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Murgia N, Akgun M, Blanc PD, Costa JT, Moitra S, Muñoz X, Toren K, Ferreira AJ. Issue 3-The occupational burden of respiratory diseases, an update. Pulmonology 2024:S2531-0437(24)00045-X. [PMID: 38704309 DOI: 10.1016/j.pulmoe.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 05/06/2024] Open
Abstract
INTRODUCTION AND AIMS Workplace exposures are widely known to cause specific occupational diseases such as silicosis and asbestosis, but they also can contribute substantially to causation of common respiratory diseases. In 2019, the American Thoracic Society (ATS) and the European Respiratory Society (ERS) published a joint statement on the occupational burden of respiratory diseases. Our aim on this narrative review is to summarise the most recent evidence published after the ATS/ERS statement as well as to provide information on traditional occupational lung diseases that can be useful for clinicians and researchers. RESULTS Newer publications confirm the findings of the ATS/ERS statement on the role of workplace exposure in contributing to the aetiology of the respiratory diseases considered in this review (asthma, COPD, chronic bronchitis, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, infectious pneumonia). Except for COPD, chronic bronchitis and infectious pneumonia, the number of publications in the last 5 years for the other diseases is limited. For traditional occupational lung diseases such as silicosis and asbestosis, there are old as well as novel sources of exposure and their burden continues to be relevant, especially in developing countries. CONCLUSIONS Occupational exposure remains an important risk factor for airways and interstitial lung diseases, causing occupational lung diseases and contributing substantially in the aetiology of common respiratory diseases. This information is critical for public health professionals formulating effective preventive strategies but also for clinicians in patient care. Effective action requires shared knowledge among clinicians, researchers, public health professionals, and policy makers.
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Affiliation(s)
- N Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy.
| | - M Akgun
- Department of Chest Diseases, School of Medicine, Ağrı İbrahim Çeçen University, Ağrı, Turkey
| | - P D Blanc
- Division of Occupational, Environmental, and Climate Medicine, Department of Medicine, University of California San Francisco, California, USA
| | - J T Costa
- Faculdade de Medicina da Universidade do Porto, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
| | - S Moitra
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - X Muñoz
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - K Toren
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A J Ferreira
- Faculty of Medicine, University of Coimbra. Coimbra, Portugal
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Vinnikov D, Abenova A, Raushanova A, Rapisarda V. Occupational exposure to fine particulate matter in the reinforced concrete production and its association with respiratory symptoms and lung function. BMC Public Health 2023; 23:1813. [PMID: 37723523 PMCID: PMC10506342 DOI: 10.1186/s12889-023-16753-x] [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: 03/25/2023] [Accepted: 09/12/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Reinforced concrete production is widespread, but little is known about the occupational exposure to fine particulate matter (PM) in such workplaces, including from metalworking and concrete processing. Therefore, the aim was to characterize exposure to fine PM in the typical workplaces of the whole production cycle and to quantify the risk of respiratory symptoms and lung function in a cohort of reinforced concrete parts production industry. METHODS At a reinforced concrete parts producing facility in Almaty, we collected 50 personal PM2.5 samples from the main exposure sites and the measured mass concentrations using gravimetric method. Workers also completed questionnaires on a detailed working history, respiratory symptoms (chronic obstructive pulmonary disease (COPD) Assessment Tool (CAT)), followed by spirometry. The association of cumulative dose with CAT score and forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was tested with multiple regression. RESULTS The highest PM2.5 concentrations were found in the concrete-mixing unit (median 1180 µg/m3), followed by metalworking (510 µg/m3), armature workshop (375 µg/m3) and molding site (245 µg/m3), different from the concentrations in the office (29.5 µg/m3), Kruskall-Wallis p < 0.001. Cumulative PM2.5 dose, mg/m3-year (beta 0.10 (95% confidence interval (CI) 0.05; 0.15)) was strongly associated with CAT score, whereas production with FEV1/FVC (beta -4.96 (-8.31; -1.61)), independent of smoking and chronic bronchitis and sex. CONCLUSIONS Mixing concrete and metalworks pose the greatest risk for worker's health in the reinforced concrete production from the inhalational exposure to aerosol, adversely affecting respiratory health.
