561 results found
Burney P, Knox-Brown B, Amaral A, 2023, "Small lung syndrome": the need to re-classify chronic lung disease, The Lancet Respiratory Medicine, ISSN: 2213-2600
Nafees AA, Muneer MZ, Irfan M, et al., 2023, Byssinosis and lung health among cotton textile workers: baseline findings of the MultiTex trial in Karachi, Pakistan, OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, ISSN: 1351-0711
Ratanachina J, Amaral A, De Matteis S, et al., 2023, Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study, European Respiratory Journal, Vol: 60, Pages: 1-16, ISSN: 0903-1936
Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study.We analysed cross-sectional data from 28,823 adults (≥40years) in 34 countries. Eleven occupations were considered and grouped by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, FEV1/FVC and FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income (GNI).Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20years were more likely to have chronic cough (OR=1.52, 95%CI 1.19-1.94), wheeze (OR=1.37, 95%CI 1.16-1.63), and dyspnoea (OR=1.83, 95%CI 1.53-2.20), but not lower FVC (β=0.02L, 95%CI -0.02L to 0.06L) or lower FEV1/FVC (β=0.04%, 95%CI -0.49% to 0.58%). Some findings differed by sex and GNI. In summary, at a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they associate with more respiratory symptoms. As not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.
Knox-Brown B, Patel J, Potts J, et al., 2023, Prevalence of small airways obstruction and its risk factors in the multinational Burden of Obstructive Lung Disease (BOLD) study, The Lancet Global Health, Vol: 11, Pages: e69-e82, ISSN: 2214-109X
Background:Small Airways Obstruction (SAO) is a common feature of obstructive lung diseases. There is limited research on SAO, its global prevalence and risk factors.Methods:Using data from 41 sites in the cross-sectional Burden of Obstructive Lung Disease study (N=26,448), we defined SAO as either: 1) mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FEF25-75) less than lower limit of normal (LLN), or 2) forced expiratory volume in three seconds to forced vital capacity ratio (FEV3/FVC) less than the LLN. We estimated the prevalence of pre- and post-bronchodilator SAO for each site. To identify risk factors for SAO, we performed multivariable regression analyses within each site, and pooled estimates using random effects meta-analysis.Findings:Prevalence of pre-bronchodilator SAO ranged from 5% (34/624) in Tartu (Estonia) to 34% (189/555) in Mysore (India) for FEF25-75, while for FEV3/FVC it ranged from 5% (31/667) in Riyadh (Saudi Arabia) to 31% (287/981) in Salzburg (Austria). Prevalence of post-bronchodilator SAO was universally lower. Risk factors associated with FEV3/FVC included increasing age, low body mass index, active and passive smoking, low level of education, working in a dusty job for more than 10 years, and previous tuberculosis. Results were similar for FEF25-75, except for increasing age, which was associated with reduced odds of SAO.Interpretation:Despite the wide geographical variation, SAO is common and more prevalent than chronic airflow obstruction worldwide. SAO shows the same risk factors as chronic airflow obstruction. However, further research is required to investigate whether it also associates with respiratory symptoms and lung function decline.Funding:National Heart and Lung Institute; Wellcome Trust (085790/Z/08/Z).
Ahmed R, Osman N, Noory B, et al., 2022, Prevalence and determinants of chronic respiratory diseases in adults in Khartoum State, Sudan, International Journal of Tuberculosis and Lung Disease, ISSN: 1027-3719
Background:Chronic respiratory diseases are considered a significant cause of morbidity and mortality worldwide, although data from Africa are limited. This study aimed to determine the prevalence and determinants of chronic respiratory diseases in Khartoum, Sudan.Methods:Data was collected from 516 participants, aged ≥ 40, who had completed a questionnaire and undertook pre- and post-bronchodilator spirometry testing. Trained field workers conducted questionnaires and spirometry. Survey-weighted prevalence of respiratory symptoms and spirometric abnormalities were estimated. Regression analysis models were used to identify risk factors for chronic lung diseases.Results:Using the NHANESIII reference equations, the prevalence of Chronic Airflow Obstruction (CAO) was 10%. The main risk factor was older age 60-69 years (Odds ratio 3.16, 95% Confidence Interval 1.20 – 8.31). Lower education, high body mass index and a history of tuberculosis were also identified as significant risk factors. The prevalence of a low forced vital capacity (FVC) using NHANES III was 62.7% [SE 2.2] and 11.3% [SE 1.4] using locally derived values.Conclusion:The prevalence of spirometric abnormality mainly (low FVC); was high suggesting that chronic respiratory disease is of substantial public health importance in urban Sudan. Strategies for the prevention and control of these problems are needed.
