Decrease In FEV1 Research Articles

Comparison of demographic, clinical, spirometry, and radiological parameters between smoking and non-smoking COPD patients in rural Gujarat, India.

Context:A total of 20% of Chronic Obstructive Pulmonary Disease(COPD) patients are non-smokers due to preventable causes, such as biomass fuel exposure, post tuberculous sequelae, occupational exposure, air pollution, persistent chronic asthma, and genetic predisposition.Aims:To compare smokers and non-smokers with COPD.Settings and Design:An observational study was conducted at a tertiary care hospital on 60 patients diagnosed with COPD, (GOLD criteria), who were divided into smoker and non-smoker groups.Subjects and Methods:Demographic data, clinical profile, smoking history, and radiological data were collected and compared. Exclusion criteria were individuals having active pulmonary tuberculosis and reversible air flow limitations.Statistical Analysis Used:Using STATA 14.2, quantitative and qualitative data were presented using descriptive statistics.Results:A total of 100% of smokers were male, whereas 70% of non-smokers were female. Compared to non-smokers (16.67%), smokers (26.6%) presented with higher grade of dyspnea. A statistically significant difference was seen with more smokers diagnosed as severe (40%) and very severe (30%) COPD compared to non-smokers with mild (16.67%) and moderate (46.67%) COPD (P < 0.012), Post bronchodilator FEV1 among smokers (42.63) compared to non-smokers (56.63) (P < 0.01) and decrease in FEV1 as the grade of dyspnea increased (P < 0.002). Compared to 36.67% in non-smokers, 70% smokers showed emphysematous x-rays.Conclusions:In our study we found majority of non-smokers to be female, and smokers had a higher grade of dyspnea, more severe COPD, lower post bronchodilator FEV1, and more emphysematous changes on x-rays.

Serum magnesium level in asthmatic children as an indicator of asthma severity

Background Bronchial asthma is a chronic inflammatory disease of the respiratory tract, characterized by airway hyperresponsiveness. Magnesium (Mg++) has been shown to relax bronchial smooth muscle and influence the function of respiratory muscles. Hypomagnesemia has been associated with diminished respiratory muscle power. Objective This study aims to assess serum Mg level in children with asthma and its correlation with the severity of asthma. Patients and methods It was a case–control study carried out at Alzahraa University Hospital on two groups of children: group 1 consisted of 60 patients with bronchial asthma, comprising 41 males and 24 females, with age ranged from 6 to 15 years, with a mean 10.8±1.6 years, and the second group (control group) consisted of 30 apparently healthy children, with age and sex matched to the diseased patients. Pulmonary function test was done for the studied children, and serum levels of Mg were measured. Results The data hence collected were systematically tabulated and analyzed with SPSS software. The descriptive statistics for the case and control group showed there was a statistically significant decrease in mean serum Mg in asthmatic patients in comparison with controls (P&lt;0.05). Moreover, there was a highly significant lower level of Mg in patients with severe persistent asthma compared with those with mild intermittent asthma and mild, moderate, and persistent asthma (P&lt;0.001), and also, there were significant (P&lt;0.001) positive correlations between serum Mg level and each of forced expiratory volume in 1 s (FEV1)% (r=0.712) and FEV1/forced vital capacity% (0.680) (i.e. in most cases, serum Mg level tended to decrease with the decrease in FEV1% and FEV1/forced vital capacity% ratio). Conclusion Children with bronchial asthma have a great risk of Mg deficiency, and serum Mg level has a significant relation to the severity of asthma and pulmonary function test.

Circulating white blood cells and lung function impairment: the observational studies and Mendelian randomization analysis

