiological surveys that reported the prevalence of chronic cough in general adult populations during the years 1980 to 2013. A literature search was performed on Pubmed and Embase without language restriction. Epidemiological definitions for chronic cough were classified according to their components, such as cutoff duration. Meta-analyses were performed for the male-to-female ratio of chronic cough prevalence to explore operational characteristics of epidemiological definitions. Results A total of 70 studies were included in the systematic review. The most common epidemiological definition was identified as 'cough ≥3 months' duration without specification of phlegm (n=50); however, it conflicted with the cutoff duration in current clinical guidelines (cough ≥8 weeks). Meta-analyses were performed for the male-to-female ratio of chronic cough among 28 studies that reported sex-specific prevalence using the most common definition. The pooled male-to-female odds ratio was 1.26 (95% confidence interval 0.92-1.73) with significant heterogeneity (I2=96%, P<0.001), which was in contrast to clinical observations of female predominance from specialist clinics. Subgroup analyses did not reverse the ratio or reduce the heterogeneity. Conclusions This study identified major issues in defining chronic cough in future epidemiological studies. The conflict between epidemiological and clinical diagnostic criteria needs to be resolved. The unexpected difference in the gender predominance between the community and clinics warrants further studies. Clinical validation of the existing definition is required.
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Affiliation(s)
- Woo Jung Song
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Shoaib Faruqi
- Centre for Cardiovascular and Metabolic Research, Hull York Medical School, Castle Hill Hospital, University of Hull, Cottingham, East Yorkshire, United Kingdom
| | - Min Koo Kang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Young Kim
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Min Gyu Kang
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sujeong Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Seung Eun Lee
- Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Min Hye Kim
- Department of Internal Medicine, Ewha Woman's University School of Medicine, Seoul, Korea
| | - Jana Plevkova
- Department of Pathophysiology and Simulation Centre, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic
| | - Heung Woo Park
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Heon Cho
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
| | - Alyn H Morice
- Centre for Cardiovascular and Metabolic Research, Hull York Medical School, Castle Hill Hospital, University of Hull, Cottingham, East Yorkshire, United Kingdom.
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Marchetti N, Garshick E, Kinney GL, McKenzie A, Stinson D, Lutz SM, Lynch DA, Criner GJ, Silverman EK, Crapo JD. Association between occupational exposure and lung function, respiratory symptoms, and high-resolution computed tomography imaging in COPDGene. Am J Respir Crit Care Med 2015; 190:756-62. [PMID: 25133327 DOI: 10.1164/rccm.201403-0493oc] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Although occupational exposure to dust and fumes is considered a risk factor for chronic obstructive pulmonary disease, this determination has been limited by reliance on spirometry alone to assess disease severity in predominantly male populations. OBJECTIVES To determine the effect of occupational exposure on lung function, respiratory symptoms, and findings of emphysema and airway wall thickness measured using quantitative computed tomography in men and women. METHODS COPDGene is a multicenter study of current and former smokers that underwent standardized volumetric chest computed tomography scans to assess airways, % emphysema, and % gas trapping. Spirometry and a respiratory questionnaire including occupational history were also analyzed in 9,614 subjects (4,496 women). Logistic regression and analysis of covariance was used to assess associations with exposure. MEASUREMENTS AND MAIN RESULTS Occupational exposure to both dust and fumes was reported by 47.9% of men and 20.1% of women. Adjusting for age, race, body mass index, education, and current and lifetime smoking, the odds ratios for persons with dust and fume exposures for chronic cough, chronic phlegm, persistent wheeze, and Global Initiative for Chronic Obstructive Lung Disease stages 2 and higher chronic obstructive pulmonary disease were significantly elevated and similar for men (1.83, 1.84, 2.0, 1.61, respectively) and women (1.65, 1.82, 1.98, 1.90, respectively). The % predicted FEV1 was similarly lower in those with exposure in men (70.7 ± 0.8 vs. 76.0 ± 0.9; P < 0.001) and women (70.5 ± 0.8 vs. 77.2 ± 0.8; P < 0.001). Percent emphysema and gas trapping was greater in those exposed to dust and fumes in men and women. In men, but not in women, persons with exposure had a greater mean square root wall area of 10-mm internal perimeter airways. CONCLUSIONS Occupational exposure to dust and fumes in men and women is similarly associated with airflow obstruction, respiratory symptoms, more emphysema, and gas trapping in men and women.
