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6. Asthma inflammatory phenotypes on four continents: most asthma is non-eosinophilic

Author

Pembrey, L, Brooks, C, Mpairwe, H, Figueiredo, CA, Oviedo, AY, Chico, M, Ali, H, Nambuya, I, Tumwesige, P, Robertson, S, Rutter, CE, van Veldhoven, K, Ring, S, Barreto, ML, Cooper, PJ, Henderson, J, Cruz, AA, Douwes, J, Pearce, N, and WASP Study Group

Abstract

BACKGROUND: Most studies assessing pathophysiological heterogeneity in asthma have been conducted in high-income countries (HICs), with little known about the prevalence and characteristics of different asthma inflammatory phenotypes in low-and middle-income countries (LMICs). This study assessed sputum inflammatory phenotypes in five centres, in Brazil, Ecuador, Uganda, New Zealand (NZ) and the United Kingdom (UK). METHODS: We conducted a cross-sectional study of 998 asthmatics and 356 non-asthmatics in 2016-20. All centres studied children and adolescents (age range 8-20 years), except the UK centre which involved 26-27 year-olds. Information was collected using questionnaires, clinical characterization, blood and induced sputum. RESULTS: Of 623 asthmatics with sputum results, 39% (243) were classified as eosinophilic or mixed granulocytic, i.e. eosinophilic asthma (EA). Adjusted for age and sex, with NZ as baseline, the UK showed similar odds of EA (odds ratio 1.04, 95% confidence interval 0.37-2.94) with lower odds in the LMICs: Brazil (0.73, 0.42-1.27), Ecuador (0.40, 0.24-0.66) and Uganda (0.62, 0.37-1.04). Despite the low prevalence of neutrophilic asthma in most centres, sputum neutrophilia was increased in asthmatics and non-asthmatics in Uganda. CONCLUSIONS: This is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in HICs and LMICs. Most cases were non-eosinophilic, including in settings where corticosteroid use was low. A lower prevalence of EA was observed in the LMICs than in the HICs. This has major implications for asthma prevention and management, and suggests that novel prevention strategies and therapies specifically targeting non-eosinophilic asthma are required globally.

Published
2022

7. Occupational exposures to pesticides and other chemicals: a New Zealand motor neuron disease case-control study

Author

Chen, Grace Xia, Douwes, J, van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J, 't Mannetje, Andrea Martine, Chen, Grace Xia, Douwes, J, van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J, and 't Mannetje, Andrea Martine

Abstract

Objectives: To assess associations between occupational exposures to pesticides and other chemicals and motor neuron disease (MND). Methods: A population-based case-control study that included 319 MND cases (64% male/36% female) recruited through the New Zealand MND Association complemented with hospital discharge data, and 604 controls identified from the Electoral Roll. For each job held, a questionnaire collected information on 11 exposure categories (dust, fibres, tobacco smoke, fumes, gas, fumigants, oils/solvents, acids/alkalis, pesticides, other chemicals and animals/animal products). ORs were estimated using logistic regression adjusting for age, sex, ethnicity, socioeconomic status, education, smoking, alcohol consumption, physical activities, head/spine injury and other occupational exposures. Results: Two exposure categories were associated with increased MND risks: pesticides (OR 1.70, 95% CI 1.17 to 2.48) and fumigants (OR 3.98, 95% CI 1.81 to 8.76), with risks increasing with longer exposure duration (p<0.01). Associations were also observed for: methyl bromide (OR 5.28, 95% CI 1.63 to 17.15), organochlorine insecticides (OR 3.28, 95% CI 1.18 to 9.07), organophosphate insecticides (OR 3.11, 95% CI 1.40 to 6.94), pyrethroid insecticides (OR 6.38, 95% CI 1.13 to 35.96), inorganic (copper) fungicides (OR 4.66, 95% CI 1.53 to 14.19), petrol/diesel fuel (OR 2.24, 95% CI 1.27 to 3.93) and unspecified solvents (OR 1.91, 95% CI 1.22 to 2.99). In women, exposure to textile fibres (OR 2.49, 95% CI 1.13 to 5.50), disinfectants (OR 9.66, 95% CI 1.29 to 72.44) and cleaning products (OR 3.53, 95% CI 1.64 to 7.59) were also associated with MND; this was not observed in men (OR 0.80, 95% CI 0.44 to 1.48; OR 0.72, 95% CI 0.29 to 1.84; OR 0.57, 95% CI 0.21 to 1.56, respectively). Conclusions: This study adds to the evidence that pesticides, especially insecticides, fungicides, and fumigants, are risk factors for MND.