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Affiliation(s)
- Denis Vinnikov
- Al-Farabi, Kazakh National University, 71 Al-Farabi Avenue, Almaty, 050040 Kazakhstan
- Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya street, Moscow, 117198 Russian Federation
| | - Anel Abenova
- Al-Farabi, Kazakh National University, 71 Al-Farabi Avenue, Almaty, 050040 Kazakhstan
| | - Aizhan Raushanova
- Al-Farabi, Kazakh National University, 71 Al-Farabi Avenue, Almaty, 050040 Kazakhstan
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Piazza Università, 2, 95131 Catania, Italy
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Wardyn PM, Edme JL, de Broucker V, Cherot-Kornobis N, Ringeval D, Amouyel P, Sobaszek A, Dauchet L, Hulo S. The impact of occupational exposure to crystalline silica dust on respiratory function (airway obstruction and FEF 25-75) in the French general population. ENVIRONMENTAL RESEARCH 2023; 222:115382. [PMID: 36736759 DOI: 10.1016/j.envres.2023.115382] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/20/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Although several studies have studied the relationship between occupational exposure to crystalline silica dust and respiratory mortality, few have examined the relationship with impairments in respiratory function and the exposure threshold triggering spirometric monitoring in exposed workers. The objective of the present study was to evaluate the impact of exposure to crystalline silica dust on respiratory function. METHODS We included 1428 male participants (aged 40 to 65) recruited from the French general population, at random from electoral rolls, in the cross-sectional ELISABET study and for whom data on forced expiratory flow-volume curve indices z-scores (calculated using the Global Lung Function Initiative 2012 equations) and exposure (via a questionnaire) were available. A cumulative exposure index (CEI) for crystalline silica dust (CEIsilica, expressed in mg.m-3.year) was calculated using the Matgéné occupational exposure matrix. RESULTS 293 of the 1428 participants (20.52%) reported exposure to silica dust. We found that the adjusted z-scores for the forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) ratio decreased significantly as CEIsilica increased. After adjustment, the adjusted z-scores for FEV1/FVC (β: -0.426 (95% confidence interval (CI): -0.792, -0.060) per 1 mg m-3.year increment) and the mean forced expiratory flow between 25 and 75% of the forced vital capacity (FEF25-75) (β: -0.552 (95% CI: -0.947, -0.157)) were significantly lower in the participants with CEIsilica ≥1 mg m-3.year than in non-exposed participants. The likelihoods of having airway obstruction (odds ratio (OR): 3.056 (95% CI: 1.107, 7.626)) or having an impaired FEF25-75 (OR: 4.305 (95% CI: 1.393, 11.79)) were also significantly higher in participants with CEIsilica ≥1 mg m-3.year. CONCLUSION Our results emphasize the importance of spirometry-based monitoring in workers exposed to more than 1 mg m-3.year of crystalline silica dust, in order to identify small airway obstruction or airway obstruction as early as possible.
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Affiliation(s)
- Pierre-Marie Wardyn
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France.
