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Sritharan J, Arrandale VH, Kirkham TL, Dakouo M, MacLeod JS, Demers PA. Risk of chronic obstructive pulmonary disease in a large cohort of Ontario, Canada workers. Sci Rep 2024; 14:8756. [PMID: 38627517 PMCID: PMC11021393 DOI: 10.1038/s41598-024-59429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
Although several occupational exposures have been linked to the risk of COPD; limited data exists on sex-specific differences. This study aimed to identify at-risk occupations and sex differences for COPD risk. Cases were identified in a large surveillance system established through the linkage of former compensation claimants' data (non-COPD claims) to physician visits, ambulatory care data, and hospital inpatient data (1983-2020). Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CI) for occupation groups (occupation at time of claim), stratified by sex. HRs were indirectly adjusted for cigarette smoking using another population dataset. A total of 29,445 male and 14,693 female incident cases of COPD were identified. Increased risks were observed in both sexes for construction (HRmale 1.15, 95% CI 1.12-1.19; HRfemale 1.54, 95% CI 1.29-1.83) transport/equipment operating (HRmale 1.32, 95% CI 1.28-1.37; HRfemale 1.53, 95% CI 1.40-1.68) farming (HRmale 1.23, 95% CI 1.15-1.32; HRfemale 1.19, 95% CI 1.04-1.37) and janitors/cleaners (HRmale 1.31, 95% CI 1.24-1.37; HRfemale 1.40, 95% CI 1.31-1.49). Increased risks were observed for females employed as chefs and cooks (HR 1.44, 95% CI 1.31-1.58), bartenders (HR 1.38, 95% CI 1.05-1.81), and those working in food/beverage preparation (HR 1.34, 95% CI 1.24-1.45) among other occupations. This study demonstrates elevated risk of COPD among both male and female workers potentially exposed to vapours, gases, dusts, and fumes, highlighting the need for occupational surveillance of COPD.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Victoria H Arrandale
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tracy L Kirkham
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
| | - Jill S MacLeod
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Ontario Health, 525 University Avenue, 3rd Floor, Toronto, ON, M5G 1X3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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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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Zhu RX, Nie XH, Liu XF, Zhang YX, Chen J, Liu XJ, Hui XJ. Short-term effect of particulate matter on lung function and impulse oscillometry system (IOS) parameters of chronic obstructive pulmonary disease (COPD) in Beijing, China. BMC Public Health 2023; 23:1417. [PMID: 37488590 PMCID: PMC10367330 DOI: 10.1186/s12889-023-16308-0] [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: 01/03/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the associations between particulate matter (PM), lung function and Impulse Oscillometry System (IOS) parameters in chronic obstructive pulmonary disease (COPD) patients and identity effects between different regions in Beijing, China. METHODS In this retrospective study, we recruited 1348 outpatients who visited hospitals between January 2016 and December 2019. Ambient air pollutant data were obtained from the central monitoring stations nearest the participants' residential addresses. We analyzed the effect of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) exposure on lung function and IOS parameters using a multiple linear regression model, adjusting for sex, smoking history, education level, age, body mass index (BMI), mean temperature, and relative humidity . RESULTS The results showed a relationship between PM2.5, lung function and IOS parameters. An increase of 10 µg/m3 in PM2.5 was associated with a decline of 2.083% (95% CI: -3.047 to - 1.103) in forced expiratory volume in one second /predict (FEV1%pred), a decline of 193 ml/s (95% CI: -258 to - 43) in peak expiratory flow (PEF), a decline of 0.932% (95% CI: -1.518 to - 0.342) in maximal mid-expiratory flow (MMEF); an increase of 0.732 Hz (95% CI: 0.313 to 1.148) in resonant frequency (Fres), an increase of 36 kpa/(ml/s) (95% CI: 14 to 57) in impedance at 5 Hz (Z5) and an increase of 31 kpa/(ml/s) (95% CI: 2 to 54) in respiratory impedance at 5 Hz (R5). Compared to patients in the central district, those in the southern district had lower FEV1/FVC, FEV1%pred, PEF, FEF75%, MMEF, X5, and higher Fres, Z5 and R5 (p < 0.05). CONCLUSION Short-term exposure to PM2.5 was associated with reductions in lung function indices and an increase in IOS results in patients with COPD. The heavier the PM2.5, the more severe of COPD.
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Affiliation(s)
- Rui-Xia Zhu
- Department of pulmonary and critical care medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiu-Hong Nie
- Department of pulmonary and critical care medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Xiao-Fang Liu
- Department of pulmonary and critical care medicine, Tong Ren Hospital, Capital Medical University, Beijing, China
| | - Yong-Xiang Zhang
- Department of pulmonary and critical care medicine, Daxing District People's Hospital, Beijing, China.
| | - Jin Chen
- Respiratory department, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Xue-Jiao Liu
- Department of pulmonary and critical care medicine, Daxing District People's Hospital, Beijing, China
| | - Xin-Jie Hui
- Department of pulmonary and critical care medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Zhu R, Chen J. Long-term effects of air pollution on hospital admissions and mortality for chronic obstructive pulmonary disease in Beijing, China. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:672-683. [PMID: 37392082 PMCID: PMC10363839 DOI: 10.1111/crj.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE We aimed to clarify the association between air pollution and hospital admissions for chronic obstructive pulmonary disease (COPD) and mortality in Beijing, China. METHODS In this retrospective study, we recruited 510 COPD patients from 1 January 2006 to 31 December 2009. The patient data were obtained from the electronic medical records of Peking University Third Hospital in Beijing. Air pollution and meteorological data were obtained from the Institute of Atmospheric Physics of the Chinese Academy of Sciences. Monthly COPD hospital admissions, mortality and air pollution data were analysed using Poisson regression in generalised additive models adjusted for mean temperature, pressure and relative humidity. RESULTS There were positive correlations between sulfur dioxide (SO2 ), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10 ) and COPD hospital admissions in the single-pollutant model. An increase of 10 μg/m3 in SO2 and PM10 were associated with an increase of 4.053% (95% CI: 1.470-5.179%) and 1.401% (95%CI: 0.6656-1.850%) in COPD hospital admissions. In the multiple-pollutant model [SO2 and nitrogen dioxide (NO2 ) combinations], there was only a positive correlation between SO2 and COPD hospital admissions. An increase of 10 μg/m3 in SO2 were associated with an increase of 1.916% (95% CI: 1.118-4.286%) in COPD hospital admissions. There was no correlation between three pollutant combinations and COPD hospital admissions. We did not find correlations between air pollution and COPD mortality in either single- or multiple-pollutant models. CONCLUSIONS SO2 and PM10 may be important factors for the increase in COPD hospital admissions in Beijing, China.