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Affiliation(s)
- Nathaniel Marchetti
- 1 Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
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Cho Y, Lee J, Choi M, Choi W, Myong JP, Kim HR, Koo JW. Work-related COPD after years of occupational exposure. Ann Occup Environ Med 2015; 27:6. [PMID: 25767717 PMCID: PMC4357143 DOI: 10.1186/s40557-015-0056-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 02/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is known as the most important risk factor of chronic obstructive pulmonary disease (COPD). However, occupational exposure to other substances can result in COPD. CASE REPORT A 76-year-old man with occupational exposures to mixtures of silica dust, gas, and fumes for 10 years and with a 25 pack-year smoking history was diagnosed with COPD. His computed tomogram scan revealed some hyperinflation with emphysematous change in both upper lobes. In the pulmonary function tests, his post-bronchodilator forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC% were 2.20 L (67% of the predicted value), 1.12 L (52% of the predicted value), and 51%, respectively, indicating moderate COPD. This case of COPD was confirmed as a work-related disease by the Occupational Lung Disease Research Institute in Korea Workers' Compensation & Welfare Service. CONCLUSION Exposure to various substances such as silica dust, gas, and fumes from furnace and boiler installation was likely the cause of COPD in this patient. Thus, occupational exposure should be considered an important risk factor of COPD.
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Affiliation(s)
- YounMo Cho
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701 Republic of Korea
| | - JongIn Lee
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701 Republic of Korea
| | - Min Choi
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701 Republic of Korea
| | - WonSeon Choi
- />Department of Occupational & Environmental Medicine, Korea Medical Institute, Suwon, Republic of Korea
| | - Jun-Pyo Myong
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701 Republic of Korea
- />Center for Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Hyoung-Ryoul Kim
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701 Republic of Korea
- />Center for Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Jung-Wan Koo
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
- />Department of Occupational & Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero Seocho-gu, Seoul, 137-701 Republic of Korea
- />Center for Occupational and Environmental Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
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Wang F, Zou Y, Shen Y, Zhong Y, Lv Y, Huang D, Chen K, Li Q, Qing L, Xia B, Su C, Ma S, Yang X. Synergistic impaired effect between smoking and manganese dust exposure on pulmonary ventilation function in Guangxi manganese-exposed workers healthy cohort (GXMEWHC). PLoS One 2015; 10:e0116558. [PMID: 25664879 PMCID: PMC4321994 DOI: 10.1371/journal.pone.0116558] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/10/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose The aims of this study were to investigate the effects of manganese (Mn) dust exposure on lung functions and evaluate the potential synergistic effect between smoking and Mn dust exposure among refinery workers. Methods A retrospective study including 1658 workers in a ferromanganese refinery was conducted, with subjects who were from the Guangxi manganese-exposed workers healthy cohort (GXMEWHC). Based on the Mn manganese cumulative exposure index (Mn-CEI), all subjects were divided into the low exposure group (n = 682) and the high exposure group (n = 976). A pulmonary function test was performed using an electronic spirometer, including the values and percentages of FVC, FEV1, FEV1/FVC, MMEF, PEFR, MVV, respectively. Results No significant effect of Mn dust exposure on the pulmonary function was found in the female workers (all p>0.05). However, there was an obvious decrease in the male workers in the high exposure group compared with those in the low exposure group (FVC -60 ml, FEV1 -120 ml, MMEF -260 ml/s, MVV -5.06 L, all p<0.05). In the high exposure group, the reduction in FVC% predicted, MMEF and MMEF% predicted was 1.0%, 210 mL/s, and 4.9%, respectively. In particular, among the exposed subjects smokers had a statistically significant decrease in lung function compared with non-smokers and the reduction in FVC% predicted, MMEF and MMEF% predicted was 1.0%, 210 mL/s, and 4.9%, respectively (p<0.05). Partial correlation analysis showed that there was also negative correlation between Mn-CEI and decreased changes in MMEF (r = -0.159, p = 0.018) and also MMEF% predicted (r = -0.163, p = 0.015). Conclusions Mn dust can impair the pulmonary ventilation function of male workers but not females, and individual smoking habits and manganese exposure had a synergistic effect on the lung function decrease.
