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Objective: The coexistence of asthma and COPD (asthma + COPD) is a condition found among patients who present with clinical features of both asthma and COPD. Epidemiological evidence points to an increasingly disproportionate burden of asthma + COPD and COPD in females. The objective of this cross-sectional study is to identify female and male-specific epidemiological and clinical characteristics associated with asthma + COPD. Methods: Baseline data from the comprehensive cohort of Canadian Longitudinal Study on Aging (CLSA) were used in this cross-sectional study which included 30,097 subjects between the ages of 45- and 85-years Participants were categorized into four mutually exclusive groups: asthma + COPD, COPD-only, asthma-only and neither asthma nor COPD. Results: The prevalence was significantly greater in females than males for asthma + COPD (2.71% vs. 1.41%; p < 0.001), COPD-only (3.22% vs. 2.87%; p < 0.001) and asthma-only (13.31% vs. 10.11%; p < 0.001). The association between smoking and asthma + COPD was modified by age in females. Osteoporosis and underactive thyroid disease were significantly more prevalent in females than in males in asthma + COPD, COPD-only and asthma-only groups. In asthma + COPD group, a greater proportion of respiratory symptoms associated with asthma was observed in females whereas a greater proportion of respiratory symptoms associated with COPD was observed in males. Severity of airway obstruction determined by spirometry measurements was greater in males than females. Conclusions: In the Canadian adult population, several epidemiological and clinical characteristics in asthma + COPD varied between females and males. The findings in this study will help healthcare professional in the recognition and management of coexisting asthma and COPD in females and males. [ABSTRACT FROM AUTHOR]

Objectives The aim was to identify, appraise, and synthesize the scientific evidence of the relationship between potential occupational sensitizing exposures and the development of asthma based on systematic reviews. Methods The study was conducted as an overview of systematic reviews. A systematic literature search was conducted for systematic reviews published up to 9 February 2020. Eligibility study criteria included persons in or above the working age, potential occupational sensitizing exposures, and outcomes defined as asthma. Potential occupational sensitizing exposures were divided into 23 main groups comprising both subgroups and specific exposures. Two reviewers independently selected studies, extracted study data, assessed study quality, and evaluated confidence in study results and level of evidence of the relationship between potential occupational sensitizing exposures and asthma. Results Twenty-seven systematic reviews were included covering 1242 studies and 486 potential occupational sensitizing exposures. Overall confidence in study results was rated high in three systematic reviews, moderate in seven reviews, and low in 17 reviews. Strong evidence for the main group of wood dusts and moderate evidence for main groups of mites and fish was found. For subgroups/specific exposures, strong evidence was found for toluene diisocyanates, Aspergillus, Cladosporium , Penicillium, and work tasks involving exposure to laboratory animals, whereas moderate evidence was found for 52 subgroups/specific exposures. Conclusions This overview identified hundreds of potential occupational sensitizing exposures suspected to cause asthma and evaluated the level of evidence for each exposure. Strong evidence was found for wood dust in general and for toluene diisocyanates, Aspergillus, Cladosporium , Penicillium, and work tasks involving exposure to laboratory animals. [ABSTRACT FROM AUTHOR]

Background: Street sweepers are exposed to a variety of risk factors such as dust, bioaerosols, and volatile organic matter, which are responsible for the development of various respiratory symptoms and lung function impairments. However, there is a limited data on the prevalence of respiratory symptoms and associated factors among street sweepers in Ethiopia, especially in the study area. Objective: This study aimed to assess the prevalence of respiratory symptoms and associated factors among street sweepers in Gondar town, northwest Ethiopia, in 2021. Methods: Using simple random sampling technique, a total of 391 workers were selected between August 10 and September 15, 2021. The data was entered and analyzed using the Epi Info Version 7 and Statistical Package for Social Science (SPSS) 22 software, respectively. Descriptive statistics, bivariable, and multivariable logistic regression model were used. P ⩽.05 and adjusted odds ratios (AOR) with 95% confidence interval (CI) were used to declare the statistical significance. Result: A total of 391 respondents, with a response rate of 99.2% participated. The prevalence of respiratory symptoms among street sweepers was 35.3% (95% CI: 30.2, 40.5). History of respiratory illness (AOR = 7.75, (95% CI: 3.45, 17.45), washing personal protective equipments (PPE) after use (AOR = 4.77; 95% CI: 2.02, 11.28), previous work in cement (AOR = 3.10, 95% CI: 1.32, 7.34), and flour factories (AOR = 2.13, 95% CI: 2.02, 4.43), and alcohol drinking (AOR = 3.77, 95% CI: 1.94, 7.29) were associated with respiratory symptom among street sweepers. Conclusion: The overall prevalence of respiratory symptoms among street sweepers was 35.3%. Previous respiratory illness, washing personal protective equipment after use, previous work in a cement and flour factory, and drinking alcohol were independently associated with respiratory symptoms. To reduce the respiratory symptoms among street sweeper, it is advisable implementing safe work practice measures and behavioral changes among workers. [ABSTRACT FROM AUTHOR]

The 12 years old male patient presented here suffers from neuronal ceroid lipofuscinoses 2 (CLN2) (MIM# 204500) and receives intracerebroventricular enzyme replacement therapy (ICV-ERT) every 14 days. After the emergence of the coronavirus disease 2019 (COVID-19) pandemic, routine care of children and adolescents with rare chronic diseases has become challenging. Although, in general, children do not develop severe COVID-19, when severe acute respiratory syndrome coronavirus 2 infection was detected by polymerase chain reaction-screening examination in our CLN2 patient before hospital admission for ICV-ERT, he was regarded to be at risk. Upon diagnosis, the patient developed respiratory deterioration symptoms and was admitted to our pediatric intensive care unit to receive oxygen, remdesivir, and steroids. As far as we know, this is the first CLN2 patient receiving intraventricular enzyme therapy with COVID-19 who required intensive care treatment and specific therapy. [ABSTRACT FROM AUTHOR]

