Mortality among uranium miners in North America and Europe: the Pooled Uranium Miners Analysis (PUMA)

2020 ◽  
Author(s):  
D B Richardson ◽  
E Rage ◽  
P A Demers ◽  
M T Do ◽  
N DeBono ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Excess Mortality ◽  
Occupational Exposures ◽  
Chronic Obstructive ◽  
Calendar Period ◽  
Obstructive Pulmonary Disease ◽  
Uranium Miner ◽  
Uranium Miners ◽  
Long Term Follow Up ◽  
The Usa

Abstract Background The Pooled Uranium Miners Analysis (PUMA) study draws together information from cohorts of uranium miners from Canada, the Czech Republic, France, Germany and the USA. Methods Vital status and cause of death were ascertained and compared with expectations based upon national mortality rates by computing standardized mortality ratios (SMRs) overall and by categories of time since first hire, calendar period of first employment and duration of employment as a miner. Results There were 51 787 deaths observed among 118 329 male miners [SMR = 1.05; 95% confidence interval (CI): 1.04, 1.06]. The SMR was elevated for all cancers (n = 16 633, SMR = 1.23; 95% CI: 1.21, 1.25), due primarily to excess mortality from cancers of the lung (n = 7756, SMR = 1.90; 95% CI: 1.86, 1.94), liver and gallbladder (n = 549, SMR = 1.15; 95% CI: 1.06, 1.25), larynx (n = 229, SMR = 1.10; 95% CI: 0.97, 1.26), stomach (n = 1058, SMR = 1.08; 95% CI: 1.02, 1.15) and pleura (n = 39, SMR = 1.06; 95% CI: 0.75, 1.44). Lung-cancer SMRs increased with duration of employment, decreased with calendar period and persisted with time since first hire. Among non-malignant causes, the SMR was elevated for external causes (n = 3362, SMR = 1.41; 95% CI: 1.36, 1.46) and respiratory diseases (n = 4508, SMR = 1.32; 95% CI: 1.28, 1.36), most notably silicosis (n = 814, SMR = 13.56; 95% CI: 12.64, 14.52), but not chronic obstructive pulmonary disease (n = 1729, SMR = 0.98; 95% CI: 0.93, 1.02). Conclusions Whereas there are important obstacles to the ability to detect adverse effects of occupational exposures via SMR analyses, PUMA provides evidence of excess mortality among uranium miners due to a range of categories of cause of death. The persistent elevation of SMRs with time since first hire as a uranium miner underscores the importance of long-term follow-up of these workers.

scholarly journals Determinants of COVID-19 preventive behaviours among adults with chronic diseases in the USA: an analysis of the nationally representative COVID-19 impact survey

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044600
Author(s):  
Jessica Y. Islam ◽  
Denise C. Vidot ◽  
Marlene Camacho-Rivera
Keyword(s):  
Chronic Diseases ◽  
Rural Areas ◽  
Prevalence Ratio ◽  
Face Mask ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
High School Degree ◽  
The Usa ◽  
Nationally Representative

BackgroundPreventive behaviours have been recommended to control the spread of SARS-CoV-2. Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population. Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours.Study designCross-sectional.Setting and participantsWe used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA.Primary measuresAdults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54%).ResultsCompared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (χ2-p<0.001), social distancing (χ2-p<0.001), washing or sanitising hands (χ2-p<0.001), and avoiding some or all restaurants (χ2-p=0.002) and public or crowded places (χ2-p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82, 95% Confidence interval (CI)1.04 to 3.17], household income <US$50 000 (aPR:2.03, 95% CI 1.34 to 2.72), uninsured (aPR:1.65, 95% CI1.09 to 2.52), employed (aPR:1.48, 95% CI 1.02 to 2.17), residing in rural areas (aPR:1.70, 95% CI 1.01 to 2.85) and without any CD (aPR:1.78, 95% CI 1.24 to 2.55) were more likely to not adhere to COVID-19 preventive behaviours.ConclusionAdults with CDs are more likely to adhere to recommended COVID-19 preventive behaviours. Public health messaging targeting specific demographic groups and geographic areas, such as adults without CD or adults living in rural areas, should be prioritised.

