Community Respiratory Health Survey Questionnaire Research Articles

Analysis of Risk Factors and The Impact of Nitric Oxide (NO) and Carbon Monoxide (CO) Levels on Lung Function: A Comparative Study of Palm Oil Factory Workers and the Community in Kuantan Mudik District, Riau, Indonesia

Background: Air pollution, particularly from industrial sources like palm oil factories, poses a significant risk to respiratory health. This study aimed to investigate the impact of nitric oxide (NO) and carbon monoxide (CO) exposure on lung function in palm oil factory workers and compare it to the lung function of individuals in the surrounding community. Methods: A cross-sectional study was conducted in Kuantan Mudik District, Riau, Indonesia. One hundred palm oil factory workers with a minimum of two years of employment and 100 community members not occupationally exposed to NO and CO were recruited. Lung function was assessed using spirometry, and NO and CO levels were measured using specialized analyzers. Participants completed the European Community Respiratory Health Survey (ECRHS) questionnaire, and demographic and clinical data were collected. Statistical analyses included univariate, bivariate, and multivariate logistic regression. Results: Factory workers exhibited significantly higher levels of NO (p=0.000) and a higher prevalence of restrictive lung function (17%) compared to the community members (3%). Multivariate analysis identified NO exposure as the most significant risk factor for restrictive lung function (p=0.005). Each unit increase in NO was associated with a 1.12-fold increased risk of restrictive lung function. CO exposure, age, gender, smoking history, and the use of personal protective equipment (PPE) were not significantly associated with lung function impairment in this study. Conclusion: Occupational exposure to NO in palm oil factories is a significant risk factor for restrictive lung function impairment. Regular monitoring of NO levels and the implementation of effective control measures are crucial to protect the respiratory health of palm oil factory workers.

РАННЯЯ ДИАГНОСТИКА ПОЗДНЕЙ БРОНХИАЛЬНОЙ АСТМЫ У КОМОРБИДНЫХ ПАЦИЕНТОВ

Abstract. Introduction. Underdiagnosis of late-onset bronchial asthma and improvement of methods for its early detection is an important trend in medicine, which is associated with the increasing number of adult patients with variable respiratory symptoms, allergologic history, and comorbid background. It seems reasonable to improve the early diagnosis of late-onset asthma in comorbid patients using screening scales. Aim. To assess the risk of late-onset bronchial asthma in comorbid patients, using the Adult Epidemiologic Asthma Scale (A2) and the European Community Respiratory Health Survey (ECRHS) questionnaire. Material and Methods. Eighty patients aged 59.9±11.6 (–51.3% of them being female patients) were examined. Group 1: Comorbid patients with the established asthma; group 2: Comorbid patients without asthma. Asthma risk factors, respiratory symptoms, frequency of comorbid conditions, and blood eosinophil count were evaluated. Additionally, questionnaires including A2 and ECRHS scales were used in asthma screening. The diagnostic significance of questionnaires for early detection of late-onset asthma was assessed using ROC analysis. Results and Discussion: The patients examined were comparable in age, sex, and adherence to smoking. Over 63% of the group 1 patients had hereditary history of asthma and sensitization to allergens in contrast to the group 2 patients (0%). Patients in both groups frequently reported choking (group 1: 100%, group 2: 85.1%), cough (100% and 57.4%, respectively), and wheezing (69.7% and 38.3%, respectively). Among comorbidities, the frequency of which was comparable between the groups (p>0.05), arterial hypertension (group 1: 66.7%, group 2: 59.6%) and obesity (60.6% and 42.6%, respectively) were predominant. Over 35% of patients in each group had chronic heart failure. There was a trend toward more frequent development of diabetes mellitus in patients with asthma (30.3% and 12.8%; p=0.054). The sum of A2 and ECRHS scale scores exceeded 4 in all patients with asthma. In group 2, “Probable asthma” was reported by 46.8% of patients in the A2 questionnaire and by 27.7% on the ECRHS scale. According to ROC-analysis, “Probable asthma” in the group 2 patients on A2 scale was recorded at the sum of scores > 6 (100% sensitivity and 82.9% specificity) and > 4 scores (87.8% sensitivity and 87.2% specificity) for ECRHS questionnaire. Conclusions. High diagnostic value of A2 and ECRHS questionnaires was determined in comorbid patients with respiratory symptoms without asthma. In 30% of cases, the questionnaire results established “Probable asthma” in this category of patients.

