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Aram SA, Wang H. Prevalence and associations between occupational diseases, emotional exhaustion, and dust mask anxiety among coal miners in Northern China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:122066-122086. [PMID: 37966655 DOI: 10.1007/s11356-023-30737-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
This study examined the prevalence and associations between occupational-related diseases, emotional exhaustion, and dust mask anxiety among coal miners in Northern China. The study sampled 506 miners from two coal mines in Northern China. Descriptive (frequency, percentages, and chi-square tests) and inferential (complementary log-log logistic regression) analyses were carried out to assess prevalence and associations. The prevalence of coal mining-related pulmonary diseases was 94%, with 40% and 37% reporting pneumoconiosis and bronchitis respectively. Emphysema and tuberculosis were less prevalent with a total prevalence of 5% while 12% of the miners reported two, three, or four of these diseases. For cardiovascular diseases, 66% of the miners reported 3H (hypertension, hyperlipemia, and hyperglycemia) while heart disease and cerebral infarction were reported by 6% and 2% of the miners respectively. Also, 5% and 2% of the miners reported two or all three of 3H, heart condition, and cerebral infarction. The overall prevalence of cardiovascular diseases was 81% while 82% and 63% of the miners reported experiencing some frequency of emotional exhaustion and dust mask anxiety respectively. The study also identified associations between mining-related diseases, emotional exhaustion, dust mask anxiety, and other demographic, personal habits and work-related factors. Miners with pulmonary diseases were more likely to experience emotional exhaustion and dust mask anxiety. Contrariwise, miners with cardiovascular diseases were less likely to experience dust mask anxiety. Factors such as age, engaging in physical exercises, rhinitis, source of pressure and shift system were also associated with emotional exhaustion and dust mask anxiety. These findings highlight the prevalence of occupational diseases, emotional exhaustion, and dust mask anxiety among coal miners in China. The study emphasizes the need for interventions to address health risks, improve work conditions, and support miners' well-being in the coal mining industry.
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Affiliation(s)
- Simon Appah Aram
- College of Safety and Emergency Management Engineering, Taiyuan University of Technology, Taiyuan, People's Republic of China.
- Center of Shanxi Engineering Research for Coal Mine Intelligent Equipment, Taiyuan University of Technology, Taiyuan, 030024, People's Republic of China.
| | - Hongwei Wang
- Center of Shanxi Engineering Research for Coal Mine Intelligent Equipment, Taiyuan University of Technology, Taiyuan, 030024, People's Republic of China
- College of Mechanical and Vehicle Engineering, Taiyuan University of Technology, Taiyuan, 030024, People's Republic of China
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Ren X, Bai D, Zhang Y, Lin H, Zhang S, Li D, Wei H, Yue S. Residents of Mountainous Areas Have a Higher Low Back Pain Prevalence Than Flat Areas of Chongqing, China: A Cross-Sectional Study. J Pain Res 2023; 16:1169-1183. [PMID: 37064955 PMCID: PMC10095945 DOI: 10.2147/jpr.s401894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/14/2023] [Indexed: 04/18/2023] Open
Abstract
Background and Purpose Epidemiological studies on low back pain in residents living in mountainous areas are scarce. The study was aimed at investigating the prevalence and associated factors of low back pain in Chongqing, relatively impoverished mountainous areas of China. Materials and Methods This was a cross-sectional study conducted at selected community or village health service centers in Chongqing over a 2-month period (May 2021 to June 2021), which included adults of Chongqing aged >18 years with or without low back pain (N=1820) chosen by stratified, cluster-sampling. Associated factors of low back pain including sociodemographic characteristics, lifestyle, and occupational features were collected, along with medical history, Oswestry Disability Questionnaire (ODI), and Numerical Rating Scale (NRS) of patients with low back pain, and carried out for at least 20 minutes per respondent. Univariate and multivariate logistic regression models were utilized for statistical analysis. Results Overall, 30.5% of 1704 respondents presented with low back pain, with 26.3% living in flat areas and 35.6% in mountainous areas. The associated factors of low back pain were mountainous area residence (OR 1.4, 95% CI 1.1-1.8), advanced age (OR 1.8, 95% CI 1.3-2.5 for those aged 45-59 years, OR 2.3, 95% CI 1.6-3.4 for those aged 60-74 years, and OR 2.1, 95% CI 1.2-3.6 for those aged ≥75 years), married or remarried (OR 1.9, 95% CI 1.1-3.2), divorced or widowed (OR 2.7, 95% CI 14-5.4), moderate labor intensity (OR 1.4, 95% CI 1.1-1.8), frequent stoop (OR 1.6, 95% CI 1.1-2.4), and depressed mood (OR 1.6, 95% CI 1.2-2.1). Residents in the mountainous areas had a higher score on Oswestry Disability Questionnaire (8.3 [SD 6.3] vs 6.2 [SD 4.3]) than those in flat areas. Conclusion Mountainous areas in Chongqing had higher prevalence of low back pain as 35.6%, compared with 26.3% in flat areas, with more severe dysfunction in low back pain patients. Multifactorial analysis found that the factors associated with low back pain in Chongqing residents included mountain residence, labor intensity, stoop, psychological factors and frequency of exercise.
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Affiliation(s)
- Xiaomin Ren
- Rehabilitation Center, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Dingqun Bai
- Department of Physical Medicine & Rehabilitation, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yuan Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Haidan Lin
- Department of Physical Medicine & Rehabilitation, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Shu Zhang
- Department of Physical Medicine & Rehabilitation, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Danyang Li
- Rehabilitation Center, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Hui Wei
- Rehabilitation Center, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
| | - Shouwei Yue
- Rehabilitation Center, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
- Correspondence: Shouwei Yue; Hui Wei, Rehabilitation Center, Qilu Hospital of Shandong University, Jinan, 250012, People’s Republic of China, Tel +18560086655; +18560083563, Fax +531 82166115, Email ;
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Dagestani AA, Qing L, Abou Houran M. What Remains Unsolved in Sub-African Environmental Exposure Information Disclosure: A Review. JOURNAL OF RISK AND FINANCIAL MANAGEMENT 2022; 15:487. [DOI: 10.3390/jrfm15100487] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background: Africa comprises the bulk of struggling economies. However, Sub-Saharan Africa is experiencing rapid industrialization and urbanization. Excessive resource use, pollution, and the absence of relevant environmental disclosure are factors that contribute to these human-made damages. Environmental pollution as a threat to sustainable development results from these damages. Although it has been established that Sub-Saharan Africa would benefit from resource-management development, sustainable environmental strategies, and a reduction in urbanization and persistent poverty, the information on these issues has not been made public. Objective: To provide a full account of the level of environmental-exposure disclosure in Sub-Saharan African countries, including the current level of progress, gaps, and prospects, we reviewed the literature on environmental exposure information research in African populations. Methodology: We searched PubMed and Google Scholar for peer-reviewed research articles, reviews, or books examining environmental exposure and information disclosure in human populations in Africa. Results: In total, 89 full-text articles were eligible for the inclusion criteria. A quality assessment of the retrieved articles using the PRISMA guidelines resulted in the exclusion of 40 articles; therefore, 49 studies were included in the final analysis. In Sub-Saharan Africa, the environmental exposure information on household injuries, the use of chemicals such as pesticides in farming, industry-linked vectors and diseases, laboratory chemical exposure, industrial exposure, and epigenetic factors are not well-disclosed to the population. Conclusion: Environmental information disclosure standards should be incorporated into central-government policy recommendations. Standards should identify polluting industries, and companies should refrain from the voluntary disclosure of environmental information to manage their reputation. Heavy-pollution industries should be made sufficiently transparent to lessen the company–media collusion on information disclosure.
