Prevalence Of Respiratory Symptoms Research Articles

Association of antenatal or neonatal SARS-COV-2 exposure with developmental and respiratory outcomes, and healthcare usage in early childhood: a national prospective cohort study

Perinatal exposure to SARS-CoV-2 may affect neurodevelopment before 12 months of age, but longer-term outcomes remain unknown. We examined whether antenatal or neonatal SARS-CoV-2 exposure compared with non-exposure is associated with neurodevelopment, respiratory symptoms, and health care usage in early childhood. This prospective national population-based cohort study was conducted in England and Wales, United Kingdom. We enrolled term-born children (≥37 weeks' gestation) with and without antenatal or neonatal exposure to SARS-CoV-2 infection by approaching parents of eligible children who were cared for in 87 NHS hospitals. Potential participants were identified through the national active surveillance studies of pregnant women and newborn infants hospitalised with confirmed SARS-CoV-2 infection conducted through the UK Obstetric Surveillance System and the British Paediatric Surveillance Unit. We defined antenatal and neonatal SARS-CoV-2 exposure as infants born to mothers hospitalised with confirmed SARS-CoV-2 infection between 14+0 and 36+6 weeks gestation and infants admitted to hospital with confirmed SARS-CoV-2 infection within the first 28 days after birth. Children born preterm or with major congenital anomaly or who were not residing in the UK were excluded. We assessed children's development (Ages and Stages Questionnaire 3rd Edition (ASQ-3); Ages and Stages Questionnaire Social-Emotional 2nd Edition (ASQ:SE-2)), respiratory symptoms (Liverpool Respiratory Symptom Questionnaire (LRSQ)) and health care usage (parent-completed questionnaire) at 21-32 months of age. Primary outcome: total ASQ-3 score, converted to z-scores. Secondary outcomes: ASQ:SE-2 z-scores; risk of delay in ASQ-3 domains; total LRSQ scores, converted to z-scores. Analyses were adjusted for children's age, sex, maternal ethnicity, parental education, and index of multiple deprivation. Between October 20, 2021 and January 27, 2023, we approached 668 and 1877 families out of 712 and 1917 potentially eligible participants in the exposed and comparison cohort. Of the 125 and 306 participants who were enrolled to the exposed and comparison cohort 121 and 301 participants completed the questionnaires and 96 and 243 participants were included in the analysis. In the age adjusted analysis, the mean total ASQ-3 z-score was lower in the exposed than the comparison cohort (-0.3, 95% CI:-0.6 to-0.05), however, when adjusted for sex, parental education, ethnicity and IMD quintile, there was no significant difference (difference in mean z-score=-0.2 95% CI:-0.5 to 0.03). SARS-CoV-2 exposure was associated with increased risk of delayed personal-social skills (odds ratio=3.81; 95% CI: 1.07-13.66), higher ASQ:SE-2 total z-scores (difference in mean z-score=0.4; 95% CI: 0.2-0.6) and increased risk of delayed social-emotional development (OR=3.58, 95% CI: 1.30-9.83), after adjusting for sex, age at assessment, parental education, ethnicity and IMD quintile. The exposed cohort had a higher mean total LRSQ z-score than the comparison cohort (0.3 95% CI: 0-0.6) and higher inpatient (38% vs. 21%, p=0.0001), outpatient (38% vs. 30%, p=0.0090), and General Practitioner appointments (60% vs. 50%, p=0.021) than the comparison cohort, after adjusting for sex, age at assessment, parental education, ethnicity and IMD quintile. No differences in other secondary outcomes between the exposed and comparison cohorts were found. Although the exposed cohort did not differ from the comparison cohort on the primary outcome, total ASQ-3 score, the exposed cohort were at greater risk of delayed social-emotional development, had a greater prevalence of respiratory symptoms and increased health care usage relative to the comparison cohort. The study is limited by the smaller sample size due to the low response rate and lack of clinical developmental assessments. Given the association of poor social-emotional development with antenatal or neonatal SARS-CoV-2 exposure, developmental screening, and follow-up of children with confirmed antenatal or neonatal SARS-CoV-2 infection may be warranted to identify those in need of early intervention. Action Medical Research for Children.

