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Zheng XY, Zheng YJ, Liao TT, Xu YJ, Liu L, Wang Y, Xiao N, Li C, He ZX, Tan XM, Meng RL, Guan WJ, Lin LF. Effects of occupational exposure to dust, gas, vapor and fumes on chronic bronchitis and lung function. J Thorac Dis 2024; 16:356-367. [PMID: 38410603 PMCID: PMC10894404 DOI: 10.21037/jtd-23-646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/08/2023] [Indexed: 02/28/2024]
Abstract
Background Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors [such as exposure to vapors, gases, dust and fumes (VGDF)] for accelerate disease progression has important significance. Methods We conducted COPD surveillance in six cities of southern China between 2014 and 2019. We recorded the diagnosis of chronic bronchitis, respiratory symptoms, occupational exposure to VGDF and other covariates by using a structured questionnaire. Logistic regression and multivariate linear regression model were adopted for analysis. We performed sensitivity analyses based on two methods of propensity score (PS) methods to evaluate the robustness of our results. Results A total of 7,418 participants were included. Cough [odds ratios (ORs): 1.60, 95% confidence interval (CI): 1.22 to 2.08] and phlegm (OR: 1.49, 95% CI: 1.19 to 1.85) correlated significantly with exposure to dust. There was an increased risk of cough (OR: 1.53, 95% CI: 1.11 to 2.07) for occupational exposure to gas/vapor/fume. Dual exposure to dust and gas/vapor/fume was associated with a significantly increased risk of chronic bronchitis (OR: 1.74, 95% CI: 1.20 to 2.52), cough (OR: 1.43, 95% CI: 1.15 to 1.79) and phlegm (OR: 1.49, 95% CI: 1.24 to 1.79). In 5,249 participants with complete data of spirometry, gas/vapor/fume was associated with a decreased ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC) (β: -1.05, 95% CI: -1.85 to -0.26) and maximal mid-expiratory flow (MMEF) (β: -0.15, 95% CI: -0.23 to -0.07). Dual exposure to dust and gas/vapor/fume was significantly associated with decreased FEV1/FVC (β: -0.74, 95% CI: -1.28 to -0.20) and MMEF (β: -0.06, 95% CI: -0.12 to -0.01). Results of sensitivity analysis were not materially changed. Conclusions VGDF exposure is associated with chronic bronchitis, respiratory symptoms and decreased lung function, suggesting that VGDF contributes to the pathogenesis and progression of COPD.
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Affiliation(s)
- Xue-Yan Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yi-Jin Zheng
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Ting-Ting Liao
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Medicine, Jinan University, Guangzhou, China
| | - Yan-Jun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Ye Wang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Ni Xiao
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Chuan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zhao-Xuan He
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiao-Min Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Rui-Lin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and Critical Care Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Li-Feng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
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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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Lyu Y, Zhang Q, Liu Y, Zhang WP, Tian FJ, Zhang HF, Hu BH, Feng J, Qian Y, Jiang Y, Zhang PH, Ma N, Tang SC, Zheng JP, Qiu YL. Nano-Calcium Carbonate Affect the Respiratory and Function Through Inducing Oxidative Stress: A Cross-sectional Study Among Occupational Exposure of Workers and a Further Research for Underlying Mechanisms. J Occup Environ Med 2023; 65:184-191. [PMID: 36165499 DOI: 10.1097/jom.0000000000002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of the study is to investigate whether nano-calcium carbonate (nano-CaCO 3 ) occupational exposure could induce adverse health effects in workers. METHODS A cross-sectional study was conducted in a nano-CaCO 3 manufacturing plant in China. Then, we have studied the dynamic distribution of nano-CaCO 3 in nude mice and examined the oxidative damage biomarkers of subchronic administrated nano-CaCO 3 on Sprague-Dawley rats. RESULTS The forced vital capacity (%) and the ratio of FEV1 to FVC is the rate of one second of workers were significantly decreased than unexposed individuals. Dynamic imaging in mice of fluorescence labeled nano-CaCO 3 showed relatively high uptake and slow washout in lung. Similar to population data, the decline in serum glutathione level and elevation in serum MDA were observed in nano-CaCO 3 -infected Sprague-Dawley rats. CONCLUSIONS We found that nano-CaCO 3 exposure may result in the poor pulmonary function in workers and lead to the changes of oxidative stress indexes.