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Yang S, Tian C, Yang F, Chen Q, Geng R, Liu C, Wu X, Lam WK. Cardiorespiratory function, resting metabolic rate and heart rate variability in coal miners exposed to hypobaric hypoxia in highland workplace. PeerJ 2022; 10:e13899. [PMID: 36061757 PMCID: PMC9438770 DOI: 10.7717/peerj.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/23/2022] [Indexed: 01/19/2023] Open
Abstract
Background Owing to intermittent/acute exposure to hypobaric hypoxia, highland miners may often suffer, the physiological characteristics between highland and lowland miners, however, are rarely reported. The objective of this study was to compare the physiological characteristics of coal miners working at disparate altitudes. Methods Twenty-three male coal mining workers acclimating to high altitude for 30 ± 6 days in Tibet (highland group; approx. 4500 m above sea level; 628.39 millibar), and 22 male coal mining workers in Hebei (lowland group; less than 100 m above sea level; 1021.82 millibar) were recruited. Tests were conducted to compare ventilatory parameters, circulation parameters, resting metabolic rate (RMR), and heart rate variability (HRV) indices between the two groups in resting state. Results Ventilation volume per minute (VE) of the highland group was markedly raised compared to that of the lowland group (11.70 ± 1.57 vs. 8.94 ± 1.97 L/min, p = 0.000). In the meanwhile, O2 intake per heart beat (VO2/HR) was strikingly decreased (3.54 ± 0.54 vs. 4.36 ± 0.69 ml/beat, p = 0.000). Resting metabolic rate relevant to body surface area (RMR/BSA) was found no significant difference between the two groups. Evident reduction in standard deviation of NN intervals (SDNN) and remarkable increase in ratio of low- and high- frequency bands (LF/HF) were manifest in highland miners compared to that of lowland ones (110.82 ± 33.34 vs. 141.44 ± 40.38, p = 0.008 and 858.86 ± 699.24 vs. 371.33 ± 171.46, p = 0.003; respectively). Conclusions These results implicate that long-term intermittent exposure to high altitude can lead miners to an intensified respiration, a compromised circulation and a profound sympathetic-parasympathetic imbalance, whereas the RMR in highland miners does not distinctly decline.
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Affiliation(s)
- Sanjun Yang
- Department of Physical Education, China University of Mining and Technology-Beijing, Beijing, China
| | - Chunhu Tian
- Department of Physical Education, China University of Mining and Technology-Beijing, Beijing, China
| | - Fan Yang
- Sports Science Research Center, Li Ning Center, Beijing, China
| | - Qi Chen
- The University of International Business and Economics, Beijing, China
| | - Ruiyuan Geng
- Department of Physical Education, China University of Mining and Technology-Beijing, Beijing, China
| | - Chunyan Liu
- The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xinrong Wu
- School of Emergency Management and Safety Engineering, China University of Mining and Technology-Beijing, Beijing, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Sha Tin, Hong Kong, China
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Pulmonary Capacity, Blood Composition and Metabolism among Coal Mine Workers in High- and Low-Altitude Aboveground and Underground Workplaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148295. [PMID: 35886146 PMCID: PMC9318192 DOI: 10.3390/ijerph19148295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
(1) Background: While previous studies revealed how underground mining might adversely affect the cardiopulmonary functions of workers, this study further investigated the differences between under- and aboveground mining at both high and low altitudes, which has received little attention in the literature. (2) Methods: Seventy-one healthy male coal mine workers were recruited, who had worked at least 5 years at the mining sites located above the ground at high (>3900 m; n = 19) and low (<120 m; n = 16) altitudes as well as under the ground at high (n = 20) and low (n = 16) altitudes. Participants’ heart rates, pulmonary functions, total energy expenditure and metabolism were measured over a 5-consecutive-day session at health clinics. (3) Results: Combining the results for both above- and underground locations, workers at high-altitude mining sites had significantly higher peak heart rate (HR), minimum average HR and training impulse as well as energy expenditure due to all substances and due to fat than those at low-altitude sites. They also had significantly higher uric acid, total cholesterol, creatine kinase and N-osteocalcin in their blood samples than the workers at low-altitude mining sites. At underground worksites, the participants working at high-altitude had a significantly higher average respiratory rate than those at low-altitude regions. (4) Conclusion: In addition to underground mining, attention should be paid to high-altitude mining as working under a hypoxia condition at such altitude likely presents physiological challenges.
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POLAT E, İNANÇ İH, ŞABANOĞLU C. The effect of altitude difference on gastrointestinal bleeding in the chronic period. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1033697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Calderon-Jofre R, Moraga D, Moraga FA. The Effect of Chronic Intermittent Hypobaric Hypoxia on Sleep Quality and Melatonin Serum Levels in Chilean Miners. Front Physiol 2022; 12:809360. [PMID: 35222064 PMCID: PMC8864145 DOI: 10.3389/fphys.2021.809360] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
High-altitude mining is an important economic resource for Chile. These workers are exposed to chronic intermittent hypobaric hypoxia (CIHH), which reduces their sleep quality and increases the risk of accidents and long-term illnesses. Melatonin, a hormone produced by the pineal gland, is a sleep inducer that regulates the circadian cycle and may be altered in populations subjected to CIHH. This work aimed to assess the relationship between altitude, sleep quality, and plasma melatonin concentrations in miners with CIHH exposure. 288 volunteers were recruited from five altitudes (0, 1,600, 2,500, 3,500, and 4,500 m). All volunteers worked for 7 days at altitude, followed by 7 days of rest at sea level. We performed anthropometric assessments, nocturnal oximetry, sleep quality and sleepiness surveys, and serum melatonin levels upon awakening. Although oxygen saturation progressively decreased and heart rate increased at higher altitudes, subjective perception of sleep quality was not significantly different, and sleepiness increased in all groups compared to population at sea level. Similarly, melatonin levels increased at all assessed altitudes compared to the population at sea level. These data confirm that sleep disturbances associated with CIHH increase morning melatonin levels. Therefore, this hormone and could potentially serve as a biomarker of sleep quality.
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Affiliation(s)
- Rodrigo Calderon-Jofre
- Laboratorio de Fisiología, Hipoxia y Función Vascular, Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Daniel Moraga
- Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile
| | - Fernando A. Moraga
- Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile
- *Correspondence: Fernando A. Moraga,
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Korneeva Y. The Adverse Environmental Impact Factors Analysis on Fly-In-Fly-Out Personnel at Industrial Enterprises. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020997. [PMID: 35055818 PMCID: PMC8776049 DOI: 10.3390/ijerph19020997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: the research purpose is to identify and describe the general and different factors of adverse environmental impact on FIFO personnel at industrial enterprises at different levels of differential analysis of professional activity. (2) Methods: The research involved 359 employees of industrial enterprises with FIFO work organization. The study was carried out using a questionnaire, including a subjective assessment of the discomfort of three groups of negative environment impact factors to the FIFO personnel: climatic-geographical, industrial and social. (3) Results: The relationship between the increase in the degree of discomfort of production factors due to the in-fluence of climatic, geographical and social conditions has been established. With a various location of objects, the greatest discomfort is felt from the action of climatic and production factors; with varying degrees of group isolation and the shift period duration—all three groups, with the greatest influence of domestic and social; in various industries and enterprises—all three groups. (4) Conclusions: The differential analysis of the professional activities of FIFO personnel of industrial enterprises should be carried out at the following levels: the location of an industrial facility, the degree of group isolation, the duration of the shift period, the industry, the type of enterprise and the professional group.
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Affiliation(s)
- Yana Korneeva
- Department of Psychology, Northern (Arctic) Federal University, 163002 Arkhangelsk, Russia
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Muñoz S, Nazzal C, Jimenez D, Frenz P, Flores P, Alcantara-Zapata D, Marchetti N. Health Effects of Chronic Intermittent Hypoxia at a High Altitude among Chilean Miners: Rationale, Design, and Baseline Results of a Longitudinal Study. Ann Work Expo Health 2021; 65:908-918. [PMID: 34435202 DOI: 10.1093/annweh/wxab029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/09/2021] [Accepted: 03/31/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study aims to assess the health effects on mining workers of exposure to chronic intermittent hypoxia (CIH) at high- and very high-altitude mining compared with similar work at lower altitudes in Chile, and it also aims to constitute the baseline of a 5-year follow-up study. METHODS We designed a cross-sectional study to assess health conditions in 483 miners working at 2 levels of altitude exposure: 336 working at a very high or high altitude (HA; 247 above 3900-4400 m, and 89 at 3000-3900 m), and 147 below 2400 m. Subjects were randomly selected in two stages. First, a selection of mines from a census of mines in each altitude stratum was made. Secondly, workers with less than 2 years of employment at each of the selected mines were recruited. The main outcomes measured at the baseline were mountain sickness, sleep alterations, hypertension, body mass index, and neurocognitive functions. RESULTS Prevalence of acute mountain sickness (AMS) was 28.4% in the very high-altitude stratum (P = 0.0001 compared with the low stratum), and 71.7% experienced sleep disturbance (P = 0.02). The adjusted odds ratio for AMS was 9.2 (95% confidence interval: 5.2-16.3) when compared with the very high- and low-altitude groups. Motor processing speed and spatial working memory score were lower for the high-altitude group. Hypertension was lower in the highest-altitude subjects, which may be attributed to preoccupational screening even though this was not statistically significant. CONCLUSIONS Despite longer periods of acclimatization to CIH, subjects continue to present AMS and sleep disturbance. Compromise of executive functions was detected, including working memory at HA. Further rigorous research is warranted to understand long-term health impacts of high-altitude mining, and to provide evidence-based policy recommendations.