A Retrospective Analysis of Postmortem Salmonella Dublin Cases in Dairy Cattle in British Columbia

Salmonella Dublin is a bovine-adapted bacterial pathogen that primarily affects dairy cattle. The incidence of S. Dublin has been increasing across North America, including strains that are multidrug resistant. In British Columbia, the Ministry of Agriculture’s Animal Health Center (AHC) reported an increase in cases since 2015, warranting an investigation into how S. Dublin is spreading within the province. The objectives of this study were to make use of historical data collected from dairy farms across the province to (1) describe S. Dublin cases diagnosed at the AHC between 2007 and 2021, (2) identify risk factors for S. Dublin transmission across British Columbia dairy farms, and (3) identify any potential biases associated with passive laboratory-based data that may apply to our results. We found that S. Dublin cases diagnosed at the AHC have been increasing over time. Over half of the cases had respiratory symptoms; however, clinical signs tended to be highly variable. The prevalence of respiratory symptoms was mirrored by florfenicol treatment and was suggested to be due to using a first-line antibiotic for more common causes of pneumonia when presented with an S. Dublin case. Calves were 38 times more likely to have S. Dublin when compared to adults (odds ratio = 38.43, confidence interval = 7.26–203.64), and given the sample population (postmortem cases), it is reasonable to conclude clinical disease is most severe in this age group. Farm premise accounted for a large amount of variability within our model (92% of unexplained variance), suggesting that farm-level management practices may be the most important risk factor for S. Dublin infection. In total, only 54% of BC dairy farms submitted to the laboratory between 2007 and 2021; however, proximity to the laboratory did not appear to influence submissions as proportionally; farms within the Fraser Valley submitted as frequently as farms from other regions. We strongly suggest that future work explore factors associated with farm management practices, given our findings regarding the clustering by premises.

Risk of Chronic Obstructive Pulmonary Disease and Receipt of a Breathing Test in 26 States and the District of Columbia, 2017–2018

Risk of Chronic Obstructive Pulmonary Disease and Receipt of a Breathing Test in 26 States and the District of Columbia, 2017–2018

Exposures and Health Effects of Diacetyl and 2,3-Pentanedione in a Coffee Processing Facility

Diacetyl and 2,3-pentanedione are alpha-diketones that are generated during the coffee roasting process and have been shown to be related to respiratory symptoms, abnormal lung function, and in rare cases, an irreversible disease called obliterative bronchiolitis. This study measured personal exposures in a coffee roastery in New Zealand using thermal desorption tubes and explored the prevalence of respiratory symptoms with a health questionnaire. Exposures from task samples were highest for grinding (Geometric Mean (GM): 22.5 ppb diacetyl; GM: 19.3 ppb 2,3-pentanedione), followed by packaging (GM: 10.8 ppb diacetyl; GM: 9.3 ppb 2,3-pentanedione) and then roasting (GM: 4.7 ppb diacetyl; GM: 4.1 ppb diacetyl). 8-h time-weighted average (TWA) diacetyl exposures exceeded the National Institute of Occupational Safety and Health (NIOSH) Recommended Exposure Limit (REL) of 5 ppb for Roaster/Packager (GM: 6.6 ppb) and Grinder (GM: 5.3 ppb). 8-h TWA concentrations were below the NIOSH REL of 9.3 ppb for 2,3-pentanedione (Roaster/Packager, GM: 5.7 ppb; Grinder, GM: 4.6 ppb). Workers reported nose, eye symptoms and systemic symptoms (flu-like illness or achy joints, fever or chills, or unusual tiredness or fatigue). The results indicated that exposure was highest for tasks involving ground coffee beans and that coffee processing workers can be exposed to alpha-diketones above the NIOSH RELs. Further research into alpha-diketone exposure and health effects, and control measures to minimise exposure are recommended.

Outcome-based Definition of the Lower Limit of Normal in Spirometry: A Study of 26,000 Young Adult Men.