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Affiliation(s)
- Yi Lyu
- From the Department of Health Toxicology, School of Public Health, Shanxi Medical University, Taiyuan, China (Ms Lyu, Ms Zhang, Ms Liu, Dr Zhang, Ms Tian, Ms Zhang, Mr Hu, Ms Feng, Ms Qian, Mr Jiang, Ms Zhang, Ms Ma, Dr Zheng, Dr Qiu); Department of Biochemistry and Molecular Biology, School of Preclinical Medicine, Shanxi Medical University, Taiyuan, China (Ms Lyu); Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi, China (Dr Zheng); and Institute of Urban Safety and Environmental Science, Beijing Academy of Science and Technology, Beijing, China (Dr Tang)
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Keer S, Brooks C, Glass B, McLean D, Harding E, Douwes J. Respiratory symptoms and use of dust-control measures in New Zealand construction workers – A cross-sectional study. PLoS One 2022; 17:e0266668. [PMID: 35390070 PMCID: PMC8989237 DOI: 10.1371/journal.pone.0266668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 03/24/2022] [Indexed: 11/18/2022] Open
Abstract
Dust-exposed construction workers have an increased risk of respiratory symptoms, but the efficacy of dust-control measures remains unclear. This study compared respiratory symptoms, using a modified European Community Respiratory Health Survey questionnaire, between construction workers (n = 208) and a reference group of bus drivers and retail workers (n = 142). Within the construction workers, we assessed the effect of collective (on-tool vacuum/’wet-cut’ systems) and personal (respirators) exposure controls on symptom prevalence. Logistic regression assessed differences between groups, adjusted for age, ethnicity, and smoking status. Construction workers were more likely to cough with phlegm at least once a week (OR 2.4, 95% CI 1.2–4.7) and cough with phlegm ≥3 months/year for ≥2 years (OR 2.8, CI 1.2–7.0), but they had similar or fewer asthma symptoms. Construction workers who had worked for 11–20 years reported more cough/phlegm symptoms (OR 5.1, 1.7–15.0 for cough with phlegm ≥3 months/year for ≥2 years) than those who had worked <10 years (OR 1.9, 0.6–5.8), when compared to the reference group. Those who used ‘wet-cut’ methods reported less cough with phlegm, although the evidence for this association was weak (OR 0.4, CI 0.2–1.1 for cough with phlegm at least once a week); use of on-tool extraction showed a similar trend. No associations between respiratory protective equipment-use and symptoms were found. In conclusion, construction workers reported more symptoms suggestive of bronchitis, particularly those employed in the industry for >10 years. Use of collective dust exposure controls might protect against these symptoms, but this requires confirmation in a larger study.
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Affiliation(s)
- Samuel Keer
- Centre for Public Health Research, Massey University, Wellington, New Zealand
- * E-mail:
| | - Collin Brooks
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Bill Glass
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Dave McLean
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Elizabeth Harding
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
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Han G, Li M, Du J, Chen Y, Xu C. Nucleotide-Oligomerizing Domain-1 Activation Exaggerates Cigarette Smoke-Induced Chronic Obstructive Pulmonary-Like Disease in Mice. Int J Chron Obstruct Pulmon Dis 2021; 16:2605-2615. [PMID: 34556981 PMCID: PMC8453445 DOI: 10.2147/copd.s323616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/16/2021] [Indexed: 12/28/2022] Open
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) is a progressive condition related to abnormal inflammatory responses. As an inflammatory driver, nucleotide-binding oligomerizing domain-1 (NOD1) is highly expressed in pulmonary inflammatory cells; however, the roles of NOD1 in COPD are unknown. Methods A COPD mouse model was established by lipopolysaccharides tracheal instillation plus cigarette smoke (CS) exposure. NOD1 activation was induced by C12-iE-DAP (iE) treatment in both control and COPD mice. Inflammatory infiltration, pulmonary histological damage and gene expression were measured to evaluate the lung function of treated mice. Results The results showed that NOD1 was up-regulated in COPD mice, which significantly exaggerated CS-induced impairment of lung function, demonstrated by increased airway resistance, functional residual capacity and pulmonary damages. Mechanistically, NOD1 activation strongly activated the TLR4/NF-κB signaling pathway and then increased inflammatory responses and promoted the secretion of inflammatory cytokines. Discussion This study demonstrates that NOD1 is an important risk factor in the progression of COPD; therefore, targeting NOD1 in lung tissues is a potential strategy for COPD treatment.
