1
|
Svanes Ø, Bertelsen RJ, Lygre SHL, Carsin AE, Antó JM, Forsberg B, García-García JM, Gullón JA, Heinrich J, Holm M, Kogevinas M, Urrutia I, Leynaert B, Moratalla JM, Le Moual N, Lytras T, Norbäck D, Nowak D, Olivieri M, Pin I, Probst-Hensch N, Schlünssen V, Sigsgaard T, Skorge TD, Villani S, Jarvis D, Zock JP, Svanes C. Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction. Am J Respir Crit Care Med 2019; 197:1157-1163. [PMID: 29451393 DOI: 10.1164/rccm.201706-1311oc] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described. OBJECTIVES This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction. METHODS The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders. MEASUREMENTS AND MAIN RESULTS As compared with women not engaged in cleaning (ΔFEV1 = -18.5 ml/yr), FEV1 declined more rapidly in women responsible for cleaning at home (-22.1; P = 0.01) and occupational cleaners (-22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = -8.8 ml/yr; -13.1, P = 0.02; and -15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV1 decline (-22.0, P = 0.04; and -22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV1/FVC decline or airway obstruction. CONCLUSIONS Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.
Collapse
Affiliation(s)
- Øistein Svanes
- 1 Department of Clinical Science, and.,2 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Stein H L Lygre
- 2 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Anne E Carsin
- 3 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain.,4 Universitat Pompeu Fabra, Barcelona, Spain.,5 Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - Josep M Antó
- 3 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain
| | - Bertil Forsberg
- 6 Division of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | | | - José A Gullón
- 7 Pneumology Department, University Hospital San Agustín, Avilés, Spain
| | - Joachim Heinrich
- 8 Institute and Outpatient Clinic for Occupational and Environmental Medicine, Clinic Center, Ludwig Maximillian University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany
| | - Mathias Holm
- 9 Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Manolis Kogevinas
- 3 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain
| | - Isabel Urrutia
- 10 Pulmonology Department, Galdakao Hospital, Galdakao, Spain
| | - Bénédicte Leynaert
- 11 Institut National de la Santé et de la Recherche Médicale, U1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France.,12 Unité mixte de recherche 1152, Université Paris Diderot Paris7, Paris, France
| | - Jesús M Moratalla
- 13 Servicio de Numología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Nicole Le Moual
- 14 Institut National de la Santé et de la Recherche Médicale, U1168, Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807, Villejuif, France.,15 Université Versailles St-Quentin-en-Yvelines, Unité mixte de recherche-S 1168, Yvelines, France
| | - Theodore Lytras
- 3 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain.,16 Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Dan Norbäck
- 17 Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Dennis Nowak
- 8 Institute and Outpatient Clinic for Occupational and Environmental Medicine, Clinic Center, Ludwig Maximillian University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany
| | | | - Isabelle Pin
- 19 Pneumologie Pédiatrique, Antenne Pédiatrique du Centres d'Investigation Clinique Grenoble, France
| | - Nicole Probst-Hensch
- 20 Swiss Tropical and Public Health Institute, Basel, Switzerland.,21 Department Public Health, University of Basel, Basel, Switzerland
| | - Vivi Schlünssen
- 22 Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.,23 National Research Center for the Working Environment, Copenhagen, Denmark
| | - Torben Sigsgaard
- 22 Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Trude D Skorge
- 2 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Simona Villani
- 24 Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; and
| | - Debbie Jarvis
- 25 National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Jan P Zock
- 3 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain
| | - Cecilie Svanes
- 26 Centre for International Health, University of Bergen, Bergen, Norway.,2 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
4
|
Petsonk EL, Wang ML. Interpreting screening questionnaires: specific respiratory symptoms and their relationship to objective test results. J Occup Environ Med 2011; 52:1225-9. [PMID: 21124238 DOI: 10.1097/jom.0b013e3181fd728f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To better delineate the relationship between responses to screening respiratory symptom questionnaires and various pulmonary function test results. METHODS Spirometry, methacholine challenge, standardized questionnaires, smoking, medical, and work histories were recorded at initial and 5-year follow-up surveys among 411 participants. Percent-predicted forced expiratory volume in 1 second (ppFEV1), 5-year FEV1 decline, and proportion of methacholine responders (% hyper-responders) were compared with questionnaire responses utilizing generalized estimating equations modeling and analysis of variance. RESULTS Significant associations were found between ppFEV1 and cough, phlegm, dyspnea, or ever wheezing; between greater percentage of hyper-responders and dyspnea with wheezing, ever/persistent wheezing, or history of asthma/hay fever; and between accelerated FEV1 decline and new onset dyspnea with wheezing, phlegm, or persistent wheeze. CONCLUSIONS Particular respiratory symptoms reported on screening questionnaires are associated with specific physiologic abnormalities, enhancing questionnaire utility in workplace health surveillance.
