Risk Factor For Respiratory Diseases Research Articles

Cooperation of immune regulators Tollip and surfactant protein A inhibits influenza A virus infection in mice

BackgroundInfluenza A virus (IAV) infection is a significant risk factor for respiratory diseases, but the host defense mechanisms against IAV remain to be defined. Immune regulators such as surfactant protein A (SP-A) and Toll-interacting protein (Tollip) have been shown to be involved in IAV infection, but whether SP-A and Tollip cooperate in more effective host defense against IAV infection has not been investigated.MethodsWild-type (WT), Tollip knockout (KO), SP-A KO, and Tollip/SP-A double KO (dKO) mice were infected with IAV for four days. Lung macrophages were isolated for bulk RNA sequencing. Precision-cut lung slices (PCLS) from WT and dKO mice were pre-treated with SP-A and then infected with IAV for 48 h.ResultsViral load was significantly increased in bronchoalveolar lavage (BAL) fluid of dKO mice compared to all other strains of mice. dKO mice had significantly less recruitment of neutrophils into the lung compared to Tollip KO mice. SP-A treatment of PCLS enhanced expression of TNF and reduced viral load in dKO mouse lung tissue. Pathway analysis of bulk RNA sequencing data suggests that macrophages from IAV-infected dKO mice reduced expression of genes involved in neutrophil recruitment, IL-17 signaling, and Toll-like receptor signaling.ConclusionsOur data suggests that both Tollip and SP-A are essential for the lung to exert more effective innate defense against IAV infection.

The aging lung: microenvironment, mechanisms, and diseases.

With the development of global social economy and the deepening of the aging population, diseases related to aging have received increasing attention. The pathogenesis of many respiratory diseases remains unclear, and lung aging is an independent risk factor for respiratory diseases. The aging mechanism of the lung may be involved in the occurrence and development of respiratory diseases. Aging-induced immune, oxidative stress, inflammation, and telomere changes can directly induce and promote the occurrence and development of lung aging. Meanwhile, the occurrence of lung aging also further aggravates the immune stress and inflammatory response of respiratory diseases; the two mutually affect each other and promote the development of respiratory diseases. Explaining the mechanism and treatment direction of these respiratory diseases from the perspective of lung aging will be a new idea and research field. This review summarizes the changes in pulmonary microenvironment, metabolic mechanisms, and the progression of respiratory diseases associated with aging.

Stenotrophomonas maltophilia contributes to smoking-related emphysema through IRF1-triggered PANoptosis of alveolar epithelial cells

Cigarette smoke (CS), the main source of indoor air pollution and the primary risk factor for respiratory diseases, contains chemicals that can perturb microbiota through antibiotic effects. Although smoking induces a disturbance of microbiota in the lower respiratory tract, whether and how it contributes to initiation or promotion of emphysema are not well clarified. Here, we demonstrated an aberrant microbiome in lung tissue of patients with smoking-related COPD. We found that Stenotrophomonas maltophilia (S. maltophilia) was expanded in lung tissue of patients with smoking-related COPD. We revealed that S. maltophilia drives PANoptosis in alveolar epithelial cells and represses formation of alveolar organoids through IRF1 (interferon regulatory factor 1). Mechanistically, IRF1 accelerated transcription of ZBP1 (Z-DNA Binding Protein 1) in S. maltophilia-infected alveolar epithelial cells. Elevated ZBP1 served as a component of the PANoptosome, which triggered PANoptosis in these cells. By using of alveolar organoids infected by S. maltophilia, we found that targeting of IRF1 mitigated S. maltophilia-induced injury of these organoids. Moreover, the expansion of S. maltophilia and the expression of IRF1 negatively correlated with the progression of emphysema. Thus, the present study provides insights into the mechanism of lung dysbiosis in smoking-related COPD, and presents a potential target for mitigation of COPD progression.

