Occupational Dust Exposure Research Articles

Impact of Occupational Cement Dust Exposure on Hematological Health Parameters: A Cross-Sectional Study.

Introduction Contact with the dust of cement consisting of toxic components brings about inflammatory damage (often irreversible) to the body of a human being. The circulatory system exhibits sensitivity to inflammatory changes in the body, and one of the earliest changes may be observed in the blood parameters like mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). MCHC and MCH are possibly easily accessible and affordable parameters that can detect harmful changes in the body before any irreversible damage occurs. Objectives This research aimed to seek the changes in MCHC and MCH upon occupational contact with the toxic dust of cement. Methods The execution of this research was done in the Department of Physiology, Dhaka Medical College, Bangladesh, and a cement plant in Munshiganj, Bangladesh. This research was carried out between September 2017 and August 2018. Individuals (20 to 50 years old, 92 male adults) participated and were grouped into the group with occupational cement dust impact (46 subjects) and the group without occupational dust of cement impact (46 subjects). Data was collected in a pre-designed questionnaire. An independent sample t-test was conducted to analyze statistical and demographic data like body mass index and blood pressure. A multivariate regression model was applied to note the impact of cement dust on the group working in this dusty environment. Again, a multivariate regression model was employed to observe whether the duration of exposure to this dust affected MCHC and MCH. The significance level was demarcated at p < 0.05 Stata-15 (StataCorp LLC, College Station, TX, US) for statistical analysis, and GraphPad Prism v8.3.2 (Insight Venture Management, LLC, New York, NY, US) was employed to present the data graphically when required. Results There was a reduction in MCHC by 0.58 g/dL and MCH levels by 0.68 pg in the cement dust-exposed subjects when compared to controls, but not significant (95% CI: -0.93, 2.10;p = 0.448 and 95% CI: -0.37, 1.73;p= 0.203, respectively). However, MCHC was reduced significantly by 0.51 g/dL (p = 0.011) with the duration of exposure to the dust. Conclusion The study showed that MCHC was significantly reduced with the duration of exposure to cement dust in cement plant workers. Such alterations may hamper heme synthesis, hemolysis, and inflammatory changes in the body.

Prediction and validation of mild cognitive impairment in occupational dust exposure population based on machine learning

ObjectiveWorkers exposed to dust for extended periods may experience varying degrees of cognitive impairment. However, limited research exists on the associated risk factors. This study aims to identify key variables using machine learning algorithms (ML) and develop a model to predict the occurrence of mild cognitive impairment in miners. Methods: A total of 1938 miners were included in the study. Univariate analysis and multivariable logistic regression were employed to identify independent risk factors for cognitive impairment among miners. The dataset was randomly divided into a training set and a validation set in an 8:2 ratio of 1550 and 388 individuals, respectively. An additional group of 351 miners was collected as a test set for cognitive impairment assessment. Seven machine learning algorithms, including XGBoost, Logistic Regression, Random Forest, Complement Naive Bayes, Multi-layer Perceptron, Support Vector Machine, and K-Nearest Neighbors, were used to establish a predictive model for mild cognitive impairment in the dust-exposed population, based on baseline characteristics of the workers. The predictive performance of the models was evaluated using the Area Under the Receiver Operating Characteristic Curve (AUC), and the XGBoost model was further explained using the Shapley Additive exPlanations (SHAP) package. Cognitive function assessments using rank sum tests were conducted to compare differences in cognitive domains between the mild cognitive impairment group and the normal group. Results: Univariate and multivariable logistic regression analyses revealed that education level, Age, Work years, SSRS (Self-Rating Scale for Stress), and HAMA (Hamilton Anxiety Rating Scale) were independent risk factors for cognitive impairment among dust-exposed workers. Comparative analysis of the performance of the seven machine learning algorithms demonstrated that XGBoost (training set: AUC=0.959, validation set: AUC=0.795) and Logistic Regression (training set: AUC=0.818, validation set: AUC=0.816) models exhibited superior predictive performance. Results from the test set showed that the AUC of the XGBoost model (AUC=0.913) outperformed the Logistic Regression model (AUC=0.778). Miners with mild cognitive impairment exhibited significant impairments (p<0.05) in visual-spatial abilities, attention, abstract thinking, and memory areas. Conclusion: Machine learning algorithms can predict the risk of cognitive impairment in this population, with the XGBoost algorithm showing the best performance. The developed model can guide the implementation of appropriate preventive measures for dust-exposed workers.