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Affiliation(s)
- Fenfen Wang
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yunfeng Zou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yuefei Shen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yaoqiu Zhong
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yingnan Lv
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Damin Huang
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Kangcheng Chen
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Qin Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Qing
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Bing Xia
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Cheng Su
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Shuyan Ma
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaobo Yang
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi, China
- * E-mail:
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Ryu JY, Sunwoo YE, Lee SY, Lee CK, Kim JH, Lee JT, Kim DH. Chronic Obstructive Pulmonary Disease (COPD) and Vapors, Gases, Dusts, or Fumes (VGDF): A Meta-analysis. COPD 2014; 12:374-80. [DOI: 10.3109/15412555.2014.949000] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Brüske I, Thiering E, Heinrich J, Huster KM, Nowak D. Respirable quartz dust exposure and airway obstruction: a systematic review and meta-analysis. Occup Environ Med 2014; 71:583-9. [DOI: 10.1136/oemed-2013-101796] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Andersson E, Murgia N, Nilsson T, Karlsson B, Torén K. Incidence of chronic bronchitis in a cohort of pulp mill workers with repeated gassings to sulphur dioxide and other irritant gases. Environ Health 2013; 12:113. [PMID: 24354705 PMCID: PMC3882105 DOI: 10.1186/1476-069x-12-113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/06/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis. METHODS The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970-2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated. RESULTS The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22). CONCLUSIONS Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment.
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Affiliation(s)
- Eva Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Nicola Murgia
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - Tohr Nilsson
- Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, Sweden
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Berndt Karlsson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Kjell Torén
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
- Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Brüske I, Thiering E, Heinrich J, Huster K, Nowak D. Biopersistent granular dust and chronic obstructive pulmonary disease: a systematic review and meta-analysis. PLoS One 2013; 8:e80977. [PMID: 24278358 PMCID: PMC3835577 DOI: 10.1371/journal.pone.0080977] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/08/2013] [Indexed: 11/25/2022] Open
Abstract
Objective Applying a systematic review to identify studies eligible for meta-analysis of the association between occupational exposure to inorganic dust and the development of chronic obstructive pulmonary disease (COPD), and conducting a meta-analysis. Data Sources Searches of PubMed and Embase for the time period 1970–2010 yielded 257 cross-sectional and longitudinal studies on people exposed to inorganic dust at the workplace with data on lung function. These studies were independently abstracted and evaluated by two authors; any disagreement was resolved by a third reviewer. Of 55 publications accepted for meta-analysis, 27 investigated the effects of occupational exposure to biopersistent granular dust (bg-dust). Methods A random effects meta-analysis allowed us to provide an estimate of the average exposure effect on spirometric parameters presented in forest plots. Between-study heterogeneity was assessed by using I2 statistics, with I2>25% indicating significant heterogeneity. Publication bias was investigated by visual inspection of funnel plots. The influence of individual studies was assessed by dropping the respective study before pooling study-specific estimates. Results The mean FEV1 of workers exposed to bg-dust was 160 ml lower or 5.7% less than predicted compared to workers with no/low exposure. The risk of an obstructive airway disease—defined as FEV1/FVC < 70%—increased by 7% per 1 mg· m-3 respirable bg-dust. Conclusion Occupational inhalative exposure to bg-dust was associated with a statistically significant decreased FEV1 and FEV1/FVC revealing airway obstruction consistent with COPD.