Rationale The definition of the lower limit of normal (LLN) of spirometric variables is not well established. Objectives To investigate the relationship between spirometric abnormalities defined with different thresholds of the LLN and clinical outcomes, and to explore the possibility of using different LLN thresholds according to the pre-test probability of disease. Methods We studied the associations between pre-bronchodilator spirometric abnormalities (FEV1 < LLN, FVC < LLN, airflow obstruction, spirometric restriction) defined with different thresholds of the LLN (10th, 5th, 2.5th, 1st percentile) and multiple outcomes (prevalence of spirometric abnormalities, respiratory symptoms, all-cause and respiratory mortality) in 26,091 30-46 years old men who participated in a general population survey in Norway in 1988-1990 and were followed for 26 years. Analyses were performed with both local and GLI-2012 reference equations, stratified by pre-test risk (presence or absence of respiratory symptoms), and adjusted for age, BMI, smoking, and education. Results In the total population, the prevalence of airflow obstruction was 11.6% with GLI-LLN10, 11.0% with Local-LLN5, 6.1% with GLI-LLN5, 7.6% with Local-LLN2.5, and 3.5% with GLI-LLN2.5. The prevalence of spirometric restriction was 5.9% with GLI-LLN10, 5.2% with Local-LLN5, and 2.8% with GLI-LLN5. Increasingly lower thresholds of the LLN were associated with increasingly higher odds of respiratory symptoms and hazard of mortality for all spirometric abnormalities with both reference equations. Spirometric abnormalities defined with Local-LLN2.5 in asymptomatic subjects were associated with lower hazard of all-cause mortality (hazard ratio 1.50 (1.15, 1.95, 95% confidence intervals) for FEV1 < LLN) than those defined with Local-LLN5 in the general population (1.67 (1.50, 1.87) for FEV1 < LLN) and symptomatic subjects (1.67 (1.46, 1.91) for FEV1 < LLN). Overall, prevalence of spirometric abnormalities and associations with outcomes obtained with Local-LLN5 were comparable to those obtained with GLI-LLN10, and those obtained with Local-LLN2.5 to GLI-LLN5. Conclusions There is a relationship between statistically-based thresholds of the LLN of spirometric variables and clinical outcomes. Different thresholds of the LLN may be used in different risk subgroups of subjects, but the choice of the threshold needs to be evaluated together with the choice of reference equations.

Bridging the knowledge gap! Health outcomes in informal e-waste workers.

Although several studies analyzed the impact of e-waste recycling on human health, most publications did not differ between e-waste workers and bystanders, such as residents. This could lead to an underestimation of health effects in workers. In addition, frequently reported surrogate findings do not properly reflect clinical significant health outcomes. The aim of this review was to analyze the direct health effects of informal e-waste recycling in informal e-waste workers. According to PRISMA guidelines, we systematically searched 3 databases (Embase®, PubMed®, Web of Science) for studies from low- and middle-income countries published in German or English between 1980 and 1 November 2021. Of the 2613 hits, 26 studies (cross-sectional, longitudinal and case-control studies) met the specified criteria and were included. We categorized the results into hormonal, respiratory, renal, cardiovascular, musculoskeletal health and general symptoms in informal e-waste workers. Exposure to e-waste was associated with altered lipid metabolism, thyroid hormonal imbalances, impaired fertility, renal dysfunction, increased prevalence of respiratory symptoms, asthma, cardiac arrhythmias, hypertension, musculoskeletal pain, injuries in up to 89% and skin disorders in up to 87.5-100% of e-waste workers. Due to inconsistent findings, weak associations or poor study quality, it has rarely been possible to establish a causal relationship between informal e-waste work and health effects, except for injuries or skin conditions. Besides high-quality studies, a collective national and international political focus on e-waste disposal is needed.

Prevalence of Adverse Respiratory Symptoms Among E-Cigarette Users in Saudi Arabia – A Cross-Sectional Study

ABSTRACT Electronic cigarettes, frequently referred to as e-cigarettes, have emerged as a controversial and rapidly growing phenomenon in the realm of tobacco and nicotine consumption worldwide. This study reports the prevalence of respiratory symptoms among e-cigarette users. This study also helps to understand the potential harmful effects and importance of quitting e-cigarette smoking. An observational cross-sectional study was carried out in Saudi Arabia. The study period was from September 2022 to August 2023. The sample size was 447 participants. Among recent e-cigarette users in this Saudi study, usage varied, with 44.1% using 1–5 days, 33.6% using 6–30 days, and 22.4% using e-cigarettes previously but not in the previous month. Vape devices were predominant (42.7%). There were significant associations emerged between e-cigarette use frequency and symptoms such as fatigue, breathlessness, and shortness of breath. E-cigarette use was notably linked to asthma-related symptoms, underscoring its concerning impact on respiratory health (P &lt; 0.05). E-cigarette consumption has a significant impact on respiratory effects and specifically asthma-related symptoms among this Saudi population.

Welding fume exposure and prevalence of chronic respiratory symptoms among welders in micro- and small-scale enterprise in Akaki Kality sub-city, Addis Ababa, Ethiopia: a comparative cross-sectional study.

