scholarly journals Airborne occupational exposures and the risk of developing respiratory symptoms and airway obstruction in the Lifelines Cohort Study

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216721
Author(s):  
Md Omar Faruque ◽  
H Marike Boezen ◽  
Hans Kromhout ◽  
Roel Vermeulen ◽  
Ute Bültmann ◽  
...  
Keyword(s):  
Cohort Study ◽  
Airway Obstruction ◽  
Chronic Bronchitis ◽  
Chronic Cough ◽  
Respiratory Symptoms ◽  
Occupational Exposures ◽  
Control Measures ◽  
High Exposure ◽  
Pesticides Exposure

ObjectivesTo date, only a few studies have investigated the associations between occupational exposures and respiratory outcomes longitudinally in the general population. We investigated the associations between occupational exposures and the development of respiratory symptoms and airway obstruction in the Lifelines Cohort Study.MethodsWe included 35 739 occupationally active subjects with data on chronic cough, chronic phlegm, chronic bronchitis or airway obstruction at baseline and approximately 4.5 years follow-up. Exposures to biological dust, mineral dust, gases/fumes, pesticides, solvents and metals in the current job at baseline were estimated with the ALOHA+job-exposure matrix (JEM). Airway obstruction was defined as FEV1/FVC below the lower limit of normal. Logistic regression analysis adjusted for baseline covariates was used to investigate the associations.ResultsAt follow-up, 1888 (6.0%), 1495 (4.7%), 710 (2.5%) and 508 (4.5%) subjects had developed chronic cough, chronic phlegm, chronic bronchitis and airway obstruction, respectively. High exposure to biological dust was associated with a higher odds to develop chronic cough and chronic bronchitis. High exposure to pesticides was associated with a higher odds for the development of all respiratory symptoms and airway obstruction. In the multiple exposures analyses, only the association between pesticides exposure and respiratory symptoms remained.ConclusionsSubjects exposed to high pesticides had a higher odds to develop respiratory symptoms on average 4.5 years later. Control measures should be taken to reduce pesticides exposure among the working population to prevent respiratory symptoms and airway obstruction.

Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study

2020 ◽  
Author(s):  
Thomas Bénet ◽  
Sélilah Amour ◽  
Martine Valette ◽  
Mitra Saadatian-Elahi ◽  
Ludwig Serge Aho-Glélé ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Cumulative Incidence ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Control Measures ◽  
T1 And T2 ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Abstract Background Influenza is an important cause of viral hospital-acquired infection involving patients, healthcare workers (HCW), and visitors. The frequency of asymptomatic influenza among HCW with possible subsequent transmission is poorly described. The objective is to determine the cumulative incidence of asymptomatic, paucisymptomatic, and symptomatic influenza among HCW. Method A multicenter prospective cohort study was done in 5 French university hospitals, including 289 HCW during the 2016–2017 influenza season. HCW had 3 physical examinations (time [T] 0, before epidemic onset; T.1, before epidemic peak; T.2, T.3, after epidemic peak). A blood sample was taken each time for influenza serology and a nasal swab was collected at T1 and T2 for influenza detection by polymerase chain reaction (PCR). Positive influenza was defined as either a positive influenza PCR, and/or virus-specific seroconversion against influenza A, the only circulating virus, with no vaccination record during follow-up. Symptoms were self-reported daily between T1 and T2. Cumulative incidence of influenza was stratified by clinical presentation per 100 HCW. Results Of the 289 HCW included, 278 (96%) completed the entire follow-up. Overall, 62 HCW had evidence of influenza of whom 46.8% were asymptomatic, 41.9% were paucisymptomatic, and 11.3% were symptomatic. Cumulative influenza incidence was 22.3% (95% confidence interval [CI]: 17.4%–27.2%). Cumulative incidence of asymptomatic influenza was 5.8% (95% CI: 3.3%–9.2%), 13.7% (95% CI: 9.9%–18.2%) for paucisymptomatic influenza, and 2.9% (95% CI: 1.3%–5.5%) for symptomatic influenza. Conclusions Asymptomatic and paucisymptomatic influenza were frequent among HCW, representing 47% and 42% of the influenza burden, respectively. These findings highlight the importance of systematic implementation of infection control measures among HCW regardless of respiratory symptoms from preventing nosocomial transmission of influenza. Clinical Trials Registration NCT02868658.

