Risk Of Impaired Lung Function Research Articles

Abdominal fat and risk of impaired lung function and asthma in children: A population‐based prospective cohort study

AbstractBackgroundObesity, specifically abdominal adiposity, is associated with increased risks of lung function impairment and asthma in children, but potential adverse effects among adolescents are unknown. We hypothesized that elevated amounts of specific abdominal fat depots during childhood and adolescence may lead to adverse respiratory outcomes in adolescents.MethodsIn a population‐based prospective cohort study among 2877 children at 13 years, we measured specific abdominal fat depots including subcutaneous fat mass and visceral fat mass by magnetic resonance imaging. Lung function was measured by spirometry, and current asthma by a questionnaire. Conditional regression analyses were used to examine the associations of abdominal fat depots with respiratory outcomes in adolescence.ResultsAfter adjustment for confounders and child's body mass index, higher subcutaneous and visceral fat mass index at age 13 years, independent of these measures at earlier age, were associated with lower FEV1, FEV1/FVC, and FEF75 (range Z‐score difference (95% CI): −0.10 (−0.15, −0.06) to −0.06 (−0.11, −0.01)). Also, an increase in subcutaneous and visceral fat between ages 10 and 13 years was associated with a decrease in FEV1, FEV1/FVC, and FEF75 during the same period. No associations of abdominal fat depots with asthma were observed.ConclusionAdolescents with higher amounts of subcutaneous and visceral fat, independent of that at an earlier age and body mass index, have an increased risk of lung function impairment.

Association of Muscle Fat Content and Muscle Mass With Impaired Lung Function in Young Adults With Obesity: Evaluation With MRI

Although low muscle mass is associated with decreased lung function, studies exploring the relationship between muscle fat content and lung function impairment are scarce. This study aimed to evaluate the association of muscle mass and fatty infiltration with lung function in young adults with obesity. We performed a retrospective cross-sectional study of patients aged 18-45 years with obesity who had impaired pulmonary function (case group, n=66) and those with normal pulmonary function (control group, n=198) by matching age, sex, body mass index (BMI), and height to assess whether muscle characteristics differed. Muscle mass and muscle fat content were assessed by MRI using a chemical shift-encoded sequence (IDEAL-IQ). A total of 264 patients were enrolled (124 females; mean age 32.0 years). The case group had lower muscle mass than the control group (p=0.012), and there was an association between low muscle mass and lung function impairment (odds ratio (OR), 3.74; 95% confidence interval (CI), 1.57-8.93). Furthermore, muscle fat content was significantly higher in cases compared to controls (7.4 (2.7) % vs. 6.2 (2.5) %, p=0.001). Multiple logistic regression analysis showed that muscle fat content was associated with a higher risk of impaired lung function (OR, 2.10; 95% CI, 1.65-2.66), regardless of adiposity and muscle mass. Both muscle fat content and muscle mass are associated with impaired lung function in young adults with obesity.

Respiratory function in uncomplicated type 1 diabetes: Blunted during exercise even though normal at rest!

Type 1 diabetes is associated with a substantially increased risk of impaired lung function, which may impair aerobic fitness. We therefore aimed to examine the ventilatory response during maximal exercise and the pulmonary diffusion capacity function at rest in individuals with uncomplicated type 1 diabetes. In all, 17 adults with type 1 diabetes free from micro-macrovascular complications (glycated haemoglobin: 8.0 ± 1.3%), and 17 non-diabetic adults, carefully matched to the type 1 diabetes group according to gender, age, level of physical activity and body composition, participated in our study. Lung function was assessed by spirometry and measurements of the combined diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) at rest. Subjects performed a maximal exercise test during which the respiratory parameters were measured. At rest, DLCO (30.4 ± 6.1ml min-1 mmHg-1 vs. 31.4 ± 5.7ml min-1 mmHg-1 , respectively, p=0.2), its determinants Dm (membrane diffusion capacity) and Vc (pulmonary capillary volume) were comparable among type 1 diabetes and control groups, respectively. Nevertheless, spirometry parameters (forced vital capacity=4.9 ± 1.0L vs. 5.5 ± 1.0L, p < 0.05; forced expiratory volume 1=4.0 ± 0.7L vs. 4.3 ± 0.7L, p < 0.05) were lower in individuals with type 1 diabetes, although in the predicted normal range. During exercise, ventilatory response to exercise was different between the two groups: tidal volume was lower in type 1 diabetes vs. individuals without diabetes (p < 0.05). Type 1 diabetes showed a reduced VO2max (34.7 ± 6.8 vs. 37.9 ± 6.3, respectively, p=0.04) in comparison to healthy subjects. Individuals with uncomplicated type 1 diabetes display normal alveolar-capillary diffusion capacity and at rest, while their forced vital capacity, tidal volumes and VO2 are reduced during maximal exercise.