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Affiliation(s)
- Sergio Muñoz
- Department of Public Health-CIGES, Faculty of Medicine, Universidad de La Frontera, 01145 Av. Francisco Salazar, Casilla 54-D, Temuco, Chile
| | - Carolina Nazzal
- Program of Occupational Health, School of Public Health, Faculty of Medicine, University of Chile, 939 Av. Independencia, Santiago, Chile
| | - Daniel Jimenez
- Program of Occupational Health, School of Public Health, Faculty of Medicine, University of Chile, 939 Av. Independencia, Santiago, Chile
| | - Patricia Frenz
- Program of Occupational Health, School of Public Health, Faculty of Medicine, University of Chile, 939 Av. Independencia, Santiago, Chile
| | - Patricia Flores
- Faculty of Medicine, Psychiatry Department, Catholic University of Chile, 12351 Camino El Alba, Las Condes, Santiago, Chile.,Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Avenida Vitacura 5951, Región Metropolitana de Santiago, Santiago de Chile, Chile
| | - Diana Alcantara-Zapata
- Program of Occupational Health, School of Public Health, Faculty of Medicine, University of Chile, 939 Av. Independencia, Santiago, Chile
| | - Nella Marchetti
- Program of Occupational Health, School of Public Health, Faculty of Medicine, University of Chile, 939 Av. Independencia, Santiago, Chile
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Mining Industry Impact on Environmental Sustainability, Economic Growth, Social Interaction, and Public Health: An Application of Semi-Quantitative Mathematical Approach. Processes (Basel) 2021. [DOI: 10.3390/pr9060972] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The mining industry plays a significant role in economic growth and development. Coal is a viable renewable energy source with 185.175 billion deposits in Thar, which has not been deeply explored. Although coal is an energy source and contributes to economic development, it puts pressure on environmental sustainability. The current study investigates Sindh Engro coal mining’s impact on environmental sustainability and human needs and interest. The Folchi and Phillips Environmental Sustainability Mathematics models are employed to measure environmental sustainability. The research findings demonstrated that Sindh Engro coal mining is potentially unsustainable for the environment. The toxic gases (methane, carbon dioxide, sulfur, etc.) are released during operational activities. The four significant environment spheres (atmosphere, hydrosphere, biosphere, and lithosphere) are negatively influenced by Thar coal mining. The second part of the analysis results shows that human needs and interests have a positive and significant relationship except for human health and safety with Sindh Engro coal mining. Environmental pollution can be controlled by utilizing environmentally friendly coal mining operations and technologies. Plantation and ecological normalization can protect the species, flora, and fauna of the Thar Desert. The government of Pakistan and the provincial government of Sind should strictly check the adaptation of environmental standards. Furthermore, the researchers should explore the environmental issues and solutions so that coal mining becomes a cost-efficient and environmental-friendly energy source in Pakistan.
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Pedreros-Lobos A, Calderón-Jofré R, Moraga D, Moraga FA. Cardiovascular Risk Is Increased in Miner's Chronic Intermittent Hypobaric Hypoxia Exposure From 0 to 2,500 m? Front Physiol 2021; 12:647976. [PMID: 33841183 PMCID: PMC8032972 DOI: 10.3389/fphys.2021.647976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
Over the past 40 years, mining activities in Chile have relocated miners who normally live at sea level to work at high altitudes. This results in a form of chronic intermittent hypobaric hypoxia (CIHH) characterized by alternating periods of work at high altitude and rest periods at sea level. Previous studies performed in our laboratory showed that aerobic capacity is reduced at 3,800 m, even when oxygen content is maintained. Our study aimed to determine the corporal composition, food intake, maximum oxygen uptake, and concentration of high sensitivity C reactive protein (hsCRP) in an acclimatized miner population that work from 0 to 2,500 m with CIHH exposure over 4 years. All miners recruited for our study were operators of heavy trucks with CIHH for over 4 years (shiftwork 7*7 days), and our experimental population was composed of 54 miners at sea level, 61 at 1,600 m, and 38 at 2,500 m. All evaluations were performed on the 3rd or 4th day of diurnal shiftwork. To determine corporal composition, we measured weight and height (to calculate body mass index, BMI), skinfolds (to calculate body fatty, BF), and waist circumference (WC); maximal aerobic capacity was evaluated using a ramp-incremental cycling to exhaustion protocol and a venous blood sample before the exercise test to measure (hsCRP) via an ELISA test. We found higher values of BMI, BF, and WC, in the miners' population but observed no significant difference between populations. We found a decrease in VO2 of 11.6% at 1,600 m and 25.9% at 2,500 m compared to miners at sea level. An increase in (hsCRP) at 1,600 and 2,500 m regards sea level. We observed a high prevalence of overweight and obese subjects, which was related to the ad libitum availability of food and low physical activity (sedentarism). We found that work capacity was maintained despite a decreased VO2 max at moderate altitude. However, overweight and obesity support an increased risk of cardiometabolic disease in miner's which is unrelated to altitude. In contrast, an increased hsCRP level could be associated with increased inflammatory mechanisms at 1,600 and 2,500 m.
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Affiliation(s)
- Andrés Pedreros-Lobos
- Laboratorio de Fisiología, Hipoxia y Función Vascular, Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Rodrigo Calderón-Jofré
- Laboratorio de Fisiología, Hipoxia y Función Vascular, Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile.,Departamento de Ciencias Básicas, Universidad Central La Serena, La Serena, Chile
| | - Daniel Moraga
- Departamento de Medicina, Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile
| | - Fernando A Moraga
- Laboratorio de Fisiología, Hipoxia y Función Vascular, Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
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Richalet JP. [Adaption to chronic hypoxaemia by populations living at high altitude]. Rev Mal Respir 2021; 38:395-403. [PMID: 33541755 DOI: 10.1016/j.rmr.2020.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 10/13/2020] [Indexed: 12/14/2022]
Abstract
Permanent life at high altitude induces important physiological stresses linked to the exposure to chronic hypoxia. Various strategies have been adopted by diverse populations living in the Andes, Tibet or East Africa. The main mechanism is an increase in red blood cell production, more marked in Andeans than in Tibetans or Ethiopians. Other changes are observed in the cardiovascular or respiratory systems, as well as in the utero-placental circulation. Sometimes, a de-adaptation process to hypoxia develops, when erythrocytosis becomes excessive and leads to haematological, vascular and cerebral complications (Monge's disease or chronic mountain sickness). Pulmonary hypertension may also appear. Therapeutic options are available but not sufficiently used. Genetic studies have recently been undertaken to try to better understand the evolution of the human genome in populations living in various high altitude regions of the world, as well as the genetic risk factors for chronic diseases. A new model has appeared, intermittent chronic hypoxia, due to the development of economic activities (mainly mining) in desert regions of the Altiplano.
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Affiliation(s)
- J-P Richalet
- Laboratoire « Hypoxie & Poumon », UMR Inserm U1272, Université Sorbonne Paris Nord 13, 74, rue Marcel-Cachin, 93017 Bobigny cedex, France.
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Souza TP, Souza R, Watte G, de Souza JA, Moreira JDS, Knorst MM. Predictors of health-related quality of life among semi-precious stone mineworkers exposed to silica dust. Int Arch Occup Environ Health 2021; 94:679-687. [PMID: 33392750 DOI: 10.1007/s00420-020-01622-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The study aimed to comparatively evaluate HRQOL in miners of semi-precious stones with and without silicosis, and determine the associated factors, as well as the performance of two different questionnaires in measuring HRQOL. METHODS In a cross-sectional study of 348 male miners (129 with silicosis) who underwent an interview and spirometry, HRQOL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and the Saint George's Respiratory Questionnaire (SGRQ). RESULTS Miners with silicosis were older, had less schooling, worked more hours daily, and had longer exposure to silica. They also had worse scores of QoL in both questionnaires. Respiratory symptoms and %FEV1 were contributing factors for the models of total health and all the domains of the SGRQ, and 40% of the variability of the general health domain of WHOQOL-BREF was due to dyspnea, wheezing, %FEV1, and pack-years of cigarette smoking. Respiratory symptoms, lung function, pack-years of cigarette smoking, years of education, and average monthly income were contributing factors for the models of the different domains of the WHOQOL-BREF. CONCLUSIONS Our study revealed impaired HRQOL in semi-precious stone miners evaluated using both questionnaire tools of SGRQ and WHOQOL-BREF, of which SGRQ had superior performance. Respiratory symptoms, functional impairment, and pack-years of cigarette smoking were the most important determinants of the workers' general HRQOL.