Background Circulating white blood cell (WBC) counts have been related to lung function impairment, but causal relationship was not established. We aimed to evaluate independent effects and causal relationships of WBC subtypes with lung function. Methods The 19,159 participants from NHANES 2011–2012 (n = 3570), coke-oven workers (COW, n = 1762) and Dongfeng-Tongji (DFTJ, n = 13,827) cohorts were included in the observational studies. The associations between circulating counts of WBC subtypes and prebronchodilator lung function were evaluated by linear regression models and LASSO regression was used to select effective WBC subtypes. Summary statistics for WBC-associated SNPs were extracted from literature, and Mendelian randomization (MR) analysis with inverse-variance weighted (IVW) method was applied to estimate the causal effects of total WBC and subtypes on lung function among 4012 subjects from COW (n = 1126) and DFTJ cohorts (n = 2886). Results Total WBC counts were negatively associated with lung function among three populations and their pooled analysis indicated that per 1 × 109 cells/L increase in total WBC was associated with 36.13 (95% CI: 30.35, 41.91) mL and 25.23 (95% CI: 19.97, 30.50) mL decrease in FVC and FEV1, respectively. Independent associations with lung function were found for neutrophils, monocytes, eosinophils and basophils (all p < .05), except lymphocytes. Besides, IVW MR analysis showed that genetically predicted total WBC and neutrophil counts were associated with reduced FVC (p = .017 and .021, respectively) and FEV1 (p = .048 and .043, respectively). Conclusions WBC subtypes were independently associated with lower lung function except lymphocytes. Our findings suggest that circulating neutrophils may be causal factors in lung function impairment. KEY MESSAGES White blood cell (WBC) subtypes were negatively associated with lung function level except lymphocytes in the observational studies. Associations of WBC subtypes with lung function may be modified by sex and smoking. Mendelian randomization analysis shows that neutrophils may be causal factors in lung function impairment.

Многофакторный анализ дифференциально-диагностических параметров у больных бронхиальной астмой средней тяжести с пульмогенной артериальной гипертензией и эссенциальной артериальной гипертензией

Objective: to analyze differential diagnostic parameters in patients with moderate bronchial asthma with pulmogenic arterial hypertension with essential arterial hypertension. Material and Methods: 25 patients with moderate bronchial asthma with pulmogenic arterial hypertension (the 1st group) and 25 patients with moderate bronchial asthma with essential arterial hypertension (the 2nd group) were included in the study. Both groups of patients received step therapy (berodual + inhaled glucocorticosteroids). All patients underwent complex ultrasound examination of intracardiac hemodynamics, examination of blood flow in the right ventricle excretory tract. Systemic arterial pressure was measured according to N. S. Korotkov’s method. ECG was studied (24-hour monitoring). Cold test (at -20 °C-40 °C) was performed in both groups of patients, blood gas composition and pulmonary ventilation function indices were studied. Results: As a result of research established reliable differences in the spirographic indices, blood gas composition in patients with moderate bronchial asthma with pulmogenic arterial hypertension (the 1st group), and reliable differences in partial pressure of oxygen and carbon dioxide (p &lt; 0,05). The 1st group of patients has also higher values of PaCO2 and reliably (p &lt; 0,0,5) and lower values of PaO2, SaO2 in comparison with the comparison group of patients with bronchial asthma of average severity with essential arterial hypertension (the 2nd group). Our data have shown, that in the 1st and 2nd group patients systolic-diastolic cardiac function indexes reliably (p &lt; 0,05; p &lt; 0,001) differed from those ones in healthy subjects. At the same time systolic pressure in the pulmonary artery in the 1st group patients was higher than in the 2nd group patients, and left ventricular ejection fraction was significantly different from that in healthy people and was lower in the 1st group patients than in the 2nd group. We have revealed a reliable correlation between systolic blood pressure and Sа02 (r = 0,52, p &lt; 0,05), studied after cold test, which confirmed the hypothesis of the formation of pulmogenic arterial hypertension against the background of hypoxia. More pronounced changes of FEV1, Sа02, systolic blood pressure in group 1 patients were to some extent due to significant cold hyperresponsiveness in this category of patients. Conclusions: the results of our studies have shown that the decrease of FEV1, FEV50, FEV75, PaO2, SaO2, increased systolic pressure in the pulmonary artery, signs of right heart hypertrophy, disturbances of systolic-diastolic heart function were more pronounced in moderate bronchial asthma patients with pulmogenic arterial hypertension than in moderate bronchial asthma patients with essential arterial hypertension. The proportion of patients (in %) with rhythm disturbances, especially sinus tachycardia, extrasystoles were detected significantly more frequently in group 1 patients than in group 2 patients, which was due to a more pronounced disturbance of systolic-diastolic heart function, higher systolic pressure in the pulmonary artery in persons with moderate bronchial asthma with pulmogenic arterial hypertension.