Air pollution and childhood respiratory consultations in primary care: a systematic review

BackgroundOutdoor air pollution is a known risk factor for respiratory morbidity worldwide. Compared with the adult population, there are fewer studies that analyse the association between short-term exposure to air...

Disparities in prevalence and outcomes of respiratory disease in low- and middle-income countries.

To provide a comprehensive overview of disparities in prevalence and outcomes of respiratory diseases and notable challenges for providing optimal treatment to pediatric patients with respiratory diseases living in low- and middle-income countries (LMICs), as an input to help better understand the roots of respiratory health disparities. We conducted a narrative review of relevant literature published in electronic databases from inception to February 2023 that present data on disparities in prevalence and outcomes of respiratory disease in LMICs. Additionally, we included studies that describe and discuss challenges for providing optimal treatment to pediatric patients with respiratory diseases living in LMICs. A number of early life exposures have been associated with adverse respiratory outcomes in later life. Several studies have shown marked geographical variations in the prevalence and burden of pediatric asthma, with consistently lower prevalence rates but significantly higher burdens and worse outcomes in LMICs. There is a wide range of challenges that adversely affect the efficient care of children with respiratory diseases that can be classified into three categories: patient-related factors, social/environmental factors, and factors related to healthcare providers or the healthcare system. Respiratory health disparities in children living in LMICs represent a global public health issue mainly explained by an unequal distribution of preventable and modifiable risk factors for respiratory diseases across different demographic groups.

Association between smoking and obstructive sleep apnea based on the STOP-Bang index

Smoking is a risk factor for respiratory diseases, and it worsens sleep quality due to nicotine stimulation and sudden nicotine withdrawal during sleep. This can increase the severity of OSA through alterations upper airway inflammation and neuromuscular function, arousal mechanisms, and sleep architecture. Therefore, it may lead to sleep-disrupted breathing, particularly obstructive sleep apnea (OSA). Herein, this study aims to research the association between smoking and OSA through the STOP-Bang index. In this study, total sample of 3442 participants (1465 men and 1977 women) were analyzed. We used data from the Korea National Health and Nutrition Examination Survey in 2020 by classifying adults into current, ex-, and non-smokers. A multiple logistic regression analysis was used to investigate the association between smoking and OSA. Furthermore, multinomial regression analysis was used to investigate the effect of smoking cessation. For males, compared to the non-smokers, the odds ratios (OR) for the OSA were significantly higher in the ex-smokers (OR: 1.53, 95% confidence interval(CI) 1.01–2.32) and current smokers (OR: 1.79, 95% CI 1.10–2.89). In females, higher ORs were observed for OSA risk, similar to the non-smokers, smoking cessation, and pack-years. Among men, OSA was significantly associated with a moderate risk for ex-smokers (OR: 1.61, 95% CI 1.05–2.48) and a severe risk for current smokers (OR: 1.88, 95% CI 1.07–3.29). This study observed that smoking might contribute to OSA risk among adults. Smoking cessation can help to manage sleep quality properly.

Radiological Differences in COVID-19 Related Lung Manifestations Between Smokers and Non-smokers: A Single-Center Retrospective Study in Jordan.

Introduction Despite the fact that smoking has been identified as a risk factor for respiratory diseases and lung infections, the relationship between smoking and coronavirus severity remains ambiguous. It is believed that smoking is a risk factor for pulmonary infections. However, the effect of smoking on COVID-19 patients is still controversial. Objective The aim of the study was to identify and analyze the distinct radiological features in COVID-19 patients with different smoking statuses. Additionally, the study sought to examine the association between smoking and the severity of pulmonary changes. Methods A retrospective cohort study of 111 patients who were referred to Al-Salt/Hussein Hospital, Al-Salt, Jordan, from January to June 2021, with a confirmed COVID-19 diagnosis and smoking status recorded. Patients' demographics, medical history, age, gender, comorbidity, and length of hospitalization were obtained from their medical records. Results Study groups were similar in median age, prevalence of chosen chronic diseases, and median length of hospital stay. Based on the median scores of the radiological findings in each lung lobe, no statistically significant differences were found between the scores and smoking status (p-values of >0.05; Mann-Whitney test). Conclusion Smoking is an independent risk factor for the severity of COVID-19. Smoking has no noticeable impact on interstitial manifestation in COVID-19 patients.