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Affiliation(s)
- Irene Brüske
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
- * E-mail:
| | - Elisabeth Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - Katharina Huster
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre, Ludwig Maximilian University, Munich, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre, Ludwig Maximilian University, Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
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Low-Toxicity Dusts: Current Exposure Guidelines Are Not Sufficiently Protective. ACTA ACUST UNITED AC 2013; 57:685-91. [DOI: 10.1093/annhyg/met038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Attarchi M, Dehghan F, Afrasyabi M, Sadeghi Z, Mohammadi S. Combined Effect of Cigarette Smoking and Occupational Exposures on Lung Function: A Cross-sectional Study of Rubber Industry Workers. Workplace Health Saf 2013. [DOI: 10.3928/21650799-20130418-66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Attarchi M, Dehghan F, Afrasyabi M, Sadeghi Z, Mohammadi S. Combined effect of cigarette smoking and occupational exposures on lung function: a cross-sectional study of rubber industry workers. Workplace Health Saf 2013; 61:213-20. [PMID: 23650896 DOI: 10.1177/216507991306100505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 01/28/2013] [Indexed: 11/16/2022]
Abstract
Workers in the rubber industry are exposed to pulmonary health hazards. The main purpose of this study was to assess the combined effect of cigarette smoking and occupational exposures on lung function. The exposed group consisted of tire manufacturing workers in production units and the non-exposed group included executives from the same factory. The researchers calculated the synergy index (SI) to determine the combined effect of exposures to cigarette smoke and pulmonary health hazards on lung function. A significant correlation was found between occupational exposures in the rubber industry and abnormal spirometric findings (p < .05). The synergistic effect of cigarette smoking and occupational exposures on lung function was significant (SI = 2.25; p < .05). This study demonstrated that occupational exposures and smoking may have a synergistic effect on the respiratory systems of tire manufacturing workers. The results suggest that tire manufacturing companies should consider establishing spirometric surveillance systems in their factories. Also, smoking cessation should be promoted, engineering controls applied, and respiratory protection provided to workers.
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Affiliation(s)
- Mirsaeed Attarchi
- Occupational Medicine Department, Tehran University of Medical Sciences, Tehran, Iran
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Hochgatterer K, Moshammer H, Haluza D. Dust is in the air: effects of occupational exposure to mineral dust on lung function in a 9-year study. Lung 2013; 191:257-63. [PMID: 23568145 DOI: 10.1007/s00408-013-9463-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 03/18/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Occupational mineral dust exposure is a well-known risk factor for numerous respiratory and systemic diseases. The aim of the present longitudinal study was to assess the influence of work-associated dust exposure on spirometric results. Furthermore, the impact of implementation of stricter limit values for occupational contact with quartz dust on lung function was evaluated. METHODS Anthropometric data (age, gender, BMI), smoking behavior, and lung function parameters (FVC, FEV1, MEF50) from 7,204 medical examinations of 3,229 female and male workers during the years 2002-2010 were examined following Austrian standards for occupational medicine and the guidelines of the European Respiratory Society. Analysis of data was performed using models of multiple linear regression. RESULTS Lung function decrease over time was associated with smoking habits and duration of occupational dust exposure. Specifically, occupational quartz exposure negatively influenced the annual lung function parameters (FVC, -6.68 ml; FEV1, -6.71 ml; and MEF50, -16.15 ml/s, all p < 0.001). Thus, an overadditive effect of smoking and work-related contact with quartz was found regarding decline in MEF50 (p < 0.05). Implementation of stricter occupational limit values for dust exposure resulted in a highly significant deceleration of the annual decrease in respiratory function (p = 0.001). CONCLUSIONS Individual smoking habits and occupational dust exposure had a negative impact on lung function. To reduce the risk of loss of respiratory capacity, smoking cessation is especially recommended to workers exposed to quartz dust. Moreover, stricter limit values could prevent chronic occupational damage to the respiratory system.
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Abstract
Chronic obstructive pulmonary disease represents a major cause of morbidity and mortality in industrialized and nonindustrialized countries. Although tobacco use remains the main factor associated with development of the disease, occupational risk factors represent an important and preventable cause. The most common occupationally related factors include exposure to organic dusts, metallic fumes, and a variety of other mineral gases and/or vapors. This article summarizes the literature on the subject and provides an update of the most recent advances in the field.
