Imperial College London

Professor Peter GJ Burney MA MD FRCP FFPHM FMedSci

Faculty of MedicineNational Heart & Lung Institute

Emeritus Professor of Respiratory Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 7941p.burney

 
 
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Location

 

07Emmanuel Kaye BuildingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

520 results found

Ratanachina J, Amaral A, De Matteis S, Cullinan P, Burney Pet al., 2021, Farming, pesticide exposure and respiratory health: a cross-sectional study in Thailand, Occupational and Environmental Medicine, ISSN: 1351-0711

Objective: To assess the association of lung function and respiratory symptoms with farming, particularly pesticide use, in an agricultural province in Thailand.Methods: We undertook a cross-sectional survey of adults aged 40–65 in Nan province, Thailand, between May and August 2019. We randomly recruited 345 villagers and enriched the sample with 82 government employees. All participants performed post-bronchodilator spirometry and completed a questionnaire covering information on respiratory symptoms, farming activities, pesticide use and known risk factors for respiratory disease. Associations of respiratory outcomes with farming and pesticide exposures were examined by multivariable regression analysis.Results: The response rate was 94%. The prevalence of chronic airflow obstruction among villagers was 5.5%. Villagers had, on average, a lower percent predicted post-bronchodilator forced expiratory volume in one second/forced vital capacity (FEV1/FVC) than government employees (98.3% vs 100.3%; p=0.04). There was no evidence of association of lung function with farming activities, the use of specific herbicides (glyphosate and paraquat), insecticides (organophosphates and pyrethroids) or fungicides. The exceptions were poultry farming, associated with chronic cough and an increase of FEV1/FVC, and atrazine, for which duration (p-trend <0.01), intensity (p-trend <0.01) and cumulative hours (p-trend=0.01) of use were all associated with higher FEV1/FVC in an exposure–response manner. Cumulative hours (−280 mL/hour), low duration (−270 mL/year) and intensity (−270 mL/hour/year) of atrazine use were associated with lower FVC.Conclusions: Chronic airflow obstruction is uncommon among villagers of an agricultural province in Nan, Thailand. Farming and pesticide use are unlikely to be major causes of respiratory problems there.

Journal article

Burney P, Patel J, Minelli C, Gnatiuc L, Amaral A, Kocabas A, Cherkaski H, Gulsvik A, Nielsen R, Bateman E, Jithoo A, Mortimer K, Sooronbaev T, Lawin H, Nejjari C, Elbiaze M, El Rhazi K, Zheng J-P, Ran P, Welte T, Obaseki D, Erhabor G, Elsony A, Osman N, Ahmed R, Nizankowska -Mogilnicka E, Mejza F, Mannino D, Barbara C, Wouters E, Idolor L, Loh L-C, Rashid A, Juvekar S, Gislason T, Al Ghobain M, Studnicka M, Harrabi I, Denguezli M, Koul P, Jenkins C, Marks G, Jogi R, Hafizi H, Janson C, Tan W, Aquart-Stewart A, Mbatchou B, Nafees A, Gunasekera K, Seemungal T, Mahesh PA, Enright P, Vollmer W, Blangiardo M, Elfadaly F, Buist ASet al., 2021, Prevalence and population attributable risk for chronic airflow obstruction in a large multinational study, American Journal of Respiratory and Critical Care Medicine, Vol: 203, Pages: 1353-1365, ISSN: 1073-449X

Rationale: The Global Burden of Disease programme identified smoking, and ambient and household air pollution as the main drivers of death and disability from Chronic Obstructive Pulmonary Disease (COPD). Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors. Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a post-bronchodilator one-second forced expiratory volume to forced vital capacity ratio < lower limit of normal, and the relative risks associated with different risk factors. Local RR were estimated using a Bayesian hierarchical model borrowing information from across sites. From these RR and the prevalence of risk factors, we estimated local Population Attributable Risks (PAR). Measurements and Main Results: Mean prevalence of CAO was 11.2% in men and 8.6% in women. Mean PAR for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index (BMI), and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: While smoking remains the most important risk factor for CAO, in some areas poor education, low BMI and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.