Associations of dermal diethyl phthalate level with changes in lung function test value mediated by absolute eosinophil count: A panel study of adults in southern Taiwan

Phthalate concentrations in indoor and outdoor dust are associated with respiratory disease. Both immunoglobulin E (IgE) and eosinophil count are associated with airway inflammation from exposure to environmental allergens. Dermal phthalate level can be used as a matrix for assessing personal exposure through direct absorption from the air, particle deposition, or contact with contaminated products. However, the association between dermal phthalate level and changes in lung function test values, as mediated by immunological response, remains unclear. In total, 237 adults in southern Taiwan were recruited. Spirometry measurements (in L) of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were taken on visits 1 (2016–2018) and 2 (2019). Dermal phthalate level, absolute eosinophil count, and IgE level were recorded on visit 1. Mean changes in FVC and FEV1 decrease pear year, as determined through pairwise comparisons, were significant (diffFVCper year: −0.46, 95% CI: −0.51, −0.41; p < 0.001; diffFEV1per year: −0.37, 95% confidence interval [CI]: −0.41, −0.34; p < 0.001). For FEV1 decrease, log-unit increases in dermal diethyl phthalate (DEP) were positively associated with diffFEV1per year (β = 0.096; 95% CI: 0.042, 0.150; p = 0.001) and negatively associated with absolute eosinophil count (β= −0.201; 95% CI: −0.380, −0.023; p= 0.027). Log-unit increases in absolute eosinophil count were negatively associated with diffFEV1per year (β= −0.109; 95% CI: −0.150, −0.068; p < 0.001). Absolute eosinophil count mediated 19.70% of the association between dermal DEP level and diffFEV1per year. For FVC decrease, log-unit increases in dermal DEP were positively associated with diffFVCper year (β = 0.095; 95% CI: 0.035, 0.155; p = 0.002) and negatively associated with absolute eosinophil count (β = −0.243; 95% CI: −0.427, −0.060; p = 0.010). Log-unit increases in absolute eosinophil count were negatively associated with diffFVCper year (β= −0.122; 95% CI: −0.168, −0.076; p < 0.001). Absolute eosinophil count mediated 29.98% of the association between dermal DEP level and diffFVCper year. The results suggest that dermal DEP level is positively associated with changes in lung function test values and is mediated by absolute eosinophil count.

Acute respiratory response to individual particle exposure (PM1.0, PM2.5 and PM10) in the elderly with and without chronic respiratory diseases.

Limited data were on the acute respiratory responses in the elderly in response to personal exposure of particulate matter (PM). In order to evaluate the changes of airway inflammation and pulmonary functions in the elderly in response to individual exposure of particles (PM1.0, PM2.5 and PM10), we analyzed 43 elderly subjects with either asthma, chronic obstructive pulmonary disease (COPD) or Asthma COPD Overlap (ACO) and 40 age-matched subjects without asthma nor COPD in an urban community in Shanghai, China. Data were collected at the baseline and in 6 follow-ups from August 2016 to December 2018, once every 3 months except for the last twice with a 6-month interval. In each follow-up, pulmonary functions, fractional exhaled nitric oxide (FeNO), 7-day continuous personal exposure to airborne particles were measured. Multivariate linear mixed effect regression models were applied to investigate the quantitative changes of pulmonary functions and FeNO in two respective groups. The results showed that on average 4.7 follow-up visits were completed in each participant. In subjects with CRDs, an inter-quartile range (IQR) increase of personal exposure to PM1.0, PM2.5 and PM10 was significantly associated with an average increase of FeNO(Lag1) of 6.7ppb (95%CI 1.2, 9.9ppb), 6.2ppb (95%CI 1.5, 12.0ppb) and 5.6ppb (95%CI 1.5, 11.0ppb), respectively, and an average decrease of FEV1(Lag2) of-3.6L (95%CI -6.0,-1.1L),-3.6L (95%CI -6.4,-0.8L) and-3.2L (95%CI -5.8,-0.6L), respectively, in the single-pollutant model. These associations remained consistent in the two-pollutant models adjusting for gaseous air pollutants. Stratified analysis showed that subjects with lower BMI, females and non-allergies were more sensitive to particle exposure. No robust significant effects were observed in the subjects without CRDs. Our study provided data on the susceptibility of the elderly with CRDs to particle exposure of PM1.0 and PM2.5, and the modification effects by BMI, gender and history of allergies.

