Prevalence Of Chronic Respiratory Diseases Research Articles

Occupational status and chronic respiratory diseases: a cross-sectional study based on the data of the Rafsanjan Cohort Study

BackgroundThe aim of the present study was to investigate the possible connection between occupational status and chronic respiratory diseases (CRDs) among the Iranian population.MethodsThe present cross-sectional study was conducted on 9934 individuals aged 35–70 years enrolled in the Rafsanjan Cohort Study (RCS), a component of the Prospective Epidemiological Research Studies in Iran (PERSIAN). Detailed questionnaires were used to collect information on various factors, such as occupation, sociodemographic characteristics, medical history, anthropometric measurements, physical activity, cigarette and hookah smoking, opium use, and alcohol consumption. The association between occupational class and CRD was evaluated using logistic regression models for rare events.ResultsIn the present study, 4624 (46.55%) participants were male, and 5310 (53.45%) were female. The prevalence of CRD among all participants was 2.61%. Occupational activities were classified into two categories: In class I, the largest group was the homemaker and unemployment category (41.73%), followed by self-employment (34.39%), employment (13.03%), and retired individuals (10.84%). In class II, there were pistachio farmers (12.61%), copper miners (3.62%), and others in various occupations (83.76%). Subjects with CRD were significantly more likely to be homemakers, unemployed, elderly, female, less educated, and obese. There was no significant relationship between CRD and job type/occupational status after adjusting for some potential confounding variables.ConclusionsThere was no significant relationship between CRD and job type/occupational status. However, longitudinal studies are needed to assess the impact of job type/occupational status on the risk of CRD.

Association of dietary flavonoid intakes with prevalence of chronic respiratory diseases in adults

Background and aimsFlavonoids are a class of secondary plant metabolites that have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. This study was to explore the association between dietary flavonoid consumption and the prevalence of chronic respiratory diseases (CRDs) in adults.Methods and resultsThe six main types of flavonoids, including isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols, were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 and 2017–2018 by the two 24-h recall interviews. The prevalence of CRDs, including asthma, emphysema, and chronic bronchitis, was determined through a self-administered questionnaire. The analysis included 15,753 participants aged 18 years or older who had completed a diet history interview. After adjustment for potential confounders, the inverse link was found with total flavonoids, anthocyanidins, flavanones, and flavones, with an OR (95%CI) of 0.86 (0.75–0.98), 0.84 (0.72–0.97), 0.80(0.69–0.92), and 0.85(0.73–0.98) for the highest group compared to the lowest group. WQS regression revealed that the mixture of flavonoids was negatively linked with the prevalence of CRDs (OR = 0.88 [0.82–0.95], P < 0.01), and the largest effect was mainly from flavanones (weight = 0.41). In addition, we found that flavonoid intake was negatively linked with inflammatory markers, and systemic inflammation significantly mediated the associations of flavonoids with CRDs, with a mediation rate of 12.64% for CRP (P < 0.01).ConclusionHigher flavonoid intake was related with a lower prevalence of CRDs in adults, and this relationship may be mediated through systemic inflammation.

Nursing Interventions for Client and Family Training in the Proper Use of Noninvasive Ventilation in the Transition from Hospital to Community: A Scoping Review.

Noninvasive ventilation is an increasingly disseminated therapeutic option, which is explained by increases in the prevalence of chronic respiratory diseases, life expectancy, and the effectiveness of this type of respiratory support. This literature review observes that upon returning home after hospital discharge, there are difficulties in adhering to and maintaining this therapy. The aim of this study is to identify nursing interventions for client and family training in the proper use of noninvasive ventilation in the transition from hospital to community. A scoping review was carried out by searching MEDLINE, CINAHL, Scopus, and Web of Science. The articles were selected by two independent reviewers by applying the predefined eligibility criteria. Regarding transitional care, the authors opted to include studies about interventions to train clients and families during hospital stay, hospital discharge, transition from hospital to home, and the first 30 days after returning home. The eight included publications allowed for identification of interventions related to masks or interfaces, prevention of complications associated with noninvasive ventilation, leakage control, maintenance and cleaning of ventilators and accessories, respiratory training, ventilator monitoring, communication, and behavioral strategies as transitional care priority interventions to guarantee proper training in the transition from hospital to community.