Journal article

Amaral A, Burney P, Patel J, Minelli C, Mejza F, Mannino D, Seemungal T, Padukudru Anand M, Loh LC, Janson C, Juvekar S, Denguezli M, Harrabi I, Wouters E, Cherkaski H, Mortimer K, Jogi R, Bateman E, Fuertes E, Al Ghobain M, Tan W, Obaseki D, El Sony A, Studnicka M, Aquart-Stewart A, Koul P, Lawin H, Nafees A, Awopeju O, Erhabor G, Gislason T, Welte T, Gulsvik A, Nielsen R, Gnatiuc L, Kocabas A, Marks G, Sooronbaev T, Mbatchou Ngahane B, Barbara C, Buist ASet al., 2021, Chronic airflow obstruction and ambient particulate air pollution, Thorax, ISSN: 0040-6376

Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita and the local annual mean level of ambient particulate matter (PM2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improved understanding of the link between CAO and poverty should be prioritised.

Journal article

Marcon A, Locatelli F, Dharmage SC, Svanes C, Heinrich J, Leynaert B, Burney P, Corsico A, Caliskan G, Calciano L, Gislason T, Janson C, Jarvis D, Jõgi R, Lytras T, Malinovschi A, Probst-Hensch N, Toren K, Casas L, Verlato G, Garcia-Aymerich J, Accordini S, Ageing Lungs in European Cohorts ALEC studyet al., 2021, The coexistence of asthma and COPD: risk factors, clinical history and lung function trajectories., Eur Respir J

RATIONALE: Patients with concomitant features of asthma and chronic obstructive pulmonary disease (COPD) have a heavy disease burden. OBJECTIVES: Using data collected prospectively in the European Community Respiratory Health Survey, we compared the risk factors, clinical history, and lung function trajectories from early adulthood to the late sixties of middle aged subjects having asthma+COPD (n=179), past (n=263) or current (n=808) asthma alone, COPD alone (n=111), or none of these (n=3477). METHODS: Interview data and prebronchodilator FEV1 and FVC were obtained during three clinical examinations in 1991-1993, 1999-2002, and 2010-2013. Disease status was classified in 2010-2013, when the subjects were aged 40-68, according to the presence of fixed airflow obstruction (postbronchodilator FEV1/FVC below the lower limit of normal), a lifetime history of asthma, and cumulative exposure to tobacco or occupational inhalants. Previous lung function trajectories, clinical characteristics, and risk factors of these phenotypes were estimated. MAIN RESULTS: Subjects with asthma+COPD reported maternal smoking (28.2%) and respiratory infections in childhood (19.1%) more frequently than subjects with COPD alone (20.9 and 14.0%, respectively). Subjects with asthma+COPD had an impairment of lung function at age 20 that tracked over adulthood, and more than half of them had asthma onset in childhood. Subjects with COPD alone had the highest lifelong exposure to tobacco smoking and occupational inhalants, and they showed accelerated lung function decline during adult life. CONCLUSIONS: The coexistence between asthma and COPD seems to have its origins earlier in life compared to COPD alone. These findings suggest that prevention of this severe condition, which is typical at older ages, should start in childhood.

Journal article

Charles D, Gethings LA, Potts JF, Burney PGJ, Garcia-Larsen Vet al., 2021, Mass spectrometry-based metabolomics for the discovery of candidate markers of flavonoid and polyphenolic intake in adults, Scientific Reports, Vol: 11, ISSN: 2045-2322

Robust biological markers of dietary exposure are essential in improving the understanding of the link between diet and health outcomes. Polyphenolic compounds, including flavonoids, have been proposed to mitigate the risk of chronic diseases where oxidative stress and inflammation play a central role. Biomarkers can provide objective measurement of the levels of polyphenolic compounds. In this study, we provide methodology to identify potential candidate markers of polyphenol intake in human serum. Seventeen participants from the UK arm of the Global Allergy and Asthma Network of Excellence (GA2LEN) had their dietary intake estimated using a validated food frequency questionnaire, and serum samples were assessed using mass spectrometry to identify potential candidate markers. 144 features were assigned identities, of these we identified four biologically relevant compounds (rhamnazin 3-rutinoside, 2-galloyl-1,4-galactarolactone methyl ester, 2″,32″-di-O-p-coumaroylafzelin and cyclocommunin), which were significantly increased in the serum of participants with high predicted level of fruit and vegetable intake. 2-galloyl-1,4-galactarolactone methyl ester was strongly correlated with total flavonoids (r = 0.62; P = 0.005), flavan-3-ols (r = 0.67; P = 0.002) as well as with other four subclasses. Rhamnazin 3-rutinoside showed strong correlation with pro-anthocyanidins (r = 0.68; P = 0.001), flavones (r = 0.62; P = 0.005). Our results suggest that serum profiling for these compounds might be an effective way of establishing the relative intake of flavonoids and could contribute to improve the accuracy of epidemiological methods to ascertain flavonoid intake.

