Assessment Of Respiratory Health Research Articles

Respiratory health assessment of outdoor workers exposed to urban air pollution based on satellite observations

Human health impact assessment due to air pollution is critical for evaluating environmental hazards. In this research, levels of three air pollutants (CO, NO2, and SO2) were estimated based on satellite data (sentinel-5p) to assess the air quality over three areas (Al-Mahaad Al-Dinni, Bus Stop, and Oil Company areas) at Banha city, Qalyobia in addition to evaluating the human health risks resulting from exposure to these air pollutants. Unlike the conventional approaches for human health risk assessment, which depend on in-situ air pollution measurements, in this study, the spatial distribution of the pollutants was acquired from satellite remote sensing for the period 2021–2022. The respiratory health assessment of 151 outdoor workers, exposed to air pollution in Banha City was conducted. Results showed that the highest concentration of the pollutants was found in areas of Bus Stop and Oil Company. Consequently, the percentage of predicted pulmonary function tests was significantly lower among those working in the Oil company area than those working in the Bus Stop and Al-Mahaad Al-Dinni areas. Additionally, 47.6 % of the studied group complained of nasal congestion and 67.5 % of them complained of wheezing, 30.5% of them had obstructive airway diseases. In conclusion, remotely sensed air quality data proved its efficiency in health impact studies which could be carried out in different regions globally with less cost than traditional measurement techniques. Urban pollution can influence outdoor workers with varied percentages according to their exposure rate to pollutants and work-related factors.

Oleoresin Capsicum (OC) Spray: An Assessment of Respiratory Health and its Management Following Accidental and Deliberate Exposures.

Introduced into law enforcement in 1976, the oleoresin capsicum (OC) spray has been labeled as one of the most significant and radical developments in law enforcement. However, epidemiological research on OC health effects is deficient, receiving little public support. The major responses to acute exposure to OC spray can be found in the pulmonary system. The molecular mechanism(s) involved in the action of capsaicinoids, the active constituents in OC, are complex cascades of reactions which end up in necrosis or apoptosis. OC may also damage and deplete biological redox systems in the epithelial lining fluids and within cells and mitochondria, modifying structural proteins and nucleic acids and leading to enzyme inactivation. Since there are no characteristic laboratory tests available for identification or confirmation of OC exposure, and on the basis of prevailing data, reassessment of the health risks of OC exposures in vulnerable populations and in-depth study of the molecular mechanics of receptors is the need of the hour for the development of effective countermeasures. This review aims to consider evidence for adverse effects of OC spray used in ways comparable to their application by law enforcement personnel and civilians, with possible treatment recommendations that are precedent for improved management.

Wearable Devices for Respiratory Monitoring

AbstractRespiratory diseases are currently monitored through traditional pulmonary function tests, such as spirometry. However, the restrictions of these procedures, particularly in the context of the COVID‐19 pandemic, have underscored the need for alternative approaches to respiratory health assessment. Wearable devices have emerged as a promising solution, providing continuous data collection, and overcoming the limitations posed by conventional methods. This review explores the multifaceted field of wearable devices for respiratory monitoring, presenting the most common sensing technologies applied to pulmonary ventilation, their constituent materials, fabrication techniques, and diverse morphologies to enhance sensor performance. The role of machine learning algorithms and ethical data sharing is highlighted, contributing to the forthcoming patient‐centered healthcare landscape. Ultimately, the importance of validation and calibration protocols for wearable devices is underlined. In anticipation of evolving healthcare needs, this in‐depth study addresses the current challenges in wearable respiratory monitoring while laying a robust foundation for a personalized, connected, and ethically sound future for respiratory care.