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Affiliation(s)
- Tamires Patrícia Souza
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. .,Programa de Pós-Graduação em Enfermagem, Faculdade de Enfermagem, Universidade Estadual de Campinas, Unicamp. Rua Tessália Vieira de Camargo, 126. Cidade Universitária, Campinas, SP, CEP 13083-887, Brazil.
| | - Rafaela Souza
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Guilherme Watte
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - José da Silva Moreira
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marli Maria Knorst
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
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14
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Aragón-Vela J, Bejder J, R Huertas J, Plaza-Diaz J, Nordsborg NB. Does intermittent exposure to high altitude increase the risk of cardiovascular disease in workers? A systematic narrative review. BMJ Open 2020; 10:e041532. [PMID: 33444211 PMCID: PMC7682469 DOI: 10.1136/bmjopen-2020-041532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Several working groups (eg, miners, flight crews and soldiers) are subjected to chronic intermittent hypoxic exposure. The cardiovascular implications have been studied but not systematically reviewed with focus on possible negative health implications. The aim of the present review was to systematically evaluate the hypothesis that intermittent hypoxic exposure causes cardiovascular stress detrimental to health in workers. DESIGN Systematic review. DATA SOURCES Electronic database search of PubMed, Scopus and Web of Science up to April 2020. ELIGIBILITY CRITERIA Studies of workers ≥18 years repeatedly subjected to months to years of irregular intermittent hypoxia, lasting from a few hours (eg, flight crews), one or a few days (eg, soldiers), or several days to weeks (eg, miners working at high altitude), written in English and evaluating the effect of intermittent hypoxia on cardiovascular disease were included. Animal studies, books, book chapters, personal communication and abstracts were excluded. The primary outcome measure was changes in standardised mortality ratio. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed risk of bias using the Cochrane Collaboration's tool. RESULTS 119 articles were identified initially, 31 of which met the inclusion criteria. Of these, 17 were retrospective cohort mortality studies (irregular short-term intermittent hypoxia), and 14 studies were observational (long-term intermittent hypoxia). The population of irregular short-term intermittent hypoxia users (flight crew) showed a lower mortality by cardiovascular disease. Long-term intermittent hypoxia over several years such as in miners or soldiers may produce increased levels of cardiac disorders (12 studies), though this is probably confounded by factors such as obesity and socioeconomic status. CONCLUSION This systematic narrative review found that cardiovascular disease mortality in flight crews is lower than average, whereas miners and soldiers exposed to intermittent hypoxia experience increased risks of cardiovascular diseases. The impact of socioeconomic status and lifestyle appears of importance. PROSPERO REGISTRY NUMBER CRD42020171301.
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Affiliation(s)
- Jerónimo Aragón-Vela
- Department of Nutrition, Exercise, and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jacob Bejder
- Department of Nutrition, Exercise, and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jesús R Huertas
- Department of Physiology, School of Sport Sciences, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Centre, University of Granada, Granada, Spain
| | - Julio Plaza-Diaz
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Biochemistry & MolecularBiology II, School of Pharmacy, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria IBS Granada, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Nikolai B Nordsborg
- Department of Nutrition, Exercise, and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
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15
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Hancco I, Bailly S, Baillieul S, Doutreleau S, Germain M, Pépin JL, Verges S. Excessive Erythrocytosis and Chronic Mountain Sickness in Dwellers of the Highest City in the World. Front Physiol 2020; 11:773. [PMID: 32760289 PMCID: PMC7373800 DOI: 10.3389/fphys.2020.00773] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
Background While millions of people are living permanently at high altitude (>2,500 m) worldwide, the mechanisms underlying their tolerance to chronic hypoxia and those responsible for the occurrence of chronic mountain sickness (CMS) remain to be elucidated. Excessive erythrocytosis (EE) is thought to be the main mechanism responsible for CMS symptoms and is included in the definition of CMS, but the precise interplay between EE and symptoms of CMS requires further investigations. Methods The present study benefits from an exceptional dataset coming from 1,594 dwellers of La Rinconada, the highest city in the world (5,100-5,300 m). Based on individual clinical characteristics, subjects were categorized according to the presence of EE and CMS diagnosis, based on current guidelines. Results In this population of relatively young [32 (23; 39) years] highlanders residing in La Rinconada for only a few years [3 (2; 5) years], the internal prevalence of EE (44%) was high, whereas the internal prevalence of CMS (14%) was similar compared to previous reports in highlander populations living at lower altitude (∼4,000 m) in the Andes. Individuals with EE reported less symptoms compared to individuals with lower hematocrit values. Multivariable analysis revealed that age and sex are the main factors associated with EE, whereas age, hematocrit and number of years living at La Rinconada are factors associated with CMS symptoms. Conclusion In this specific population of La Rinconada, high hematocrit values were observed but were associated with limited symptoms. These results raise important questions regarding the definition of EE and CMS and their underlying mechanisms in high-altitude populations.
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Affiliation(s)
- Ivan Hancco
- HP2 Laboratory, Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Grenoble, France
| | - Sébastien Bailly
- HP2 Laboratory, Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Grenoble, France
| | - Sébastien Baillieul
- HP2 Laboratory, Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Grenoble, France
| | - Stéphane Doutreleau
- HP2 Laboratory, Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Grenoble, France
| | - Michèle Germain
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team "Vascular Biology and Red Blood Cell", Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Jean-Louis Pépin
- HP2 Laboratory, Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Grenoble, France
| | - Samuel Verges
- HP2 Laboratory, Univ. Grenoble Alpes, INSERM, Grenoble Alpes University Hospital, Grenoble, France
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16
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Stauffer E, Loyrion E, Hancco I, Waltz X, Ulliel‐Roche M, Oberholzer L, Robach P, Pichon A, Brugniaux JV, Bouzat P, Doutreleau S, Connes P, Verges S. Blood viscosity and its determinants in the highest city in the world. J Physiol 2020; 598:4121-4130. [DOI: 10.1113/jp279694] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/07/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Emeric Stauffer
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424 Team ‘Biologie vasculaire et du globule rouge’ Université Claude Bernard Lyon 1 Université de Lyon France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Centre de Médecine du Sommeil et des Maladies Respiratoires Hospices Civils de Lyon Hôpital Croix Rousse Lyon France
| | - Emmanuelle Loyrion
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Ivan Hancco
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Xavier Waltz
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Mathilde Ulliel‐Roche
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Laura Oberholzer
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research Rigshospitalet University of Copenhagen Copenhagen Denmark
| | - Paul Robach
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
- National School for Mountain Sports Site of the National School for Skiing and Mountaineering (ENSA) Chamonix France
| | | | - Julien V. Brugniaux
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Pierre Bouzat
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Stéphane Doutreleau
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
| | - Philippe Connes
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424 Team ‘Biologie vasculaire et du globule rouge’ Université Claude Bernard Lyon 1 Université de Lyon France
- Laboratoire d'Excellence du Globule Rouge (Labex GR‐Ex) PRES Sorbonne Paris France
- Institut Universitaire de France Paris France
| | - Samuel Verges
- HP2 laboratory Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Faculté de Médecine Grenoble 38000 France
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17
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Han S, Zhao L, Ma S, Chen Z, Wu S, Shen M, Xia G, Jia G. Alterations to cardiac morphology and function among high-altitude workers: a retrospective cohort study. Occup Environ Med 2020; 77:447-453. [PMID: 32269133 DOI: 10.1136/oemed-2019-106108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Exposure to high altitude can affect human health, including the development of adverse cardiovascular effects. This study aimed to investigate alterations in cardiac morphology and function in high-altitude workers and to identify risk factors associated with cardiac abnormalities. METHODS A retrospective cohort study was conducted with 286 Qinghai-Tibetan Railroad maintenance workers. Participant data were collected from company personnel records. Data on echocardiography and diagnosis of cardiac abnormalities were extracted from participants' medical records. Time-to-event analysis was used to investigate the risk of cardiac abnormalities among participants with different baseline characteristics and identify risk factors associated with cardiac abnormalities that developed as a result of working at high altitude. RESULTS A total of 173 participants had developed cardiac abnormalities during the follow-up period. The most common cardiac abnormality was right atrial enlargement, followed by left ventricular diastolic dysfunction and tricuspid regurgitation. Among participants with cardiac abnormalities, the median follow-up time was 17 months. Compared with participants who were younger than 20 years and working at altitude <4000 m, participants older at employment and working at extremely high altitude were more likely to develop cardiac abnormalities. Nearly 40% of the participants who worked at altitude <4000 m remained without cardiac abnormalities during the follow-up period. CONCLUSIONS Over 60% of participants developed cardiac abnormalities after working at high altitude, predominantly right heart enlargement and left ventricular diastolic dysfunction. Age at employment and workplace altitude were significant risk factors for cardiac abnormalities. Enhanced regular physical examinations are recommended for high-altitude workers.