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Waked M, Salame J, Khayat G, Salameh P. Correlates of COPD and chronic bronchitis in nonsmokers: data from a cross-sectional study. Int J Chron Obstruct Pulmon Dis 2012; 7:577-85. [PMID: 23055708 PMCID: PMC3459656 DOI: 10.2147/copd.s35044] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Our objective was to assess the prevalence of chronic bronchitis and chronic obstructive pulmonary disease (COPD) and their correlates among a Lebanese nonsmoker group. Material and methods A cross-sectional study was conducted between October 2009 and September 2010, using a multistage cluster sample throughout Lebanon including Lebanese residents aged 40 years and above with no exclusion criteria. Pre- and postbronchodilator spirometry measurements were performed and carbon monoxide level was measured in exhaled air. COPD was defined and classified according to the Global Initiative for Chronic Obstructive Lung Disease guidelines or according to the lower limit of normal (forced expiratory volume in 1 second/forced vital capacity postbronchodilator < 5th percentile of the healthy population having the same age and sex). Chronic bronchitis was defined by the declaration of morning cough and expectorations for more than 3 months a year over more than 2 years in individuals with normal spirometry. Results Out of 2201 individuals, 732 were never-smokers: 25 (3.4%) of them had COPD, and 86 (11.75%) fulfilled the definition of chronic bronchitis. Correlates of COPD included a childhood respiratory disease, house heated by diesel, and older age. On the other hand, correlates of chronic bronchitis included childhood respiratory diseases, living in southern Lebanon versus other regions, heating home by gas, older age, number of smokers at work, and lower height. Conclusion A substantial percentage of the nonsmoking population may exhibit chronic bronchitis or COPD. The significant correlates mentioned above should be taken into consideration in order to reduce the risk of developing such chronic and debilitating respiratory diseases.
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Affiliation(s)
- Mirna Waked
- Faculty of Medicine, Balamand University, and St George Hospital, Beirut, Lebanon.
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Occupational diesel exhaust exposure as a risk factor for chronic obstructive pulmonary disease. Curr Opin Pulm Med 2012; 18:151-4. [PMID: 22234274 DOI: 10.1097/mcp.0b013e32834f0eaa] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) is a major source of morbidity and mortality worldwide. Although cigarette smoking is the major cause of COPD, occupational exposures have emerged as an important risk factor, especially in nonsmokers. In this review, we assess the state of the literature on the association of COPD with a specific occupational exposure, diesel exhaust. RECENT FINDINGS A large body of literature links general occupational exposures to dust and fumes with an increased risk of COPD, particularly in nonsmokers. Few studies, however, have explicitly examined the role of occupational diesel exhaust exposures to COPD risk. Suggestive recent findings link occupational diesel exposures to an increased risk of COPD. SUMMARY The available literature directly examining the effects of occupational diesel exhaust on risk of COPD is quite small, but does suggest that increasing exposures are associated with increasing risk. Additional research, with more advanced exposure metrics, is needed to fully elucidate this association.
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Abstract
INTRODUCTION There is growing interest in preventable, non-smoking causes of chronic obstructive pulmonary disease (COPD), among which are chronic exposures to respiratory irritants in the workplace. SOURCES OF DATA Reviews of occupational COPD in specific occupations and industries and in general populations; supplemented with other or more recently published material. AREAS OF AGREEMENT There is good evidence for an increased risk of COPD from certain specific exposures (coal mine dust, silica, welding fume, textile dust, agricultural dust, cadmium fume). AREAS OF CONTROVERSY Less clear is the causal role of non-specific dusts or fumes/gases in general populations where the available literature is notably uncritical. GROWING POINTS Other specific exposures, such as diesel fume; interactions between specific exposures and cigarette smoking; the development of safe working limits. AREAS TIMELY FOR DEVELOPING RESEARCH Occupations with large numbers of exposed employees, particularly in low-income countries.