Physicochemical hazard assessment of ash and dome rock from the 2021 eruption of La Soufrière, St Vincent, for the assessment of respiratory health impacts and water contamination

Abstract La Soufrière, St Vincent, began an extrusive eruption on 27 December 2020. The lava dome was destroyed, along with much of the pre-existing 1979 dome, in explosive eruptions from 9 to 22 April 2021. Lava domes generate crystalline silica – inhalation of which can cause silicosis in occupational settings – which can become hazardous when dome material is incorporated into volcanic ash. La Soufrière ash (17 samples) was analysed, according to IVHHN protocols, to rapidly quantify crystalline silica and test for other health-relevant properties. The basaltic andesitic ash contained <5 wt% crystalline silica, which agrees with previous analyses of ash of similar compositions and mirrors the low quantities measured in dome samples (2 area %). It contained substantial inhalable material (7–21 vol% <10 µm). Few fibre-like particles were observed, reducing concern about particle shape. Leaching assays found low concentrations of potentially toxic elements, which indicates low potential to impact health, contaminate drinking-water sources or harm grazing animals through ingestion. Collectively, these data indicate that the primary health concern from this eruption was the potential for fine-grained ash to increase ambient particulate matter, an environmental risk factor for respiratory and cardiovascular morbidity and mortality. Precautionary measures were advised to minimize exposure.

Prevalence and Characteristics of Chronic Obstructive Pulmonary Disease in Dairy Farmers

Objective: To assess the prevalence and characteristics of chronic obstructive pulmonary disease (COPD) in dairy farmers, and evaluate the role of job exposure and smoking as predictors for respiratory health impairment. Methods: A cross-sectional study was performed, including 83 dairy farmers (mean age: 52.6±8.7 years; mean exposure duration: 23.7±7.6 years) and 80 office workers as a control group (mean age: 52.7±8.2 years) matched for age, smoking habits, and socioeconomic status. Methods for evaluation of study participants included a questionnaire on respiratory symptoms in the last 12 months, baseline spirometry and bronchodilator reversibility testing, and diagnostic criteria for COPD. Results: The mean post-bronchodilator values of spirometric parameters are significantly lower in subjects among EG with negative bronchodilator test compared to those in CG, while the mean post-bronchodilator values of spirometric parameters are lower in dairy farmers with negative BD tests exposed more than 20 years compared to those with exposure less than 20 years, being statistically significant for FEV1/FVC%, MEF25, MEF50 and MEF75. The COPD prevalence is non-significantly higher in dairy farmers compared to controls, and is significantly associated with age over 40 years in dairy farmers (P=0.035). The risk for COPD development in dairy farmers is about 36 fold higher in subjects exposed more than 20 years (OR = 36.00 (1.21-37.77) CI 95%) compared to those with exposure duration less than 20 years, and is about 6 fold higher in dairy farmers who are current smokers (OR = 6.12 (0.95-37.77) CI 95%). COPD is significantly associated with smoking duration among smokers in both groups, while combined effect of smoking, smoking duration, and number of cigarettes smoked daily has a significant impact on COPD development in dairy farmers. According to the GOLD classification, depending on the degree of airflow limitation, mild and moderate types of COPD are detected in dairy farmers, and only mild type in controls, showing no significant difference between the two groups. Conclusion: The study findings recognized the role of farming exposure, and smoking as well, as predictors for respiratory health impairment, and furthermore confirmed their potential to be a predictive factor in the COPD development. These facts should be helpful in detection of critical points for action, indicate the need of adverse occupational exposures reduction through adequate preventive measures and regular health examinations, implementation of relevant engineering controls, smoking cessation programs, and complete and efficient respiratory health assessment.

Assessment of Respiratory Morbidity and Epidemiological Survey of Tobacco Smokers and Non-Smokers Among Educated Young Adults in Visva-Bharati, Santiniketan: A Case Study

