scholarly journals The occupations at increased risk of COPD: analysis of lifetime job-histories in the population-based UK Biobank Cohort

2019 ◽  
Vol 54 (1) ◽  
pp. 1900186 ◽  
Author(s):  
Sara De Matteis ◽  
Deborah Jarvis ◽  
Andrew Darnton ◽  
Sally Hutchings ◽  
Steven Sadhra ◽  
...  
Keyword(s):  
High Risk ◽  
Occupational Exposures ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Preventive Strategies ◽  
Uk Biobank ◽  
Increased Risk ◽  
New Findings ◽  
Never Smokers

Occupational exposures are important, preventable causes of chronic obstructive pulmonary disease (COPD). Identification of COPD high-risk jobs is key to focus preventive strategies, but a definitive job-list is unavailable.We addressed this issue by evaluating the association of lifetime job-histories and lung function data in the population-based UK Biobank cohort, whose unprecedented sample size allowed analyses restricted to never-smokers to rule out the most important confounder, tobacco smoking. COPD was spirometrically defined as forced expiratory volume in 1 s/forced vital capacity ratio below the lower limit of normal. Lifetime job-histories were collected via OSCAR (Occupations Self-Coding Automatic Recording), a new validated online tool that automatically codes jobs into the UK Standard Occupational Classification v.2000. Prevalence ratios for COPD by employment duration in each job compared to lifetime office workers were estimated using robust Poisson regression adjusted for age, sex, centre and smoking. Only associations confirmed among never-smokers and never-asthmatics were considered reliable.From the 116 375 participants with complete job-histories, 94 551 had acceptable/repeatable spirometry data and smoking information and were included in the analysis. Six occupations showed an increased COPD risk among never-smokers and never-asthmatics; most of these also with positive exposure-response trends. Interesting new findings included sculptors, gardeners and warehouse workers.COPD patients, especially never-smokers, should be asked about their job-history for better disease management. Focussed preventive strategies in COPD high-risk jobs are warranted.

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 The effects of marijuana smoking on lung function in older people

2019 ◽  
Vol 54 (6) ◽  
pp. 1900826 ◽  
Author(s):  
Wan C. Tan ◽  
Jean Bourbeau ◽  
Shawn D. Aaron ◽  
James C. Hogg ◽  
François Maltais ◽  
...  
Keyword(s):  
Lung Function ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Long Term Effects ◽  
Obstructive Pulmonary Disease ◽  
Before And After ◽  
Rate Of Decline ◽  
Never Smokers

BackgroundPrevious studies have associated marijuana exposure with increased respiratory symptoms and chronic bronchitis among long-term cannabis smokers. The long-term effects of smoked marijuana on lung function remain unclear.MethodsWe determined the association of marijuana smoking with the risk of spirometrically defined chronic obstructive pulmonary disease (COPD) (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio <0.7) in 5291 population-based individuals and the rate of decline in FEV1 in a subset of 1285 males and females, aged ≥40 years, who self-reported use (or non-use) of marijuana and tobacco cigarettes and performed spirometry before and after inhaled bronchodilator on multiple occasions. Analysis for the decline in FEV1 was performed using random mixed effects regression models adjusted for age, sex and body mass index. Heavy tobacco smoking and marijunana smoking was defined as >20 pack-years and >20 joint-years, respectively.Results∼20% of participants had been or were current marijuana smokers with most having smoked tobacco cigarettes in addition (83%). Among heavy marijuana users, the risk of COPD was significantly increased (adjusted OR 2.45, 95% CI 1.55–3.88). Compared to never-smokers of marijuana and tobacco, heavy marijuana smokers and heavy tobacco smokers experienced a faster decline in FEV1 by 29.5 mL·year−1 (p=0.0007) and 21.1 mL·year−1 (p<0.0001), respectively. Those who smoked both substances experienced a decline of 32.31 mL·year−1 (p<0.0001).InterpretationHeavy marijuana smoking increases the risk of COPD and accelerates FEV1 decline in concomitant tobacco smokers beyond that observed with tobacco alone.