Green spaces in highly urbanized tracts tied to lower prevalence of chronic respiratory diseases: A nationwide study across levels of urbanicity

Previous studies have found conflicting results between green space and respiratory diseases, possibly due to the use of generalized green space measures and the diverse urbanicity levels in which they were conducted. Few nationwide studies examined how urbanicity modifies the relationship between green spaces and respiratory diseases while considering the geospatial relation between green space and human population, population density, and accessibility.This study evaluates the relationships between population-weighted forest and open space exposure (inside and outside park), chronic obstructive pulmonary disease (COPD), and asthma in the contiguous United States. The COPD and asthma data were obtained from the Centers for Disease Control and Prevention. The green space exposure within an 800 m buffer was computed using National Land-cover Dataset and WorldPop Global Population Data. The associations were estimated using spatial error models and adjusted for important covariates. We also performed stratified analyses by four urbanicity levels.Green spaces inside but not outside park were associated with a lower prevalence of COPD and asthma. We found that a 1 m2 increase in forest inside park was associated with a decrease of 3.57 and 2.97 cases per 100,000 population in COPD and asthma, and a 1 m2 increase in open space inside park was associated with a decrease of 4.82 and 7.66 cases per 100,000 population in COPD and asthma. A trend of an inverse relationship was observed across urbanicity: the beneficial associations occurred in highly urbanized tracts but not in the three less-urbanized tracts.Our results provide further evidence that nearby forests and open spaces inside park, particularly in urban areas, were tied to a lower prevalence of respiratory diseases in the US. The beneficial association suggests the necessity of ensuring access to nearby green spaces, especially those in parks, to promote respiratory health.

Perspective on Particulate Matter: From Biomass Burning to the Health Crisis in Mainland Southeast Asia.

Air pollution, notably particulate matter pollution, has become a serious concern in Southeast Asia in recent decades. The combustion of biomass has been recognized to considerably increase air pollution problems from particulate matter in this region. Consequently, its effect on people in this area is significant. This article presents a synthesis of several datasets obtained from satellites, global emissions, global reanalysis, and the global burden of disease (GBD) to highlight the air quality issue and emphasize the health crisis in mainland Southeast Asia. We found that the death rates of people have increased significantly along with the rise of hotspots in mainland Southeast Asia over the last two decades (2000-2019). In comparison, most countries saw a considerable increase in the predicted fatality rates associated with chronic respiratory illnesses during those two decades. Several reports highlight the continued prevalence of chronic respiratory diseases likely related to poor air quality in Southeast Asia.

Global burden of chronic respiratory diseases and risk factors, 1990-2019: an update from the Global Burden of Disease Study 2019.

Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6-4.3) with a prevalence of 454.6 million cases (417.4-499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4-225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9-3.6) deaths. With 262.4 million (224.1-309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries.

Assessment of Cardiorespiratory Dysfunctions of Health Professionals above the Age of 40 years by means of Electrocardiography and Spirometry

Background: The increasing prevalence of chronic respiratory diseases, particularly chronic bronchitis andemphysema (COPD), is reflected as a growing concern regarding its diagnosis and control. Moreover medicalpersonnel working in different medical set up are at greater risk of stress and disease related susceptibility.Materials and Methods: Descriptive observational study based on ‘convenience sampling done on Healthprofessional viz. Doctors, Nurses and Technicians attached with Medical College, Kolkata and Ruby GeneralHospital, Kolkata between Feb 2015 to May 2016. Overall 50 doctors, 25 nurses and 25 technicians were taken fromMedical College, Kolkata. Pulmonary function tests were done by Spirotech ©, a software after rest for 10-15 minand briefing about to the technique of FVC (maximum inhalation followed by maximum exhalation) and MVV(voluntary hyperventilation for 15 seconds) tests were carried out. Spirometric parameters recorded for analysiswere FVC, FEV1, FEV1/FVC, PEFR, FEF25%-75% and MVV. The controls were selected from relatives of Out PatientDepartment (OPD) of Medical College who were non-health professionals. They followed the same procedure asthe cases.Results: It shows among cases of Medical College, 8 people are hypertensive and 42 people are normotensive,whereas in control group 5 people are hypertensive and 44 people are normotensive and 1 person had hypotension,which is not statistically significant (P Value 0.419). It shows among Medical college cases Mean FEV1 / FVC ratiois 114.50 (SD 12.63) whereas that of control is 103.90 (SD 15.94), which is statistically significant (P Value 0.000).Conclusion: Medical personnel are more obese particularly in corporate hospital. Medical personnel have similarblood pressure level as in general population. RBBB pattern is the most predominant QRS abnormality which isnot uncommon. Medical personnel have lower mean FEV1%, FEV1/ FVC and PEFR % than general population.Predominant spirometry abnormality in our study is restrictive pattern.