Sinonasal intestinal-type adenocarcinoma in northern Portugal: a woodworker’s occupational hazard

Abstract Background Sinonasal carcinomas (SNC) constitute about 3% of all head and neck carcinomas, squamous cell carcinoma being the most common histologic subtype. Some geographical patterns in incidence are observed, as occupational exposure to wood dust is associated with intestinal-type adenocarcinoma (ITAC). Aims This study aims to describe the prevalence and characteristics of sinonasal ITAC cases in a region of northern Portugal with a robust wood industry. Methods A retrospective study of all sinonasal malignancies diagnosed over 5 years, in a tertiary hospital, primarily focused on ITAC subtypes. Data on sociodemographic and clinical variables were collected through electronic medical records and telephonic assessments. Results Of all 33 cases, 85% were ITAC. ITAC predominantly affected males (96%) with a mean age of 66.2 years. Most patients diagnosed with sinonasal ITAC had occupational wood dust exposure (96%), particularly to hardwoods. Initial symptoms included unilateral nasal obstruction (75%) and epistaxis (71%). Despite a median time of 3 months from symptoms to consultation, 50% presented at an advanced stage, with a 29% mortality rate. Conclusions Sinonasal ITAC is an occupational hazard of woodworkers and represents the vast majority of SNC in the region. This study advocates for targeted community interventions, emphasizing occupational safety measures and healthcare awareness to reduce morbimortality associated with this occupational cancer.

Association between biomass exposure and COPD occurrence in Fez, Morocco: results from the BOLD study

ObjectiveTo investigate the association between biomass exposure and chronic obstructive pulmonary disease (COPD) in a representative sample of adults from the Moroccan populationMethodsA cross-sectional study was conducted in Fez as...

Occupational and environmental risk factors for idiopathic pulmonary fibrosis: A case-control study

BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown etiology. The aim of this study was to evaluate the environmental and occupational risk factors of IPF. MethodsThis hospital-based, case-control study included 206 patients with IPF selected from the Seoul National University Bundang Hospital Interstitial Lung Disease registry and 167 controls without lung disease. Data on occupation, lifestyle, transportation, and types of environmental and occupational dust exposure were obtained using a questionnaire. IPF diagnosis was confirmed based on the recent guidelines, and the possibility of hypersensitivity pneumonitis was excluded. Multiple logistic regression was performed to determine the risk factors for IPF. ResultsAfter adjusting for age and sex, ever-smokers (odds ratio [OR], 2.35; 95 % confidence interval [CI]: 1.51–3.68) and individuals who smoked more than 30 pack-years (OR, 2.79; 95%CI: 1.70–4.68) showed an increased risk for IPF. Any occupational dust exposure (adjusted OR, 2.08; 95%CI: 1.19–3.72), especially exposure to chemicals (adjusted OR, 3.52; 99%CI: 1.56–9.05), was associated with IPF after adjusting for age, sex, and smoking. ConclusionsSmoking and occupational dust exposure are associated with an increased risk for IPF. Both factors have dose and duration-dependent relationships with the risk for IPF.

Prognostic value of coexisting conditions and complications in pleuroparenchymal fibroelastosis: a single-center retrospective study.