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Affiliation(s)
- Paul Cullinan
- Occupational and Environmental Medicine, Imperial College (NHLI), London, UK.
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Abstract
BACKGROUND AND AIMS This review summarizes the scientific literature relevant to occupational risk factors for chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS This review emphasizes recent work in the field, while placing this in the context of two previous systematic reviews of the subject. RESULTS Both the earlier summaries of the literature estimated that the population attributable risk percent (PAR%) of COPD linked to occupational exposures is approximately 15%. More recent studies also strongly support the association between workplace exposures and COPD. Among never smokers, the PAR% for work-related factors may approach 40%. Emerging data also indicate that occupational exposures, at a minimum, are additive to smoking-associated risk of COPD. CONCLUSIONS The PAR% for work-related COPD is at least 15%. Scientific significance. The consistency, strength, and plausibility of these data support a causal relationship between occupational exposures and COPD.
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Affiliation(s)
- Paul D Blanc
- Department of Medicine, Division of Occupational and Environmental Medicine, University of California, San Francisco, San Francisco, CA 94117, USA.
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Eisner MD, Anthonisen N, Coultas D, Kuenzli N, Perez-Padilla R, Postma D, Romieu I, Silverman EK, Balmes JR. An official American Thoracic Society public policy statement: Novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2010; 182:693-718. [PMID: 20802169 DOI: 10.1164/rccm.200811-1757st] [Citation(s) in RCA: 612] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
RATIONALE Although cigarette smoking is the most important cause of chronic obstructive pulmonary disease (COPD), a substantial proportion of COPD cases cannot be explained by smoking alone. OBJECTIVES To evaluate the risk factors for COPD besides personal cigarette smoking. METHODS We constituted an ad hoc subcommittee of the American Thoracic Society Environmental and Occupational Health Assembly. An international group of members was invited, based on their scientific expertise in a specific risk factor for COPD. For each risk factor area, the committee reviewed the literature, summarized the evidence, and developed conclusions about the likelihood of it causing COPD. All conclusions were based on unanimous consensus. MEASUREMENTS AND MAIN RESULTS The population-attributable fraction for smoking as a cause of COPD ranged from 9.7 to 97.9%, but was less than 80% in most studies, indicating a substantial burden of disease attributable to nonsmoking risk factors. On the basis of our review, we concluded that specific genetic syndromes and occupational exposures were causally related to the development of COPD. Traffic and other outdoor pollution, secondhand smoke, biomass smoke, and dietary factors are associated with COPD, but sufficient criteria for causation were not met. Chronic asthma and tuberculosis are associated with irreversible loss of lung function, but there remains uncertainty about whether there are important phenotypic differences compared with COPD as it is typically encountered in clinical settings. CONCLUSIONS In public health terms, a substantive burden of COPD is attributable to risk factors other than smoking. To prevent COPD-related disability and mortality, efforts must focus on prevention and cessation of exposure to smoking and these other, less well-recognized risk factors.
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Brass DM, Hollingsworth JW, Cinque M, Li Z, Potts E, Toloza E, Foster WM, Schwartz DA. Chronic LPS inhalation causes emphysema-like changes in mouse lung that are associated with apoptosis. Am J Respir Cell Mol Biol 2008; 39:584-90. [PMID: 18539952 PMCID: PMC2574529 DOI: 10.1165/rcmb.2007-0448oc] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 04/28/2008] [Indexed: 11/24/2022] Open
Abstract
Lipopolysaccharide (LPS) is ubiquitous in the environment. Recent epidemiologic data suggest that occupational exposure to inhaled LPS can contribute to the progression of chronic obstructive pulmonary disease. To address the hypothesis that inhaled LPS can cause emphysema-like changes in mouse pulmonary parenchyma, we exposed C57BL/6 mice to aerosolized LPS daily for 4 weeks. By 3 days after the end of the 4-week exposure, LPS-exposed mice developed enlarged airspaces that persisted in the 4-week recovered mice. These architectural alterations in the lung are associated with enhanced type I, III, and IV procollagen mRNA as well as elevated levels of matrix metalloproteinase (MMP)-9 mRNA, all of which have been previously associated with human emphysema. Interestingly, MMP-9-deficient mice were not protected from the development of LPS-induced emphysema. However, we demonstrate that LPS-induced airspace enlargement was associated with apoptosis within the lung parenchyma, as shown by prominent TUNEL staining and elevated cleaved caspase 3 immunoreactivity. Antineutrophil antiserum-treated mice were partially protected from the lung destruction caused by chronic inhalation of LPS. Taken together, these findings demonstrate that inhaled LPS can cause neutrophil-dependent emphysematous changes in lung architecture that are associated with apoptosis and that these changes may be occurring through mechanisms different than those induced by cigarette smoke.