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Affiliation(s)
- Guangchao Han
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, People's Republic of China
| | - Min Li
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, People's Republic of China
| | - Junfeng Du
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, People's Republic of China
| | - Yang Chen
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, People's Republic of China
| | - Chen Xu
- Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, People's Republic of China
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Decharat S. Urinary toluene levels and adverse health symptoms among automotive garage workers, Nakhon Si Thammarat province, Thailand. Environ Anal Health Toxicol 2021; 36:e2021018-0. [PMID: 34353007 PMCID: PMC8598402 DOI: 10.5620/eaht.2021018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/05/2021] [Indexed: 11/11/2022] Open
Abstract
To determine their urinary toluene levels, to describe the workers’ hygiene behaviors and the prevalence of adverse health symptoms among automotive garage workers exposed to chemical substances. A cross-sectional descriptive study was conducted by interviewing among automotive garages located in the Nakhon Si Thammarat province, Thailand. During between 1 November 2020 and 31 December 2020. A total of 140 automotive garages workers were selected using a purposive sampling method. The questionnaire was conducted via face-to-face interview and the toluene was quantified using gas chromatography. Descriptive statistics were computed for the variables. Risk factors were evaluated using multiple logistic regression analysis. Adjusted odds ratio (ORadj) and 95% confidence interval (CI) were presented as statistically significant when the p value was < 0.05. The Mann–Whitney U test was used to compare the medians of continuous variables of the two groups. The prevalence of skin effects (60.71%); respiratory tract irritation (49.29%); nausea (46.43%); and dizziness (40.71%) was remarkable in the automotive garage workers. Several socio-demographic variables were significantly associated with increased skin effects, respiratory tract irritant, nausea, and dizziness. The median urinary toluene level of the automotive garage workers was 145 μg/L (range, 12.0–958.0 μg/L) which the median urinary levels and demographic characteristics, occupational lifestyle, personal protective equipment used, hygiene behavior, and adverse health symptoms had significantly significant different (p< 0.05).Urine is one of the most useful a sample for biomonitoring of occupational exposure to toluene. Personal hygiene is important for the automotive garage workers, and it should be emphasized in education programs.
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Affiliation(s)
- Somsiri Decharat
- Department of Occupational health and Safety, Faculty of Health and Sports Science, Thaksin University, 222 Papayom District , Phattalung Province 93210, Thailand
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Cunalata-Paredes AV, Gea-Izquierdo E. COPD in the major nonsmoking adult: A systematic review and meta-analysis. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:319-329. [PMID: 33021899 DOI: 10.1080/19338244.2020.1828243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) main cause is attributed to active smokers, but there's a small percentage that comes from risk factors that have been less considered. The aim of this research was to identify the risk factors and the clinical presentation of the population over 64 years of age that lead to the development of COPD. A systematic review and a meta-analysis was performed. From the 92 studies interpreted, we identified seven studies on the presence of COPD in nonsmokers older adults, having a universe of 14,920 patients. The primary risk factor to trigger the development of COPD was secondhand smoking. The study defined the most common risk factors that currently trigger COPD development among nonsmokers and provided an insight into the potential clinical differences between nonsmokers and smokers.
