Self-reported Respiratory Symptoms Research Articles

Associations between vaping and self-reported respiratory symptoms in young people in Canada, England and the US

BackgroundPrevalence of youth nicotine vaping has increased, heightening concerns around negative health effects. This study aimed to compare self-reported respiratory symptoms among youth by vaping behaviours.MethodsParticipants (n = 39,214) aged 16–19 from the 2020 and 2021 International Tobacco Control Policy Evaluation Project (ITC) Youth Tobacco and Vaping Surveys (Canada, England, US). Weighted multivariable logistic regression assessed associations between reporting any of five respiratory symptoms in the past week (shortness of breath, wheezing, chest pain, phlegm, cough) and: past 30-day smoking and/or vaping; lifetime/current vaping. Among past-30-day vapers (n = 4644), we assessed associations between symptoms and vaping frequency, use of nicotine salts, usual flavour and device type(s).ResultsOverall, 27.8% reported experiencing any of the five respiratory symptoms. Compared with youth who had only vaped, those who had only smoked had similar odds of symptoms [adjusted odds ratio, OR (95% confidence interval, CI): 0.97 (0.85–1.10)], those who both smoked and vaped had higher odds [1.26 (1.12–1.42)], and those who had done neither, lower odds [0.67 (0.61–0.72)]. Compared with those who had never vaped, past use, experimentation and current regular or occasional use were all associated with higher odds. Reporting usually using nicotine salts was associated with higher odds of symptoms [1.43 (1.22–1.68)] than non-salt but was often uncertain. Compared with tobacco flavour (including with menthol), menthol/mint and sweets flavours were associated with similar odds; fruit [1.44 (1.07–1.93)], multiple [1.76 (1.30–2.39)] and ‘other’ [2.14 (1.45–3.16)] flavours with higher odds. All device types were associated with similar odds.ConclusionsAmong youth, vaping was associated with increased reporting of past-week respiratory symptoms. Among those who vaped, some flavour types and potentially nicotine salts were associated with respiratory symptoms.

Impact of Using Pre- and Post-Bronchodilator Spirometry Reference Values in a Chinese Population.

Spirometry reference equations that are derived from a large, nationally representative, general population are warranted in China and the impact of using pre- and post-BD spirometry reference values has yet to be assessed in Chinese populations. To present both the pre-BD and post-BD spirometry reference values for Chinese adults using the China Pulmonary Health (CPH) study. A reference population of 17969 healthy, non-smoking participants in the CPH study was used to calculate the pre- and post-BD reference values for the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC. Both pre- and post-BD reference values were applied to the entire CPH population (50991 individuals) to illustrate the divergence between the use of references in determining the disease prevalence and severity grading. The prevalence of airflow limitation was 5.36% using pre-BD reference and 8.02% using the post-BD reference. Individuals who had post-BD FEV1/FVC below post-BD but higher than pre-BD reference values were found to have significantly higher rates of self-reported respiratory symptoms, and significantly lower values in spirometry indicators than those above post-BD reference values. An additional 3.51% of participants were identified as grade II-IV COPD using the post-BD FEV1 predicted values. This study generated and applied pre- and post-bronchodilator spirometry reference values in a nationally representative Chinese adult population. Post-BD reference values may serve as an additional criterion in identifying individuals at risk for obstructive pulmonary diseases, its diagnostic and prognostic values should be further investigated.

Immunosurveillance associated with upper respiratory symptoms in elite swimmers: The 8-month period leading into Commonwealth Games

ObjectivesTo monitor individual mucosal immunity and identify potential risk factors of upper respiratory symptoms in elite swimmers over a competitive season. DesignEight-month longitudinal study, observing mucosal immunity, Epstein–Barr virus status, training loads and illness symptoms of elite international swimmers, leading into the Commonwealth Games 2018. MethodsParticipants were fourteen elite swimmers (age ± standard deviation = 19.9 ± 0.8 years, height = 178.9 ± 6.3 cm, and mass = 75.0 ± 7.7 kg). Self-reported upper respiratory symptoms, training load and saliva samples were collected weekly. Venous blood samples were taken at study commencement to determine Epstein–Barr virus status. ResultsThroughout the study, 70 episodes of upper respiratory symptoms were recorded resulting in 34 days of missed training. Incidence (p = 0.001), severity (p = 0.022), and duration of upper respiratory symptoms (p = 0.001) were significantly higher during high training loads, compared to low. Eight swimmers (61 %) had evidence of past infection with Epstein–Barr virus, but this had no relationship with incidence, severity, or duration of upper respiratory symptoms (p > 0.05). Relative individual salivary immunoglobulin A concentration was 12 % lower when upper respiratory symptoms were present but was not statistically significant (p = 0.101). ConclusionsThis study highlights the importance of individual athlete monitoring, to identify swimmers at increased illness risk. Identification of possible risk factors for upper respiratory symptoms, such as increased training load, may allow for modifications in training or other illness preventative strategies for elite swimmers.