Objectives Fiberglass-reinforced plastics (FRP) manufacturing has been related to cases of severe airway obstruction and elevated risk of respiratory mortality. But the specific job content risk is not clear. This study evaluated the respiratory health effects of the FRP lamination process. Methods A questionnaire was used to evaluate respiratory symptoms of workers in two yacht-building plants. Pre-shift (07:30-08:30 hours) and post-shift (17:00-18:00 hours) lung function was measured, while post-shift induced sputum was collected on the first day of the week. The participants were grouped into FRP laminators and non-laminators. Linear and logistic regression was used to investigate the effects of the lamination process on lung function. Results Laminators had a higher prevalence of chronic cough, lower pre-shift forced expiratory volume in first second (FEV1) and FEV1/force vital capacity (FVC) (-3.3% and -1.5%), lower post-shift FVC and FEV1 (-3.6% and -4.9%), and larger post-shift reduction of FVC (-2.1%) compared to non-laminators. The laminators also had higher risk of early obstructive and overall (obstructive plus restrictive) lung function impairment, and post-shift reduction of FVC >10% [odds ratio (OR) 5.98, 4.98, and 3.87, respectively). They also had higher percentages of neutrophils and lymphocytes in the induced sputum. Conclusion Laminators should undergo regular check-ups of respiratory symptoms and lung function. Further toxicologic studies are warranted to identify the specific causal agent in the FRP lamination process. [ABSTRACT FROM AUTHOR]

Introduction: The expansions of labor-intensive investments in a developing countries, especially in textile production create a dusty work environment for workers, and those workers are from the low socio-economic group and need special safety concern. Objective: This study was aimed at assessing the prevalence of respiratory symptoms and associated factors among textile factories workers in Bahir Dar, Amhara region, Ethiopia, 2015. Methods: Institutional based cross-sectional study design was employed among randomly selected 384 textile workers using pre-tested interviewer-administered questionnaire. We stratified workers by their working section in the textile industries. Then the proportional numbers of workers were selected from each working section of the factory by using a random number generator. The identification number of workers from each factory was used for selection. The data were checked, coded, and entered to Epi-info Version 7 and exported to the Statistical Package for Social Science Version 20 for further analysis. Both bivariate and multivariate logistic regressions were used to identify associated factors. Variables having a P ⩽.2 were fitted to multivariate logistic regression so as to assess the presence and strength of association with the respiratory symptom. Variables having a P <.05 were considered as significant. Results: Three hundred eighty-three (99.74%) of the study participants responded completely filling the questionnaire. In this study, the prevalence of cough, phlegm, bronchitis, chronic bronchitis, and chest pain among the respondents were 31 (8.1%), 45 (11.7%), 26 (6.8%), 2 (0.5%), and 21 (5.5%), respectively. Generally, 141 (36.81%) of the respondents have either of the above respiratory symptoms in the textile industry. Working in the spinning section (AOR = 3.26, 95% CI: 1.80, 5.89), being in the grade 11 and 12 level and below (AOR = 2.36, 95% CI: 1.50, 3.70) and personal protective equipment (PPE) utilization (AOR = 4.88 95% CI: 1.54-15.45) were significantly associated with respiratory symptoms in the multivariate analysis. Conclusion: The prevalence of respiratory symptoms in Bahir Dar Textile workers was relatively high. Working department, educational status, and PPE use were variables significantly associated with respiratory symptoms in this study. Experience sharing across departments, employing educated workers and provision of personal protective equipment are important tasks to be followed to reduce respiratory symptoms in the industry. [ABSTRACT FROM AUTHOR]

Introduction: The expansions of labor-intensive investments in a developing countries, especially in textile production create a dusty work environment for workers, and those workers are from the low socio-economic group and need special safety concern. Objective: This study was aimed at assessing the prevalence of respiratory symptoms and associated factors among textile factories workers in Bahir Dar, Amhara region, Ethiopia, 2015. Methods: Institutional based cross-sectional study design was employed among randomly selected 384 textile workers using pre-tested interviewer-administered questionnaire. We stratified workers by their working section in the textile industries. Then the proportional numbers of workers were selected from each working section of the factory by using a random number generator. The identification number of workers from each factory was used for selection. The data were checked, coded, and entered to Epi-info Version 7 and exported to the Statistical Package for Social Science Version 20 for further analysis. Both bivariate and multivariate logistic regressions were used to identify associated factors. Variables having a P ⩽.2 were fitted to multivariate logistic regression so as to assess the presence and strength of association with the respiratory symptom. Variables having a P <.05 were considered as significant. Results: Three hundred eighty-three (99.74%) of the study participants responded completely filling the questionnaire. In this study, the prevalence of cough, phlegm, bronchitis, chronic bronchitis, and chest pain among the respondents were 31 (8.1%), 45 (11.7%), 26 (6.8%), 2 (0.5%), and 21 (5.5%), respectively. Generally, 141 (36.81%) of the respondents have either of the above respiratory symptoms in the textile industry. Working in the spinning section (AOR = 3.26, 95% CI: 1.80, 5.89), being in the grade 11 and 12 level and below (AOR = 2.36, 95% CI: 1.50, 3.70) and personal protective equipment (PPE) utilization (AOR = 4.88 95% CI: 1.54-15.45) were significantly associated with respiratory symptoms in the multivariate analysis. Conclusion: The prevalence of respiratory symptoms in Bahir Dar Textile workers was relatively high. Working department, educational status, and PPE use were variables significantly associated with respiratory symptoms in this study. Experience sharing across departments, employing educated workers and provision of personal protective equipment are important tasks to be followed to reduce respiratory symptoms in the industry. [ABSTRACT FROM AUTHOR]