The Effects of Lead and Zinc on Asthma: A Systematic Review and Meta-Analysis

Context: In recent decades, the growing number of factories and vehicles has accelerated the release of environmental contaminants such as heavy metals. These inhalable pollutants often cause respiratory diseases and can endanger human health. Some heavy metals (e.g., zinc), on the other hand, are beneficial micronutrients, playing critical roles in the body. Objectives: This systemic review and meta-analysis study aimed to examine the role of lead (Pb) and zinc (Zn) in asthma. Methods: MeSH keywords, including lead, asthma, and zinc, along with their Persian equivalents were searched in the PubMed, Google, Web of Sciences, Google Scholar, and SID databases. The articles published between 2000 and 2018 were included. For assessing heterogeneity, the Q and I2 statistics were applied. STATA version 14 was used for data analysis. The review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Results: The frequency of asthma was 12% (95% CI: 11 - 13%, P < 0.001). The frequencies of high blood lead levels (BLL) in controls and patients with asthma were 2% (95% CI: 0 - 2.03, P < 0.001) and 3% (95% CI: 0 - 3.04, P < 0.001), respectively. The ratios of BLL of < 5, 5 - 10, and > 10 µg/dL were found to be 8% (95% CI: 0 - 9.7, P < 0.001), 10% (95% CI: 0.8 - 11, P < 0.001), and 9% (95% CI: 0.08 - 11, P < 0.001), respectively. The forced expiratory volume (FEV) was significantly correlated with zinc level. The results from meta-regression analysis suggested an increasing trend in asthma occurrence from 2000 to 2018. Conclusions: While zinc may have been protective against asthma, lead was a risk factor for respiratory diseases and asthma. Educating children and their parents about lead poisoning may have prevented or reduced lead intoxication and asthma in children.

Mortality Rate and Years of Life Lost Due to Premature Death From Respiratory Diseases: A Five-year Trend (2014-2018)

Background: Chronic respiratory diseases impose a significant socioeconomic burden on individuals and communities and are severely overlooked compared to other non-communicable diseases, such as cardiovascular disease, cancer, and diabetes. This study aimed to investigate the mortality rate and years of life lost due to respiratory diseases in northern Iran. Methods: The documentary research method was used and data were collected using the census. The population included all deaths registered in the Department of Health, Golestan University of Medical Sciences in Iran during 2014-2018. Results: Between 2014 and 2018, 2462 deaths due to respiratory diseases were recorded in Golestan Province, of which 1416 people (57.5%) were men and 1046 people (42.5%) were women. The Mean±SD age of death was 62.28±26.29 years, with an Mean±SD of 62.56±25.32 years for men and 61.90±27.56 years for women. The highest number of deaths due to respiratory diseases in all the studied years was in men and women aged 80 years and above (28.7% and 31.1%, respectively). Approximately, 6864 years of life were lost due to premature death during this period, with men (3511 years, 7.2 per 1,000) contributing more than women (3353 years, 7.2 per 1,000). Conclusion: Given the rapid increase in population and given that the crucial risk factors for respiratory diseases are smoking, exposure to pollutants, and allergens, more comprehensive research seems necessary throughout Iran. In addition, this study was designed before the onset of the COVID-19 pandemic, and due to changes that this pandemic has caused in the mortality rate, therefore, it is recommended to investigate the trend of mortality by respiratory diseases during this pandemic.

