Deployment Exposures, Respiratory Symptoms, and the Limits of Resting Lung Function

Alterations in Pulmonary Function Following Respiratory Viral Infection

Respiratory symptoms and obstructive pulmonary disease in a population aged over 70 years

Lower respiratory tract illness is a major cause of childhood morbidity and mortality. It is unknown whether infants are predisposed to illness because of impaired lung function or whether respiratory illness reduces lung function. To investigate the impact of early life exposures, including lower respiratory tract illness, on lung function during infancy. Infants enrolled in the Drakenstein child health study had lung function at 6 weeks and 1 year. Testing during quiet natural sleep included tidal breathing, exhaled nitric oxide, and multiple breath washout measures. Risk factors for impaired lung health were collected longitudinally. Lower respiratory tract illness surveillance was performed and any episode investigated. Lung function was tested in 648 children at 1 year. One hundred and fifty (29%) infants had a lower respiratory tract illness during the first year of life. Lower respiratory tract illness was independently associated with increased respiratory rate (4%; 95% confidence interval [CI], 1.01-1.08; P = 0.02). Repeat episodes further increased respiratory rate (3%; 95% CI, 1.01-1.05; P = 0.004), decreased tidal volume (-1.7 ml; 95% CI, -3.3 to -0.2; P = 0.03), and increased the lung clearance index (0.13 turnovers; 95% CI, 0.04-0.22; P = 0.006) compared with infants without illness. Tobacco smoke exposure, lung function at 6 weeks, infant growth, and prematurity were other independent predictors of lung function at 1 year. Early life lower respiratory tract illness impairs lung function at 1 year, independent of baseline lung function. Preventing early life lower respiratory tract illness is important to optimize lung function and promote respiratory health in childhood.

Viral respiratory tract infections and asthma: The course ahead

Airflow Limitation as a Screening Tool

Gas cooking appliances and indoor pollution.

Background: Climate change will increase the average temperature and frequency of heat waves. Many studies have showed that ambient temperature is significantly related to mortality and morbidity. Children have less effective heat adaptation capacity than adults, because of their differences in physiology and baseline metabolism. The prevalence of asthma among children in Australia is the leading cause of burden of disease in children aged 0–14 years in Australia, accounting for 17.9% of the total burden in boys and 18.6% in girls. However, no study has examined the impact of ambient temperature on lung function and respiratory symptoms in children with asthma in Australia. Aims: This thesis aims to assess the effect of ambient temperature/temperature variability on lung function and respiratory symptoms in children with asthma in Australia. In addition, this thesis aims to discover whether the effects of ambient temperature on lung function in children are different in Australia and China. Methods and Results: A comprehensive literature review examined the associations between air pollutants and lung function and respiratory symptoms in children. The review found that a panel study with mixed models is a good choice for examining the short-term effects of ambient temperature on lung function and respiratory symptoms, since many studies have used this method to examine the short-term impacts of air pollutants on lung function and respiratory symptoms in children while controlling for the effect of ambient temperature. So, in the thesis, I used a panel study with mixed models to assess the association between temperature and lung function and respiratory symptoms. In this thesis, a panel of 270 children (7‒12 years) with asthma living in six Australian cities was recruited. They were asked to perform three successive forced expiratory manoeuvres using a portable electronic peak flow meter twice daily for four weeks. The highest values for peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) were stored for each session. At the same time, they were asked to record their respiratory symptoms (e.g., “cough/phlegm” and “wheeze/chest tightness”) every morning (for night-time symptoms) and evening (for daytime symptoms). Mixed models were used to examine the effects of temperature on lung function, controlling for individual characteristics and environmental factors. I found that ambient temperature was negatively related to both morning and evening PEF and FEV1. In general, the effects of temperature were stronger for boys than for girls for PEF, while the effects for evening FEV1 were stronger for girls. Children with asthma living in southern cities were more sensitive to high temperature than those in the north. A mixed logistic regression model was used to examine the effects of ambient temperature on respiratory symptoms. I found that the relationships between ambient temperature and respiratory symptoms were linear. Higher temperatures increased the risks of children’s asthmatic symptoms, especially for “wheeze/chest tightness” and to a lesser extent for “cough/phlegm”. With increasing ambient temperature, boys were more at risk than girls. Mixed models, adjusting for children’s individual characteristics and air pollution, were used to examine the effects of diurnal temperature range (DTR) on lung function and respiratory symptoms. I found that DTR had linear effects on PEF and respiratory symptoms. An increase in DTR induced a reduction in lung function and increased the occurrence of respiratory symptoms. I also examined the impact of ambient temperature on children’s lung function in spring in Baotou, China, to compare the results with the Australian’s. I found that low temperature was significantly associated with a decrease in lung function in Baotou, China. Conclusion: The thesis gives a new insight into the association between ambient temperature and lung function and respiratory symptoms in children. The results show that high temperature is a risk factor for children with asthma in Australia. The effect estimates varied by gender and city. Low temperature is negatively associated with children’s lung function in Baotou, China, when data was used only in the spring. The findings can be used to help plan and implement interventions to reduce respiratory problems related to ambient temperature for children.

