Occupations with an increased prevalence of self-reported asthma in Indian adults

Chronic respiratory disease surveys in adults in low- and middle-income countries: A systematic scoping review of methodological approaches and outcomes

Background

Chronic respiratory diseases (CRDs) contribute significantly towards the global burden of disease, but the true prevalence and burden of these conditions in adults is unknown in the majority of low- and middle-income countries (LMICs). We aimed to identify strategies - in particular the definitions, study designs, sampling frames, instruments, and outcomes - used to conduct prevalence surveys for CRDs in LMICs. The findings will inform a future RESPIRE Four Country ChrOnic Respiratory Disease (4CCORD) study, which will estimate CRD prevalence, including disease burden, in adults in LMICs.

Methods

We conducted a scoping review to map prevalence surveys conducted in LMICs published between 1995 and 2018. We followed Arksey and O'Malley's six-step framework. The search was conducted in OVID Medline, EMBASE, ISI Web of Science, Global Health, WHO Global Index Medicus and included three domains: CRDs, prevalence and LMICs. After an initial title sift, eight trained reviewers undertook duplicate study selection and data extraction. We charted: country and populations, random sampling strategies, CRD definitions/phenotypes, survey procedure (questionnaires, spirometry, tests), outcomes and assessment of individual, societal and health service burden of disease.

Results

Of 36 872 citations, 281 articles were included: 132 from Asia (41 from China). Study designs were cross-sectional surveys (n = 260), cohort studies (n = 11) and secondary data analysis (n = 10). The number of respondents in these studies ranged from 50 to 512 891. Asthma was studied in 144 studies, chronic obstructive pulmonary disease (COPD) in 112. Most studies (100/144) based identification of asthma on symptom-based questionnaires. In contrast, COPD diagnosis was typically based on spirometry findings (94/112); 65 used fixed-ratio thresholds, 29 reported fixed-ratio and lower-limit-of-normal values. Only five articles used the term 'phenotype'. Most studies used questionnaires derived from validated surveys, most commonly the European Community Respiratory Health Survey (n = 47). The burden/impact of CRD was reported in 33 articles (most commonly activity limitation).

Conclusion

Surveys remain the most practical approach for estimating prevalence of CRD but there is a need to identify the most predictive questions for diagnosing asthma and to standardise diagnostic criteria.

Asthma-associated risk for COVID-19 development

The newly described severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for a pandemic (coronavirus disease 2019 [COVID-19]). It is now well established that certain comorbidities define high-risk patients. They include hypertension, diabetes, and coronary artery disease. In contrast, the context with bronchial asthma is controversial and shows marked regional differences. Because asthma is the most prevalent chronic inflammatory lung disease worldwide and SARS-CoV-2 primarily affects the upper and lower airways leading to marked inflammation, the question arises about the possible clinical and pathophysiological association between asthma and SARS-CoV-2/COVID-19. Here, we analyze the global epidemiology of asthma among patients with COVID-19 and propose the concept that patients suffering from different asthma endotypes (type 2 asthma vs non-type 2 asthma) present with a different risk profile in terms of SARS-CoV-2 infection, development of COVID-19, and progression to severe COVID-19 outcomes. This concept may have important implications for future COVID-19 diagnostics and immune-based therapy developments.

Socioeconomic and demographic predictors of high blood pressure, diabetes, asthma and heart disease among adults engaged in various occupations: evidence from India

In India, non-communicable diseases (NCDs) accounted for nearly 62% of all deaths in 2016. Four NCDs - high blood pressure, diabetes, asthma and heart disease - together accounted for over 34% of these deaths. Using data from two rounds of the India Human Development Surveys (IHDSs), levels and changes in the prevalence rates of the four NCDs (based on diagnosed cases) among adults aged 15-69 years in India between 2004-05 and 2011-12 were examined by socioeconomic and demographic factors and for five broad occupation categories. The socioeconomic and demographic risk factors for each of these NCDs were determined using multiple linear logistic regression analysis of pooled data from two rounds of the IHDS. The results showed that while urban residence, age, female sex and education were associated with higher odds of high blood pressure, diabetes and heart disease, household economic status was associated with higher odds for all four NCDs. Furthermore, increased higher odds of high blood pressure, diabetes and heart disease were found for the legislator/senior official/professional occupation group compared with non-workers. Skilled agricultural/elementary workers had lower odds of high blood pressure, diabetes, asthma and heart disease. Craft/machine-related trade workers had higher odds of high blood pressure and diabetes, and reduced odds of asthma and heart disease. Compared with non-workers, the odds ratios for asthma were lower for all other occupational categories. During the two study decades, the Government of India implemented several programmes designed to improve the health and well-being of its people. However, more focused attention on the adult population is needed, and special attention should be paid to the issue of the occupational health of the working population through the strict implementation of work place safety protocols and the removal of potential health hazards.

Prevalence and Occupational and Environmental Risk Factors of Self-Reported Asthma: Evidence from a Cross-Sectional Survey in Seven Chinese Cities

OBJECTIVE

Asthma is one of the most common chronic diseases and associated with significant morbidity and mortality. However, few data on occupational and environmental risk factors of asthma are available, particularly in Asian adults. Based on a national cross-sectional survey, we assessed the prevalence and risk factors of asthma in Chinese adults.

METHODS

A total of 9974 participants aged 15 years and over in seven Chinese cities were selected using a stratified four-stage random sampling. All participants were interviewed face-to-face in their homes using a standardized self-administered questionnaire. Multivariate logistic regression analyses were adopted to determine various risk factors for asthma.

RESULTS

The prevalence of self-reported lifetime asthma was 2.46% among the entire adult population, 3.02% among males and 1.93% among females. The prevalence varied by age group, ethnicity, marital status, education, and floor space per person (p < 0.05). After adjusting for socio-demographic variables and smoking, we found independent occupational and environmental determinants of asthma, including a clearance-related job (OR = 2.28, 95%CI: 1.07-4.89), occupational exposure to industrial or occupational poisonous gas (OR = 4.21, 95%CI: 2.43-7.30), having large amounts of carpet in the workplace (OR = 2.61, 95%CI: 1.20-5.69) and using coal for cooking (OR = 2.65, 95%CI: 1.26-5.57).

CONCLUSIONS

Asthma is a serious public health problem in China. Our study provides important updated information on the prevalence of asthma and its associated risk factors, which may help us better understand the epidemiology of asthma and prevent this disorder.

Prevention and Early Detection of Occupational Cancers - a View of Information Technology Solutions

Thousands of people die each year from cancer due to occupational causes. To reduce cancer in workers, preventive strategies should be used in the high-risk workplace. The effective prevention of occupational cancer requires knowledge of carcinogen agents. Like other areas of healthcare industry, occupational health has been affected by information technology solutions to improve prevention, early detection, treatment and finally the efficiency and cost effectiveness of the healthcare system. Information technology solutions are thus an important issue in the healthcare field. Information about occupational cancer in information systems is important for policy makers, managers, physicians, patients and researchers; because examples that include high quality data about occupational cancer patients and occupational cancer causes are able to determine the worker groups which require special attention. As a result exposed workers who are vulnerable can undergo screening and be considered for preventive interventions.