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Affiliation(s)
- Shurong Han
- Labor & Health Department, China Railway, No.10 Fuxing Road, Beijing, China
| | - Lin Zhao
- Department of Epidemiology, School of Public Health, Shandong University, No.44 Wenhuaxi Road, Jinan, China
| | - Shiwei Ma
- Energy Saving & Environmental & Occupational Safety and Health Research Institute, China Academy of Railway Sciences Co., Ltd, No.2 Daliushu Road, Beijing, China
| | - Zhangjian Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, China
| | - Shiping Wu
- Labor & Health Department, China Railway, No.10 Fuxing Road, Beijing, China
| | - Min Shen
- Labor & Health Department, China Railway Qinghai-Tibet Group Co., Ltd., No.22 Jianguo Road, Xining, China
| | - Guobin Xia
- China Railway 12th Bureau Group Railway Maintenance Engineering Co., Ltd., No.13-1 Linqionggang Road, Lhasa, China
| | - Guang Jia
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, China
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18
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Melatonin Relations with Energy Metabolism as Possibly Involved in Fatal Mountain Road Traffic Accidents. Int J Mol Sci 2020; 21:ijms21062184. [PMID: 32235717 PMCID: PMC7139848 DOI: 10.3390/ijms21062184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 12/18/2022] Open
Abstract
Previous results evidenced acute exposure to high altitude (HA) weakening the relation between daily melatonin cycle and the respiratory quotient. This review deals with the threat extreme environments pose on body time order, particularly concerning energy metabolism. Working at HA, at poles, or in space challenge our ancestral inborn body timing system. This conflict may also mark many aspects of our current lifestyle, involving shift work, rapid time zone crossing, and even prolonged office work in closed buildings. Misalignments between external and internal rhythms, in the short term, traduce into risk of mental and physical performance shortfalls, mood changes, quarrels, drug and alcohol abuse, failure to accomplish with the mission and, finally, high rates of fatal accidents. Relations of melatonin with energy metabolism being altered under a condition of hypoxia focused our attention on interactions of the indoleamine with redox state, as well as, with autonomic regulations. Individual tolerance/susceptibility to such interactions may hint at adequately dealing with body timing disorders under extreme conditions.
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19
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Injury-Related Deaths according to Environmental, Demographic, and Lifestyle Factors. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2019; 2019:6942787. [PMID: 30944571 PMCID: PMC6421738 DOI: 10.1155/2019/6942787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/29/2019] [Indexed: 01/22/2023]
Abstract
Background Environmental, demographic, and lifestyle variables have been associated with injury-related deaths. The current study identifies the simultaneous association of selected environmental, demographic, and lifestyle variables with deaths from homicide, unintentional injuries, and suicide. Materials and Methods Analyses are based on county-level mortality data in the contiguous United States, 2011–15. Basic summary statistics and Poisson regression were used to evaluate the data. Results The selected causes of death were impacted differently by age, sex, and race: for homicide, mortality rates were greater in ages 20–39, males, and blacks; for unintentional injuries, the rates increased with age, most noticeably in the oldest age group, and were highest among males and whites; and for suicide, the rates tended to increase with age and were greater in males and whites. Mortality rates from homicide were positively associated with poverty, cigarette smoking, air temperature, and leisure-time physical inactivity. They were negatively associated with precipitation and sunlight. Mortality rates from unintentional injuries were positively associated with altitude, cigarette smoking, air temperature, poverty, obesity, and precipitation. They were negatively associated with population density. Mortality rates from suicides were positively associated with altitude, cigarette smoking, obesity, air temperature, and precipitation and negatively associated with population density. Conclusion The results confirm and extend previous research in which death from homicide, unintentional injuries, and suicide are distinctly associated with a combination of environmental, demographic, and lifestyle variables. The findings may be useful in developing strategies for reducing injury-related deaths.
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20
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Pun M, Guadagni V, Bettauer KM, Drogos LL, Aitken J, Hartmann SE, Furian M, Muralt L, Lichtblau M, Bader PR, Rawling JM, Protzner AB, Ulrich S, Bloch KE, Giesbrecht B, Poulin MJ. Effects on Cognitive Functioning of Acute, Subacute and Repeated Exposures to High Altitude. Front Physiol 2018; 9:1131. [PMID: 30246787 PMCID: PMC6111975 DOI: 10.3389/fphys.2018.01131] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/30/2018] [Indexed: 01/12/2023] Open
Abstract
Objective: Neurocognitive functions are affected by high altitude, however the altitude effects of acclimatization and repeated exposures are unclear. We investigated the effects of acute, subacute and repeated exposure to 5,050 m on cognition among altitude-naïve participants compared to control subjects tested at low altitude. Methods: Twenty-one altitude-naïve individuals (25.3 ± 3.8 years, 13 females) were exposed to 5,050 m for 1 week (Cycle 1) and re-exposed after a week of rest at sea-level (Cycle 2). Baseline (BL, 520 m), acute (Day 1, HA1) and acclimatization (Day 6, HA6, 5,050 m) measurements were taken in both cycles. Seventeen control subjects (24.9 ± 2.6 years, 12 females) were tested over a similar period in Calgary, Canada (1,103 m). The Reaction Time (RTI), Attention Switching Task (AST), Rapid Visual Processing (RVP) and One Touch Stockings of Cambridge (OTS) tasks were administered and outcomes were expressed in milliseconds/frequencies. Lake Louise Score (LLS) and blood oxygen saturation (SpO2) were recorded. Results: In both cycles, no significant changes were found with acute exposure on the AST total score, mean latency and SD. Significant changes were found upon acclimatization solely in the altitude group, with improved AST Mean Latency [HA1 (588 ± 92) vs. HA6 (526 ± 91), p < 0.001] and Latency SD [HA1 (189 ± 86) vs. HA6 (135 ± 65), p < 0.001] compared to acute exposure, in Cycle 1. No significant differences were present in the control group. When entering Acute SpO2 (HA1-BL), Acclimatization SpO2 (HA6-BL) and LLS score as covariates for both cycles, the effects of acclimatization on AST outcomes disappeared indicating that the changes were partially explained by SpO2 and LLS. The changes in AST Mean Latency [ΔBL (−61.2 ± 70.2) vs. ΔHA6 (−28.0 ± 58), p = 0.005] and the changes in Latency SD [ΔBL (−28.4 ± 41.2) vs. ΔHA6 (−0.2235 ± 34.8), p = 0.007] across the two cycles were smaller with acclimatization. However, the percent changes did not differ between cycles. These results indicate independent effects of altitude across repeated exposures. Conclusions: Selective and sustained attention are impaired at altitude and improves with acclimatization.The observed changes are associated, in part, with AMS score and SpO2. The gains in cognition with acclimatization during a first exposure are not carried over to repeated exposures.