Tobacco smoking among adults have become a serious health concern worldwide due to its increasing addicting nature. Tobacco smoke contains highly harmful gaseous and volatile chemical substances that impair the respiratory system and reduce lung function capacity. The study's primary objectives were to investigate the cause of smoking, behaviour of smokers, social responsibility, family history of the smoker, and significant respiratory health problems among young educated adults. The survey was conducted with some pre-framed questionnaires and screening relevant to the subjects for our study. The respiratory health assessment was carried out by questionnaire-based personal interviews for different respiratory and non-respiratory health symptoms. Subsequently, the lung function or pulmonary function test (LFT or PFT) for selected individuals was performed, revealing the lung performances of smokers and non-smokers. The LFT or PFT test predicts the normal and abnormal breathing patterns of exposed and non-exposed studied groups. The significant findings indicated that curiosity (72%) and displaying of smartness were the leading cause of smoking in early adulthood (16 to 20 years). Family history of smoking also influenced young adults to initiate regular smoking. Smoking within thirty minutes after waking up in the morning was - a habit in 52% of smokers. Findings revealed that 50% of the heavy smokers smoke 11-15 units daily. The average weekly expenditure for the smoking materials was INR 100 to 150 (26.32%) rupees for smokers. Spirometric indices such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percentage forced expiratory volume in one second (FEV1%), and peak expiratory flow rate (PEFR), showed a reduced performance of lungs in smokers as compared to their fellow non-smokers. This study has focused on the smoking behaviour of educated young adults and revealed the presence of different respiratory symptoms in smokers than non-smokers, which is an immerging health issue. The study revealed that smokers grouped are more susceptible to lung diseases than non-smokers in the future due to their reduced lung function capacity compared to non-smokers.

The physics of respiratory particle generation, fate in the air, and inhalation.

Given that breathing is one of the most fundamental physiological functions, there is an urgent need to broaden our understanding of the fluid dynamics that governs it. There would be many benefits from doing so, including a better assessment of respiratory health, a basis for more precise delivery of pharmaceutical drugs for treatment, and the understanding and potential minimization of respiratory infection transmission. We review the physics of particle generation in the respiratory tract, the fate of these particles in the air on exhalation and the physics of particle inhalation. The main focus is on evidence from experimental studies. We conclude that although there is qualitative understanding of the generation of particles in the respiratory tract, a basic quantitative knowledge of the characteristics of the particles emitted during respiratory activities and their fate after emission, and a theoretical understanding of particle deposition during inhalation, nevertheless the general understanding of the entire process is rudimentary, and many open questions remain.

Hajj health examination for pilgrims with asthma in Malaysia: An ethnographic study.

BackgroundAsthma was one of the top causes of hospitalization and unscheduled medical attendances due to acute exacerbations and its complications. In Malaysia, all pilgrims must undergo a mandatory health examination and certified fit to perform pilgrimage. We studied the current organisational and clinical routines of Hajj health examination in Malaysia with a focus on the delivery of care for pilgrims with asthma.MethodsWe conducted non-participant observation to obtain ethnographic understanding of Hajj health examination activities for 2019. Observations were guided by a checklist and recorded as notes that were analysed thematically. The study was conducted at 11 public (from each region in Malaysia, namely, North, South, East, West of Peninsular Malaysia, and Sabah and Sarawak of East Malaysia) and two private primary care clinics.ResultsWe observed considerable variation in the implementation and practice of Hajj health examinations among the 11 public clinics but no marked variation among the private clinics. The short time span of between three to four months was inadequate for disease control measures and had put pressure on health care providers. They mostly viewed the Hajj health examination as merely a certification of fitness to perform the pilgrimage, though respiratory health assessment was often inadequate. The opportunity to optimise the health of pilgrims with asthma by providing the appropriate medications, asthma action plan and asthma education including the preventive measures was disregarded. The preliminary health screening, which aimed to optimise pilgrims’ health before the actual Hajj health examination was not appreciated by either pilgrims or health care providers.ConclusionsThere is great potential to reform the current system of Hajj health certification in order to optimise its potential benefits for pilgrims with asthma. A systematic approach to restructuring the delivery of Hajj health examination could address the time constraints, clinical competency of primary health care providers and resources limitations.