Association of birthweight with lung function and respiratory diseases: results from the GEIRD study

Abstract Background Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW) is however conflicting. We examined associations of BW with lung function and respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) study. Methods GEIRD is an Italian multi-centre, multi-case control study of people aged 20-84 from the general population conducted from 2008 to 2014. The study included cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status (control/COPD/asthma/allergic rhinitis) as response variable, and BW as main determinant adjusting for sex, age and smoking status. Results Of 2,287 reporting BW, 6.4 % (n = 147) had low BW (<2500 gr), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Lung volumes were significantly lower in individuals with low than normal BW. Median FEV1 was 3.01 L (p25-p75=2.60-3.45 L) versus 3.16 L (2.65-3.86 L) (p = 0.019) and median FVC was 3.68 L (3.19-4.34 L) versus 3.91 (3.34-4.81 L) (p = 0.003). However, FEV1 and FVC were not affected by BW when expressed as percent predicted. Of note, both men and women with low BW were shorter than those with normal BW (mean±SD: 160.2±5.5 vs. 162.6±6.5 cm in women, p = 0.009; 172.4±6.1 vs. 174.8±7.2 cm in men, p < 0.001). FEV1/FVC expressed as absolute ratio or as percent predicted, was not affected by BW. In multinomial analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before age 2 (10.3% vs. 4.1%) and severe respiratory infection before age 5 (16.9% vs. 8.8%) (p = 0.003). Conclusions BW was not associated with lung function in adulthood, when controlling for sex and height. Low BW was a risk factor for respiratory diseases in childhood, not in adulthood. Key messages • Low birthweight was associated with respiratory diseases in childhood but not in adulthood. • Although spirometrically-assessed lung volumes were lower in adults with low birthweight, this is likely explained by associations of low birthweight with sex and height.

Cigarette Smoke Impairs Airway Epithelial Wound Repair: Role of Modulation of Epithelial-Mesenchymal Transition Processes and Notch-1 Signaling.

Cigarette smoke (CS) induces oxidative stress and chronic inflammation in airway epithelium. It is a major risk factor for respiratory diseases, characterized by epithelial injury. The impact of CS on airway epithelial repair, which involves epithelial-mesenchymal transition (EMT) and the Notch-1 pathway, is incompletely understood. In this study, we used primary bronchial epithelial cells (PBECs) to evaluate the effect of CS on epithelial repair and these mechanisms. The effect of CS and/or TGF-beta1 on wound repair, various EMT and Notch-1 pathway markers and epithelial cell markers (TP63, SCGB1A) was assessed in PBECs cultured submerged, at the air–liquid interface (ALI) alone and in co-culture with fibroblasts. TGF-beta1 increased epithelial wound repair, activated EMT (shown by decrease in E-cadherin, and increases in vimentin, SNAIL1/SNAIL2/ZEB1), and increased Notch-1 pathway markers (NOTCH1/JAGGED1/HES1), MMP9, TP63, SCGB1A1. In contrast, CS decreased wound repair and vimentin, NOTCH1/JAGGED1/HES1, MMP9, TP63, SCGB1A1, whereas it activated the initial steps of the EMT (decrease in E-cadherin and increases in SNAIL1/SNAIL2/ZEB1). Using combined exposures, we observed that CS counteracted the effects of TGF-beta1. Furthermore, Notch signaling inhibition decreased wound repair. These data suggest that CS inhibits the physiological epithelial wound repair by interfering with the normal EMT process and the Notch-1 pathway.

The effects of air pollutants exposure on the transmission and severity of invasive infection caused by an opportunistic pathogen Streptococcus pyogenes