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Affiliation(s)
- Matiram Pun
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Veronica Guadagni
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kaitlyn M Bettauer
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychology, Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Lauren L Drogos
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Julie Aitken
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada
| | - Sara E Hartmann
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael Furian
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zürich, Zurich, Switzerland
| | - Lara Muralt
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zürich, Zurich, Switzerland
| | - Mona Lichtblau
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zürich, Zurich, Switzerland
| | - Patrick R Bader
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zürich, Zurich, Switzerland
| | - Jean M Rawling
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrea B Protzner
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Silvia Ulrich
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zürich, Zurich, Switzerland
| | - Konrad E Bloch
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zürich, Zurich, Switzerland
| | - Barry Giesbrecht
- Department of Psychological and Brain Sciences, Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Marc J Poulin
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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21
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Pun M, Hartmann SE, Furian M, Dyck AM, Muralt L, Lichtblau M, Bader PR, Rawling JM, Ulrich S, Bloch KE, Poulin MJ. Effect of Acute, Subacute, and Repeated Exposure to High Altitude (5050 m) on Psychomotor Vigilance. Front Physiol 2018; 9:677. [PMID: 29915546 PMCID: PMC5994420 DOI: 10.3389/fphys.2018.00677] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/15/2018] [Indexed: 12/20/2022] Open
Abstract
Aim: High altitude (HA) hypoxia may affect cognitive performance and sleep quality. Further, vigilance is reduced following sleep deprivation. We investigated the effect on vigilance, actigraphic sleep indices, and their relationships with acute mountain sickness (AMS) during very HA exposure, acclimatization, and re-exposure. Methods: A total of 21 healthy altitude-naive individuals (25 ± 4 years; 13 females) completed 2 cycles of altitude exposure separated by 7 days at low altitude (LA, 520 m). Participants slept at 2900 m and spent the day at HA, (5050 m). We report acute altitude exposure on Day 1 (LA vs. HA1) and after 6 days of acclimatization (HA1 vs. HA6). Vigilance was quantified by reaction speed in the 10-min psychomotor vigilance test reaction speed (PVT-RS). AMS was evaluated using the Environmental Symptoms Questionnaire Cerebral Score (AMS-C score). Nocturnal rest/activity was recorded to estimate sleep duration using actigraphy. Results: In Cycle 1, PVT-RS was slower at HA1 compared to LA (4.1 ± 0.8 vs. 4.5 ± 0.6 s-1, respectively, p = 0.029), but not at HA6 (4.6 ± 0.7; p > 0.05). In Cycle 2, PVT-RS at HA1 (4.6 ± 0.7) and HA6 (4.8 ± 0.6) were not different from LA (4.8 ± 0.6, p > 0.05) and significantly greater than corresponding values in Cycle 1. In both cycles, AMS scores were higher at HA1 than at LA and HA6 (p < 0.05). Estimated sleep durations (TST) at LA, 1st and 5th nights were 431.3 ± 28.7, 418.1 ± 48.6, and 379.7 ± 51.4 min, respectively, in Cycle 1 and they were significantly reduced during acclimatization exposures (LA vs. 1st night, p > 0.05; LA vs. 5th night, p = 0.012; and 1st vs. 5th night, p = 0.054). LA, 1st and 5th nights TST in Cycle 2 were 477.5 ± 96.9, 430.9 ± 34, and 341.4 ± 32.2, respectively, and we observed similar deteriorations in TST as in Cycle 1 (LA vs. 1st night, p > 0.05; LA vs. 5th night, p = 0.001; and 1st vs. 5th night, p < 0.0001). At HA1, subjects who reported higher AMS-C scores exhibited slower PVT-RS (r = -0.56; p < 0.01). Subjects with higher AMS-C scores took longer time to react to the stimuli during acute exposure (r = 0.62, p < 0.01) during HA1 of Cycle 1. Conclusion: Acute exposure to HA reduces the PVT-RS. Altitude acclimatization over 6 days recovers the reaction speed and prevents impairments during subsequent altitude re-exposure after 1 week spent near sea level. However, acclimatization does not lead to improvement in total sleep time during acute and subacute exposures.
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Affiliation(s)
- Matiram Pun
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sara E Hartmann
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michael Furian
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Adrienna M Dyck
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Lara Muralt
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Mona Lichtblau
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Patrick R Bader
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Jean M Rawling
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Silvia Ulrich
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Konrad E Bloch
- Pulmonary Division, Sleep Disorders Centre and Pulmonary Hypertension Clinic, University Hospital Zurich, Zurich, Switzerland
| | - Marc J Poulin
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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22
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Ishtiaq M, Jehan N, Khan SA, Muhammad S, Saddique U, Iftikhar B. Potential harmful elements in coal dust and human health risk assessment near the mining areas in Cherat, Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018. [PMID: 29532380 DOI: 10.1007/s11356-018-1655-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
This study was aimed to investigate the potential harmful element (PHE) concentrations in coal dust and evaluate the human risk assessment and health effects near coal mining areas. For this purpose, dust samples were collected near various coal mines in Cherat, Pakistan, and analyzed for the PHE concentrations. Determined PHE concentrations were evaluated for the health risk assessment. Results revealed that ingestion was the major pathway as compared to others for PHE exposure. Individual chronic daily intake (CDI) of PHEs was higher than their respective permissible exposure limits set for oral exposure routes by the Agency for Toxic Substances and Disease Registry (ATSDR). Chronic risk or health index (HI) values were observed < 1 for all PHEs and in the order of Pb > Cr > Cd > Ni > Cu > Co > Zn. Higher HI values of Pb, Cr, and Cd could attribute to various chronic health problems as observed during the medical examination survey of this study. Cancer risk (CR) values for this study were observed within the US Environmental Protection Agency (EPA) limits. However, if current practices continued, the PHEs will cross these limits in a near future. Therefore, this study strongly recommends the provision of safety measures, rules, and regulation to avoid health hazards in the future.
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Affiliation(s)
- Muhammad Ishtiaq
- Department of Community Medicine and Public Health, Khyber Medical College, Peshawar, Pakistan
| | - Noor Jehan
- Department of Environmental Sciences, University of Peshawar, Peshawar, 25120, Pakistan
| | - Said Akbar Khan
- Department of Earth and Environmental Sciences, Bahria University, Islamabad, 44000, Pakistan
| | - Said Muhammad
- Department of Earth Sciences, COMSATS University, Abbottabad, 22060, Pakistan.
| | - Umar Saddique
- Department of Chemistry, Abdul Wali Khan University, Mardan, 23200, Pakistan
| | - Bushra Iftikhar
- Department of Community Medicine and Public Health, Khyber Medical College, Peshawar, Pakistan
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Rey de Castro J, Liendo A, Ortiz O, Rosales-Mayor E, Liendo C. Ventilatory Cycle Measurements and Loop Gain in Central Apnea in Mining Drivers Exposed to Intermittent Altitude. J Clin Sleep Med 2017; 13:27-32. [PMID: 27707449 DOI: 10.5664/jcsm.6380] [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: 11/25/2015] [Accepted: 08/30/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES By measuring the apnea length, ventilatory phase, respiratory cycle length, and loop gain, we can further characterize the central apneas of high altitude (CAHA). METHODS Sixty-three drivers of all-terrain vehicles, working in a Peruvian mine located at 2,020 meters above sea level (MASL), were evaluated. A respiratory polygraph was performed in the first night they slept at high altitude. None of the subjects were exposed to oxygen during the test or acetazolamide in the preceding days of the test. RESULTS Sixty-three respiratory polygraphs were performed, and 59 were considered for analysis. Forty-six (78%) were normal, 6 (10%) had OSA, and 7 (12%) had CAHA. Key data from subjects include: residing altitude: 341 ± 828 MASL, Lake Louise scoring: 0.4 ± 0.8, Epworth score: 3.4 ± 2.7, apneahypopnea index: 35.7 ± 19.3, CA index: 13.4 ± 14.2, CA length: 14.4 ± 3.6 sec, ventilatory length: 13.5 ± 2.9 sec, cycle length: 26.5 ± 4.0 sec, ventilatory length/CA length ratio 0.9 ± 0.3 and circulatory delay 13.3 ± 2.9 sec. Duty ratio media [ventilatory duration/cycle duration] was 0.522 ± 0 0.128 [0.308-0.700] and loop gain was calculated from the duty ratio utilizing this formula: LG = 2π / [(2πDR-sin(2πDR)]. All subjects have a high loop gain media 2.415 ± 1.761 [1.175-6.260]. Multiple correlations were established with loop gain values, but the only significant correlation detected was between central apnea index and loop gain. CONCLUSIONS Twelve percent of the studied population had CAHA. Measurements of respiratory cycle in workers with CAHA are more similar to idiopathic central apneas rather than Hunter-Cheyne-Stokes respiration. Also, there was a high degree of correlation between severity of central apnea and the degree of loop gain. The abnormal breathing patterns in those subjects could affect the sleep quality and potentially increase the risk for work accidents.