Aspirin-Exacerbated Respiratory Disease: Association Between Patient-Reported Sinus and Asthma Morbidity

The association between sinonasal and pulmonary symptoms in aspirin-exacerbated respiratory disease is not fully established. To characterize sinonasal and asthma symptomatology, and to determine whether reported sinonasal symptoms predict asthma severity. Prospectively collected data from an aspirin-exacerbated respiratory disease registry cohort were included from 2013 to 2018. Sinonasal symptomatology measured by Sino-Nasal Outcomes Test (SNOT) 22-item total scores was used as the predictor variable, with Asthma Control Test (ACT) scores and percent predicted FEV1 (FEV1% predicted) as primary outcomes. All instances of paired data on the same date were used. ACT score was also evaluated with FEV1% predicted as the outcome. Mixed effects regression was completed. From 1065 aspirin-exacerbated respiratory disease registry subjects (mean age, 48.1 ± 12.8 years; 68.0% females, 29.8% males), mean SNOT-22 score was 42.3 ± 24.12 (n= 1307 observations from 869 subjects), mean ACT score was 19.4 ± 5.2 (n= 1511 observations from 931 subjects), and mean FEV1% predicted was 82.8 ± 19.6 (n= 777 observations from 307 subjects). SNOT-22 score significantly predicted ACT scores (P < .0001, 1185 paired observations from 845 subjects) and FEV1% predicted (P= .018, 485 observations from 246 subjects). Any 10-point increase in SNOT-22 score was associated with a 0.87-point decrease in ACT score and a 0.75% decrease in FEV1% predicted. Any 1-point increase in ACT score was associated with a 1.0% increase in FEV1% predicted (P < .0001, 616 observations from 269 subjects). The most severe SNOT-22 symptoms were sense of smell/taste and blockage/congestion of nose. SNOT-22 scores significantly predict ACT scores and FEV1% predicted, and ACT scores significantly predict FEV1% predicted. This study demonstrates an association between patient-reported rhinosinusitis and asthma symptom severity and subjective and objective measures of asthma severity.

Airway closing index in school-age children during exercise bronchoprovocation

Objective Airway Closing Index (ACI), the ratio of % change in FVC to % change in FEV1 with bronchoprovocation, may represent changes in airflow due to airway closure, as opposed to airway narrowing. The objective of this study was to evaluate ACI during exercise bronchoprovocation (EB) in children. Methods Children, 6 to 18 years of age, who underwent EB using a stationary bicycle ergometer over a 6-year period were reviewed. Pulmonary function, including ACI, in patients with a positive exercise challenge, defined as ≥10% decrease in FEV1 following exercise, were compared to patients with a negative challenge. Results A total of 1030 children with a median age of 13 (IQR 11–15) underwent EB, of which 376 (37%) had a positive exercise challenge. There was wide variability in ACI, with a median of 0.75 (0.28–1.21). Median ACI in those with a positive test was 0.68 (IQR 0.41–0.93) compared to 0.84 (IQR 0.09–1.06) for those with a negative test, p = 0.017. Median ACI was higher in older children (p < 0.001) and females (p < 0.0001). Median percent change in FEV1 following bronchodilator for children in the highest quintile for ACI was 4.5 (IQR 1.3–8.1) compared to 5.5 (IQR 2–9.2) for children in the lowest quintile, p = 0.04. Conclusions There is wide variability in the ACI in children undergoing EB. ACI was lower in children with a positive challenge, the significance is unknown. Children with higher ACI may have increased airway closure with bronchoprovocation, and less response to bronchodilators.

Ambient air pollution, lung function and COPD: cross-sectional analysis from the WHO Study of AGEing and adult health wave 1

BackgroundLong-term exposure to ambient air pollution leads to respiratory morbidity and mortality; however, the evidence of the effect on lung function and chronic obstructive pulmonary disease (COPD) in older adult...

Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists.

Salbutamol and terbutaline are short-acting β2 adrenergic agonists that produce bronchial smooth muscle relaxation and are widely used in obstructive pulmonary diseases. Nevertheless, their use has been the cause of a paradoxical bronchoconstriction, which is a rare and potentially serious adverse reaction. The aim of this study is to report a case of paradoxical bronchoconstriction caused by β2 adrenergic agonists. This case is about a 50-year-old asthmatic patient who describes a history of repeated acute asthma attacks after salbutamol inhalation or terbutaline nebulization. A double-blind crossover study was performed over 3 days, in order to compare the effects of each bronchodilator. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and maximal expiratory flow 25-75 (MEF25-75) were measured. On the first day, a bronchoconstriction caused by deep and repeated inhalations was eliminated. On the second day, an airway obstruction was confirmed by a decrease in FEV1 at 40% from baseline values after nebulization of a standard dose of terbutaline. On the third day, a spirometry was performed before and after nebulization of a standard dose of ipratropium bromide, and there were no significant changes in the spirometric parameters. Finally the patient was discharged with a written warning mentioning the danger of salbutamol and terbutaline use. Salbutamol and terbutaline are generally well-tolerated β2 adrenergic agonists. Nevertheless, in rare cases, these substances can cause a paradoxical bronchoconstriction. Doctors must therefore remain vigilant about its side effect and possibly investigate each case.