Pleuroparenchymal fibroelastosis (PPFE) is a rare idiopathic interstitial lung disease (ILD) characterized by subpleural parenchymal fibrosis and elastosis mainly in the upper lobes. PPFE occurs in a secondary form that overlaps with underlying medical conditions or complications. This study evaluated the clinical impact of coexisting factors on the survival of patients with PPFE. Fifty-five PPFE patients were retrospectively evaluated. The patients' diagnoses were categorized as "idiopathic PPFE" with no known cause or "secondary PPFE" with underlying medical conditions or complications. The clinical characteristics and survival rates of these groups were compared. Twenty-eight patients (50.9%) were diagnosed with idiopathic PPFE and 27 (49.1%) with secondary PPFE, including cases of occupational dust exposure, connective tissue disease (CTD), post-hematopoietic stem cell transplantation (HSCT), and a family history of ILD. The idiopathic and secondary PPFE groups had similar clinical features, laboratory tests, and pulmonary function profiles, including a low body mass index, normal Krebs von den Lungen-6, high surfactant protein-D, and high residual volume/total lung capacity. In the secondary PPFE group, post-HSCT was associated with a worse prognosis, and CTD was associated with better prognosis. A multivariate analysis demonstrated that post-HSCT and a reduced forced vital capacity were significantly associated with a worsened survival in patients with PPFE. The prognosis of PPFE is highly influenced by underlying medical conditions or complications. Patients with post-HSCT PPFE should be monitored particularly closely, as they are at higher risk of a poor prognosis than others.

Red Cell Distribution Width and Mean Corpuscular Volume Alterations: Detecting Inflammation Early in Occupational Cement Dust Exposure.

Introduction Cement dust emitted during cement manufacture consists of toxic components. Occupational cement dust exposure may cause inflammation in the human body, which may be detected early by observing changes in blood parameters such as red blood cell distribution width (RDW) and mean corpuscular volume (MCV). Objectives The study aims to observe the effect of occupational cement dust exposure on RDW and MCV. Methods This study was performed in the Department of Physiology of Dhaka Medical College, Dhaka, Bangladesh, and a factory in Munshiganj, Bangladesh, from September 2017 to August 2018. Ninety-two participants between 20 and 50 years were included (46 subjects were occupationally exposed to cement dust, and 46 were not exposed to cement dust). A pre-designed questionnaire was used for data collection. An independent sample t-test was used to analyze basic information, such as blood pressure and BMI. The multivariate regression model was used to analyze the effect of cement dust exposure on the study group. The impact of cement dust exposure duration was analyzed using the multivariate regression model. The level of significance was p < 0.05. The statistical analysis was performed using STATA-15 (StataCorp, College Station, TX), and the graphical presentation used GraphPad Prism v8.3.2. Results The cement dust-exposed participants had a significantly higher value of MCV by 1.19 fi (95% CI = 0.02, 4.84; p = 0.049) and a 5.92% increase in RDW (95% CI = 5.29, 6.55; p < 0.001) than that of the control group. Conclusion The study reveals that exposure to cement dust causes significant changes in RDW and MCV. These changes may indicate hemolysis due to inflammation.

Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure

BackgroundOrganic dust is associated with hypersensitivity pneumonitis, and associations with other types of interstitial lung disease (ILD) have been suggested. We examined the association between occupational organic dust exposure and...

The Upper Limit of Normal Rate of Lung Function Decline in Healthy Adults in the Framingham Heart Study