Objective: Asthma is a chronic disease affecting both children and adults, whereas chronic obstructive pulmonary disease (COPD) is a respiratory disease most commonly related to smoking and is usually seen in adults. When the airway disease shares features of both asthma and COPD, the phenotype is referred to as asthma and COPD overlap syndrome (ACOS). The objective of this cross-sectional study is to characterize ACOS in the Canadian population. Methods: Data from the first three cycles of the Canadian Health Measures Survey (CHMS) were used in this study. The study included 9059 subjects aged 30 years and above. The CHMS included a detailed interviewer-administered questionnaire and spirometry measurements. Based on the self-report, subjects were categorized into control, ACOS, COPD only and asthma only groups. Results: The prevalence of ACOS, COPD and asthma groups was 1.59%, 2.21% and 6.65%, respectively. The proportion of females was significantly greater than males in the ACOS group. The proportion of wheeze was highest in the ACOS group (64.93%) whereas the prevalence of shortness of breath was the highest in the COPD group (46.25%). Heart disease, cancer, arthritis and liver disease were more prevalent in the ACOS group than in COPD, asthma and control groups. Severity of airway obstruction was the highest in the ACOS group and was followed by COPD, asthma and control groups, respectively. Conclusions: Characteristics of ACOS in the Canadian population were similar to those observed in the developed countries and longitudinal studies are required to determine the incidence and risk factors of ACOS. [ABSTRACT FROM AUTHOR]

Background: Respirable dust exposure is associated with increased respiratory impairment. As there are various airborne contaminants in the foundry industry, our aim was to thoroughly examine the acute effects of ambient respiratory dust on the respiratory system. Materials and Methods: A cross-shift study was conducted in a cast iron foundry in Iran. A total of 200 participants, including 110 workers from production department and 90 office workers were enrolled in this study. Workers were evaluated with regard to respiratory symptoms using the American Thoracic Society (ATS) questionnaire and examination of their lung function by spirometry. Results: The mean exposure of all studied substances was higher than occupational exposure limits. The most common respiratory symptom in exposed workers was cough (24.5%). A statistically significant post shift reduction in FEV1 and FEF25-75 was seen in exposed group. After adjusting for age, working history, smoking and Body Mass Index (BMI), there was a significant decrease based on exposure in FEV1 and FVC. Conclusion: Dust exposure was a significant predictor of lung function. Implementing the health promotion program, periodic medical surveillance and efficient use of respiratory protection equipment could help to protect foundry workers from respiratory impairment. [ABSTRACT FROM AUTHOR]

This study aimed to determine the particulate matter concentrations (PM10) in workplace air and personal dust, and their effects on the respiratory health of exposed workers. The lung function of 449 exposed workers was examined. The concentration of PM10 in workplace air and personal dust exposure was measured. Spirometry was used to evaluate the lung function capacity included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory volume ratio (FEV%) and peak expiratory flow rate (PEF). The forced expiratory flow at 25% to 75% of the FVC (FEF 25-75%) was determined. The PM10 concentration in workplace air (6 study sites) and personal dust (4 study sites) exceeded the standard (REL) of 0.12 mg/m3. The results of this study showed a decrease in the mean values and percent predicted value of FVC, FEV1, FEV1%, PEF and FEF 25-75%. The lung capacity of participants revealed that 24.50%, 4.45% and 7.13% had mildly, moderately restrictive and small airway disease. The respiratory symptoms were dyspnoea (22.49%), wheezing (10.69%), chest pain (10.69%) and chronic cough (2.90%). Factors influencing lung capacity included mask usage (Adj.OR: 0.44 CI: 0.25-0.79 p-value: 0.006) and chest pain (Adj.OR: 2.68 CI: 1.14-6.30 p-value: 0.024). [ABSTRACT FROM PUBLISHER]

Background: Ulaanbaatar, Mongolia, is one of the world's worst air-polluted cities, but effects of this air pollution on the population health status have not yet been evaluated. Therefore, we developed a Mongolian version of the SF-36v2 questionnaire to investigate the health status of Mongolian population. Methods: Health checkups were conducted in Ulaanbaatar and the health status was measured using a Mongolian translated version of the SF-36v2 questionnaire. The reliability and validity of the Mongolian SF-36v2 questionnaire, and the relationship between health status and respiratory condition were examined. Results: Factor analysis of the Mongolian SF-36v2 questionnaire showed that the 'Role-physical' and 'Role-emotional' were classified into a single subscale. The 'Mental health' and 'Vitality' were each divided into two subscales. Cronbach's alpha and intraclass correlation coefficient (ICC) for reproducibility were >0.7, except for 'General health perceptions' (Cronbach's alpha and ICC < 0.7), 'Social functioning' (Cronbach's alpha < 0.7), and 'Vitality' (ICC < 0.7). The SF-36v2 subscales and the corresponding items of the COOP/WONCA charts were correlated, and subjects with respiratory symptoms showed lower SF-36v2 scores compared to normal subjects, suggesting external validity. Subjects with respiratory symptoms showed significantly lower scores for the majority of the SF-36v2 subscales than those with normal lung function. In subjects with combined ventilatory impairment, 'Physical functioning', 'Role-physical', 'Bodily pain', and 'Vitality' scores were significantly lower than those with normal lung function. Conclusions: The Mongolian version of the SF-36v2 questionnaire provides substantial reliability and validity, and is useful for evaluating the health status of Mongolian adults with ventilatory impairment. Health status measured by SF-36v2 was significantly aggravated by combined ventilatory impairment when compared with normal lung function. [ABSTRACT FROM AUTHOR]

BACKGROUND: According to the growth of photocopier usage in workplaces, the potential risk of occupational exposure to the airborne chemicals has been raised up. Hence, monitoring the photocopy worker's respiratory functions seems to be necessary. We aimed to evaluate the respiratory health on photocopy and printing workers so that a reliable description can be made about their occupational hygiene. METHODS: This study was performed in Shiraz, southwest Iran in 2014 and a group of 150 photocopy and printing workers were surveyed as exposed group in addition to a group of 114 office staff as unexposed group. The respiratory standard questionnaire was used to evaluate the prevalence of respiratory symptoms among the selected staff. Pulmonary function indexes including VC, FVC, FEV1 and the FEV1/FVC ratio were calculated. Finally, t-test, Chi Square and multiple logistic regressions were conducted. RESULTS: VC, FVC and FEV1 in photocopy and printing workers were lower than the unexposed group of which these differences for FVC and FEV1 were statistically significant (P CONCLUSIONS: The prevalence of excess respiratory symptoms along with pattern of pulmonary restrictive sings in photocopy and printing workers revealed that the workplace conditions can result in occupational respiratory diseases. [ABSTRACT FROM AUTHOR]