Environmental and Behavioral Factors in Association with Lung Function Impairment in Children Living in Wuhan, China.

Children’s lung function is a significant predictor of health status throughout their lifetime. This study aims to identify the prevalence of impaired lung function in children and the potential influencing factors in elementary school children of Wuhan, China. Children of 6−12 years old were enrolled from elementary schools in Wuhan, China, in 2018, on the basis of a cross-sectional study design. Information on personal behavior patterns and household characteristics, as well as parental factors, was collected based on a questionnaire survey. Spirometry was used to measure fifteen lung function indicators. Logistic regression models were used to estimate odds ratios of prevalence of impaired lung function with regard to socioeconomic, personal behavior patterns, household, and parental factors, respectively. Four lung function indicators such as FET and EVC in urban children had higher values than in the suburban children after adjusting for confounders (p < 0.05). A higher prevalence of impaired lung function (FEV6, FEV3, EVC, and VC) was found in the children from the rural area than in those from the urban area. A sex difference in FET impairment was observed, however, no significant difference in impairment in other lung function indicators were found between girls and boys. The elevated height and weight of the children was significantly associated with an increased and decreased prevalence of impaired lung function, respectively, particularly both for FEV6, FEV3, FIVC, and FIV1. Opening windows for a longer time in summer was significantly associated with a lower prevalence of impaired FEF25 and MVV, and an extended time of opening windows in winter was significantly associated with a lower prevalence of impaired FEV6. While, opening windows for a longer time in autumn was significantly associated with higher prevalence of impaired FEV6 and FEV1/VC. Home renovations, doing physical exercise for more than 30 min per day, air pollution exposure during commuting, sleeping in own rooms, height stunting, and preterm birth were significantly associated with an increased risk of impaired lung function. Breastfeeding, having a father with a white-collar profession and with a higher education level were positively associated with the lower prevalence of impaired lung function. Impaired lung function is commonly found in school children in Wuhan, nowadays. Breastfeeding, opening windows long-term in summer and winter, higher socioeconomics, and an urban living environment were protective factors for impaired lung function. However, opening windows long-term and using air conditioning short-term in autumn, as well as home renovations, doing physical exercise for more than 30 min per day, preterm birth, height stunting, and air pollution exposure during commuting were regarded as significant risk factors for impaired lung function. Promoting breastfeeding, lengthening window opening times in winter and summer, and controlling household renovation and air pollution exposure during commuting are recommended to reduce the risk of impaired lung function in children in Wuhan.

Automobile Pollution and Risk of Impaired Lung Function and Oxygen Saturation among Vendors Near Road Traffic in Brazzaville, Congo

Context: Automobile pollution is becoming a potential threat to the cardiorespiratory health of the urban population of sub-Saharan Africa. The present study aims to evaluate the level of concentrations of fine particles (PM2.5 and PM10) near road traffic and the effects of exposure to automobile pollutants on pulmonary function and arteriolar blood oxygen saturation among sellers around road traffic. Materials and Methods: The study recruited 48 healthy people carrying out a sales activity near road traffic. PM2.5 and PM10 measurements were taken from 6 a.m. to 6 p.m. using a Temtop Airing-1000 portable particle detector. Spirometric measurements were taken in the morning and in the evening from a portable Spirobank G spirometer. Oxygen saturation measurements were also taken in the morning and evening using a Pulse oxymeter CMS50D pulse oxymeter. Results: Mean values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25 - 75) recorded in the evening were significantly lower than those obtained in the morning in the subjects of the total group and in the men. Only the mean values of PEF and FEF25 - 75 obtained in the evening were significantly lower than those recorded in the morning in women. Minimum PM2.5 values recorded near road traffic were negatively correlated with evening PEF in men, while maximum PM10 values were negatively correlated with evening PEF in women. The blood oxygen saturation recorded in the evening was significantly lower than that obtained in the morning. Conclusion: Short-term exposure to automobile pollutants has adverse effects on lung function and oxygen saturation in people carrying out a sales activity near road traffic.