Determinants of life expectancy at birth: a longitudinal study on OECD countries

This paper analyses the influence of several determinants on life expectancy at birth in 36 OECD countries over the 1999–2018 period. We utilized a cross-country fixed-effects multiple regression analysis with year and country dummies and used dynamic models, backward stepwise selection, and Arellano–Bond estimators to treat potential endogeneity issues. The results show the influence of per capita health-care expenditure, incidence of out-of-pocket expenditure, physician density, hospital bed density, social spending, GDP level, participation ratio to labour, prevalence of chronic respiratory diseases, temperature, and total size of the population on life expectancy at birth. In line with previous studies, this analysis confirms the relevance of both health care expenditure and health care system (physicians and hospital beds in our analysis) in influencing a country’s population life expectancy. It also outlines the importance of other factors related to population behaviour and social spending jointly considered on this outcome. Policy makers should carefully consider these mutual influences when allocating public funds, particularly after the COVID-19 pandemic period.

Prevalence of chronic respiratory diseases in Aboriginal children: A whole population study.

The burden of bronchiectasis is disproportionately high in Aboriginal adults, with early mortality. Bronchiectasis precursors, that is, protracted bacterial bronchitis (PBB) and chronic suppurative lung disease (CSLD), often commence in early childhood. We previously reported a 10% prevalence of PBB in Aboriginal children aged 0 to 7 years, however there are no data on prevalence of chronic lung diseases in older children. Our study aimed to determine the prevalence of PBB, CSLD, bronchiectasis, and asthma in Aboriginal children living in four communities. A whole-population cross-sectional community co-designed study of Aboriginal children aged <18-years in four remote communities in Western Australia across two-time points, a month apart. Children were assessed by pediatric respiratory clinicians with spirometry undertaken (when possible) between March-September 2021. Children with respiratory symptoms were followed up via medical record audit from either the local medical clinic or via a respiratory specialist clinic through to March 2022 to establish a final diagnosis. We recruited 392 (91.6%) of those in the selected communities; median age = 8.4 years (interquartile range[IQR] 5.1-11.5). Seventy children (17.9%) had a chronic respiratory pathology or abnormal spirometry results. PBB was confirmed in 30 (7.7%), CSLD = 13 (3.3%), bronchiectasis = 5 (1.3%) and asthma = 17 (4.3%). The prevalence of chronic wet cough significantly increased with increasing age. The prevalence of PBB, CSLD and bronchiectasis is high in Aboriginal children and chronic wet cough increases with age. This study highlights the high disease burden in Aboriginal children and the urgent need for strategies to address these conditions.

Association of the Time to First Cigarette and the Prevalence of Chronic Respiratory Diseases in Chinese Elderly Population.

BackgroundIncreasing number of studies have suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them focused on the Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations.MethodsCross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD.ResultsThis study includes 13,208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3,779 participants were ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1,492 had suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65–2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44–2.00), although the difference was statistically insignificant (Pinteraction = 0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and ex-smokers (Pinteraction < 0.05).ConclusionShorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might partially reduce its detrimental impact on respiratory disease in these specific subpopulations.

Impact of COVID-19 on chronic respiratory disease outcome survey in Pakistan

Introduction: Pakistan has high prevalence of chronic respiratory diseases, especially bronchial asthma and chronic obstructive pulmonary disease (COPD). Objectives: The main objective of the study is to find the impact of COVID-19 on chronic respiratory disease in Pakistan. Material and methods: This cross sectional study was conducted in King Edward Medical University, Mayo Hospital Lahore during January 2021 to July 2021. Before and after the COVID-19 period were defined by a predetermined set of criteria in the form of a questionnaire. Results: The data was collected from 314 respondents. According to the respondents, the survey also queried about the presence of respiratory comorbidities in patients who had tested positive for COVID 19. COPD was mentioned as a comorbidity by more than a third of those who responded, and several others, including bronchial asthma, ILD, and tuberculosis (TB), were also mentioned by many respondents. Conclusion: It is concluded that because of the lockout's efficacy and the widespread use of masks outside the facility, the air was probably rather clean. As a result, both the number of people visiting an asthma outpatient clinic and the number of people being admitted to the hospital with acute severe asthma dropped. Keywords: COVID-19, Respiration, Patients, COPD

Prevalência de doenças respiratórias crônicas e uso de medicamentos entre crianças e adolescentes no Brasil - um estudo transversal de base populacional

