Standardized Respiratory Questionnaire Research Articles

Preserved ratio impaired spirometry is associated with small airway dysfunction and reduced total lung capacity

Background:Preserved ratio impaired spirometry (PRISm) refers to decreased forced expiratory volume in 1 s (FEV1) in the setting of preserved ratio. Little is known about the role of PRISm and its complex relation with small airway dysfunction (SAD) and lung volume. Therefore, we aimed to investigate the associations between PRISm and SAD and lung volume.Methods:We conducted a cross-sectional community-dwelling study in China. Demographic data, standard respiratory epidemiology questionnaire, spirometry, impulse oscillometry (IOS) and computed tomography (CT) data were collected. PRISm was defined as post-bronchodilator FEV1/FVC ≥ 0.70 and FEV1 < 80% predicted. Spirometry-defined SAD was defined as at least two of three of the post-bronchodilator maximal mid-expiratory flow (MMEF), forced expiratory flow 50% (FEF50), and forced expiratory flow 75% (FEF75) less than 65% of predicted. IOS-defined SAD and CT-defined gas trapping were defined by the fact that the cutoff value of peripheral airway resistance R5–R20 > 0.07 kPa/L/s and LAA− 856>20%, respectively. Analysis of covariance and logistic regression were used to determine associations between PRISm and SAD and lung volume. We then repeated the analysis with a lower limit of normal definition of spirometry criteria and FVC definition of PRISm. Moreover, we also performed subgroup analyses in ever smoker, never smoker, subjects without airway reversibility or self-reported diagnosed asthma, and subjects with CT-measured total lung capacity ≥70% of predicted.Results:The final analysis included 1439 subjects. PRISm had higher odds and more severity in spirometry-defined SAD (pre-bronchodilator: odds ratio [OR]: 5.99, 95% confidence interval [95%CI]: 3.87–9.27, P < 0.001; post-bronchodilator: OR: 14.05, 95%CI: 8.88–22.24, P < 0.001), IOS-defined SAD (OR: 2.89, 95%CI: 1.82–4.58, P < 0.001), and CT-air trapping (OR: 2.01, 95%CI: 1.08–3.72, P = 0.027) compared with healthy control after adjustment for confounding factors. CT-measured total lung capacity in PRISm was lower than that in healthy controls (4.15 ± 0.98 vs. 4.78 ± 1.05 L, P < 0.05), after adjustment. These results were robust in repeating analyses and subgroup analyses.Conclusion:Our finding revealed that PRISm was associated with SAD and reduced total lung capacity. Future studies to identify the underlying mechanisms and longitudinal progression of PRISm are warranted.

Do hospital workers experience a higher risk of respiratory symptoms and loss of lung function?

BackgroundHospital work environment contains various biological and chemical exposures that can affect indoor air quality and have impact on respiratory health of the staff. The objective of this study was to investigate potential effects of occupational exposures on the risk of respiratory symptoms and lung function in hospital work, and to evaluate potential interaction between smoking and occupational exposures.MethodsWe conducted a cross-sectional study of 228 staff members in a hospital and 228 employees of an office building as the reference group in Shiraz, Iran. All subjects completed a standardized ATS respiratory questionnaire and performed a spirometry test.ResultsIn Poisson regression, the adjusted prevalence ratios (aPR) among the hospital staff were elevated for cough (aPR 1.90, 95% CI 1.15, 3.16), phlegm production (aPR 3.21, 95% CI 1.63, 6.32), productive cough (aPR 2.83, 95% CI 1.48, 5.43), wheezing (aPR 3.18, 95% CI 1.04, 9.66), shortness of breath (aPR 1.40, 95% CI 0.93, 2.12), and chest tightness (aPR 1.73, 95% CI 0.73, 4.12). Particularly laboratory personnel experienced increased risks of most symptoms. In linear regression adjusting for confounding, there were no significant differences in lung function between the hospital and office workers. There was an indication of synergism between hospital exposures and current smoking on FEV1/FVC% (interaction term β = − 5.37, 95% CI − 10.27, − 0.47).ConclusionsWe present significant relations between hospital work, especially in laboratories, and increased risks of respiratory symptoms. Smoking appears to enhance these effects considerably. Our findings suggest that policymakers should implement evidence-based measures to prevent these occupational exposures.