Published
2022

8. Occupational exposures to pesticides and other chemicals: a New Zealand motor neuron disease case-control study

Author

IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Chen, Grace Xia, Douwes, J, van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J, 't Mannetje, Andrea Martine, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Chen, Grace Xia, Douwes, J, van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J, and 't Mannetje, Andrea Martine

Published
2022

9. Geographic Disparities in Stroke Outcomes and Service Access: A Prospective Observational Study.

Author

Thompson, SG, Barber, PA, Gommans, JH, Cadilhac, DA, Davis, A, Fink, JN, Harwood, M, Levack, W, McNaughton, HK, Feigin, VL, Abernethy, V, Girvan, J, Kim, J, Denison, H, Corbin, M, Wilson, A, Douwes, J, Ranta, A, Thompson, SG, Barber, PA, Gommans, JH, Cadilhac, DA, Davis, A, Fink, JN, Harwood, M, Levack, W, McNaughton, HK, Feigin, VL, Abernethy, V, Girvan, J, Kim, J, Denison, H, Corbin, M, Wilson, A, Douwes, J, and Ranta, A

Abstract

BACKGROUND AND OBJECTIVES: International evidence shows that patients treated at nonurban hospitals experience poorer access to key stroke interventions. Evidence for whether this results in poorer outcomes is conflicting and generally based on administrative or voluntary registry data. The aim of this study was to use prospective high-quality comprehensive nationwide patient-level data to investigate the association between hospital geography and outcomes of patients with stroke and access to best-practice stroke care in New Zealand. METHODS: This is a prospective, multicenter, nationally representative observational study involving all 28 New Zealand acute stroke hospitals (18 nonurban) and affiliated rehabilitation and community services. Consecutive adults admitted to the hospital with acute stroke between May 1 and October 31, 2018, were captured. Outcomes included functional outcome (modified Rankin Scale [mRS] score shift analysis), functional independence (mRS score 0-2), quality of life (EuroQol 5-dimension, 3-level health-related quality of life questionnaire), stroke/vascular events, and death at 3, 6, and 12 months and proportion accessing thrombolysis, thrombectomy, stroke units, key investigations, secondary prevention, and inpatient/community rehabilitation. Results were adjusted for age, sex, ethnicity, stroke severity/type, comorbid conditions, baseline function, and differences in baseline characteristics. RESULTS: Overall, 2,379 patients were eligible (mean [SD] age 75 [13.7] years; 51.2% male; 1,430 urban, 949 nonurban). Patients treated at nonurban hospitals were more likely to score in a higher mRS score category (greater disability) at 3 (adjusted odds ratio [aOR] 1.28, 95% CI 1.07-1.53), 6 (aOR 1.33, 95% CI 1.07-1.65), and 12 (aOR 1.31, 95% CI 1.06-1.62) months and were more likely to have died (aOR 1.57, 95% CI 1.17-2.12) or experienced recurrent stroke and vascular events at 12 months (aOR 1.94, 95% CI 1.14-3.29 and aOR 1.65, 95% CI 1.09-2.

Published
2022

10. Occupational exposures to pesticides and other chemicals: a New Zealand motor neuron disease case-control study

Author

MS CGO, Neurologen, Projectafdeling ALS, Brain, Regenerative Medicine and Stem Cells, Chen, Grace Xia, Douwes, J, van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J, 't Mannetje, Andrea Martine, MS CGO, Neurologen, Projectafdeling ALS, Brain, Regenerative Medicine and Stem Cells, Chen, Grace Xia, Douwes, J, van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J, and 't Mannetje, Andrea Martine

Published
2022

15. Costs and quality adjusted life years at 12 months after stroke by urban and non-urban areas: Regions care economic evaluation.

Author

Kim J., Cadilhac D., Thompson S., Gommans J., Davis A., Barber A., Fink J., Harwood M., Levack W., Mcnaughton H., Abernethy G., Girvan J., Feigin V., Denison H., Corbin M., Wilson A., Douwes J., Ranta A., Kim J., Cadilhac D., Thompson S., Gommans J., Davis A., Barber A., Fink J., Harwood M., Levack W., Mcnaughton H., Abernethy G., Girvan J., Feigin V., Denison H., Corbin M., Wilson A., Douwes J., and Ranta A.