Cement dust exposure is associated with increased respiratory impairment. As the major occupational hazard in the cement production industry is cement particles, our aim was to more thoroughly examine the acute effects of occupational exposure to cement dust on the respiratory system. A cross-shift study was conducted in a cement factory in Iran. 100 high exposed workers from production and packing sections and 100 low exposed from office workers were included. Environmental total dust was measured in each section. Assessment of lung function was done by pre and post shift spirometry. At the end of the day shift, acute respiratory symptoms were recorded. The means of total dust among high and low exposed workers were 16.55 mg/m3 and 0.9 mg/m3, respectively. The most common acute respiratory symptoms in high exposed workers were stuffy nose (52 %) and shortness of breath (49 %). A statistically significant post shift reduction in PEF, FEV1, FEF 25-75, FVC and FEV1/ FVC was demonstrated in high exposed group. Multivariate linear regression showed a significant relationship between the percentage of the cross-shift decrease in spirometric indices and exposure to cement dust. We detected significant relationship between exposure to cement dust and acute respiratory symptoms and pulmonary function indices. Effective dust-control measures and preparing a suitable strategy for respiratory protection are highly recommended. [ABSTRACT FROM AUTHOR]

Background: Bicycle commuting in an urban environment of high air pollution is known to be a potential health risk, especially for susceptible individuals. While risk management strategies aimed to reduce exposure to motorised traffic emissions have been suggested, only limited studies have assessed the utility of such strategies in real-world circumstances.Objectives: The potential to lower exposure to ultrafine particles (UFP; < 0.1 μm) during bicycle commuting by reducing proximity to motorised traffic was investigated with real-time air pollution and intermittent acute inflammatory measurements in healthy individuals using their typical higher proximity, and an alternative lower proximity, bicycle commute route.Methods: Thirty-five healthy adults (mean ± SD: age = 39 ± 11 yr; 29% female) completed two return trips, one each in the condition of their typical route (HIGH) and a pre-determined alternative route of lower proximity to motorised traffic (LOW); proximity being determined by the proportion of on-road cycle paths. Particle number concentration (PNC) and diameter (PD) were monitored in-commute in real-time. Acute inflammatory indices of respiratory symptoms (as a scalar of frequency from very low to very high / 1 to 5), lung function and spontaneous sputum (for inflammatory cell analyses) were collected immediately pre-commute, and immediately and three hours post-commute.Results: In the condition of LOW, compared to in the condition of HIGH, there was a significant decrease in mean PNC (1.91 x e4 ± 0.93 × e4 ppcc vs. 2.95 × e4 ± 1.50 × e4 ppcc; p ≤ 0.001), and the mean frequency of in-commute offensive odour detection (2.1 vs. 2.8; p = 0.019), dust and soot observation (1.7 vs. 2.3; p = 0.038) and nasopharyngeal irritation (1.5 vs. 1.9; p = 0.007). There were no significant differences between LOW and HIGH in the commute distance and duration (12.8 ± 7.1 vs. 12.0 ± 6.9 km and 44 ± 17 vs. 42 ± 17 min, respectively), or other indices of acute airway inflammation.Conclusions: Exposure to PNC and offensive odour, and nasopharyngeal irritation, can be significantly lowered when utilising a route of lower proximity to motorised traffic whilst bicycle commuting, without significantly affecting commute distance or duration. This may bring health benefits for both healthy and susceptible individuals. [ABSTRACT FROM AUTHOR]

SUMMARY The effect of antisecretory treatment on extraesophageal symptoms of gastroesophageal reflux disease was evaluated. Seventy-eight children presenting with typical and extraesophageal symptoms of gastroesophageal reflux disease underwent a multichannel intraluminal impedance and pH monitoring (MII/pH). Children with a positive MII/pH were randomly treated with proton pump inhibitors (PPIs) or histamine H2-receptor antagonists (H2RAs) during 3 months. At the end of the treatment period, all patients were recalled. A second treatment period of 3 months was given to those patients who were not symptom-free after 3 months. Thirty-five of the forty-one (85.4%) children with a pathologic MII/pH presented with extraesophageal symptoms and were treated with PPIs (omeprazole; n:19) or H2RAs (ranitidine; n:16) for 12 weeks. After 3 months, 11/19 (57.9%) PPI-treated patients had a complete resolution of symptoms; 6/8 nonresponders were treated with PPI for another 3 months and became all symptom-free. The other two underwent a Nissen fundoplication. Only 5/16 (31.2 %) patients treated with H2RAs had a complete resolution of symptoms after 3 months; 1/11 was treated again with H2RAs during 3 months, and 10/11 were changed to PPIs. In 3/10, a partial resolution of symptoms was achieved, while in 7/10, a complete remission was obtained ( P < 0.05). Antisecretory reflux treatment improves extraesophageal reflux symptoms. The efficacy of PPIs is superior to that of H2RAs in these children. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and objective: A major type of smoking in Middle Eastern countries is water pipe (WP) smoking. In the present study, pulmonary function tests (PFT) and respiratory symptoms (RS) were compared in WP smokers and deep inspiration (S-DI) or normal inspiration (S-NI) cigarette smokers. Methods: Pulmonary function and RS were compared among WP smokers, deep or normal inspiration cigarette smokers, and non-smokers. Results: All PFT values in WP smokers and S-DI, but only some values in S-NI, were lower than those of non-smokers ( P < 0.05 to P < 0.001). In addition, all PFT values in WP smokers and S-DI were lower than the corresponding values in S-NI, except for forced expiratory volume in 1 s and maximal expiratory flow at 25% of forced vital capacity ( P < 0.05 to P < 0.001). The prevalence of RS, except for sputum production, was greater in all three groups of smokers than in non-smokers ( P < 0.05 to P < 0.001). However, the severity of most RS in WP smokers and S-DI, but only the severity of wheezing in S-NI, was greater than that in non-smokers ( P < 0.05 to P < 0.01). There were inverse correlations for PFT values and positive correlations for RS, with duration and total amount of smoking ( P < 0.05 to P < 0.001). Conclusions: The results from this study showed that there was a profound effect of WP smoking on PFT values and RS, which were similar to the effects of deep inspiration cigarette smoking. [ABSTRACT FROM AUTHOR]