Collapse
Affiliation(s)
- Edward L Petsonk
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
| | | |
Collapse
|
11
|
Beeckman LA, Wang ML, Petsonk EL, Wagner GR. Rapid declines in FEV1 and subsequent respiratory symptoms, illnesses, and mortality in coal miners in the United States. Am J Respir Crit Care Med 2001; 163:633-9. [PMID: 11254516 DOI: 10.1164/ajrccm.163.3.2008084] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Coal mine dust exposure is associated with accelerated loss of lung function. We assessed long-term health outcomes in two groups of underground coal miners who during previous mine surveys had shown either high rates of FEV1 decline (cases, n = 310) or relatively stable lung function (referents, n = 324). Cases and referents were matched initially for age, height, smoking status, and FEV1. We determined vital status for 561 miners, and obtained a follow-up questionnaire for 121 cases and 143 referents. Responses on the follow-up questionnaire were compared with those on the last previous mine health survey questionnaire. Cases showed a greater incidence of symptoms than did referents for cough, phlegm production, Grades II and III dyspnea, and wheezing, and greater incidences than referents of chronic bronchitis and self- reported asthma and emphysema. More cases than referents (15% versus 4%) left mining before retirement because of chest illnesses. After controls were applied for age and smoking, cases had twice the risk of dying of cardiovascular and nonmalignant respiratory diseases and a 3.2-fold greater risk of dying of chronic obstructive pulmonary disease than did referents. Rapid declines in FEV1 experienced by some coal miners are associated with subsequent increases in respiratory symptoms, illnesses, and mortality from cardiovascular and nonmalignant respiratory diseases.
Collapse
Affiliation(s)
- L A Beeckman
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Morgantown, West Virginia 26505-2888, USA
| | | | | | | |
Collapse
|
12
|
Markowitz SB, Morabia A, Lilis R, Miller A, Nicholson WJ, Levin S. Clinical predictors of mortality from asbestosis in the North American Insulator Cohort, 1981 to 1991. Am J Respir Crit Care Med 1997; 156:101-8. [PMID: 9230732 DOI: 10.1164/ajrccm.156.1.9610108] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Recorded mortality from asbestosis has increased markedly in the United States in recent decades, from 0.49 to 3.06 per million persons between 1970 and 1990. Although asbestosis is generally considered to be a slowly progressive disorder, little is known about how clinical and exposure parameters among individuals with asbestosis quantitatively predict subsequent risk of death from asbestosis. We followed 2,609 insulators from the North American insulator cohort 10 yr to determine cause of death and to relate clinical findings to risk of death. This group had undergone clinical and radiologic examination between 1981 and 1983 in 19 cities in the United States. Seventy-four (11.0%) of 674 deaths during the subsequent 10 yr were due to asbestosis, according to the best clinical and radiologic evidence available at the time of death. The 10 yr risk of death (expressed as a percentage) due to asbestosis rose sharply with increasing interstitial fibrosis as identified on the baseline chest X-ray, from 0.9% to 2.4%, 10.8%, and 35.4% for International Labor Office (ILO) profusion categories 0, 1, 2, and 3, respectively. Dyspnea, a low FVC, and/or physical examination findings typical of interstitial fibrosis (rales, clubbing, or cyanosis) raised the risk of subsequent death from asbestosis by 2- to 6-fold. The effect of cigarette smoking on risk of death from asbestosis was small and disappeared after adjustment for ILO profusion score.
Collapse
Affiliation(s)
- S B Markowitz
- Department of Community Medicine, Mount Sinai School of Medicine, New York City, NY 10029, USA
| | | | | | | | | | | |
Collapse
|