Abstract

Background and Aims: Initiatives at non-urban hospitals in New Zealand have improved access to reperfusion therapies for patients with stroke.We aimed to investigate if any additional costs are offset by improved outcomes and costs savings after discharge. Method(s): REGIONS Care involved consecutive patients admitted with stroke to all 28 acute stroke hospitals in New Zealand (12 urban) between May and October 2018. Costs from a societal perspective at 12 months after stroke were estimated using standardised data collected on the hospital stay and a follow-up survey. Estimated costs were assigned to the initial hospital patients presented to. Quality adjusted life years (QALYs) were estimated using outcomes at discharge from hospital, vital status and responses to the EuroQol-5D questionnaire at 12 months follow-up. Multiple imputation and multivariable regression analyses were used to assess differences between groups. Result(s): There were 946 patients from non-urban and 1419 from urban hospitals. Costs of acute care for patients presenting to urban hospitals were $1786 greater on average than those presenting to nonurban hospitals (p<0.001). Estimated costs until 12 months were no different between groups (urban $26137 vs non-urban $25067, p=0.396). The average QALYs per person was greater in the urban cohort than the non-urban cohort (0.58 vs 0.53, p=0.001). Conclusion(s): Despite greater costs of acute care, patients who presented to urban hospitals had similar costs at 12 months compared to non-urban counterparts. Further research is required to investigate if additional funding to non-urban hospitals can reduce downstream costs and improve outcomes.

Published
2021

16. Poster presentations

Author

Olds, T., Blunden, S., Petkov, J., Forchino, F., Teng, A., Bartle, A., Sadeh, A., Mindell, J., Thompson, K., Richdale, A., Schreck, K., Gibson, R., Gander, P., Elder, D., Levendowski, D., Rosen, C., Berka, C., Zavora, T., Olmstead, R., Popovic, D., Westbrook, P., Piteo, A., Roberts, R., Nettelbeck, T., Lushington, K., Van Den Heuvel, C., Kohler, M., Martin, J., Kennedy, D., Jackman, A., Davey, M., Nixon, G., Hope, S., Catroppa, C., O’Driscoll, D., Anderson, V., Trinder, J., Horne, R., Milte, C., Sinn, N., Quach, J., Hiscock, H., Wake, M., Fulton, M., Sciberras, E., Efron, D., Oberklaid, F., Jay, S., Eng, A., ’t Mannetje, A., Cheng, S., Douwes, J., Ellison-Loschmann, L., Mclean, D., Pearce, N., Zhou, X., Sargent, C., Darwent, D., Ferguson, S., Paech, G., Mattews, R., Williams, L., Roach, G., Martin, D., Lastella, A., Matthews, R., Wilsmore, N., Galante, R., Lee, J., Barnes, M., Kennedy, G., Howard, M., Smith, S., Doye, G., Mangie, J., Signal, L., Phipps-Nelson, J., Redman, J., Rajaratnam, S., Lamond, N., Dorrian, J., Whitwell, B., Rogers, N., Sutherland, K., Chan, A. S. L., Deane, S. A., Zeng, B., Lee, R. W. W., Darendeliler, M. A., Cistulli, P. A., Spong, J., Brown, D., Berlowitz, D., Keihani, S. M., Hillman, D., Collins, A., Jackson, M., Pierce, R., O’Donoghue, F., Bignold, J., Mercer, J., Gorman, M., Mcevoy, D., Antic, N., Catcheside, P., Verma, M., Wheatley, J., Amis, T., Marshall, N., Grunstein, R., Peltonen, M., Carlson, L., Hedner, J., Stenlof, K., Sjostrom, L., Williams, S., Kennerson, M., Liu, P., Little, C., Watson, A., Dunn, N., Beevers, A., Douglas, J., Ruehland, W., Singh, P., Thornton, A., Copland, J., Rochford, P., Perri, R., Ward, K., Palmer, L., Mukherjee, S., Cooper, M., Love, G., Fedson, A., Simpson, L., Edwards, C., Szegner, B., Wong, K., Cistulli, P., Marks, G., Zwar, N., Norman, M., Middleton, S., Sullivan, C., Terrill, P., Mason, D., Parsley, C., Dakin, C., Wilson, S., Khandoker, A., Palaniswami, M., Karunajeewa, A., Abeyratne, U., Hukins, C., Lee, S., Borodzicz, J., Amatoury, J., Robinson, T., Ip, T., Mackenzie, J., Scott, E., Hickie, I., Lovato, N., Lack, L., Wright, H., Muller, D., van Den Berg, M., van Dongen, H. P. A., Miller, B., Orr, R., O’Connor, H., Chow, C. M., Litchfield, C., Glozier, N., Ogeil, R., Broadbear, J., Bakar, R. A., Denotti, A., Rae, C., Bartlett, D. J., Wong, K. K. H., Yang, Q., Walton, D., Sachinwalla, T., Grunstein, R. R., Dang, D., Cunnington, D., Swieca, J., Chen, Y., Young, A., Jakobson, A., Fitzgerald, P., Conduit, R., Smith, D., Jorgensen, G., Lee, H. L., Simpson, G., Ferns, J., Shepherd, K., James, A., Musk, A., Hunter, M., Eastwood, P., Duce, B., Al-Abri, M., Al-Hashmi, K., Jaju, D., Al-Rawas, O., Hassan, M., Ngan, A., Marshall, M. J., Dawson, A. D. G., Bucks, R. S., Walker, A., Hensley, R., Machaalani, R., Waters, K., Harrison, H., Tai, A., Raju, S., Williamson, B., Richardson, H. L., Walker, A. M., Horne, R. S. C., Yuill, M., Harris, M. A., Griffiths, A., Trang, L., Paramalingam, N., Davis, E., Jones, T., Stick, S., Wilson, A., Suresh, S., Cooper, D., Walsh, J., Maddison, K., Hoegh, T., Daulatzai, M., Karmakar, C., Khan, N., Bei, B., Nicholas, C., Worsnop, C., Jordan, A., Saboisky, J., White, D., Malhotra, A., Stadler, D., Mcevoy, R. D., Paul, D., Bradley, J., Maclean, J., Fitzgerald, D., Witcombe, N., Yiallourou, S., Sands, S., Ratnavadivel, R., George, K., Ryan, M., Thompson, C., Catcheside, P. G., Harmer, L., Deacon, N., Wang, D., Piper, A., Yee, B., Mihai, R., Davey, M. J., Nixon, G. M., Tyler, L., Vidal, A., Lambert, S., Tolson, J., Henderson, M., Maree, B., Campbell, A., Neill, A., Heraganahally, S., Bowden, J., Carney, S., Robinson, S., Sajkov, D., Bakker, J., Rixon, K., Hanssen, K., Chia, C., Sather, T., Keir, G., Chikazaza, M., Shirlaw, T., Jones, D., West, J., Dooney, N., Teo, M. Y., Falland, K., Phung, S., Cullen, S., Kevin, G., Mcardle, N., Joosten, S., Turton, A., Hamilton, G., Lavercombe, M., Hocking, V., Clarence, M., Thien, F., Senin, S. R., Ong, T. H., Ong, G., Roebuck, T., Ho, S., Langan-Fox, J., Davis, S., Van, E., Paul, E., Naughton, M., Iqbal, S. M., Gray, P., Urquhart, D., Williams, G., Verginis, N., Boynton, A., Gradinger, F., Partinen, M., Stucki, G., Cooper, P., Biggs, S., Dollman, J., Sweeney, B., Jones, L., Milgrom, J., Ericksen, J., Parry, B., Meliska, C., Sorenson, D., Lopez, A., Martinez, F., Nowakowski, S., Hauger, R., Elliott, J., Kripke, D., Duncan, S., Larsson, E., Fuller, J., Krass, I., Saini, B., and Junge, M.