Exposure to farm environment and its correlations with total IgE, IL-13, and IL-33 serum levels in patients with atopy and asthma.

The aim of the study was to evaluate total immunoglobulin E (IgE), IL-13, and IL-33 serum level in people with bronchial asthma and atopy, and in healthy control group depending on their exposure to farm animals currently and in the first year of life. The study included 174 individuals living in rural areas and in a small town. Standardized questions from the International Study of Asthma and Allergy in Childhood and The European Community Respiratory Health Survey (ECRHS) questionnaires were used to define asthma. Atopic status was verified by skin prick tests. Rural exposure including contact with livestock was verified by adequate questionnaire. Total serum IgE, IL-13, and IL-33 levels were assessed by ELISA (enzyme-linked immunosorbent assay) tests. Participants with atopy and bronchial asthma were characterized by high level of immunoglobulin E. Tendency to lower serum IgE level was observed among people reporting present contact with farm animals. Also, among those having contact with livestock in their first year of life, the analogous tendency was noticed. No difference in serum IL-13 levels in participants with asthma and atopy, and controls was observed, and there was no effect of exposure on farm animals on the concentration of IL-13. The highest IL-33 level was found in the atopic group, and the lowest in the control group. Participants currently exposed to farm animals were predisposed to have lower IL-33 serum level. Exposure of farm animals currently and in first year of life may result in a lower level of total IgE. Correlation between IL-13 and IL-33 serum levels and contact with livestock was not confirmed.

Per- and polyfluoroalkyl substances (PFAS) and immune system-related diseases: results from the Flemish Environment and Health Study (FLEHS) 2008–2014

BackgroundThe successive FLEHS campaigns assess internal exposure to pollutants and associated early biological and health effects in participants of different age groups.Materials and methodsMother–newborn pairs (N = 220 in 2008–2009, age 18–42 years; N = 269 in 2013–2014, age 18–44 years), 197 adolescents 14–15 years (2010–2011), 201 adults 20–40 years (2008–2009) and 205 adults 50–65 years (2014) were recruited. For the various groups of subjects different sets of PFAS were assessed. Perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA) and perfluorobutane sulfonate (PFBS) were determined in cord plasma and peripheral serum as these were the PFAS compounds for which we had access to high quality measurements and which were expected to be present in the highest concentrations. Participants filled out a questionnaire based on the European Community Respiratory Health Survey questionnaire on asthma and allergy. In these cross-sectional studies associations were assessed using stepwise multiple logistic regression, with confounders (including smoking and familial occurrence of the disease) and potential covariates selected on the basis of experience in our previous studies and a literature search. Forest plots of odds ratios summarize the associations between the various PFAS on the one hand and the different immune outcomes on the other hand.ResultsFor several self-reported immune system-related diseases inverse associations with PFAS serum concentrations were observed. These inverse associations were more pronounced in mothers and adults than in adolescents. A significant inverse association was observed in adults and mothers (for mothers based on measurements on cord plasma) between PFNA, PFOS, and PFHxS and asthma (for mothers also for PFOA), in mothers between PFHxS, PFNA and PFOS and allergic rhinitis, in mothers and adults between PFHxS and PFOS and some forms of allergy (for mothers also for PFOA), in adults between PFOA and eczema, and in adolescents between PFOS and systemic allergy.ConclusionInternal exposure to PFAS was associated with changes in immunological processes consistent with what has been reported in the literature. Whereas these changes were observed in many publications to be associated with adverse health effects, our findings suggest that they can also lead to inverse associations with certain immune system-related diseases.

Validation of the Arabic Version of the European Community Respiratory Health Survey Screening Questionnaire.