Currently, urbanization is associated with an increase in air pollutants that contribute to invasive pathogen infections by altering the host's innate immunity and antimicrobial resistance capability. Streptococcus pyogenes, also known as Group A Streptococcus (GAS), is a gram-positive opportunistic pathogen that causes a wide range of diseases, especially in children and immunosuppressed individuals. Diesel exhaust particle (DEP), a significant constituent of particulate matter (PM), are considered a prominent risk factor for respiratory illness and circulatory diseases worldwide. Several clinical and epidemiological studies have identified a close association between PM and the prevalence of viral and bacterial infections. This study investigated the role of DEP exposure in increasing pulmonary and blood bacterial counts and mortality during GAS M1 strain infection in mice. Thus, we characterized the upregulation of reactive oxygen species production and disruption of tight junctions in the A549 lung epithelial cell line due to DEP exposure, leading to the upregulation of GAS adhesion and invasion. Furthermore, DEP exposure altered the leukocyte components of infiltrated cells in bronchoalveolar lavage fluid, as determined by Diff-Quik staining. The results highlighted the DEP-related macrophage dysfunction, neutrophil impairment, and imbalance in pro-inflammatory cytokine production via the toll-like receptor 4/mitogen-activated protein kinase signaling axis. Notably, the tolerance of the GAS biofilms toward potent antibiotics and bacterial resistance against environmental stresses was also significantly enhanced by DEP. This study aimed to provide a better understanding of the physiological and molecular interactions between exposure to invasive air pollutants and susceptibility to invasive GAS infections.

Spatial autocorrelation may bias the risk estimation: An application of eigenvector spatial filtering on the risk of air pollutant on asthma

Air pollutants are major risk factors for respiratory diseases, particularly asthma, socially and spatially correlated. Many existing environment-asthma-related studies, however, have evaluated the impact of crude trends at the largest district level, which accounts only for temporal effects and may produce biased results with spatial autocorrelation. This study aimed to investigate how the spatial autocorrelation affects the air pollution effect estimations (sulfur dioxide [SO2], nitrogen dioxide [NO2], carbon monoxide [CO], and particulate matter [PM10]) on daily asthma emergency department (ED) visits in two metropolitan areas in Korea (Seoul Metropolitan Area [SMA] and Busan Metropolitan City, Ulsan Metropolitan City, Gyeongsangnamdo [BUG]). We applied eigenvector spatial filter (ESF) to the spatio-temporal model to remove spatial autocorrelation and distributed lag nonlinear model (DLNM) to explore nonlinear patterns between air pollutant concentration and lagged days on the three models including aggregated model (a temporal model), spatial model without ESF, and spatial model with ESF (both are spatio-temporal models). The effect of SO2 was not statistically significant for asthma ED visits in the aggregated model for SMA (cumulative relative risks [CRR] = 0.99, confidence intervals [CI]: 0.93–1.05), while the effect was statistically significant in the spatial model with ESF (CRR = 1.10, CI: 1.08–1.12). NO2 and CO were positively correlated to asthma ED visits in the spatial model without ESF (CRR = 0.84, CI: 0.81–0.86; 0.91, 0.89–0.94, respectively), but the spatial model with ESF showed significant risks (CRR = 1.21, CI: 1.18–1.24; 1.13, 1.11–1.16). Moreover, the spatial model with ESF successfully removed spatial autocorrelation (P-values for Moran's I 0.83–0.98) and demonstrated the highest model fit (McFadden's pseudo R2 0.42–0.43 for SMA and 0.26–0.27 for BUG) among the three models. Our findings demonstrate how ESF can be introduced into spatial correlation to remove bias and construct more reliable models.

Evaluation of In-Vehicle Pollutants Exposure and Respiratory Symptoms among Bus Drivers in Kota Bahru, Malaysia