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Affiliation(s)
- Rui‐xia Zhu
- Respiratory Department, Fuxing HospitalCapital Medical UniversityBeijingChina
| | - Jin Chen
- Respiratory Department, Fuxing HospitalCapital Medical UniversityBeijingChina
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Holtjer JCS, Bloemsma LD, Beijers RJHCG, Cornelissen MEB, Hilvering B, Houweling L, Vermeulen RCH, Downward GS, Maitland-Van der Zee AH. Identifying risk factors for COPD and adult-onset asthma: an umbrella review. Eur Respir Rev 2023; 32:32/168/230009. [PMID: 37137510 PMCID: PMC10155046 DOI: 10.1183/16000617.0009-2023] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/27/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND COPD and adult-onset asthma (AOA) are the most common noncommunicable respiratory diseases. To improve early identification and prevention, an overview of risk factors is needed. We therefore aimed to systematically summarise the nongenetic (exposome) risk factors for AOA and COPD. Additionally, we aimed to compare the risk factors for COPD and AOA. METHODS In this umbrella review, we searched PubMed for articles from inception until 1 February 2023 and screened the references of relevant articles. We included systematic reviews and meta-analyses of observational epidemiological studies in humans that assessed a minimum of one lifestyle or environmental risk factor for AOA or COPD. RESULTS In total, 75 reviews were included, of which 45 focused on risk factors for COPD, 28 on AOA and two examined both. For asthma, 43 different risk factors were identified while 45 were identified for COPD. For AOA, smoking, a high body mass index (BMI), wood dust exposure and residential chemical exposures, such as formaldehyde exposure or exposure to volatile organic compounds, were amongst the risk factors found. For COPD, smoking, ambient air pollution including nitrogen dioxide, a low BMI, indoor biomass burning, childhood asthma, occupational dust exposure and diet were amongst the risk factors found. CONCLUSIONS Many different factors for COPD and asthma have been found, highlighting the differences and similarities. The results of this systematic review can be used to target and identify people at high risk for COPD or AOA.
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Affiliation(s)
- Judith C S Holtjer
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Lizan D Bloemsma
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Rosanne J H C G Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Merel E B Cornelissen
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Bart Hilvering
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Laura Houweling
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Roel C H Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - George S Downward
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anke-Hilse Maitland-Van der Zee
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
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Puci MV, Ferraro OE, Monti MC, Gnesi M, Borrelli P, Cadum E, Perotti P, Migliazza S, Dalle Carbonare S, Montomoli C, Villani S. Asthma, COPD, Respiratory, and Allergic Health Effects in an Adult Population Living near an Italian Refinery: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11071037. [PMID: 37046964 PMCID: PMC10093894 DOI: 10.3390/healthcare11071037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND AND AIM Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Globally, 545 million people suffer from chronic respiratory diseases with a wide geographical variability. Risk factors for asthma are both genetic and related to several environmental factors (internal and external pollutants); these also have an important role in the occurrence of COPD. The aim of this study was to describe the prevalence of asthma, COPD, and asthma/COPD overlap (ACO) in an adult population living in two municipalities located in the Po Valley. METHODS A standardized questionnaire on respiratory symptoms and sociodemographic characteristics was self-administered to a random sample of the adult population aged 20-64 years, living near a refinery in Northern Italy during the period between 2016 and 2019. Logistic and multinomial regression were implemented to explore factors associated with asthma, COPD, and ACO. RESULTS In total, 1108 subjects filled out the questionnaire, the mean age was 48.02 ± 12.34 years (range 21-68), and 53% of the respondents/participants were female. Half of the responders were non-smokers, but the frequency of current and former smokers was significantly greater in men than in women (p < 0.001). The likelihood of being a probable case of asthma decreased with increasing age and increased for smokers. Tobacco smoke was associated with the presence of COPD and ACO. CONCLUSION Respiratory diseases such as asthma and COPD are common in the general population, with differences among countries worldwide. Our findings show, on the basis of the main confirmed risk factor, namely smoking, that it is useful to plan target programs and actions in order to reduce smoking, thus improving the quality of life in public health.
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Affiliation(s)
- Mariangela Valentina Puci
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Ottavia Eleonora Ferraro
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Maria Cristina Monti
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Marco Gnesi
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Paola Borrelli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Ennio Cadum
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Pietro Perotti
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | - Simona Migliazza
- Health Protection Agency of Pavia (ATS Pavia), 27100 Pavia, Italy
| | | | - Cristina Montomoli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
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Nguyen TC, Tran HVT, Nguyen TH, Vo DC, Godin I, Michel O. Identification of Modifiable Risk Factors of Exacerbations Chronic Respiratory Diseases with Airways Obstruction, in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11088. [PMID: 36078802 PMCID: PMC9517880 DOI: 10.3390/ijerph191711088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES to determine modifiable risk factors of exacerbations in chronic respiratory diseases with airways obstruction (i.e., asthma and COPD) in southern Vietnam. METHODS an environmental and health-related behavioural questionnaire was submitted to patients with both chronic respiratory symptoms and airways obstruction. An exacerbation was defined as any acute worsening in clinical symptoms requiring a change in treatment, in a patient receiving prophylactic therapy. RESULTS 235 patients were evaluated, including 131 (56%) chronic obstructive pulmonary disease (COPD) and 104 (44%) asthmatics. There were 75% males and 69% smokers. Occupational exposure accounted for 66%, mainly among construction and industry workers. Smoking was associated with more severe airways obstruction. Respiratory exacerbations were reported in 56/235 patients (24%). The risk of exacerbation was increased in patients with a lower education level, exposure to occupational pollutants, cumulative smoking ≥ 20 pack year, housing space < 10 m2, and poorly ventilated housing. Based on multivariate analysis, the risk of exacerbation remained significantly higher among patients with occupational exposure and low housing space per person. CONCLUSIONS besides smoking cessation, more supportive policies, including improvement of occupational environment and housing design for better ventilation, are needed to prevent the severity of chronic respiratory diseases in Vietnam.