The European Community Respiratory Health Survey (ECRHS) questionnaire has been widely used in epidemiological studies to quantify respiratory symptoms and screen for asthma, but there is no formally validated Arabic version. This study developed an Arabic ECRHS screening questionnaire, comprehensively evaluated its reliability and validity, and used it to estimate the population prevalence of respiratory symptoms and asthma in Saudi Arabia. The ECRHS screening questionnaire was adapted to Arabic through translation and back-translation by bilinguals with consultation to a professional committee and lay panel. Reliability and validity were evaluated in a prospective, cross-sectional convenience sample of adults (>18 years) between January and July 2022 in Riyadh, Saudi Arabia. A subgroup completed the questionnaire again three weeks later to assess test-retest reliability. All respiratory symptom-positive participants were invited for spirometry to diagnose asthma according to GINA criteria. Internal consistency was assessed using Cronbach's α coefficient, test-retest reliability with Cohen κ coefficients, and reliability by calculating the sensitivity and specificity for diagnosing asthma. Of 2500 invited individuals, 1881 participated (75.2%). A total of 668 (35.5%) participants reported respiratory symptoms according to the ECRHS questionnaire, and 157/1881 (8.3%) had a current diagnosis of asthma on ECRHS questions. Cronbach's α coefficient for internal consistency was 0.831, "good" internal consistency. The test-retest reliability (n = 303) was "excellent" for all questions (Cohen's κ≥0.75). A total of 543 (81.3%) screening-positive participants underwent spirometry, of whom 278 (52%) were diagnosed with asthma according to GINA guidelines, an overall estimated prevalence of 14.8%. Most questions showed good-to-fair specificity and variable sensitivity for physician-diagnosed asthma. This Arabic version of the ECRHS screening questionnaire is conceptually similar to the English version, comprehensible, and reliable. Many asthma cases remain hidden and undiagnosed. In addition to utility in epidemiological studies, the ECRHS screening questionnaire might be a simple, quick, and useful tool for asthma case finding.

The association between wood dust exposure and respiratory disorders and oxidative stress among furniture workers.

BackgroundThis study was undertaken to determine the effect of wood dust on the respiratory system and oxidative stress in furniture workers and to determine whether any associations exist between respiratory parameters and oxidative stress.MethodsThis cross-sectional study was performed on 45 furniture workers and 45 office workers as a reference group in Iran.The NIOSH method 0600 was used to determine the concentration of particulates. The prevalence of respiratory symptoms was estimated via the European Community Respiratory Health Survey (ECRHS) questionnaire. Oxidative stress biomarkers and respiratory parameters were also measured.ResultsThe mean concentrations of respirable and non-respirable dust were found to be 1.51 mg/m3 and 1.23 mg/m3, respectively. Pulmonary function parameters, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, and antioxidant capacity biomarkers such as total antioxidant capacity (TAC) and superoxide dismutase (SOD) were significantly lower, while the prevalence of respiratory symptoms, and malondialdehyde (MDA) levels, were significantly higher in the furniture workers than in the reference group. There were significant positive associations between FVC and FEV1 with SOD and TAC.ConclusionThe present study results indicated that exposure to wood dust significantly increased respiratory disorders and confirmed the association between lung function parameters and oxidative stress.

Respiratory symptoms and use of dust-control measures in New Zealand construction workers - A cross-sectional study.

Dust-exposed construction workers have an increased risk of respiratory symptoms, but the efficacy of dust-control measures remains unclear. This study compared respiratory symptoms, using a modified European Community Respiratory Health Survey questionnaire, between construction workers (n = 208) and a reference group of bus drivers and retail workers (n = 142). Within the construction workers, we assessed the effect of collective (on-tool vacuum/’wet-cut’ systems) and personal (respirators) exposure controls on symptom prevalence. Logistic regression assessed differences between groups, adjusted for age, ethnicity, and smoking status. Construction workers were more likely to cough with phlegm at least once a week (OR 2.4, 95% CI 1.2–4.7) and cough with phlegm ≥3 months/year for ≥2 years (OR 2.8, CI 1.2–7.0), but they had similar or fewer asthma symptoms. Construction workers who had worked for 11–20 years reported more cough/phlegm symptoms (OR 5.1, 1.7–15.0 for cough with phlegm ≥3 months/year for ≥2 years) than those who had worked <10 years (OR 1.9, 0.6–5.8), when compared to the reference group. Those who used ‘wet-cut’ methods reported less cough with phlegm, although the evidence for this association was weak (OR 0.4, CI 0.2–1.1 for cough with phlegm at least once a week); use of on-tool extraction showed a similar trend. No associations between respiratory protective equipment-use and symptoms were found. In conclusion, construction workers reported more symptoms suggestive of bronchitis, particularly those employed in the industry for >10 years. Use of collective dust exposure controls might protect against these symptoms, but this requires confirmation in a larger study.