Physical Activity, Depression and Quality of Life in COPD - Results from the CLARA II Study.

Symptoms of depression, pain and limitations in physical activity may affect quality of life in COPD patients independent from their respiratory burden. We aimed to analyze the associations of these factors in outpatients with COPD in Austria in a stable phase of disease. We conducted a national, cross-sectional study among patients with COPD. For depression, the Patient Health Questionnaire-9 (PHQ-9) and for respiratory symptoms the St. George's Respiratory Questionnaire for COPD patients (SGRQ-C) were used along with 10-point scales for physical activity and pain. After exclusion of 211 patients due to non-obstructive spirometry or missing data, 630 patients (62.5% men; mean age 66.8±8.6 (SD) years; mean FEV1%pred. 54.3 ± 16.5 (SD)) were analyzed. Of these, 47% reported one or more exacerbations in the previous year, 10.4% with hospitalization. A negative depression score was found in 54% and a score suggesting severe depression (PHQ-9 score≥15) in 4.7%. In a multivariate linear regression model, self-reported pain, dyspnea, and number of exacerbations were predictors for higher PHQ-9-scores. A negative pain score was found in 43.8%, and a score suggesting severe pain in 2.9% (8-10 points of 10-point scale). Patients reporting severe pain were more often female, had more exacerbations, and reported more respiratory and depressive symptoms, a lower quality of life, and less physical activity. About 46% of patients rated their physical activity as severely impaired. These patients were significantly older, had more exacerbations, concomitant heart disease, a higher pain and depression score, and a lower quality of life (SGRQ-C - total score and all subscores). In Austria, nearly half of stable COPD outpatients reported symptoms of depression, which were associated with lower levels of self-reported physical activity, more pain, and respiratory symptoms. The associations were particularly strong for depression with SGRQ-C.

The Prevalence and Risk Factors of Self-Reported Respiratory and Other Health Symptoms among Street Vendors in Gaborone, Botswana

Background: Air pollution is a serious public health concern, killing an estimated 800,000 people annually in developing and developed nations. In urban areas, traffic is one of the most significant sources of hazardous exhaust pollutants. Street vendors are often exposed to air pollutants as a result of their proximity to busy roads and intersections where vehicle emissions are high. Street vendors form an integral part of urban life globally as they provide convenience, affordable goods, and services to the general public. Aim: This study aimed to assess the prevalence and factors associated with respiratory and other health symptoms among street vendors in Gaborone, Botswana. Materials and Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire distributed to randomly selected street vendors. The questionnaire gathered information on demographic characteristics and respiratory and other health symptoms among street vendors. Data was analysed using logistic regression. Results: About 392 street vendors participated in the study, with 71% females. The mean age (M±SD) of the respondents was 46±13 years, with an age range of 25–66 years. About 46%) and 38% attained senior and junior secondary school certificates, respectively and 78%) worked for >8 hours/day. Coughing, headache and dizziness were reported by 89%, 62% and 58% of respondents respectively. Female vendors were at increased risk of wheezes (Odds Ratio (OR): 3.12, 95% Confidence Intervals (CI):1.24-7.85) and headaches (OR: 4.61, 95% CI: 2.02-10.54) when compared to males. Increasing age and working for >5 days/week were significantly associated with respiratory and other health symptoms such as sore throat, nasal congestion and wheezes. Tobacco smoking and alcohol consumption predisposed street vendors to nasal congestion (OR: 4.34, 95% CI: 1.28-14.72) and shortness of breath (OR: 3.70, 95% CI: 1.29-10.65), respectively. Physical exercise provided a protective effect against chest tightness (OR: 0.133, 95% CI: 0.03-0.06) and dizziness (OR: 0.73, 95% CI: 0.15-0.35). Conclusion: Street vendors reported a high prevalence of respiratory and related health symptoms. Factors such as increasing age, tobacco smoking and alcohol consumption have been associated with respiratory and related health symptoms among street vendors. Large scale research that quantifies TRAP pollutants and health symptoms is needed to inform policy development.