Background/Aim: Respiratory symptoms and gastro-oesophageal reflux disease (GORD) are common within the general population. Although a number of epidemiological studies have addressed their relationship, none has investigated the confounding effects of body mass index (BMI) and obstructive sleep apnoea (OSA), both of which are associated with reflux. Methods: Men and women (2700) from the 2005-2007 cross-sectional Busselton health survey were included. Questionnaire data included demography, information on general health, asthma, cough, wheeze, dyspnoea and reflux symptoms (never, monthly or less often and weekly or more often). BMI, risk of OSA (Berlin questionnaire definition), spirometry and airway hyperresponsiveness (AHR) were recorded. The effects of BMI and OSA on the relationship between respiratory and reflux symptoms were examined using logistic regression models, expressed as adjusted odds ratios for risk of respiratory symptoms by reflux symptom category. Results: Fifty per cent had reflux symptoms (5-10% weekly or more often). Reflux symptoms had strong positive, dose-related associations with cough/phlegm, breathlessness, chest tightness and wheeze in the last 12 months ( P < 0.001), but were not related to diagnosed asthma or AHR. Twenty-three per cent were at high risk of OSA and 63% had a BMI of >25 (22% > 30). Increased weight or high risk of OSA did not affect the relationship between respiratory symptoms and reflux symptoms. Conclusion: The relationship between reflux and respiratory symptoms was independent of BMI, high risk of OSA or AHR. These findings suggest that reflux contributes directly to respiratory symptoms. [ABSTRACT FROM AUTHOR]

Objective: Our objective is to summarize the new findings concerning the respiratory subtype (RS) of panic disorder (PD) since its first description. Methods: Two searches were made in the Institute for Scientific Information Web of Science: with the keywords “panic disorder” and “respiratory symptoms,” and all articles that cited Briggs and colleagues’ 1993 article “Subtyping of Panic Disorder by Symptom Profile” (Br J Psychiatry 1993;163:201–9). Altogether, 133 articles were reviewed. Results: We describe and discuss RS epidemiology, genetics, psychopathology, demographic features, clinical features, correlations with the respiratory system, traumatic suffocation history, provocative tests, and nocturnal panic. Compared to patients with the nonrespiratory subtype (non-RS), the RS patients had higher familial history of PD, lower comorbidity with depression, longer duration of illness, lower neuroticism scores, and higher scores in severity scales, such as the Panic and Agoraphobia Scale, Panic-Agoraphobia Spectrum scale and the Clinical Global Impression scale. Tests to induce panic attacks, such as those with CO2, hyperventilation, and caffeine, produce panic attacks in a higher proportion of RS patients than non-RS patients. Differences in the subtypes’ improvement with the pharmacologic treatment were found. There are also some controversial findings regarding the RS, including the age of onset of PD, and alcohol and tobacco use in RS patients. Conclusions: Some characteristics, such as the increased sensitivity to CO2 and the higher familial history of PD, clearly distinguish the RS from the non-RS. Nevertheless, there are also controversial findings. More studies are needed to determine the validity of the RS subtype. [ABSTRACT FROM AUTHOR]

Gastroesophageal reflux disease (GERD) was diagnosed and fundoplication was performed, which relieved the symptoms. This paper explores the effect of fundoplication on GERD-related respiratory symptoms. From January 2007 to October 2008, 64 patients with respiratory symptoms related to GERD were consecutively enrolled for laparoscopic fundoplication. Of these, 60 patients had respiratory symptoms mainly combined with gastroesophageal reflux, while four had respiratory symptoms only. All patients had GERD confirmed, and medical treatment provided before surgery resulted in an insufficiently favorable effect or even producing further complications. All the patients were requested to fill a questionnaire form regarding the severity of symptoms and their medication so as to make an evaluation score for the follow-up. The outcome of respiratory symptoms after surgery was as follows: excellent in 23 cases (35.9%); good in 28 (43.8%); fair in 5 (7.8%); poor in 8 (12.5%). The mean respiratory symptom score decreased from 6.3±2.65 to 2.33±2.37. Laparoscopic fundoplication can be an effective treatment for the majority of patients with GERD-related respiratory symptoms. [ABSTRACT FROM AUTHOR]

The article focuses on the study regarding the relationship between lung function and ischemic stroke incidence among African Americans and Whites in the U.S. The study revealed that White patients with impaired lung function have a higher risk of ischemic stroke even if they had no respiratory symptoms and have never smoked. On the other hand, no significant relationship was found between lung function and ischemic stroke among African Americans.

Objectives: To examine asthma control in conjunction with medication use in asthma patients from general practice. To determine features of patients with inadequately controlled asthma.Methods: A cross-sectional study was performed among 661 adult asthma patients recruited from general practice. Disease control was defined by: (1) respiratory symptoms; (2) forced expiratory volume in 1 s (FEV1)% predicted; (3) PEF variability; and (4) the use of β2-agonists. Medical treatment was categorised according to the step-care therapy rules following the 1997 guideline of the Dutch College of General Practitioners (DDGP).Results: Of the 661 asthma patients studied, 262 (40%) had a good disease control, 84 (13%) a mildly reduced, 235 (36%) a moderately reduced, and 80 (12%) had a poor disease control. Of the 399 patients (60%) inadequately controlled, in 292 patients (44%) adequate control might be achieved by changing treatment, in 99 patients (15%) adequate control might not completely be achieved by changing treatment, and 8 (1%) were already maximally treated. Compared to patients with a good disease control, patients inadequately controlled were usually older, less educated, younger at onset of pulmonary complaints, and in addition had more severe dyspnea and poorer health-related quality of life (HRQoL).Conclusion: Using our criteria, a substantial proportion of asthma patients primarily treated in general practice is not adequately controlled. Assessing patients’ disease control together with the level of medical treatment may help to gain insight into the effectiveness of current disease management. [Copyright &y& Elsevier]