To evaluate whether there are any associations between parentally reported symptoms, clinical findings and lung function in young children with recurrent lower respiratory tract symptoms. In 2000-2003, 148 children, aged 3-26 months, with recurrent lower respiratory tract symptoms underwent physical examination, investigation of a chest radiograph, whole body plethysmography and skin prick testing to common food and inhalant allergens. Lung function was considered abnormal (i.e. functional residual capacity z-score of > or =1.65 and/or specific conductance z-score of < or =-1.65) in 83 (56%) children. Findings of increased work of breathing (p < 0.001) and nonspecific noisy breathing sounds (p < 0.001) in the physical examination, as well as an abnormal chest radiograph (p = 0.028) were independently associated with abnormal lung function, explaining up to 34% of the variation in lung function. In contrast, parentally reported respiratory symptoms, environmental exposures or atopic trait were not associated with lung function abnormalities. The results of this study emphasize the importance of the meticulous clinical examination in the evaluation of early childhood respiratory disorders. As physical examination alone cannot predict lung function abnormalities reliably in preschool children with troublesome respiratory symptoms, lung function testing may be considered in such patients to obtain additional objective information.

Purpose Occupational exposure to dust is a major health and safety concern for workers in developing countries. Such laborers are often exposed to dust without being aware of its threat to their health. In the process of crushing stone, mineralogical materials are released into the environment. The material includes dust, fumes, ashes or other industrial waste which may constitute toxic elements. The purpose of this paper is to investigate the respiratory health problems of stone crushing industry workers in Bangladesh. Design/methodology/approach This cross-sectional descriptive research study was conducted by adopting a multi-method approach. Data were collected by use of a questionnaire survey, focus group discussions, in-depth interview and spirometric examinations. Focus group discussions and questionnaire surveys were conducted among 240 workers. The respondents were divided in six groups for the spirometric examination. The questionnaire was formulated by following standards set by the American Thoracic Society Division of Lung Disease questionnaire and European Coal and Steel Community. Data on respondent’s height, weight and smoking habits were collected by using a structured checklist. Meanwhile, lung functions were assessed by spirometry. A Statistical Package for Social Sciences was used to analyze the data. Findings The results show that there was a significant relation between respiratory problems and inhalation of dust and particulate matter and cigarette smoking. It also shows that coughing was the most common problem among the respondents. The majority of respondents suffered from obstructive types of respiratory problems. Originality/value Findings of the study reveals that chronic exposure to dust at stone crushing plants increases the risk of respiratory problems and the impaired lung function of workers. It also reveals that there is a significant relation between respiratory problems and inhalation of dusts and cigarette smoking. Raising awareness about health risks amongst workers could reduce these health hazards. The government should make a national policy for the prevention, control and elimination of silica exposure and silicosis. The results would help to raise awareness of the issue. Finally, it would raise awareness on respiratory health problems of workers at stone crushing industries in Bangladesh and help the government to make a policy for the prevention, control and elimination of silica exposure and silicosis, and thus enhancing public health policy and practices in the country.

BackgroundRespiratory symptoms are common in the general population, and their presence is related to Health-related quality of life (HRQoL). The objective was to describe the association of respiratory symptoms with HRQoL in subjects with and without asthma or COPD and to investigate the role of atopy, bronchial hyperresponsiveness (BHR), and lung function in HRQoL.MethodsThe European Community Respiratory Health Survey (ECRHS) I and II provided data on HRQoL, lung function, respiratory symptoms, asthma, atopy, and BHR from 6009 subjects. Generic HRQoL was assessed through the physical component summary (PCS) score and the mental component summary (MCS) score of the SF-36.Factor analyses and linear regressions adjusted for age, gender, smoking, occupation, BMI, comorbidity, and study centre were conducted.ResultsHaving breathlessness at rest in ECRHS II was associated with mean score (95% CI) impairment in PCS of -8.05 (-11.18, -4.93). Impairment in MCS score in subjects waking up with chest tightness was -4.02 (-5.51, -2.52). The magnitude of HRQoL impairment associated with respiratory symptoms was similar for subjects with and without asthma/COPD. Adjustments for atopy, BHR, and lung function did not explain the association of respiratory symptoms and HRQoL in subjects without asthma and/or COPD.ConclusionSubjects with respiratory symptoms had poorer HRQoL; including subjects without a diagnosis of asthma or COPD. These findings suggest that respiratory symptoms in the absence of a medical diagnosis of asthma or COPD are by no means trivial, and that clarifying the nature and natural history of respiratory symptoms is a relevant challenge.Several community studies have estimated the prevalence of common respiratory symptoms like cough, dyspnoea, and wheeze in adults [1-3]. Although the prevalence varies to a large degree between studies and geographical areas, respiratory symptoms are quite common. The prevalences of respiratory symptoms in the European Community Respiratory Health Study (ECRHS) varied from one percent to 35% [1]. In fact, two studies have reported that more than half of the adult population suffers from one or more respiratory symptoms [4,5].Respiratory symptoms are important markers of the risk of having or developing disease. Respiratory symptoms have been shown to be predictors for lung function decline [6-8], asthma [9,10], and even all-cause mortality in a general population study [11]. In patients with a known diagnosis of asthma or chronic obstructive pulmonary disease (COPD), respiratory symptoms are important determinants of reduced health related quality of life (HRQoL) [12-15]. The prevalence of respiratory symptoms exceeds the combined prevalences of asthma and COPD, and both asthma and COPD are frequently undiagnosed diseases [16-18]. Thus, the high prevalence of respipratory symptoms may mirror undiagnosed and untreated disease.The common occurrence of respiratory symptoms calls for attention to how these symptoms affect health also in subjects with no diagnosis of obstructive airways disease. Impaired HRQoL in the presence of respiratory symptoms have been found in two population-based studies [6,19], but no study of respiratory sypmtoms and HRQoL have separate analyses for subjects with and without asthma and COPD, and no study provide information about extensive objective measurements of respiratory health.The ECRHS is a randomly sampled, multi-cultural, population based cohort study. The ECRHS included measurements of atopy, bronchial hyperresponsiveness (BHR), and lung function, and offers a unique opportunity to investigate how respiratory symptoms affect HRQoL among subjects both with and without obstructive lung disease.In the present paper we aimed to: 1) Describe the relationship between respiratory symptoms and HRQoL in an international adult general population and: 2) To assess whether this relationship varied with presence of asthma and/or COPD, or presence of objective functional markers like atopy and BHR.