Published
2009
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17. Poster Presentations

Author

Maclean, J., Fitzgerald, D., Fitzsimons, D., Hayward, P., Waters, K., Chu, J., Richdale, A., Elder, D., Campbell, A., Larsen, P., Galletly, D., Cranage, S., Walter, L., Foster, A., Patterson, R., Nixon, G., Davey, M., Anderson, V., Trinder, J., Walker, A., Horne, R., Tan, S., Seton, C., Sandford, D., Dorrian, J., Blunden, S., Kohler, M., Thormaehlen, S., Kennedy, D., van den Heuvel, C., Lushington, K., Martin, J., Yorkston, S., Southwell, K., O’Driscoll, D., Gillman, A., Roebuck, T., van Braak, E., Naughton, M., Blake, J., Smith, S., Douglas, J., Sellers, R., Lee, R., Petocz, P., Prvan, T., Chan, A., Grunstein, R., Cistulli, P., Hiramatsu, R., Kasai, T., Maeno, K.-I., Tomo, Y., Kato, M., Kawana, F., Narui, K., Copland, J., Ho, M., Duggan, T., Harris, K., Vakulin, A., Antic, N., Catcheside, P., Mcevoy, D., Litchfield, C., Baulk, S., Neill, A., Wu, P., Amis, T., Lee, S., Verma, M., Wheatley, J., Sands, S., Edwards, B., Berger, P., Wilkinson, M., Wilkinson, V., Malhotra, A., Nicholas, C., Worsnop, C., Jordan, A., Butler, J., Saboisky, J., Gandevia, S., White, D., Ratnavadivel, R., Stadler, D., Windler, S., Bradley, J., Paul, D., Maddison, K., Walsh, J., Mclaughlin, R., Becker, S., Armstrong, J., Sampson, D., Hillman, D., Eastwood, P., Piper, A., Hollier, C., Flunt, D., Mendadue, C., Fiene, A., Robinson, P., Jorgensen, G., Sather, T., Hukins, C., Jackson, M., Radford, L., Kennedy, G., Swann, P., Pierce, R., Howard, M., Jay, S., Thomas, M., Weissenfeld, A., Dawson, D., Ferguson, S., Sletten, T., Revell, V., Middleton, B., Lederle, K., Skene, D., Segal, A., Redman, J., Lockley, S., Rajaratnam, S., Lovato, N., Lack, L., Wright, H., Bambrick, C., Swann, C., Yelland, G., Roach, G., Darwent, D., O’Keeffe, K., Gander, P., Scott, G., Scott, H., Coussens, S., Baumert, M., Pamula, Y., Saint, D., Terrill, P., Wilson, S., Dakin, C., Suresh, S., Cooper, D., Michell, B., Salvini, A., Gulliver, T., Longley, J., Heussler, H., Parsley, C., Wawruszak, M., Verginis, N., Yang, J., Gyulay, S., Pretto, J., Hensley, M., Marshall, N., Wong, K., Phillips, C., Liu, P., Knuiman, M., Liaw, H. S., Veale, A., Homan, S., Wilson, D., Ellett, L., Crowe, S., Barnes, M., Spong, J., Riley, D., Brown, D., Berlowitz, D., Lee, J., Fedson, A., Simpson, L., Ward, K., Love, G., Cooper, M., Singh, B., Palmer, L., Mukherjee, S., Grant, K., Robillard, R., Boissonneault, M., Martin, N., Filipini, D., Prince, F., Carrier, J., Sukovic, A., Sweeney, B., Signal, L., Ellison-Loschmann, L., Shekleton, J., Parcell, D., Phipps-Nelson, J. O., Ponsford, J., Ho, S., Conduit, R., Stuart, K., Bei, B., Milgrom, J., Ericksen, J., Bakker, J., Turton, A., Kumagai, T., Kasagi, S., Ishiwata, S., Burgess, K., Havryk, A., Whitelaw, W. A., Mikel, M., Newing, G., Newton, S., Rixon, K., Cheney, L., Chikazaza, M., Clarke, P., Duce, B., Hanssen, K., Milosavljevic, J., Popovich, J., Saarinen, K., Shirlaw, T., Khandoker, A., Gubbi, J., Karmakar, C., Palaniswami, M., Keir, G., Rochford, P., Ruehland, W., Thornton, A., Potts, A., Warman, G., Anderson, B., Wanklyn, C., Biggs, S., Blecher, G., Evans, C., Wilson, A., Nadasan, M., Nguyen, K., Dollman, J., Herbert, A., Delima, J., Collins, J., Tang, J., Goh, A., Teoh, O. H., Chay, O. M., Tan, C. H., Gibson, R., Cheng, S., Brogan, S.-B., Duckett, H., Douwes, J., Kabir, M., Dimitri, H., Sanders, P., Abbott, D., Roy, A., Antic, R., Young, T., Anson, M., Bergman, N., O’Donoghue, F., Teuwen, P., Morrison, S., Allen, R., Silburn, P., Mcwhae, S., Rose, A., Harmer, L., Yeo, A., Jurisevic, M., Mercer, J., Muller, D., van den Berg, M., Garden, A., Cvetkovic, D., Cosic, I., Zhou, X., Matthews, R., Croucher, N., Weng, T., Williams, L., Sargent, C., Halson, S., Tokley, M., Ball, M., Bruck, D., Sutherland, K., Schwab, R., Zeng, B., Darendeliler, M. A., Rowland, S., Hennessy, C., Tang, T., Song, P., Rahim, S. A., Ong, T. H., Noakes, M., Southcott, A. M., Smith, B., Woods, M., Mclean, N., Godde, K., Kirkness, J., and Daulatzai, M.

Published
2008
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18. Occupational exposures to pesticides and other chemicals: a New Zealand motor neuron disease case-control study.