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Affiliation(s)
| | - Enrique Gea-Izquierdo
- Faculty of Medicine, Pontifical Catholic University of Ecuador, Quito, Ecuador
- Chair of Health and Safety at Work, Occupational Risk Prevention, University of Malaga, Malaga, Spain
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Sadhra SS, Mohammed N, Kurmi OP, Fishwick D, De Matteis S, Hutchings S, Jarvis D, Ayres JG, Rushton L. Occupational exposure to inhaled pollutants and risk of airflow obstruction: a large UK population-based UK Biobank cohort. Thorax 2020; 75:468-475. [DOI: 10.1136/thoraxjnl-2019-213407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 02/17/2020] [Accepted: 02/26/2020] [Indexed: 11/04/2022]
Abstract
BackgroundAlthough around 10% to 15% of COPD burden can be attributed to workplace exposures, little is known about the role of different airborne occupational pollutants (AOP). The main aim of the study was to assess the effect size of the relationship between various AOP, their level and duration of exposure with airflow obstruction (AFO).MethodsA cross-sectional analysis was conducted in 228 614 participants from the UK Biobank study who were assigned occupational exposure using a job exposure matrix blinded to health outcome. Adjusted prevalence ratios (PRs) and 95% CI for the risk of AFO for ever and years of exposure to AOPs were estimated using robust Poisson model. Sensitivity analyses were conducted for never-smokers, non-asthmatic and bi-pollutant model.ResultsOf 228 614 participants, 77 027 (33.7%) were exposed to at least one AOP form. 35.5% of the AFO cases were exposed to vapours, gases, dusts or fumes (VGDF) and 28.3% to dusts. High exposure to vapours increased the risk of occupational AFO by 26%. Exposure to dusts (adjusted PR=1.05; 95% CI 1.01 to 1.08), biological dusts (1.05; 1.01 to 1.10) and VGDF (1.04; 1.01 to 1.07) showed a significantly increased risk of AFO, however, statistically not significant following multiple testing. There was no significant increase in risk of AFO by duration (years) of exposure in current job. The results were null when restricted to never-smokers and when a bi-pollutant model was used. However, when data was analysed based on the level of exposure (low, medium and high) compared with no exposure, directionally there was increase in risk for those with high exposure to vapours, gases, fumes, mists and VGDF but statistically significant only for vapours.ConclusionHigh exposure (in current job) to airborne occupational pollutants was suggestive of higher risk of AFO. Future studies should investigate the relationship between lifetime occupational exposures and COPD.
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Li G, Liang L, Yang J, Zeng L, Xie Z, Zhong Y, Ruan X, Dong M, Yang Z, Lai G, Huang W, Yang A, Chen J, Wu B, Xu H, Meng D, Hu S, Xia L, Yang X, Li L, Ichihara S, Ichihara G, Huang H, Huang Z. Pulmonary hypofunction due to calcium carbonate nanomaterial exposure in occupational workers: a cross-sectional study. Nanotoxicology 2018; 12:571-585. [PMID: 29732947 DOI: 10.1080/17435390.2018.1465606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Guoliang Li
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, PR China
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Lihong Liang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, PR China
| | - Jingchao Yang
- School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Lihai Zeng
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Zhiwei Xie
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Yizhou Zhong
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Xiaolin Ruan
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Ming Dong
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Zhanhong Yang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Guanchao Lai
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Weixin Huang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Aichu Yang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Jiabing Chen
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Banghua Wu
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Huaming Xu
- Luoding City Center for Disease Prevention and Control, Luoding, PR China
| | - Dezhi Meng
- Luoding City Center for Disease Prevention and Control, Luoding, PR China
| | - Shijie Hu
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Lihua Xia
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Xingfen Yang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, PR China
| | - Laiyu Li
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
| | - Sahoko Ichihara
- Department of Environmental and Preventive Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Gaku Ichihara
- Department of Occupational and Environmental Health, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Hanlin Huang
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
- Guangdong Provincial Hospital for Women and Children’s Healthcare, Guangzhou, PR China
| | - Zhenlie Huang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, PR China
- Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Department of Toxicology, Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment, Guangzhou, PR China
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Liang X, Wang J, Guan R, Zhao L, Li D, Long Z, Yang Q, Xu J, Wang Z, Xie J, Lu W. Limax extract ameliorates cigarette smoke-induced chronic obstructive pulmonary disease in mice. Int Immunopharmacol 2018; 54:210-220. [DOI: 10.1016/j.intimp.2017.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/06/2017] [Accepted: 11/03/2017] [Indexed: 01/01/2023]
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Huang YC, Yang MC. Associations between occupational inhalation risks and FeNO levels in airway obstruction patients: results from the National Health and Nutrition Examination Survey, 2007-2012. Int J Chron Obstruct Pulmon Dis 2017; 12:3085-3093. [PMID: 29118577 PMCID: PMC5659225 DOI: 10.2147/copd.s146168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate associations between occupational inhalation risks and fractional exhaled nitric oxide (FeNO) levels in patients with chronic obstructive pulmonary disease (COPD). Patients and methods Data of 16,486 subjects who had undergone spirometry with pre-bronchodilator and post-bronchodilator lung function assessment were retrieved from the National Health and Nutrition Examination Survey, 2007–2012 database. After excluding 2,638 subjects with missing spirometry values, data of 13,336 subjects were included for analysis. Factors associated with occupational inhalation, FeNO levels and COPD were analyzed using logistic regression analysis. Results COPD was associated with occupational exposures to mineral dusts, organic dusts, exhaust fumes, other fumes, and second-hand smoking (P<0.05). Long-term exposure to these occupational hazards carried significantly higher risk for subjects with COPD than for controls (crude odds ratios [ORs]: mineral dusts: 2.364, organic dusts: 2.427, exhaust fumes: 2.728, other fumes: 2.144). In subgroup analysis, COPD correlated positively with long-term exposures to organic dusts and exhaust fumes in subjects with FeNO ≤50 ppb (ORs 1.361 and 1.314, respectively); conversely, COPD correlated negatively with intermediate to long-term exposures to organic dusts and exhaust fumes in those with FeNO >50 ppb (ORs 0.058 and 0.210, respectively). Conclusion Occupational exposures to airborne pollutants carries higher risk of COPD than non-exposure and the risk is higher the longer the duration of exposure. Exposure–response relationships are inconsistent in subjects with suspected asthmatic airway inflammation (FeNO ≥50 ppb). More careful risk assessment is needed in occupational inhalation exposure, since COPD with asthmatic airway inflammation, or asthma-COPD overlapping syndrome, may have the distinguishing features of both COPD and asthma.