Journal article

Nafees AA, Rabbani U, Razzaq S, Minai K, Khan MA, Naeem S, Fatmi Z, Burney Pet al., 2021, Indoor air quality and its relationship with cluster type in urban Pakistani households, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 25, Pages: 113-+, ISSN: 1027-3719

Journal article

Akhter Z, Razzaq S, Rabbani U, Irfan M, Burney P, Nafees AAet al., 2021, Prevalence of and risk factors for respiratory symptoms in an adult urban population, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 25, Pages: 16-+, ISSN: 1027-3719

Journal article

Njoroge MW, Rylance S, Nightingale R, Gordon S, Mortimer K, Burney P, Rylance J, Obasi A, Niessen L, Devereux Get al., 2020, Cohort profile: The Chikwawa lung health cohort; a population-based observational non-communicable respiratory disease study of adults in Malawi, PLOS ONE, Vol: 15, ISSN: 1932-6203

Journal article

Lyons SA, Knulst AC, Burney PGJ, Fernandez-Rivas M, Ballmer-Weber BK, Barreales L, Bieli C, Clausen M, Dubakiene R, Fernandez-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kummeling I, Mustakov TB, van Os-Medendorp H, Papadopoulos NG, Popov TA, Potts J, Xepapadaki P, Welsing PMJ, Mills ENC, van Ree R, Thuy-My Let al., 2020, Predictors of Food Sensitization in Children and Adults Across Europe, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 8, Pages: 3074-+, ISSN: 2213-2198

Journal article

Lyons SA, Knulst AC, Burney PGJ, Fernandez-Rivas M, Ballmer-Weber BK, Barreales L, Bieli C, Clausen M, Dubakiene R, Fernandez-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kummeling I, Kralimarkova T, Mustakov TB, van Os-Medendorp H, Papadopoulos NG, Popov TA, Potts J, Versteeg SA, Xepapadaki P, Welsing PMJ, Mills C, van Ree R, Le T-Met al., 2020, Predicting food allergy: The value of patient history reinforced, ALLERGY, Vol: 76, Pages: 1454-1462, ISSN: 0105-4538

Journal article

Amaral AFS, Patel J, Buist AS, Burney Pet al., 2020, Risk factors for low forced vital capacity in the multinational BOLD study: An update, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Rabbani U, Razzak S, Burney P, Nafees AAet al., 2020, Indoor air pollutants and respiratory outcomes among adult Pakistani papulation: A cross sectional survey, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Ratanachina J, Amaral A, De Matteis S, Cullinan P, Burney Pet al., 2020, Farming and respiratory health: a cross-sectional study in Thailand, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Lyons SA, Clausen M, Knulst AC, Ballmer-Weber BK, Fernandez-Rivas M, Barreales L, Bieli C, Dubakiene R, Fernandez-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kralimarkova T, Kummeling I, Mustakov TB, Papadopoulos NG, Popov TA, Xepapadaki P, Welsing PMJ, Potts J, Mills ENC, van Ree R, Burney PGJ, Thuy-My Let al., 2020, Prevalence of Food Sensitization and Food Allergy in Children Across Europe, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 8, Pages: 2736-+, ISSN: 2213-2198

Journal article

Denguezli M, Daldoul H, Harrabi I, Chouikha F, Ghali H, Burney P, Tabka Zet al., 2020, Prevalence and Characteristics of Undiagnosed COPD in Adults 40 Years and Older - Reports from the Tunisian Population-Based Burden of Obstructive Lung Disease Study, COPD-JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, Vol: 17, Pages: 515-522, ISSN: 1541-2555