Occupational Exposure to Dust and the Relationship with the Respiratory Symptoms, Lung Function among Construction Workers of the University of Malaysia Sabah

BACKGROUND: The respiratory tract often becomes the site of injury from occupational exposure. All construction sites generate high levels of dust, typically from concrete, silica, asbestos, cement, wood, and stone, sand, and therefore, the workers are exposed to this airborne dust and increased their risk of developing respiratory disorders. Limited studies have been conducted to assess the relationship between respiratory symptoms, lung function, and occupational dust exposure among construction workers in Sabah. AIM: The objectives of this study are to determine the occupational exposure to dust and the relationship with the respiratory symptoms as well as lung function among construction workers in UMS Teaching Hospital. MATERIALS AND METHODS: This cross-sectional study consisted of construction workers working in all sections in the development of UMS Teaching Hospital. A standard respiratory questionnaire was distributed to construction workers and lung function measurement was performed using Spirometry and the results of their respiratory status were compared between workers who were exposed and unexposed to dust. Occupational dust exposure was determined by the gravimetric method using an air sampler. The total duration of the collection was 8 h and the filters with the dust samples were analyzed in the laboratory. RESULTS: The result showed three parameters that were significantly associated with respiratory symptoms, namely, age, marital status, and smoking status. Male workers had a higher prevalence (42.7%) of having respiratory symptoms compared to female workers (21.4%). Widow/widower/divorced (50.0%) had a higher prevalence of having respiratory symptoms compared to married (45.8%) or single workers (25.0%). Workers who smoke had a higher prevalence (51.2%) of having respiratory symptoms compared to non-smoker’s workers (22.7%). CONCLUSION: The highest dust exposure is the piping workstation, followed by the cement and plastering workstations. These warrant the compulsory use of personal protective equipment by construction workers during work, improving the quality of dust masks, and standardizing their usage. Effective engineering controls should also be promoted on construction sites.

Household mold exposure in association with childhood asthma and allergic rhinitis in a northwestern city and a southern city of China.

BackgroundThe prevalence of asthma and allergic diseases has increased rapidly in Chinese cities over the past decades. Few studies have examined the potential role of household mold in asthma and allergies in Chinese cities.MethodsA cross-sectional survey in 4,691 school-age children was performed in Lanzhou and Wuhan. The two cities represent distinct climate conditions, as Lanzhou, located in northwestern China, has dry and cold winter and relatively cool summer whereas Wuhan, located in central-southern China, has hot and humid summer and mild winter temperatures. Two schools were randomly selected from a suburb and an urban area of each city, respectively. Data were collected using a modified Chinese version of the American Thoracic Society (ATS) standard respiratory health questionnaire for children, regarding asthma, substance allergy, allergic rhinitis, presence of mold in residence, and household characteristics. Logistic regression models were applied to identify the odds ratios of childhood asthma and allergies with regard to mold.ResultsThe prevalence rates of asthma, substance allergy, allergic rhinitis, and mold, were all higher in Wuhan than in Lanzhou. We observed significant associations of household mold with increased prevalence for both asthma [odds ratio (OR) =2.399, 95% confidence interval (95% CI): 1.309–4.398], substance allergy (OR =1.729, 95% CI: 1.282–2.332) and allergic rhinitis (OR =1.969, 95% CI: 1.491–2.600), with spatial heterogeneity across urban versus suburban schools. The mold effect was modified by age group and breast-feeding status.ConclusionsAcross two climatically distinct cities, household mold exposure was significantly associated with an increased risk for asthma and allergies. Younger children and children from the suburbs were more likely to be affected by mold. Whether breastfeeding enhanced or weakened the mold effects were inconsistent across the cities and across the health outcomes.

Respiratory Disorders Related to e-Waste Exposure among Workers in the Informal Sector in a Sub-Saharan African City: An Exposed Nonexposed Study.