Exposure to welding fumes can lead to different respiratory health disorders, including lung cancer, due to long-term exposures. In Ethiopia, large numbers of people are engaged in the welding sector. Often, these workers are exposed to welding fumes at their workplaces, however, the level of exposure and its health effects have never been studied. To measure the level of personal welding fume exposure and assess chronic respiratory symptoms and associated factors, among micro and small-scale enterprise metal workshop workers, in Akaki Kality Sub city, Ethiopia. A comparative cross-sectional study involving 226 welders and 217 controls. Chronic respiratory symptoms were assessed using a standardized questionnaire adopted from the American Thoracic Society (ATS). Welding fumes were collected from the welder's breathing zone using 37mm close-faced plastic cassettes fitted with Polyvinyl Chloride (PVC) filters connected to Casella pumps at an airflow rate of 2L/min. The overall prevalence of chronic respiratory symptoms among welders and controls were 54 (23.9%) and 20 (9.2%) respectively. The geometric mean and geometric standard deviation (GSD) of personal welding fume exposure, among welders was 5.98 mg/m3 (± GSD = 1.54). In this study, 53.3% of the samples exceeded the Occupational Exposure Limit defined by the American Conference of Governmental Industrial Hygiene. Chronic respiratory symptoms were significantly associated with educational status (Adjusted Odds Ratio (AOR): 5.11, 95% CI: 1.35, 19.33), respiratory protective equipment use (AOR: 3.33, 95% CI: 1.52, 7.31), safety training (AOR: 2.41, 95% CI: 1.10, 5.28), smoking (AOR:3.57, 95% CI: 1.54, 8.23), welding machine maintenance (AOR: 1.87, 95% CI: 1.01, 3.59) and welding site (i.e. indoors vs. outdoor) (AOR: 6.85. 95% CI: 2.36, 19.89). The prevalence of chronic respiratory symptoms among welding workers was significantly higher than controls. More than half of the samples exceeded the Occupational Exposure Limit. Educational status, implementation of safety training, and welding sites were significantly associated with chronic respiratory symptoms. The results suggested a need to reduce welding fume exposure to improve the respiratory health of the workers.

Repetitive sulfur dioxide exposure in mice models post-deployment respiratory syndrome.

Soldiers deployed to Iraq and Afghanistan have a higher prevalence of respiratory symptoms than nondeployed military personnel and some have been shown to have a constellation of findings on lung biopsy termed post-deployment respiratory syndrome (PDRS). Since many of the subjects in this cohort reported exposure to sulfur dioxide (SO2), we developed a model of repetitive exposure to SO2 in mice that phenocopies many aspects of PDRS, including adaptive immune activation, airway wall remodeling, and pulmonary vascular (PV) disease. Although abnormalities in small airways were not sufficient to alter lung mechanics, PV remodeling resulted in the development of pulmonary hypertension and reduced exercise tolerance in SO2-exposed mice. SO2 exposure led to increased formation of isolevuglandins (isoLGs) adducts and superoxide dismutase 2 (SOD2) acetylation in endothelial cells, which were attenuated by treatment with the isoLG scavenger 2-hydroxybenzylamine acetate (2-HOBA). In addition, 2-HOBA treatment or Siruin-3 overexpression in a transgenic mouse model prevented vascular remodeling following SO2 exposure. In summary, our results indicate that repetitive SO2 exposure recapitulates many aspects of PDRS and that oxidative stress appears to mediate PV remodeling in this model. Together, these findings provide new insights regarding the critical mechanisms underlying PDRS.NEW & NOTEWORTHY We developed a mice model of "post-deployment respiratory syndrome" (PDRS), a condition in Veterans with unexplained exertional dyspnea. Our model successfully recapitulates many of the pathological and physiological features of the syndrome, revealing involvement of the ROS-isoLGs-Sirt3-SOD2 pathway in pulmonary vasculature pathology. Our study provides additional knowledge about effects and long-term consequences of sulfur dioxide exposure on the respiratory system, serving as a valuable tool for future PDRS research.

Swimming was associated with rhinitis and pollinosis in a duration-dependent manner.

Previous studies have reported conflicting results regarding the effects of childhood swimming on respiratory allergic symptoms. We investigated the relationship between swimming and respiratory allergic symptoms in schoolchildren. A questionnaire regarding participation in sports club activities and respiratory allergic symptoms in schoolchildren was distributed to the parents of all 6853 public school students (aged 6-14 years) in Omihachiman City, Shiga, Japan. The relationships between participation in sports club activities and the prevalence of respiratory allergic symptoms were analyzed by multivariable logistic regression analyses. Questionnaires were returned for 4991 schoolchildren (response rate: 72.8%). Logistic regression analysis revealed significant positive associations between swimming and rhinitis (42.9% vs. 38.9%; adjusted odds ratio, 1.26; 95% confidence interval, 1.10-1.44), and swimming and pollinosis (32.1% vs. 28.1%; adjusted odds ratio, 1.28; 95% confidence interval, 1.11-1.47). The duration of participation in swimming activities was also significantly positively associated with the prevalence of rhinitis and pollinosis. Those who had participated in swimming activities for 6 years or more showed significantly higher prevalences of rhinitis and pollinosis (46.3% and 36.4%, respectively) than those without swimming activities (38.9% and 28.1%, respectively) and those who had participated in swimming activities for 5 years or less (40.1% and 28.5%, respectively). Swimming was associated with the prevalence of rhinitis and pollinosis in schoolchildren, especially among those who had participated in swimming activities for 6 years or more. Preventive measures and early interventions for rhinitis and pollinosis should be recommended to these children.