Journal article

Lyons SA, Knulst AC, Burney PGJ, Fernandez-Rivas M, Ballmer-Weber BK, Barreales L, Bieli C, Clausen M, Dubakiene R, Fernandez-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kummeling I, Mustakov TB, Van Os-Medendorp H, Papadopoulos NG, Popov TA, Potts J, Xepapadaki P, Welsing PMJ, Mills ENC, Van Ree R, Le TTMet al., 2020, Predictors of food sensitisation in European children and adults, European-Academy-of-Allergology-and-Clinical-Immunology Digital Congress (EAACI), Publisher: WILEY, Pages: 250-251, ISSN: 0105-4538

Conference paper

Lyons SA, Clausen M, Knulst AC, Ballmer-Weber BK, Fernandez-Rivas M, Barreales L, Bieli C, Dubakiene R, Fernandez-Perez C, Jedrzejczak-Czechowicz M, Kowalski ML, Kralimarkova T, Kummeling I, Mustakov TB, Papadopoulos NG, Popov TA, Xepapadaki P, Welsing PMJ, Potts J, Mills ENC, Van Ree R, Burney PG, Le TTMet al., 2020, Prevalence of food sensitisation and food allergy in children across Europe, European-Academy-of-Allergology-and-Clinical-Immunology Digital Congress (EAACI), Publisher: WILEY, Pages: 89-90, ISSN: 0105-4538

Conference paper

Portas L, Pereira M, Shaheen SO, Wyss AB, London SJ, Burney PGJ, Hind M, Dean CH, Minelli Cet al., 2020, Lung development genes and adult lung function, American Journal of Respiratory and Critical Care Medicine, Vol: 202, Pages: 853-865, ISSN: 1073-449X

RATIONALE: Poor lung health in adult life may occur partly through suboptimal growth and development, as suggested by epidemiological evidence pointing to early life risk factors. OBJECTIVES: To systematically investigate the effects of lung development genes on adult lung function. METHODS: Using UK Biobank data, we tested the association of 391 genes known to influence lung development with FVC and FEV1/FVC. We split the dataset into two random subsets of 207,616 and 138,411 individuals, using the larger to select the most promising signals and the smaller for replication. MEASUREMENTS AND MAIN RESULTS: We identified 55 genes, of which 36 (16 for FVC; 19 for FEV1/FVC; 1 for both) had not been identified in the largest, most recent genome-wide study of lung function. Most of these 36 signals were intronic variants; expression data from blood and lung tissue showed that the majority affect the expression of the genes they lie within. Further testing of 34 of these 36 signals in the CHARGE and SpiroMeta consortia showed that 16 replicated after Bonferroni correction and another 12 at nominal significance level. 53 of the 55 genes fell into four biological categories whose function is to regulate organ size and cell integrity (growth factors; transcriptional regulators; cell-cell adhesion; extra-cellular matrix), suggesting that these specific processes are important for adult lung health. CONCLUSIONS: Our study demonstrates the importance of lung development genes in regulating adult lung function and influencing both restrictive and obstructive patterns. Further investigation of these developmental pathways could lead to druggable targets.

Journal article

Conyette L, Lutchmansingh F, Sakhamuri S, Simeon D, Ivey MA, Burney P, Seemungal Tet al., 2020, Prevalence and risk factors of airflow obstruction in a Caribbean population, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 24, Pages: 512-519, ISSN: 1027-3719

Journal article

Burney P, Amaral AF, 2020, Asthma exacerbations, air pollution and allergens: Authors' reply, The Lancet, ISSN: 0140-6736

Journal article

Li J, Ogorodova LM, Mahesh PA, Wang MH, Fedorova OS, Leung TF, Fernandez-Rivas M, Mills ENC, Potts J, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney PGJ, Wong GWKet al., 2020, Comparative Study of Food Allergies in Children from China, India, and Russia: The EuroPrevall-INCO Surveys, JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, Vol: 8, Pages: 1349-+, ISSN: 2213-2198

Journal article

Amaral A, Burney P, Fuertes E, Jarvis Det al., 2020, Body mass index and weight change are associated with adult lung function trajectories: a prospective European survey, Thorax, Vol: 4, Pages: 313-320, ISSN: 0040-6376