Introduction Exposure to electrical and electronic equipment waste (e-waste) has become a growing health concern. The objective of this study was to measure the effect of exposure to e-waste on respiratory symptoms and on lung function parameters in workers involved in informal recycling activities in Cotonou city, Benin. Methods This was a cross-sectional study, in which exposed e-waste workers in Cotonou city were randomly selected. A matching nonexposed group based on age and sex was recruited from the general population. Respiratory symptoms were investigated using a questionnaire adapted from the British Medical Research Council's standardized respiratory questionnaire. Participants underwent lung function test using a portable spirometer (MIR SPIROBANK). Data were analyzed with STATA version 15 software. Results The overall prevalence of respiratory symptoms in e-waste workers was statistically higher in the exposed group (33.1% vs. 21.6%; p = 0.027). Chest tightness (11.8% vs. 2.1%; p = 0.003) and breathlessness (6.8% vs. 1.4%; p = 0.018) were the most reported symptoms by e-waste workers. Lung function testing showed a higher proportion of disorders among e-waste workers (25.0% vs. 14.9%, p = 0.029), with a higher proportion of probable restrictive (10.8% vs. 2.7, p = 0.005) and mixed (4.1% vs. 0%, p = 0.013) ventilatory disorders. Handling or working with e-waste was found associated with a significant reduction in forced expiratory volume in one second (FEV1) by 0.4 L (95% CI: 0.3-0.6) and forced vital capacity (FVC) by 0.75 L (95% CI: 0.6-0.9) after adjustment for age, BMI, smoking habits, asthma history, and daily income. Conclusion Work involving e-waste is associated with a higher prevalence of respiratory symptoms and with an increased risk of FEV1 and FVC decline, as well as of lung function impairment, particularly of restrictive disorders. Further studies to better clarify this association are needed. Awareness on this major public health threat should be raised in other sub-Saharan and Asian urban areas.

Sex Differences in Baseline Risk Factors for Asthma Between Early Adolescence and Young Adulthood.

Several studies have shown sex differences in the prevalence of asthma and an association with age. The aim of the present study was to prospectively investigate the development of asthma, wheeze, rhinitis, and allergic symptoms in adolescence and adulthood. We also aimed to determine whether sex modifies the association between baseline risk factors and incidence of asthma in early adulthood. In the Screening Project Asthma in Schools (SPAIS) study, adolescents aged 12-15 years completed a standardized respiratory questionnaire (International Study of Asthma and Allergies in Childhood) and underwent measurements of fractional exhaled nitric oxide (FeNO) and lung function (FEV1) at baseline. Two follow-up assessments with similar questionnaires were performed after 4 and 16 years, with a total of 491 participants in all 3 examinations. The prevalence of asthma and wheeze were unchanged after 4 years but had increased after 16 years. However, the increase was significant only for females. The prevalence of rhinitis and allergy symptoms increased steadily, albeit with no differences between the sexes. The sex interaction analysis showed that higher FeNO (P=.01) and a family history of asthma (P=.02) increased the risk of incident asthma for males but not for females. An increased prevalence of respiratory symptoms was seen primarily between late adolescence and young adulthood; the difference was significant for females but not for males. Allergic risk factors in early adolescence for incident asthma in early adulthood were confirmed in males but not in females. Awareness of these sex differences in the development of symptoms and of the associated risk factors is important in clinical practice.