Effects of Residential Proximity to Industrial Zone on Respiratory Symptoms among Residents in Parit Raja, Batu Pahat

Introduction: The industrial park in the district of Parit Raja, Batu Pahat resulted in rapid growth of the town during the last 20 years and has been a reason of concern that this park also has contributed greatly to the problem of air pollution. The aim of this study was to evaluate the association between industrial air pollution and respiratory symptoms in adults living in the Parit Raja. Methods: A comparative cross-sectional study was undertaken among residents in the district of Parit Raja, Batu Pahat, Johor, Malaysia. A total of 110 residents aged between 19 and 65 years were randomly selected and information on personal characteristics and respiratory symptoms was obtained through a validated questionnaire. The prevalence of respiratory symptoms was compared between residents recruited from the areas situated about 5km radius of the industrial park (exposed) and &gt;5km radius from the industrial park (comparative). Results: A total of 34.5% and 25.5% of adults from the exposed group reported experiencing coughing for the last 3 months and chest tightness for the last 3 years. The logistic regression models showed that symptoms of coughing was associated with the exposed group (aOR=6.34, 95% CI=2.08-19.35), male respondents (aOR=3.18, 95% CI=1.10-9.16) and who stay in Part Raja for more than 14 years (aOR=3.16, 95% CI=1.14-8.79). Conclusion: This study demonstrated that long-term air pollution exposures are consistently associated with respiratory symptoms in residents living in the proximity of industrial parks. Therefore, public health initiatives that aim to provide more conducive environment are needed, especially for residents living near industrial parks.

Prognostic value of clinical and microbiological parameters in COVID-19: the COMEPA study

Purpose. Clusters’ analysis may indicate distinct phenotypes and symptom profiles potentially due to differing pathophysiology and needing different clinical approaches in COVID-19. However, the research about clusters combining clinical and microbiological information is still limited. The purpose of our study was to examine the prognostic role of clusters, including clinical and microbiological parameters in terms of severity of lung involvement, in-hospital mortality, and the occurrence of long COVID. Methods. Information regarding COVID-19, mortality, severity of lung involvement derived from medical records; long COVID symptomatology was ascertained using phone calls. A k-means clustering method was considered to partition data into clusters considering typical symptoms of COVID-19 present at hospital admission and SarsCov2 variants. Results. Our analysis identified among 414 patients (mean age: 65 years; males: 59.9%) four different clusters. Cluster 1: higher prevalence of respiratory COVID symptoms at hospital admission; Cluster 2: higher frequency of non-respiratory COVID symptoms and a higher prevalence of the Alpha variant; Cluster 3: older subjects and more frequently men, reporting more severe medical conditions and with a higher prevalence of Wild type variant; Cluster 4: patients that more often reported general and gastrointestinal COVID symptoms at the admission. From a prognostic point of view, patients in cluster 3 more frequently died and were admitted in a nursing home, with significantly lower presence of long COVID symptomatology. Conclusions. Clusters combining clinical and microbiological information in individuals hospitalized with COVID-19 that had different not only different profiles, but also different prognostic values, also in terms of long COVID.

Particulate Matter 2.5 and Respiratory Symptoms in Urban and Suburban Schoolchildren in Ho Chi Minh City, Vietnam

Objective: To document the pattern of particulate matter 2.5 (PM2.5) concentration in urban and suburban schools in Ho Chi Minh City (HCMC) and to estimate the prevalence of wheezing and rhinitis among schoolchildren according to sociodemographic characteristics and school-related conditions.Material and Methods: A cross-sectional study was conducted in two suburban and two urban schools in HCMC. PM2.5 concentrations were monitored hourly from August to December in 2022. Children aged 9-13 years (N=1,033) provided data on wheezing and rhinitis symptoms in the previous year. The daily levels of PM2.5 were monitored in each school. Respiratory symptoms were compared between areas and across school-related conditions.Results: Geometric means of the daily PM2.5 concentration in the suburban and urban areas were 61.2 μg/m3 and 31.0 μg/m3, respectively (p-value&lt;0.001). In both areas, PM2.5 levels increased in the evening to high levels at night and early morning. The prevalence of respiratory symptoms did not differ significantly between the suburban and urban areas: wheezing 20.6% and 16.9%, and rhinitis 55.7% and 61.5%, respectively. However, school-related conditions in which the prevalence was increased were travelling to school by bus, spending more than 15 minutes/day on the road and attending extra classes outside normal school hours.Conclusion: Despite the significantly higher PM2.5 levels in suburban schools, the prevalence of wheezing and rhinitis did not reveal significant differences between areas. However, respiratory symptoms were more common among those travelling by bus, having been infected with Coronavirus Disease-19 (COVID-19), spending longer time on the road and attending classes outside normal school hours.