A Study to Assess Respiratory Health Status among Bricks Workers

Introduction: Respiratory health problem is one of the major health problem among bricks industryworkers those who are working in dusty area. These problem can be reduce when proper interventiontaken like use of mask, hanky and other devices during working time.Objectives:1. To assess respiratory health status of bricks workers working in brisk industry.2. To find the association among respiratory health status and selected demographic variables.Methodology: Quantitative research approach utilized with cross sectional research study among Bricksworkers .91 Samples were collected by non probability convenient sampling technique. Demographicand respiratory health assessment done through questionnaire.Results: Result showed that Average age of participants was 33.20 ± 5.123(mean ± SD),Averagemonthly income of participants were 12659.34,Average year of experience was 7.35 ± 4.510 (mean ±SD), Gender majority of participants were males 82(91.1%), Disease or any issue other then respiratoryhealth,89 (97.8 %) had no any diseases, 67(73.6%) were not using any devices during working time,47(51.6%) were smoker. In respiratory assessment symmetrical chest movement had seen in 91(100%)participants. 21(23.1%) had Acute Cough. 8(8.8%) had white colour phlegm and 4(4.4%) had blackcolour phlegm. 23(25.3) had Grade I of shortness of breath,1(1.1%) had history of self reported asthma.there was significant Association found between cough and Age in year, Experience in year, OtherHealth problem and Issue , Habits of smoking.There was significant Association found between phlegm and Age in years , Other Health Issue , Habitsof smoking, drug and other supplements.There was significant Association found between shortness of breath and Age , Qualification, Experiencein year , Habits of smoking.

How severe acute respiratory syndrome coronavirus-2 aerosol propagates through the age-specific upper airways.

The recent outbreak of the COVID-19 causes significant respirational health problems, including high mortality rates worldwide. The deadly corona virus-containing aerosol enters the atmospheric air through sneezing, exhalation, or talking, assembling with the particulate matter, and subsequently transferring to the respiratory system. This recent outbreak illustrates that the severe acute respiratory syndrome (SARS) coronavirus-2 is deadlier for aged people than for other age groups. It is evident that the airway diameter reduces with age, and an accurate understanding of SARS aerosol transport through different elderly people's airways could potentially help the overall respiratory health assessment, which is currently lacking in the literature. This first-ever study investigates SARS COVID-2 aerosol transport in age-specific airway systems. A highly asymmetric age-specific airway model and fluent solver (ANSYS 19.2) are used for the investigation. The computational fluid dynamics measurement predicts higher SARS COVID-2 aerosol concentration in the airway wall for older adults than for younger people. The numerical study reports that the smaller SARS coronavirus-2 aerosol deposition rate in the right lung is higher than that in the left lung, and the opposite scenario occurs for the larger SARS coronavirus-2 aerosol rate. The numerical results show a fluctuating trend of pressure at different generations of the age-specific model. The findings of this study would improve the knowledge of SARS coronavirus-2 aerosol transportation to the upper airways which would thus ameliorate the targeted aerosol drug delivery system.

The benefits of a systematic assessment of respiratory health in illness-susceptible athletes.

Respiratory tract illness is a leading cause of training and in-competition time loss in elite athletes. Asthma is known to be prevalent in athletes, but the coexistence of other respiratory problems in those deemed to be susceptible to respiratory tract illness is unknown. The aim of this study was to apply a comprehensive prospective approach to identify respiratory problems and explore relationships in athletes with heightened respiratory illness susceptibility.UK World Class Performance Programme athletes prospectively completed a systematic review of respiratory health with validated questionnaires and respiratory-focused investigations, including studies of nasal flow, exhaled nitric oxide, spirometry, bronchoprovocation testing and allergy testing.Systematic respiratory health assessment was completed by 122 athletes (55 females, mean±sd age 24±4 years). At least one respiratory health issue, requiring intervention, was identified in 97 (80%) athletes and at least two abnormalities were found in 73 (60%). Sinonasal problems were the most commonly identified problem (49%) and 22% of athletes had a positive indirect bronchoprovocation test. Analysis revealed two respiratory health clusters: 1) asthma, sinus problems and allergy; and 2) laryngeal and breathing pattern dysfunction. Respiratory illness susceptible athletes had 3.6±2.5 episodes in the year prior to assessment and were more likely to have allergy (OR 2.6, 95% CI 1.0-6.5), sinonasal problems (2.6, 1.1-6.0) and symptoms of laryngeal (5.4, 1.8-16.8) and breathing pattern dysfunction (3.9, 1.1-14.0) than nonsusceptible athletes (all p<0.05).A systematic approach to respiratory assessment identifies a high prevalence and coexistence of multiple respiratory problems in illness-susceptible athletes.