Author

Xia Chen, Grace, Douwes, J., van den Berg, Leonard, Pearce, Neil, Kromhout, Hans, Glass, Bill, McLean, David J., Mannetje, Andrea Martine't, Chen, Grace Xia, and 't Mannetje, Andrea Martine

Abstract

Objectives: To assess associations between occupational exposures to pesticides and other chemicals and motor neuron disease (MND).Methods: A population-based case-control study that included 319 MND cases (64% male/36% female) recruited through the New Zealand MND Association complemented with hospital discharge data, and 604 controls identified from the Electoral Roll. For each job held, a questionnaire collected information on 11 exposure categories (dust, fibres, tobacco smoke, fumes, gas, fumigants, oils/solvents, acids/alkalis, pesticides, other chemicals and animals/animal products). ORs were estimated using logistic regression adjusting for age, sex, ethnicity, socioeconomic status, education, smoking, alcohol consumption, physical activities, head/spine injury and other occupational exposures.Results: Two exposure categories were associated with increased MND risks: pesticides (OR 1.70, 95% CI 1.17 to 2.48) and fumigants (OR 3.98, 95% CI 1.81 to 8.76), with risks increasing with longer exposure duration (p<0.01). Associations were also observed for: methyl bromide (OR 5.28, 95% CI 1.63 to 17.15), organochlorine insecticides (OR 3.28, 95% CI 1.18 to 9.07), organophosphate insecticides (OR 3.11, 95% CI 1.40 to 6.94), pyrethroid insecticides (OR 6.38, 95% CI 1.13 to 35.96), inorganic (copper) fungicides (OR 4.66, 95% CI 1.53 to 14.19), petrol/diesel fuel (OR 2.24, 95% CI 1.27 to 3.93) and unspecified solvents (OR 1.91, 95% CI 1.22 to 2.99). In women, exposure to textile fibres (OR 2.49, 95% CI 1.13 to 5.50), disinfectants (OR 9.66, 95% CI 1.29 to 72.44) and cleaning products (OR 3.53, 95% CI 1.64 to 7.59) were also associated with MND; this was not observed in men (OR 0.80, 95% CI 0.44 to 1.48; OR 0.72, 95% CI 0.29 to 1.84; OR 0.57, 95% CI 0.21 to 1.56, respectively).Conclusions: This study adds to the evidence that pesticides, especially insecticides, fungicides, and fumigants, are risk factors for MND. [ABSTRACT FROM AUTHOR]

Published
2022
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20. Household dampness and microbial exposure related to allergy and respiratory health in Danish adults

Author

Holst, G. Juel, Porneki, Ad, Lindgreen, J., Thuesen, B., Bonlokke, J., Hyvarinen, A., Elholm, G., Ostergaard, K., Loft, S., Brooks, C., Douwes, J., Linneberg, A., Sigsgaard, T., Holst, G. Juel, Porneki, Ad, Lindgreen, J., Thuesen, B., Bonlokke, J., Hyvarinen, A., Elholm, G., Ostergaard, K., Loft, S., Brooks, C., Douwes, J., Linneberg, A., and Sigsgaard, T.

Abstract

Background Indoor dampness has consistently been associated with respiratory symptoms and exacerbations. The causal mechanisms may involve increased microbial exposures. However, the evidence regarding the influence of indoor microbial exposures under damp- and non-damp conditions on the risk of asthma and allergy has been inconclusive. Objective The aim of this study was to investigate the association between dampness and microbial exposure with allergy and respiratory health in Danish adults using a cross-sectional design. Methods From 1,866 participants of the Health2006 cohort, we selected three non-overlapping groups: 196 at random, 107 with confirmed atopy, and 99 without atopy. Bedroom dust was sampled using electrostatic dust fall collectors and analysed for endotoxin, β-(1,3)-D-glucan, 19 microbial species or groups, and total fungal load. Household moisture-related problems and asthma were self-reported by questionnaire. Atopy was determined by skin-prick-testing and lung function was measured by spirometry. Results Household moisture damage was positively associated with asthma outcomes, although this was statistically significant only in atopics for self-reported asthma (odds ratio (OR) 3.52; 95%CI 1.01–12.7). Mould odor was positively associated with wheezing (OR 6.05; 95%CI 1.19–30.7) in atopics. Inconsistent associations were found for individual microbial exposures and health outcomes. Inverse associations were observed between microbial diversity and rhinitis in the random sample and both doctor-diagnosed and self-reported asthma in non-atopics. Conclusions In conclusion, our findings suggest that household moisture damage may increase the risk of asthma and wheeze with mould odor in atopics. In addition, asthma and allergy may be affected by the indoor microbial composition in urban domestic environments. Further studies are needed to identify and understand the causal agents and underlying me

Published
2020

21. Measuring stroke and transient ischemic attack burden in New Zealand: Protocol for the fifth Auckland Regional Community Stroke Study (ARCOS V)