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Affiliation(s)
- Yi-Chih Huang
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City.,The School of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Mei-Chen Yang
- Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City.,The School of Medicine, Tzu-Chi University, Hualien, Taiwan
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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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Sadhra S, Kurmi OP, Sadhra SS, Lam KBH, Ayres JG. Occupational COPD and job exposure matrices: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2017; 12:725-734. [PMID: 28260879 PMCID: PMC5327910 DOI: 10.2147/copd.s125980] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The association between occupational exposure and COPD reported previously has mostly been derived from studies relying on self-reported exposure to vapors, gases, dust, or fumes (VGDF), which could be subjective and prone to biases. The aim of this study was to assess the strength of association between exposure and COPD from studies that derived exposure by job exposure matrices (JEMs). Methods A systematic search of JEM-based occupational COPD studies published between 1980 and 2015 was conducted in PubMed and EMBASE, followed by meta-analysis. Meta-analysis was performed using a random-effects model, with results presented as a pooled effect estimate with 95% confidence intervals (CIs). The quality of study (risk of bias and confounding) was assessed by 13 RTI questionnaires. Heterogeneity between studies and its possible sources were assessed by Egger test and meta-regression, respectively. Results In all, 61 studies were identified and 29 were included in the meta-analysis. Based on JEM-based studies, there was 22% (pooled odds ratio =1.22; 95% CI 1.18–1.27) increased risk of COPD among those exposed to airborne pollutants arising from occupation. Comparatively, higher risk estimates were obtained for general populations JEMs (based on expert consensus) than workplace-based JEM were derived using measured exposure data (1.26; 1.20–1.33 vs 1.14; 1.10–1.19). Higher risk estimates were also obtained for self-reported exposure to VGDF than JEMs-based exposure to VGDF (1.91; 1.72–2.13 vs 1.10; 1.06–1.24). Dusts, particularly biological dusts (1.33; 1.17–1.51), had the highest risk estimates for COPD. Although the majority of occupational COPD studies focus on dusty environments, no difference in risk estimates was found for the common forms of occupational airborne pollutants. Conclusion Our findings highlight the need to interpret previous studies with caution as self-reported exposure to VGDF may have overestimated the risk of occupational COPD.