The Effects of Indoor Pollutants Exposure on Allergy and Lung Inflammation: An Activation State of Neutrophils and Eosinophils in Sputum.

Background: To explore the inflammation phenotypes following indoor pollutants exposure based on marker expression on eosinophils and neutrophils with the application of chemometric analysis approaches. Methods: A cross-sectional study was undertaken among secondary school students in eight suburban and urban schools in the district of Hulu Langat, Selangor, Malaysia. The survey was completed by 96 students at the age of 14 by using the International Study of Asthma and Allergies in Children (ISAAC) and European Community Respiratory Health Survey (ECRHS) questionnaires. The fractional exhaled nitric oxide (FeNO) was measured, and an allergic skin prick test and sputum induction were performed for all students. Induced sputum samples were analysed for the expression of CD11b, CD35, CD63, and CD66b on eosinophils and neutrophils by flow cytometry. The particulate matter (PM2.5 and PM10), NO2, CO2, and formaldehyde were measured inside the classrooms. Results: Chemometric and regression results have clustered the expression of CD63 with PM2.5, CD11b with NO2, CD66b with FeNO levels, and CO2 with eosinophils, with the prediction accuracy of the models being 71.88%, 76.04%, and 76.04%, respectively. Meanwhile, for neutrophils, the CD63 and CD66b clustering with PM2.5 and CD11b with FeNO levels showed a model prediction accuracy of 72.92% and 71.88%, respectively. Conclusion: The findings indicated that the exposure to PM2.5 and NO2 was likely associated with the degranulation of eosinophils and neutrophils, following the activation mechanisms that led to the inflammatory reactions.

Prevalencia y características del asma en mayores de 18 años en la República de Panamá: estudio de base poblacional PRENFOR

ObjectiveTo determine the prevalence of asthma in adults in the Republic of Panama. MethodsA national survey was conducted by way of telephone calls and digital tools, using a shortened modified version of the European Community Respiratory Health Survey questionnaire; patients with respiratory symptoms subsequently underwent clinical evaluation, simple spirometry, and bronchodilator testing to confirm asthma. ResultsBetween January and June 2019, we administered 1,532 questionnaires in the 10 provinces of the Republic of Panama, of which 1,514 were valid for the study. Respiratory symptoms were determined in 240 patients who were invited for clinical evaluation. Clinical and spirometric characteristics consistent with asthma were detected in 109/1,514 (7.2%) and clinical characteristics of asthma with normal spirometry in 44/1,514 (2.9%), for an overall prevalence of 10.1%. In total, 68.6% of asthmatics were women (χ2=23.62; P≤.0001), 22.2% (34/153) had a previous diagnosis of asthma, and 7.8% (12/153) had performed spirometry previously. Body mass index was≥25 in 72.5% (111/153) of the subjects, with no differences between sexes for this variable, while 43.1% (66/153) had presented some exacerbation in the previous year. Risk factors were rhinitis (χ2=11.9; P<.005), OR 2.38 (95% CI 1.4-3.9), and smoking (χ2=5.5; P<.005), OR 5.28 (95% CI 1.1-24.5). ConclusionsThe prevalence of asthma in adults in Panama is similar to other Latin American countries, and is more prevalent in women. Low use of spirometry leads to underdiagnosis. Rhinitis and smoking are risk factors. Obesity is a common condition in our country.