Incidence of health problems in travelers to Southeast Asia: a prospective cohort study

2019 ◽  
Vol 26 (7) ◽  
Author(s):  
Phimphan Pisutsan ◽  
Ngamphol Soonthornworasiri ◽  
Wasin Matsee ◽  
Weerapong Phumratanaprapin ◽  
Suda Punrin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Southeast Asia ◽  
Prospective Cohort Study ◽  
Acute Diarrhea ◽  
Prospective Cohort ◽  
Respiratory Symptoms ◽  
Final Analysis ◽  
Health Problems ◽  
Rabies Exposure

Abstract Background There are few studies of the incidence of health problems among travelers to Southeast Asia. The current study sought to determine the incidence of self-reported health problems among travelers visiting the region. Methods A prospective questionnaire-based study was conducted among travelers from high-income countries who visited Southeast Asia. Participants were enrolled at time of their pre-travel visit at Mahidol University, Bangkok, Thailand. Travelers were prospectively followed by self-administered questionnaires 2 weeks after arrival, upon return to their home country and 2 weeks after return. Results During January 2018–February 2019, 359 travelers were enrolled in Bangkok, Thailand, and the first questionnaire was administered. Follow-up questionnaires were returned by 191, 96 and 64 participants 2 weeks later, at the end of the trip and 2 weeks after return, respectively. A total of 6094 travel days were included in the final analysis. The incidence of acute diarrhea per month per 1000 travelers was 217 [95% confidence interval (CI), 189–248] episodes; skin problems, 197 (95% CI, 170–227); respiratory symptoms, 133 (95% CI, 111–158); fever, 49 (95% CI, 36–65); and potential rabies exposure, 34 (95% CI, 24–48). The incidence of acute diarrhea episodes per month per 1000 travelers was significantly higher during the first 2 weeks of travel compared with subsequent weeks of travel: 325 (95% CI, 291–362) vs 132 (95% CI, 110–1157) (P < 0.05). The incidence of outpatient visits and hospitalizations per month per 1000 travelers was 49 (95% CI, 36–65) and 5 (95% CI, 2–10), respectively. Conclusions In this prospective cohort study we observed substantial burden of acute diarrhea and skin and respiratory symptoms among travelers to Southeast Asia. The higher incidence of diarrhea in the first 2 weeks of travel should be further investigated.

scholarly journals The Health of Firefighters Deployed to the Fort McMurray Fire: Lessons Learnt

2021 ◽  
Vol 9 ◽  
Author(s):  
Nicola Cherry ◽  
Jeremy Beach ◽  
Jean-Michel Galarneau
Keyword(s):  
Mental Health ◽  
Respiratory Symptoms ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
High Exposure ◽  
Fort Mcmurray ◽  
Particulate Exposure ◽  
Exposure Mitigation ◽  
Over Time

Introduction: Firefighters were working in exceptionally difficult conditions during the Fort McMurray/Horse River fire in May 2016.Methods: From mid-May, we recruited firefighters from 13 fire services as they returned from the fire. In October 2016 we extended recruitment to all Alberta-based firefighters deployed to the fire. In December 2017–May 2018 we sent a first online follow-up: this concentrated on mental health supports. The second follow-up, in October 2018–January 2019, included screening scales for respiratory ill-health and PTSD. All three contacts included visual analogue scales for chest symptoms and the Hospital Anxiety and Depression Scale. We estimated exposure to PM2.5, and calculated an exposure mitigation index from reports of respiratory protective equipment (RPE).Results: We recruited 1,234 firefighters and examined the relation of respiratory symptoms to estimated particulate exposure. The relation was strong immediately post fire but weakened over time. We found less chest tightness and cough in those whose RPE in the first week mitigated exposure by at least 10%. We examined the relation between particulate exposure and mental ill-health from screening questionnaires and found those with high exposure (reflecting the ferocity of the fire) had poorer mental health scores. Firefighters reporting their “worst moment during the fire” was life threatening were more anxious at second follow-up. Overall both anxiety and depression scores increased at successive contacts, more so in those with mental ill-health recorded in physician billing records before the fire.Discussion: The results from this study overall suggest on-going fire-related health effects in a substantial minority of firefighters, similar to those reported in the longitudinal follow-up of firefighters after the collapse of the World Trade Centre. Self-reports of both respiratory symptoms and mental ill-health were strongly related, soon after the fire, to estimated particulate exposures. Anxiety increased over time since the fire in those who felt their life or safety had been threatened, underlining the need for ongoing support. Our conclusions about the benefits of rapid research relate particularly to the collection of biomarkers of exposure as quickly and widely as possible, and the establishment of a nominal list of participants before they are too widely dispersed.

