scholarly journals Occupational Exposures and Chronic Airflow Limitation

1996 ◽  
Vol 3 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Helen Dimich-Ward ◽  
Susan M Kennedy ◽  
Moira Chan-Yeung
Keyword(s):  
Recent Literature ◽  
Airflow Obstruction ◽  
Occupational Exposures ◽  
Airflow Limitation ◽  
Smoking History ◽  
Compelling Evidence ◽  
Occupational History ◽  
Gold Miners ◽  
Hardrock Mining ◽  
Inorganic Dusts

The recent literature was reviewed to evaluate whether chronic airflow limitation is associated with occupational exposures to dusts. Only those studies that controlled for the effects of smoking were included. There is compelling evidence that exposure to inorganic dusts, such as from coal and hardrock mining or asbestos, are associated with the development of chronic airflow limitation, independently of pneumoconiosis. Nonsmoking gold miners are particularly at high risk of airflow obstruction and emphysema. Findings from studies of organic dusts, such as exposures to wood, cotton, grain or other agricultural dusts, or to mixed dust exposures, were less consistent but tended to show positive dose-response associations. In the majority of studies, no statistical interaction was shown between dust exposures and smoking; however, the effects of the dust exposures were often more pronounced. An occupational history should be considered, in addition to a smoking history, as an integral part of an investigation of chronic airflow limitation in a patient.

Perception of bronchoconstriction in smokers with airflow limitation

2001 ◽  
Vol 101 (5) ◽  
pp. 515-522 ◽  
Author(s):  
R. OTTANELLI ◽  
E. ROSI ◽  
M.C. RONCHI ◽  
M. GRAZZINI ◽  
B. LANINI ◽  
...  
Keyword(s):  
Airflow Obstruction ◽  
Clinical Score ◽  
Forced Expiratory Volume ◽  
Airflow Limitation ◽  
Smoking History ◽  
Stepwise Multiple Regression ◽  
Differential Count ◽  
Dynamic Hyperinflation ◽  
Residual Capacity ◽  
Bronchial Hyper Responsiveness

To our knowledge, no data have been provided as to whether and to what extent dynamic hyperinflation, through its deleterious effect on inspiratory muscle function, affects the perception of dyspnoea during induced bronchoconstriction in patients with chronic airflow obstruction. We hypothesized that dynamic hyperinflation accounts in part for the variability in dyspnoea during acute bronchoconstriction. We therefore studied 39 consecutive clinically stable patients whose pulmonary function data were as follows (% of predicted value): vital capacity (VC), 97.8% (S.D. 16.0%); functional residual capacity, 105.0% (18.8%); actual forced expiratory volume in 1s (FEV1)/VC ratio, 56.1% (6.3%). Perception of dyspnoea using the Borg scale was assessed during a methacholine-induced fall in FEV1. The clinical score and the treatment score, the level of bronchial hyper-responsiveness and the cytological sputum differential count were also assessed. In each patient, the percentage fall in FEV1 and the concurrent Borg rating were linearly related, with the mean slope (PD slope) being 0.09 (0.06). The percentage fall in FEV1 accounted for between 41% and 94% of the variation in the Borg score. At a 20% fall in FEV1, the decrease in inspiratory capacity (ΔIC) was 0.156 (0.050) litres. Patients were divided into three subgroups according to the PD slope (arbitrary units/% fall in FEV1): subgroup I [eight hypoperceivers; PD slope 0.026 (0.005)], subgroup II [26 moderate perceivers; 0.090 (0.037)] and subgroup III [five hyperperceivers; 0.200 (0.044)]. By applying stepwise multiple regression analysis with the PD slope as the dependent variable, and other characteristics (demographic, clinical and functional characteristics, smoking history, level of bronchial hyper-responsiveness and sputum cytological profile) as independent variables, ΔIC (r2 = 45%, P < 0.00001) and to a lesser extent treatment score (r2 = 17.3%, P < 0.0006), and to an even lesser extent age (r2 = 3%, P < 0.05), independently predicted a substantial amount (r2 = 65.27%, P < 0.00001) of the variability in the Borg slope. Thus acute hyperinflation, and to a lesser extent treatment score and age, account in part for the variability in the perception of dyspnoea after accounting for changes in FEV1 during bronchoconstriction in patients with chronic airflow obstruction.

scholarly journals A literature review on depression and its risk factors among people suffering from chronic obstructive pulmonary disease in Asian sub-continent