Abstract Objectives: to describe the prevalence of chronic respiratory diseases and their pharmacological management in children and adolescents in Brazil. Methods: data from the Pesquisa Nacional de Acesso, Uso e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM)(National Access Survey, Use and Promotion of Rational Use of Medicines in Brazil),a population-based cross-sectional study, were analyzed. Household surveys were conducted between September 2013 and February 2014. We included the population under 20 years of age with chronic respiratory diseases. Prevalence of disease, indication of pharmacological treatment, and their use were assessed. Results: the prevalence of chronic respiratory diseases in children aged less than 6 years old was 6.1% (CI95%= 5.0-7.4), 4.7% (CI95%= 3.4-6.4) in those 6-12 years, and 3.9% (CI95%= 2.8-5.4) in children 13 years and older. Children under 6 showed a higher prevalence of pharmacological treatment indication (74.6%; CI95%= 66.0-81.7), as well as medication use (72.6%; CI95%= 62.8-80.7). Of those using inhalers, 56.6% reported using it with a spacer. The most frequent pharmacologic classes reported were short-acting β2 agonists (19.0%), followed by antihistamines (17.2%). Conclusion: children and adolescents who report chronic respiratory diseases living in urban areas in Brazil seem to be undertreated for their chronic conditions. Pharmacological treatment, even if indicated, was not used, an important finding for decision-making in this population.

Prevalence of Chronic Respiratory Diseases in Aboriginal Children: A Whole Population Study

Prevalence of Chronic Respiratory Diseases in Aboriginal Children: A Whole Population Study

Impact of COVID-19 on (Non-COVID) chronic respiratory disease outcome survey in India (CCROS study).

Background:India has high prevalence of chronic respiratory diseases, especially bronchial asthma and chronic obstructive pulmonary disease (COPD). Both of these are also recognized as risk factors for severity and poor outcome of COVID-19 disease. It is assumed that COVID-19 outbreak as well as an effective lockdown might have affected the incidence and outcome of some of these.Methods:To substantiate above hypothesis, an online survey was mailed to 547 pulmonologists across the country; 314 (54.7%) responses were recorded in the given period. The survey included observations on incidence and outcome of common chronic respiratory diseases such as asthma, COPD and interstitial lung diseases (ILD) in predefined pre-COVID and during COVID period in a total of 24 questions.Results:It was observed that the reduction in incidence of outpatient department cases, acute exacerbations and hospitalization for asthma, COPD and ILD was statistically significant. The outcome of acute exacerbations of these chronic respiratory diseases was analyzed in terms of discharges from hospitals after satisfactory recovery and/ or mortalities. For COPD and ILD, it was not significantly affected during the COVID period. At the same time, a relatively higher proportion of acute asthma mortality was reported. A wide variation in nebulization practices was reported during this period. The doses of inhaled corticosteroids in asthma management were not affected. A wide variety of factors including effective lockdown, better quality of air and regular use of masks were probably responsible for reduced incidence of exacerbations of these chronic respiratory diseases.Conclusion:We conclude that while outpatient department visits, acute exacerbations and hospitalizations were significantly reduced during COVID-19 period, outcome of asthmatics was relatively unfavorable as compared to that of COPD and ILDs.

Prevalence of respiratory disorder in the Northern population of Gujarat

Introduction: Diseases of respiratory tract are non curable diseases; however there can be increase in quality of life of individual with different types of treatment which leads to major air passages dilatation and shortness of breath improvement is achieved. It was in this context that the current study was undertaken to know the prevalence of chronic respiratory diseases in a rural area of Gujarat District in West India among people aged 20 years and above. Material and Methods: the individual above the age of 20 years in the selected area and who agreed to participate in the study were included in the study. A sample size of 1900 were included in the study. There was administration of modified British medical research council to all the individuals included in the study for the diagnosis of bronchial asthma cases and chronic bronchitis. Results: There were 1000 males and 900 females in the study. Majority of the population were in the age range of 20 – 39 years. The crude prevalence of chronic bronchitis was estimated to be 5.64% for males as compared to 2.23% for females. The prevalence of bronchial asthma in the current study was estimated at 2.10%. Discussion & Conclusion: The reason for the higher prevalence found in the present study is the probable, the majority of the individuals did not use the cleaner fuels in the domestic kitchens. This is found to be common practise in the rural kitchens of North Gujarat. Keywords: Gujarat, Population, Prevalence, Respiratory Disorders.