Knox-Brown B, Patel J, Burney P, et al., 2022, THE ASSOCIATION OF SMALL AIRWAYS OBSTRUCTION WITH RESPIRATORY SYMPTOMS, CARDIOMETABOLIC DISEASE, AND QUALITY OF LIFE: RESULTS FROM THE BURDEN OF OBSTRUCTIVE LUNG DISEASE (BOLD) STUDY, Publisher: BMJ PUBLISHING GROUP, Pages: A64-A65, ISSN: 0040-6376
Knox-Brown B, Patel J, Burney P, et al., 2022, Prevalence and risk factors for small airways obstruction: Results from the Burden of Obstructive Lung Disease (BOLD) study., Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Binegdie AB, Brenac S, Devereux G, et al., 2022, Post-TB lung disease in three African countries, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 26, Pages: 891-893, ISSN: 1027-3719
Hsan S, Lakhdar N, Harrabi I, et al., 2022, Reduced forced vital capacity is independently associated with, aging, height and a poor socioeconomic status: a report from the Tunisian population-based BOLD study, BMC PULMONARY MEDICINE, Vol: 22, ISSN: 1471-2466
- Author Web Link
- Citations: 1
Denguezli M, Lakhdar N, Harrabi I, et al., 2022, UNDIAGNOSED COPD IN ADULTS 40 YEARS AND OLDER: REPORTS FROM THE TUNISIAN POPULATION-BASED BURDEN OF OBSTRUCTIVE LUNG DISEASE STUDY, CHEST Congress, Publisher: ELSEVIER, Pages: 363A-363A, ISSN: 0012-3692
Knox-Brown B, Amaral A, Burney P, 2022, Concerns about PRISm, The Lancet Respiratory Medicine, Vol: 10, Pages: e51-e52, ISSN: 2213-2600
Burney P, 2022, Genetic ancestry has the same major problems as phenotypic ancestry, American Journal of Respiratory and Critical Care Medicine, Vol: 206, Pages: 797-798, ISSN: 1073-449X
Binegdie AB, Haile T, Worku A, et al., 2022, Chronic Respiratory Diseases in Ethiopia: Risk Factors and Determinants of Pulmonary Function Impairment. Hospital Based Cross-Sectional Study, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Burney P, 2022, Genetic ancestry has the same major problems as phenotypic ancestry, American Journal of Respiratory and Critical Care Medicine, ISSN: 1073-449X
Nafees A, De Matteis S, Amaral A, et al., 2022, Impact of using different predictive equations on the prevalence of chronic byssinosis in textile workers in Pakistan, Occupational and Environmental Medicine, Vol: 79, Pages: 242-244, ISSN: 1351-0711
Objective Byssinosis remains a significant problem among textile workers in low/middle-income countries. Here we share our experience of using different prediction equations for assessing ‘chronic’ byssinosis according to the standard WHO classification using measurements of forced expiratory volume in 1 s (FEV1).Methods We enrolled 1910 workers in a randomised controlled trial of an intervention to improve the health of textile workers in Pakistan. We included in analyses the 1724 (90%) men who performed pre-bronchodilator spirometry tests of acceptable quality. We compared four different equations for deriving lung function percentage predicted values among those with symptoms-based byssinosis: the third US National Health and Nutrition Examination Survey (NHANES-III, with ‘North Indian and Pakistani’ conversion factor); the Global Lung Function Initiative (GLI, ‘other or mixed ethnicities’); a recent equation derived from survey of a western Indian population; and one based on an older and smaller survey of Karachi residents.Results 58 men (3.4%) had symptoms-based byssinosis according to WHO criteria. Of these, the proportions with a reduced FEV1 (<80% predicted) identified using NHANES and GLI; Indian and Pakistani reference equations were 40%, 41%, 14% and 12%, respectively. Much of this variation was eliminated when we substituted FEV1/forced vital capacity (FVC) ratio (<lower limit of normality) as a measure of airway obstruction.Conclusion Accurate measures of occupational disease frequency and distribution require approaches that are both standardised and meaningful. We should reconsider the WHO definition of ‘chronic’ byssinosis based on changes in FEV1, and instead use the FEV1/FVC.