Particulate Matter 2.5 and Respiratory Symptoms in Urban and Suburban Schoolchildren in Ho Chi Minh City, Vietnam

Objective: To document the pattern of particulate matter 2.5 (PM2.5) concentration in urban and suburban schools in Ho Chi Minh City (HCMC) and to estimate the prevalence of wheezing and rhinitis among schoolchildren according to sociodemographic characteristics and school-related conditions.Material and Methods: A cross-sectional study was conducted in two suburban and two urban schools in HCMC. PM2.5 concentrations were monitored hourly from August to December in 2022. Children aged 9-13 years (N=1,033) provided data on wheezing and rhinitis symptoms in the previous year. The daily levels of PM2.5 were monitored in each school. Respiratory symptoms were compared between areas and across school-related conditions.Results: Geometric means of the daily PM2.5 concentration in the suburban and urban areas were 61.2 μg/m3 and 31.0 μg/m3, respectively (p-value&lt;0.001). In both areas, PM2.5 levels increased in the evening to high levels at night and early morning. The prevalence of respiratory symptoms did not differ significantly between the suburban and urban areas: wheezing 20.6% and 16.9%, and rhinitis 55.7% and 61.5%, respectively. However, school-related conditions in which the prevalence was increased were travelling to school by bus, spending more than 15 minutes/day on the road and attending extra classes outside normal school hours.Conclusion: Despite the significantly higher PM2.5 levels in suburban schools, the prevalence of wheezing and rhinitis did not reveal significant differences between areas. However, respiratory symptoms were more common among those travelling by bus, having been infected with Coronavirus Disease-19 (COVID-19), spending longer time on the road and attending classes outside normal school hours.

Prevalence of chronic respiratory symptoms and associated factors among woodwork workers in Bahir Dar City, Ethiopia; a comparative cross-sectional study

BackgroundExposure to wood dust can cause respiratory symptoms, like cough, phlegm, breathlessness, and chest pain, reduce lung function.ObjectiveThe objective of the study was to assess the prevalence of respiratory symptoms and associated factors among woodwork workers in Bahir-Dar city, Ethiopia.MethodsA comparative cross-sectional study was employed among 229 exposed and 228 unexposed groups. Participants for the study were selected using simple random sampling technique. The chronic respiratory symptoms were assessed using a questionnaire adopted from the American Thoracic Society. The data was entered using Epi-Data version 4.6 and export to SPSS version 22 for analysis. Poisson regression, Multivariate linear regression and multivariable logistic regression analysis were used to identify factors associated with woodworkers, general population and in pooled analysis.ResultThe prevalence of having at least one chronic respiratory symptom was higher among exposed group (59.4%) than unexposed group (18.0%) with PR = 3.03(95%CI: 2.45, 4.45). In woodworker; Not taking health and safety training(5.15,95%(CI:1.93–13.76),primary educational(3.85,95%,CI:(1.1,13.47), not using Mask(6.38, 95%CI:(2.69–15.76) & number of families(3.05,95%,CI:1.04–9.028), In general population; Number of family members(2.75, 95%CI:1.1–7.19)& lower monthly income (3.3, 95%CI: (1.49–7.4), and In pooled analysis; wood dust exposure status 14.36 95%, CI:(7.6–27.00),primary education(2.93,95%CI:1.24–6.92), number of families(3.46,95%CI:1.8–6.64), lower monthly income(2.13,95%CI:1.19–3.81), & smoking (6.65, 95%CI:1.19–36.9) were associated with respiratory symptom.ConclusionPrevalence of respiratory symptoms was higher among exposed group than unexposed group. Reduced wood dust exposure status, Provision of occupational safety and health training, use of respiratory protective devices is recommended to reduce respiratory symptoms among woodwork workers.