RESPONSE TO ACLIDINIUM IN PATIENTS WITH COPD, AN EXACERBATION HISTORY, AND CARDIOVASCULAR RISK FACTORS IN THE ASCENT STUDY

RESPONSE TO ACLIDINIUM IN PATIENTS WITH COPD, AN EXACERBATION HISTORY, AND CARDIOVASCULAR RISK FACTORS IN THE ASCENT STUDY

The Impact of Lung Function on Extra-Pulmonary Diseases and All-Cause Mortality in US Adult Population with and without COPD.

ObjectiveSpirometric lung function is usually used to evaluate respiratory health. However, the impact of lung function on extra-pulmonary diseases and all-cause mortality has not been fully elucidated, especially in people without chronic obstructive pulmonary disease (COPD).Patients and MethodsParticipants aged ≥20 and underwent spirometry test from the US National Health and Nutrition Examination Surveys (NHANES) 2007–2012 were analyzed in this study. Multivariate logistic and Cox regressions were used to evaluate the impact of forced expiratory volume in 1 second percent of predicted (FEV1% predicted) and forced vital capacity percent of predicted (FVC% predicted) on 14 extra-pulmonary diseases and all-cause morbidity after adjusting for multiple confounders.ResultsDuring 2007–2012, 1800 COPD patients and 11,437 non-COPD subjects were included. The prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, metabolic syndrome (MS), congestive heart failure (CHF), coronary disease, stroke, chronic kidney disease (CKD), arthritis, cancer, underweight and osteoporosis in COPD patients was higher than that in the non-COPD population. After adjusting for confounders, the decrease of FEV1% predicted and FVC% predicted was related with higher odds of having hypertension, DM, obesity, MS, CHF, coronary disease and depression (OR > 1, P<0.05) in both the COPD and non-COPD populations. These 2 indices were also related with higher odds of dyslipidemia, CKD, arthritis and osteoporosis in the non-COPD population. The risk of stroke, anemia and cancer was not related with the decrease of lung function. In addition, the decrease of lung function was independent risk factors for the increase of all-cause mortality. These risks were gradually increased with the decrease of lung function.ConclusionThe decrease of FEV1% predicted and FVC% predicted was related with higher risk of multiple extra-pulmonary diseases and all-cause mortality in both the COPD and non-COPD population.

Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma: a double-blind placebo-controlled trial

BackgroundMany patients suffering from exercise-induced asthma (EIA) have normal lung function at rest and show symptoms and a decline in FEV1 when they do sports or during exercise-challenge. It has been described that long-chain polyunsaturated fatty acids (LCPUFA) could exert a protective effect on EIA.MethodsIn this study the protective effect of supplementation with a special combination of n-3 and n-6 LCPUFA (sc-LCPUFA) (total 1.19 g/ day) were investigated in an EIA cold air provocation model. Primary outcome measure: Decrease in FEV1 after exercise challenge and secondary outcome measure: anti-inflammatory effects monitored by exhaled NO (eNO) before and after sc-LCPUFA supplementation versus placebo.ResultsNinety-nine patients with exercise-induced symptoms aged 10 to 45 were screened by a standardized exercise challenge in a cold air chamber at 4 °C. Seventy-three patients fulfilled the inclusion criteria of a FEV1 decrease > 15% and were treated double-blind placebo-controlled for 4 weeks either with sc-LCPUFA or placebo. Thirty-two patients in each group completed the study. Mean FEV1 decrease after cold air exercise challenge and eNO were unchanged after 4 weeks sc-LCPUFA supplementation.ConclusionSupplementation with sc-LCPUFA at a dose of 1.19 g/d did not have any broncho-protective and anti-inflammatory effects on EIA.Trial registrationClinical trial registration number: NCT02410096. Registered 7 February 2015 at Clinicaltrial.gov

Relationship of Serum Levels of IL-17, IL-18, TNF-α, and Lung Function Parameters in Patients with COPD, Asthma-COPD Overlap, and Bronchial Asthma.