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Affiliation(s)
- David M Brass
- Environmental Lung Diseases Research Group, Laboratory of Respiratory Biology, National Heart Lung and Blood Institute at the National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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Association of Cytokine Gene Polymorphisms With Rate of Decline in Lung Function. J Occup Environ Med 2008; 50:642-8. [DOI: 10.1097/jom.0b013e31816515e1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE To examine the association between occupation and chronic bronchitis among a cross section of Chinese women who participated in the Shanghai Women's Health Study. METHODS Cases were 4873 women who self-reported a physician-diagnosed bronchitis during adulthood. Controls were 9746 women randomly selected from Shanghai Women's Health Study participants and matched with the cases by year of birth and age at diagnosis. Lifetime occupational histories were obtained. Logistic regressions were used to evaluate the association between chronic bronchitis and occupation, adjusting for smoking, education, family income, and concurrent asthma. RESULTS We observed excess prevalence of bronchitis for textile occupation (odds ratio, OR = 1.09; 95% CI = 1.00-1.18) and industry (OR = 1.11; 95% CI = 1.03-1.19), welders (OR = 1.40; 95% CI = 1.01-1.92), packing and baling workers (OR = 1.39; 95% CI = 1.15-1.68), and warehousing industry (OR = 1.58; 95% CI = 1.08-2.30) We also identified several new associations that may warrant further exploration and confirmation, including employment in some metal fabrication industries, postal and telecommunication industry, and a few white-collar occupations and industries. CONCLUSIONS Our study indicates that the risk of chronic bronchitis among women may be increased in some occupations and industries.
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Hoppin JA, Valcin M, Henneberger PK, Kullman GJ, Umbach DM, London SJ, Alavanja MCR, Sandler DP. Pesticide use and chronic bronchitis among farmers in the Agricultural Health Study. Am J Ind Med 2007; 50:969-79. [PMID: 17975796 PMCID: PMC2806052 DOI: 10.1002/ajim.20523] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Farmers have increased risk for chronic bronchitis. Few investigators have considered pesticides. METHODS We evaluated pesticides as risk factors for chronic bronchitis using the Agricultural Health Study enrollment data on lifetime pesticide use and history of doctor-diagnosed chronic bronchitis from 20,908 private pesticide applicators, primarily farmers. RESULTS A total of 654 farmers (3%) reported chronic bronchitis diagnosed after age 19. After adjustment for correlated pesticides as well as confounders, 11 pesticides were significantly associated with chronic bronchitis. Heptachlor use had the highest odds ratio (OR=1.50, 95% Confidence Interval (CI)=1.19, 1.89). Increased prevalence for chronic bronchitis was also seen for individuals who had a history of a high pesticide exposure event (OR=1.85, 95% CI=1.51, 2.25) and for those who also applied pesticides in off-farm jobs (OR=1.40, 95% CI=1.04, 1.88). Co-morbid asthma and current farm activities did not explain these results. CONCLUSIONS These results provide preliminary evidence that pesticide use may increase chronic bronchitis prevalence.
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Affiliation(s)
- Jane A Hoppin
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina 27709-2233, USA.