Association between E-cigarette use and chronic obstructive pulmonary disease in non-asthmatic adults in the USA

2020 ◽  
Author(s):  
Godfred O Antwi ◽  
Darson L Rhodes
Keyword(s):  
Sex Education ◽  
Smoking Status ◽  
Secondary Data ◽  
Chronic Obstructive ◽  
Behavioral Risk ◽  
Cigarette Use ◽  
Obstructive Pulmonary Disease ◽  
The Usa ◽  
Potential Link ◽  
Using Data

Abstract Background Concern about the health impacts of e-cigarette use is growing; however, limited research exists regarding potential long-term health effects of this behavior. This study explored the relationship between e-cigarette use and COPD in a sample of US adults. Methods A secondary data analysis using data from the 2018 Behavioral Risk Factor Surveillance Survey in the USA was computed to examine associations between e-cigarette use and COPD controlling for conventional cigarette smoking status, past month leisure physical activity and demographic characteristics including age, sex, education, race, marital status and body mass index. Results Significant associations between e-cigarette use and COPD among former combustible cigarette smokers and those who reported never using combustible cigarettes were found. Compared with never e-cigarette users, the odds of having COPD were significantly greater for daily e-cigarette users (OR = 1.53; 95% CI: 1.11–2.03), occasional users (OR = 1.43, 95% CI: 1.13–1.80) and former users (OR = 1.46 95% CI: 1.28–1.67). Conclusions Findings from this study indicate a potential link between e-cigarette use and COPD. Further research to explore the potential effects of e-cigarette on COPD is recommended.

scholarly journals Women's COPD

2022 ◽  
Vol 8 ◽  
Author(s):  
Maéva Zysman ◽  
Chantal Raherison-Semjen
Keyword(s):  
Disease Management ◽  
Pulmonary Rehabilitation ◽  
Clinical Presentation ◽  
Chronic Obstructive ◽  
Specific Population ◽  
Obstructive Pulmonary Disease ◽  
Medical Consultations ◽  
The Usa

Chronic obstructive pulmonary disease (COPD) is no longer a respiratory disease that predominantly affects men, to the point where the prevalence among women has equaled that of men since 2008, partly due to their increasing exposure to tobacco and to biomass fuels. Indeed, COPD has become the leading cause of death in women in the USA. A higher susceptibility of female to smoking and pollutants could explain this phenomenon. Besides, the clinical presentation appears different among women with more frequent breathlessness, anxiety or depression, lung cancer (especially adenocarcinoma), undernutrition and osteoporosis. Quality of life is also more significantly impaired in women. The theories advanced to explain these differences involve the role of estrogens, smaller bronchi, impaired gas exchange in the lungs and smoking habits. Usual medications (bronchodilators, ICS) demonstrated similar trends for exacerbation prevention and lung function improvement in men and women. There is an urgent need to recognize the increasing burden of COPD in women and therefore to facilitate global improvements in disease management (smoking cessation, pulmonary rehabilitation…) in half of the population. Nevertheless, important limitations to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. In conclusion there is an urgent need to recognize the increasing burden of COPD in women and therefore to facilitate globally improvements in disease management in this specific population.

scholarly journals Mortality in Emergency Services in a University Teaching Hospital: A Retrospective Study

2019 ◽  
Vol 41 (2) ◽  
pp. 17-20
Author(s):  
Tirtha Man Shrestha ◽  
Ramesh P Aacharya ◽  
Ram P Neupane ◽  
Bigyan Prajapati
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Septic Shock ◽  
Mortality Rate ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Emergency Services ◽  
University Teaching ◽  
Chronic Obstructive ◽  
Age Group ◽  
Obstructive Pulmonary Disease