Trace and Major Element Concentrations in Cadaveric Lung Tissues from World Trade Center Health Registry Decedents and Community Controls.

Studies of the health impacts of the 11 September 2001 terrorist attacks on New York City's (NYC's) World Trade Center (WTC) towers have been hindered by imprecise estimates of exposure. We sought to identify potential biomarkers of WTC exposure by measuring trace and major metal concentrations in lung tissues from WTC-exposed individuals and less exposed community controls. We also investigated associations of lung tissue metal concentrations with self-reported exposure and respiratory symptoms. The primary analyses contrasted post-mortem lung tissue concentrations obtained from autopsies in 2007-2011 of 76 WTC Health Registry (WTCHR) enrollees with those of 55 community controls. Community controls were frequency-matched to WTCHR decedents by age at death, calendar quarter of death, gender, race, ethnicity and education and resided at death in NYC zip codes less impacted by WTC dust and fumes. We found WTCHR decedents to have significantly higher iron (Fe) lung tissue concentrations than community controls. Secondary analyses among WTCHR decedents adjusted for sex and age showed the log(molybdenum (Mo)) concentration to be significantly associated with non-rescue/recovery exposure. Post hoc analyses suggested that individuals whose death certificates listed usual occupation or industry as the Sanitation or Police Departments had elevated lung tissue Fe concentrations. Among WTCHR decedents, exposure to the WTC dust cloud was significantly associated with elevated lung tissue concentrations of titanium (Ti), chromium (Cr) and cadmium (Cd) in non-parametric univariable analyses but not in multivariable analyses adjusted for age and smoking status. Logistic regression adjusted for age and smoking status among WTCHR decedents showed one or more respiratory symptoms to be positively associated with log (arsenic (As)), log(manganese (Mn)) and log(cobalt (Co)) concentrations, while new-onset wheezing and sinus problems were negatively associated with log(Fe) concentration. Fe concentrations among individuals with wheezing, nonetheless, exceeded those in community controls. In conclusion, these data suggest that further research may be warranted to explore the utility as biomarkers of WTC exposure of Fe in particular and, to a lesser extent, Mo, Ti, Cr and Cd in digestions of lung tissue.

Frequent Allergic Sensitization to Farmed Edible Insects in Exposed Employees

Exposure to insects used in pet food, scientific research, or live fish bait can cause an occupational allergy. The recent shift toward enhanced insect production for human consumption and animal feed will likely expose more employees. To investigate sensitization and symptoms in employees exposed to edible insects in Flanders. Fifteen insect-exposed employees were recruited and sensitization was explored by skin prick test, basophil activation test, and immunoblotting. Lung function, FeNO, histamine provocation, and sputum induction were studied. Airborne dust sampling was performed and proteins were studied by silver stain and immunoblotting. Sixty percent of employees self-reported upper respiratory tract symptoms related to insect exposure. Ten employees (71.4%) had a positive histamine provocation test concentration causing a 20% drop in FEV1 less than 8 mg/mL and four (26.7%) had FeNO levels above 25 ppb. Four employees (30.7%) had a positive skin prick test for at least one insect, and seven (58.3%) had a positive basophil activation test. In eight participants with insect sensitization, four (50%) had co-occurring house dust mite sensitization. Two participants had strong IgE binding to a 50-kDa migratory locust allergen, one to a 25-kDa mealworm allergen, and one to mealworm α-amylase. In one center, facility adjustment resulted in a substantial decrease in the inhalable dust fraction. Insect exposure leads to high levels of sensitization among employees. Most employees reported symptoms of the upper respiratory system, and two-thirds of employees had bronchial hyperreactivity. Prevention and health surveillance will be important in the developing insect-rearing industry.