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Drivas S, Rachiotis G, Vlastos FD, Zacharias C, Alexopoulos CG, Symvoulakis M, Vasiliou M, Behrakis PK. Occupational exposure to lignite and impact on respiratory system among heavy industry personnel. INDUSTRIAL HEALTH 2007; 45:409-14. [PMID: 17634690 DOI: 10.2486/indhealth.45.409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Objective is to evaluate the impact of occupational exposure to lignite dust on respiratory system. 103 blue-collar workers exposed to lignite dust and 62 controls completed a questionnaire on respiratory symptoms and underwent spirometry. Levels of lignite dust in workplace were measured. Univariate and multivariate analysis of the data were performed. The concentration of lignite dust varied from 0.6 to 1.4 mg/m3. Current smokers and workers exposed to lignite dust presented higher prevalence of chronic bronchitis symptoms and of FEV<80% and FEV1/FVC<70%. Multivariate analysis has shown that smoking and occupational exposure to lignite dust were independent predictors of chronic bronchitis symptoms, as well as of an obstructive ventilation pattern. Further analysis showed that exposed workers who were current smokers presented a five fold rate for developing an obstructive ventilation pattern in comparison to exposed workers non currently smokers. Occupational exposure to lignite dust and smoking were independent determinants of chronic bronchitis symptoms and obstructive ventilation pattern. There is some evidence for a combined effect of smoking and lignite dust exposure on respiratory system.
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Affiliation(s)
- Spyros Drivas
- Greek Institute for Occupational Safety and Health, Athens, Greece
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van Gageldonk-Lafeber AB, van der Sande MAB, Heijnen MLA, Peeters MF, Bartelds AIM, Wilbrink B. Risk factors for acute respiratory tract infections in general practitioner patients in The Netherlands: a case-control study. BMC Infect Dis 2007; 7:35. [PMID: 17466060 PMCID: PMC1871593 DOI: 10.1186/1471-2334-7-35] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 04/27/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute respiratory tract infections (ARTI) are an important public health problem. Improved identification of risk factors might enable targeted intervention. Therefore we carried out a case-control study with the aim of identifying environmental risk factors for ARTI consultations in the Dutch general population. METHODS A subset of patients visiting their GP in the period of 2000-2003 with an ARTI (cases) and age-matched controls (visiting for other complaints) were included in a case-control study. They were asked to complete a questionnaire about potential risk factors. Conditional logistic regression was used to calculate odds ratio's (OR) and 95% confidence intervals (CI) to estimate the independent effect of potential risk factors. RESULTS A total of 493 matched pairs of case and control subjects were enrolled. Exposure to persons with respiratory complaints, both inside and outside the household, was found to be an independent risk factor for visiting a GP with an ARTI (respectively ORadj = 1.9 and ORadj = 3.7). Participants exposed to dampness or mould at home (ORadj=0.5) were significantly less likely to visit their GP. In accordance with the general risk of consultations for ARTI, participants with a laboratory-confirmed ARTI who were exposed to persons with respiratory complaints outside the household were also significantly more likely to visit their GP (ORadj=2.5). CONCLUSION This study confirmed that heterogeneity in the general population as well as in pathogens causing ARTI makes it complicated to detect associations between potential risk factors and respiratory infections. Whereas it may be difficult to intervene on the risk posed by exposure to persons with respiratory complaints, transmission of ARTI in the general population might be reduced by improved hygienic conditions.
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Affiliation(s)
- Arianne B van Gageldonk-Lafeber
- National Institute of Public Health and the Environment, Centre for Infectious Disease Control, Epidemiology and surveillance, Bilthoven, The Netherlands
| | - Marianne AB van der Sande
- National Institute of Public Health and the Environment, Centre for Infectious Disease Control, Epidemiology and surveillance, Bilthoven, The Netherlands
| | - Marie-Louise A Heijnen
- National Institute of Public Health and the Environment, Centre for Infectious Disease Control, Epidemiology and surveillance, Bilthoven, The Netherlands
- Netherlands Association for Community Health Services, Utrecht, The Netherlands
| | | | - Aad IM Bartelds
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Berry Wilbrink
- National Institute of Public Health and the Environment, Centre for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, Bilthoven, The Netherlands
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