Disease risk among elderly smokers is considered to be doubled due to their smoking habits and age as compared with elderly non-smokers. The investigators conducted risk assessments of smoking for respiratory symptoms among elderly people. A questionnaire survey on smoking habits and respiratory symptoms was conducted among 3,000 persons of 56 years of age and over who were randomly selected from suburban residents in a prefecture in Japan in October, 1997. A total 1,954 or 65.1%, of individuals responded, consisting of 42.8% for men and 57.2% for women, with an average age of 73.6 years. In addition to descriptive analysis, multiple logistic regression analysis was conducted. The results are summarized as follows: Smokers accounted for 28.1% of men and 3.6% of women. Among all age-groups, the highest rate of smokers was observed in men of 56–69 years old (34.7%) which was lower than the national average rate for the 60–69 year-old group (56.1% of men and 14.5% of women in '97). The odds ratios and 95 percent confidence interval (95%CI) for “having phlegm every day” and “having phlegm for more than 4 days a week” among smokers were 2.06 (95%CI=1.41−3.01) and 2.77(95%CI=1.80−4.27). Significantly higher odds ratios among smokers were also observed for “wheezing” and “shortness of breath when hurrying”. Odds ratios for some respiratory symptoms including “having phlegm for more than 4 days per week” among inhalers were significantly high compared with non-smokers, whereas those among non-inhalers were not significantly different from 1.0. Odds ratios for symptoms of phlegm and wheezing were significantly higher (Odds ratio≥2.0) among heavy smokers (Brinkman Index [B.1] >900) compared to non-smokers, while odds ratios of the same symptoms were not different from 1.0 among light smokers (B. I. ≤500). [ABSTRACT FROM AUTHOR]

A 4-year cohort study was designed to assess the exposure-effect relationship of working in polyurethane foam (PF) manufacturing factories with exposure to toluene diisocyanate (TDI) and its effects on the respiratory system. This paper describes the results of the first cross-sectional observations. The study population included 90 male workers who had been working in PF factories for 0.5-25 years (mean 13.3 years) (PF workers) and 44 reference workers in the same factories. The mean exposure concentration of TDI calculated from 129 personal samples was 3.2 ppb. Peak exposure excursions above 20 ppb occurred in 16 of 129 samples. Pulmonary function and its change during the working day as assessed by examining the forced expiratory flow-volume curve, respiratory impedance, and airway resistance and specific airway conductance were not different in the PF workers from those in the reference workers. Chest X-radiographs did not show any noteworthy radiological changes. Prevalences of 'phlegm in winter,' 'nasal stuffiness or discharge in winter,' and 'irritation of eye and throat mucous membranes' were significantly higher in the PF workers. The findings indicate that TDI exposure at levels around 3 ppb may not adversely affect the pulmonary function over many years of exposure of those who are not hypersensitive to TDI. The causal chemicals inducing some respiratory and irritative symptoms could not be specifically identified since the PF workers were exposed not only to TDI but also to other irritative agents in the PF manufacturing processes. [ABSTRACT FROM AUTHOR]

Objective: To study the airway response and its mechanism to weldingfumes in six welders with respiratory symptoms. Methods: Methacholine and welding challenge tests were carried out. The concentration of welding fumes during the exposure test was measured. On two subjects who developed bronchoconstriciton to welding challenge, additional tests were carried out including prick, patch, and inhalation challenges with metal salt solutions. Results: Three subjects developed immediate bronchial reaction to exposure to welding fume; one to mild steeland stainless steel welding, another to mild steel and galvanised welding, and one only to galvanised welding. They all had a moderate topronounced degree of non-specific bronchial hyperresponsiveness. Theconcentration of fumes during welding tests, particularly to galvanised welding, was high. An inhalation challenge test with zinc chloride salt solution in two subjects who reacted to galvanised welding wasnegative. Prick and patch tests with zinc chloride were also negative. Conclusions: The airway response to welding in these subjects is non-specific and is due to irritation rather than to sensitisation. [ABSTRACT FROM AUTHOR]

Background: There are few reports about longitudinal changes in lung function in asthmatic patients. Patients with asthma had a greater loss of lung function than normal healthy adults. To date, there have been no studies about the longitudinal changes in lung function in patients with occupational asthma.Methods: 280 male patients with red cedar asthma (RCA) who were followed up for at least one year were the study group. The exposed controls consisted of 399 male sawmill workers. Forced expiratory volume in one second (FEV1) was measured with a Collins water spirometer. Changes in FEV1 over time (FEV1 slope) were calculated by a two point method for each subject. Atopy was considered to be present if the subjects showed at least one positive response to three allergens by skin prick test.Results: Multiple regression analysis was carried out to examine factors that might affect longitudinal decline in FEV1. Patients with RCA who were still exposed had a greater decline in FEV1 slope (-26 ml/y) than sawmill workers. Smokers also showed a greater rate of decline in FEV1 (-43 ml/y) than non-smokers.Conclusions: Patients with RCA who continued to be exposed had a greater rate of decline in FEV1 than sawmill workers. Early diagnosis of occupational asthma and removal of these patients from a specific sensitiser is important in the prevention of further deterioration of lung function and respiratory symptoms. [ABSTRACT FROM AUTHOR]

Objectives: To assess the relation between measured levels of exposure to soluble oil mists in a plant manufacturing ball bearings, and both respiratory symptoms and airway responsiveness in the workforce.Methods: 114 male workers exposed to oil mist and 55 unexposed male controls from nearby factories were studied. Soluble oil mist concentrations were measured with area samplers. Respiratory symptoms were assessed by questionnaire and measurement of airway responsiveness to methacholine with an abbreviated method. Subjects were labelled positive to methacholine airway challenge (MAC+) if forced expiratory volume in one second (FEV1) fell by > or = 20%. The linear dose-response slope was calculated as the percentage fall in FEV1 at the last dose divided by the total dose given.Results: Geometric mean concentrations of oil mists ranged from 0.65 mg/m3 (GSD 1.29) to 2.20 mg/m3 (GSD 1.55) based on 92 measurements obtained from 1979-93. The prevalence of chronic cough or phlegm, bouts of bronchitis, and dyspnoea was greater among exposed workers than among controls (odds ratio (OR) 4.64, P = 0.002 for chronic cough and phlegm). After adjustment for smoking and age, dyspnoea was significantly related to an index of cumulative exposure to oil mist (OR 1.44, P = 0.006/10 y.mg/m3). The proportion of MAC+ subjects was similar in the two groups. However, after adjustment for baseline FEV1 and age, the dose-response slope was significantly steeper among exposed workers than among controls (P = 0.01), a finding indicating airway hyperresponsiveness in the exposed workers. Furthermore, the dose-response slope was significantly related to baseline FEV1, age, and, after adjustment for FEV1, the index of cumulative exposure to oil (P = 0.004).Conclusion: Subjects with exposure to soluble oil mist in the metal industry are at risk of developing both respiratory symptoms and airway hyperresponsiveness. [ABSTRACT FROM AUTHOR]