Socioeconomic position over the life course and impaired lung function of older adults in Central and Eastern Europe: the HAPIEE study

BackgroundSocial differences in lung functioning have been reported, but the role of socioeconomic position (SEP) at different stages of life is less well understood, particularly in Central and Eastern Europe....

Lung function reduction among welders

Welding is associated with regular exposure to dust and fumes. Many studies have proven that there is a decrease in lung function due to exposure to this agent. This study aimed to quantitatively analyze the risk factors of impaired lung function among welders in Binong, Tangerang, Indonesia. This was a cross-sectional study design. The lung function of 30 welders is measured by spirometry using the parameters of vital capacity (VC), forced vital capacity (FCV), forced expiratory volume in one second (FEV1), and the ratio of FEV1/FVC. Chi-square analysis was performed and showed that 20 respondents (67%) had impaired lung function, while 10 respondents (33%) had normal lung function. Another factor contributing to impaired lung function among welding workers was their nutritional status, whereby respondents with abnormal nutritional status (body mass index (BMI) 18.4 or ≥25.1) were at 2.15 times higher risk of suffering from impaired lung function compared to respondents with normal nutritional status. Additionally, respondents who did not exercise regularly were at 1.22 times higher risk of impaired lung function compared to those who exercised regularly. Therefore, it is necessary to collaborate with the local community health center to monitor the health of the welders. It is recommended to carry out regular health checks, specifically pulmonary examination, at least once at a year to keep track of the health development of the workers. It is important to equip the workspace with a good ventilation system, and to have the welder work with appropriate personal protective equipment.

The effect of metabolic health and obesity on lung function: A cross sectional study of 114,143 participants from Kangbuk Samsung Health Study.

Although the role of obesity-induced metabolic abnormalities in impaired lung function is well-established, the risk of impaired lung function among obese individuals without metabolic abnormalities, referred to metabolically-healthy obesity (MHO), is largely unexplored. Therefore, we evaluated the impact of MHO on lung function in a large health-screening cohort. 114,143 subjects (65,342 men, mean age and BMI: 39.6 years and 23.6) with health examinations in 2019 were divided into four groups as follows: metabolically healthy non-obese (MHNO), MHO, metabolically unhealthy non-obese (MUHNO), and metabolically unhealthy obese (MUHO). Metabolic health was defined as fewer than two metabolic syndrome components. Obesity was defined as BMI ≥25 kg/m2. Adjusted odds ratios (aORs), using MHNO as a reference, were calculated to determine lung function impairment. Approximately one-third (30.6%) of the study subjects were obese. The prevalence of MHO was 15.1%. Subjects with MHO had the highest FEV1% and FVC% values but the lowest FEV1/FVC ratio (p<0.001). These results persisted after controlling for covariates. Compared with MHNO, the aORs (95% confidence interval) for FEV1% < 80% in MHO, MUHNO and MUHO were 0.871 (0.775-0.978), 1.274 (1.114-1.456), and 1.176 (1.102-1.366), respectively (P for trend = 0.014). Similarly, the aORs in MHO, MUHNO, and MUHO were 0.704 (0.615-0.805), 1.241 (1.075-1.432), and 1.226 (1.043-1.441), respectively, for FVC% < 80% (p for trend = 0.013). However, the aORs for FEV1/FVC<0.7 were not significantly different between groups (p for trend = 0.173). The MHO group had better lung function than other groups. However, longitudinal follow-up studies are required to validate our findings.

Organic Wood Dust Exposure as a Risk Factor for Lung Function Disorders in Workers : Systematic Review

Wood dust is wood particles that result from wood processing and handling. The level of fine dust in the work environment can expose to workers breathing and cause lung function disorders. Obstructive lung function disorders, namely blockages that make it difficult for air to escape from the lungs, resulting in a decrease in airflow velocity. The purpose of this systematic review was to determine wood dust exposure and risk factors for impaired lung function for workers. Article searches carried out through the Portal Garuda Indonesia, PubMed, Scopus, ProQuest, and Google Scholar. There are 9 articles reviewed. Exposure to wood dust was assessed as a significant risk factor for impaired lung function in workers as seen from the statistical analysis results in each study showing that the p-value &lt; 0.05. The risk factors that were stated to have a significant relationship were the concentration of wood dust, gender, work location, use of personal protective equipment (mask), length of work, and smoking habits. Exposure to wood dust increases the risk of impaired lung function in workers, with dust levels ranging from 1.15 mg/m3– 24 mg/m3.