2020 ◽  
Vol 7 (11) ◽  
pp. 4653
Author(s):  
Amrit Sharma
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Low Income ◽  
Airflow Obstruction ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Inflammatory Response ◽  
Basic Activity

Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. It has been suggested that emotional disturbances such as depression and anxiety are common among patients with COPD. This review aims to highlight the presence of depression and associated risk factors among patients suffering from COPD in Asia. Fifty-eight observational studies were retrieved through data sources like PubMed, Medical subject heading (MeSH) search and Google scholar. After thorough screening total thirteen studies were identified and included in this review. Based on the results of these studies, the south and west Asian countries had higher proportion of depression. However, risk factor results were mixed which includes severity of obstruction/global initiative for obstructive lung disease (GOLD) criteria, Stage 2 COPD, teetotallers, smoking, alcohol consumption, body mass index, airflow obstruction, dyspnoea, and exercise (BODE) index, urban residence, female gender, education level, dyspnoea, low income, poor Quality of life (QOL) scores, age, poor self-reported health, basic activity of daily living (BADL) disability. Further superior research studies with larger sample size are required on Asian population. All in all, it is recommended that early diagnosis and treatment of depression should be included as a part of management in COPD as it can help to minimize the risk of morbidity and mortality in the patients.

scholarly journals Airway responsiveness to methacholine and incidence of COPD: an international prospective cohort study

Thorax ◽  
2018 ◽  
Vol 73 (9) ◽  
pp. 825-832 ◽  
Author(s):  
Alessandro Marcon ◽  
Francesca Locatelli ◽  
Dirk Keidel ◽  
Anna B Beckmeyer-Borowko ◽  
Isa Cerveri ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Dose Response ◽  
Respiratory Health ◽  
Heart Diseases ◽  
Airflow Obstruction ◽  
Occupational Exposures ◽  
Airway Responsiveness ◽  
History Of ◽  
Rate Ratios

BackgroundIt has been debated, but not yet established, whether increased airway responsiveness can predict COPD. Recognising this link may help in identifying subjects at risk.ObjectiveWe studied prospectively whether airway responsiveness is associated with the risk of developing COPD.MethodsWe pooled data from two multicentre cohort studies that collected data from three time points using similar methods (European Community Respiratory Health Survey and Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). We classified subjects (median age 37 years, 1st–3rd quartiles: 29–44) by their level of airway responsiveness using quintiles of methacholine dose–response slope at the first examination (1991–1994). Then, we excluded subjects with airflow obstruction at the second examination (1999–2003) and analysed incidence of COPD (postbronchodilator FEV1/FVC below the lower limit of normal) at the third examination (2010–2014) as a function of responsiveness, adjusting for sex, age, education, body mass index, history of asthma, smoking, occupational exposures and indicators of airway calibre.ResultsWe observed 108 new cases of COPD among 4205 subjects during a median time of 9 years. Compared with the least responsive group (incidence rate 0.6 per 1000/year), adjusted incidence rate ratios for COPD ranged from 1.79 (95% CI 0.52 to 6.13) to 8.91 (95% CI 3.67 to 21.66) for increasing airway responsiveness. Similar dose–response associations were observed between smokers and non-smokers, and stronger associations were found among subjects without a history of asthma or asthma-like symptoms.ConclusionsOur study suggests that increased airway responsiveness is an independent risk factor for COPD. Further research should clarify whether early treatment in patients with high responsiveness can slow down disease progression.

Arterial Oxygen Desaturation during Sleep in Children with Asthma and Its Relation to Airway Obstruction and Ventilatory Drive

PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 746-751
Author(s):  
Thomas F. Smith ◽  
David W. Hudgel
Keyword(s):  
Arterial Oxygen Saturation ◽  
Airflow Obstruction ◽  
Airflow Limitation ◽  
Arterial Oxygen ◽  
Healthy Children ◽  
Medication Regimen ◽  
Asthmatic Children ◽  
Control Subjects ◽  
Ventilatory Drive ◽  
Maximum Decrease