Background: Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood according to 20-years weight change profiles, using data from the population-based European Community Respiratory Health Survey (ECRHS).Methods: We included 3,673 participants recruited at age 20-44 years with repeated measurements of weight and lung function (FVC, FEV1) in three study waves (1991-93, 1999-2003, 2010-14) until they were 39-67 years. We classified subjects into weight change profiles according to baseline BMI categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations.Results: In individuals with normal BMI, overweight and obesity at baseline, moderate (0.25–1kg/year) and high weight gain (>1kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared to participants with baseline normal BMI and stable weight (±0.25kg/year), obese with high weight gain during follow-up had -1,011 ml [95%CI: -1,259 to -763] lower estimated FVC at 65 years, despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<-0.25kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline. Conclusion: Moderate and high weight gain over 20-years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.

Journal article

Accordini S, Calciano L, Marcon A, Pesce G, Antó JM, Beckmeyer-Borowko AB, Carsin A-E, Corsico AG, Imboden M, Janson C, Keidel D, Locatelli F, Svanes C, Burney PGJ, Jarvis D, Probst-Hensch NM, Minelli Cet al., 2020, Incidence trends of airflow obstruction among European adults without asthma: a 20-year cohort study, Scientific Reports, Vol: 10, ISSN: 2045-2322

Investigating COPD trends may help healthcare providers to forecast future disease burden. We estimated sex- and smoking-specific incidence trends of pre-bronchodilator airflow obstruction (AO) among adults without asthma from 11 European countries within a 20-year follow-up (ECRHS and SAPALDIA cohorts). We also quantified the extent of misclassification in the definition based on pre-bronchodilator spirometry (using post-bronchodilator measurements from a subsample of subjects) and we used this information to estimate the incidence of post-bronchodilator AO (AOpost-BD), which is the primary characteristic of COPD. AO incidence was 4.4 (95% CI: 3.5-5.3) male and 3.8 (3.1-4.6) female cases/1,000/year. Among ever smokers (median pack-years: 20, males; 12, females), AO incidence significantly increased with ageing in men only [incidence rate ratio (IRR), 1-year increase: 1.05 (1.03-1.07)]. A strong exposure-response relationship with smoking was found both in males [IRR, 1-pack-year increase: 1.03 (1.02-1.04)] and females [1.03 (1.02-1.05)]. The positive predictive value of AO for AOpost-BD was 59.1% (52.0-66.2%) in men and 42.6% (35.1-50.1%) in women. AOpost-BD incidence was 2.6 (1.7-3.4) male and 1.6 (1.0-2.2) female cases/1,000/year. AO incidence was considerable in Europe and the sex-specific ageing-related increase among ever smokers was strongly related to cumulative tobacco exposure. AOpost-BD incidence is expected to be half of AO incidence.

Journal article

Burney P, Atassi M, Kava A, Nejjari C, Benjelloun M, El Biaze M, El Kinany K, Patel J, El Rhazi Ket al., 2020, Association between chronic airflow obstruction and socio-economic position in Morocco: BOLD results., International Journal of Tuberculosis and Lung Disease, Vol: 24, Pages: 202-206, ISSN: 1027-3719

Objective. Chronic Obstructive Lung Disease (COPD) is the third most common cause of death in the world. Other factors than smoking could be involved in the development of COPD such as socio-economic status. The aim of this study was to investigate the association between chronic airflow obstruction and socio-economic status in Morocco. Design. In the BOLD (Burden of Obstructive Lung Disease) study carried out in Fez Morocco, questionnaires and spirometry tests were performed. Socio-economic status was evaluated using a wealth score (0-10) based on household assets. The forced expiratory volume in 1s (FEV1)/ forced vital capacity (FVC) ratio was used to measure airflow obstruction. Results. In total, 760 subjects were included in the analysis. The mean age was 55.3 years (SD=10.2); the wealth score was on average 7.54 (SD=1.63). After controlling for other factors and potential confounders, the FEV1/ FVC increased by 0.4% (95% CI: 0.01, 0.78; p<0.04) per unit increase in wealth score. Aging, tobacco-smoking, underweight, history of tuberculosis and asthma were also independently associated with a higher risk of airflow obstruction. Conclusion. Our findings suggest that airflow obstruction is associated with poverty in Morocco. Further investigations are needed to better understand the mechanisms of this association.