Inhomogeneity of ventilation in smokers and mild COPD assessed by the ratio of alveolar volume to total lung capacity

BackgroundPrevious studies have shown that the ratio between alveolar volume (VA) and total lung capacity (TLC) reflects ventilation heterogeneity in subjects with chronic obstructive pulmonary disease (COPD). However, the ratio and its correlation to respiratory symptoms had to our knowledge not previously been investigated in subjects with mild chronic airflow obstruction or without airflow obstruction (normal ratio FEV1/VC).The purpose of this study was to investigate potential connection between VA/TLC and respiratory symptoms, smoking habits and lung function parameters in subjects with normal spirometry and with mild chronic airflow obstruction. MethodsWe examined 450 subjects (82 non-smokers with normal spirometry, 298 subjects who smoked or had smoked earlier but had a normal spirometry and 70 subjects with chronical airflow obstruction) with routine lung function tests and a questionnaire regarding respiratory symptoms. ResultsThis study showed 31 out of 54 subjects with a low VA/TLC had a normal ratio FEV1/VC. Of these subjects, 58.1 % had respiratory symptoms, compared to the group with normal ratio for both VA/TLC and FEV1/VC where 35.8 % had respiratory symptoms (p-value 0.02). ConclusionThis study has shown that within the group of subjects with a normal ratio FEV1/VC, those with a decreased ratio VA/TLC had a higher prevalence of respiratory symptoms compared to subjects with a normal VA/TLC ratio. These findings indicate that including the ratio VA/TLC in the evaluation of a pulmonary function test assessment might increase the possibility to identify subjects with early or at risk of lung disease.

Passive Smoking and Respiratory Symptoms among Children in Tertiary Care Hospital of Sindh

Background: Passive exposure to environmental tobacco smoke in the home and other places, and active smoking throughout later childhood all have an impact on the respiratory health of children. Parental smoking has been associated with respiratory symptoms and deteriorated lung function in children. Objective: This study aims to determine the prevalence of respiratory symptoms among children and their association with passive smoking and respiratory symptoms among children aged up to 12 years in selected tertiary care hospitals in Sindh. Methods: This study was a cross-sectional study, conducted in two tertiary care hospitals from where 217 children aged up to 12 years were selected who attended the pediatric OPD for a routine checkup. Results: A total of 217 children with a mean age of 6.4 years (±5.0) years participated in this study. Approximately 73.6 % of children between 0-6 years and 85% between 7-12 years had cough respectively. The results show a significant association between the smoking status of parents and respiratory health among children (0.049), according to the analysis symptoms like coughing, shortness of breath while running/walking, and getting tired p-values 0.038, 0.035, and 0.003 easily show statistically significant association whereas phlegm production shows non-significant (p-value 0.380) association with passive smoking exposure among children up to 12 years of age, experienced in last 30 days for more than 2 times/week. Conclusion: Children's health experts should discuss the negative effects of smoking and the necessity of reducing exposure to secondhand smoke; parents should be informed about these issues and advised not to smoke in front of children.

2628. Prevalence of respiratory symptoms in children and staff in Pre-K—12th grade schools and subsequent results from respiratory virus testing

Abstract Background Little is known about the prevalence of respiratory symptoms and associated respiratory virus detection in students/ staff in primary and secondary schools. Methods School KIDS is a prospective respiratory viral surveillance program in a large Missouri school district. Participating students/ staff complete a monthly electronic symptom survey that asks about respiratory symptoms (sx) in the preceding 7 days; participants are categorized based on the presence of any respiratory sx: ongoing (current), resolved, and no sx. Within 36 hours of survey completion, participants undergo surveillance respiratory viral testing at school. Self-administered nasal swabs are tested via multipathogen PCR assay (Table). Prevalence of respiratory viruses in participants with and without sx were calculated. A mixed-effect multivariable logistic regression model was used to compare odds of a sample testing positive based on surveillance sx and enrollee age. Results A total of 544 students (30 pre-kindergarten (preK), 320 elementary, 117 middle, and 77 high) and 224 staff enrolled. A total of 2,537 sx surveys with corresponding respiratory samples were collected from November 2, 2022–April 15, 2023 (Table). Of the samples provided, 1,138 were preK-elementary (45%), 368 middle (14%), 276 high (11%), and 755 staff (30%). Participants reported ongoing (20%), resolved (14%), and no sx (66%). Prevalence of commonly reported sx were congestion (21%), runny nose (17%), cough (16%), and fever (3%). Overall respiratory virus test positivity was 26%; 50% of positive samples came from participants without sx. Flu A, PIV, and RSV were more frequently detected in those with ongoing sx. AdV, HMPV, RV/EV, and SARS-CoV-2 were more frequently detected in those with no sx. Increased odds of a positive test were observed among enrollees who reported runny nose (adjusted OR 1.4 [CI 1.0, 1.8]), congestion (adjusted OR 2.2 [CI1.6, 2.8]), cough (adjusted OR 1.5 [CI 1.1, 1.9]), or sore throat (adjusted OR 1.5 [CI 1.1, 2.0]) but not fever (adjusted OR 1.1 [CI 0.7,1.8]). Conclusion More research is needed to understand if students with respiratory sx are more likely than asymptomatic students to shed transmissible respiratory viruses. Disclosures Rangaraj Selvarangan, BVSc, PhD, D(ABMM), FIDSA, FAAM, Abbott: Honoraria|Altona Diagnostics: Grant/Research Support|Baebies Inc: Advisor/Consultant|BioMerieux: Advisor/Consultant|BioMerieux: Grant/Research Support|Bio-Rad: Grant/Research Support|Cepheid: Grant/Research Support|GSK: Advisor/Consultant|Hologic: Grant/Research Support|Lab Simply: Advisor/Consultant|Luminex: Grant/Research Support