| | - Jean-Louis Edme
- Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la, Santé humaine, F-59000, Lille, France
| | - Virginie de Broucker
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Nathalie Cherot-Kornobis
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - David Ringeval
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Philippe Amouyel
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, F-59000, France
| | - Annie Sobaszek
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
| | - Luc Dauchet
- Univ. Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, Lille, F-59000, France
| | - Sébastien Hulo
- Univ. Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000, Lille, France
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Vinnikov D, Romanova Z, Raushanova A, Beisbekova A, Vitale E, Bimuratova G, Rapisarda V. Exposure to Respirable Particulate Matter and Its Association with Respiratory Outcomes in Beauty Salon Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032429. [PMID: 36767795 PMCID: PMC9915914 DOI: 10.3390/ijerph20032429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 05/22/2023]
Abstract
We aimed to assess exposure to respirable particulate matter (PM) of beauty salon personnel, identify its determinants and ascertain the associated respiratory effects. We collected 122 full-day respirable PM samples from 12 beauty salons (floor area ranging from 24 to 550 m3, staff from 4 to 8) in Almaty, Kazakhstan, taking 10 samples from each place using a portable SidePak AM520 monitor. We also assessed lifestyle (smoking, etc.), respiratory symptoms and health-related quality of life (HRQL) of the personnel using questionnaires. Out of 11,831 5-min data points, daily median respirable PM concentrations were highly variable and ranged from 0.013 to 0.666 mg/m3 with 8.5-times difference in the median concentrations between the venue with the highest median (0.29 mg/m3) and the least median (0.034 mg/m3). In a multivariate linear regression modelling, ambient PM2.5 concentration was the strongest predictor of daily median respirable PM concentration (beta 2.12; 95% CI 1.89; 2.39), and R2 of the model was 0.63. We also found a positive association of the median respirable PM with respiratory symptoms and seasonal allergy, but not with HRQL. Short-term respirable PM levels in the beauty salons may be very high, but the median concentrations are mainly determined by the ambient air pollution.
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Affiliation(s)
- Denis Vinnikov
- Environmental Health Laboratory, al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
- Occupational Health Risks Laboratory, Peoples’ Friendship University of Russia (RUDN University), Moscow 117198, Russia
- Correspondence: ; Tel.: +7-705-2068036
| | - Zhanna Romanova
- Environmental Health Laboratory, al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Aizhan Raushanova
- Environmental Health Laboratory, al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Arailym Beisbekova
- Environmental Health Laboratory, al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
- Department of Nutrition, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan
| | - Ermanno Vitale
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, 95124 Catania, Italy
| | - Gulnar Bimuratova
- City Polyclinic #7 of the Public Health Department of Almaty, Almaty 050040, Kazakhstan
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, 95124 Catania, Italy
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Vinnikov D, Raushanova A, Mukatova I, Nurpeissov T, Кushekbayeva A, Toxarina A, Yessimova B, Bespayeva F, Brimkulov N. Asthma control in Kazakhstan: need for urgent action. BMC Pulm Med 2023; 23:7. [PMID: 36611130 PMCID: PMC9826583 DOI: 10.1186/s12890-022-02287-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Asthma control, patients' awareness level and adherence to treatment in Kazakhstan have never been studied. The aim of this study was to verify the prevalence of controlled, poorly controlled and uncontrolled asthma in a large sample of three largest cities of Kazakhstan. METHODS We recruited 600 (median age 54 (interquartile range (IQR) 22) years, 64% females) patients with diagnosis confirmed earlier in the outpatient facilities in Almaty, Astana and Shymkent in 2020-2021. We offered a structured questionnaire on asthma control and risk factors as of GINA and performed spirometry. We report the prevalence of asthma control, knowledge and skills and pharmacological treatment with 95% confidence interval (CI) and the association of selected predictors with asthma control. RESULTS With the median of 9 (IQR 13) years of diagnosis, 40% of patients had comorbid COPD and 42% had allergic rhinitis, whereas 32% lived with pets. Asthma was well-controlled in only 12.3% (95% CI 9.7-15.0), partly controlled in 29.8% (95% CI 26.2-33.5) and uncontrolled in 57.8% (95% CI 53.9-61.8) patients. ACQ-5 score (range 0-5.8, median 2) equaled 0.2 (IQR 0.85) in well-controlled asthma patients, 1.4 (IQR 1) in partly controlled and 2.8 (IQR 1.4) in uncontrolled asthma patients. Knowledge and skills levels were very low. Only 54% were on inhaled corticosteroids (52.2% of them used budesonide/formoterol and 39.5% used fluticasone/salmeterol). 39% used steroids per os or parenterally within a period of 12 months (51% of patients with uncontrolled asthma). CONCLUSION Asthma control, knowledge and skills levels of asthma patients in the largest cities of Kazakhstan remain unacceptably low, whereas pharmacological treatment is far from optimal. Urgent action should be taken to support doctors' training, and we call to launch a national asthma program to coordinate asthma care in Kazakhstan.