Objectives: The pathogenic basis of respiratory disorders associated with isocyanates are still obscure. One reason for this is the lack of good estimates of human exposure. In this study exposure was estimated by measurement of isocyanate metabolites in biological samples.Methods: In a factory using isocyanate based polyurethane (PUR) glue, isocyanate concentrations in air were measured by liquid chromatography. Samples from 174 employees were analysed for metabolites of 4,4'-methylene diphenyl diisocyanate (MDI) in plasma (P-MDX) and urine (U-MDX). After hydrolysis, 4,4'-methylenedianiline was measured by gas chromatography-mass spectrometry (GC-MS). The employees were screened for work related respiratory symptoms and tested for specific immunoglobulin E (IgE) and IgG antibodies directed against isocyanate conjugated to human serum albumin.Results: The time weighted isocyanate concentrations in air were low (MDI < 0.2-7; hexamethylene diisocyanate (HDI) < 0.1-0.7; 2,6-toluene diisocyanate (TDI) < 0.1 microgram/m3). All subjects had detectable P-MDX and U-MDX. There were significant associations between the estimates of exposure to thermal degradation products of an MDI based glue and P-MDX (range < or = 0.10-5.5 micrograms/l); and U-MDX (< or = 0.04-5.0 micrograms/g creatinine); in cases of heavy exposure. P-MDX and U-MDX were associated with each other (r = 0.64; P = 0.0001), work related symptoms (P-MDX: P = 0.03; Mann-Whitney U test), and serum concentrations of MDI specific IgG antibodies (r = 0.26; P = 0.0007). Unexpectedly, high P-MDX and U-MDX concentrations were also encountered in workers cutting textile (P-MDX 2.4-4.5 micrograms/l; U-MDX 0.81-3.8 micrograms/g creatinine); the reason is still unknown. Equally unexpected, there were significant negative associations between P-MDX and liver function tests.Conclusions: The results clearly show the value of biomarkers for isocyanate exposure; in particular, P-MDX is useful. Further, these results show the risk connected with thermal degradation of PUR. [ABSTRACT FROM AUTHOR]

Objectives: The respiratory effects of exposure to welding fumes have been investigated in numerous studies; but results of these studies have not been consistent. The aim of the present study was to investigate the respiratory effects of welding exposure in a large group of manual are welders exposed primarily to mild steel welding processes in confined spaces without respiratory protection.Methods: Respiratory symptoms and spirometry were studied in 110 welders and 55 controls. The welders and controls were of similar average age and height; smoking habits of the groups were similar. Chest x ray films were taken to exclude people with radiological abnormalities that may influence pulmonary function tests. Welders were grouped according to smoking habits and duration of employment (< 20 years or > 20 years).Results: No gross radiological abnormalities were found. Respiratory symptoms and chronic bronchitis were more prevalent in welders (P < 0.05). Welders who were smokers showed a higher frequency of chronic bronchitis than controls who smoked (P < 0.05). No significant difference in the occurrence of chronic bronchitis was found between welders who smoked and welders who were non-smokers or exsmokers. Compared with the controls, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and maximum midexpiratory flow (MMEF) were significantly lower in welders (mean values of FVC for welders and controls were 86.06 (25.74) and 96.40 (13.03); and values for FEV1 were 87.54 (13.70) and 95.36 (12.40) respectively; P < 0.01). There was no significant difference in pulmonary function tests between welders who were non-smokers and controls who were non-smokers; whereas FVC, FEV1, PEF, and MMEF were significantly lower in welders who smoked than controls who smoked (P < 0.01). There were no significant differences in pulmonary function tests and occurrence of chronic bronchitis between welders with more or less than 20 years at work.Conclusion: Welders working in conditions of inadequate ventilation, have increased risk of chronic bronchitis and impairment of pulmonary function. [ABSTRACT FROM AUTHOR]

Respiratory symptoms and ventilatory capacity were studied in a group of 288 workers (259 women and 29 men) employed in a confectionery plant. A group of workers (96 women and 31 men) not exposed to confectionery manufacture were also studied as controls. The prevalence of chronic respiratory symptoms was higher in exposed than in control workers, being greatest for confectionery workers exposed to the dust of flour, talc, and starch and the vapours of alcohol. Chronic bronchitis was reported by 7% of the women and 21% of the men, and chest tightness was reported by 27% of women and 66% of men. There was a high prevalence of acute irritative symptoms during the workshift in all groups of confectionery workers, especially for cough, dyspnoea, burning and dryness of the throat, and eye irritation. For all groups of confectionery workers there were statistically significant across shift reductions in ventilatory capacity, being most pronounced for maximum flow rate at 50% of the control vital capacity (FEF50; range 4.6-13.0%) and at 25% of the control vital capacity (FEF25; range 4.7-22.3%). Preshift values of FEF50 and FEF25 were significantly lower than predicted values. The data suggest that some workers employed in confectionery plants may develop acute and chronic respiratory symptoms associated with changes in lung function. [ABSTRACT FROM AUTHOR]