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Affiliation(s)
- Thuy Chau Nguyen
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 740500, Vietnam
| | - Hoa Vi Thi Tran
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 740500, Vietnam
| | - Thanh Hiep Nguyen
- Department of Family Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 740500, Vietnam
| | - Duc Chien Vo
- Nguyen Tri Phuong Hospital, Ho Chi Minh City 740500, Vietnam
| | - Isabelle Godin
- School of Public Health, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
| | - Olivier Michel
- Clinic of Immuno-Allergology, CHU Brugmann, Université Libre de Bruxelles (ULB), 4 Place A-Van Gehuchten, 1020 Brussels, Belgium
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Klepaker G, Henneberger PK, Torén K, Brunborg C, Kongerud J, Fell AKM. Association of respiratory symptoms with body mass index and occupational exposure comparing sexes and subjects with and without asthma: follow-up of a Norwegian population study (the Telemark study). BMJ Open Respir Res 2022; 9:9/1/e001186. [PMID: 35365552 PMCID: PMC8977753 DOI: 10.1136/bmjresp-2021-001186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/22/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Occupational exposure and increased body mass index (BMI) are associated with respiratory symptoms. This study investigated whether the association of a respiratory burden score with changes in BMI as well as changes in occupational exposure to vapours, gas, dust and fumes (VGDF) varied in subjects with and without asthma and in both sexes over a 5-year period. METHODS In a 5-year follow-up of a population-based study, 6350 subjects completed a postal questionnaire in 2013 and 2018. A respiratory burden score based on self-reported respiratory symptoms, BMI and frequency of occupational exposure to VGDF were calculated at both times. The association between change in respiratory burden score and change in BMI or VGDF exposure was assessed using stratified regression models. RESULTS Changes in respiratory burden score and BMI were associated with a β-coefficient of 0.05 (95% CI 0.04 to 0.07). This association did not vary significantly by sex, with 0.05 (0.03 to 0.07) for women and 0.06 (0.04 to 0.09) for men. The association was stronger among those with asthma (0.12; 0.06 to 0.18) compared with those without asthma (0.05; 0.03 to 0.06) (p=0.011). The association of change in respiratory burden score with change in VGDF exposure gave a β-coefficient of 0.15 (0.05 to 0.19). This association was somewhat greater for men versus women, with coefficients of 0.18 (0.12 to 0.24) and 0.13 (0.07 to 0.19), respectively (p=0.064). The estimate was similar among subjects with asthma (0.18; -0.02 to 0.38) and those without asthma (0.15; 0.11 to 0.19). CONCLUSIONS Increased BMI and exposure to VGDF were associated with increased respiratory burden scores. The change due to increased BMI was not affected by sex, but subjects with asthma had a significantly larger change than those without. Increased frequency of VGDF exposure was associated with increased respiratory burden score but without statistically significant differences with respect to sex or asthma status.
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Affiliation(s)
- Geir Klepaker
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Keefer Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Kjell Torén
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics, Epidemiology and Health Economics, Oslo University Hospital, Oslo, Norway
| | - Johny Kongerud
- Department of Respiratory Medicine, University of Oslo, Oslo, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.,Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo Faculty of Medicine, Oslo, Norway
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Challenges in Diagnosing Occupational Chronic Obstructive Pulmonary Disease. MEDICINA-LITHUANIA 2021; 57:medicina57090911. [PMID: 34577834 PMCID: PMC8469547 DOI: 10.3390/medicina57090911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
Occupational chronic obstructive pulmonary disease (oCOPD) represents 15–20% of the global burden of this disease. Even if industrial bronchitis has long been known, new occupational hazards continue to emerge and enlarge the number of people exposed to risk. This review discusses the challenges related to the early detection of oCOPD, in the context of new exposures and of limited usage of methods for an efficient disease occupational screening. It underlines that a better translation into clinical practice of the new methods for lung function impairment measurements, imaging techniques, or the use of serum or exhaled breath inflammation biomarkers could add significant value in the early detection of oCOPD. Such an approach would increase the chance to stop exposure at an earlier moment and to prevent or at least slow down the further deterioration of the lung function as a result of exposure to occupational (inhaled) hazards.
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A Comparison Analysis of Causative Impact of PM2.5 on Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) in Two Typical Cities in China. ATMOSPHERE 2021. [DOI: 10.3390/atmos12080970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a major and increasingly prevalent respiratory health problem worldwide and the fine particulate matter (PM2.5) is now becoming a rising health threat to it. This study aims to conduct a comparison analysis of health effect on acute exacerbation of COPD (AECOPD) associated with PM2.5 exposure in two typical cities (Beijing and Shenzhen) with different levels of PM2.5 pollution. Both correlational relationship and causal connection between PM2.5 exposure and AECOPD are investigated by adopting a time series analysis based on the generalized additive model (GAM) and convergent cross mapping (CCM). The results from GAM indicate that a 10 μg/m3 increase in PM2.5 concentration is associated with 2.43% (95% CI, 0.50–4.39%) increase in AECOPD on Lag0-2 in Beijing, compared with 6.65% (95% CI, 2.60–10.87%) on Lag0-14 in Shenzhen. The causality detection with CCM reveals similar significant causative impact of PM2.5 exposure on AECOPD in both two study areas. Findings from two methods agree that PM2.5 has non-negligible health effect on AECOPD in both two study areas, implying that air pollution can cause adverse consequences at much lower levels than common cognition. Our study highlights the adverse health effect of PM2.5 on people with COPD after exposure to different levels of PM2.5 and emphasizes that adverse effect in area with relative low pollution level cannot be overlooked. Governments in both high-pollution and low-pollution cities should attach importance to the adverse effects of PM2.5 on humans and take corresponding measures to control and reduce the related losses.
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Jalasto J, Lassmann-Klee P, Schyllert C, Luukkonen R, Meren M, Larsson M, Põlluste J, Sundblad BM, Lindqvist A, Krokstad S, Kankaanranta H, Kauppi P, Sovijärvi A, Haahtela T, Backman H, Lundbäck B, Piirilä P. Occupation, socioeconomic status and chronic obstructive respiratory diseases - The EpiLung study in Finland, Estonia and Sweden. Respir Med 2021; 191:106403. [PMID: 33994287 DOI: 10.1016/j.rmed.2021.106403] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To study occupational groups and occupational exposure in association with chronic obstructive respiratory diseases. METHODS In early 2000s, structured interviews on chronic respiratory diseases and measurements of lung function as well as fractional expiratory nitric oxide (FENO) were performed in adult random population samples of Finland, Sweden and Estonia. Occupations were categorized according to three classification systems. Occupational exposure to vapours, gases, dusts and fumes (VGDF) was assessed by a Job-Exposure Matrix (JEM). The data from the countries were combined. RESULTS COPD, smoking and occupational exposure were most common in Estonia, while asthma and occupations requiring higher educational levels in Sweden and Finland. In an adjusted regression model, non-manual workers had a three-fold risk for physician-diagnosed asthma (OR 3.18, 95%CI 1.07-9.47) compared to professionals and executives, and the risk was two-fold for healthcare & social workers (OR 2.28, 95%CI 1.14-4.59) compared to administration and sales. An increased risk for physician-diagnosed COPD was seen in manual workers, regardless of classification system, but in contrast to asthma, the risk was mostly explained by smoking and less by occupational exposure to VGDF. For FENO, no associations with occupation were observed. CONCLUSIONS In this multicenter study from Finland, Sweden and Estonia, COPD was consistently associated with manual occupations with high smoking prevalence, highlighting the need to control for tobacco smoking in studies on occupational associations. In contrast, asthma tended to associate with non-manual occupations requiring higher educational levels. The occupational associations with asthma were not driven by eosinophilic inflammation presented by increased FENO.