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Affiliation(s)
- Denis Vinnikov
- grid.77184.3d0000 0000 8887 5266Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, 050040 Almaty, Kazakhstan ,grid.77642.300000 0004 0645 517XPeoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Aizhan Raushanova
- grid.77184.3d0000 0000 8887 5266Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, 050040 Almaty, Kazakhstan
| | | | - Tair Nurpeissov
- grid.443453.10000 0004 0387 8740Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Assia Кushekbayeva
- grid.443628.f0000 0004 1799 358XSouth-Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | | | - Baktygul Yessimova
- grid.443453.10000 0004 0387 8740Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Nurlan Brimkulov
- grid.444253.00000 0004 0382 8137Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
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Vinnikov D, Rapisarda V, Babanov S, Vitale E, Strizhakov L, Romanova Z, Mukatova I. High levels of indoor fine particulate matter during the cold season in Almaty prompt urgent public health action. PLoS One 2023; 18:e0285477. [PMID: 37141317 PMCID: PMC10159184 DOI: 10.1371/journal.pone.0285477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/22/2023] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Almaty is the largest city of Kazakhstan with extreme air pollution, mostly in the cold season, but little is known whether staying indoors could lessen the exposure. The aim was to quantitatively characterize indoor fine PM levels and to verify the contribution of ambient pollution to it in a polluted city like Almaty. METHODS We collected forty-six 24-hour 15-min average samples of the ambient air and a similar number of paired indoor samples (total 92 samples). Predictors of both ambient and indoor PM2.5 mass concentrations in mg/m3, including ambient concentration, precipitation, minimal daily temperature and humidity, along with the indoor/outdoor (I/O) ratio were tested in the adjusted regression models at eight 15-min lags. RESULTS Ambient air PM2.5 15-min average mass concentrations were highly variable and ranged from 0.001 to 0.694 mg/m3 (geometric mean (GM) 0.090, geometric standard deviation (GSD) 2.285). Snowing was the strongest predictor of lower ambient PM2.5 24-hour mass concentrations (median 0.053 vs 0.135 mg/m3 (p<0.001)). Indoor mean 15-min PM2.5 concentrations ranged from 0.002 to 0.228 mg/m3 (GM 0.034, GSD 2.254). In adjusted models, outdoor PM2.5 concentration explained 0.58 of all variability of the indoor concentration with a 75-min delay (R2 0.67 at lag8 on snowing days). Median I/O ranged from 0.386 (IQR 0.264 to 0.532) at lag0 to 0.442 (IQR 0.339 to 0.584) at lag8. CONCLUSION During the cold season when fossil fuel is burnt for heating, the population in Almaty is exposed to very high fine PM levels even indoors. Urgent public health action is needed.