BackgroundLung function declines over the course of adulthood; however, a consensus on the normal range of decline in an individual’s lung function is lacking. Research QuestionWhat is the normal range and the upper limit of normal (ULN) decline in lung function of adults without prior tobacco use, occupational dust exposure, or a known diagnosis or symptoms of cardiopulmonary disease? Study Design and MethodsA retrospective analysis of healthy, never-smokers (n=1,305) from the Framingham Heart Study with repeated lung function meeting standards for acceptability and reproducibility was conducted. Longitudinal change was derived using a linear mixed-effects model and estimated to a 6-year interval. The ULN decline was defined as the 95th percentile. ResultsThe mean follow-up between spirometry examinations was 5.5 years, while the mean follow-up between diffusing capacity for carbon monoxide (DLCO) studies was 5.9 years. Decline in forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and DLCO accelerated with age, while decline in FEV1/FVC decelerated with age. Decline varied with sex, age, and height. Over a 6-year period, the ULN decline in FEV1 ranged from 383 mL to 667 mL, and the ULN decline in DLCO ranged from 3.6 ml/min/mmHg to 9.5 ml/min/mmHg. Overall, men had faster absolute rates of decline than women, while relative (%) rates of decline were similar between sexes. InterpretationLung function decline is non-linear and accelerates with age. In this cohort, the ULN decline over 6-years often exceeded current guidelines for interpreting significant longitudinal change in lung function.

Perceived occupational health risks, noise and dust exposure levels among street sweepers in Mwanza City in Northern Tanzania.

Solid waste has been a major problem particularly in Sub-Saharan Africa countries as it has been increasing in several years. One of the methods employed in solid waste management is street sweeping which is done by street sweepers. Street sweepers are being predisposed to respiratory and non-respiratory infection like eye infection, skin infection and musculoskeletal disorders. This analytical cross-sectional study enrolled a total of 233 street sweepers to assess perceived occupational health risks, particulate matters (i.e., PM2.5, PM5 and PM10 measured in (mg/m3)) dust and noise exposure levels in decibel units-dB(A), and utilization of protective personnel equipment among street sweepers in Mwanza city, Northern Tanzania. Modified poison regression was used to determine the association between exposures variables (i.e., sociodemographic, and socioeconomic factors) and outcomes ((i.e., noise dose level and particulate matters))). More than half (50.2%) of the participants were aged between 46-80 years. Their Median age was 46(IQR: 28-59) years. Large percent (63.1%) of the participants reported that their working environment have high health risks. The Median concentrations of the noise dose and particulates matters were 85.4 (IQR = 76.4-92.3) for noise dose, 13426 (IQR = 9637-17632) for PM2.5, 5522 (IQR = 2453-7679) for PM5, and 2310(IQR = 1263-3201). The Median concentrations of the noise dose and particulates matters were 85.4 (IQR = 76.4-92.3) for noise dose in decibel units dB(A); 13426 (IQR = 9637-17632) for PM2.5; 5522 (IQR = 2453-7679) for PM5; and 2310(IQR = 1263-3201) for PM10. Individual Street sweepers in Mwanza city are highly exposed to noise dose and fine particulate matters at levels above the reference values for human of 85dB(A) and 5mg/m3 respectively, making it a public health issue that requires holistic public health measures.

Occupational Dust Exposure as a Risk Factor for Developing Lung Function Impairment.

Dust exposure is high in several industries. We investigated associations of exposure in paper mills, wood pellet plants, and iron foundries with lung function impairment. Respirable silica, inhalable paper dust, or inhalable wood dust were collected as personal samples and spirometry was performed. Multiple linear regression analyzed associations with FEV 1 %pred and FVC%pred. Wood pellet workers with high exposure to inhalable dust had lower FEV 1 %pred (95% CI) (-9.4 [-16 to -2.6]) and FVC%pred (-9.8 [-15 to -4.0]) compared with lowest exposure level. Workers at paper mills and foundries had no dose-dependent association but lower FEV 1 %pred and FVC%pred than in workers at wood pellets plants. Increased exposure to inhalable wood dust is associated with decreased lung function. Foundry and paper mill workers have generally lower lung function than wood pellet workers. Spirometry should be considered in workers in industries with airborne particulate matter pollution.