Actigraphy informs distinct patient-centered outcomes in Pre-COPD

BackgroundActigraphy can provide useful patient-centered outcomes for quantification of physical activity in the “real-world” setting. MethodsTo characterize the relationship of actigraphy outputs with “in-laboratory” measures of cardiopulmonary function and respiratory symptoms in pre-COPD, we obtained actigraphy data for 8 h/day for 5 consecutive days a week before in-laboratory administration of respiratory questionnaires, PFT, and CPET to a subgroup of subjects participating in the larger study of the health effects of exposure to secondhand tobacco smoke who had air trapping but no spirometric obstruction (pre-COPD). Using machine learning approaches, we identified the most relevant actigraphy predictors and examined their associations with symptoms, lung function, and exercise outcomes. ResultsSixty-one subjects (age = 66±7 years; BMI = 24±3 kg/m2; FEV1/FVC = 0.75 ± 0.05; FEV1 = 103 ± 17 %predicted) completed the nested study. In the hierarchical cluster analysis, the activity, distance, and energy domains of actigraphy, including moderate to vigorous physical activity, were closely correlated with each other, but were only loosely associated with spirometric and peak exercise measures of oxygen consumption, ventilation, oxygen-pulse, and anaerobic threshold (VO2AT), and were divergent from symptom measures. Conversely, the sedentary domain clustered with respiratory symptoms, air trapping, airflow indices, and ventilatory efficiency. In Regression modeling, sedentary domain was inversely associated with baseline lung volumes and tidal breathing at peak exercise, while the activity domains were associated with VO2AT. Respiratory symptoms and PFT data were not associated with actigraphy outcomes. DiscussionOutpatient actigraphy can provide information for “real-world” patient-centered outcomes that are not captured by standardized respiratory questionnaires, lung function, or exercise testing. Actigraphy activity and sedentary domains inform of distinct outcomes.

Dust Exposure and Respiratory Health Effects Among Stones Crushers in Haut-Katanga Province, D.R. Congo

RésuméLe but de ce travail était de déterminer la prévalence des symptômes et pathologies respiratoires, d'évaluer la fonction respiratoire, ainsi que d'élaborer des mesures préventives chez les broyeurs de pierres dans la province du Haut-Katanga, en République démocratique du Congo (RDC). Une étude transversale à visée analytique a été réalisée dans deux carrières. Au total, 293 broyeurs de pierres et 295 agents administratifs des bureaux communaux (sujets contrôles) ont participé à cette étude. Un questionnaire standardisé a été utilisé pour recueillir les données. La fonction respiratoire a été explorée à l'aide d'un débitmètre de pointe. Les particules fines (PM 2,5) et les composés organiques volatils (COV) dans les différents milieux de travail ont été également mesurés. La prévalence des symptômes respiratoires rapportée chez les broyeurs de pierres a été supérieure à celle du groupe contrôle. Une concentration élevée de PM 2,5 [197,5 μg/m3(185-210 μg/m3)] et des COV [1,95 mg/m3(1,5-2,4 mg/m3)] a été notée chez les broyeurs de pierres par rapport au groupe contrôle [respectivement 33,5 μg/m3(22-45 μg/m3); 0,75 mg/m3(0,6-0,9 mg/m3)]. Le débit expiratoire de pointe (DEP en l/mn) a été significativement réduit chez les broyeurs de pierres (421,84±88,18 l/mn) par rapport aux contrôles (450,37±70,90 l/min) (p<0,05). Il est donc impératif d'améliorer l'environnement et les conditions de travail des broyeurs des pierres.

Occupational exposures and respiratory symptoms and lung function among hairdressers in Iran: a cross-sectional study

ObjectiveExposures at hairdressers’ work have been reported to lead to an increased risk of several health outcomes. The present study aimed to investigate the relations between occupational exposures and respiratory symptoms and lung function among hairdressers in Iran.MethodsWe conducted a cross-sectional study to compare potential respiratory effects among 140 women working as hairdressers to such effects among 140 women working as office workers (administrative personnel). Both groups worked in Shiraz, Iran. Respiratory symptoms were assessed by a standard respiratory questionnaire. The questionnaire also inquired about substances used and workspace conditions, including ventilation type. Lung function levels were measured by spirometry.ResultsRespiratory symptoms, including cough, wheezing, shortness of breath, and chest tightness were significantly more frequent in hairdressers compared to the reference group (p < 0.05). After controlling for potential confounders, hairdressers had a prevalence ratio (PR) of 2.18 (95% CI 1.26–3.77) for cough, 9.59 (95% CI 1.004–91.73) for wheezing, 2.06 (95% CI 1.25–3.39) for shortness of breath, and 3.31 (95% CI 1.84–5.97) for chest tightness compared to the reference group. Lung function parameters (including VC, FVC, and FEV1) were significantly reduced in hairdressers (p < 0.001). Absence of air conditioning predicted greater reduction in lung function (p < 0.05) in the exposed. Decrease in FVC with normal FEV1/FVC in the exposed group suggested existence of restrictive lung function.ConclusionsThis study provides evidence of increased prevalence of respiratory symptoms and restrictive lung function impairment among hairdressers in Iran.