Abstract Exposure to in-vehicle air pollutants has been recognized as a risk factor for respiratory diseases. The present study, therefore, investigates the factors, including duration of employment and in-vehicle concentrations of fine particulate matter (PM2.5), carbon dioxide (CO2) and nitrogen dioxide (NO2) that can influence the prevalence of respiratory symptoms in commercial bus drivers. A total of 34 bus drivers and 51 administrative staff (comparative group) from the bus operator in Kota Bahru, Malaysia were randomly enrolled in this cross-sectional study. The personal characteristics and respiratory symptoms were reported using a validated questionnaire from the American Thoracic Society (ATS-DLD-78-A). In-vehicle concentrations of PM2.5, CO2 and NO2 were continuously measured over eight hours on each bus driver. The prevalence of self-reported cough, phlegm and chronic phlegm among bus drivers were 55.9%, 73.5% and 35.3%, respectively, significantly higher compared to the comparative group (p < 0.001). Moreover, the duration of employment with bus operators for more than four years was significantly related to the manifestation of phlegm (OR = 8.27, 95% CI = 3.12-21.89) and cough (OR = 4.57, 95% CI = 1.66-12.59). Among the pollutants measured, concentrations of PM2.5 (92.1 µg/m3) and CO2 (286.9 ppm) inside the buses were significantly higher in the morning compared to afternoon hours (p < 0.001). These findings provide important evidence for further surveillance programs that could reduce occupational exposure for bus drivers.

SMOKING, PRODUCTION FACTORS AND PULMONARY INJURIES IN MECHANICAL ENGINEERING WORKERS

The aim of the study is to determine what is the incidence of respiratory diseases among workers in mechanical engineering enterprises and which are leading risk factors. The subject of the study are 80 persons working in mechanical engineering enterprises. The studies were carried out at the University Hospital - Pleven during the period 2017-2020. Specific clinical and instrumental methods of diagnosis have been used. The largest number are people with professional experience over 15 years, 72% of them are smokers. The most frequent cases are Chronic Obstructive Pulmonary Disease and Chronic bronchitis. The risk of developing lung disease in smokers (OR) is 22,71 times higher than their non-smoker counterparts in the same work environment. When using modern protective equipment, the main risk factors for respiratory diseases among mechanical engineering workers are related to lifestyle and smoking as a leading factor.

Основные аспекты изучения факторов риска развития заболеваний респираторного тракта у детей раннего и дошкольного возраста

Представленный обзор литературы позволил выделить основные причины, влияющие на развитие заболеваний у детей раннего и дошкольного возраста. Знание различных факторов риска, способствующих развитию заболеваний респираторного тракта, позволит более эффективно планировать и осуществлять профилактические и оздоровительные мероприятия у детей. Необходима реализация комплекса превентивных мер, направленных на подготовку будущих родителей к рождению здоровых детей, работу с семьями по пропаганде здорового образа жизни и рационального питания, вовлечению родителей в процесс оздоровления детей, закаливания, применения лечебной физкультуры и массажа, нормализации режима дня, а также санация очагов хронических инфекций, лечение сопутствующих заболеваний, использование иммунотропных препаратов, создание и внедрение оздоровительных программ в детских дошкольных учреждениях.

The Role of Di(2-Ethylhexyl) Phthalate as an Exacerbating Factor in Chronic Spontaneous Urticaria.

Phthalates are one of the most commonly used endocrine disruptors and have been considered a risk factor for respiratory disease including asthma. However, it is not yet known how they are related to urticaria. We investigated the association between phthalate exposure and urticaria in 10 healthy controls and 20 adult patients with active urticaria. The urinary levels of mono-n-butyl phthalate (MnBP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), mono-(2-ethyl-5-oxohexyl) phthalate, and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) were measured by using high performance liquid chromatography tandem mass spectrometry, and mast cell releasability was determined after phthalate treatment. The levels of phthalate metabolites, especially di-ethylhexyl phthalate (DEHP), are significantly increased in the urine of patients with urticaria compared to the healthy controls. The release of β-hexosaminidase in human mast cells is more significantly increased by MnBP, mono-benzyl phthalate, MEHHP, and MECPP compared to the negative controls; interestingly, the highest secretion of β-hexosaminidase is observed after the lowest stimulation of MECPP. Phthalates, including DEHP, may act as aggravating factors for chronic spontaneous urticaria and can be used as potential therapeutic targets in future studies.