Analysis on occupational dust or harmful gas exposure and protection in people aged 40 and above in China, 2019-2020

Objective: To understand the current status of occupational exposure to dust or harmful gases and occupational protection in people aged ≥40 years in China, and provide data support for the prevention and control of occupational dust or harmful gas exposure. Methods: The data were obtained from the surveillance for chronic obstructive pulmonary disease (COPD) in adults aged ≥40 years selected by multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) during 2014-2015 and 2019-2020, and relevant information about occupational dust or harmful gas exposure and protection measures were collected through face-to-face interviews. Occupational dust or harmful gas exposure rate and occupational protection rate were estimated by using weighting complex sampling methods, and then the results were compared. Results: From 2014 to 2015 and from 2019 to 2020, a total of 71 061 and 71 023 individuals aged ≥40 years were surveyed, respectively. The rate of occupational exposure to dust or hazardous gas was 33.8% (95%CI: 29.9%-37.7%) during 2019-2020. The occupational exposure rate was higher in men than in women and in rural residents than in urban residents. With the increase of education level, the rate of occupational exposure to dust or harmful gas showed a downward trend. The protection rate against occupational dust or hazardous gas exposure was 47.9% (95%CI: 43.2%-52.6%) during 2019-2020. Compared with 2014-2015, the rate of occupational exposure to dust or hazardous gas decreased by 10.7 percentage points in different gender, area and occupational groups and the occupational protection rate increased by 21.9 percentage points during 2019-2020. The decrease in occupational exposure rate was higher in western China than in eastern and central China, and the increase in occupational protection rate was higher in western China than in eastern and central China. Conclusions: The rate of occupational exposure to dust or harmful gas decreased and the rate of occupational protection against dust or harmful gas exposure increased in China during 2019-2020. However, about one-third of the population still suffer from the occupational exposure, and less than half of them take protection measures. It is necessary to pay more attention to the key populations, such as workers with lower cultural level and rural migrant workers, in occupational health practice.

Prevalence and Risk Factors of Allergic Rhinitis; A systematic Review

Allergic rhinitis (AR), an immunoglobulin E-induced nasal infection, significantly impacts nasal mucosa function and quality of life. Its incidence has risen globally, showing variations across income categories. This systematic study aimed to determine the prevalence and risk factors of AR. Data were sourced from PubMed/Medline, Scopus, and Embase, following PRISMA guidelines. English-language articles (2010–2023) discussing AR prevalence and risk factors were included. A total of 15 articles were reviewed, with surveys and national database analyses being predominant (n=15). The search initially yielded 95 studies, of which 15 met inclusion criteria. Enhanced knowledge of prevalence and risk factors is crucial for future treatment improvements. The prevalence of AR has surged, necessitating evidence-based assessments of risk factors. For adults, risk factors include smoking, asthma, family history of AR, drug and food allergies, pollen allergy history, antibiotic use, occupational dust exposure, home renovation, and middle school education. In children, passive smoking, asthma, family history of AR, allergies, eczema, pet ownership, seafood consumption, male gender, and breastfeeding were identified as risk factors. The study highlights AR prevalence\&amp;apos;s correlation with allergic diseases, familial allergy history, and environmental factors. Comprehending these associations is pivotal for enhancing adherence to preventive management plans.

Evidence-based dust exposure prediction and/or control tools in occupational settings: A scoping review protocol.

Workplace atmospheric exposure monitoring is the standard method to assess and control hazardous dust exposure; however, feasibility and cost constraints often limit its application. In recent decades, evidence-based tools supporting exposure modelling and control banding have been developed to aid in predicting and/or controlling occupational exposure to various contaminants. However, there is limited information on the availability and applicability of evidence-based tools for predicting and/or controlling occupational dust exposure, as well as on the methods for evaluating these tools across different exposure scenarios. Therefore, this planned scoping review aims to identify existing evidence-based tools for dust exposure predicting and/or controlling and to present evaluation approaches. We will employ the scoping review methods developed by the Joanna Briggs Institute (JBI). The search will be conducted on PubMed, Scopus, and Web of Science databases, in addition to grey literature from the National Institute for Occupational Safety and Health (NIOSH) and advanced Google searches. Studies will be included if they report evidence-based tools for predicting and/or controlling dust exposure using quantitative or semi-quantitative designs and provide a detailed explanation of the methods used for tool development. There will be no restrictions on publication date or geographical location; however, only studies published in English will be considered. Studies focusing exclusively on dust exposure in environmental settings will be excluded. Each member of the review team will screen titles, abstracts, and full texts independently and in collaboration, based on the inclusion criteria. The extracted data will encompass details such as author, title, country, accessible platforms, method/tool names, intended users, types of dust, and occupational settings. Descriptions of the identified tools will include numerical data and narrative summaries to ensure a comprehensive overview. OSF (https://doi.org/10.17605/OSF.IO/S6EZJ).

