Risk Factor For Respiratory Diseases Research Articles

RESPIRATORY CONSEQUENCES OF OBESITY – AN OVERVIEW

At the beginning of the 21st century obesity has become the leading chronic disease in the world. It is a major cause of morbidity mainly in the metabolic and cardiovascular areas. Moreover, it has progressively emerged as an important risk factor for respiratory diseases, a field that is often neglected. In this article, we reviewed the current understanding of the influence of obesity in adulthood on respiratory function, obstructive sleep apnoea- hypopnoea, obesity hypoventilation syndrome and asthma.

La exposición al humo de tabaco en el hogar aumenta la frecuentación por patología respiratoria en la infancia

Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events. A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed. A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked. Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure.

Volatile organic compounds in dwelling houses and stables of dairy and cattle farms in Northern Germany

Farmers are exposed to a complex mixture of airborne substances which can represent a health hazard. Especially animal production on a farm can be a risk factor for respiratory diseases. Most studies in this context focused on bioaerosols, compounds attached to bioaerosols or on gases such as ammonia or hydrogen sulfide. Less attention was paid to volatile organic compounds (VOCs) which may also cause respiratory diseases. This pilot study presents results of measuring VOCs in the air of the dwellings and stables, as well as in the outdoor environment, of cattle farms in Northern Germany in spring and autumn. Farmers on all selected farms complained of symptoms such as asthma, rhinitis and conjunctivitis which occurred especially during work in the stable but also in the dwellings. The mean concentration of total VOC (TVOC) for the outdoor environment, the dwellings, and the stables were 100 microg m(-3), 763 microg m(-3), 322 microg m(-3) in spring and 143 microg m(-3), 544 microg m(-3), 595 microg m(-3) in autumn, respectively. There was no significant difference in season. TVOC concentrations in dwellings on farms were elevated when compared to dwellings in other environments, probably because of an additional exposure to fuels and chemicals used in agriculture. Aliphatic and alicyclic hydrocarbons, aromatic compounds, and terpenes were main compounds of the dwellings and ketones, alcohols, and esters of the stables. Terpene concentrations in the stables were low probably because straw, which was not a strong terpene emitter, was used instead of sawdust as floor covering. Large amounts of methylethylketone were encountered in the air of one stable, probably from animal exhalation caused by increased animal activity. However, it was unlikely that this caused respiratory symptoms. Generally it was likely that the concentrations of VOCs were too low to have health effects on their own. On the other hand, the VOC concentrations were in a multifactor concentration range in which health effects could occur depending on the interaction with other exposure factors. Fungal spores and bacteria were observed in addition to VOCs at the examined locations. Therefore it is possible that the observed VOCs played a role in exacerbating respiratory symptoms in this multifactor exposure.

The global burden of chronic respiratory diseases

<h3>Key points</h3> Currently, the serious consequences of chronic diseases and their risk factors are not fully recognised by the international health community. In the period of 1990–2020, COPD deaths are expected to increase from 2.2 to 4.7 million worldwide. Reducing chronic disease death rates by an additional 2% annually would avert 36 million deaths by 2015. The abatement of the main risk factors for respiratory diseases, in particular tobacco smoking, environmental tobacco smoke, indoor biomass fuels, outdoor air pollution and unhealthy diet, can achieve huge health benefits. <h3>Educational aims</h3> To define the burden of chronic respiratory diseases all over the world. To underline the importance of chronic diseases recognition by the international health community. To provide details about the burden of chronic obstructive pulmonary disease (COPD): the predicted third cause of death by 2020. <h3>Summary</h3> Currently, the serious consequences of chronic diseases and their risk factors are not fully recognised by the international health community. Moreover, chronic diseases are not only a problem of the ageing population in developed countries. In fact, it has been estimated that 80% of mortality for chronic diseases occurred in low-income and middleincome countries in 2005. Thus, the World Health Organization (WHO) Dept of Chronic Diseases and Health Promotion has suggested a new Millennium Development Goal for the next few years: to reduce chronic disease death rates by an additional 2% annually, in order to avert 36 million deaths by 2015.