Determination of markers of systemic inflammation is one of the important directions in the study of pathogenesis and improvement of diagnosis of chronic obstructive pulmonary disease (COPD), asthma-COPD overlap (ACO), and bronchial asthma (BA). The aim of our work was a comparative study of the features of changes in serum levels of IL-17, IL-18, and TNF-α in patients with COPD, ACO, and BA with various severity of the disease, as well as evaluation of the relationship between the level of these cytokines and lung ventilation function. A total of 147 patients with COPD (n = 58), ACO (n = 57), and BA (n = 32) during a stable period have been examined in this study. The control group included 21 healthy nonsmokers with similar sex-age indicators. Serum levels of IL-17, IL-18, and TNF-α were determined by ELISA. The concentrations of these cytokines in the circulation in the studied patients with COPD, ACO, and BA were higher than those in healthy nonsmokers (p ≤ 0.001). IL-17 and IL-18 levels in the blood serum were comparable in all examined patients. The mean TNF-α concentrations in the circulation in COPD and ACO were significantly higher than those in BA (p < 0.001). In patients with COPD, the levels of IL-17 and TNF-α increased progressively against the background of a decrease in numerous spirometric indicators, which allows us to consider these cytokines as systemic biomarkers of disease severity. In BA, the inverse correlations between the level of IL-17 and FEV1/FVC (%) and FEV1 have been found. In patients with ACO, the increase in IL-18 levels was associated with a decrease in FEV1 and TNF-α with FEV1/FVC (%). These findings indicate that IL-17, IL-18, and TNF-α can participate in the mechanisms of systemic inflammation and the genesis of disorders of airway obstruction in COPD, AСO, and BA. An increase in the levels of IL-17 and TNF-α may be associated with impaired bronchial patency in COPD and BA. The established associations of the IL-18 concentration in the blood serum and FEV1 only in patients with ACO allow using the level of IL-18 as a potential marker of the degree of impaired airway obstruction in this disease.

Oxidative damage mediates the association between polycyclic aromatic hydrocarbon exposure and lung function

BackgroundExposure to polycyclic aromatic hydrocarbons (PAHs) is related to decreased lung function. However, whether oxidative damage is involved in this relationship remains unclear. This study was aimed to explore the potential mediating role of oxidative DNA or lipid damage in the association between PAH exposure and lung function.MethodsThe urinary levels of monohydroxy polycyclic aromatic hydrocarbon metabolites (OH-PAHs) and lung function parameters were measured among 3367 participants from the baseline of the Wuhan-Zhuhai cohort. Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) and 8-isoprostane (8-iso-PGF2α) were determined to evaluate the individuals’ oxidative DNA and lipid damage degrees, respectively. Linear mixed models were used to investigate the associations of urinary OH-PAHs, 8-OHdG and 8-iso-PGF2α with lung function parameters. Mediation analysis was further conducted to assess the potential role of oxidative damage in the association between urinary OH-PAHs and lung function.ResultsEach one-percentage increase in the sum of urinary OH-PAHs, high-molecular-weight or low-molecular-weight OH-PAHs (ƩOH-PAHs, ƩHMW OH-PAH or ƩLMW OH-PAHs, respectively) was associated with a 0.2152-, 0.2076- or 0.1985- ml decrease in FEV1, and a 0.1891-, 0.2195- or 0.1634- ml decrease in FVC, respectively. Additionally, significantly positive dose-response relationships of ƩOH-PAHs, ƩHMW OH-PAH and ƩLMW OH-PAHs with urinary 8-OHdG or 8-iso-PGF2α, as well as an inverse dose-response relationship between urinary 8-OHdG and FVC, were observed (all P for trend < 0.05). Mediation analysis indicated that urinary 8-OHdG mediated 14.22% of the association between ƩHMW OH-PAH and FVC.ConclusionHigher levels of oxidative DNA damage might be involved in the decreased levels of FVC caused by high-molecular-weight PAH exposure.

Does The Mixed Relay Triathlon Affect Respiratory Function In Healthy Junior Triathletes?