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Affiliation(s)
- Juuso Jalasto
- Department of Clinical Physiology, HUS Medical Diagnostic Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
| | - Paul Lassmann-Klee
- Department of Clinical Physiology, HUS Medical Diagnostic Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Christian Schyllert
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | | | - Mari Meren
- National Institute for Health Development, Tallinn, Estonia and North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - Matz Larsson
- Clinical Health Promotion Centre, University of Lund, and Örebro University Hospital, Örebro, Sweden
| | - Jaak Põlluste
- National Institute for Health Development, Tallinn, Estonia and North Estonia Medical Centre Foundation, Tallinn, Estonia
| | | | - Ari Lindqvist
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
| | - Hannu Kankaanranta
- Krefting Research Centre, Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Paula Kauppi
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Anssi Sovijärvi
- Department of Clinical Physiology, HUS Medical Diagnostic Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | | | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden; Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden
| | - Päivi Piirilä
- Department of Clinical Physiology, HUS Medical Diagnostic Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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Cruz MM, Pereira M. Epidemiology of Chronic Obstructive Pulmonary Disease in Brazil: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2020; 25:4547-4557. [PMID: 33175061 DOI: 10.1590/1413-812320202511.00222019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/25/2019] [Indexed: 11/22/2022] Open
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of morbidity and mortality in developing countries; however, few systematic reviews are available in the literature. This review examines the prevalence of COPD in the Brazilian population. For this purpose, a systematic review and meta-analysis was conducted of epidemiological observational studies indexed in the databases PubMed, Cochrane, Ovid, Scopus, ScienceDirect, SciELO, Lilacs, and Google Scholar published up to May 2018. The prevalence was estimated using a random effects model. Of the 1,182 articles identified, 12 were eligible. The prevalence of COPD in Brazil was 17% (95%CI: 13-22; I2 = 94%) and the region with the highest prevalence of COPD was the Center-western region (25%), followed by the Southeastern region (23%). The Southern region had the lowest prevalence among the studies (12%). We found that Brazil has a high occurrence of COPD, higher than the estimates of Latin American and world population Hence, additional studies are necessary to support intervention strategies, as well as formulation of specific public health policies to control and prevent COPD.
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Affiliation(s)
- Marina Malheiro Cruz
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Oeste da Bahia. Barreiras BA Brasil
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Basílio da Gama s/n, Campus Universitário Canela. 40110-040 Salvador BA Brasil.
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Abstract
BACKGROUND A meta-analysis was performed to evaluate the relationship between chronic obstructive pulmonary disease (COPD) and occupational dust exposure, and to provide a scientific basis for the prevention and treatment of COPD caused by occupational factors. METHODS PubMed and Embase databases were used to search for original epidemiological literature related to theme. Both random and fixed effects models were used to calculate pooled odds ratios and their corresponding 95% confidence intervals. Review Manager was used to perform data analysis. RESULTS Nine studies were included in the meta-analysis in accordance with the inclusion criteria. There was a significantly obvious correlation between occupational dust exposure and COPD of the population-based studies assessed in this article. The risk of developing COPD for workers exposed to dust was 1.51 times higher than for controls (I = 40%, 95% confidence interval: 1.27-1.79). The presence of publication bias was not found. CONCLUSION The study provided evidence supporting the association between occupational dust exposure and the risk of developing COPD.
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Affiliation(s)
- Cong Peng
- Shandong First Medical University & Shandong Academy of Medical Sciences, Taian
- Shandong Academy Occupational Health and Occupational Medicine
| | - Yongjian Yan
- Shandong Academy Occupational Health and Occupational Medicine
| | - Zhen Li
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China
| | - Yuxin Jiang
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China
| | - Yu Cai
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China
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Zhu RX, Nie XH, Chen YH, Chen J, Wu SW, Zhao LH. Relationship Between Particulate Matter (PM2.5) and Hospitalizations and Mortality of Chronic Obstructive Pulmonary Disease Patients: A Meta-Analysis. Am J Med Sci 2020; 359:354-364. [DOI: 10.1016/j.amjms.2020.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 10/24/2022]
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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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Blanc PD, Annesi-Maesano I, Balmes JR, Cummings KJ, Fishwick D, Miedinger D, Murgia N, Naidoo RN, Reynolds CJ, Sigsgaard T, Torén K, Vinnikov D, Redlich CA. The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement. Am J Respir Crit Care Med 2020; 199:1312-1334. [PMID: 31149852 PMCID: PMC6543721 DOI: 10.1164/rccm.201904-0717st] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.
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Raju S, Keet CA, Paulin LM, Matsui EC, Peng RD, Hansel NN, McCormack MC. Rural Residence and Poverty Are Independent Risk Factors for Chronic Obstructive Pulmonary Disease in the United States. Am J Respir Crit Care Med 2020; 199:961-969. [PMID: 30384774 DOI: 10.1164/rccm.201807-1374oc] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
RATIONALE In developing countries, poor and rural areas have a high burden of chronic obstructive pulmonary disease (COPD), and environmental pollutants and indoor burning of biomass have been implicated as potential causal exposures. Less is known about the prevalence of COPD in the United States with respect to urban-rural distribution, poverty, and factors that uniquely contribute to COPD among never-smokers. OBJECTIVES To understand the impact of urban-rural status, poverty, and other community factors on COPD prevalence nationwide and among never-smokers. METHODS We studied a nationally representative sample of adults in the National Health Interview Survey 2012-2015, with data linkage between neighborhood data from the U.S. Census's American Community Survey and the National Center for Health Statistics Urban-Rural Classification Scheme. The main outcome was COPD prevalence. MEASUREMENTS AND MAIN RESULTS The prevalence of COPD in poor, rural areas was almost twice that in the overall population (15.4% vs. 8.4%). In adjusted models, rural residence (odds ratio [OR], 1.23; P < 0.001) and census-level poverty (OR, 1.12; P = 0.012) were both associated with COPD prevalence, as were indicators of household wealth. Among never-smokers, rural residence was also associated with COPD (OR, 1.34; P < 0.001), as was neighborhood use of coal for heating (OR, 1.09; P < 0.001). CONCLUSIONS In a nationally representative sample, rural residence and poverty were risk factors for COPD, even among never-smokers. The use of coal for heating was also a risk factor for COPD among never-smokers. Future disparities research to elucidate contributors to COPD development in poor and rural areas, including assessments of heating sources and environmental pollutants, is needed.