Long-term effects of bronchopulmonary dysplasia on lung function: a pilot study in preschool children’s cohort

Introduction Although the long term negative effects of bronchopulmonary dysplasia (BPD) are well known, follow-up studies of preterm infants with BPD into childhood are lacking. Methods Forty-two preschool children (age range 3–6 years) who were born before 32 weeks of gestational age and affected by BPD were enrolled. Pre-, peri-, and post-natal data were collected. During the follow up appointment complete physical examination and lung function (impulse oscillometry (IOS)) were recorded. The European Community Respiratory Health Survey (ECRHS) questionnaire was administered to all enrolled subjects. Results Thirty patients were included in the final analysis. The BPD group did not differ in comparison to the non-BPD group in terms of lung function (p > 0.05). By comparing all subjects enrolled, We detected extremely low-birth-weight (ELBW) infants with height-, weight-, and gender-related reference values and a significant trend of increasing resistance values (R5Hz, R5-20 Hz) and respiratory impedance (Z5Hz) (p < 0.05). No significant difference in bronchial reversibility test was observed among BPD non-BPD groups (p < 0.05). The frequency of gastroesophageal reflux disease was significantly higher in patients with BPD when compared to non-BPD group (p < 0.05). Significant differences in gestational age, oxygen supplementation (days), mechanical ventilation therapy (days), and sepsis between BPD and non-BPD groups were also observed (p < 0.05). There were no significant differences in the prevalence of family and personal history of atopy and/or allergic diseases, tobacco exposure, respiratory symptoms, respiratory syncytial virus bronchiolitis, exercise induced dyspnea, treatment with ß-2 bronchodilators and inhaled corticosteroids among the groups (p > 0.05). Conclusions The respiratory function in preschool children born with ELBW is characterized by an increase in impedance and resistance of small airways. No statistically significant differences were found between ELBW children with BPD and without BPD. With regards to the smallest gestational age, the longer duration of O2 therapy during hospitalization, and sepsis significantly resulted in a worse respiratory function.

The Prevalence of Asthma and Asthma-Like Symptoms among Seasonal Agricultural Workers.

Aim The aim of the study was to determine the prevalence and risk factors of asthma and asthma-like symptoms in seasonal agricultural workers living in fields with toxic chemical exposure. Methods European Community Respiratory Health Survey (ECRHS) questionnaire was used to assess the prevalence of asthma and asthma-like symptoms in the study. Results Of the study group, 51.1% (267) were male and the age of the study group ranged from 18 to 88 years and the mean (SD) was 45.68 (13.39) years. The prevalence of asthma attacks in seasonal agricultural workers in the last one year (current prevalence) was 11.2%; the prevalence of asthma (cumulative prevalence) was 15.1%. In the study, smoking was found to be an important risk factor for current asthma. The prevalence of cumulative asthma was higher in seasonal agricultural workers with allergic rhinitis (p < 0.05 for each). Conclusions Seasonal agricultural workers are exposed to the worst conditions of working groups. These difficult conditions also cause many health problems. Asthma has also been identified as an important health problem among seasonal agricultural workers.

Asthma and rhinitis in Greek furniture workers

Objective: The detection of asthma and rhinitis in furniture workers exposed to chemicals in the area of Thessaloniki Greece and the determination of the most useful tests for diagnosing the above occupational diseases.Methods: Eighty-three workers (76 men), 35 exposed to chemicals (CW), 23 to wood dust (WW), and 25 office workers (OW), serving as controls, filled in a specialized European Community Respiratory Health Survey (ECRHS) questionnaire for asthma and were submitted to clinical evaluation, spirometry, bronchodilation test, PEF computer algorithm OASYS-2, FeNO, skin prick tests (SPTs), rhinomanometry and methacholine inhalation challenge. Working conditions and protective measurements were also recorded. According to the results of all conducted tests, each subject was distributed to a subgroup: (a) normal, (b) asthma, (c) rhinitis, (d) asthma and rhinitis. Comparisons were performed among work groups.Results: The presence of asthma and/or rhinitis was higher among CW and WW compared to OW (p = 0.004). Significant differences among groups were observed in the questions «better weekend» (p < 0.034) and “improvement on vacation» (p < 0.000), in OASYS-2 Score (p < 0.000), in ABC Score (p < 0.000), and in methacholine score (p < 0.022). Rhinomanometry, FeNO, spirometry, and spirometry after bronchodilation had no significant differences among groups. Working conditions, ventilation system, work practice, use and type of mask revealed no significant differences.Conclusion: Asthma and rhinitis are significantly common among CW. Protective measurements used were not adequate to prevent asthma and or work related rhinitis. Early diagnosis might contribute to disease prevention and control.