RISIKO PAJANAN BAHAN PENCEMAR TERHADAP PEKERJA PENGECATAN MOBIL DI PT.STEELINDO MOTOR KOTA PADANG

Car painting work is one of the jobs that are at great risk of impaired lung function. Paint particles consist of hazardous chemicals such as cadmium, chromium, plumbum, mercury, acrylic resin, isocyanate, and toluene solvents. These materials when proven to enter the respiratory tract can cause lung function disorders. The purpose of this study is to identify hazards, analyze dose-response, analyze exposure and analyze the risk characterization of pollutants. This research is descriptive by analyzing environmental health risks to pollutants around the work environment. The population is all sanding, picking, and painting workers totaling 21 people which become sample. The instruments used in this study were low volume air sampler (LVAS), thermo hygrometers, anemometers, scales, and checklists for observing activity patterns. Data analysis uses stages in environmental risk analysis. Respondents smoke at work as much as 47.6%, and do not use APD 71.4%. Pollutants that exceed the quality standard are dust (0.1538 μg / m3), and Cd (0.0025 μg / m3). RQ value (life time) &gt; 1 for all exposure materials, which means that agent risk is not safe after 30 years of work. Management needs to manage risks such as reducing concentration, exposure time, and frequency of exposure to safe limits by managing risk through a technological approach, socioeconomic approach, and an institutional approach.

Factors Influencing Lung Function in Patients with Cystic Fibrosis in Western Romania.

PurposeThe aim of this cross-sectional study was to identify the major factors influencing pulmonary function in CF patients from western side of Romania.Patients and MethodsThe study enrolled 51 patients with CF between the ages of 6 and 27.8 years who were monitored at regular visits to the National Cystic Fibrosis Centre and Pius Branzeu County Hospital in Timisoara, Romania, over a period of 2 years. The relationships between lung function, as measured by forced expiratory volume in 1 s (FEV1), with patient age, sex, body mass index (BMI), pancreatic insufficiency (PI), microbial infection, CF-related diabetes (CFRD), CF-associated liver disease (CFLD), and physical activity <30 min/day, were evaluated by multivariate regression analysis.ResultsThe results showed that FEV1 was 0.32% higher for each increase in percentile of BMI (95% confidence interval: 0.034–0.619). In addition, mean FEV1 was 1.52% lower with every year rise of age. PI and female sex increased the risk of impaired lung function (FEV1 <60%). The factors most closely correlated with pulmonary function in pediatric CF patients were current age (negative) and BMI (positive).ConclusionThe findings of this study, in combination with what is known from other studies in CF, suggest that a better nutritional status and infection prophylaxis should be part of a comprehensive clinical management strategy for pediatric CF in Romania.

Abstract 5258: Determinants of impaired lung function among never-smokers in the UK Biobank Cohort