Assessment of respiratory health and environmental safety measures in phosphate fertilizer industry in the middle region of the Nile Delta, Egypt.

Phosphate fertilizer industry is one of the most environmental polluting industries in Egypt. To identity the prevalence of abnormal ventilatory functions and to assess environmental safety measures in phosphate fertilizer industry in the middle region of the Nile Delta, Egypt. The study included 180 exposed male workers in phosphate fertilizer factory at Kafr El-Zayat City. An interview questionnaire was used to collect data related to socio-demographic, occupational history, and work-related respiratory manifestations. Spirometer was used for measuring ventilatory functions tests. Assessment of workplace safety measures was done by using Occupational Safety and Health (OSH) Inspection Checklist, and environmental measures of total dust and sulfur dioxides (SOx) were obtained from records. Self-reported respiratory manifestations were found in 74/180 workers (41.11%), with rhinitis (49.3%), cough (38.9%), and expectoration (38.3%) were the most frequent. Abnormal ventilatory functions were confirmed and reported in about one-fourth of workers (43/180, 23.9%) with prominence of obstructive pattern. Significant negative correlation was found between age and MVV values (r = - 0.449, p = 0.001) and between duration of work and values of both FEV1(r = - 0.248, p = 0.033) and MVV (r = - 0.473, p = 0.001). The mean percent of applied safety practices and measures in workplace was 53.39% ± 16.4. The mean of sulfur dioxides values in English acid unit exceeded the permissible exposure level (PEL). Preventive medical and environmental safety measures were inadequate with a relatively high prevalence of abnormal ventilatory functions among workers. Sulfur dioxides measurements exceeded PEL.

Prognostic factors in chronic hypersensitivity pneumonitis.

Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease resulting from exposure to inhaled environmental antigens. Prognosis is variable, with a subset of patients developing progressive fibrosis leading to respiratory failure and death. Therefore, there is an urgent need to identify factors which predict prognosis and survival in patients with HP. We undertook a narrative review of existing evidence to identify prognostic factors in patients with chronic HP. Patient demographics, smoking history, extent of antigen exposure and comorbidities all have reported associations with disease outcome, and physiological, radiological and laboratory markers have been shown to predict overall survival. While no single marker has been demonstrated to accurately and reliably predict prognosis, older age, more severe impairment of pulmonary function at baseline and established fibrosis on either biopsy or high-resolution computed tomography are consistently associated with worse survival. The vast majority of existing studies are retrospective, and this review identifies a need for prospective longitudinal studies with serial assessment of respiratory health to ascertain factors associated with nonfatal deterioration. Future developments, including the development of HP-specific composite scores may help further improve our ability to predict outcomes for individual patients.

Asthma and Chronic Obstructive Pulmonary Disease Associated With Occupational Exposure in Dairy Farmers - Importance of Job Exposure Matrices.

AIM:To evaluate the prevalence of chronic respiratory symptoms, lung function impairment, and chronic obstructive respiratory diseases in dairy farmers. Our objective is to then examine their relation to exposure duration and to explore the usefulness of job exposure matrices as tools for exposure assessment, and predictors for respiratory health impairment.METHODS:A cross-sectional study was performed, including 83 dairy farmers (mean age: 52.6 ± 8.7 years; mean exposure duration: 23.7 ± 7.6 years) and 80 office workers as a control group (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Methods of evaluating examined subjects included a questionnaire on respiratory symptoms in the last 12 months, spirometry and histamine challenge, as well as the use of job exposure matrices (JEM).RESULTS:Dairy farmers had a significantly higher prevalence of cough (38.5), phlegm (27.7%), and wheezing (21.7%), than controls (p < 0.05). All mean baseline spirometric parameters were lower in dairy farmers compared to the controls, but statistical significance was confirmed only for MEF25, MEF50, and MEF75% (p = 0.010, p = 0.001, and p = 0.004, respectively). The prevalence of bronchial hyperresponsiveness, asthma, and chronic obstructive pulmonary disease was higher in dairy farmers but without statistical significance. JEM were useful tools for exposure assessment and predictors of factors for asthma and COPD development.CONCLUSION:The results suggest that occupational exposure among crop farmers is associated with a higher prevalence of respiratory symptoms, lung function impairment, and a higher prevalence of chronic respiratory diseases. JEM showed good potential for farming exposure evaluation and promoted their applicability within the diagnostic algorithm focused on respiratory health assessment.