Risk factors associated with asthma among adults in Khuzestan, southwest Iran

IntroductionThere is limited information on the risk factors of epidemiological of bronchial asthma in adults. This research aims at studying the risk factors associated with asthma in adults. MethodsThe validated European Community Respiratory Health Survey questionnaire was used to conduct a field study on adults aged 20–65 years old in Khuzestan province, Iran. For this, the researchers used a two-stage cluster sampling method. Univariate and multiple logistic regression modeling were used to obtain odds ratio of potential risk factors. ResultsThe researchers handed out 5720 questionnaires of which 5708 were filled in. 231 cases of 478 individuals with asthma were male. The results showed that having airway hyper responsiveness (OR = 13.52; 95% CI: 9.61–19.02), having a family history of asthma (OR = 2.88; 95% CI: 2.23–3.71), residence in urban areas (OR = 2.15; 95% CI: 1.43–3.21), the presence of mildew in the building (OR = 1.95; 95% CI: 1.29–2.92) and the location of the house in the main street with respect to the auxiliary road (OR = 1.44; 95% CI: 1.14–1.82), respectively, were the most potent risk factors for asthma in adults. However, the presence of dense green space in the 200-m radius of the residential home (OR = 1.69; 95% CI: 1.30–2.20) and home gardening (OR = 1.42; 95% CI: 1.12–1.80) are the most important protection factors against asthma. ConclusionsThis study showed the association between some environmental factors with the odds of having asthma. These factors can be considered in primary prevention programs for asthma.

Respiratory Health Outcomes, Rhinitis, and Eczema in Workers from Grain Storage Facilities in Costa Rica

To examine the associations of inhalable grain dust exposure with respiratory health outcomes, rhinitis, and eczema reported by workers from rice, wheat, and maize storage facilities. A cross-sectional study of 136 workers (73 operators and 63 administrative staff and other workers) from eight Costa Rican grain storage facilities was conducted in 2014-2015. Full-shift personal inhalable dust samples from all workers were collected. Study participants were administered a short version of the European Community Respiratory Health Survey questionnaire to identify symptoms of asthma, chronic bronchitis, rhinitis, and eczema. Associations between grain dust exposure and health outcomes were assessed using multivariable logistic and negative binomial regression models adjusted for age, smoking history, grain type, and presence of pets or farm animals in the home. The median inhalable grain dust concentration was 2.0 (25th to 75th percentile: 0.3-7.0) mg m-3. Higher concentrations of inhalable dust were associated with increased odds of (i) asthma symptoms or medication use [adjusted Odds ratio (ORa) per 10-fold increase in dust concentration 2.7; 95% confidence interval (CI): 1.3-6.7]; (ii) a score of at least two out of five symptoms suggestive of asthma (ORa 1.2; 95% CI: 1.0-1.3); and (iii) eczema (ORa 3.6; 95% CI: 1.7-9.6). No associations of inhalable grain dust exposure with chronic bronchitis and rhinitis were observed. High exposure to inhalable dust in Costa Rican grain storage facilities was associated to asthma symptoms and eczema in workers.

Prevalence and Features of Asthma in Young Adults in Urban Areas of Argentina

ObjectiveTo investigate the burden of asthma in a young adult population in urban areas of Argentina. DesignA nationwide telephone survey in subjects aged 20–44 years was performed in urban areas in Argentina. The European Community Respiratory Health Survey questionnaire was used. Asthma was defined as an exacerbation in the last year or use of asthma medications. ResultsIn total, 1521 subjects responded (62.4% females, mean age 33 years), of whom 91 were classified as asthmatics (5.9%, 95% CI 4.7–7.1). Prevalence adjusted for age, sex and education level was 6.4% (95% CI 5.1–7.7). Wheezing was reported by 13.9% (95% CI 15.6–12.2) and a diagnosis of asthma by 9.5% (95% CI 8.0–11.0). Among individuals with a diagnosis of asthma (n=154), 71.3% had undergone spirometry. Among those treated (n=77), 51.9% used medications daily and 46.8% as a rescue measure. Of those reporting an exacerbation in the last year (n=60), 55% had attended an emergency department and 23% were admitted. Asthma was associated with rhinitis (OR 11.1, 95% CI 6.2–19.9) and family history (OR 3.6, 95% CI 2.3–5.5). ConclusionAsthma prevalence in young adults in Argentina is similar to Europe. Although attacks and admissions were common, regular use of medications was reported by half of those treated. These results may be useful for other Latin American countries.