Exercise-induced bronchoconstriction (EIB) is a transient narrowing of the airway that can be attributed to heavy ventilation associated with sustained high intensity exercise greater than 8 min. High aerobic and ventilatory training demands can exacerbate the EIB response and lead to prevalence of EIB in endurance athletes like triathletes. The mixed relay triathlon, due to its high intensity and short duration format, will induce heavy ventilation that could lead to EIB. However, no research at present has determined the influence of a mixed relay on respiratory function and baseline spirometry measures which influence EIB. PURPOSE: To determine severity and prevalence of EIB in healthy triathletes competing in a mixed relay and understand if baseline spirometry is predictive of the EIB response and race performance. METHODS: Seven males (17.7 ± 0.4 years, 183.7 ± 3.0 cm) and 5 females (17.6 ± 0.6 years, 171.1 ± 2.7 cm) competed in the Canadian Championships (300m swim, 6km bike, 1.6km run). Spirometry measures of Forced Expiratory Volume in 1 sec (FEV1), Forced Vital Capacity (FVC), FEV1/FVC (%), Forced Expiratory Flow at 50% FVC (FEF50), FEF 25-75% and Peak Expiratory Flow (PEF) was performed before warm up and 5 min post-race. Measures were calculated as % delta change (for EIB determination) and in raw units to determine pre-post differences in measures via paired sample t-tests. RESULTS: Mean race time was 22.4 ± 1.5 min including transitions (swim 4.5 ± 0.5 min, bike 10.4 ± 0.7 min, run 6.1 ± 0.6 min). No spirometry measure was significantly decreased post-race. One athlete had mild EIB (% decrease in FEV1 between 10 and 25%) and 2 athletes had a baseline FEV1/FVC ratio <0.7. Percent delta change in PEF and FEF 25-75% were correlated to finish time (r=-0.78, r=-0.83, p<0.05 respectively). CONCLUSION: An all-out 20 min ultra-short triathlon does not negatively affect respiratory function in young healthy junior triathletes. It maybe that the decrease in PEF and FEF 25-75 affected finish time due to reduced airway function affecting exercise intensity. The low prevalence of EIB compared to older endurance athletes supports the late onset of EIB in endurance athletes (> 25 years) although the 2 athletes with <0.7 resting FEV1/FVC ratios show signs of underlying airway obstruction.

Changes In Pulmonary Function In Us Firefighters Over A 5-year Period

Acute and chronic changes in pulmonary function have been previously reported in US firefighters. However, the majority of research on pulmonary function in US firefighters was conducted more than three decades ago. Due to the changes in the use of protective equipment and changes in materials that are burning in structure fires, it is important to examine pulmonary function in firefighters and to explore changes in pulmonary function over time. PURPOSE: To examine pulmonary function and changes in pulmonary function over a 5-year period in US firefighters. METHODS: Occupational medical exams separated by 5 years (2009-2016) were examined from a cohort of US career firefighters in Virginia (males, n=603; females, n=69). The exam results were compared to the expected changes over time based on spirometric reference equations generated from NHANES III data. Paired t-tests were used to compare observed changes between Time 1 and Time 2. One-sample t-tests were used to compare the expected with the observed change. RESULTS: There were significant decreases (p<0.001) in FEV1, FVC, and FEV1/FVC over the 5-year period. There were significant differences (p<0.001) between observed changes in FEV1, FVC, and FEV1/FVC and the expected changes over a 5-year period (Table). CONCLUSION: Pulmonary function declined significantly over time. The observed decreases over the 5-year period in FEV1, FVC, and FEV1/FVC were two to four times greater than what would be expected in the general population. Increased efforts are needed to address respiratory protection for US firefighters in order to minimize their risk of pulmonary illnesses and occupational cancer. Supported by FEMA AFG Grant EMW 2017-FP-00445.Table: 5-Year Changes in Pulmonary Measurements Among US Firefighters

Decreased Pulmonary Function Over 5 Years in US Firefighters.

Objective:To examine changes in pulmonary function over a 5-year period in US firefighters.Methods:Spirometry values from occupational medical examinations separated by 5 years (2009 to 2016) were examined from 662 career firefighters in Virginia. Predicted values and expected 5-year changes in one-second forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC were estimated using reference equations generated from the Third National Health and Nutrition Examination Survey (NHANES III) data. Paired t-tests were used to identify significant changes over time and between the observed and expected changes.Results:FEV1 and FVC (percentage of predicted) decreased (P < 0.001) from 100.9 ± 0.6% to 92.3 ± 0.5% and 99.0 ± 0.6% to 91.9 ± 0.5%, respectfully. The observed decreases in FEV1, FVC, and FEV1/FVC were two to four times greater (P < 0.001) than the expected decrease over 5 years.Conclusion:Increased efforts are needed to ensure respiratory protection for US firefighters to minimize their risk of pulmonary damage.