Objective: The survey aimed at studying the associations between prevalent respiratory symptoms in an occupational population and sickness absence due to respiratory disorders.Methods: A cross sectional survey among male workers in an animal feed mill was conducted. A total of 303 production workers and 102 office clerks completed a questionnaire on respiratory complaints, smoking habits, and occupational history. The questionnaire was used to identify workers with respiratory symptoms in the past 12 months. During this period all spells of sickness absence were recorded. Causes of sickness were classified in broad categories encompassing respiratory symptoms, influenza, musculoskeletal disorders, and others.Results: Logistic regression analysis showed that workers with respiratory complaints experienced a higher sickness absence than those without respiratory complaints. Adjusted for age and smoking the odds ratio (OR) for sickness prevalence was 1.9 among office clerks and 2.6 among blue collar workers. Smoking increased the risk on sickness absence with ORs of 2.4 and 1.6, respectively. When restricting the analysis to sickness due to respiratory complaints, subjects with respiratory complaints had significantly higher risks for absence prevalence and absence rate than those without respiratory complaints. There were no differences in sickness absence between workers with asthma like complaints and those with chronic bronchitis like complaints.Conclusion: The clear associations between respiratory complaints and prevalence and rate of respiratory sickness absence indicate that workers with respiratory complaints are at risk of temporary disability and, thus, may experience a reduced ability to cope with routine activities at work. [ABSTRACT FROM AUTHOR]

After identification of a case of extrinsic allergic alveolitis due to exposure to wood dust at a sawmill, all employees at the sawmill where he worked were studied with an occupational, environmental, and symptom questionnaire, spirometry, skin prick tests, and serum specific IgG measurements. Ninety five of current and 14 of 17 ex-sawmill workers were studied. As a basis for comparison, a group of 58 workers from a nearby light engineering factory were also studied. Few women (6) were employed and they were excluded from the analysis. Workers at the sawmill were stratified into high and low exposure groups depending on their place of work. This division was supported both by their subjective assessment of the dustiness of their environment and the results of personal dust samples. There were no significant differences between the three groups in age, height, smoking habits, exposure to other causes of extrinsic allergic alveolitis, forced expiratory volume in one second, forced vital capacity, atopic state, or cutaneous reactivity to moulds. In the high exposure group the prevalence of work related cough and nasal and eye symptoms was higher than in the low exposure and comparison groups. The prevalence of work related wheeze was similar in both the high exposure and comparison groups, but was lower in the low exposure group. The prevalences of chronic bronchitis and symptomatic bronchial hyper-reactivity were similar in the high and low exposure groups but were lower in the comparison group. Serum concentrations of specific IgG against extracts of sawdust and Trichoderma koningii were significantly higher in the high exposure group than in the other two groups. The prevalence of symptoms suggestive of extrinsic allergic alveolitis was 4.4% in the high exposure group, greater than in the low exposure group (0%), and the comparison group (1.9%). In conclusion extrinsic allergic alveolitis probably occurs in British sawmills, and among the exposed population its prevalence may be as high as that reported in Sweden. The allergen responsible is likely to be from mould growing on the wood and may be from Trichoderma koningii. [ABSTRACT FROM AUTHOR]

As part of a 1992 survey of both environmental and occupational determinants of health, 973 non-smoking women aged 20-40 years who were employed in three comparable modern Chinese cotton textile mills were given a questionnaire that included questions on standard respiratory history and symptoms. All women had some potential exposure to cotton dust; mean employment was 8.7 years. Comparisons were made between those with lowest or no current exposure (job classification in administration, quality control, and testing, n = 112) and those in the more heavily exposed classifications (yarn production areas, n = 861). Association of symptoms with job was tested by logistic regression, adjusting for age, passive smoking at home, and the use of home coal burning stoves. Odds ratios for prevalence of current frequent symptoms in those working in production jobs, after adjustment for home exposure to passive tobacco smoke and coal heating, were frequent cough 2.23 (95% confidence interval (95% CI) 1.05-4.75), frequent phlegm 3.24 (1.54-6.84), shortness of breath 4.54 (1.40-14.72), and wheeze 2.96 (1.16-7.55). Nine cases with grade I byssinosis (chest tightness or shortness of breath on return to work after two days off) were found; all were in production jobs. In these non-smoking women textile workers, chronic respiratory symptoms were associated with job category after correction for domestic indoor air quality. These data support evidence for an increased prevalence of respiratory disease in populations exposed to cotton dust. [ABSTRACT FROM AUTHOR]

Covid-19 is a novel virus with high affinity to spread in the community. In December 2019, it was first identified in Wuhan, China. The symptoms are non-specific, so fever, cough, dyspnea, are prominent features. Respiratory failure and mortality have also been reported. The most common lung CT scan findings are bilateral ground glass opacities. [ABSTRACT FROM AUTHOR]

Factors, including air pollution, influencing the prevalence of respiratory symptoms were investigated in a cross-sectional study in policemen and their wives (530 couples) in Bangkok. Information on respiratory symptoms was obtained using the American Thoracic Society Division of Lung Diseases (ATS-DLD) questionnaire. Effects of working and residential locations were evaluated using a multiple logistic model adjusted for several potential confounding factors. In the policemen the increased risk of frequent cough or phlegm was related to smoking (OR=2.19, 95% Cl: 1.47-3.26) and working in heavy traffic locations (OR=1.27, Cl: 1.01-1.61), whereas in their wives it was related to their residential locations (OR=1.53, Cl: 1.10-2.13). [ABSTRACT FROM AUTHOR]

This paper reports on the prevalence of respiratory symptoms, skin disorders, status of spirometric lung functions, and amino acid profiles among sewage workers. The data showed that sewage workers had a higher prevalence of respiratory symptoms than manual workers, being significantly greater for chronic cough (p<0.02), chronic phlegm (p<0.03), chronic bronchitis (p<0.02), asthma (p<0.02), dyspnea (p<0.001), and nasal catarrh (p<0.001). Also a higher prevalence of all acute symptoms of pruritus (p<0.003), tinea (p<0.004), dermatitis (p<0.001), and nose irritation (p<0.005) was recorded among sewage workers than in manual workers (non-sewage workers). Furthermore, all forced spirometric tests in the exposed sewage workers tended to be lower than inmanual workers. Finally, the results revealed that the most plasma amino acid concentrations were higher among sewage workers than those among manual workers. All essential amino acids except two (valine and arginine) were significantly higher among the sewage workers than those among the manual workers. The present study suggests that a highprevalence of respiratory symptoms is associated with an exposure tosewage as a working place. [ABSTRACT FROM AUTHOR]