Особливості формування та динаміки професійної захворюваності від впливу пилових, фізичних та хімічних факторів в Україні у 2011–2021 роках

Aim. On the basis of literature data, statistical data provided by the State Labour Service of Ukraine, the Fund of Social Insurance against accidents at work and occupational diseases to analyse the situation in relation to occupational morbidity in Ukraine for the period 2011–2021, identifying trends in its dynamics, peculiarities of development depending on regional distribution, economic sectors, influence of workplace related etiological factors. Materials and Methods. Analytical review of scientific publications was performed using reference databases of Pub Med, Medline scientific libraries and text databases of Pub Med, Central, BMJ group scientific publishing houses and other VIP databases. The statistical data of the State Labour Service of Ukraine, the Fund of Social Insurance against accidents at work and occupational diseases were analysed. The methods of system, comparative and content analysis were applied. Results and Conclusions. As a result of the analysis of the situation in relation to occupational morbidity in Ukraine for the period 2011–2021 trends of its dynamics, peculiarities of development in terms of regional distribution, branches of economy, influence of workplace related etiological factors and compared with international data are determined. A decrease in the number of victims of occupational diseases over 10 years was established from 8112 to 2904 (more than 3.5 times). The occupational morbidity rate per 100,000 working population in Ukraine (4.5) is almost 7 times lower than the European average (30.1). It was determined that in the structure of occupational morbidity, the first place belongs to diseases caused by occupational dust exposure, the second – to diseases of the musculoskeletal system, the third to vibration disease, and the fourth to sensorineural deafness. The highest risk of occupational pathology development is noted in the mining industry, which is associated with the influence of a complex of unfavourable workplace factors during underground mining of minerals. A particularly catastrophic situation regarding the detection of occupational diseases is observed in agriculture; poisoning with chemical substances during the last decade has almost not been registered. Statistical data on the state of occupational morbidity in Ukraine contradict the world experience of this pathology detection, which is due to the lack of proper monitoring of the state of health of workers, as well as of managerial leverages for creating and maintaining proper working conditions. Keywords: work conditions, workplace factor, occupational diseases.

Early Diagnosis and Development of Referral System for Silicosis among Sandstone Miners in Western India