Respiratory health assessment and exposure to polycyclic aromatic hydrocarbons in Mexican indigenous population.

Indoor air pollution is an important risk factor for the generation of lung diseases in developing countries. The indigenous population is particularly susceptible to be exposed to the mixture of pollutants from the biomass burning, among them, polycyclic aromatic hydrocarbons (PAHs). The objective of this study was to assess respiratory health and exposure to PAHs in indigenous populations of the Huasteca Potosina in Mexico. The urinary metabolite 1-hydroxypyrene (1-OHP) was evaluated by HPLC with fluorescence detector, the forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio (forced vital capacity) by spirometry in the Teenek indigenous adult population of the communities from Tocoy (TOC), Xolol (XOL), and Tanjajnec (TAN). A total of 134 subjects participated in the study: 64 from TOC, 30 from XOL, and 40 from TAN; in all the communities, high percentages of overweight and obesity were presented (from 50 to 73%). The average hours of firewood usage per year were 281.06, 284.6, and 206.6 in TOC, XOL, and TAN, respectively. The average of the three communities of the % FEV1 post-bronchodilator was 86.1%. There were identified from 4.5 to 6.6% and from 12.5 to 15.5% of spirometric obstructive and restrictive patterns respectively, in all communities. The highest exposure levels reported as median were found in TOC (1.15 μmol/mol of creatinine) followed by TAN (0.94 μmol/mol of creatinine) and XOL (0.65 μmol/mol of creatinine). Considering the magnitude of the indigenous population exposed to pollutants from the biomass burning and the possible effects on respiratory health, it is important to design strategies that mitigate exposure and evaluate the effectiveness through biological monitoring and effects.

Interaction of pulmonary surfactant with silica and polycyclic aromatic hydrocarbons: Implications for respiratory health

Understanding the interaction between pulmonary surfactant (PS) and inhalable pollutants is vital for risk assessment of respiratory health. Here, PS extracted from porcine lung (EPS) was used to investigate the interaction of PS with nano-silica particles and polycyclic aromatic hydrocarbons (PAHs). Our results demonstrated that silica significantly affected the phase behavior and foaming ability of EPS; EPS and its major components (dipalmitoyl phosphatidylcholine, DPPC; bovine serum albumin, BSA) exhibited great enhancing effect on PAHs solubility, which follows the order: EPS > DPPC > BSA, and it was positively correlated with the hydrophobicity of PAHs. Further experiments demonstrated that mixed phospholipids of EPS were largely responsible for the solubilization of EPS on PAHs. In the presence of EPS, DPPC or BSA, adsorption of PAHs by silica was notably inhibited, indicating competitive adsorption between PAHs and PS components on silica. These findings provide evidence for the surface chemistry by which PS facilitates the solubilization of PAHs and reducing the adsorption of PAHs on silica, which may be helpful for deeply understanding the effects of particulate matter and PAHs on lung health.

Towards scalable capacitive cantilever arrays for emerging biomedical applications

This paper presents the design and implementation of a cantilever array device using a multi-user MEMS process for emerging point-of-care (PoC) diagnostic technologies. Each cantilever is incorporated with two capacitive sensing electrodes for the measurement of its beam deflection. A custom-made multichannel interface readout circuit was also developed using off-the-shelf elements for capacitance recording and data acquisition purposes. Herein, we demonstrate and discuss the functionality of the proposed capacitive cantilever array platform using interferometry and non-invasive rapid air-based characterization techniques. Based on simulation and experimental results, the proposed cantilever based platform can accurately measure μN-scale forces applied on each cantilever. The applicability of the proposed cantilever system was successfully investigated for PoC lung diagnostic purposes. Based on these results, the proposed system shows significant promise for use as an emerging free breathing measurement system for continuous assessment of respiratory health.

