Prevalence Of Upper Respiratory Symptoms Research Articles

Questionnaire survey for health risk assessment of exposure to semi-volatile organic compounds-contaminated floor dust in housing: preliminary survey on prevalence

BACKGROUND AND AIM: Phthalates or phosphates present in many products in indoor environment. A majority of those compounds are classified as semi-volatile organic compounds (SVOCs), which are mainly found in both gas and condensed phases. They are easily distributed from their original source over time to indoor air, indoor dust, and other indoor surfaces, including adhesion to foods, toys, or household products. Indoor dust is the main exposure media for low volatile SVOCs. Thus, health risk assessment of human exposure to SVOCs-contaminated indoor dust is essential to appropriately clarify the risk level of indoor environment. We report the preliminary nationwide questionnaire survey for the risk assessment. METHODS: Web based-surveys were conducted from October through November 2019 and 2020 in five large areas in Japan, including Hokkaido, Kanto, Chubu, Kansai, and Kyushu. Questionnaires to obtain information on characteristics of housing and collection of the floor dust were administered to a family nurturer randomly selected from approximately one hundred seventy thousand monitors registered in a leading online research company. Questionnaires to obtain information on medical histories, symptoms, and housing-related symptoms (HRSs), i.e. sick-building syndromes in housing were also administered to the family members. RESULTS:A total of 154 households and 487 individuals (50.9% females; mean: 34.3 years; range: 0–93 years) responded. Indoor floor dust in 154 houses was collected. Prevalence of hay fever, allergic rhinitis, atopic dermatitis, asthma, allergic conjunctivitis, and depression were 6.8%, 5.3%, 2.7%, 1.9%, 1.7%, and 1.5%, respectively. Prevalence of upper respiratory symptoms, skin symptoms, eye irritation, general symptoms, and any symptoms related to the housing were 6.2%, 2.1%, 1.0%, 0.6%, and 8.6%, respectively. CONCLUSIONS:Our results suggested that prevalence of allergic diseases and HRSs induced in upper airway were high. Future analyses would indicate the associations with SVOCs in flood dust. KEYWORDS: Allergies, Chemical exposures, Incidence, Multi-pollutant, Risk assessment

Respiratory impact of a grand tour: insight from professional cycling.

The aim of this study was to evaluate the respiratory function and symptom perception in professional cyclists completing a Grand Tour (GT). Nine male cyclists completed La Vuelta or Tour de France (2018/19). At study entry, airway inflammation was measured via fractional exhaled nitric oxide (FeNO). Respiratory symptoms and pulmonary function were assessed prior to the first stage (Pre-GT), at the second rest day (Mid-GT) and prior to the final stage of the GT (Late-GT). Sniff nasal inspiratory pressure (SNIP) was assessed at pre and late-GT timepoints. Seven cyclists reported respiratory symptoms during the race (with a prominence of upper airway issues). Symptom severity increased either mid or late-GT for most cyclists. A decline in FEV1 from pre-to-mid GT (-0.27 ± 0.24l, -5.7%) (P = 0.02) and pre-to-late GT (-0.27 ± 0.13l, -5.7%) (P < 0.001) was observed. Similarly, a decline in FVC (-0.22 ± 0.17l, -3.7%) (P = 0.01) and FEF25-75 (-0.49 ± 0.34l/s, -11%) (P = 0.02) was observed pre-to-late GT. Overall, eight (89%) and six (67%) demonstrated a clinically meaningful decline (> 200ml) in FEV1 and FVC during the GT follow-up, respectively. SNIP remained unchanged pre-to-late GT (n = 5), however, a positive correlation was observed between ΔSNIP and ΔFVC (r = 0.99, P = 0.002). GT competition is associated with a high prevalence of upper respiratory symptoms and a meaningful decline in lung function in professional cyclists. Further research is now required to understand the underpinning physiological mechanisms and determine the impact on overall respiratory health and elite cycling performance and recovery.