From sawdust to safety: Examining knowledge and practices of respiratory protective measures among sawmill workers in South-Eastern Nigeria

The availability of timber products and the increase in demand for construction and export have made it a thriving business in Nigeria. . Chronic respiratory symptoms are common among sawmill workers because of their exposure to occupational-related sawdust hazards. This study aimed to assess the knowledge, self-reported respiratory symptoms, and protective measure in place by the sawmill workers. This was a cross-sectional study and it was carried out at Timber market, Nkwo-Nnewi, Anambra state, Nigeria with a sample size of 157. Structured interviewer-administered questionnaire was used for data collection. Data were analyzed with the statistical package for social sciences. The result of the study showed that nearly all the respondents were male (97.5%) and the majority were between 30-49 years of age. 45.9% of the respondents had worked at the sawmill for 10 years and above. The majority of the respondents were aware that the sawmill dust can affect their respiratory health 119(75.8%).Some of the respiratory problem reported include: Cough 97(61.8%), Cold 81(51.6%), Chest tightness 18(11.5%), Wheeze 17(10.5%), Shortness of breath 12(7.6%). The study indicated that majority of the respondents do not make use of personal protective device 100(63.7%) whilst only 57(36.3%) make use of personal protective equipment. Some of the common reasons cited for not using PPE were that it was not comfortable 44(43%) and that the PPE was not available 34(34%). A great percentage of the sawmill workers had poor knowledge of respiratory protective measures (37.0%). The sawmill workers had a high prevalence of respiratory symptoms probably because poor safety practices were evident. It is therefore essential to improve the level of knowledge among sawmill workers about occupational hazards and safety practices in order to mitigate its negative consequences. These can be achieved via periodic health awareness campaigns, and health policies by the government with the aim to enforce the sawmill workers to observe proper protective measures while working.

Self-reported respiratory health symptoms and respiratory protection behaviors of young adult hog producers in the United States.

In this study, we evaluated self-reported respiratory symptoms during agricultural work, respiratory protection use and experience, and perceived value of receiving respirators using Gear Up for Ag Health and Safety Program™ pre- and post-surveys from 703 to 212 young adult hog producers in the United States. To our knowledge, this is one of the most extensive survey data sets on self-reported respiratory symptoms and respiratory protection behaviors of collegiate-aged young adults working in USlivestock production. About one-third (37%) of young adult hog producers stated that they have experienced cough, shortness of breath, fever, and chills after working in dusty areas on the farm. Most (76.2%) stated that they were already "always"or "sometimes"wearing filtering facepiece (N95-style) respirators, even before participating in an outreach program. About one-third (30%) reported experience wearing a cartridge-style respirator but only 5% reported having been fit-tested for a respirator. Young adult male producers were significantly more likely to report use of both respirator types when compared to females, both before and after the program. Male producers were also more likely than females to engage in high-risk farm tasks where respirators are recommended, such as cleaning out grain bins and mixing or grinding feed. Following an educational program, males and females reported using the respirators that they received at similar rates, and 20% of overall participants purchased additional respiratory protection. The study found that young adult hog producers in postsecondary education are already wearing respirators with some frequency and at rates higher than previously reported by agricultural workers. More research is needed to make effective task-based respirator-use recommendations and investigate some significant gender differences among young adult hog producers observed in this study.

Lung volumes differentiate the predominance of emphysema versus airway disease phenotype in early COPD: an observational study of the COPDGene cohort.

Lung volumes identify the "susceptible smokers" who progress to develop spirometric COPD. However, among susceptible smokers, development of spirometric COPD seems to be heterogeneous, suggesting the presence of different pathological mechanisms during early establishment of spirometric COPD. The objective of the present study was to determine the differential patterns of radiographic pathologies among susceptible smokers. We categorised smokers with preserved spirometry (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 0) in the Genetic Epidemiology of COPD (COPDGene) cohort based on tertiles (low, intermediate and high) of lung volumes (either total lung capacity (TLC), functional residual capacity FRC or FRC/TLC) at baseline visit. We then examined the differential patterns of change in spirometry and the associated prevalence of computed tomography measured pathologies of emphysema and airway disease with those categories of lung volumes. The pattern of spirometric change differed when participants were categorised by TLC versus FRC/TLC: those in the high TLC tertile showed stable forced expiratory volume in 1 s (FEV1), but enlarging forced vital capacity (FVC), while those in the high FRC/TLC tertile showed decline in both FEV1 and FVC. When participants from the high TLC and high FRC/TLC tertiles were partitioned into mutually exclusive groups, compared to those with high TLC, those with high FRC/TLC had lesser emphysema, but greater air trapping, more self-reported respiratory symptoms and exacerbation episodes and higher likelihood of progressing to more severe spirometric disease (GOLD stages 2-4 versus GOLD stage 1). Lung volumes identify distinct physiological and radiographic phenotypes in early disease among susceptible smokers and predict the rate of spirometric disease progression and the severity of symptoms in early COPD.