Background: The grilled meat (Suya) business exposes its employees to wood smoke and cooking oil fumes, which can cause impaired lung function. Objective: To compare the prevalence of respiratory and non-respiratory symptoms and lung function indices of suya meat sellers with those of control subjects in Calabar, Nigeria. Methods: Cluster sampling was used. The population consisted of 83 male grilled meat sellers and 83 male control subjects aged 19 – 40. A self-structured questionnaire was used to obtain their biodata and information on respiratory and non-respiratory symptoms. After that, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC and peak expiratory flow rate (PEFR) were measured and used as indices of pulmonary function. Results: Age, anthropometric parameters (weight, height and chest circumference), pulse rate, and oxygen saturation were not significantly different between the two groups. FVC, FEV1, FEV1/FVC and PEFR were significantly lower (p = 0.042, &lt;0.001, &lt;0.001, and &lt;0.001, respectively) in the test group compared with the control and correlated negatively (p&lt;0.001, &lt;0.001, 0.004 and &lt;0.001, respectively) with the duration of work of the test subjects. About 74% and 60.24% of the test subjects reported chest pain and sneezing, against only 28.91% and 19.28% of the control subjects who reported having these respiratory symptoms. Many test subjects had headaches (84.34%) and waist pain (74.70%), while only a few control subjects had these symptoms (14.46% and 9.64%, respectively). Conclusion: Chronic exposure to wood smoke and cooking oil fumes from grilled meat (suya) preparation impairs lung function, which worsens with increasing duration of exposure.

Nocturnal gastroesophageal reflux, lung function and symptoms of obstructive sleep apnea: Results from an epidemiological survey

Respiratory inflammation-related diseases pose significant health challenges globally, necessitating effective therapeutic interventions. Herbal medicines have emerged as promising candidates for managing these conditions due to their diverse bioactive compounds with anti-inflammatory properties. This abstract reviews the role of herbal medicines in alleviating respiratory inflammation and associated disorders. Herbal medicines offer a rich source of phytochemicals such as flavonoids, terpenoids, and polyphenols, known for their anti-inflammatory, antioxidant, and immunomodulatory effects. These compounds target various pathways involved in respiratory inflammation, including the inhibition of pro- inflammatory cytokines, suppression of oxidative stress, and modulation of immune responses. Several herbal remedies have demonstrated efficacy in alleviating respiratory inflammation-related diseases such as asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis. Commonly used herbs include ginger, turmeric, licorice, and boswellia, each possessing specific mechanisms of action against inflammatory mediators. Clinical studies have supported the therapeutic potential of herbal medicines in managing respiratory inflammation-related diseases. Parameters such as lung function, symptom severity, and inflammatory biomarkers are commonly evaluated to assess treatment efficacy. Moreover, herbal formulations are often well-tolerated with minimal adverse effects, making them suitable adjuncts or alternatives to conventional therapies. Furthermore, herbal medicines offer the advantage of holistic treatment by addressing not only the symptoms but also underlying inflammatory processes and immune dysregulation associated with Respiratory diseases. In conclusion, herbal medicines represent promising therapeutic options for respiratory inflammation-related diseases, offering a natural and multifaceted approach to manage these conditions. Further research is warranted to elucidate the mechanisms of action, Optimize formulations, and validate their long-term efficacy and safety profiles.

NO2: the gas that won't go away.

ObjectiveWe evaluated the short-term effects of exposure to cleaning products on lung function and respiratory symptoms among professional cleaning women.MethodsTwenty-one women with current asthma and employed as professional cleaners participated...