The prevalence of upper respiratory symptoms in a cohort of adults presenting with symptoms of gastro-oesophageal reflux disease.

Gastro-oesophageal reflux disease (GORD) is the pathological reflux of gastric contents into the oesophagus. The oesophagus and the upper respiratory tract have a common origin from the foregut. There is increasing evidence for multiple associations of GORD with the upper respiratory tract. To study the presence of and association of upper respiratory symptoms (URS) with GORD. Seventy adults scoring ≥12.5 on a previously validated GORD symptom score (GORD patients) and 70 healthy controls who had infrequent GORD symptoms or no upper gastro-intestinal complaints completed a pre-tested URS questionnaire on the frequency of 14 URS in 5 categories (laryngeal, nasal, pharyngeal, sinusal and aural). All GORD patients underwent upper gastro-intestinal endoscopy. The calculated URS score was correlated against the GORD symptom score and endoscopy findings. URS scores and individual symptom scores were higher in GORD patients compared to controls (mean ± SE, 4.7 ± 4.0; 1.9 ± 2.3). Individuals with higher GORD symptom scores reported more frequent URS. Pharyngeal symptoms had the highest correlation with the GORD symptom score (r=0.507, p<0.001). The presence of oeso-phagitis did not seem to influence the frequency of reporting URS. Upper respiratory symptoms are common in individuals with GORD symptoms though there appears to be no association with oesophageal mucosal damage.

The impact of a 24-h ultra-marathon on salivary antimicrobial protein responses.

Depressed oral respiratory mucosal immunity and increased incidence of upper respiratory symptoms are commonly reported after bouts of prolonged exercise. The current study observed the impact of a 24-h continuous overnight ultra-marathon competition (distance range: 122-208 km; ambient temperature range: 0-20 °C) on salivary antimicrobial protein responses and incidence of upper respiratory symptoms. Body mass, unstimulated saliva and venous blood samples were taken from ultra-endurance runners (n=25) and controls (n=17), before and immediately after competition. Upper respiratory symptoms were assessed during and until 4-weeks after event completion. Samples were analyzed for salivary IgA, lysozyme, α-amylase and cortisol in addition to plasma osmolality. Decreased saliva flow rate (p<0.001), salivary IgA (p<0.001) and lysozyme (p=0.015) secretion rates, and increased salivary α-amylase secretion rate (p<0.001) and cortisol responses (p<0.001) were observed post-competition in runners, with no changes being observed in controls. No incidences of upper respiratory symptoms were reported by participants. A 24-h continuous overnight ultra-marathon resulted in the depression of some salivary antimicrobial protein responses, but no incidences of upper respiratory symptoms were evident during or following competition. Salivary antimicrobial protein synergism, effective management of non-infectious episodes, maintaining euhydration, and (or) favourable environmental influences could have accounted for the low prevalence of upper respiratory symptoms.

Zinc or Multiple Micronutrient Supplementation to Reduce Diarrhea and Respiratory Disease in South African Children: A Randomized Controlled Trial

BackgroundProphylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain.ObjectiveTo determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.DesignRandomized, double-blind, controlled trial.SettingRural community in South Africa.ParticipantsThree cohorts: 32 HIV-infected children; 154 HIV-uninfected children born to HIV-infected mothers; and 187 HIV-uninfected children born to HIV-uninfected mothers.InterventionsChildren received either 1250 IU of vitamin A; vitamin A and 10 mg of zinc; or vitamin A, zinc, vitamins B1, B2, B6, B12, C, D, E, and K and copper, iodine, iron, and niacin starting at 6 months and continuing to 24 months of age. Homes were visited weekly.Outcome MeasuresPrimary outcome was percentage of days of diarrhea per child by study arm within each of the three cohorts. Secondary outcomes were prevalence of upper respiratory symptoms and percentage of children who ever had pneumonia by maternal report, or confirmed by the field worker.ResultsAmong HIV-uninfected children born to HIV-infected mothers, median percentage of days with diarrhea was 2.3% for 49 children allocated to vitamin A; 2.5% in 47 children allocated to receive vitamin A and zinc; and 2.2% for 46 children allocated to multiple micronutrients (P = 0.852). Among HIV-uninfected children born to HIV-uninfected mothers, median percentage of days of diarrhea was 2.4% in 56 children in the vitamin A group; 1.8% in 57 children in the vitamin A and zinc group; and 2.7% in 52 children in the multiple micronutrient group (P = 0.857). Only 32 HIV-infected children were enrolled, and there were no differences between treatment arms in the prevalence of diarrhea. The prevalence of upper respiratory symptoms or incidence of pneumonia did not differ by treatment arms in any of the cohorts.ConclusionWhen compared with vitamin A alone, supplementation with zinc, or with zinc and multiple micronutrients, did not reduce diarrhea and respiratory morbidity in rural South African children.Trial RegistrationClinicalTrials.gov NCT00156832