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Affiliation(s)
| | | | - Laura M Paulin
- 1 Department of Medicine and.,3 Department of Environmental Health Sciences and
| | | | - Roger D Peng
- 4 Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Nadia N Hansel
- 1 Department of Medicine and.,3 Department of Environmental Health Sciences and
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Vinnikov D, Raushanova A, Kyzayeva A, Romanova Z, Tulekov Z, Kenessary D, Auyezova A. Lifetime Occupational History, Respiratory Symptoms and Chronic Obstructive Pulmonary Disease: Results from a Population-Based Study. Int J Chron Obstruct Pulmon Dis 2019; 14:3025-3034. [PMID: 31920299 PMCID: PMC6941608 DOI: 10.2147/copd.s229119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/02/2019] [Indexed: 01/29/2023] Open
Abstract
Purpose To ascertain the effect of lifelong occupational history, ambient air pollution, and biochemically verified smoking status on chronic obstructive pulmonary disease (COPD) in a general population of one the largest cities in Central Asia, Almaty. Patients and methods 1500 adults (median age 49, interquartile range (IQR) 28 years), 50% females, were randomly selected from a registry of enlisted population of a primary care facility in Almaty, Kazakhstan and they filled in the questionnaire on demographics, respiratory symptoms (CAT and mMRC), smoking status, verified by exhaled carbon monoxide, and detailed lifetime occupational history. COPD was defined as postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) below lower limit of normal (LLN) using Belintelmed MAS-2 spirometer (Belarus). Results 230 (15%) subjects had CAT≥10; 136 (9%) participants had mMRC score ≥2. Greater CAT score was associated with age, smaller income, and less exercise, but not with smoking or living closer to a major road. 26% of the population was ever exposed to vapors, gases, dusts, and fumes (VGDF). In age group 40 years and above (N=1024), COPD was found in 57 participants (prevalence 5.6%), more in men (8.7% vs 3.4%). In the multivariate model adjusted for age, sex, ever-smoking, income, and exercise, any exposure to VGDF increased the odds of COPD (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.03; 2.84), more in the highest exposure category (OR 2.36 (95% CI 1.20; 4.66)). Conclusion Lifetime exposure to VGDF, found in ¼ of the general population, increased the odds of COPD independent of smoking by 71%.
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Affiliation(s)
- Denis Vinnikov
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, al-Farabi Kazakh National University, Almaty, Kazakhstan.,Biological Institute, National Research Tomsk State University, Tomsk, Russian Federation.,Department of Biochemistry, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Aizhan Raushanova
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Aizhan Kyzayeva
- Department of Biostatistics, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanna Romanova
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Zhangir Tulekov
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Dinara Kenessary
- Department of General Hygiene and Ecology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Ardak Auyezova
- Department of Healthcare Management, KSPH Kazakhstan Medical University, Almaty, Kazakhstan
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Saussereau J, Guillien A, Soumagne T, Laplante JJ, Laurent L, Bouhaddi M, Rocchi S, Annesi-Maesano I, Roche N, Dalphin JC, Degano B. Dietary Patterns and Prevalence of Post-bronchodilator Airway Obstruction in Dairy Farmers Exposed to Organic Dusts. COPD 2019; 16:118-125. [PMID: 31298600 DOI: 10.1080/15412555.2019.1631775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Exposure to organic dusts is an independent causative factor of chronic obstructive pulmonary disease (COPD). Unhealthy dietary patterns have been associated with poor lung function in smokers. This study investigated whether dietary patterns were associated with post-bronchodilator airway obstruction, a hallmark of COPD, in dairy farmers exposed to organic dusts. All subjects were identified by screening programs and patients with airflow obstruction were matched with subjects with normal spirometry. Six groups were compared, defined by their exposures (non-smoking dairy farmers, smokers ≥ 10 pack-years with no occupational exposure, and smoking dairy farmers) and the presence or absence of post-bronchodilator airflow obstruction, resulting in 321 study subjects. The Alternative Healthy Eating Index (AHEI) score was calculated based on an adapted food frequency questionnaire. Mean total AHEI scores were similar in all groups. Comparison between smokers with post-bronchodilator airway obstruction and subjects with post-bronchodilator airway obstruction related to occupational exposure found minimal differences in dietary patterns: dairy farmers had lower scores for the ratio of white to red meat and higher scores for cereal fiber consumption. As in previous studies, smokers with post-bronchodilator airway obstruction exhibited higher lipid intakes and lower carbohydrate intakes than their counterparts with normal spirometry. No evidence of any meaningful difference in dietary patterns was found between subjects with post-bronchodilator airway obstruction detected by screening and healthy controls, either in dairy farmers or in smokers with no occupational exposure.