Abstract Introduction: The role of impaired lung function in lung cancer etiology remains contentious, especially in never-smokers who do not have primary smoking as a major risk factor, and represent an increasing proportion of lung cancers at 10-25%. Lung cancer in never-smokers (LCINS) would be the 7th most incident cancer worldwide if considered separately from smoking-related lung cancer. There has been a dearth of studies to evaluate lung function in a large cohort exclusively of never-smokers. The objective of this study was to address this gap. Methods: Based on the UK Biobank cohort, which recruited more than 500,000 individuals aged 40-69 between 2006-2010, we analyzed the association between lung function (measured as forced expiratory volume in 1-second, FEV1 and forced vital capacity, FVC) and early life factors, air pollution, and lifestyle exposures. Never-smokers were defined as those who smoked &amp;lt; 100 cigarettes, and impaired lung function was defined by FEV1/FVC based on GOLD criteria, FEV1 percent predicted (pp), or both (based on NICE criteria). To construct the percent predicted, reference FEV1 values were estimated using linear models in healthy never-smokers, with the predictors height, height2, age, sex, age by sex interaction, and ethnicity. Logistic regression was used to evaluate risk of impaired lung function, adjusted for all other predictors. We constructed risk-prediction models for LCINS incorporating lung function based on area under the curve (AUC) and corrected for optimism using bootstrap validation methods. Results: After excluding participants with prevalent respiratory cancers, 249,052 never-smokers were included in the analysis. The proportions of never-smokers with lung impairment based on the three criteria were: 11%, 12%, and 5%, for FEV1pp, GOLD, and NICE, respectively. Low birth weight (OR=1.32, 95% CI: 1.24-1.41) and any second-hand smoke exposure (OR=1.18, 95% CI: 1.13-1.23) increased risk of impaired FEV1 among never-smokers, as did air pollution, with PM2.5 (OR=1.83, 95% CI: 1.52-2.21) conferring the greatest increase in risk, and these associations were similar for impaired lung function based on NICE and GOLD criteria. High body mass index (OR=1.70, 95% CI: 1.62-1.77) was associated with increased risk of FEV1 impairment, but the opposite was observed with impairment defined by FEV1/FVC ratio. Risk-prediction models for LCINS incorporating lung function will also be presented. Conclusions: The association of obesity with FEV1/FVC remains paradoxical. Severe lung impairment can lead to both restrictive (FVC) and obstructive (FEV1) effects, and non-proportional impairment of these measures may help explain some of the paradoxical associations observed in this study and in the literature. Findings from this study suggest that evaluating multiple aspects of lung function may reveal a more complete picture of impairment and may inform approaches toward risk prediction. Citation Format: Matthew T. Warkentin, Rayjean J. Hung. Determinants of impaired lung function among never-smokers in the UK Biobank Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5258.

Association between HOMA-IR and Lung Function in Korean Young Adults based on the Korea National Health and Nutrition Examination Survey

Metabolic syndrome, including obesity and insulin resistance, has been reported to lower lung function in elderly subjects with asthma or chronic obstructive lung disease. This study aimed to find the association between lung function and insulin resistance in Korean young adults. This study used data from the Korean National Health and Nutrition Examination Survey 2011–2013, which is a representative sample of the Korean population. A total of 1,922 young adults aged 19 to 40 were included in the analysis. The association between lung function test and insulin resistance was evaluated. Weighted logistic regression analyses showed a significant negative correlation of insulin resistance with FVC% predicted (correlation coefficient γ = −0.130, P < 0.0001), FEV1% predicted (γ = −0.074, P = 0.004) and FEV1/FVC ratio (γ = −0.059, P = 0.019) in young adults, especially in subjects without asthma (γ for FVC% predicted, FEV1% predicted and FEV1/FVC ratio = −0.138, −0.092, and −0.061, respectively). This study demonstrates an inverse correlation between insulin resistance and lung function in Korean young adults. Young adults with preclinical insulin resistance have a higher risk of impaired lung function.

Physical activity, black carbon exposure, and DNA methylation in the FOXP3 promoter

BackgroundPhysical activity is associated with improvement in lung function; however, pollution exposure during physical activity can lead to a transient reduction in lung function. This paradoxical relationship may be linked to altered T regulatory (Treg) cell activity, which increases with exercise and suppresses airway inflammation, but decreases in association with exposure to air pollution. To clarify these relationships, we investigated buccal cell DNA methylation of the forkhead box p3 (FOXP3) gene promoter, a proposed biomarker of Treg activity. We hypothesized that active urban children would have lower FOXP3 promoter methylation, associated with better lung function compared to non-active children. We also hypothesized that this relationship would be attenuated by high exposure to the air pollutant black carbon (BC).MethodsWe performed a cross-sectional study of 135 children ages 9–14 who live in New York City. Activity was measured across 6 days. BC exposure was assessed by personal monitors worn for two 24-h periods, followed by lung function assessment. Buccal swabs were collected for DNA methylation analysis of three regions (six CpG sites) in the FOXP3 promoter.ResultsIn multivariable regression models, overall, there was no significant relationship between physical activity and FOXP3 promoter methylation (p > 0.05). However, in stratified analyses, among children with higher BC exposure (≥1200 ng/m3), physical activity was associated with 2.37% lower methylation in promoter 2 (CpGs −77, −65, and −58) (βestimate = −2.37%, p < 0.01) but not among those with lower BC exposure (βestimate = 0.54%, p > 0.05). Differences across strata were statistically significant (pinteraction = 0.04). Among all children, after controlling for BC concentration, promoter 2 methylation was associated with reduced FEV1/FVC (βestimate = −0.40%, p < 0.01) and reduced FEF25–75% (βestimate = −1.46%, p < 0.01).ConclusionsPhysical activity in urban children appeared associated with lower FOXP3 promoter methylation, a possible indicator of greater Treg function, under conditions of high BC exposure. Reduced FOXP3 promoter methylation was associated with higher lung function. These findings suggest that physical activity may induce immunologic benefits, particularly for urban children with greater risk of impaired lung function due to exposure to higher air pollution. FOXP3 promoter buccal cell methylation may function as a useful biomarker of that benefit.