β2-adrenergic receptor polymorphisms are associated with asthma and COPD in adults

The beta(2)-adrenergic receptor (beta(2)AR) is a transmembrane protein expressed by airway smooth muscle cells. In vitro studies have shown that polymorphisms at amino acid positions 16 and 27 alter receptor function. The aim of this study was to examine the associations between the beta ( 2 ) AR polymorphisms and risks of asthma, chronic obstructive pulmonary disease (COPD) and respiratory symptoms in a sample of adults. Participants were part of a cross-sectional population-based study of risk factors for respiratory disease. A total of 1,090 Caucasian participants completed a detailed respiratory questionnaire, spirometry, methacholine challenge and measurement of gas transfer. Genotyping for beta ( 2 ) AR polymorphisms at positions 16 and 27 was performed using the tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) method. Haplotype frequencies for the two polymorphisms were estimated using the E-M algorithm. We found the Arg16 homozygotes had an increased risk of COPD (OR 5.13; 95% CI 1.40,18.8), asthma (2.44; 1.12,5.31) and symptoms of wheeze (1.84; 1.02,3.35). The Gln27 homozygotes had an increased risk of asthma (2.08; 1.05,4.13) and bronchial hyperreactivity (BHR) (1.92; 1.07,3.46). The Arg16/Gln27 haplotype was associated with asthma (1.63; 1.12,2.38) and COPD (2.91; 1.42,5.94). The Arg16/Gln27 beta(2)AR haplotype is important in COPD, asthma and BHR, and may be associated with more severe respiratory symptoms in middle-aged and older adults.

Pesticides associated with Wheeze among Commercial Pesticide Applicators in the Agricultural Health Study

Pesticides are potential risk factors for respiratory disease among farmers, but farmers are also exposed to other respiratory toxicants. To explore the association of pesticides with wheeze in a population without other farming exposures, the authors analyzed data from 2,255 Iowa commercial pesticide applicators enrolled in the Agricultural Health Study. Controlling for age, smoking status, asthma and atopy history, and body mass index, the authors calculated odds ratios for the relationship between wheeze and 36 individual pesticides participants had used during the year before enrollment (1993-1997). Eight of 16 herbicides were associated with wheeze in single-agent models; however, the risk was almost exclusively associated with the herbicide chlorimuron-ethyl (odds ratio (OR) = 1.62, 95% confidence interval (CI): 1.25, 2.10). Inclusion of chlorimuron-ethyl in models for the other herbicides virtually eliminated the associations. The odds ratios for four organophosphate insecticides (terbufos, fonofos, chlorpyrifos, and phorate) were elevated when these chemicals were modeled individually and remained elevated, though attenuated somewhat, when chlorimuron-ethyl was included. The association for dichlorvos, another organophosphate insecticide, was not attenuated by chlorimuron-ethyl (OR = 2.48, 95% CI: 1.08, 5.66). Dose-response trends were observed for chlorimuron-ethyl, chlorpyrifos, and phorate; the strongest odds ratio was for applying chlorpyrifos on more than 40 days per year (OR = 2.40, 95% CI: 1.24, 4.65). These results add to the emerging literature linking organophosphate insecticides and respiratory health and suggest a role for chlorimuron-ethyl.

A day at the European Respiratory Society Congress: passive smoking influences both outdoor and indoor air quality: Fig. 1—

To the Editors: Outdoor and indoor air quality is a well known determinant of human health 1. Environmental tobacco smoke (ETS) is a recognised risk factor for respiratory diseases 2 and the most important source of indoor particulate matter (PM) pollution 3. In recent years, several countries have issued smoking policy rules to protect nonsmoking people from ETS with a good compliance 4. This year, the European Respiratory Society (ERS) Congress was held in Copenhagen (Denmark), a country where, like many others, comprehensive anti-smoking rules are not yet fully endorsed 5. In fact, although smoking has been restricted in state-owned governmental premises since 1988, the legislation doesn't apply to the hospitality industry or to workplaces in the private sector. The ERS has made the case of passive smoking one of utmost importance for respiratory prevention 6. Congress participants were advised to refrain from smoking both inside and in front of the Copenhagen Congress venue at the Bella Center, which was indicated by signs stating the following: “Tobacco is the major cause of lung disease. Please refrain from smoking in and …