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Affiliation(s)
- Steven Sadhra
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham
| | - Om P Kurmi
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Sandeep S Sadhra
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham
| | - Kin Bong Hubert Lam
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK
| | - Jon G Ayres
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham
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Fireman E, Edelheit R, Stark M, Shai AB. Differential pattern of deposition of nanoparticles in the airways of exposed workers. JOURNAL OF NANOPARTICLE RESEARCH : AN INTERDISCIPLINARY FORUM FOR NANOSCALE SCIENCE AND TECHNOLOGY 2017; 19:30. [PMID: 28163602 PMCID: PMC5241343 DOI: 10.1007/s11051-016-3711-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 12/15/2016] [Indexed: 06/06/2023]
Abstract
Ultrafine particles (UFP) have been postulated to significantly contribute to the adverse health effects associated with exposure to particulate matter (PM). Due to their extremely small size (aerodynamic diameter <100 nm), UFP are able to deposit deep within the lung after inhalation and evade many mechanisms responsible for the clearance of larger particles. There is a lack of biologically relevant personal exposure metrics for exposure to occupational- and environmental-related micro- and nano-sized PM. The aim of the present study is to assess UFP in induced sputum (IS) and exhaled breath condensate (EBC) as possible biomarkers for assessing lung function impairment. Sputum induction and EBC testing were performed by conventional methods. UFP particles were assessed with the NanoSight LM20 (NanoSight Ltd, London, UK). The subjects included 35 exposed and 25 non-exposed workers. There were no group differences in pulmonary function test results and differential cell counts, but 63.6% of the exposed subjects had a higher percentage of neutrophils (OR3.28 p = 0.03) compared to the non-exposed subjects. The exposed subjects had higher percentages of UFP between 10 and 50 nm (69.45 ± 18.70 vs 60.11 ± 17.52 for the non-exposed group, p = 0.004). No differences were found in the IS samples. Years of exposure correlated positively to UFP content (r = 0.342 p = 0.01) and macrophage content (r = -0.327 p = 0.03). The percentage of small fraction of UFP in EBC, but not IS, is higher in exposed workers, and EBC may be a sensitive biomarker to assess exposure to nanoparticles.
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Affiliation(s)
- Elizabeth Fireman
- Laboratory of Pulmonary and Allergic Diseases, Tel Aviv University, Tel Aviv, Israel
- Pulmonology Department, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64239 Tel Aviv, Israel
- Department of Occupational and Environmental Health School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rinat Edelheit
- Department of Occupational and Environmental Health School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Stark
- Laboratory of Pulmonary and Allergic Diseases, Tel Aviv University, Tel Aviv, Israel
| | - Amir Bar Shai
- Pulmonology Department, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64239 Tel Aviv, Israel
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López-Campos JL, Fernández-Villar A, Calero-Acuña C, Represas-Represas C, López-Ramírez C, Leiro Fernández V, Casamor R. Occupational and Biomass Exposure in COPD: Results of a Cross-Sectional Analysis of the On-Sint Study. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.arbr.2016.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Deslee G, Burgel PR, Escamilla R, Chanez P, Court-Fortune I, Nesme-Meyer P, Brinchault-Rabin G, Perez T, Jebrak G, Caillaud D, Paillasseur JL, Roche N. Impact of current cough on health-related quality of life in patients with COPD. Int J Chron Obstruct Pulmon Dis 2016; 11:2091-2097. [PMID: 27695305 PMCID: PMC5028084 DOI: 10.2147/copd.s106883] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cough and sputum production are frequent in chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the relationship between cough and sputum production and health-related quality of life in COPD. METHODS A cross-sectional study was conducted in the French Initiatives COPD cohort and assessed cough and sputum production within the past 7 days using the cough and sputum assessment questionnaire (CASA-Q), health-related quality of life, spirometry, smoking status, dyspnea, exacerbations, anxiety and depression, and comorbidities. RESULTS One hundred and seventy-eight stable COPD patients were included (age, 62 [56-69] years, 128 male, forced expiratory volume in 1 second [FEV1]: 57 [37-72] % predicted) (median [Q1-Q3]). In univariate analyses, health-related quality of life (Saint George's respiratory questionnaire total score) was associated with each CASA-Q domain and with chronic bronchitis, exacerbations, dyspnea, FEV1, depression, and anxiety. All four domains introduced separately were independently associated with health-related quality of life. When introduced together in multivariate analyses, only the cough impact domain remained independently associated with health-related quality of life (R2=0.60). With chronic bronchitis (standard definition) instead of the CASA-Q, the R2 was lower (R2=0.54). CONCLUSION This study provides evidence that current cough in the previous 7 days is an important determinant of health-related quality of life impairment in stable COPD patients.