Chronic cough and phlegm in relation to occupational exposures in a prospective cohort study (ECRHS III)

2015 ◽  
Author(s):  
Theodore Lytras ◽  
Hans Kromhout ◽  
Josep Maria Antó ◽  
Per Bakke ◽  
Geza Benke ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Chronic Cough ◽  
Prospective Cohort ◽  
Occupational Exposures

scholarly journals Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050824
Author(s):  
Laure Mortgat ◽  
Kristien Verdonck ◽  
Veronik Hutse ◽  
Isabelle Thomas ◽  
Cyril Barbezange ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Vaccination Strategy ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Online Questionnaire ◽  
Reverse Transcription Pcr

ObjectivesTo describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April–December 2020.DesignProspective cohort study. Follow-up was originally planned until September and later extended.SettingMulticentre study, 17 hospitals.Participants50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April–May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit.Outcome measuresA semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire.ResultsAmong all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion.ConclusionsThe seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy.Trial registration numberNCT04373889

Respiratory symptoms and ventilatory function among health-care workers exposed to cleaning and disinfectant chemicals, a 2-year follow-up study

2016 ◽  
Vol 32 (12) ◽  
pp. 2002-2008 ◽  
Author(s):  
Mohamed El-Helaly ◽  
Hanan H Balkhy ◽  
Khan Waseem ◽  
Sahdia Khawaja
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Respiratory Symptoms ◽  
Control Measures ◽  
Effective Control ◽  
Ventilatory Function ◽  
Work Related ◽  
Follow Up Study ◽  
Care Workers

Previous cross-sectional studies have shown that exposure to cleaning chemicals among health-care workers (HCWs) is associated with respiratory disorders and ventilatory function changes. This study aimed to further explore this association using a longitudinal approach. A prospective 2-year follow-up study was carried out at a tertiary care hospital in Saudi Arabia from June 2012 to June 2014 among 56 nurses who were responsible for disinfection and sterilization of medical instruments and equipment. The workplaces of the participants were assessed for engineering, environmental, and safety control measures. Self-administered questionnaires were distributed to all participants to assess their exposure to cleaning chemicals and their medical history. Spirometric parameters were measured for all nurses in 2012 (baseline) and again in 2014 (follow-up). The prevalence of work-related respiratory symptoms did not increase significantly over this time. Among all the spirometric parameters, only forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio decreased significantly, and only 10.7% of participants who were exposed to cleaning chemicals for more than 10 years had FEV1 and FVC less than their longitudinal normal limits at the end of the study. Smoking and gender were associated with statistically significant decreases in some of the spirometric parameters. Our 2-year follow-up study did not demonstrate significant association between exposure to cleaning chemicals among HCWs and changes in the prevalence of work-related respiratory symptoms, but indicated early effects on ventilatory function among them. The study highlights the importance of periodic spirometry, proper work practices, and effective control measures to protect HCWs against potentially harmful workplace chemicals for disinfection and sterilization.

scholarly journals Chinese primary knee osteoarthritis progression cohort (CPKOPC) to evaluate the progression of knee osteoarthritis in the Beijing population: a prospective cohort study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029430 ◽  
Author(s):  
Minwei Zhao ◽  
Yupeng Liang ◽  
Xinguang Wang ◽  
Lin Zeng ◽  
Hua Tian
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Study Protocol ◽  
Occupational Exposures ◽  
Beijing Area ◽  
Knee Oa ◽  
The Impact