Respiratory disease in relation to patient residence near to hazardous waste sites

We have examined rates of hospitalization for respiratory diseases in relation to residences in zip codes with hazardous waste sites, as well as socio-economic status. Chronic bronchitis and chronic airway obstruction were elevated in persons who live in zip codes containing persistent organic pollutants (POPs) (PCBs and persistent pesticides) as compared to “clean” zip codes without hazardous waste sites or zip codes with hazardous waste sites containing other kinds of wastes, but the differences could be due to socio-economic status and behavioral risk factors since these are also important risk factors for respiratory diseases. Therefore, we investigated rates of hospitalization for individuals living in zip codes along the Hudson River, because here the average per capita income is higher than in the rest of the state, and there is less smoking, better diet and more exercise. We found a similar elevation of chronic bronchitis and chronic airway obstruction along the Hudson. These observations are consistent with the possibility that living near a POPs-contaminated site poses a risk of exposure and increased risk of chronic respiratory disease, probably secondary to suppression of the immune system.

Household gas cooking: a risk factor for respiratory illnesses in preschool children

Aims: To explore the association of household gas cooking and respiratory illnesses in preschool children and their relation to outdoor air pollution. Methods: Cross-sectional study among households that used gas...

Respiratory diseases in European farmers. Part 1: Literature review

Farming is still one of the most important economic sectors in the world. At the same time, a high prevalence of respiratory diseases in farmers is well known. Among these, allergic and non-allergic asthma, chronic bronchitis, hypersensitivity pneumonitis and organic dust toxic syndrome (ODTS) are of uppermost importance. Because of the large variety of agriculture across Europe exposure conditions and risk factors for airway diseases may vary largely. While exposure to organic dusts and irritants are most important in grain and animal production, workers in greenhouses are mainly exposed to pollen, fungi, as well as pesticides. Up to now, the knowledge about the prevalence of respiratory diseases in European farmers working in different agricultural sectors was limited. Furthermore, reliable data on farming characteristics as well as exposure patterns that might prone risk factors for respiratory diseases were missing. Therefore, the European Farmers' Project was initiated. The results of this study are given in the second part of this paper.

Traffic-related air pollution and respiratory symptoms in children living along trunk roads in Chiba Prefecture, Japan.

Automobile exhaust is considered to be a potential risk factor for respiratory diseases. To investigate the effects of traffic-related air pollution on respiratory symptoms among children who lived near trunk roads, we conducted a cohort study on 2,506 schoolchildren in eight different communities in Japan. Over that four-year period, the prevalence of asthma was higher among girls who lived less than 50 m from trunk roads (roadside areas) than among girls in the other areas studied. Testing for trends showed that the prevalence of asthma among girls increased significantly with increases in the concentration of air pollution in each area. Among boys, the prevalence of asthma did not differ in relation to the distance from roads, although the rate was higher in urban areas than in rural areas. The incidence of asthma during the follow-up period significantly increased among boys living in roadside areas relative to rural areas (odds ratio = 3.75; 95% confidence interval: 1.00-14.06). Among girls, the incidence of asthma also increased (odds ratio = 4.06; 95% confidence interval:0.91-18.10), although the risk was not significant. These findings suggest that traffic-related air pollution may be of particular importance in the development of asthma among children living near major trunk roads with heavy traffic.

Environmental tobacco smoke as a risk factor for respiratory disease in children

Respiratory diseases are a frequent reason for using health care. In 1995–1996, diseases of the respiratory tract (ICD 460–519) contributed seven of the top 15 reasons for visits to physician offices among children under 15 years of age in the United States. Environmental tobacco smoke (ETS) is a wide-spread environmental pollutant that has been long linked with respiratory problems. This paper will review the available literature on the role ETS plays in respiratory diseases, including asthma. This review focuses not only on the respiratory problems caused by ETS, but also examines the influence of age at exposure on the consequences of ETS and the importance of the differing sources of ETS exposure. As ETS is a completely preventable form of environmental pollution, the success or failure of various types of interventions will also be reviewed.