The possibility that arterial oxygen saturation (Sao2) decreases during sleep in children with chronic bronchial asthma was investigated. The relationship between decreases in sleep Sao2 and airflow obstruction and ventilatory drives, as characterized by ventilatory and inspiratory muscle activity responses to hypoxia and hypercapnia was also examined. Sixteen asthmatics on suboptimal bronchodilator therapy and ten healthy children were studied. Both maximum decrease in Sao2 and number of desaturations (decrease in Sao2 ≥4%) per hour during sleep were greater in the asthmatics than in the control subjects. Both maximum decrease in Sao2 and number of desaturations per hour asleep were correlated with change in FEV1 and FEF25%-75% over the sleep period. Changes in Sao2 were not related to awake measurements of ventilatory drive. Eight of the asthmatics also were studied when on a more optimal medication regimen. On this program they had less airflow obstruction before and after sleep, and the number and extent of decreases in Sao2 were not different from those of the control subjects. We conclude: (1) decreases in Sao2 occurred during sleep in suboptimally treated asthmatic children; (2) Sao2 changes during sleep were related to the amount of airflow obstruction that developed during sleep; (3) Sao2 changes during sleep were not related to ventilatory drive measured during wakefulness; and (4) a good therapeutic regimen eliminated abnormal amounts of sleep hypoxemia by inproving airflow limitation. However, as the results of this study indicate, when their pulmonary status is unstable, asthmatic children may develop clinically significant hypoxemia during sleep.

Airflow limitation as a risk factor for vascular stiffness

2020 ◽  
Vol 24 (6) ◽  
pp. 577-584
Author(s):  
S. S. Sheen ◽  
H. J. Kim ◽  
D. Singh ◽  
S. C. Hwang ◽  
K. J. Park ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Forced Expiratory Volume ◽  
Vascular Stiffness ◽  
University Hospital ◽  
Airflow Limitation ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Health Examination

BACKGROUND: Cardiovascular disease is one of the main causes of mortality in patients with chronic obstructive pulmonary disease (COPD), and atherosclerosis is a cause of cardiac comorbidities in COPD. However, it is not clear whether airflow limitation is associated with atherosclerosis irrespective of smoking.OBJECTIVE: To investigate whether airflow limitation is independently associated with vascular stiffness.METHODS: We enrolled 18 893 participants (male 70.5%; mean age 47.5 ± 9.8 years; never smokers 44.2%) who underwent spirometry and brachial-ankle pulse wave velocity (baPWV) as part of a standard health examination at Ajou University Hospital, Suwon, South Korea, from January 2010 to December 2015.We defined vascular peripheral atherosclerosis as baPWV ≥ 1400 cm/s and airflow limitation as pre-bronchodilator ratio of forced expiratory volume in 1 sec (FEV1) to forced vital capacity (FVC) <70%.RESULTS: Mean baPWV was higher in subjects with airflow limitation (1477.6 ± 331.7 cm/sec, n = 638) than in those without airflow limitation (1344.1 ± 231.8 cm/sec, n = 18255, P < 0.001). In multivariate logistic regression analysis, the following were independent predictors associated with peripheral atherosclerosis (P < 0.05): age, male sex, fasting serum glucose, mean blood pressure, serum leukocyte count, serum low density lipoprotein level and FEV1.CONCLUSION: Airflow limitation was an independent predictor of vascular stiffness irrespective of smoking history, which suggests that airflow limitation is linked with atherosclerosis.

Occupational exposure to inhaled pollutants and risk of airflow obstruction: a large UK population-based UK Biobank cohort

Thorax ◽  
2020 ◽  
Vol 75 (6) ◽  
pp. 468-475
Author(s):  
Steven S Sadhra ◽  
Nuredin Mohammed ◽  
Om P Kurmi ◽  
David Fishwick ◽  
Sara De Matteis ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Airflow Obstruction ◽  
Occupational Exposures ◽  
Sensitivity Analyses ◽  
Uk Biobank ◽  
High Exposure ◽  
Increased Risk ◽  
Never Smokers ◽  
The Relationship ◽  
Increase In Risk

BackgroundAlthough around 10% to 15% of COPD burden can be attributed to workplace exposures, little is known about the role of different airborne occupational pollutants (AOP). The main aim of the study was to assess the effect size of the relationship between various AOP, their level and duration of exposure with airflow obstruction (AFO).MethodsA cross-sectional analysis was conducted in 228 614 participants from the UK Biobank study who were assigned occupational exposure using a job exposure matrix blinded to health outcome. Adjusted prevalence ratios (PRs) and 95% CI for the risk of AFO for ever and years of exposure to AOPs were estimated using robust Poisson model. Sensitivity analyses were conducted for never-smokers, non-asthmatic and bi-pollutant model.ResultsOf 228 614 participants, 77 027 (33.7%) were exposed to at least one AOP form. 35.5% of the AFO cases were exposed to vapours, gases, dusts or fumes (VGDF) and 28.3% to dusts. High exposure to vapours increased the risk of occupational AFO by 26%. Exposure to dusts (adjusted PR=1.05; 95% CI 1.01 to 1.08), biological dusts (1.05; 1.01 to 1.10) and VGDF (1.04; 1.01 to 1.07) showed a significantly increased risk of AFO, however, statistically not significant following multiple testing. There was no significant increase in risk of AFO by duration (years) of exposure in current job. The results were null when restricted to never-smokers and when a bi-pollutant model was used. However, when data was analysed based on the level of exposure (low, medium and high) compared with no exposure, directionally there was increase in risk for those with high exposure to vapours, gases, fumes, mists and VGDF but statistically significant only for vapours.ConclusionHigh exposure (in current job) to airborne occupational pollutants was suggestive of higher risk of AFO. Future studies should investigate the relationship between lifetime occupational exposures and COPD.