The Maternal Diet, Gut Bacteria, and Bacterial Metabolites during Pregnancy Influence Offspring Asthma.

This review focuses on the current evidence that maternal dietary and gut bacterial exposures during pregnancy influence the developing fetal immune system and subsequent offspring asthma. Part 1 addresses exposure to a farm environment, antibiotics, and prebiotic and probiotic supplementation that together indicate the importance of bacterial experience in immune programming and offspring asthma. Part 2 outlines proposed mechanisms to explain these associations including bacterial exposure of the fetoplacental unit; immunoglobulin-related transplacental transport of gut bacterial components; cytokine signaling producing fetomaternal immune alignment; and immune programming via metabolites produced by gut bacteria. Part 3 focuses on the interplay between diet, gut bacteria, and bacterial metabolites. Maternal diet influences fecal bacterial composition, with dietary microbiota-accessible carbohydrates (MACs) selecting short-chain fatty acid (SCFA)-producing bacteria. Current evidence from mouse models indicates an association between increased maternal dietary MACs, SCFA exposure during pregnancy, and reduced offspring asthma that is, at least in part, mediated by the induction of regulatory T lymphocytes in the fetal lung. Part 4 discusses considerations for future studies investigating maternal diet-by-microbiome determinants of offspring asthma including the challenge of measuring dietary MAC intake; limitations of the existing measures of the gut microbiome composition and metabolic activity; measures of SCFA exposure; and the complexities of childhood respiratory health assessment.

Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in Chronic Obstructive Pulmonary Disease

There is limited evidence of the effect of exposure to heat on chronic obstructive pulmonary disease (COPD) morbidity, and the interactive effect between indoor heat and air pollution has not been established. To determine the effect of indoor and outdoor heat exposure on COPD morbidity and to determine whether air pollution concentrations modify the effect of temperature. Sixty-nine participants with COPD were enrolled in a longitudinal cohort study, and data from the 601 participant days that occurred during the warm weather season were included in the analysis. Participants completed home environmental monitoring with measurement of temperature, relative humidity, and indoor air pollutants and simultaneous daily assessment of respiratory health with questionnaires and portable spirometry. Participants had moderate to severe COPD and spent the majority of their time indoors. Increases in maximal indoor temperature were associated with worsening of daily Breathlessness, Cough, and Sputum Scale scores and increases in rescue inhaler use. The effect was detected on the same day and lags of 1 and 2 days. The detrimental effect of temperature on these outcomes increased with higher concentrations of indoor fine particulate matter and nitrogen dioxide (P < 0.05 for interaction terms). On days during which participants went outdoors, increases in maximal daily outdoor temperature were associated with increases in Breathlessness, Cough, and Sputum Scale scores after adjusting for outdoor pollution concentrations. For patients with COPD who spend the majority of their time indoors, indoor heat exposure during the warmer months represents a modifiable environmental exposure that may contribute to respiratory morbidity. In the context of climate change, adaptive strategies that include optimization of indoor environmental conditions are needed to protect this high-risk group from the adverse health effects of heat.

Toward spirometry-on-chip: design, implementation and experimental results

This paper presents a new approach towards the development of a spirometer-on-chip device for point-of-care diagnostics. The proposed device consists of a cantilever based airflow sensor fabricated through a multi-user MEMS process. The deflection of each cantilever beam is measured using capacitive electrodes integrated on a single semiconductor chip. These electrodes are connected to an off-chip custom-made readout interface circuit for the measurement of minute capacitive changes and for the acquisition of data into a computer. Herein, we discuss and demonstrate the characterization results of such a system using a low complexity air-based technique. Additionally, we demonstrate the applicability of these devices for spirometry on breathing tests of human subjects. Based on these results, the proposed spirometer-on-chip shows significant promise for use as a mobile portable system for continuous health assessment of respiratory health.