Bronchiolar Remodeling in Adult Mice Following Neonatal Exposure to Hyperoxia: Relation to Growth

Preterm infants who receive supplemental oxygen for prolonged periods are at increased risk of impaired lung function later in life. This suggests that neonatal hyperoxia induces persistent changes in small conducting airways (bronchioles). Although the effects of neonatal hyperoxia on alveolarization are well documented, little is known about its effects on developing bronchioles. We hypothesized that neonatal hyperoxia would remodel the bronchiolar walls, contributing to altered lung function in adulthood. We studied three groups of mice (C57BL/6J) to postnatal day 56 (P56; adulthood) when they either underwent lung function testing or necropsy for histological analysis of the bronchiolar wall. One group inhaled 65% O2 from birth until P7, after which they breathed room air; this group experienced growth restriction (HE+GR group). We also used a group in which hyperoxia-induced GR was prevented by dam rotation (HE group). A control group inhaled room air from birth. At P56, the bronchiolar epithelium of HE mice contained fewer Clara cells and more ciliated cells, and the bronchiolar wall contained ∼25% less collagen than controls; in HE+GR mice the bronchiolar walls had ∼13% more collagen than controls. Male HE and HE+GR mice had significantly thicker bronchiolar epithelium than control males and altered lung function (HE males: greater dynamic compliance; HE+GR males: lower dynamic compliance). We conclude that neonatal hyperoxia remodels the bronchiolar wall and, in adult males, affects lung function, but effects are altered by concomitant growth restriction. Our findings may partly explain the reports of poor lung function in ex-preterm children and adults.

Gender differences in the effect of occupational endotoxin exposure on impaired lung function and death: the Shanghai Textile Worker Study

ObjectiveAirborne endotoxin exposure has adverse and protective health effects. Studies show men have augmented acute inflammatory responses to endotoxin. In this longitudinal cohort study we investigated the effect of long-term...

Impact of preterm birth and bronchopulmonary dysplasia on the developing lung: Long‐term consequences for respiratory health

Preterm birth affects 8-10% of human pregnancies and is a major cause of long-term disability. Individuals who are born very preterm, especially if they develop bronchopulmonary dysplasia (BPD), have an increased risk of impaired lung function in infancy, childhood and adulthood, as well as an increased risk of respiratory illness. Our aim is to briefly review current understanding of the basis for long-term impairments in lung function and respiratory health following preterm birth and BPD. Histopathology of the lungs of infants and children following preterm birth and BPD shows altered development of the lung parenchyma, conducting airways and pulmonary vasculature. Owing to improvements in the care of preterm infants, especially the use of exogenous surfactant and lower concentrations of administered oxygen, lung pathology following preterm birth and BPD is less severe than in the past. Recent studies indicate that very preterm birth and BPD can lead to hyperplasia of airway smooth muscle, impaired alveolarization, pulmonary inflammation and an increase in pulmonary artery muscularization. Imaging of adult lungs suggests that the deficit in alveoli can persist into later life. Long-term lung injury apparently relates to the use of mechanical ventilation and the use of supplemental oxygen in infancy. Impaired lung function in later life is due to airway hyper-reactivity and fewer alveoli, resulting in reductions in the surface area for gas exchange and physical support for bronchioles. Because the incidence of preterm birth is not declining, it will continue to be a major cause of respiratory ill-health in adults.

Metabolic syndrome biomarkers predict lung function impairment: a nested case-control study.