scholarly journals Association of NLRP1 Coding Polymorphism with Lung Function and Serum IL-1β Concentration in Patients Diagnosed with Chronic Obstructive Pulmonary Disease (COPD)

Genes ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 783 ◽  
Author(s):  
Ozretić ◽  
da Silva Filho ◽  
Catalano ◽  
Sokolović ◽  
Vukić-Dugac ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Minor Allele ◽  
Fine Tuning ◽  
Airflow Limitation ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Impact

Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by a progressive decline in lung function due to airflow limitation, mainly related to IL-1β-induced inflammation. We have hypothesized that single nucleotide polymorphisms (SNPs) in NLRP genes, coding for key regulators of IL-1β, are associated with pathogenesis and clinical phenotypes of COPD. We recruited 704 COPD individuals and 1238 healthy controls for this study. Twenty non-synonymous SNPs in 10 different NLRP genes were genotyped. Genetic associations were estimated using logistic regression, adjusting for age, gender, and smoking history. The impact of genotypes on patients’ overall survival was analyzed with the Kaplan–Meier method with the log-rank test. Serum IL-1β concentration was determined by high sensitivity assay and expression analysis was done by RT-PCR. Decreased lung function, measured by a forced expiratory volume in 1 s (FEV1% predicted), was significantly associated with the minor allele genotypes (AT + TT) of NLRP1 rs12150220 (p = 0.0002). The same rs12150220 genotypes exhibited a higher level of serum IL-1β compared to the AA genotype (p = 0.027) in COPD patients. NLRP8 rs306481 minor allele genotypes (AG + AA) were more common in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of group A (p = 0.0083). Polymorphisms in NLRP1 (rs12150220; OR = 0.55, p = 0.03) and NLRP4 (rs12462372; OR = 0.36, p = 0.03) were only nominally associated with COPD risk. In conclusion, coding polymorphisms in NLRP1 rs12150220 show an association with COPD disease severity, indicating that the fine-tuning of the NLRP1 inflammasome could be important in maintaining lung tissue integrity and treating the chronic inflammation of airways.

scholarly journals Comparision of the Spirometric Measurements of Multi-National Under-graduate Medical Students from a Medical College of Central Nepal

2019 ◽  
Vol 15 (2) ◽  
pp. 144-149
Author(s):  
Sameer Timilsina ◽  
Sirisa Karki ◽  
Bhuwan Baskota
Keyword(s):  
Medical Students ◽  
Pulmonary Function ◽  
Clinical Medicine ◽  
Airflow Obstruction ◽  
Preoperative Assessment ◽  
Prediction Equation ◽  
Airflow Limitation ◽  
Sri Lankan ◽  
Anthropometric Parameters ◽  
Significant Difference

Background: The application of pulmonary function testing is increasing in many areas of clinical medicine, including assessment of airflow limitation, diagnosis of airflow obstruction and lung restriction, evaluation of pulmonary impairment, preoperative assessment as well as public health screening. In this study, attempt has been made to evaluate Pulmonary Function Test (PFT) of healthy Nepalese young adults and compare their values with healthy Indian and Sri Lankan counterparts. Further, it tries to shed light on the correlation of these data with anthropometric parameters. Methods: A total of 133 pre-clinical medical students of Manipal College of Medical Sciences were included in the study. PFT was done using a computerized automatic spirometer. Results: All the pulmonary parameters showed significant gender differences. All mean value of PFT parameters were higher in males. The comparisons of different parameters of PFT according to gender between three countries namely Nepal, India and Sri Lanka showed that Nepalese and Indian females had a higher FEV1 and FVC values than Sri Lankan females (p<0.05). Sri Lankan females had lower FEV1 and FVC as compared to Nepalese and Indian females (p<0.05). However, no correlation was observed between PFTs and BMI. Conclusions: Although some significant differences on PFT parameters were observed in Sri Lankan data when compared with Nepalese and Indian data, no significant difference was noticed between Nepalese and Indian values of PFT. Therefore Indian prediction equation for PFT can be used for Nepal but only after further study with a larger sample size.