Introduction: Emergency services are the gateway between the community and hospital that provides 24-hour access for most needy patients in critical and emergency conditions. Mortality rate varies in emergency department across the world and even in different emergency units of the same hospital. This retrospective study was done in adult emergency services of a tertiary hospital to determine mortality rate and analyze causes of death. Methods: A retrospective observational study of mortality cases to analyze mortality rate and causes of death of patients for a period of 6 months between October 2017 to March 2018 was carried out in the adult emergency services of Tribhuvan University Teaching Hospital, Kathmandu. Data required were collected from copies of death certificates. Results: During the study period, a total of 128 patients died in emergency, accounting 0.5% of total patient. Male deaths (52.3%) were slightly higher compared to female deaths (47.7%). Age group 66-75 years had the highest (24.2%) of total mortalities in the emergency. The most common immediate cause of death was sepsis/septic shock (21.9%) followed by cardiopulmonary arrest, aspiration, respiratory failure, other causes of shock and poisoning. The commonest antecedent cause of death was attributed to respiratory causes. Similarly, the most common contributory cause of death was chronic obstructive pulmonary disease. Conclusion: Older age group is prone to the mortality risk. Sepsis/septic shock was the most common immediate cause of death. Pneumonia was the most common antecedent causes of death. Chronic obstructive pulmonary disease was the commonest contributory cause.

scholarly journals Iranian Sub Cohort Chronic Obstructive Pulmonary Disease (IrSCCOPD): Need for Longitudinal Observational Studies COPD in Southwest of Iran

2021 ◽  
Author(s):  
Fatemeh Zeynab Kiani ◽  
Ali Ahmadi ◽  
Akbar Soleymani Babadi ◽  
Hamid Rouhi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cohort Study ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Occupational Exposures ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
The Mean ◽  
Southwestern Iran

Abstract Background: Chronic obstructive pulmonary disease (COPD) is a chronic and complex respiratory disorder that is associated with the airflow limitation and increased inflammatory response of the lungs to harmful particles and gases. The purpose of this original study was to describe the profile of Shahrekord PERSIAN Cohort Study regarding COPD in southwestern Iran. Methods: This study of asthma and respiratory diseases is a subcohort of the larger cohort study, i.e., Shahrekord PERSIAN cohort, a population-based prospective study on people aged 35-70 years in southwestern Iran (n=10,075). The sample size of the subcohort was 8500 people. Annual follow-ups (person-year) of the cohort were designed to be conducted up to 2036. The instruments to collect data on various exposures were derived from the questionnaires previously developed in extensive multinational studies (occupational exposures, smoking, housing status, and fuel consumption, history of respiratory and chronic diseases, comorbidity, etc.). The Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the lower limit of normal (NLL) spirometric criteria were used to confirm COPD diagnosis. Results: The response rate was 93.85%. The mean age of the participants was 49.48 ± 9.32; 47.9% were male and 52.9% were female; about 20% were in rural areas and nearly 16% of the population was current smokers; the fuel used by most of the participants for heating the house and cooking was gas. The most common comorbidity among participants was dyslipidemia; 30% of people have three or more comorbidities. According to GOLD and LLN criteria, 3.6% and 8.4% of participants had COPD, respectively. 4.3% of the participants had a history of chronic lung disease. The mean FEV1/ FVC was 92.48 (SD, 7.47), the mean FEF 25-75 was 3.43 (SD, 1.28) L. 47.6% had a history of chronic phlegm; 2.7% of the participants had shortness of breath and wheezingConclusion: Epidemiological research is necessary to create an appropriate framework to fight COPD. This framework requires a better description of men and women at risk of developing COPD and describing people with early-stage illnesses.

scholarly journals Jordan Minov. COPD and the Workplace. New York: Nova Science Publishers, Inc.; 2016. 83 pages; ISBN 978-1-63484-249-5

2016 ◽  
Vol 4 (4) ◽  
pp. 740-741
Author(s):  
Jovanka Karadzinska-Bislimovska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
New York ◽  
Tobacco Smoke ◽  
Occupational Exposures ◽  
Joint Effect ◽  
Medical Professionals ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Scientific Support

PURPOSE: The aim of this monograph is to present a role of the workplace exposures on the development and progression of chronic obstructive pulmonary disease (COPD), the joint effect of the workplace exposures and tobacco smoke in its development and progression, the diagnostics of the COPD related to occupational exposures, as well as its management and prevention.CONTENTS: The publication consists of seven chapters supplemented by a list of abbreviations and index of terms. The cited literature at the end of the monograph obtains scientific support to the elaborated professional knowledge.CONCLUSION: The monograph COPD and the Workplace presents a comprehensive literature dedicated to this problem and a serious effort for improvement of detection and management of COPD related to workplace exposures by medical professionals and its prevention.

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