Cross-sectional studies demonstrate an association between metabolic syndrome and impaired lung function. To define if metabolic syndrome biomarkers are risk factors for loss of lung function after irritant exposure. A nested case-control study of Fire Department of New York personnel with normal pre-September 11th FEV(1) and who presented for subspecialty pulmonary evaluation before March 10, 2008. We correlated metabolic syndrome biomarkers obtained within 6 months of World Trade Center dust exposure with subsequent FEV(1). FEV(1) at subspecialty pulmonary evaluation within 6.5 years defined disease status; cases had FEV(1) less than lower limit of normal, whereas control subjects had FEV(1) greater than or equal to lower limit of normal. Clinical data and serum sampled at the first monitoring examination within 6 months of September 11, 2001, assessed body mass index, heart rate, serum glucose, triglycerides and high-density lipoprotein (HDL), leptin, pancreatic polypeptide, and amylin. Cases and control subjects had significant differences in HDL less than 40 mg/dl with triglycerides greater than or equal to 150 mg/dl, heart rate greater than or equal to 66 bpm, and leptin greater than or equal to 10,300 pg/ml. Each increased the odds of abnormal FEV(1) at pulmonary evaluation by more than twofold, whereas amylin greater than or equal to 116 pg/ml decreased the odds by 84%, in a multibiomarker model adjusting for age, race, body mass index, and World Trade Center arrival time. This model had a sensitivity of 41%, a specificity of 86%, and a receiver operating characteristic area under the curve of 0.77. Abnormal triglycerides and HDL and elevated heart rate and leptin are independent risk factors of greater susceptibility to lung function impairment after September 11, 2001, whereas elevated amylin is protective. Metabolic biomarkers are predictors of lung disease, and may be useful for assessing risk of impaired lung function in response to particulate inhalation.

Lung Function in Relation to 2-Thiothiazolidine-4-Carboxylic Acid and Genetic Effect Modification Among Rubber Workers in Sweden

What is the risk of impaired lung function in contemporary Swedish rubber workers and are there modifying effects of genetic variants? Included in the study were 159 rubber exposed and 118 not-rubber exposed workers. Lung function was analyzed as forced vital capacity percent of predicted and forced expiratory volume in 1 second percent of predicted. Levels of 2-thiothiazolidine-4-carboxylic acid (a marker of carbon disulfide and vulcanization fumes) was assessed with liquid chromatography tandem mass spectrometry. Polymorphisms in glutathione-related genes were analyzed by Taqman-based allelic discrimination and ordinary polymerase chain reaction. There was an association between increasing levels of 2-thiothiazolidine-4-carboxylic acid and impaired lung function among exposed workers. The association was modified by glutathione S-transferase alpha 1 (GSTA1)-52 and GSTP1-114. GSTM1 had an influence on lung function among unexposed workers. There may be a risk of impaired lung function in contemporary rubber workers. Gene-modifying effects may be considered in risk assessments.

Chapter 11: Environment-related health — focus on children

N Children’s health in Sweden is generally good, even though, for example, asthma and allergy diseases are a considerable problem. N The Children’s Environmental Health Questionnaire Survey 2003 (BMHE 03) shows that around one-quarter of all 4and 12-year-olds have eczema, asthma, hay fever, food allergy or other allergy symptoms. N One-tenth of four-year-olds and one-fifth of 12year-olds stated that they were allergic to airborne substances or foodstuffs. Allergy to pollen was most common, followed by allergy to furred animals. Contact allergy to nickel was reported by 9% of the 12-year-old girls and 2% of the boys. N More than 1,000 children aged up to 4 are afflicted annually by asthma symptoms because they live in homes with problems of damp. N Parents’ smoking is estimated to lead to more than 500 cases a year of acute lowerairway disease in children, chiefly infant asthma, and just over 500 cases of ear inflammation. N Ambient air pollutants can give airway symptoms in children and increase the risk of impaired lung function. N Every seventh 12-year-old, corresponding to almost 18,000 people in this year class, experiences discomfort from some kind of noise in or near the home. Around 9,000 of the 12-year-olds state that noise disturbances have made it difficult for them to sleep. N It is particularly worrying that children and young people are exposed to noise that may damage their hearing to an extent that appears not to have occurred previously. At the age of 4 years, around 2,000 children are reported to have impaired hearing and at 12, around 4,000 children. N Of 12-year-olds, around 12,000 state that they often or always have tinnitus. In day-care centres and schools, sound levels have been measured that in some cases exceed the limit for when hearing protection must be worn according to work-environment legislation. N Exposure to certain metals and persistent organic substances that accumulate in the environment is near the level where they can affect child and, above all foetal, development.