Monitoring metrics for short-term exposure to ambient ozone and pulmonary function and airway inflammation in healthy young adults

To assess the associations of different monitoring metrics for short-term exposure to ambient ozone (O3) with pulmonary function and airway inflammation in healthy young adults. A total of 97 healthy young college students were recruited and followed in a panel study conducted from December 2017 to June 2018. Each participant underwent 3 follow-up visits, and lung function and fractional exhaled nitric oxide (FeNO) were measured at each visit. Ambient air pollutant concentrations were obtained from the environment monitoring station of Beijing closest to the participant residences, and meteorological data were collected from China Meteorological Data Service Center. Linear mixed-effect models were applied to assess the associations between different monitoring metrics for ambient O3 short-term exposure with pulmonary function or airway inflammation in the healthy young adults. During the study period, the P50 (P25, P75) values for ambient O3 concentration expressed as daily 1-hour maximum (O3-1 h max), daily maximum 8-hour average (O3-8 h max) and 24-hour average (O3-24 h avg) were 102.5 (76.8, 163.0) μg/m3, 91.1 (68.3, 154.3) μg/m3 and 61.6 (36.9, 81.7) μg/m3, respectively. The different monitoring metrics for short-term exposure to ambient O3 were significantly associated with reduced forced expiratory volume in the first second (FEV1) and increased FeNO. An interquartile range (IQR) increase in 6-d moving average of O3-1 h max (IQR=71.5 μg/m3) was associated with a 6.2% (95%CI: －11.8%, －0.5%) decrease in FEV1 and a 63.3% (95%CI: 13.8%, 134.3%) increase in FeNO. An IQR increase in 7-d moving average of O3-8 h max (IQR=62.0 μg/m3) was associated with a 6.2% (95%CI: －11.6%, －0.7%) decrease in FEV1and a 75.5% (95%CI: 19.3%, 158.0%) increase in FeNO. An IQR increase in 5-d moving average of O3-24 h avg (IQR=32.9 μg/m3) was associated with a 3.7% (95%CI: －7.1%, －0.2%) decrease in FEV1and a 25.3% (95%CI: 3.6%, 51.6%) increase in FeNO. There was no significant association between the three monitoring metrics for O3 exposure and peak expiratory flow (PEF). Short-term exposure to ambient O3 was associated with decreased lung function and increased airway inflammation among the healthy young adults, and daily 1-hour maximum was more sensitively to the respiratory effects of O3.

Artificial Stone Silicosis: Rapid Progression Following Exposure Cessation

Silicosis is rapidly emerging in high-income countries in relation to the replacement of natural stone with artificial stone, especially in the manufacturing and installation of kitchen and bathroom countertops. Progression of this form of silicosis following the cessation of exposure is unknown. The objective of this study was to determine the radiologic progression and lung function in individuals with artificial stone silicosis. Between 2009 and 2018, a total of 106 patients were diagnosed with artificial stone silicosis in the Bay of Cádiz area (southern Spain), 14.15%by using biopsy results and the remainder according to chest radiography and high-resolution CT imaging. Follow-up consisted of respiratory function tests and radiographic studies. All patients stopped working in the stone industry following diagnosis. All patients were men; their mean ± SD age at diagnosis was 36.2 ± 7.0 years, and the mean duration of exposure was 12.0 ± 4.3 years. At diagnosis, 99 patients were considered to have simple silicosis (93.4%) and seven to have progressive massive fibrosis (PMF) (6.6%). After a mean follow-up of 4.01 ± 2.1 years, disease in 56%of patients had progressed two or more International Labour Office subcategories, and the number of patients with PMF had increased to 40 (37.7%). Regarding lung function, there was a decrease in FVC and FEV1, with an average decrease of 86.8 and 83.4mL per year, respectively; in 25%of patients, the annual decrease was > 157mL in FVC and > 133mL in FEV1. Multivariable analysis showed that lower FVC at diagnosis and longer duration of exposure to silica were associated with progression to PMF. Artificial stone silicosis rapidly progresses to PMF even following exposure cessation, and a significant percentage of patients experience a very rapid decrease in lung function.