scholarly journals Comprehensive Analysis of Transcriptome Sequencing Data in the Lung Tissues of COPD Subjects

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Woo Jin Kim ◽  
Jae Hyun Lim ◽  
Jae Seung Lee ◽  
Sang-Do Lee ◽  
Ju Han Kim ◽  
...  
Keyword(s):  
Oxidative Phosphorylation ◽  
Complex Disease ◽  
Chromatin Modification ◽  
Airflow Obstruction ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Sequencing Data ◽  
Obstructive Pulmonary Disease ◽  
Control Subjects ◽  
Expression Of Genes

Background and Objectives.Chronic obstructive pulmonary disease (COPD) is a complex disease characterized by airflow limitation. Although airway inflammation and oxidative stress are known to be important in the pathogenesis of COPD, the mechanism underlying airflow obstruction is not fully understood. Gene expression profiling of lung tissue was performed to define the molecular pathways that are dysregulated in COPD.Methods.RNA was isolated from lung tissues obtained from 98 subjects with COPD and 91 control subjects with normal spirometry. The RNA samples were processed with RNA-seq using the HiSeq 2000 system. Genes expressed differentially between the two groups were identified using Student’st-test.Results.After filtering for genes with zero counts and noncoding genes, 16,676 genes were evaluated. A total of 2312 genes were differentially expressed between the lung tissues of COPD and control subjects (false discovery rate correctedq<0.01). The expression of genes related to oxidative phosphorylation and protein catabolism was reduced and genes related to chromatin modification were dysregulated in lung tissues of COPD subjects.Conclusions. Oxidative phosphorylation, protein degradation, and chromatin modification were the most dysregulated pathways in the lung tissues of COPD subjects. These findings may have clinical and mechanistic implications in COPD.

scholarly journals INTERACTION BETWEEN CLINICAL AND PSYCHOLOGICAL CHANGES AMONG PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND PULMONARY TUBERCULOSIS CO-MORBIDITY

2019 ◽  
Vol 72 (4) ◽  
pp. 635-638
Author(s):  
Natalia V. Zhovanyk ◽  
Mariana I. Tovt-Korshynska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Disease ◽  
Airflow Limitation ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Co Morbidity ◽  
Situational Anxiety ◽  
Personal Anxiety

Introduction: The association of chronic obstructive pulmonary disease and pulmonary tuberculosis is an important medical and social problem with a significant burden in terms of morbidity and mortality. The course and prognosis of chronic diseases such as chronic obstructive pulmonary disease and pulmonary tuberculosis is greatly influenced not only by the clinical features but also by the psychological characteristics of the patient. The aim: To study the interaction between clinical changes and psychological characteristics considering gender differences among patients with chronic obstructive pulmonary disease in association with pulmonary tuberculosis. Materials and methods: We studied 41patients with chronic obstructive pulmonary disease (grade 2, 3, groups А, B, С, D) and infiltrative pulmonary tuberculosis co-morbidity (11 women and 30 men). All patients underwent general clinical examination, Acid-Fast Bacillus Testing, spirometry, Spielberg anxiety scale, Beck depression scale. Results: Patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity with more severe symptoms (according to Assesment Test scores) were older and, regardless of it, showed elevated depression and personal anxiety scores while situational anxiety scores were significantly lower compared to those with less severe symptoms. The correlation between symptoms severity and airflow limitation or smoking history was very mild. The elevated depression and personal anxiety could cause more severe symptoms. The revealed discrepancy between the symptoms severity and low levels of situational anxiety may be due to adaptation with displacement mechanisms to illness related chronic life stressors. We also observed elevated personal anxiety and depression scores together with less severe symptoms among female versus male chronic obstructive pulmonary disease/pulmonary tuberculosis patients, possibly reflecting physically ill women’s higher risk for depressive and anxiety related symptomatology relative to ill men. Conclusions: We revealed that among patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity symptoms severity was largely influenced by the patients’ age, gender and psychological factors (depression and personal anxiety), but, unexpectedly, much less – by airflow limitation and smoking history. We also found higher emotional distress, namely elevated personal anxiety and depression scores, in combination with less severe symptoms among female versus male patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity.

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