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Affiliation(s)
- Denis Vinnikov
- Occupational Health Risks Laboratory, RUDN University, Moscow, Russian Federation
- Environmental Health Laboratory, al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sergey Babanov
- Department of Clinical Pharmacology and Occupational Disease, Samara State Medical University, Samara, Russian Federation
| | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Leonid Strizhakov
- Department of Internal, Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Laboratory of Workers' Reproductive Health Disorders Prevention, Izmerov Research Institute of Occupational Health, Moscow, Russian Federation
- Department of Internal Diseases, Lomonosov Moscow State University, Moscow, Russian Federation
| | - Zhanna Romanova
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Irina Mukatova
- Department of Internal Diseases with Courses of Nephrology, Hematology, Allergology, and Immunology, Astana Medical University, Astana, Kazakhstan
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Miravitlles M, Soler-Cataluña JJ, Soriano JB, García-Río F, de Lucas P, Alfageme I, Casanova C, Rodríguez González-Moro JM, Sánchez G, Ancochea J, Cosío BG. Respiratory symptoms and their determinants in the general Spanish population: changes over 20 years. ERJ Open Res 2022; 8:00067-2022. [PMID: 36382234 PMCID: PMC9661281 DOI: 10.1183/23120541.00067-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background Few large epidemiological studies have analysed the prevalence of respiratory symptoms and their determinants in the general adult population. We investigated the prevalence and determinants of respiratory symptoms and compared their prevalence with that of two previous studies conducted in 1999 and 2009. Method EPISCAN II was a multicentre, cross-sectional, population-based epidemiological study in individuals older than 40 years. Results A total of 9092 individuals were included. Up to 47.5% reported at least one respiratory symptom, being more frequent in women than in men (49.4% versus 45.5%, p=0.0002) and with wheezing being the most frequent (33.7%) followed by dyspnoea (26.8%). The presence of any symptom was associated with female sex, higher body mass index (BMI), lower forced expiratory volume in 1 s (FEV1 % pred), reduced physical activity, a higher Charlson index and the presence of anxiety and depression. Smoking was also significantly associated with having at least one respiratory symptom in a dose–response fashion (OR: 1.415, 1.916, 2.192 and 2.987 for 0–10, 10–20, 20–30 and >30 pack-years, respectively, all p<0.0001). The prevalence of symptoms remained quite similar over the last 20 years (wheezing 40%, 36% and 33.7% and dyspnoea 10.4%, 9.9% and 13.1% in 1999, 2009 and 2019, respectively). Conclusions Approximately half of the adult Spanish population have respiratory symptoms and this prevalence has remained quite stable over the last 20 years. Smoking remains the main factor associated with respiratory symptoms, but female sex, comorbidities, high BMI and low FEV1 and low physical activity are also significantly associated with respiratory symptoms. Approximately half of the adult Spanish population has some respiratory symptoms and this prevalence has remained quite stable over the last 20 yearshttps://bit.ly/37uGRT7
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Vinnikov D, Raushanova A, Romanova Z, Tulekov Z. Health-related quality of life in a general population sample in Kazakhstan and its sociodemographic and occupational determinants. Health Qual Life Outcomes 2021; 19:199. [PMID: 34419062 PMCID: PMC8379595 DOI: 10.1186/s12955-021-01843-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background Health-related quality of life (HRQL) in the general population of Kazakhstan has never been characterized. We constructed this population-based study of the largest city in Kazakhstan, Almaty with the aim to quantitatively assess HRQL and ascertain whether occupation and lifestyle are associated with HRQL in this population. Methods In a random sample (N = 1500) of general population in Almaty (median age 49 (interquartile range 28) years, 50% women), we collected data on demographics, socioeconomic status, lifestyle, lifetime occupational history and general HRQL using SF-8 instrument. The association of demographic and occupational predictors with HRQL was tested in multiple regression models. Results No occupational associations were found for physical component score in the models adjusted for age, sex, income, cigarette and waterpipe smoking, electronic cigarette use, physical activity, alcohol and exposure to secondhand smoke. Ever being a manager (β − 1.63 (95% confidence interval (CI) − 2.92; − 0.34)), a welder (β − 5.11 (95% CI − 8.77; − 1.46)) and a secretary (β − 5.06 (95% CI − 8.56; − 1.56)) for one year or more was associated with poorer mental component score in the models adjusted for age, sex, income, cigarette smoking, physical activity and each other. Age, income and physical activity were independent predictors of both physical and mental components. Conclusions Occupational history is associated with HRQL in the general population in Almaty, Kazakhstan, but the mechanism explaining this association should be further elucidated.