Occurrence of respiratory symptoms and lung function deficits among fruit and vegetable market workers

ObjectiveThe objective of this study was to investigate the potential effects of occupational exposures among fruit and vegetable market workers on the occurrence of respiratory symptoms and on the level...

Spirometric evaluation of pulmonary function in Yazd’s dental laboratory workers in 1398

Introduction: Spirometry is used as a screening method for occupational lung diseases. Dental laboratory workers are exposed to solvent vapors, toxic gases, and dust from metal alloys, acrylics, and gypsum. This study aimed to investigate the spirometric function of lung function in dental staff in Yazd. Materials and Methods: This descriptive cross-sectional study was performed on 37 technicians of dental laboratories in Yazd in the three months of spring 2017. To evaluate respiratory problems and their pulmonary function, standard respiratory and spirometry questionnaires according to ATS / ESR guidelines were used, respectively. Data were analyzed by SPSS software version 18 using Mann-Whitney U, Chi-square, and Student's T-test. Results: Mean age of participants was 35.59±1.13. 54% of participants had no respiratory symptoms. The most common respiratory complain were dry and exudative cough. The work field was the only influential factor in FVC%. Age and work experience, and exercise no significant effect on respiratory parameters. Overall spirometry parameters were in the normal pattern range, and only 5% of participants showed a mild restrictive pattern. Conclusion: Spirometric pulmonary function of Yazd'dental laboratory technicians was in the normal range, and possibly working in the dental laboratory did not have a significant effect on the pulmonary Function of technicians based on spirometric indices.

Prevention of baker's asthma.

Baker's allergy and asthma continue to represent an important contributor of occupational asthma globally. This review identified recent studies related to the prevention of baker's allergy and asthma. Studies with respect to regulatory exposure standards, workplace control measures aimed at reduction of flour dust exposures, surveillance programmes (exposure monitoring, medical surveillance) and workplace information, education and training programmes were identified. Detailed knowledge on risk factors and detection methods to assess exposure and early identification of high-risk workers exist, but workplace control measures remain sub-optimal because they are rarely multifaceted. This is compounded by the lack of health-based exposure standards globally. Exposure level monitoring and medical surveillance are integral to assessing effectiveness of preventive strategies. Triage systems for optimizing the efficiency of medical surveillance programmes show promise, but need replication in different contexts. Future studies need to focus on evaluating the relevance and quantification of peak exposures in increasing risk; developing standardized respiratory questionnaires for medical surveillance; and further exploration of serial fractional exhaled nitric oxide (FeNO) measurements as an adjunct to allergic sensitization for the early identification of baker's asthma and assessing the long-term impact of interventions.

Gender differences in respiratory health outcomes among farming cohorts around the globe: findings from the AGRICOH consortium

ABSTRACT Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents. Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD). Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma. Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers.

Indoor air quality-induced respiratory symptoms of a hospital staff in Iran.

The ambient air of hospitals contains a wide range of biological and chemical pollutants. Exposure to these indoor pollutants can be hazardous to the health of hospital staff. This study aims to evaluate the factors affecting indoor air quality and their effect on the respiratory health of staff members in a busy Iranian hospital. We surveyed 226 hospital staff as a case group and 222 office staff as a control group. All the subjects were asked to fill in a standard respiratory questionnaire. Pulmonary function parameters were simultaneously measured via a spirometry test. Environmental measurements of bio-aerosols, particulate matter, and volatile organic compounds in the hospital and offices were conducted. T-tests, chi-square tests, and multivariable logistic regressions were used to analyze the data. The concentration of selected air pollutants measured in the hospital wards was more than those in the administrative wards. Parameters of pulmonary functions were not statistically significant (p > 0.05) between the two groups. However, respiratory symptoms such as coughs, phlegm, phlegmatic coughs, and wheezing were more prevalent among the hospital staff. Laboratory staff members were more at risk of respiratory symptoms compared to other occupational groups in the hospital. The prevalence of sputum among nurses was significant, and the odds ratio for the presence of phlegm among nurses was 4.61 times greater than office staff (p = 0.002). The accumulation of indoor pollutants in the hospital environment revealed the failure of hospital ventilation systems. Hence, the design and implementation of an improved ventilation system in the studied hospital is recommended.