Effects of 24-week prebiotic intervention on self-reported upper respiratory symptoms, gastrointestinal symptoms, and markers of immunity in elite rugby union players

ABSTRACT Objectives Elite rugby union players face numerous physiological and psychological stressors which can increase upper respiratory and gastrointestinal illness risk, and in turn can compromise training and competitive performance. This study aimed to investigate the effect of daily prebiotic supplementation on upper respiratory symptoms, gastrointestinal symptoms, and markers of immune function in elite rugby union players. Methods Thirty-three elite rugby union players were randomly assigned to consume a prebiotic (2.8 g/day galactooligosaccharide) or placebo (2.8 g/day maltodextrin), daily for 168 days under double-blind conditions. Participants completed daily and weekly questionnaires for self-reported upper respiratory and gastrointestinal symptoms respectively. Blood and saliva samples were collected at 0, 84, and 168 days for assessment of plasma TNF-α and CRP, and saliva IgA respectively. Results The prebiotic group experienced a 2-day reduction in upper respiratory symptom duration (P = 0.045). Gastrointestinal symptom severity and incidence were lower in the prebiotic group compared to the placebo group (P < 0.001, P = 0.041) respectively. Salivary immunoglobulin A secretion rate was 42% greater in the prebiotic group compared to the placebo group at day 168 (P = 0.004), no differences in CRP and TNF-α were found (P > 0.05). Conclusion A 168-day dietary prebiotic intervention reduced the duration of upper respiratory symptoms and reduced the incidence and severity of gastrointestinal symptoms in elite rugby union players. These findings suggest that seasonal prebiotic interventions may be beneficial for reducing illness in elite rugby union players, improving their availability to train and compete. Key points Elite athletes are susceptible to upper respiratory symptoms and gastrointestinal symptoms which may impact upon training availability and competition performance. For the first time, this study shows that a dietary prebiotic intervention can reduce the duration of upper respiratory symptoms by 2 days in elite rugby union players. Dietary prebiotic supplementation can improve the incidence and severity of gastrointestinal symptoms experienced by elite rugby union players. Prebiotic supplementation was able to increase salivary IgA secretion after 168 days. These findings can inform practice suggesting that seasonal prebiotic use has the potential to modulate immune function and reduce illness in elite rugby union, which may improve a player’s availability to train and compete. The mechanisms by which prebiotics reduce URS and GIS require further research exploration.

Exposure to cooking fumes is associated with perturbations in nasal microbiota composition: A pilot study

Air pollution is one of the leading causes of overall mortality globally. Cooking emissions are a major source of fine particulate matter (PM2.5). However, studies on their potential perturbations on the nasal microbiota as well as their association with respiratory health are lacking. This pilot study aims to assess the environmental air quality among occupational cooks and its associations with nasal microbiota and respiratory symptoms. A total of 20 cooks (exposed) and 20 unexposed controls (mainly office workers), were recruited in Singapore from 2019 to 2021. Information on sociodemographic factors, cooking methods, and self-reported respiratory symptoms were collected using a questionnaire. Personal PM2.5 concentrations and reactive oxygen species (ROS) levels were measured using portable sensors and filter samplers. DNA was extracted from nasal swabs and sequenced using 16s sequencing. Alpha-diversity and beta-diversity were calculated, and between-group variation analysis of species was performed. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between exposure groups and self-reported respiratory symptoms. Higher daily mean PM2.5 (P = 2 × 10−7) and environmental ROS exposure (P = 3.25 × 10−7) were observed in the exposed group. Alpha diversity of the nasal microbiota between the two groups was not significantly different. However, beta diversity was significantly different (unweighted UniFrac P = 1.11 × 10–5, weighted UniFrac P = 5.42 × 10−6) between the two exposure groups. In addition, certain taxa of bacteria were slightly more abundant in the exposed group compared to unexposed controls. There were no significant associations between the exposure groups and self-reported respiratory symptoms. In summary, the exposed group had higher PM2.5 and ROS exposure levels and altered nasal microbiotas as compared to unexposed controls, though further studies are required to replicate these findings in a larger population.