IntroductionMillions of patients are currently suffering from pain and dysfunction caused by osteoarthritis (OA), and billions of dollars have been invested into treatment. Because there is no effective treatment that can reverse the progression of knee OA, it is important to determine the risk factors that may influence the progression. However, although there are many studies that examine risk factors for progression, there are only a few that specifically focus on the impact of each risk factor for predicting progression of knee OA. This study aimed to develop a cohort of patients with primary knee OA in the Beijing area to establish models that identify the influence of each risk factor on the prediction of knee OA progression.Methods and analysisThis is a prospective, multicentre, hospital-based cohort study. The study population comprises 2000 patients with primary knee OA from the Beijing area. The recruitment and baseline visits started in December 2017 and will finish in November 2018. After baseline visits, the patients will be followed for 3 years or until the occurrence of primary outcomes. Demographic variables will be collected during the baseline visit. Influencing factors including occupational exposures, family history and treatment will be collected at baseline and each follow-up visit. The primary outcome measure is a comprehensive index which will be combined with clinical WOMAC score, imaging K-L grade and clinical outcomes. These data will also be collected at baseline and each follow-up visit.Ethics and disseminationThis study protocol has been approved by Peking University Third Hospital Medical Science Research Ethics Committee. All the eligible participants will give written informed consent. The findings will be published in peer-reviewed journals and presented at national or international conferences. Besides, the results will be disseminated to all participants via the social software ‘WeChat’.Trial registration numberChiCTR-ROC-17013790; preresults.

scholarly journals Pesticides and other occupational exposures are associated with airway obstruction: the LifeLines cohort study

2013 ◽  
Vol 71 (2) ◽  
pp. 88-96 ◽  
Author(s):  
K de Jong ◽  
H M Boezen ◽  
H Kromhout ◽  
R Vermeulen ◽  
D S Postma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Airway Obstruction ◽  
Occupational Exposures

scholarly journals Prevalence, incidence, and characteristics of chronic cough among adults from the Canadian Longitudinal Study on Ageing (CLSA)

2021 ◽  
pp. 00160-2021
Author(s):  
Imran Satia ◽  
Alexandra J. Mayhew ◽  
Nazmul Sohel ◽  
Om Kurmi ◽  
Kieran J. Killian ◽  
...  
Keyword(s):  
Gender Differences ◽  
Chronic Pain ◽  
Longitudinal Study ◽  
Chronic Cough ◽  
Respiratory Symptoms ◽  
Vascular Diseases ◽  
Current Smoking ◽  
And Gender ◽  
Cardio Vascular

The global prevalence of chronic cough(CC) is highly variable ranging from 2–18%. There is a lack of data on the prevalence and incidence of CC from the general population. The objective of this study was to investigate the prevalence and incidence of CC in a sample of Canadian adults, and how these influenced by age, sex, smoking, respiratory symptoms, medical co-morbidities, and lung function.Participants with chronic cough were identified from the Canadian Longitudinal Study on Ageing (CLSA) based on a self-reported daily cough in the last 12 months. This is a prospective, nationally generalisable, stratified random sample of adults aged 45–85 at baseline recruited between 2011–2015, and followed-up 3 years later. The prevalence and incidence per-100-person-years are described, with adjustments for age, sex and smoking.Of the 30 097 participants, 29 972 completed the CC question at baseline and 26 701 at follow-up. The prevalence of CC was 15.8% at baseline and 17.6% at follow-up with 10.4%–17.1% variation across 7 provinces included in the CLSA comprehensive sample. Prevalence increased with age, current smoking, and was higher in males(15.2%), Caucasians(14%), and those born in North America, Europe or Oceania(14%). The incidence of CC adjusted for age, sex and smoking was higher in males, underweight and obese. Respiratory symptoms, airways diseases, lower FEV1%predicted, cardio-vascular diseases, psychological disorders, diabetes and chronic pain had a higher incidence of CC.The prevalence and incidence of CC is high in the CLSA sample with geographic, ethnic and gender differences which is influence by a number of medical co-morbidities.

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