Author

Feigin, VL, Krishnamurthi, R, Barker-Collo, S, Barber, PA, Rathnasabapathy, Y, Te Ao, B, Parmar, P, Mahon, S, Tunnage, B, Swain, A, Arroll, B, Elder, H, Tautolo, ES, Parag, V, Anderson, C, Bennett, D, Thrift, AG, Cadilhac, DA, Brown, P, Ranta, A, Douwes, J, Feigin, VL, Krishnamurthi, R, Barker-Collo, S, Barber, PA, Rathnasabapathy, Y, Te Ao, B, Parmar, P, Mahon, S, Tunnage, B, Swain, A, Arroll, B, Elder, H, Tautolo, ES, Parag, V, Anderson, C, Bennett, D, Thrift, AG, Cadilhac, DA, Brown, P, Ranta, A, and Douwes, J

Abstract

Aim: The goal of this paper is to provide a protocol for conducting a fifth population-based Auckland Regional Community Stroke study (ARCOS V) in New Zealand. Methods and Discussion: In this study, for the first time globally, (1) stroke and TIA burden will be determined using the currently used clinical and tissue-based definition of stroke, in addition to the WHO clinical classifications of stroke used in all previous ARCOS studies, as well as more advanced criteria recently suggested for an “ideal” population-based stroke incidence and outcomes study; and (2) age, sex, and ethnic-specific trends in stroke incidence and outcomes will be determined over the last four decades, including changes in the incidence of acute cerebrovascular events over the last decade. Furthermore, information at four time points over a 40-year period will allow the assessment of effects of recent changes such as implementation of the FAST campaign, ambulance pre-notification, and endovascular treatment. This will enable more accurate projections for health service planning and delivery. Conclusion: The methods of this study will provide a foundation for future similar population-based studies in other countries and populations.

Published
2020

22. Measuring stroke and transient ischemic attack burden in New Zealand: Protocol for the fifth Auckland Regional Community Stroke Study (ARCOS V).

Author

Parag V., Thrift A.G., Douwes J., Tautolo E.-S., Anderson C., Ranta A., Brown P., Feigin V.L., Krishnamurthi R., Barker-Collo S., Barber P.A., Rathnasabapathy Y., Te Ao B., Parmar P., Mahon S., Tunnage B., Swain A., Arroll B., Elder H., Cadilhac D.A., Bennett D., Parag V., Thrift A.G., Douwes J., Tautolo E.-S., Anderson C., Ranta A., Brown P., Feigin V.L., Krishnamurthi R., Barker-Collo S., Barber P.A., Rathnasabapathy Y., Te Ao B., Parmar P., Mahon S., Tunnage B., Swain A., Arroll B., Elder H., Cadilhac D.A., and Bennett D.

Abstract

Aim: The goal of this paper is to provide a protocol for conducting a fifth population-based Auckland Regional Community Stroke study (ARCOS V) in New Zealand. Methods and Discussion: In this study, for the first time globally, (1) stroke and TIA burden will be determined using the currently used clinical and tissue-based definition of stroke, in addition to the WHO clinical classifications of stroke used in all previous ARCOS studies, as well as more advanced criteria recently suggested for an "ideal" population-based stroke incidence and outcomes study; and (2) age, sex, and ethnic-specific trends in stroke incidence and outcomes will be determined over the last four decades, including changes in the incidence of acute cerebrovascular events over the last decade. Furthermore, information at four time points over a 40-year period will allow the assessment of effects of recent changes such as implementation of the FAST campaign, ambulance pre-notification, and endovascular treatment. This will enable more accurate projections for health service planning and delivery. Conclusion(s): The methods of this study will provide a foundation for future similar population-based studies in other countries and populations.Copyright © 2019 World Stroke Organization.

Published
2020

23. Health Risks

Author

Douwes, J., primary, Howden-Chapman, P., additional, and Crane, J., additional

Published
2012
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26. Bioaerosols

Author

Douwes, J., primary, Eduard, W., additional, and Thorne, P.S., additional

Published
2008
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30. Essential Medicines at the National Level: The Global Asthma Network's Essential Asthma Medicines Survey 2014