Asthma prevalence among adults in Saudi Arabia.

Objectives:To investigate asthma prevalence and to measure asthma symptoms among Saudi adults in Riyadh, Kingdom of Saudi Arabia.Methods:A cross-sectional survey using the European Community Respiratory Health Survey (ECRHS) questionnaire carried out between April and June 2016, among male and female Saudi nationals aged 20-44 years living in Riyadh. Disproportionate cluster sampling method was used. Asthma was defined based on answering “yes” to any of the following: Have you had wheezing when you did not have a cold in the last 12 months? Have you been told by a physician to have asthma? Are you taking medicine for asthma?Results:A total of 2,405 participants completed the survey. The prevalence of wheezing in the last 12 months when not having a cold was 18.2% with no significant difference between males and females (p=0.107). The prevalence of physician-diagnosed asthma was 11.3% with no significant difference between males and females (p=0.239). The prevalence of taking medicine for asthma was 10.6%. There were no significant differences between asthmatic vs. non-asthmatic in terms of residency area (p=0.07), education level (p=0.11) and smoking tobacco (p=0.06). However, significant differences found between asthmatic and non-asthmatic in relation to nasal allergies (p<0.001).Conclusion:Asthma prevalence is high and much higher than the prevalence reported in most countries using the ECRHS questionnaire.

Prevalencia y características clínicas del asma en adultos jóvenes en zonas urbanas de Argentina

ObjectiveTo investigate the burden of asthma in a young adult population in urban areas of Argentina. DesignA nationwide telephone survey in subjects aged 20-44 years was performed in urban areas in Argentina. The European Community Respiratory Health Survey questionnaire was used. Asthma was defined as an exacerbation in the last year or use of asthma medications. ResultsIn total, 1,521 subjects responded (62.4% females, mean age 33 years), of whom 91 were classified as asthmatics (5.9%, 95% CI 4.7-7.1). Prevalence adjusted for age, sex and education level was 6.4% (95% CI 5.1-7.7). Wheezing was reported by 13.9% (95% CI 15.6-12.2) and a diagnosis of asthma by 9.5% (95% CI 8.0-11.0). Among individuals with a diagnosis of asthma (n=154), 71.3% had undergone spirometry. Among those treated (n=77), 51.9% used medications daily and 46.8% as a rescue measure. Of those reporting an exacerbation in the last year (n=60), 55% had attended an emergency department and 23% were admitted. Asthma was associated with rhinitis (OR 11.1, 95% CI 6.2-19.9) and family history (OR 3.6, 95% CI 2.3-5.5). ConclusionAsthma prevalence in young adults in Argentina is similar to Europe. Although attacks and admissions were common, regular use of medications was reported by half of those treated. These results may be useful for other Latin American countries.

Allergies and Exercise-Induced Bronchoconstriction in a Youth Academy and Reserve Professional Soccer Team.

A high prevalence of respiratory allergies and exercise-induced bronchoconstriction (EIB) has been reported among endurance athletes. This study was designed to analyze the frequency of sensitization to respiratory allergens and EIB in young soccer players. Prospective cohort design. Youth academy and reserve professional soccer team during the seasons 2012 to 2013 and 2013 to 2014. Eighty-five soccer players (mean age: 20 ± 4 years) participated. Players underwent skin prick tests (SPTs) during the seasons 2012 to 2013 and 2013 to 2014. Spirometry and a eucapnic voluntary hyperpnea test were performed on soccer players during the first season 2012 to 2013 (n = 51) to detect EIB. Two self-administered questionnaires on respiratory history and allergic symptoms (European Community Respiratory Health Survey and Allergy Questionnaire for Athletes) were also distributed during both seasons (n = 59). The number of positive SPTs, exercise-induced respiratory symptoms, presence of asthma, airway obstruction, and EIB. Forty-nine percent of players were sensitized to at least one respiratory allergen, 33% reported an allergic disease, 1 player presented airway obstruction at rest, and 16% presented EIB. Factors predictive of EIB were self-reported exercise-induced symptoms and sensitization to at least 5 allergens. Questioning players about exercise-induced respiratory symptoms and allergies as well as spirometry at the time of the inclusion medical checkup would improve management of respiratory health of soccer players and would constitute inexpensive preliminary screening to select players requiring indirect bronchial provocation test or SPTs. This study showed that despite low frequencies, EIB and allergies are underdiagnosed and undertreated in young soccer players.