Respiratory symptoms and pulmonary function impairment among textile industry workers in Alexandria, Egypt.

Occupational exposure to cotton dust is still an important cause of respiratory problems in textile workers particularly in less developed countries like Egypt. Evaluate respiratory symptoms and diseases, and pulmonary function pattern among Egyptian textile workers. Cross sectional comparative study was conducted from December 2019 to September 2020 in a textile factory in Egypt; 364 male workers (184 cotton dust exposed workers, and 180 unexposed workers) were included. Participants were subjected to an interviewing questionnaire, British Medical Research Council questionnaire, anthropometric measurements, pulmonary function tests, and byssinosis grading format. Descriptive and analytic statistics were conducted. Chronic cough, phlegm production, and shortness of breath grade I, II and III were more reported in cotton dust exposed workers than unexposed workers (P#x003C;0.01, P#x003C;0.01, and P=0.02, respectively). Prevalence of chronic bronchitis was significantly higher among cotton dust exposed workers (12%) than unexposed workers (3.9%) (P#x003C;0.01). The mean percent predicted values of lung function indices reflecting large-1irway function (VC, FVC, FEV1, FEV1%, PEFR, and FEF75) were significantly lower in cotton dust exposed workers (P#x003C;0.01). Prevalence of byssinosis was 22.8%. Workers with byssinosis had significantly higher prevalence of respiratory symptoms, chronic bronchitis, cross-shift reduction in PEFR and significant decrease in mean percent predicted values of FVC, FEV1, PEFR, FEF75, and FEF50 than workers without byssinosis. This study revealed a substantial association between cotton dust exposure at work and respiratory symptoms and morbidity. Regular measurement of cross shift change in PEFR is recommended among exposed workers for early diagnosis of byssinosis.

Differential diagnosis for multiple systemic inflammatory syndrome in children: clinical and laboratory clues

Objectives: We aimed to identify biochemical markers and clinical findings with high sensitivity and specificity that can be used in the differential diagnosis of patients suspected of having Multisystem Inflammatory Syndrome in Children (MISC) in the pediatric emergency department (PED). Moreover, we also examined early warning signs for predicting severe MIS-C patients requiring admission to intensive care unit (ICU). Methods: We conducted a retrospective analysis of patients presenting to the PED with suspected MIS-C. Patient records were assessed for initial complaints, physical examination findings, laboratory and ımaging test results, diagnoses, and follow-up plans. Patients diagnosed with MIS-C were categorized as the MIS-C group, while others were categorized as the non-MIS-C group. Comparisons were made between these two groups. Results: A total of 266 patients were included, with 68 diagnosed with COVID-19-associated MIS-C, including 20 monitored in the pediatric ICU. MIS-C patients had higher mean age, hospitalization, and ICU admission rates compared to non-MIS-C. MIS-C group showed higher prevalence of respiratory symptoms, hematological involvement, and shock. We observed lymphopenia, thrombocytopenia, hyponatremia, and elevated levels of blood C-reactive protein (CRP), procalcitonin, triglycerides, troponin, Brain Natriuretic Peptide (BNP), D-dimer, and fibrinogen in the MIS-C group. ICU patients had higher procalcitonin, aspartate aminotransferase, alanine aminotransferase, triglycerides, troponin, BNP, and ferritin levels, and lower sodium levels. Conclusions: COVID-19-associated MIS-C group had higher rates of respiratory symptoms, hematological involvement, and shock. Lymphopenia, thrombocytopenia, elevated CRP, and D-dimer can guide MIS-C differential diagnosis. Additional tests (procalcitonin, troponin, BNP, triglycerides, ferritin) are recommended for high-suspicion cases. Patients with elevated BNP levels may require ICU admission.