Chronic Upper Airway Cough Syndrome Secondary to Rhinosinus Diseases (Previously Referred to as Postnasal Drip Syndrome): ACCP Evidence-Based Clinical Practice Guidelines

To review the literature on postnasal drip syndrome (PNDS)-induced cough and the various causes of PNDS. Hereafter, PNDS will be referred to as upper airway cough syndrome (UACS). MEDLINE search (through May 2004) for studies published in the English language since 1980 on human subjects using the medical subject heading terms "cough," "causes of cough," "etiology of cough," "postnasal drip," "allergic rhinitis," "vasomotor rhinitis," and "chronic sinusitis." Case series and prospective descriptive clinical trials were selected for review. Also, any references from these studies that were pertinent to the topic were obtained. In multiple prospective, descriptive studies of adults, PNDS due to a variety of upper respiratory conditions has been shown either singly or in combination with other conditions, to be the most common cause of chronic cough. The symptoms and signs of PNDS are nonspecific, and a definitive diagnosis of PND-induced cough cannot be made from the medical history and physical examination findings alone. Furthermore, the absence of any of the usual clinical findings does not rule out a response to treatment that is usually effective for PND-induced cough. The differential diagnosis of PNDS-induced cough includes allergic rhinitis, perennial nonallergic rhinitis, postinfectious rhinitis, bacterial sinusitis, allergic fungal sinusitis, rhinitis due to anatomic abnormalities, rhinitis due to physical or chemical irritants, occupational rhinitis, rhinitis medicamentosa, and rhinitis of pregnancy. Because of a high prevalence of upper respiratory symptoms associated with gastroesophageal reflux disease (GERD), GERD may occasionally mimic PNDS. A crucial unanswered question is whether the conditions listed above actually produce cough through a final common pathway of PND or whether, in fact, in some circumstances they cause irritation or inflammation of upper airway structures that directly stimulate cough receptors and produce cough independently of or in addition to any associated PND. PNDS (ie, UACS) secondary to a variety of rhinosinus conditions is the most common cause of chronic cough. Because it is unclear whether the mechanisms of cough are the PND itself or the direct irritation or inflammation of the cough receptors located in the upper airway, the guideline committee has decided that, pending further data that address this difficult question, the committee unanimously recommends that the term upper airway cough syndrome be used in preference to postnasal drip syndrome when discussing cough associated with upper airway conditions.

Changes in hospitality workers’ exposure to secondhand smoke following the implementation of New York’s smoke-free law

Objective: To assess the impact on hospitality workers’ exposure to secondhand smoke of New York’s smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling...