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Affiliation(s)
- Julien Saussereau
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,b Service de Pneumologie, CHRU , Besançon , France
| | - Alicia Guillien
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,c EA 3920, Université de Franche-Comté , Besançon , France
| | | | | | - Lucie Laurent
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,b Service de Pneumologie, CHRU , Besançon , France
| | - Malika Bouhaddi
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,c EA 3920, Université de Franche-Comté , Besançon , France
| | - Steffi Rocchi
- e UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques, University of Bourgogne Franche-Comté , Besançon , France.,f Department of Parasitology-Mycology, University Hospital , Besancon , France
| | - Isabella Annesi-Maesano
- g Epidémiologie des Maladies Respiratoires et Allergiques (EPAR), i-PLESP INSERM and UPMC, Medical School Saint-Antoine , Paris , France
| | - Nicolas Roche
- h Service de Pneumologie et Soins Intensifs Respiratoires, Groupe Hospitalier Cochin, AP-HP and Université Paris Descartes (EA2511), Sorbonne-Paris-Cité , Paris , France
| | - Jean-Charles Dalphin
- b Service de Pneumologie, CHRU , Besançon , France.,e UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques, University of Bourgogne Franche-Comté , Besançon , France
| | - Bruno Degano
- i Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes , Grenoble , France.,j Laboratoire HP2, INSERM U1042, Université Grenoble Alpes , Grenoble , France
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van der Molen HF, Hulshof CT, Kuijer PPF. How to improve the assessment of the impact of occupational diseases at a national level? The Netherlands as an example. Occup Environ Med 2018; 76:30-32. [PMID: 30297528 PMCID: PMC6327862 DOI: 10.1136/oemed-2018-105387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/11/2018] [Accepted: 09/23/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To explore the impact of occupational diseases (ODs) through estimations of population attributable fractions (PAFs) in a national context. METHODS PAFs were calculated for eight prevalent ODs using existing data on the prevalence of exposure to risk factors at work and the strength of their association with diseases based on systematic reviews. Six systematic reviews with meta-analyses and two overview papers were selected. All addressed the relationship between occupational exposure to work-related risk factors for these eight prevalent ODs. Prevalence figures for exposure to work-related risk factors were retrieved from the Dutch National Working Conditions Survey (NWCS) based on self-reports by approximately 40 000 workers. The specific risk factors retrieved from the reviews were matched with the available and dichotomised self-reported exposure items from the NWCS by two authors. RESULTS The eight frequently reported ODs among the Dutch working population revealed PAFs varying between 3% and 25%. Lateral epicondylitis and distress/burnout had the highest attributable fractions, with percentages of 25% and 18%, respectively. For knee osteoarthritis (13%), shoulder soft tissue disorders (10%) and non-specific low back pain (10%) approximately 1 in 10 cases were attributable to work. PAFs for irritant contact dermatitis, noise-induced hearing loss and chronic obstructive pulmonary disease were 15%, 6% and 3%, respectively. CONCLUSION Data from systematic reviews and self-reported data on exposure provide opportunities to estimate the impact of ODs. For the Netherlands, they revealed substantial and varying attributions of work for prevalent diseases.
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Affiliation(s)
- Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Carel Tj Hulshof
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - P Paul Fm Kuijer
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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van der Molen HF, de Groene GJ, Hulshof CTJ, Frings-Dresen MHW. Association between Work and Chronic Obstructive Pulmonary Disease (COPD). J Clin Med 2018; 7:E335. [PMID: 30304764 PMCID: PMC6210126 DOI: 10.3390/jcm7100335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 12/25/2022] Open
Abstract
To support occupational physicians in their assessment and notification of occupational diseases, diagnostic registration guidelines are developed with information about associations between work-related risk factors and diseases. The objective of this review of systematic reviews is to examine whether work-related risk factors are associated with chronic pulmonary obstructive disease (COPD). We searched the electronic database of Medline for systematic reviews published between 1 January 2009 and 20 June 2017. Reviews were included when COPD was assessed by data on lung function and when work-related exposures to vapors, dusts, gases, or fumes (VDGF) were described. One author selected studies and extracted data; two authors assessed study quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). In all eight systematic reviews included, various exposures to vapors, dusts, gases, and fumes (VGDF) at work are associated with COPD. Two-thirds of the included studies are cross-sectional and show a high heterogeneity in population, setting, and mostly self-reported-exposures. Two high-quality reviews (AMSTAR score ≥ 9) including meta-analyses show associations and excess risk of COPD for work-related general exposure to VDGF with a summary odds ratio of 1.4 (95% confidence interval (CI) 1.19⁻1.73) and to inorganic dust with a mean difference in predicted forced expiratory volume in one second (FEV₁) of -5.7% (95% CI: -8.62% to -2.71%). Exposure to VGDF at work is associated with a small but increased risk of COPD. More detailed workplace measurements of specific VGDF are warranted to gain an insight into dose⁻response relationships.
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Affiliation(s)
- H F van der Molen
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - G J de Groene
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - C T J Hulshof
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - M H W Frings-Dresen
- Amsterdam UMC, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
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Guillien A, Laurent L, Soumagne T, Puyraveau M, Laplante JJ, Andujar P, Annesi-Maesano I, Roche N, Degano B, Dalphin JC. Anxiety and depression among dairy farmers: the impact of COPD. Int J Chron Obstruct Pulmon Dis 2017; 13:1-9. [PMID: 29296078 PMCID: PMC5741076 DOI: 10.2147/copd.s143883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) and farming are two conditions that have been associated with an increased risk of anxiety and depression. Dairy farming is an independent risk factor for COPD. Objective To test the hypotheses that the prevalence of anxiety and/or depression is higher in dairy farmers with COPD than in farmers without COPD, and higher in dairy farmers with COPD than in non-farmers with COPD. Methods Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale in 100 dairy farmers with COPD (DF-COPD), 98 dairy farmers without COPD (DF-controls), 85 non-farming patients with COPD (NF-COPD) and 89 non-farming subjects without COPD (NF-controls), all identified by screening in the Franche-Comté region of France. Anxiety and depression were considered present when the Hospital Anxiety and Depression Scale score was ≥8. COPD was defined by a post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio <0.7. Results The crude prevalence of anxiety did not differ between the four groups, ranging from 36% in NF-controls to 47% in NF-COPD (p=0.15 between groups). Similarly, the prevalence of depression did not differ significantly between the four groups (p=0.16 between groups). In dairy farmers (n=198), the only factors associated with anxiety were quality of life and current smoking. Depression in dairy farmers was associated with airflow limitation (lower forced expiratory volume in 1 second and COPD grade 2 or more) as well as with some COPD-related features (dyspnea severity, current smoking, and poorer quality of life). In non-farmers, both anxiety and depression were associated with airflow limitation and COPD-related features. Conclusion In our population, the prevalence of anxiety and/or depression was similar in dairy farmers with and without COPD and in non-farmers with COPD. Nevertheless, the degree of airway obstruction and some COPD-related features were associated with depression among dairy farmers, whereas these factors were not associated with anxiety.