Kulbacka-Ortiz K, Triest F, Franssen F, et al., 2022, Restricted spirometry and cardiometabolic comorbidities: Results from the international population based BOLD study, Respiratory Research, Vol: 23, ISSN: 1465-9921
Background:Whether restricted spirometry, i.e. low Forced Vital Capacity (FVC), predicts chronic cardiometabolic disease is not definitely known. In this international population-based study, we assessed the relationship between restricted spirometry and cardiometabolic comorbidities.Methods:A total of 23,623 subjects (47.5% males, 19.0% current smokers, age: 55.1 ± 10.8 years) from five continents (33 sites in 29 countries) participating in the Burden of Obstructive Lung Disease (BOLD) study were included. Restricted spirometry was defined as post-bronchodilator FVC < 5th percentile of reference values. Self-reports of physician-diagnosed cardiovascular disease (CVD; heart disease or stroke), hypertension, and diabetes were obtained through questionnaires.Results:Overall 31.7% of participants had restricted spirometry. However, prevalence of restricted spirometry varied approximately ten-fold, and was lowest (8.5%) in Vancouver (Canada) and highest in Sri Lanka (81.3%). Crude odds ratios for the association with restricted spirometry were 1.60 (95% CI 1.37–1.86) for CVD, 1.53 (95% CI 1.40–1.66) for hypertension, and 1.98 (95% CI 1.71–2.29) for diabetes. After adjustment for age, sex, education, Body Mass Index (BMI) and smoking, the odds ratios were 1.54 (95% CI 1.33–1.79) for CVD, 1.50 (95% CI 1.39–1.63) for hypertension, and 1.86 (95% CI 1.59–2.17) for diabetes.Conclusion:In this population-based, international, multi-site study, restricted spirometry associates with cardiometabolic diseases. The magnitude of these associations appears unattenuated when cardiometabolic risk factors are taken into account.
Nafees AA, De Matteis S, Burney P, et al., 2022, Contemporary prevalence of byssinosis in low- and middle-income countries: a systematic review, Asia-Pacific Journal of Public Health, Vol: 34, Pages: 483-492, ISSN: 1010-5395
We aimed to identify the contemporary prevalence of byssinosis through a systematic review. We used Medline, Web of Science, Embase, and Global Health databases to identify studies published in any language between 2000 and 2019, reporting primary data on byssinosis among adults. We used the Joanna Briggs Institute checklist to estimate the risk of bias in studies and undertook a qualitative, narrative data analysis. The review considered the prevalence of byssinosis, chest tightness, and airflow obstruction in textile workers in low- and middle-income countries (LMICs). We found 26 relevant studies that included 6930 workers across 12 countries. Most of the studies (n = 19) were from Asia, and 7 from African countries. Twenty-five studies were cross-sectional surveys while 1 was a cohort study. The prevalence of byssinosis was reported by 18 studies, and ranged from 8% to 38%, without any clear associations, at the group level, between the prevalence of byssinosis and durations of workers’ exposures. Prevalence of chest tightness ranged between 4% and 58% and that of airflow obstruction between 10% and 30%. We found a strong correlation (r = 0.72) between prevalence of byssinosis and cotton dust levels. Our findings indicate that byssinosis remains a significant, contemporary problem in some parts of the textile sector in LMICs.