RELATIONSHIP BETWEEN INDOOR AIR POLLUTANTS EXPOSURE AND RESPIRATORY SYMPTOMS AMONG BUS DRIVERS IN A MALAYSIAN PUBLIC UNIVERSITY

Bus drivers are continuously exposed to air pollutants such as particulate matter while working; hence, they have a high risk for respiratory diseases. This study aimed to investigate the associations of exposure to particulate matter (PM2.5, PM10) and nitrogen dioxide (NO2) inside campus transit buses with respiratory symptoms among bus drivers. A cross-sectional comparative study was conducted among 38 bus drivers as the exposed group and 38 office workers as the comparative group at a Malaysian public university. Indoor air monitoring was performed for 8 hours using SidePak Personal Aerosol Monitor, DustTrak II Aerosol Monitor, and Air Quality Monitor, while background information and self-reported respiratory symptoms were obtained using an adapted American Thoracic Society (ATS-DLD-78-A) questionnaire. Air pollutants (PM2.5, PM10 and NO2) exposure between both groups was significantly different at p&lt;0.05. The exposed group had higher odds of getting cough (OR=2.5), chronic cough (OR=2.2) and chronic phlegm (OR=4.6) than the comparative group. Moreover, there were significant associations between PM10 and PM2.5 concentrations with cough (OR=2.2), chronic cough (OR=2.2), and chronic phlegm (OR=2.2). Meanwhile, only cough was significantly associated with NO2 (OR=2.4). Multiple logistic regression showed that the main predictor for cough was PM2.5 (OR=3.2), for chronic cough was PM10 (OR=5.0), and for chronic phlegm was work duration (OR=1.3). In short, the exposed group was exposed to higher concentrations of air pollutants than the comparative group, leading to a higher prevalence of respiratory symptoms among the bus drivers. These findings provide important evidence for future programs to improve the air quality in buses. It is recommended that the indoor air quality inside the bus should be monitored periodically to ensure the drivers and the passengers are not exposed to air pollutants above the permissible limit.

Safety of elexacaftor/tezacaftor/ivacaftor dose reduction: Mechanistic exploration through physiologically based pharmacokinetic modeling and a clinical case series.

Elexacaftor/tezacaftor/ivacaftor (ETI) treatment is associated with significant improvement in lung function in people with cystic fibrosis (pwCF); however, some patients experience adverse effects (AEs) including hepatotoxicity. One potential strategy is dose reduction in ETI with the goal of maintaining therapeutic efficacy while resolving AEs. We report our experience of dose reduction in individuals who experienced AEs following ETI therapy. We provide mechanistic support for ETI dose reduction by exploring predicted lung exposures and underlying pharmacokinetics-pharmacodynamics (PK-PD) relationships. Adults prescribed ETI who underwent dose reduction due to the AEs were included in this case series, and their percent predicted forced expiratory volume in 1 s (ppFEV1 ) and self-reported respiratory symptoms were collected. The full physiologically based pharmacokinetic (PBPK) models of ETI were developed incorporating physiological information and drug-dependent parameters. The models were validated against available pharmacokinetic and dose-response relationship data. The models were then used to predict lung concentrations of ETI at steady-state. Fifteen patients underwent dose reduction in ETI due to AEs. Clinical stability without significant changes in ppFEV1 after dose reduction was observed in all patients. Resolution or improvement of AEs occurred in 13 of the 15 cases. The model-predicted lung concentrations of reduced dose ETI exceeded the reported half maximal effective concentration (EC50 ) from measurement of in vitro chloride transport, providing a hypothesis as to why therapeutic efficacy was maintained. Albeit in a small number of patients, this study provides evidence that reduced ETI doses in pwCF who have experienced AEs may be effective. The PBPK models enable exploration of a mechanistic basis for this finding by simulating target tissue concentrations of ETI that can be compared with drug efficacy in vitro.

Inconsistent Association between Perceived Air Quality and Self-Reported Respiratory Symptoms: A Pilot Study and Implications for Environmental Health Studies.