Functional disorders of the lung and symptoms of respiratory disease associated with occupational inhalation exposure to wood dust in Iran.

OBJECTIVESThe possible adverse respiratory effects of airborne pollutants in sawmills have not been thoroughly investigated in Iran. Additionally, the extent to which workers are exposed to this organic dust and its associated bioaerosols has not been extensively quantified. Likewise, the predominant bacterial and fungal species associated with wood dust have not been characterized. The present study was undertaken to address these issues.METHODSOne hundred male individuals exposed to wood dust and 100 unexposed male subjects were investigated. They completed a standardized respiratory symptom questionnaire and underwent spirometry testing. Additionally, airborne concentrations of respirable and inhalable dust particles, bacteria, and fungi were measured.RESULTSThe mean concentrations of inhalable and respirable dust particles, bacteria, and fungi were found to be 2.44, 6.76 mg/m3 , 756.38, and 299.15 colony-forming units/m3 , respectively. The predominant Gram-negative bacteria in the sawmills included the Pseudomonadaceae, Klebsiella pneumoniae, and Rhinoscleromatis spp., and the predominant fungi consisted of the zygomycetes and Aspergillus spp. Respiratory symptoms were significantly more prevalent among exposed workers. Significant cross-shift decrements were noted in some pulmonary function parameters. Similarly, pre-shift spirometry results indicated that some pulmonary function parameters were significantly lower in the exposed group.CONCLUSIONSExposure to wood dust and its bioaerosols was associated with significantly higher prevalence of respiratory symptoms and both acute (i.e., partially reversible) and chronic (i.e., irreversible) decrements in the functional capacity of the lung. Additionally, the characterized bioaerosols did not differ significantly from those isolated in other parts of the world.

The problem of broncho-obstructive syndrome early detection in cardiological patients. Review of specialized respiratory questionnaires and their use in patients with comorbid cardiovascular and broncho-obstructive pathologies

The management of patients with cardiovascular pathology and comorbid obstructive pulmonary diseases seems to be an urgent problem against the background of their widespread prevalence among the adult population. According to the latest recommendations of GOLD 2017, it is not possible to diagnose COPD and to select options for pharmacotherapy without assessing the symptoms. Evaluation of symptoms in patients with cardiorespiratory pathology is a key element in the diagnosis of both respiratory and cardiovascular deseases. It is important to conduct differential diagnosis of both nosologies for reliable evaluation of the results of standardized respiratory questionnaires. Many respiratory questionnaires have been developed now; some of them have been validated and recommended for use in clinical practice in patients with COPD and asthma. However, their sensitivity and specificity are different, these questionnaires can`t be used interchangeably. In some cases, a decrease in the informative value of standardized respiratory questionnaires was revealed in patients with comorbid cardiovascular and obstructive pulmonary diseases. There are extremely few scientific works, that assess the same aspects of this problem. In connection with this, the development of specialized questionnaires for patients with comorbid cardiovascular and obstructive pulmonary pathology is relevant.

Respiratory health of women selling cassava, corn and soybean flour in Lumbumbashi, Democratic Republic of the Congo.

The aim of this study was to determine the prevalence of respiratory complaints in Congolese women selling grain flours in Lubumbashi. The study enrolled 370 women, including 183 cassava, corn and soybean flour selling women (exposed group) and 187 tax collectors in municipal markets (control group) in Lubumbashi, DRC. A standardized respiratory health questionnaire was used, and a lung function test performed with the use of peak flow-meters. The prevalence of respiratory complaints was markedly higher in dust-exposed women than controls. In addition, peak expiratory flow rate (PEFR) was significantly lower in the exposed group than in controls (342.46± 65.62 vs. 410.89± 70.91, respectively; P<0.05). After adjustment for age and education level, women involved in cassava, corn and soybean flour selling business were more likely to develop respiratory complaints ad disorders as compared to controls.