Binegdie AB, Meme H, El Sony A, et al., 2022, Chronic respiratory disease in adult outpatients in three African countries: a cross-sectional study, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 26, Pages: 18-+, ISSN: 1027-3719
- Author Web Link
- Citations: 1
Amaral A, Burney P, Patel J, et al., 2021, Chronic airflow obstruction and ambient particulate air pollution, Thorax, Vol: 76, Pages: 1236-1241, 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.
Nafees AA, Iqbal AR, Cullinan P, et al., 2021, Use of low-cost particle counters for cotton dust exposure assessment in textile mills in low- and middle-income countries, Annals of Work Exposures and Health, Vol: 66, ISSN: 2398-7308
OBJECTIVE: There is a lack of consensus on methods for cotton dust measurement in the textile industry, and techniques vary between countries-relying mostly on cumbersome, traditional approaches. We undertook comparisons of standard, gravimetric methods with low-cost optical particle counters for personal and area dust measurements in textile mills in Pakistan. METHODS: We included male textile workers from the weaving sections of seven cotton mills in Karachi. We used the Institute of Occupational Medicine (IOM) sampler with a Casella Apex 2 standard pump and the Purple Air (PA-II-SD) for measuring personal exposures to inhalable airborne particles (n = 31). We used the Dylos DC1700 particle counter, in addition to the two above, for area-level measurements (n = 29). RESULTS: There were no significant correlations between the IOM and PA for personal dust measurements using the original (r = -0.15, P = 0.4) or log-transformed data (r = -0.32, P = 0.07). Similarly, there were no significant correlations when comparing the IOM with either of the particle counters (PA and Dylos) for area dust measurements, using the original (r = -0.07, P = 0.7; r = 0.10, P = 0.6) or log-transformed data (r = -0.09, P = 0.6; r = 0.07, P = 0.7). CONCLUSION: Our findings show a lack of correlation between the gravimetric method and the use of particle counters in both personal and area measurements of cotton dust, precluding their use for measuring occupational exposures to airborne dust in textile mills. There continues to be a need to develop low-cost instruments to help textile industries in low- and middle-income countries to perform cotton dust exposure assessment.
Marcon A, Locatelli F, Dharmage SC, et al., 2021, The coexistence of asthma and COPD: risk factors, clinical history and lung function trajectories, EUROPEAN RESPIRATORY JOURNAL, Vol: 58, ISSN: 0903-1936
- Author Web Link
- Citations: 9
Njoroge MW, Mjojo P, Chirwa C, et al., 2021, Changing lung function and associated health-related quality-of-life: A five-year cohort study of Malawian adults, ECLINICALMEDICINE, Vol: 41
- Author Web Link
- Citations: 1
Patel J, Amaral AFS, Minelli C, et al., 2021, Poverty and chronic airflow obstruction in the multinational Burden of Obstructive Lung Disease (BOLD) study: An update, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Denguezli M, Daldoul H, Lakhdar N, et al., 2021, Undiagnosed COPD in adults 40 years and older: Reports from the Tunisian Population-Based Burden of Obstructive Lung Disease Study, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Bagkeris E, Mulhern O, Amaral A, et al., 2021, Forced Vital Capacity and Mortality in The BOLD Study: Preliminary Findings, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Bagkeris E, Patel J, Janson C, et al., 2021, Forced Vital Capacity and Quality of Life: BOLD Study Cross-Sectional Analysis, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Mulhern O, Algharbi F, Amaral AFS, et al., 2021, Association of asthma diagnosis with chronic airflow obstruction: a multi-site cross-sectional study, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Tan WC, Li P, Choi R, et al., 2021, The population risk attribution associated with chronic airway obstruction from the results of the Canadian Obstructive Lung Disease study, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Ratanachina J, Amaral A, De Matteis S, et al., 2021, Farming, pesticide exposure and respiratory health: a cross-sectional study in Thailand, Occupational and Environmental Medicine, Vol: 79, 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.
Burney P, Patel J, Minelli C, et 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.
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