As public awareness of air quality issues becomes heightened, people's perception of air quality is drawing increasing academic interest. However, data about people's perceived environment need scrutiny before being used in environmental health studies. In this research, we examine the associations between people's perceptions of air quality and their self-reported respiratory health symptoms. Spearman rank correlation coefficients were estimated and the associations were tested at the 95% confidence level. Using data collected from participants in two representative communities in Hong Kong, the results indicate a weak but significant association between people's perceived air quality and their self-reported frequency of respiratory symptoms. However, there are disparities in such an association between different genders, age groups, household income levels, education levels, marital statuses, and geographic contexts. The most striking disparities are between genders and geographic contexts. Multiple significant associations were observed for male participants (correlation coefficients: 0.169~0.205, p-values: 0.021~0.049), while none was observed for female participants. Besides, multiple significant associations were observed in the old town (correlation coefficients: 0.164~0.270, p-values: 0.003~0.048), while none was observed in the new town. The results have significant implications for environmental health research using social media data, whose reliability depends on the association between people's perceived or actual environments and their health outcomes. Since inconsistent associations exist between different groups of people, researchers need to scrutinize social media data before using them in health studies.

Self-Reported Respiratory Symptoms Among Students Exposed To second hand smoke (SHS) In Academic Institutions In Gaborone: Implications For Public Health Interventions

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Adjusted incidence, remission, and relapse of self-reported physician-diagnosed asthma and asthma medication usage in endurance athletes.

Longitudinal studies are needed to increase our knowledge of the natural history of asthma in athletes. Our aims were to estimate the incidence, remission, and relapse, of self-reported asthma among endurance athletes. A postal questionnaire on self-reported physician-diagnosed asthma, asthma medication, allergy, and respiratory symptoms was sent annually 2011-2015 to 666 Swedish elite athletes competing in cross-country skiing, biathlon, ski orienteering, or orienteering. Athletes at risk for (1) incident asthma were those without previous self-reported asthma, use of asthma medication, or asthma-like symptoms, (2) remission those who discontinued asthma medication usage and (3) relapse those who resumed asthma medication usage during the observation period. The population at risk was used as denominator in the calculations of subsequent event rate. At baseline, 89% responded, the median age was 17 years and 47% were females. Of the 373 athletes with never asthma nor use of asthma medication/asthma-like symptoms at baseline, 31 (8%) reported physician-diagnosed asthma during follow-up, giving an adjusted incidence rate of asthma of 42/1000 person years. Among the 110 athletes with self-reported asthma and use of asthma medication at baseline, 26 (24%) discontinued use of asthma medication during the follow-up, giving a remission rate of 142/1000 person years. Of the 31 athletes with previous asthma and no use of asthma medication at baseline, 9 (29%) resumed use of asthma medication during follow-up, giving a relapse rate was 148/1000 person years. Elite endurance athletes have a high incidence of self-reported physician-diagnosed asthma. The remission and relapse of self-reported asthma medication usage in endurance athletes appear similar to that of the general population.

Respiratory health among adolescents living in the Highveld Air Pollution Priority Area in South Africa

BackgroundAir pollution is a global, public health emergency. The effect of living in areas with very poor air quality on adolescents’ physical health is largely unknown. The aim of this study was to investigate the prevalence of adverse respiratory health outcomes among adolescents living in a known air pollution hotspot in South Africa.MethodsAmbient air quality data from 2005 to 2019 for the two areas, Secunda and eMbalenhle, in the Highveld Air Pollution Priority Area in Mpumalanga province, South Africa were gathered and compared against national ambient air pollution standards and the World Health Organization Air Quality Guidelines. In 2019, adolescents attending schools in the areas completed a self-administered questionnaire investigating individual demographics, socio-economic status, health, medical history, and fuel type used in homes. Respiratory health illnesses assessed were doctor-diagnosed hay fever, allergies, frequent cough, wheezing, bronchitis, pneumonia and asthma. The relationship between presence (at least one) or absence (none) of self-reported respiratory illness and risk factors, e.g., fuel use at home, was explored. Logistic regression was used to estimate the odds ratio and 95% confidence interval (CI) of risk factors associated with respiratory illness adjusted for body mass index (measured by field assistants), gender, education level of both parents / guardians and socio-economic status.ResultsParticulate matter and ozone were the two pollutants most frequently exceeding national annual air quality standards in the study area. All 233 adolescent participants were between 13 and 17 years of age. Prevalence of self-reported respiratory symptoms among the participants ranged from 2% for ‘ever’ doctor-diagnosed bronchitis and pneumonia to 42% ever experiencing allergies; wheezing chest was the second most reported symptom (39%). Half (52%) of the adolescents who had respiratory illness were exposed to environmental tobacco smoke in the dwelling. There was a statistically significant difference between the presence or absence of self-reported respiratory illness based on the number of years lived in Secunda or eMbalenhle (p = 0.02). For a one-unit change in the number of years lived in an area, the odds of reporting a respiratory illness increased by a factor of 1.08 (p = 0.025, 95% CI = 1.01–1.16). This association was still statistically significant when the model was adjusted for confounders (p = 0.037).ConclusionsAdolescents living in air polluted areas experience adverse health impacts Future research should interrogate long-term exposure and health outcomes among adolescents living in the air polluted environment.