Pulmonary function and outcomes in infants randomized to a rescue course of antenatal steroids

Our objective was to obtain follow-up pulmonary function testing and assessment of clinical respiratory outcomes, at 1-2 years, in preterm infants whose mothers were randomized to a single rescue course of antenatal steroids (AS) versus placebo. Follow-up of a randomized, double-blinded trial. In the original trial pregnant women ≥14 days after initial course of AS were randomized to rescue AS or placebo. Pulmonary function testing and a standardized respiratory questionnaire were obtained at 1-2 years of corrected age. Respiratory compliance (Crs) was measured with the single-breath occlusion and functional residual capacity (FRC) with the nitrogen washout method. Analysis was by intention-to-treat. A total of 96 (87%) of available survivors were administered a respiratory questionnaire. Seventy-seven percent of available patients had pulmonary function testing performed. There was no significant difference between groups in incidence of wheezing, asthma, respiratory syncytial virus infection, respiratory readmissions, use of bronchodilators or other medications, or in measurements of pulmonary function. There was also no significant difference in corrected age at study, race, gender, or length at the time of pulmonary function testing. Infants in the rescue group had a comparable mean FRC (249.4 mL vs 246.2 mL; adjusted 95%CI for difference -15.45, 38.20; P = 0.37) versus placebo. There were no differences in tidal volume or Crs. A rescue course of AS significantly increases Crs within 72 h of age and decreases oxygen need in newborn infants, without an adverse impact on pulmonary function or clinical respiratory outcomes at 1-2 years of age [NCT00669383].

Prevalence of chronic obstructive pulmonary disease among patients with systemic arterial hypertension without respiratory symptoms.

BackgroundThe diagnosis of chronic obstructive pulmonary disease (COPD) is often delayed until later stages of the disease. The purpose of the present study was to determine the prevalence of COPD among adults on treatment for systemic arterial hypertension independently of the presence of respiratory symptoms.MethodsThis cross-sectional study included adults aged ≥40 years with tobacco/occupational exposure and systemic arterial hypertension diagnosed at three Primary Health Care facilities in Goiania, Brazil. Patients were evaluated using a standardized respiratory questionnaire and spirometry. COPD prevalence was measured considering the value of forced vital capacity and/or forced expiratory volume in 1 second <0.70.ResultsOf a total of 570 subjects, 316 (55%) met inclusion criteria and were invited to participate. Two hundred and thirty-three (73.7%) patients with arterial hypertension reported at least one respiratory symptom, while 83 (26.3%) reported no respiratory symptoms; 41 (17.6%) patients with arterial hypertension and at least one respiratory symptom, and 10 (12%) patients with arterial hypertension but no respiratory symptoms were diagnosed with COPD (P=0.24). The prevalence of COPD in people with no previous COPD diagnosis was greater among those with no respiratory symptoms (100%) than among those with respiratory symptoms (56.1%) (P=0.01).ConclusionOur findings suggest that regardless of the presence of respiratory symptoms, individuals aged ≥40 years with tobacco/occupational exposure and arterial hypertension may benefit from spirometric evaluation.

Standardized respiratory questionnaires: comparison of the old with the new.

Two standardized respiratory questionnaires were administered to 946 white male participants in a long-term study of respiratory symptoms in Washington County, Md. One half of the men were given the 1960 respiratory questionnaire developed by the British Medical Research Council (MRC) at the start of the interview and a new questionnaire developed by the American Thoracic Society and the Division of Lung Diseases (ATS-DLD) at the end. The order was reversed for the other half of the subjects. No important differences were found in the responses. To obtain a minimal basic history for evaluation of chronic obstructive pulmonary disease, either the MRC questionnaire or the corresponding questions from the ATS-DLD questionnaire may be used. More detailed information on a wider variety of historical items may be obtained by using the ATS-DLD questionnaire.