Incidence and risk factors for respiratory diseases in ganjam goats of odisha

An attempt was made to document the morbidity and mortality in Ganjam goats of Odisha due to respiratory diseases and the effects of year, season, sex, age and management on morbidity and mortality rates. Morbidity and mortality data of 11050 Ganjam goats of 175 goat keepers from four clusters of Ganjam district were recorded during April 2018 to March 2020. The overall morbidity and mortality due to respiratory diseases were 7.1%. and 1.1%, respectively. Higher morbidity (8.2%) was observed in kids and young as compared to adults (6.2%). Mortality was higher (2.0%) in kids followed by young (1.6%) and adults (0.4%) goats. Higher rates of morbidity and mortality were observed in winter than rainy season followed by summer. Male goats had higher morbidity (10.1 vs 5.7%) and mortality (1.7 vs 0.8%) than females. Goats reared in semi-intensive system of management had lower morbidity (6.2 vs 8.0%) and mortality (0.3 vs 1.8%) as compared to those reared in range system. Logistic regression analysis revealed that morbidity and mortality had significant (p<0.05) association with year, season, sex, age, and management. Thus, it can be inferred that for morbidity and mortality due to respiratory diseases, the major risk factors were winter, male goats and kids.

Relationship of Knowledge on Respiratory Disorders with Lung Function in Masons in East Surabaya

Masons are regularly exposed to air pollution in the workplace The pollution exposure received by them is a risk factor for respiratory problems. Most of the masons had insufficient knowledge that is very important for the management of a person's illness. The purpose of this study was to determine relationship of knowledge on respiratory disorders with lung function in masons in east surabaya. This research was an observational study with a cross-sectional design with a purposive method.The research was conducted from April to July 2019 in the East Surabaya area. The variables that will be observed in this study are the level of knowledge of risk factors, symptoms, and treatment and therapy regarding respiratory disorders. In this study, there were 158 respondents consisting of 79 groups with impaired lung function and 79 groups without lung function disorders. Most of the level of knowledge of both groups was good in risk factors and treatment of respiratory disease, but instead on the symptoms regarding respiratory disease. The research showed that there was a relationship between the level of knowledge about risk factors for respiratory disease (p(0.223)&lt;0.05) and lung function, but there was no difference in knowledge about symptoms (p(0.745)&lt;0.05) and treatment (p(0.741)&lt;0.05) respiratory disease with pulmonary function. Therefore, it was necessary to plan further educational programs in increasing masons' knowledge of respiratory symptoms so that they could catch respiratory diseases earlier.

Relationship of Nutritional Status to Incidency Symptom Respiratory on Online Ojek Drivers in Malang City, East Java, Indonesia

Backgrounds/Aims: Respiratory disease is one of occupational disease that increasing and becoming the biggest three diseases that contribute more than three-quarters of total work-related deaths with circulations disease and neoplasm. Exposure to dust, allergens and toxins are some of the risk factors for respiratory diseases. One of the jobs with a high risk of exposure to air pollution is online motorcycle taxi drivers, they inhale pollution from the transportation sector and pollutant gases in the air which can cause respiratory problems. In addition, nutrition and respiratory disorders have an important relationship. In the recovery process, nutritional status has an important impact in the process of breaking down proteins contained in muscles including respiratory muscles in the catabolism process. Methods: This study was an analytic observation and the data was collected retrospectively in online motorcycle taxi drivers in Malang City with inclusion criteria on April 2021. Results: 108 online motorcycle taxi drivers in Malang, aged 15-55 years, 96.3% men, respiratory disorders 76.9% respondents with 93.6% underweight. Respiratory symptom more having common cold 66,7%, cough 42,6% and phlegm 38,9%. The relationship between nutritional status and the incidence of respiratory symptoms was 8.1 times (95% CI (1.9-16.4) p = 0.017). Conclusions: There is a significant relationship between nutritional status and symptoms of respiratory disorders in online motorcycle taxi drivers in Malang City with 8 times. Keywords: acute ischemic, stroke, platelet lymphocyte ratio, poor outcome.