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Affiliation(s)
- Denis Vinnikov
- Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, 050040, Almaty, Kazakhstan. .,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.
| | - Aizhan Raushanova
- Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, 050040, Almaty, Kazakhstan
| | - Zhanna Romanova
- Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, 050040, Almaty, Kazakhstan
| | - Zhangir Tulekov
- Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, 050040, Almaty, Kazakhstan
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Vinnikov D, Romanova Z, Zhumabayeva G. Air pollution in the workplace: making shish kebab is an overlooked occupational hazard. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:777-783. [PMID: 33328553 DOI: 10.1038/s41370-020-00283-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/05/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Meat grilled with wood charcoal is the most popular meal in Central Asia, but little is known about the grillers' occupational exposure to fine particulate matter (PM) in fumes. OBJECTIVES The aim of this study was to provide a quantitative analysis of occupational exposure to fine PM in grillers in the workplace. METHODS We assessed exposure to PM2.5 from barbecue fumes using SidePak AM520 in six popular cafes in Almaty, Kazakhstan. Grillers wore devices for 8 h of work shift for 7 days in each place. Within- and between-place variances of PM2.5 mass concentrations were calculated using analysis of variance, and we also calculated the fold range of the 95% variance within (wR0.95) and between places (bR0.95), as well as exceedance (γ) and the probability of overexposure (θ). RESULTS Two modes of exposure were identified, including intermittent and continuous. The median of daily geometric mean PM2.5 concentrations was 0.143 (interquartile range (IQR): 0.213) and 0.404 (IQR: 0.243) mg/m3, accordingly. bR0.95 was very large (20.2), but wR0.95 was even greater (47.8), illustrating extremely high fluctuations in PM2.5 concentrations; γ was 0.116, and θ was 0.095. SIGNIFICANCE Very high occupational exposure to barbecue fumes in grillers is overlooked and likely causes elevated health risks.
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Affiliation(s)
- Denis Vinnikov
- al-Farabi Kazakh National University, School of Public Health, al-Farabi Avenue 71, Almaty, 050040, Kazakhstan.
- Peoples' Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, Moscow, 117198, Russian Federation.
- National Research Tomsk State University, 36 Lenin Avenue, Tomsk, 634050, Russian Federation.
| | - Zhanna Romanova
- al-Farabi Kazakh National University, School of Public Health, al-Farabi Avenue 71, Almaty, 050040, Kazakhstan
| | - Galiya Zhumabayeva
- al-Farabi Kazakh National University, School of Public Health, al-Farabi Avenue 71, Almaty, 050040, Kazakhstan
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Poulos LM, Ampon RD, Currow DC, Marks GB, Toelle BG, Reddel HK. Prevalence and burden of breathlessness in Australian adults: The National Breathlessness Survey-a cross-sectional web-based population survey. Respirology 2021; 26:768-775. [PMID: 33971059 DOI: 10.1111/resp.14070] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Chronic respiratory symptoms (in particular, breathlessness and cough) can cause physical, social and emotional distress, and may indicate the presence of an underlying disease that presages future poor health outcomes. Our aim was to investigate the burden of breathlessness in Australian adults, including breathlessness that may be undiagnosed, unlabelled or untreated. METHODS The National Breathlessness Survey was a cross-sectional, web-based survey conducted in October 2019. Australian adults were randomly selected from a large web-based survey panel with recruitment stratified by age-group, gender and state of residence according to national population data. The main outcome measures were modified Medical Research Council (mMRC) dyspnoea scale, EuroQol visual analog scale, Dyspnoea-12 score and 4-item Patient Health Questionnaire (PHQ-4). RESULTS Among all respondents (n = 10,072; 51.1% female; median age group 40-49 years), 9.5% reported clinically important breathlessness (mMRC dyspnoea grade ≥ 2, 2 = 'I walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking at my own pace on the level'). Among those with clinically important breathlessness, 49.1% rated their general health as fair or poor and 44.2% had at least moderate depression or anxiety symptoms (PHQ ≥ 6) but over half (50.8%) did not report a current respiratory or heart condition diagnosis. CONCLUSION Breathlessness is common among Australian adults, and is associated with a substantial burden of ill health, including among people without a diagnosed respiratory or heart condition. The extent of underdiagnosis of these conditions or alternative causes of breathlessness requires further investigation.