Prevalence of upper and lower respiratory symptoms in workers exposed to colophony and MBTS

Rationale We assessed the prevalence of upper and lower work-related (WR) respiratory symptoms in 66 male subjects (mean age 37.4, SD 7.8) exposed to colophony and Dibenzothiazole Disulfide (MBTS), an occupational irritant, while working in linoleum production and in 17 nonexposed control subjects. Methods All completed a questionnaire and underwent skin prick test (SPT) for common allergens, and nasal peak inspiratory flow. Spirometry was carried-out only in exposed workers. Results Mean exposure duration was 6.3 (SD 3.9). SPT were positive in 40% of exposed and in 50% of control subjects. WR asthma was found in one subject, WR rhino-conjunctivitis in 5 (7.6%), WR cough/breathlessness in 5 (7.6%), and WR upper airway irritation in 21 (31.8%). A mild airway obstruction was found in 10 subjects (15.2%) 5 of whom were nonsmokers. 6 of the subjects with mild airway obstruction had WR symptoms: 2 had asthma and rhino-conjunctivitis, 2 rhino-conjunctivitis, and 2 upper airway irritation. Nasal peak inspiratory flow measurements were not different in exposed and control subjects, or in symptomatic and asymptomatic workers, but were lower in subjects with mild airway obstruction (100.7 L/min, SD 24.1) than in those with normal spirometry (122.8 L/min, SD 48.0). Conclusions Subjects with a simultaneous exposure to colophony and MBTS tend to have a high prevalence of upper respiratory symptoms associated with a mild airway obstruction. Nasal peak inspiratory flow measurements had a low sensitivity in detecting work-related nasal symptoms.

Multiple logistic regression modelling substantiates multifactor contributions associated with sick building syndrome in residential interiors in Mauritius

This paper presents a mathematical model that depicts the relationship between the possibility of occurrence of common health problems and factors leading to Sick Building Syndrome symptoms in domestic interiors in Mauritius. The prevalence of upper respiratory symptoms (dry eyes, runny nose), central nervous system symptoms (headache, nervousness), and musculoskeletal symptoms (pain/stiffness in shoulders/neck) were found to be elevated when responses were statistically regressed to type of building and age of respondents. The model presented here will be useful in helping to identify and quantify the relative role of factors that contribute to Sick Building Syndrome. Thus it may be possible to evaluate the effectiveness of current building operation practices and to prioritise allocations of resources for reduction of risk associated with Indoor Environmental Air Quality.

Indoor environmental quality in six commercial office buildings in the midwest United States.

The aims of this study were to characterize physical, mechanical, and environmental factors influencing indoor environmental quality (IEQ) in commercial office buildings; document occupant perceptions and psychosocial attributes; and evaluate relationships among these parameters. Six large office buildings in metropolitan areas were selected in Iowa, Minnesota, and Nebraska. Comprehensive sampling was conducted over one week in each building, during all four seasons. This paper presents the study methods and selected results from the first round of sampling (November 1996 to April 1997). Air flow and recirculation rates were quite variable, with the proportion of outdoor air provided to occupants ranging from 10 to 79 CFM/person. Carbon dioxide, carbon monoxide, and temperature were within ranges anticipated for nonproblem buildings. Relative humidity was low, ranging from 11.7 to 24.0 percent. Indoor geometric mean concentrations of total volatile organic compounds (TVOCs) ranged from 73 to 235 microg/m3. The most prevalent compounds included xylene, toluene, 2-propanol, limonene, and heptane. Geometric mean formaldehyde concentrations ranged from 1.7 to 13.3 microg/m3, and mean acetaldehyde levels ranged from <3.0 to 7.5 microg/m3. Airborne concentrations of culturable bacteria and fungi were low, with no samples exceeding 150 CFU/m3. Total (direct count) bioaerosols were more variable, ranging from 5010 to 10,700 organisms/m3. Geometric mean endotoxin concentrations ranged from 0.5 to 3.0 EU/m3. Respirable particulates (PM10) were low (14 to 36 microg/m3). Noise levels ranged from 48 to 56 dBA, with mean light values ranging from 200 to 420 lux. Environmental parameters were significantly correlated with each other. The prevalence of upper respiratory symptoms (dry eyes, runny nose), central nervous system symptoms (headache, irritability), and musculoskeletal symptoms (pain/stiffness in shoulders/neck) were elevated compared to other studies using similar questionnaires. Importantly, psychosocial factors were significantly related to increased symptoms in females, while environmental factors were more closely correlated with symptoms in males. Endotoxin concentrations were associated with symptoms in both males and females. These data will help to identify and quantify the relative role of factors that contribute to sick building syndrome. The data collected in this study may also be used to evaluate the effectiveness of current building operation practices, and can be used to prioritize allocations of resources for reduction of risk associated with IEQ complaints.