Abstract Introduction: Silicosis is the most common and oldest occupational lung disease. The disease has been an ancient one and has been recognized in India for the past around 100 years. However, despite its ubiquitous presence among various mine and quarry workers, there is no uniformly available referral system in India in general for workers having occupational dust exposure and respiratory symptoms. The current study involved the clinical assessment of those working in mines and quarries in Jodhpur, Rajasthan, Western India and explore the possibility of development of a referral system for symptomatic mine workers. Materials and Methods: Workers working in mines and quarries in Jodhpur district were clinically screened for symptoms related to silicosis after choosing the quarries randomly. Demographic information and detailed occupational history were recorded using a predesigned questionnaire. Duration of exposure and morbidity/mortality details related to silicosis in the family were noted in detail. Respiratory symptom score was evaluated using a numeric score. The study was a cross-sectional one, and a 12-point respiratory symptom score based on predesigned questionnaire was constructed using the literature survey of silicosis symptoms. Results: A total of 435 mine/quarries workers (M: F = 432:3) working in sandstone belt of Jodhpur, Rajasthan, Western India were assessed clinically, and details of their symptoms were noted. Demographic information was as followed mean age = 36.44 ± 11.23 years and mean duration of dust exposure = 13.4 ± 9.6 years. A total of 96/435 workers were symptomatic (22%), and salient hypoxia was present in 113/435 (26%). Both groups of these workers were referred to nearby community health centers for further evaluation. Awareness levels among the workers were poor, as only 119/435 (27%) workers had some ideas about the silicosis prevention while working in mines and quarries. Regular wearing of masks while being on the field was observed in only 8% (35/435). Mine Worker Screening Camp approach was used for symptomatic workers and evaluation by a three-member clinical board was done in community health center in the vicinity of mining areas. Those suspected of having silicosis were referred to pneumoconiosis board for further evaluation. Conclusions: High frequency of symptomatic mine workers (22%) exposed chronically to occupational dust was found in sandstone mines and quarries of Jodhpur region. Awareness levels about silicosis prevention were poor. A referral system for those needing further evaluation has been demonstrated.

Analysis of factors affecting nonalcoholic fatty liver disease in Chinese steel workers and risk assessment studies

BackgroundThe global incidence of nonalcoholic fatty liver disease (NAFLD) is rapidly escalating, positioning it as a principal public health challenge with significant implications for population well-being. Given its status as a cornerstone of China's economic structure, the steel industry employs a substantial workforce, consequently bringing associated health issues under increasing scrutiny. Establishing a risk assessment model for NAFLD within steelworkers aids in disease risk stratification among this demographic, thereby facilitating early intervention measures to protect the health of this significant populace.MethodsUse of cross-sectional studies. A total of 3328 steelworkers who underwent occupational health evaluations between January and September 2017 were included in this study. Hepatic steatosis was uniformly diagnosed via abdominal ultrasound. Influential factors were pinpointed using chi-square (χ2) tests and unconditional logistic regression analysis, with model inclusion variables identified by pertinent literature. Assessment models encompassing logistic regression, random forest, and XGBoost were constructed, and their effectiveness was juxtaposed in terms of accuracy, area under the curve (AUC), and F1 score. Subsequently, a scoring system for NAFLD risk was established, premised on the optimal model.ResultsThe findings indicated that sex, overweight, obesity, hyperuricemia, dyslipidemia, occupational dust exposure, and ALT serve as risk factors for NAFLD in steelworkers, with corresponding odds ratios (OR, 95% confidence interval (CI)) of 0.672 (0.487–0.928), 4.971 (3.981–6.207), 16.887 (12.99–21.953), 2.124 (1.77–2.548), 2.315 (1.63–3.288), 1.254 (1.014–1.551), and 3.629 (2.705–4.869), respectively. The sensitivity of the three models was reported as 0.607, 0.680 and 0.564, respectively, while the precision was 0.708, 0.643, and 0.701, respectively. The AUC measurements were 0.839, 0.839, and 0.832, and the Brier scores were 0.150, 0.153, and 0.155, respectively. The F1 score results were 0.654, 0.661, and 0.625, with log loss measures at 0.460, 0.661, and 0.564, respectively. R2 values were reported as 0.789, 0.771, and 0.778, respectively. Performance was comparable across all three models, with no significant differences observed. The NAFLD risk score system exhibited exceptional risk detection capabilities with an established cutoff value of 86.ConclusionsThe study identified sex, BMI, dyslipidemia, hyperuricemia, occupational dust exposure, and ALT as significant risk factors for NAFLD among steelworkers. The traditional logistic regression model proved equally effective as the random forest and XGBoost models in assessing NAFLD risk. The optimal cutoff value for risk assessment was determined to be 86. This study provides clinicians with a visually accessible risk stratification approach to gauge the propensity for NAFLD in steelworkers, thereby aiding early identification and intervention among those at risk.

The association of forced expiratory volume in one second with occupational exposures in a longitudinal study of adults in a rural community in Iowa.