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Affiliation(s)
- Gaëtan Deslee
- Department of Respiratory Diseases, INSERM UMR 903, Maison Blanche Hospital, University Hospital of Reims, Reims
| | - Pierre-Régis Burgel
- Department of Respiratory Diseases, Cochin Hospital, AP-HP and University Paris Descartes, Sorbonne Paris Cité, Paris
| | - Roger Escamilla
- Department of Respiratory Diseases, Larrey Hospital, Toulouse
| | - Pascal Chanez
- Department of Respiratory Diseases, APHM, INSERM U1077, CNRS UMR 7733 Aix Marseille Université, Marseille
| | | | | | | | - Thierry Perez
- Department of Respiratory Diseases, Calmette Hospital, University Hospital of Lille, Lille
| | - Gilles Jebrak
- Department of Respiratory Diseases, Bichat Hospital, AP-HP, Paris
| | - Denis Caillaud
- Department of Respiratory Diseases, Gabriel Montpied Hospital, University Hospital of Clermont-Ferrand, Clermont-Ferrand
| | | | - Nicolas Roche
- Department of Respiratory Diseases, Cochin Hospital, AP-HP and University Paris Descartes, Sorbonne Paris Cité, Paris
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López-Campos JL, Fernández-Villar A, Calero-Acuña C, Represas-Represas C, López-Ramírez C, Fernández VL, Casamor R. Occupational and Biomass Exposure in Chronic Obstructive Pulmonary Disease: Results of a Cross-Sectional Analysis of the On-Sint Study. Arch Bronconeumol 2016; 53:7-12. [PMID: 27432162 DOI: 10.1016/j.arbres.2016.04.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although tobacco smoke is the main risk factor for chronic obstructive pulmonary disease (COPD), other inhaled toxics have also been associated with the disease. The present study analyzes data from exposure to these substances in a cohort of patients with COPD and assesses their impact on the clinical presentation of the disease. METHODS This is a cross-sectional analysis of the Clinical presentation, diagnosis and course of chronic obstructive pulmonary disease (On-Sint) study. All patients were smokers or ex-smokers as per protocol. In addition, during the inclusion visit patients were enquired about their occupational and biomass exposure history. The clinical features of patients with and without an added risk factor to tobacco were compared and those significant were entered in a multivariate logistic regression analysis, expressed as odds ratio (OR). RESULTS The sample size was 1214 patients with COPD, of which 1012 (83.4%) had tobacco as the only risk factor and 202 (16.6%) had additional ones, mainly 174 (14.3%) with occupational gases and 32 (2.6%) with biomass exposure. The geographical distribution of this exposure showed a preference for the northern parts of the country and the East coast. The biomass exposure was rather low. Male gender (OR: 2.180), CAT score (OR: 1.036) and the use of long-term oxygen therapy (OR: 1.642) were associated with having an additional risk factor in the multivariate analysis. CONCLUSIONS Occupational exposures are more common than biomass in Spain. COPD caused by tobacco plus other inhalants has some differential features and a more impaired quality of life.
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Affiliation(s)
- José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - Alberto Fernández-Villar
- Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - Carmen Calero-Acuña
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España
| | - Cristina Represas-Represas
- Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - Cecilia López-Ramírez
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, España
| | - Virginia Leiro Fernández
- Servicio de Neumología, Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Vigo, Pontevedra, España
| | - Ricard Casamor
- Departamento Médico, Novartis Farmacéutica, Barcelona, España
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18
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Lopez-Campos JL, Marquez-Martin E, Soriano JB. The role of air pollution in COPD and implications for therapy. Expert Rev Respir Med 2016; 10:849-59. [DOI: 10.1080/17476348.2016.1191356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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19
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Sadhra SS, Kurmi OP, Chambers H, Lam KBH, Fishwick D. Development of an occupational airborne chemical exposure matrix. Occup Med (Lond) 2016; 66:358-64. [PMID: 27067914 DOI: 10.1093/occmed/kqw027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Population-based studies of the occupational contribution to chronic obstructive pulmonary disease generally rely on self-reported exposures to vapours, gases, dusts and fumes (VGDF), which are susceptible to misclassification. AIMS To develop an airborne chemical job exposure matrix (ACE JEM) for use with the UK Standard Occupational Classification (SOC 2000) system. METHODS We developed the ACE JEM in stages: (i) agreement of definitions, (ii) a binary assignation of exposed/not exposed to VGDF, fibres or mists (VGDFFiM), for each of the individual 353 SOC codes and (iii) assignation of levels of exposure (L; low, medium and high) and (iv) the proportion of workers (P) likely to be exposed in each code. We then expanded the estimated exposures to include biological dusts, mineral dusts, metals, diesel fumes and asthmagens. RESULTS We assigned 186 (53%) of all SOC codes as exposed to at least one category of VGDFFiM, with 23% assigned as having medium or high exposure. We assigned over 68% of all codes as not being exposed to fibres, gases or mists. The most common exposure was to dusts (22% of codes with >50% exposed); 12% of codes were assigned exposure to fibres. We assigned higher percentages of the codes as exposed to diesel fumes (14%) compared with metals (8%). CONCLUSIONS We developed an expert-derived JEM, using a strict set of a priori defined rules. The ACE JEM could also be applied to studies to assess risks of diseases where the main route of occupational exposure is via inhalation.