Prevalence of upper respiratory symptoms in patients with symptomatic gastroesophageal reflux disease.

This study evaluated the prevalence of upper respiratory symptoms (URS) among patients with symptomatic gastroesophageal reflux disease (GERD). Seventy-four subjects with heartburn completed a URS questionnaire before dual-probe, 24-h esophageal pH monitoring. The URS questionnaire was also completed by 74 normal volunteers without previous or current symptoms of GERD. Esophageal pH monitoring results were classified as normal, distal, or proximal and distal gastroesophageal reflux using standardized criteria. Mean URS scores (+/- SD) were 8.31 +/- 3.98 in the 52 subjects with GERD and 4.57 +/- 3.57 in the 22 subjects with negative pH probe studies, p = 0.02. Subjects with negative pH probe studies and normal volunteers scored similarly on the URS questionnaire. Reflux episodes/24 h correlated with URS scores, r = 0.47, p = 0.0001. Seventy-five percent of subjects with upper reflux, 68% of subjects with lower reflux, 36% of subjects with normal esophageal pH studies, and 9% of normal volunteers reported laryngeal symptoms for at least 5 d/mo. Sixty-nine percent of subjects with upper reflux, 50% of subjects with lower reflux, 31% of subjects with normal pH studies, and 14% of normal volunteers reported nasal symptoms for at least 5 d/mo. URS are frequent among subjects with GERD. rhinitis; upper airway; gastroesophageal reflux

The interrelationships of upper and lower respiratory tract symptoms and signs in seven-year-old children.

In 1968 the parents of all the 8, 683 children born in Tasmania in 1961 were asked to complete a detailed questionnaire on respiratory symptoms for these children. Satisfactory replies were received for 97 per cent (8, 410), and 96 per cent of these (8, 087) were examined by a team of school medical officers. A history of wheezing was obtained in 16 · 2 per cent; 1 · 8 percent had had wheezing alone, while the majority (14-4 per cent) gave a history of both wheezing and productive cough. Productive cough alone was reported in a further 32·5 per cent The parents reported that 17·1 per cent of seven-year-old children had more than two or three colds a year, 5-7 per cent had 'hay fever’, and 6-8 per cent had both. There was a close association between upper and lower respiratory symptoms, the prevalence of upper respiratory symptoms ranging from 15-5 per cent in those with no lower respiratory symptoms to 60·4 per cent in those with a history of both wheezing and productive cough. Despite considerable overlap, “colds” tended to be associated with productive cough and'hay fever'with wheezing. According to the questionnaire replies, lower respiratory symptoms were commoner (48 · 6 percent) than upper respiratory symptoms (29·6 percent). Episodes of productive cough were longer in duration, less frequent and started later in life than episodes of wheezing. Those with a history of both wheezing and productive cough resembled those with wheezing alone more closely than those with productive cough alone, but tended to be more severely affected than those with wheezing alone. Eczema and other indices of atopy were associated with a history of wheezing, and also, after elimination of the effect of wheezing, with hay fever. In this respect those with productive cough alone and those with colds alone did not differ significantly from those without symptoms. Physical signs, such as the presence of a ‘loose’ cough and abnormalities on auscultation, were more frequent in those with a history of wheezing than in those without and after elimination of the effect of wheezing, more frequent in those with hay fever than in those without Consideration of both questionnaire replies and clinical findings appears to confer significance on a classification of lower respiratory disease in children of this age based upon the answers to two questions, one on cough with sputum, or 'bronchitis', and the other on wheezing, or ‘asthma’.