Childhood respiratory symptoms, hospital admissions, and long-term exposure to airborne particulate matter.

The effects of long-term exposure to air pollution on respiratory symptoms and respiratory hospitalization (for asthma, bronchitis or pneumonia) were assessed in a cross-sectional study of children (ages 7--11 years, N=667) living in a moderately industrialized city in Central Slovakia. Individual health, residence and family history data obtained through the CESAR study were coupled, using Geographic Information System (GIS) technologies, with total suspended particulate (TSP) exposure estimates derived from dispersion modeling of almost all local stationary sources. These data were used to assess, at the intra-city level and child-specific level, the potential for TSP as a risk factor for respiratory disease in children. TSP, PM10, and PM2.5 monitored ambient concentrations are highly correlated in the study location. Modeled TSP concentrations resulting from local source emissions are dominated by a large wood processing facility, suggesting variation in exposures among children. The prevalence of respiratory non-asthmatic symptoms and hospitalizations was associated with increased TSP. No association between long-term exposure to TSP and asthma diagnosis or wheeze symptoms was found. Logistic regression modeling indicated a significant increase in hospital admissions for asthma, bronchitis or pneumonia associated with increasing air pollution (OR 2.16, CI, 1.01--4.60), doctor-diagnosed bronchitis (OR 1.53, CI, 1.02-2.30), and parent-reported chronic phlegm (OR 3.43, CI, 1.64--7.16), expressed as odds for a 15 microg/m3 increase in estimated TSP exposure, and these increases are not due to differences in socio-economic, health care or other identified factors.

Cytotoxicity of Airborne Particulates Sampled Roadside in Rodent and Human Lung Fibroblasts.

The number of diesel-powered vehicles has been increasing in Japan in recent years. And chronic exposure to relatively low levels of diesel exhaust may be a risk factor for respiratory diseases. It has been demonstrated that the airborne particulates sampled at a roadside contain exhaust from diesel engines. The present study has been undertaken to evaluate the cytotoxicity of airborne particulates in human and Chinese hamster lung fibroblast cell lines (WI-38 and CHL/IU). Conversion of mitochondrial MTS, leakage of lactate dehydrogenase (LDH), and the effect on cell proliferation curves were monitored. A dose‐related effect of airborne particulate extracts was observed in MTS and LDH leakage assay with both cell lines. Crude extract was most cytotoxic in the MTS assay and had a significant effect on cell proliferation. The response of extracts and fractions of these extracts on MTS assay were similar to the effect on cell proliferation in both cell systems. An increase in LDH leakage was detected in all extracts and fractions except crude extract. In comparison, CHL/IU proved to be more sensitive than WI-38 in MTS assay, but most extracts and fractions were more toxic to WI-38 in LDH leakage assay. These results suggest that even a small amount of substances in airborne particulates was toxic to both cell systems.

Abstracts

Risk factors for respiratory diseases in pigs McNamee, P. T., King, D. C., Spratt-Davidson, S., Ball, H. & Smyth, J. (2000) Guidelines for the investigation of lameness in commercial broiler...

10.14322/publons.r886224

10.14322/publons.r886224

Risk factors for respiratory diseases in New Zealand pig herds

Aims. A survey of lung lesions and risk factors for respiratory diseases was conducted in order to estimate the prevalence of respiratory diseases in the New Zealand pig population and to identify influential management practices. Methods. Eighty-nine New Zealand pig farms with a minimum herd size of 50 sows participated in the survey, and risk factor data were collected using a mailed questionnaire. Abattoir data were recorded once in winter 1995 and once in summer 1996. A total of 6887 lungs was inspected. Results. The prevalence of enzootic pneumonia, pleuropneumonia and pleurisy in winter was 63.4%, 2.7% and 19.1%, respectively. Enzootic pneumonia was significantly less frequent in summer. Pleuropneumonia/pleurisy was found to be more prevalent in the South Island. The univariate risk factor analysis was consistent with earlier published evidence on the importance of environmental factors rela:ed to housing and management of the farm. The multivariate models for enzootic pneumonia and pleuropneumonia or pleurisy had a reasonably good predictive power of 81–91% for farms with high disease prevalence. Conclusion. The results are useful to model the disease process on high-risk farms, which account for a considerable proportion of the New Zealand pig population.