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Affiliation(s)
- Jorge Rey de Castro
- Clínica Anglo Americana, Lima-Perú, School Medicine Professor, Universidad Peruana Cayetano Heredia, Lima-Perú
| | - Alicia Liendo
- University of Medicine and Health Sciences-St. Kitts, WI
| | - Oswaldo Ortiz
- Individual Member of the International Council of Occupational Health
| | - Edmundo Rosales-Mayor
- CIBERES, IDIBAPS, Respiratory Disease Department, Instituto Clínic del Tórax, Hospital Clínic de Barcelona, Barcelona, Spain
| | - César Liendo
- Multidisciplinary Sleep Clinic, Louisiana State University, Shreveport, LA; Clinical and Sleep Laboratory Director VAMC, Shreveport, LA
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San Martin R, Brito J, Siques P, León-Velarde F. Obesity as a Conditioning Factor for High-Altitude Diseases. Obes Facts 2017; 10:363-372. [PMID: 28810235 PMCID: PMC5644942 DOI: 10.1159/000477461] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 05/10/2017] [Indexed: 12/19/2022] Open
Abstract
Obesity, a worldwide epidemic, has become a major health burden because it is usually accompanied by an increased risk for insulin resistance, diabetes, hypertension, cardiovascular diseases, and even some kinds of cancer. It also results in associated increases in healthcare expenditures and labor and economic consequences. There are also other fields of medicine and biology where obesity or being overweight play a major role, such as high-altitude illnesses (acute mountain sickness, hypoxic pulmonary hypertension, and chronic mountain sickness), where an increasing relationship among these two morbid statuses has been demonstrated. This association could be rooted in the interactions between obesity-related metabolic alterations and critical ventilation impairments due to obesity, which would aggravate hypobaric hypoxia at high altitudes, leading to hypoxemia, which is a trigger for developing high-altitude diseases. This review examines the current literature to support the idea that obesity or overweight could be major conditioning factors at high altitude.
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Affiliation(s)
- Rocío San Martin
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Julio Brito
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
- *Julio Brito, Institute of Health Studies, Universidad Arturo Prat, Avda. Arturo Prat 2120, Iquique, 1110939, Chile,
| | - Patricia Siques
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Fabiola León-Velarde
- Department of Biological and Physiological Sciences. Facultad de Ciencias y Filosofía/ IIA, Universidad Peruana Cayetano Heredia, Lima, Perú
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Roch S, Guillou D, Lefort H. [The nurse on a remote mineral, gas or oil extraction site]. REVUE DE L'INFIRMIÈRE 2016; 65:25-27. [PMID: 27968966 DOI: 10.1016/j.revinf.2016.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
On mineral, gas or oil extraction sites, medical care is often provided in uncommon conditions by doctors or paramedical staff. Caregivers must fulfil certain requirements, but must also possess the necessary human, technical, physical and psychological qualities to be able to provide high quality care throughout their mission on a remote site.
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Affiliation(s)
- Stéphane Roch
- Bloc d'urgence, hôpital Édouard Herriot, 5 place d'Arsonval, 69003 Lyon, France; Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, 1 place Jules Renard, 75017 Paris, France.
| | - Damien Guillou
- Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, 1 place Jules Renard, 75017 Paris, France
| | - Hugues Lefort
- Service médical d'urgence, Brigade de sapeurs-pompiers de Paris, 1 place Jules Renard, 75017 Paris, France
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26
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Otero L, Hidalgo P, González R, Morillo CA. Association of Cardiovascular Disease and Sleep Apnea at Different Altitudes. High Alt Med Biol 2016; 17:336-341. [PMID: 27529440 DOI: 10.1089/ham.2016.0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Otero, Liliana, Patricia Hidalgo, Rafael González, and Carlos A. Morillo. Association of cardiovascular disease and sleep apnea at different altitudes. High Alt Med Biol. 17:336-341, 2016.-We evaluated the prevalence of sleep apnea (SA) in patients with cardiovascular disease (CVD) at different altitudes. A total of 398 subjects with coronary artery disease (CAD), 144 subjects with atrial fibrillation (AF), and 292 controls (without CVD) were recruited in three cities at sea level, moderate altitude, and high altitude. All participants underwent polysomnography. Multinomial logistic regression, X2, and Hosmer and Lemeshow tests were used to determine interactions among CVD, SA, and altitude. Men and women with CVD at high altitude had a higher risk for SA than men and women living at lower altitudes. The highest risk of SA was observed in men with AF and men with CAD living at high altitude. Obstructive SA (OSA) prevalence was significantly increased in CVD subjects living at high altitude (OR: 5.52; p < 0.0001). Central SA (CSA) was more frequent in subjects with CVD than control group (OR: 2.44; p < 0.021). OSA was the most frequent type of SA in subjects with CVD and overweight subjects, and in control individuals with obesity or being overweight. Significant differences in the prevalence of SA associated with altitude and gender were noted in subjects with CAD and AF.
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Affiliation(s)
- Liliana Otero
- 1 Faculties of Dentistry and Sciences, Research Dental Center , Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Patricia Hidalgo
- 2 Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio , Bogotá, Colombia
| | - Rafael González
- 3 Instituto del Corazón de Bucaramanga , Sede Bogotá, Colombia
| | - Carlos A Morillo
- 4 Department of Medicine, Cardiology Division, McMaster University , Hamilton, Ontario, Canada
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Serebrovskaya TV, Xi L. Intermittent hypoxia training as non-pharmacologic therapy for cardiovascular diseases: Practical analysis on methods and equipment. Exp Biol Med (Maywood) 2016; 241:1708-23. [PMID: 27407098 DOI: 10.1177/1535370216657614] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The global industrialization has brought profound lifestyle changes and environmental pollutions leading to higher risks of cardiovascular diseases. Such tremendous challenges outweigh the benefits of major advances in pharmacotherapies (such as statins, antihypertensive, antithrombotic drugs) and exacerbate the public healthcare burdens. One of the promising complementary non-pharmacologic therapies is the so-called intermittent hypoxia training (IHT) via activation of the human body's own natural defense through adaptation to intermittent hypoxia. This review article primarily focuses on the practical questions concerning the utilization of IHT as a non-pharmacologic therapy against cardiovascular diseases in humans. Evidence accumulated in the past five decades of research in healthy men and patients has suggested that short-term daily sessions consisting 3-4 bouts of 5-7 min exposures to 12-10% O2 alternating with normoxic durations for 2-3 weeks can result in remarkable beneficial effects in treatment of cardiovascular diseases such as hypertension, coronary heart disease, and heart failure. Special attentions are paid to the therapeutic effects of different IHT models, along with introduction of a variety of specialized facilities and equipment available for IHT, including hypobaric chambers, hypoxia gas mixture deliver equipment (rooms, tents, face masks), and portable rebreathing devices. Further clinical trials and thorough evaluations of the risks versus benefits of IHT are much needed to develop a series of standardized and practical guidelines for IHT. Taken together, we can envisage a bright future for IHT to play a more significant role in the preventive and complementary medicine against cardiovascular diseases.
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Affiliation(s)
- Tatiana V Serebrovskaya
- Department of Hypoxia, Bogomoletz Institute of Physiology, National Academy of Sciences of Ukraine, Kiev 01024, Ukraine
| | - Lei Xi
- Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23298-0204, USA Department of Sports Medicine, Chengdu Sport University, Chengdu 610041, China
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28
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Salas ML, Quezada S, Basagoitia A, Fernandez T, Herrera R, Parra M, Muñoz DM, Weigl M, Radon K. Working Conditions, Workplace Violence, and Psychological Distress in
Andean Miners: A Cross-sectional Study Across Three Countries. Ann Glob Health 2015; 81:465-74. [DOI: 10.1016/j.aogh.2015.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Smoking Increases the Risk of Acute Mountain Sickness. Wilderness Environ Med 2015; 26:164-72. [DOI: 10.1016/j.wem.2014.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 11/21/2022]
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Abstract
PURPOSE OF REVIEW The relationship of altitude and cold to cardiovascular risk is complex. Cold is hard to separate from altitude. This review highlights the latest information on cardiovascular disease associated with high altitude and cold; both represent unique clinical situations. RECENT FINDINGS Evolution and genetics are relevant to high altitude, with much new information available. Specific physiology explains some congenital heart disease at altitude. New reports of hematological changes associated with altitude and cold help clarify thrombosis, which is relevant to reports of very late in-stent thrombosis at altitude. Multiple cardiovascular risk factors are affected by altitude and cold, and an increased incidence of myocardial infarction occurs. There is new research on acute mountain sickness associated with inflammation with relevance for clinical study of pulmonary edema. Socioeconomics plays a part in altitude and cold effects on cardiovascular disease. In addition to acute disease, high altitude involves chronic mountain sickness with new knowledge of associated cardiovascular endothelial abnormalities. SUMMARY High altitude and cold involve acute disease, chronic disease, and public health issues. Continued research is essential to enable the best clinical management in this era of rapid worldwide travel.