The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV1) and longitudinal change in FEV1 were associated with occupational vapor-gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking. This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants' lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders. Mineral dust had the most consistent association with change in FEV1, including ever/never ( - 6.3ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV1 level with fumes was observed for high intensity ( - 91.4ml) among all participants, and limited to cigarette smokers with results of - 104.6ml ever/never exposed, - 170.3ml high duration, and - 172.4ml high cumulative. The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV1 results.

Chronic pulmonary mucormycosis caused by rhizopus microsporus mimics lung carcinoma in an immunocompetent adult: A case report

Pulmonary mucormycosis is a rare but life-threatening invasive fungal infection that mostly affects immunocompromised patients. This disease usually develops acutely and progresses rapidly, often leading to a poor clinical prognosis. Chronic pulmonary mucormycosis is highly unusual in immunocompetent patients. A 43-year-old man, who was a house improvement worker with a long history of occupational dust exposure, presented with an irritating cough that had lasted for two months. The patient was previously in good health, without dysglycemia or any known immunodeficiencies. Chest computed tomography revealed a mass in the left lower lobe, measuring approximately 6 cm in diameter, which was suspected to be primary lung carcinoma complicated with obstructive pneumonia. Thoracoscopic-assisted left lower lobectomy was performed, and metagenomic next-generation sequencing detection, along with special pathological staining of surgical specimens, suggested Rhizopus microsporus infection. Postoperatively, the patient's respiratory symptoms were relieved, and no signs of recurrence were found during the six-month follow-up. This article reports a rare case of chronic pulmonary mucormycosis caused by Rhizopus microsporus in a middle-aged male without dysglycemia or immunodeficiency. The patient's surgical outcome was excellent, reaffirming that surgery remains the cornerstone of pulmonary mucormycosis treatment.

Analysis of influencing factors and a predictive model of small airway dysfunction in adults

BackgroundSmall airway dysfunction (SAD) is a widespread but less typical clinical manifestation of respiratory dysfunction. In lung diseases, SAD can have a higher-than-expected impact on lung function. The aim of this study was to explore risk factors for SAD and to establish a predictive model.MethodsWe included 1233 patients in the pulmonary function room of TangDu Hospital from June 2021 to December 2021. We divided the subjects into a small airway disorder group and a non-small airway disorder group, and all participants completed a questionnaire. We performed univariate and multivariate analyses to identify the risk factors for SAD. Multivariate logistic regression was performed to construct the nomogram. The performance of the nomogram was assessed and validated by the Area under roc curve (AUC), calibration curves, and Decision curve analysis (DCA).ResultsOne. The risk factors for small airway disorder were advanced age (OR = 7.772,95% CI 2.284–26.443), female sex (OR = 1.545,95% CI 1.103–2.164), family history of respiratory disease (OR = 1.508,95% CI 1.069–2.126), history of occupational dust exposure (OR = 1.723,95% CI 1.177–2.521), history of smoking (OR = 1.732,95% CI 1.231–2.436), history of pet exposure (OR = 1.499,95% CI 1.065–2.110), exposure to O3 (OR = 1.008,95% CI 1.003–1.013), chronic bronchitis (OR = 1.947,95% CI 1.376–2.753), emphysema (OR = 2.190,95% CI 1.355–3.539) and asthma (OR = 7.287,95% CI 3.546–14.973). 2. The AUCs of the nomogram were 0.691 in the training set and 0.716 in the validation set. Both nomograms demonstrated favourable clinical consistency. 3.There was a dose‒response relationship between cigarette smoking and SAD; however, quitting smoking did not reduce the risk of SAD.ConclusionSmall airway disorders are associated with age, sex, family history of respiratory disease, occupational dust exposure, smoking history, history of pet exposure, exposure to O3, chronic bronchitis, emphysema, and asthma. The nomogram based on the above results can effectively used in the preliminary risk prediction.