Relationship between Pesticide Metabolites, Cytokine Patterns, and Asthma-Related Outcomes in Rural Women Workers.

The objective of this study was to investigate the relationship between exposure to organophosphate (OP) and pyrethroid (PYR) pesticides with serum cytokine patterns and asthma-related outcomes among rural women workers. A cross-sectional study was conducted among rural women (n = 211), including those working and living on farms and nearby town dwellers. Pesticide exposure was assessed using urinary metabolite concentrations of OP and PYR pesticides. Health outcome assessment was ascertained through the European Community Respiratory Health Survey (ECRHS) questionnaire, fractional exhaled nitric oxide (FeNO), and serum cytokines associated with asthma. The prevalence of doctor-diagnosed asthma was 11%, adult-onset asthma 9%, and current asthma 6%. In this population, the proportion of T helper type 2 (Th2) cytokines (interleukin (IL)-4, IL-5, and IL-13) detectable in subjects was between 18% and 40%, while the proportion of non-Th2 cytokines (IL-6, IL-8, IL-10, IL-17, and interferon gamma) was between 35% and 71%. Most Th2 and non-Th2 cytokines were positively associated with either OP or PYR metabolites. Non-Th2 cytokines showed much stronger associations with OP metabolites (Dimethyl phosphate OR = 4.23; 95% CI: 1.54–11.65) than Th2 cytokines (Dimethyl phosphate OR = 1.69; 95% CI: 0.83–3.46). This study suggests that exposure to most OP and some PYR pesticides may be associated with asthma-related cytokines, with non-Th2 cytokines demonstrating consistently stronger relationships.

Changes in symptoms of asthma and rhinitis by sensitization status over ten years in a cohort of young Chilean adults.

BackgroundWe investigated the net changes in prevalence of symptoms of asthma and rhinitis over 10 years in a cohort of young by baseline sensitization status.MethodsOne thousand one hundred ninety three Chilean adults subjects aged 22–28 living in a semi-rural area of central Chile answered a lifestyle and the European Community Respiratory Health Survey (ECRHS) questionnaires. Bronchial hyper-responsiveness (BHR) and skin prick test (SPT) to eight allergens were measured at baseline in 2001. Ten years later, 772 participants completed the questionnaires again. Estimates of adjusted net changes in prevalence of symptoms by sensitization status at baseline and association between sensitization status at baseline and respiratory symptoms ten years later were assessed.ResultsA quarter of the participants were sensitized to at least one allergen in 2001. Prevalence of wheeze had a net change per year of −0.37 % (95 % Confidence Interval −0.71 to 0.02 %; p = 0.067). Self-reported nasal allergies in the last 12 months increased by 0.83 % per year (95 % CI 0.49 to 1.17 %; p < 0.001). Those sensitized to either cat fur (OR 1.76; CI 1.01 to 3.05), cockroach, (OR 2.09; 1.13 to 3.86) blend of grass and pollens (1.78; 95 % CI 1.08 to 2.92), or weeds (OR 1.77; 95 % CI 1.01 to 3.12) in 2001 were more likely to have wheeze in the last 12 months 10 years later.ConclusionSymptoms of asthma remained stable or slightly changed over 10 years in adults, whilst rhinitis and nasal allergies greatly increased. Being sensitized to at least one allergen is a risk factor for persistent symptoms of asthma and rhinitis, but not for determining net changes of symptoms over time. The underlying causes for the contrasting trends between asthma and nasal allergy are unknown.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-016-0273-6) contains supplementary material, which is available to authorized users.