Author

Bissell, K, Ellwood, P, Ellwood, E, Chiang, C-Y, Marks, GB, El Sony, A, Asher, I, Billo, N, Perrin, C, Billo, NE, Garcia-Marcos, L, Mallol, J, Pearce, N, Strachan, D, Priftanji, A, Boukari, R, Taright, S, Gomez, M, Baghdasaryan, A, Burgess, S, Mattes, J, Tai, A, Riedler, J, Shpakou, A, Weyler, J, Lawin, H, de Abruzzese, AJ, Domuz, S, Brandao, HV, Camargos, PAM, Fischer, GB, Menezes, AM, Porto Neto, AC, Rosario, N, Sole, D, Mustakov, TB, Birba, E, Ngahane, MBH, Tse, SM, Standring, P, Aguirre, V, Calvo Gil, MA, Chen, Y-Z, Kan, X, Garcia, E, Niederbacher, J, Obel, KB, Soto-Quiros, ME, Banac, S, Yiallouros, P, Lochte, L, Barba, S, Bustos, C, El Falaki, M, Figueroa Colorado, M, Weihe, P, Lal, VA, Makela, M, Annesi-Maesano, I, Raherison, C, Gotua, M, von Mutius, E, Addo-Yobo, EO, Akpinar-Elci, M, Lai, CKW, Novak, Z, Kabra, SK, Ilangho, RP, Pherwani, AV, Sharma, SK, Sukumaran, TU, Dalimunthe, W, Karimi, M, Masjedi, M-R, Manning, P, Shohat, T, Forastiere, F, La Grutta, S, Petronio, MG, Piffer, S, Kahwa, E, Odajima, H, Abu-Ekteish, F, Amukoye, EI, Esamai, FO, Hong, S-J, Neziri-Ahmetaj, L, Momen, JA, Akkhavong, K, Svabe, V, Vlaski, E, Mortimer, K, Daud, M, Montefort, S, Del Rio Navarro, BE, Jimenez Gonzalez, CA, Merida-Palacio, JV, Paramo-Arroyo, RF, Munkhbayarlakh, S, Brunekreef, B, Currie, S, Douwes, J, Graham, D, Hancox, R, Moyes, C, Pattemore, P, Vis, K, Cordero, RMZ, Ayuk, A, Falade, AG, Garba, IB, Hammangabdo, A, Onyia, N, Pulu, M, Nystad, W, Al-Rawas, O, Yusuf, MO, Watson, BM, El Sharif, N, Cukier, G, Chiarella, P, Pagcatipunan, R, Breborowicz, A, Lis, G, Morais-Almeida, M, Deleanu, D, Kamaltynova, E, Kondiurina, EG, Esera-Tulifau, L, Al-Ghamdi, Memish, ZA, Nahhas, MA, Yousef, A, Toure, NO, Visnjevac, D, Zivkovic, Z, Deen, GF, Goh, DYT, Masekala, R, Zar, HJ, Carvajal-Uruena, I, Gonzalez Diaz, C, Korta Murua, J, Luna-Paredes, C, Morales-Suarez-Varela, M, Praena-Crespo, M, Kudagammana, ST, Mohammad, Y, Guo, YL, Huang, J-L, Lao-Araya, M, Teeratakulpisarn, J, Vichyanond, P, Anderson, S, Tidjani, O, Iosefa, T, Aho, G, Dookeeram, D, Hamzaoui, A, Yorgancioglu, A, Ituaso-Conway, N, Worodria, W, Fedortsiv, O, Mahboub, B, Mansur, AH, Kumar, H, Valentin-Rostan, M, Harrison, G, Fiocchi, A, Le, LTT, Wa Somwe, S, Manangazira, P, and Grp, GANS

Subjects
sense organs
Abstract

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system’s capacity to address NCDs.

Published
2019

50. Understanding asthma phenotypes: the World Asthma Phenotypes (WASP) international collaboration

Author

Pembrey, L, Barreto, ML, Douwes, J, Cooper, P, Henderson, J, Mpairwe, H, Ardura-Garcia, C, Chico, M, Brooks, C, Cruz, AA, Elliott, AM, Figueiredo, CA, Langan, SM, Nassanga, B, Ring, S, Rodrigues, L, and Pearce, N

Subjects
Study Protocol
Abstract

The World Asthma Phenotypes (WASP) study started in 2016 and has been conducted in five centres, in the UK, New Zealand, Brazil, Ecuador and Uganda. The objectives of this study are to combine detailed biomarker and clinical information in order to 1) better understand and characterise asthma phenotypes in high-income countries (HICs) and low and middle-income countries (LMICs), and in high and low prevalence centres; 2) compare phenotype characteristics, including clinical severity; 3) assess the risk factors for each phenotype; and 4) assess how the distribution of phenotypes differs between high prevalence and low prevalence centres. Here we present the rationale and protocol for the WASP study to enable other centres around the world to carry out similar analyses using a standardised protocol. Large collaborative and integrative studies like this are essential to further our understanding of asthma phenotypes. The findings of this study will help elucidate the aetiological mechanisms of asthma and might potentially identify new causes and guide the development of new treatments, thereby enabling better management and prevention of asthma in both HICs and LMICs., A protocol for the World Asthma Phenotypes study to better understand and characterise asthma phenotypes in five centres in the UK, New Zealand, Brazil, Ecuador and Uganda http://ow.ly/71CR30ldsU4

Published
2018
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