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Five-year lung function observations and associations with a smoking ban among healthy miners at high altitude (4000 m). J Occup Environ Med 2014; 55:1421-5. [PMID: 24270292 DOI: 10.1097/jom.0b013e3182a641e7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the annual lung function decline associated with the reduction of secondhand smoke exposure in a high-altitude industrial workforce. METHODS We performed pulmonary function tests annually among 109 high-altitude gold-mine workers over 5 years of follow-up. The first 3 years included greater likelihood of exposure to secondhand smoke exposure before the initiation of extensive smoking restrictions that came into force in the last 2 years of observation. RESULTS In repeated measures modeling, taking into account the time elapsed in relation to the smoking ban, there was a 115 ± 9 (standard error) mL per annum decline in lung function before the ban, but a 178 ± 20 (standard error) mL per annum increase afterward (P < 0.001, both slopes). CONCLUSION Institution of a workplace smoking ban at high altitude may be beneficial in terms of lung function decline.
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Esenamanova MK, Kochkorova FA, Tsivinskaya TA, Vinnikov D, Aikimbaev K. Chronic intermittent high altitude exposure, occupation, and body mass index in workers of mining industry. High Alt Med Biol 2014; 15:412-7. [PMID: 25162204 DOI: 10.1089/ham.2013.1150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The obesity and overweight rates in population exposed to chronic intermittent exposure to high altitudes are not well studied. The aim of the retrospective study was to evaluate whether there are differences in body mass index in different occupation groups working in intermittent shifts at mining industry at high altitude: 3800-4500 meters above sea level. Our study demonstrated that obesity and overweight are common in workers of high altitude mining industry exposed to chronic intermittent hypoxia. The obesity rate was lowest among miners as compared to blue- and white-collar employees (9.5% vs. 15.6% and 14.7%, p=0.013). Obesity and overweight were associated with older age, higher rates of increased blood pressure (8.79% and 5.72% vs. 1.92%), cholesterol (45.8% and 45.6% vs. 32.8%) and glucose (4.3% and 1.26% vs. 0.57%) levels as compared to normal body mass index category (p<0.0001 for all). There were differences in patterns of cholesterol and glucose levels in men and women employees according to occupation type. In conclusion, obesity and overweight rates are prevalent and associated with increase in blood pressure, cholesterol, and glucose levels in workers of mining industry exposed to intermittent high-altitude hypoxia. Therefore, assessment and monitoring of body mass index seems to be essential in those who live and work at high altitudes to supply the correct nutrition, modify risk factors, and prevent related disorders.
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Affiliation(s)
- Marina K Esenamanova
- 1 Department of Hygiene Disciplines, Kyrgyz State Medical Academy named after I.K. Ahunbaev , Bishkek, Kyrgyz Republic
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Burtscher M. Effects of living at higher altitudes on mortality: a narrative review. Aging Dis 2014; 5:274-80. [PMID: 25110611 PMCID: PMC4113517 DOI: 10.14336/ad.2014.0500274] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 01/21/2023] Open
Abstract
Beside genetic and life-style characteristics environmental factors may profoundly influence mortality and life expectancy. The high altitude climate comprises a set of conditions bearing the potential of modifying morbidity and mortality of approximately 400 million people who are permanently residing at elevations above 1500 meters. However, epidemiological data on the effects of high altitude living on mortality from major diseases are inconsistent probably due to differences in ethnicity, behavioral factors and the complex interactions with environmental conditions. The available data indicate that residency at higher altitudes are associated with lower mortality from cardiovascular diseases, stroke and certain types of cancer. In contrast mortality from COPD and probably also from lower respiratory tract infections is rather elevated. It may be argued that moderate altitudes are more protective than high or even very high altitudes. Whereas living at higher elevations may frequently protect from development of diseases, it could adversely affect mortality when diseases progress. Corroborating and expanding these findings would be helpful for optimization of medical care and disease management in the aging residents of higher altitudes.
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Affiliation(s)
- Martin Burtscher
- Department of Sport Science, Medical Section, University Innsbruck, Austria
- Austrian Society for Alpine and High Altitude Medicine, Innsbruck, Austria
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Dhar P, Sharma VK, Hota KB, Das SK, Hota SK, Srivastava RB, Singh SB. Autonomic cardiovascular responses in acclimatized lowlanders on prolonged stay at high altitude: a longitudinal follow up study. PLoS One 2014; 9:e84274. [PMID: 24404157 PMCID: PMC3880292 DOI: 10.1371/journal.pone.0084274] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/13/2013] [Indexed: 11/19/2022] Open
Abstract
Acute exposure to hypobaric hypoxia at high altitude is reported to cause sympathetic dominance that may contribute to the pathophysiology of high altitude illnesses. The effect of prolonged stay at high altitude on autonomic functions, however, remains to be explored. Thus, the present study aimed at investigating the effect of high altitude on autonomic neural control of cardiovascular responses by monitoring heart rate variability (HRV) during chronic hypobaric hypoxia. Baseline electrocardiography (ECG) data was acquired from the volunteers at mean sea level (MSL) (<250 m) in Rajasthan. Following induction of the study population to high altitude (4500–4800 m) in Ladakh region, ECG data was acquired from the volunteers after 6 months (ALL 6) and 18 months of induction (ALL 18). Out of 159 volunteers who underwent complete investigation during acquisition of baseline data, we have only included the data of 104 volunteers who constantly stayed at high altitude for 18 months to complete the final follow up after 18 months. HRV parameters, physiological indices and biochemical changes in serum were investigated. Our results show sympathetic hyperactivation along with compromise in parasympathetic activity in ALL 6 and ALL 18 when compared to baseline data. Reduction of sympathetic activity and increased parasympathetic response was however observed in ALL 18 when compared to ALL 6. Our findings suggest that autonomic response is regulated by two distinct mechanisms in the ALL 6 and ALL 18. While the autonomic alterations in the ALL 6 group could be attributed to increased sympathetic activity resulting from increased plasma catecholamine concentration, the sympathetic activity in ALL 18 group is associated with increased concentration of serum coronary risk factors and elevated homocysteine. These findings have important clinical implications in assessment of susceptibility to cardio-vascular risks in acclimatized lowlanders staying for prolonged duration at high altitude.
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Affiliation(s)
- Priyanka Dhar
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Vijay K. Sharma
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Kalpana B. Hota
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Saroj K. Das
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Sunil K. Hota
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Ravi B. Srivastava
- Defence Institute of High Altitude Research, Defence Research & Development Organisation, C/o 56 APO, Leh-Ladakh, Jammu and Kashmir, India
| | - Shashi B. Singh
- Defence Institute of Physiology and Allied Sciences, Defence Research & Development Organisation, Lucknow Road, Timarpur, Delhi, India
- * E-mail:
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35
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Waring WS. Intravenous lipid administration for drug-induced toxicity: a critical review of the existing data. Expert Rev Clin Pharmacol 2013; 5:437-44. [PMID: 22943123 DOI: 10.1586/ecp.12.27] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Following the discovery that administration of intravenous lipid emulsion (ILE) may reverse the cardiac and neurological toxicity of certain local anesthetic agents, ILE's potential role has recently been explored in the setting of toxicity attributed to a variety of different drugs. The potential mechanisms, safety and efficacy of this approach are considered in this review. Data are reviewed from 76 published reports involving ILE administration for severe drug toxicity, including 55 where toxicity was due to nonanesthetic agents. ILE was reported to exert a positive therapeutic effect in only a proportion of the reported cases, with greatest evidence of efficacy concerning local anesthetic agents. Administration has typically involved bolus administration followed by continuous maintenance infusion, and a number of different mechanisms are proposed, from preferential partitioning of the drug from cardiac tissue to the circulating lipid fraction and direct inotropic effects related to carnitine pathways and fatty acid oxidative metabolism. No major adverse effects have been encountered, but too few data exist to adequately address the safety profile of ILE.
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Affiliation(s)
- W Stephen Waring
- Acute Medical Unit, York Teaching Hospital NHS Foundation Trust, York, UK.
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