Spatial estimation of chronic respiratory diseases based on machine learning procedures—an approach using remote sensing data and environmental variables in quito, Ecuador

Over the last few years, the use of remote sensing data in different applications such as estimation of air pollution concentration and health applications has become very popular and new. Thus, some studies have established a possible relationship between environmental variables and respiratory health parameters. This study proposes to estimate the prevalence of Chronic Respiratory Diseases, where there is a relationship between remote sensing data (Landsat 8) and environmental variables (air pollution and meteorological data) to determine the number of hospital discharges of patients with chronic respiratory diseases in Quito, Ecuador, between 2013 and 2017. The main objective of this study is to establish and evaluate an alternative LUR model that is capable of estimate the prevalence of chronic respiratory diseases, in contrast with traditional LUR models, which typically assess air pollutants. Moreover, this study also evaluates different analytic techniques (multiple linear regression, multilayer perceptron, support vector regression, and random forest regression) that often form the basis of spatial models. The results show that machine learning techniques, such as support vector machine, are the most effective in computing such models, presenting the lowest root-mean-square error (RMSE). Additionally, in this study, we show that the most significant remote sensing predictors are the blue and infrared bands. Our proposed model is a spatial modeling approach that is capable of determining the prevalence of chronic respiratory diseases in the city of Quito, which can serve as a useful tool for health authorities in policy- and decision-making.

Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

SummaryBackgroundPrevious attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017.MethodsUsing data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs.FindingsIn 2017, 544·9 million people (95% uncertainty interval [UI] 506·9–584·8) worldwide had a chronic respiratory disease, representing an increase of 39·8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex-specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7·0% [95% UI 6·8–7·2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578–4 044 819) in 2017, an increase of 18·0% since 1990, while total DALYs increased by 13·3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14·3% decrease), age-standardised death rates (42·6%), and age-standardised DALY rates (38·2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region.InterpretationOur study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis.FundingBill & Melinda Gates Foundation.

Influence of type of dwelling on the prevalence of chronic respiratory diseases in Ho Chi Minh City, Viet Nam.

SETTING and OBJECTIVE: Exposure to pollutants is related to the type of dwelling inhabited. Besides tobacco smoke, indoor air pollution is a significant risk factor for chronic respiratory disease (CRD). The prevalence of CRD by type of dwelling was studied in Ho Chi Minh City, Viet Nam.DESIGN: A total of 1561 people living in four type of dwellings were enrolled. Information on respiratory health, lung function, dwelling characteristics and sources of indoor pollution was obtained using a symptom and demographics questionnaire and spirometry. The two main respiratory health outcomes were clinical chronic CRD (CCRD) and chronic obstructive respiratory disease (CORD) (forced expiratory volume in 1 sec/forced vital capacity <0.7). We used binary logistic regression adjusted for age, sex, time spent at home, smoking status, certain occupational exposures, previous tuberculosis, presence of pets, rats or cockroaches at home, wall dampness, biofuel use and use of airconditioning.RESULTS: The prevalence of CCRD (24.3%) and CORD (5.3%) in the type of dwellings studied were not similar (χ² P < 0.0001). CCRD and CORD prevalence was similar in tube houses and apartments. Compared to people living in apartments, those living in rental single rooms had a 46% higher risk of developing CCRD. The odds ratio of having CORD in people living in rental single rooms and in rural houses were respectively 4.64 (95%CI 1.97-10.5) and 2.99 (95%CI 1.21-7.37).CONCLUSION: Type of dwelling was associated with CCRD and CORD morbidity.

Chronic respiratory disease should be considered when interpreting indicators of community antimicrobial use in people over 65years old.

Chronic respiratory diseases (CRD) put patients at increased risk of respiratory infection and antimicrobial use, but surveillance results on community antimicrobial use are generally not adjusted for this risk factor. The objective of this study was to demonstrate the importance of accounting for CRD when interpreting indicators of community antimicrobial use in people over 65years old, in Québec, Canada. Retrospective cohort study of antimicrobial use according to CRD status in individuals over 65years old covered by Québec's public drug insurance plan between 2010 and 2015. Defined daily doses per 1000 person-days (DID) were computed per antimicrobial class and were further stratified according to chronic disease group, fiscal year, gender and age group. Antimicrobial use was 2.3 times higher in the CRD group (29.7 DID) compared with the other chronic disease group (13.1 DID) and 3.1 times higher than in the no chronic disease group (9.6 DID). The same gradient was reflected as well in use per antimicrobial class, per age group, per gender, and in time. Antimicrobial use increased throughout the study period and was higher in older age groups and in women. Interpretation of results of antimicrobial use surveillance should consider the prevalence of CRD in populations. In order to identify opportunities for adapted interventions targeting inappropriate use, finer analyses are necessary.

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

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