Association of short-term air pollution exposure with SARS-CoV-2 infection among young adults in Sweden

Background and Aim Many ecological studies reported associations of short-term air pollution exposure with Corona-virus disease (COVID-19), however, no study examined this association on individual-level. We aimed to estimate the association between short-term exposure to ambient air pollution and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among Swedish young adults. Methods We conducted a time-stratified case-crossover study within the Swedish prospective birth cohort BAMSE (Swedish abbreviation for Children, Allergy Milieu, Stockholm, Epidemiology). We linked the cohort to Swedish national infectious disease registry to identify SARS-CoV-2 PCR-test positive cases between May 5, 2020 and March 31, 2021. Daily air pollutant levels (particulate matter &amp;#x2264;2.5 &amp;#x3bc;m [PM2.5], particulate matter &amp;#x2264;10 &amp;#x3bc;m [PM10], black carbon [BC] and nitrogen oxides [NOx]) were estimated at residential addresses using dispersion models with high spatiotemporal resolution. Distributed-lag models combined with conditional logistic regression models were used to estimate the association. Results A total of 425 cases were identified, of whom 229 (53.9%) were female and median age was 25.6 years. The median exposure level for PM2.5, PM10, BC and NOx was 4.4, 7.7, 0.3, 8.2 &amp;#x3bc;g/m3 on case days and 3.8, 6.6, 0.2, 7.7 &amp;#x3bc;g/m3 on control days, respectively. Each interquartile range (IQR) increase in short-term exposure to PM2.5 and PM10 on lag 2, BC on lag 1 was statistically significantly associated with a relative increase of 6.8% (95%CI: 2.1- 11.8), 6.9% (95%CI: 2.0 -12.1), and 5.8 % (95%CI: 0.3 – 11.6) of positive SARS-CoV-2 PCR test, respectively. There was no evidence of findings to be associated with NOx or modified by sex, smoking, asthma, overweight and self-reported COVID-19 respiratory symptoms. Conclusions Short-term exposure to PM and BC was associated with increased risk of testing PCR-positive for SARS-CoV-2 in young adults, supporting the broad public health benefits of reducing ambient air pollution levels.

Respiratory and Otolaryngology Symptoms Following the 2019 Spring Floods in Quebec.

Background: Although floods may have important respiratory health impacts, few studies have examined this issue. This study aims to document the long-term impacts of the spring floods of 2019 in Quebec by (1) describing the population affected by the floods; (2) assessing the impacts on the respiratory system according to levels of exposure; and (3) determining the association between stressors and respiratory health. Methods: A population health survey was carried out across the six most affected regions 8–10 months post-floods. Data were collected on self-reported otolaryngology (ENT) and respiratory symptoms, along with primary and secondary stressors. Three levels of exposure were examined: flooded, disrupted and unaffected. Results: One in ten respondents declared being flooded and 31.4% being disrupted by the floods. Flooded and disrupted participants reported significantly more ENT symptoms (adjusted odds ratio (aOR): 3.18; 95% CI: 2.45–4.14; aOR: 1.76; 95% CI: 1.45–2.14) and respiratory symptoms (aOR: 3.41; 95% CI: 2.45–4.75; aOR: 1.45; 95% CI: 1.10–1.91) than the unaffected participants. All primary stressors and certain secondary stressors assessed were significantly associated with both ENT and respiratory symptoms, but no “dose–response” gradient could be observed. Conclusion: This study highlights the long-term adverse effects of flood exposure on respiratory health.