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Affiliation(s)
- Leanne M Poulos
- Australian Centre for Airways disease Monitoring (ACAM), the Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Rosario D Ampon
- Australian Centre for Airways disease Monitoring (ACAM), the Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Guy B Marks
- Australian Centre for Airways disease Monitoring (ACAM), the Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Brett G Toelle
- Australian Centre for Airways disease Monitoring (ACAM), the Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia.,Sydney Local Health District, Sydney, New South Wales, Australia
| | - Helen K Reddel
- Australian Centre for Airways disease Monitoring (ACAM), the Woolcock Institute of Medical Research, The University of Sydney, Sydney, New South Wales, Australia
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Vinnikov D, Rybina T, Strizhakov L, Babanov S, Mukatova I. Occupational Burden of Chronic Obstructive Pulmonary Disease in the Commonwealth of Independent States: Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 7:614827. [PMID: 33537332 PMCID: PMC7849650 DOI: 10.3389/fmed.2020.614827] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/08/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Population-based studies from the Russian Federation and neighboring countries on the occupational burden of chronic obstructive pulmonary disease (COPD) are seldom or not included in the systematic reviews. The aim of this review was to summarize published population-based studies from the Commonwealth of Independent States (CIS) in order to ascertain the occupational burden of COPD. Methods: We systematically searched www.elibrary.ru and PubMed for population-based studies on the epidemiology of COPD in nine countries using PRISMA. Quality of studies was assessed using the original tool. The odds of COPD in the included studies from vapors, gases, dusts, and fumes (VGDF) was pooled using meta-analysis (fixed effects model), whereas the population attributable fraction percent (PAF%) was pooled with meta-proportion using the random effects model in Stata 14.2. Results: Five studies, three from Russia, one from Kazakhstan, and one more from Azerbaijan and Kazakhstan (total N = 18,908) with moderate to high quality and published from 2014 to 2019 (none from Armenia, Belarus, Kyrgyzstan, Moldova, Tajikistan, and Uzbekistan), were included. Spirometry-defined COPD was the outcome in four of them. The pooled odds ratio (OR) of COPD from VGDF was 1.69 [95% confidence interval (CI) 1.34;2.13], greater in Kazakhstan [OR 1.96 (95% CI 1.35;2.85, N = 2 studies)] compared to Russia [OR 1.52 (95% CI 1.13;2.05, N = 2 studies)]. The pooled PAF% was 6% (95% CI 2; 14%) from three studies. Conclusions: Population-based studies in the CIS get little attention with very few studies published. Although the effect was greater in Kazakhstan compared to Russia, the overall effect did not differ from studies published in the rest of the world. Research capacity to study occupational risks of COPD should be strengthened to produce more evidence of higher quality.
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Affiliation(s)
- Denis Vinnikov
- Environmental and Occupational Health Lab, Al-Farabi Kazakh National University, Almaty, Kazakhstan.,Department of Biochemistry, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.,Biological Institute, National Research Tomsk State University, Tomsk, Russia
| | - Tatsyana Rybina
- Scientific and Practical Center MedEvery LLC, Minsk, Belarus
| | - Leonid Strizhakov
- Department of Internal Medicine, Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sergey Babanov
- Department of Occupational Diseases and Clinical Pharmacology, Samara State Medical University, Samara, Russia
| | - Irina Mukatova
- Department of Internal Medicine, Nephrology, Hematology, Immunology, and Allergy, Astana Medical University, Nur-Sultan, Kazakhstan
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