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Affiliation(s)
- Alicia Guillien
- Research Unit EA 3920, Franche-Comté University, Besançon, France
| | - Lucie Laurent
- Department of Clinical Physiology, University Hospital, Besançon, France
| | - Thibaud Soumagne
- Department of Respiratory Diseases, University Hospital, Besançon, France
| | - Marc Puyraveau
- Clinical Methodology Center, University Hospital, Besançon, France
| | | | - Pascal Andujar
- University of Medical Sciences, Paris-est Créteil University, Créteil, France
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris, France
| | - Nicolas Roche
- Respiratory and Intensive Care Medicine, Cochin Hospital (AP-HP), University Paris Descartes, Paris, France.,Research Unit EA 2511, University Paris Descartes, Paris, France
| | - Bruno Degano
- Research Unit EA 3920, Franche-Comté University, Besançon, France
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23
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Hoy RF, Brims F. Occupational lung diseases in Australia. Med J Aust 2017; 207:443-448. [PMID: 29129163 DOI: 10.5694/mja17.00601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/15/2017] [Indexed: 01/19/2023]
Abstract
Occupational exposures are an important determinant of respiratory health. International estimates note that about 15% of adult-onset asthma, 15% of chronic obstructive pulmonary disease and 10-30% of lung cancer may be attributable to hazardous occupational exposures. One-quarter of working asthmatics either have had their asthma caused by work or adversely affected by workplace conditions. Recently, cases of historical occupational lung diseases have been noted to occur with new exposures, such as cases of silicosis in workers fabricating kitchen benchtops from artificial stone products. Identification of an occupational cause of a lung disease can be difficult and requires maintaining a high index of suspicion. When an occupational lung disease is identified, this may facilitate a cure and help to protect coworkers. Currently, very little information is collected regarding actual cases of occupational lung diseases in Australia. Most assumptions about many occupational lung diseases are based on extrapolation from overseas data. This lack of information is a major impediment to development of targeted interventions and timely identification of new hazardous exposures. All employers, governments and health care providers in Australia have a responsibility to ensure that the highest possible standards are in place to protect workers' respiratory health.
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Dzhambov AM, Dimitrova DD. Self-reported occupational noise may be associated with prevalent chronic obstructive pulmonary disease in the us general population. Noise Health 2017; 19:115-124. [PMID: 28615541 PMCID: PMC5501021 DOI: 10.4103/nah.nah_51_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: Occupational noise exposure and chronic obstructive pulmonary disease (COPD) are common in the United States, but so far their association has not been explored. Given the neuroimmunological effects of noise, such an association seems plausible. Thus, the present study aimed to explore the association of occupational noise exposure with prevalent COPD in the US general population. Materials and Methods: We used data from the population-based National Health Interview Survey (NHIS) 2014. The cross-sectional association of self-reported duration of exposure to very loud noise during participants’ occupational lifetime with self-reported COPD and emphysema was explored using weighted logistic regression. Results and Discussion: The fully adjusted model yielded odds ratio (OR)≥15 years = 1.68 [95% confidence interval (CI): 1.28, 2.21] for COPD and OR≥15 years = 1.61 (95% CI: 1.13, 2.30) for emphysema. Race/ethnicity was a significant effect modifier. In sensitivity analysis with cumulative noise exposure based on a job exposure matrix, we found no effect. Conclusion: In conclusion, we found a relationship between self-reported occupational noise exposure and the risk of prevalent COPD in the US general population, but none with objective noise levels. Being the first study on the subject matter, and given the design limitations, these findings are tentative and should be treated with caution.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Donka D Dimitrova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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Audi C, Baïz N, Maesano CN, Ramousse O, Reboulleau D, Magnan A, Caillaud D, Annesi-Maesano I. Serum cytokine levels related to exposure to volatile organic compounds and PM 2.5 in dwellings and workplaces in French farmers - a mechanism to explain nonsmoking COPD. Int J Chron Obstruct Pulmon Dis 2017; 12:1363-1374. [PMID: 28503065 PMCID: PMC5426466 DOI: 10.2147/copd.s117866] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Although French farmers smoke less on average than individuals from the general population, they suffer more from COPD. Exposure to biological and chemical air pollutants in the farm may be the cause of these higher COPD rates. This study investigates the role of bio-contaminants, including the relationship of exposure to volatile organic compounds (VOCs) and fine particulate matter (of diameter of 2.5 µm [PM2.5]) objectively measured in the farm settings (dwellings and workplaces) to serum cytokines involved in COPD, in a sample of 72 farmers from 50 farms in the Auvergne region, France. Mean concentrations of VOCs were highest inside the home, while levels of PM2.5 were highest in workplaces (stables and granaries). After adjusting for confounders, high exposure to PM2.5 was significantly associated with a decreased level of serum cytokines (among others, IL13: β: −0.94, CI: −1.5 to −0.2, P-value =0.004; IL8: β: −0.82, CI: −1.4 to −0.2, P-value =0.005) and high exposure to VOCs according to a VOC global score with a decreased IL13 level (β: −0.5, CI: −0.9 to −0.1, P-value =0.01). Moreover, respiratory symptoms and diseases, including COPD, were associated with a decreased level of serum cytokines significantly in the case of IL5. An alteration of immune response balance in terms of cytokine levels in relation to indoor chemical air pollution exposure may contribute to respiratory health impairment in farmers.
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Affiliation(s)
- Christelle Audi
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
| | - Nour Baïz
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
| | - Cara N Maesano
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
| | | | - Damien Reboulleau
- Centre du Thorax de Nantes INSERM, UMR1087, Institut du thorax, Nantes
| | - Antoine Magnan
- Centre du Thorax de Nantes INSERM, UMR1087, Institut du thorax, Nantes
| | - Denis Caillaud
- Respiratory Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, Auvergne, France
| | - Isabella Annesi-Maesano
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
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Ziraba AK, Haregu TN, Mberu B. A review and framework for understanding the potential impact of poor solid waste management on health in developing countries. ACTA ACUST UNITED AC 2016; 74:55. [PMID: 28031815 PMCID: PMC5184495 DOI: 10.1186/s13690-016-0166-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/16/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The increase in solid waste generated per capita in Africa has not been accompanied by a commensurate growth in the capacity and funding to manage it. It is reported that less than 30% of urban waste in developing countries is collected and disposed appropriately. The implications of poorly managed waste on health are numerous and depend on the nature of the waste, individuals exposed, duration of exposure and availability of interventions for those exposed. OBJECTIVE To present a framework for understanding the linkages between poor solid waste management, exposure and associated adverse health outcomes. The framework will aid understanding of the relationships, interlinkages and identification of the potential points for intervention. METHODS Development of the framework was informed by a review of literature on solid waste management policies, practices and its impact on health in developing countries. A configurative synthesis of literature was applied to develop the framework. Several iterations of the framework were reviewed by experts in the field. Each linkage and outcomes are described in detail as outputs of this study. RESULT The resulting framework identifies groups of people at a heightened risk of exposure and the potential health consequences. Using the iceberg metaphor, the framework illustrates the pathways and potential burden of ill-health related to solid waste that is hidden but rapidly unfolding with our inaction. The existing evidence on the linkage between poor solid waste management and adverse health outcomes calls to action by all stakeholders in understanding, prioritizing, and addressing the issue of solid waste in our midst to ensure that our environment and health are preserved. CONCLUSION A resulting framework developed in this study presents a clearer picture of the linkages between poor solid waste management and could guide research, policy and action.