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Affiliation(s)
- S S Sadhra
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK,
| | - O P Kurmi
- CTSU, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - H Chambers
- Centre for Workplace Health, Health and Safety Laboratory, Harpur Hill, Buxton SK17 9JN, UK
| | - K B H Lam
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - D Fishwick
- Centre for Workplace Health, Health and Safety Laboratory, Harpur Hill, Buxton SK17 9JN, UK
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The chronic bronchitis phenotype in chronic obstructive pulmonary disease: features and implications. Curr Opin Pulm Med 2016; 21:133-41. [PMID: 25575367 DOI: 10.1097/mcp.0000000000000145] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) is a major public health problem that is projected to rank fifth worldwide in terms of disease burden and third in terms of mortality. Chronic bronchitis is associated with multiple clinical consequences, including hastening lung function decline, increasing risk of exacerbations, reducing health-related quality of life, and possibly raising all-cause mortality. Recent data suggest greater elucidation on the risk factors, radiologic characteristics, and treatment regimens. Our goal was to review the literature on chronic bronchitis that has been published in the past few years. RECENT FINDINGS A growing body of literature that more carefully describes environmental risk factors, epidemiology, and genetics associated with chronic bronchitis. In addition, as computed tomography technology continues to improve, the radiologic phenotype associated with chronic bronchitis is better understood. SUMMARY With these new data, the clinician can recognize the newly described risk factors and the associated phenotype for chronic bronchitis and entertain new treatment options for this high-risk population.
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Paulin LM, Diette GB, Blanc PD, Putcha N, Eisner MD, Kanner RE, Belli AJ, Christenson S, Tashkin DP, Han M, Barr RG, Hansel NN. Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015; 191:557-65. [PMID: 25562375 PMCID: PMC4384767 DOI: 10.1164/rccm.201408-1407oc] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 12/28/2014] [Indexed: 01/19/2023] Open
Abstract
RATIONALE Links between occupational exposures and morbidity in individuals with established chronic obstructive pulmonary disease (COPD) remain unclear. OBJECTIVES To determine the impact of occupational exposures on COPD morbidity. METHODS A job exposure matrix (JEM) determined occupational exposure likelihood based on longest job in current/former smokers (n = 1,075) recruited as part of the Subpopulations and Intermediate Outcomes in COPD Study, of whom 721 had established COPD. Bivariate and multivariate linear regression models estimated the association of occupational exposure with COPD, and among those with established disease, the occupational exposure associations with 6-minute-walk distance (6MWD), the Modified Medical Research Council Dyspnea Scale (mMRC), the COPD Assessment Test (CAT), St. George's Respiratory Questionnaire (SGRQ), 12-item Short-Form Physical Component (SF-12), and COPD exacerbations requiring health care utilization, adjusting for demographics, current smoking status, and cumulative pack-years. MEASUREMENTS AND MAIN RESULTS An intermediate/high risk of occupational exposure by JEM was found in 38% of participants. In multivariate analysis, those with job exposures had higher odds of COPD (odds ratio, 1.44; 95% confidence interval, 1.04-1.97). Among those with COPD, job exposures were associated with shorter 6MWDs (-26.0 m; P = 0.006); worse scores for mMRC (0.23; P = 0.004), CAT (1.8; P = 0.003), SGRQ (4.5; P = 0.003), and SF-12 Physical (-3.3; P < 0.0001); and greater odds of exacerbation requiring health care utilization (odds ratio, 1.55; P = 0.03). CONCLUSIONS Accounting for smoking, occupational exposure was associated with COPD risk and, for those with established disease, shorter walk distance, greater breathlessness, worse quality of life, and increased exacerbation risk. Clinicians should obtain occupational histories from patients with COPD because work-related exposures may influence disease burden.
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Affiliation(s)
- Laura M Paulin
- 1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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