The rate of respiratory symptoms among primary school children in two Dutch regions.

A cross-sectional study was conducted to evaluate possible interregional differences in respiratory health in primary school children living in two different towns of the Netherlands, Melick/Herkenbosch Asenray (MHA) (n = 511) and Leek (LK) (n = 612). The prevalence of respiratory symptoms was determined by means of a questionnaire and respiratory impedance was measures using the forced oscillation technique (FOT). Respiratory symptoms were reported consistently more often in MHA than in LK; chronic cough (17% MHA vs 5% LK), shortness of breath (15% vs 8%), wheeze (16% vs 13%) and attacks of shortness of breath with wheeze (10% vs 7%). However, doctor-diagnosed asthma was reported as 7% in MHA and 6% in LK. The prevalence rates expressed as odds ratios of MHA versus LK were all > 1 even when adjusted for known indoor environmental factors. Living in MHA appeared to be a statistically significant determinant of the reported symptom prevalence. Furthermore, the child's age, maternal smoking (> 10 cigarettes/day), and having had domestic animals were positively associated with one or more respiratory symptoms. Calculating adjusted differences in respiratory impedance between the regions resulted in a small but statistically significant difference in resonant frequency, LK being slightly at a disadvantage. Measured outdoor air pollution levels of SO2, NO2, O3 and PM10 were in general higher in MHA. In both regions however, the average levels remained below the present WHO guidelines, except for NO2 in MHA where the guideline was slightly exceeded. In this study prevalence rates of key symptoms of asthma were found to be significantly higher in children living in one region of the Netherlands (MHA) compared to another (LK). Known (indoor) risk factors for respiratory disease could not explain the observed differences in symptom prevalence between the regions. However, statistically but not clinically significant interregional differences in respiratory impedance values were found between children living in MHA and children living in LK. Further research will have to incorporate techniques to evaluate the potential influence of information bias.

Review of Epidemiological Evidence of Health Effects of Particulate Air Pollution

AbstractThis article summarizes epidemiological evidence of health effects of particulate air pollution. Acute exposure to elevated levels of particulate air pollution has been associated with increased cardiopulmonary mortality, increased hospitalization for respiratory disease, exacerbation of asthma, increased incidence and duration of respiratory symptoms, declines in lung function, and restricted activity. Small deficits in lung function, higher risk of chronic respiratory disease and symptoms, and increased mortality have also been associated with chronic exposure to respirable particulate air pollution. Health effects have been observed at levels common to many U.S. cites and at levels below current US. National Ambient Air Quality Standards. Although the biological mechanisms involved are poorly understood, recent epidemiological evidence supports the hypothesis that respirable particulate air pollution is an important risk factor for respiratory disease and cardiopulmonary mortality.

Changes in respiratory symptoms and airway hyperresponsiveness after 27 years in a population-based sample of school children

We wanted to test the hypothesis that childhood airway hyperresponsiveness, even in the absence of respiratory symptoms, is a risk factor for respiratory disease in adulthood. In a childhood survey of 1963, three groups of 20 children aged 8-11 yrs, were selected from a population sample: 1) a group with recurrent respiratory symptoms (symptomatic group); 2) a group with no symptoms but a positive family history of atopy; and 3) a control group. All children completed assessment of symptoms, atopy, lung function, and airway hyperresponsiveness. At the adulthood survey 27 yrs later, 85% of the original sample were reinvestigated. Only 10 out of 19 subjects (53%) of the original symptomatic group still had symptoms. The significant difference of forced expiratory volume in one second (FEV1) % predicted in childhood between the symptomatic and the control group had disappeared. The prevalence of airway hyperresponsiveness had decreased in all groups. In asymptomatic hyperresponders it had normalized at adult age. The asymptomatic hyperresponders in childhood had lower levels of lung function, both in childhood and in adulthood. In univariate and multivariate analyses, respiratory symptoms at adult age were related to childhood atopy. Results suggest that childhood atopy is a risk factor for respiratory symptoms in young adulthood, but that mild childhood airway hyperresponsiveness is not.