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Affiliation(s)
- Abdhalah K Ziraba
- African Population and Health Research Center, P. O. Box 10787-00100, Nairobi, Kenya
| | - Tilahun Nigatu Haregu
- African Population and Health Research Center, P. O. Box 10787-00100, Nairobi, Kenya
| | - Blessing Mberu
- African Population and Health Research Center, P. O. Box 10787-00100, Nairobi, Kenya
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Alif SM, Dharmage SC, Bowatte G, Karahalios A, Benke G, Dennekamp M, Mehta AJ, Miedinger D, Künzli N, Probst-Hensch N, Matheson MC. Occupational exposure and risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis. Expert Rev Respir Med 2016; 10:861-72. [PMID: 27187563 DOI: 10.1080/17476348.2016.1190274] [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: 12/18/2022]
Abstract
INTRODUCTION Due to contradictory literature we have performed a systematic review and meta-analyse of population-based studies that have used Job Exposure Matrices to assess occupational exposure and risk of Chronic Obstructive Pulmonary Disease (COPD). AREAS COVERED Two researchers independently searched databases for published articles using predefined inclusion criteria. Study quality was assessed, and results pooled for COPD and chronic bronchitis for exposure to biological dust, mineral dust, and gases/fumes using a fixed and random effect model. Five studies met predetermined inclusion criteria. The meta-analysis showed low exposure to mineral dust, and high exposure to gases/fumes were associated with an increased risk of COPD. We also found significantly increased the risk of chronic bronchitis for low and high exposure to biological dust and mineral dust. Expert commentary: The relationship between occupational exposure assessed by the JEM and the risk of COPD and chronic bronchitis shows significant association with occupational exposure. However, the heterogeneity of the meta-analyses suggests more wide population-based studies with older age groups and longitudinal phenotype assessment of COPD to clarify the role of occupational exposure to COPD risk.
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Affiliation(s)
- Sheikh M Alif
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia
| | - Shyamali C Dharmage
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.,b Population Health , Murdoch Childrens Research Institute , Melbourne , VIC , Australia
| | - Gayan Bowatte
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia
| | - Amalia Karahalios
- c Biostatistics Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia
| | - Geza Benke
- d Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , VIC , Australia
| | - Martine Dennekamp
- d Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , VIC , Australia
| | - Amar J Mehta
- e Department of Environmental Health, Harvard T.H.Chan School of Public Health , Harvard University , Boston , MA , USA
| | - David Miedinger
- f Clinic of Internal Medicine , Kantonsspital Baselland , Liestal , Switzerland.,h Medical Faculty , University of Basel , Basel , Switzerland
| | - Nino Künzli
- g Department of Epidemiology and Public Health , Swiss Tropical and Public Health Institute , Basel , Switzerland.,h Medical Faculty , University of Basel , Basel , Switzerland
| | - Nicole Probst-Hensch
- g Department of Epidemiology and Public Health , Swiss Tropical and Public Health Institute , Basel , Switzerland.,h Medical Faculty , University of Basel , Basel , Switzerland
| | - Melanie C Matheson
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health , The University of Melbourne , Melbourne , VIC , Australia.,b Population Health , Murdoch Childrens Research Institute , Melbourne , VIC , Australia
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28
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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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29
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Guillien A, Puyraveau M, Soumagne T, Guillot S, Rannou F, Marquette D, Berger P, Jouneau S, Monnet E, Mauny F, Laplante JJ, Dalphin JC, Degano B. Prevalence and risk factors for COPD in farmers: a cross-sectional controlled study. Eur Respir J 2015; 47:95-103. [PMID: 26453630 DOI: 10.1183/13993003.00153-2015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 07/29/2015] [Indexed: 02/03/2023]
Abstract
There are conflicting data regarding the magnitude and determinants of chronic obstructive pulmonary disease (COPD) risk in farmers.In a cross-sectional study of 917 nonfarming working controls and 3787 farmers aged 40-75 years, we assessed respiratory symptoms, tobacco exposure, job history (without direct exposure measurement) and lung function. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.70) and by the Quanjer reference equation (post-bronchodilator FEV1/FVC <lower limit of normal (LLN)).The prevalence (95% CI) of COPD according to the GOLD criterion was 5.1% (4.4-5.8%) and 2.9% (1.8-4.0%) in farmers and controls, respectively (p=0.005), and 3.1% (2.5-3.6%) and 1.5% (0.7-2.3%), respectively, for the LLN criterion (p<0.01). For both COPD criteria after adjustment for age, sex and smoking status, COPD prevalence was similar in controls and crop farmers. Compared to controls, four job categories had a higher prevalence of COPD according to the GOLD criterion, namely, cattle breeders, swine breeders, poultry breeders and breeders of two or more livestock types. Among cattle breeders, only those from Franche-Comté had higher prevalence of COPD according to both GOLD and LLN criteria.The prevalence of COPD in farmers is higher than in nonfarming working controls, and depends on the farming activity, the region and the criterion used to define COPD.
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Affiliation(s)
- Alicia Guillien
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France
| | | | - Thibaud Soumagne
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France Service de Pneumologie, CHRU, Besançon, France
| | - Stéphanie Guillot
- Service d'Explorations Fonctionnelles Respiratoires, CHRU, Rennes, France
| | - Fabrice Rannou
- Service d'Explorations Fonctionnelles Respiratoires, CHRU, Brest, France
| | - David Marquette
- Service d'Explorations Fonctionnelles Respiratoires, CHRU, Rennes, France
| | - Patrick Berger
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | | | | | | | | | - Jean-Charles Dalphin
- Service de Pneumologie, CHRU, Besançon, France Unité Mixte de Recherche, Centre National de la Recherche Scientifique Chrono-Environnement, Université de Franche-Comté, Besançon, France
| | - Bruno Degano
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France EA 3920, Université de Franche-Comté, Besançon, France
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