Journal article

Ulrich S, Furian M, Estebesova B, Toktogulova N, Beishekeeva G, Ulrich S, Burney PGJ, Sooronbaev TM, Bloch KEet al., 2020, Spirometry in Central Asian Lowlanders and Highlanders, a Population Based Study, FRONTIERS IN MEDICINE, Vol: 6

Journal article

Ratanachina J, De Matteis S, Cullinan P, Burney Pet al., 2019, Pesticide exposure and lung function: a systematic review and meta-analysis., Occupational Medicine, Vol: 70, Pages: 14-23, ISSN: 0962-7480

BACKGROUND: Epidemiological studies have reported associations between pesticide exposure and respiratory health effects, but the quantitative impact on lung function is unclear. To fill this gap, we undertook a systematic review of the available literature on the association between pesticide exposure and pulmonary function. AIMS: To examine all available literature regarding the relationship between occupational and environmental exposure to pesticides and lung function. METHODS: We searched MEDLINE, EMBASE and Web of Science databases to 1 October 2017 without any date or language restrictions using a combination of MeSH terms and free text for 'pesticide exposure' and 'lung function'. We included studies that met the criteria of our research protocol registered in PROSPERO, and we assessed their quality using a modified Newcastle-Ottawa scale. RESULTS: Of 2356 articles retrieved, 56 articles were included in the systematic review and pooled in meta-analyses for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), FVC and FEV1. There was tentative evidence that exposure to cholinesterase (ChE) inhibiting pesticides reduced FEV1/FVC and no evidence that paraquat exposure affected lung function in farmers. CONCLUSIONS: Respiratory surveillance should be enhanced in those exposed to ChE-inhibiting pesticides which reduced FEV1/FVC according to the meta-analysis. Our study is limited by heterogeneity between studies due to different types of exposure assessment to pesticides and potential confounders. Further studies with a more accurate exposure assessment are suggested.

Journal article

Nafees AA, De Matteis S, Kadir MM, Burney P, Coggon D, Semple S, Cullinan Pet al., 2019, MultiTex RCT - a multifaceted intervention package for protection against cotton dust exposure among textile workers - a cluster randomized controlled trial in Pakistan: study protocol, Trials, Vol: 20, ISSN: 1745-6215

BACKGROUND: In the Pakistani textile industry the prevalence of workplace respiratory illnesses, including byssinosis, is high. The MultiTex RCT study aims to determine the effectiveness of a multifaceted intervention package in reducing dust levels in cotton mills, decreasing the frequency of respiratory symptoms among cotton textile workers, and improving their lung function. METHODS/DESIGN: We will conduct a cluster-randomized controlled trial at 28 textile mills in Karachi. The intervention will comprise: training in occupational health for all workers and managers reinforced by regular refresher sessions; the formation of workplace committees to draw up, agree and promote a health and safety plan that includes wet mopping, safe disposal of cotton dust, and the use of simple face-masks, as well as further publicity about the risks from cotton dust; and provision of adequate supplies of face-masks to support the health and safety plan. Participating mills will be randomized to intervention and control arms following a baseline survey. The impact of the intervention will be determined through follow-up surveys conducted at 3, 12 and 18 months. Data collection in the surveys will include spirometry, questionnaire-based interviews and cotton-dust measurements. DISCUSSION: If successful, the study may pave the way for simple, low-cost interventions that can help reduce cotton-dust levels in textile mills, and improve the respiratory health of textile workers in developing countries such as Pakistan. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03738202. Registered on 12 November 2018.

Journal article

Burney P, Amaral A, 2019, Air pollution and chronic airway disease: is the evidence always clear?, The Lancet, Vol: 394, Pages: 2198-2200, ISSN: 0140-6736

Journal article

Janson C, Malinovschi A, Amaral A, Accordini S, Bousquet J, Buist AS, Garcia-Aymerich J, Gnatiuc L, Tan W, Toren K, Zuberbier T, Burney Pet al., 2019, Testing bronchodilator responsiveness, European Respiratory Journal, Vol: 54, ISSN: 0903-1936

Journal article

Miller MR, 2019, Testing bronchodilator responsiveness, EUROPEAN RESPIRATORY JOURNAL, Vol: 54, ISSN: 0903-1936

Journal article

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