scholarly journals Asthma, airflow limitation and mortality risk in the general population

2014 ◽  
Vol 45 (2) ◽  
pp. 338-346 ◽  
Author(s):  
Shuang Huang ◽  
Monica M. Vasquez ◽  
Marilyn Halonen ◽  
Fernando D. Martinez ◽  
Stefano Guerra
Keyword(s):  
Lung Function ◽  
Mortality Risk ◽  
Significant Proportion ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Cox Proportional Hazards ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Increased Risk ◽  
Asthma Group

Asthma and chronic obstructive pulmonary disease co-exist in a significant proportion of patients. Whether asthma increases mortality risk among subjects with airflow limitation remains controversial.We used data from 2121 adult participants in the population-based Tucson Epidemiological Study of Airway Obstructive Disease cohort. At enrolment (1972–1973), participants completed questionnaires and lung function tests. Participants were categorised into four groups based on the combination of airflow limitation (AL; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <70%) and physician-confirmed asthma at baseline. Vital status as of January 2011 was assessed through the National Death Index. Cox proportional hazards models were used to test differences in mortality risk across the four airflow limitation/asthma groups.In multivariate Cox models, the AL+/asthma+ group had a 114% increased mortality risk during follow-up compared with the AL-/asthma- group (adjusted HR 2.14; 95% CI 1.64–2.79). The corresponding hazard ratios were 1.09 (95% CI 0.89–1.34) and 1.34 (95% CI 1.14–1.57) for the AL-/asthma+ and AL+/asthma- groups, respectively. Among subjects with airflow limitation, asthma was associated with increased mortality risk (HR 1.58, 95% CI 1.17–2.12). However, this increased risk was substantially reduced and no longer significant after further adjustment for baseline FEV1 levels. Similar results were obtained when airflow limitation was defined as FEV1/FVC less than the lower limit of normal.In a population-based cohort, subjects with concomitant airflow limitation and asthma had an increased risk of dying, which was mainly related to their baseline lung function deficits.

scholarly journals Osteoarthritis and risk of hospitalization for ambulatory care sensitive conditions: A general population-based cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Ali Kiadaliri ◽  
Martin Englund
Keyword(s):  
Ambulatory Care ◽  
Hazard Model ◽  
Population Based ◽  
Incidence Rates ◽  
Ambulatory Care Sensitive Conditions ◽  
Chronic Obstructive ◽  
Main Diagnosis ◽  
Increased Risk ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Objective To determine the association between osteoarthritis (OA) and risk of hospitalization for ambulatory care sensitive conditions (HACSCs). Methods We included all individuals aged 40–85 years who resided in Skåne, Sweden on 31st December 2005 with at least one healthcare consultation during 1998–2005 (n = 515 256). We identified those with a main diagnosis of OA between January 1, 1998 and December 31, 2016. People were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016 (whichever occurred first). OA status was treated as a time-varying covariate (those diagnosed before January 1, 2006 considered as exposed for whole study period). We assessed relative (hazard ratios (HRs) using Cox proportional hazard model) and absolute (hazard difference using additive hazard model) effects of OA on HACSCs adjusted for potential confounders. Results Crude incidence rates of HACSCs were 239 (95% CI 235, 242) and 151 (150, 152) per 10 000 person-years among OA and non-OA persons, respectively. The OA persons had an increased risk of HACSCs (HR [95% CI] 1.11 [1.09, 1.13]) and its subcategories of medical conditions except chronic obstructive pulmonary disease (HR [95% CI] 0.86 [0.81, 0.90]). There were 20 (95% CI 16, 24) more HACSCs per 10 000 person-years in OA compared with non-OA persons. While HRs for knee and hip OA were generally comparable, only knee OA was associated with increased risk of hospitalization for diabetes. Conclusion OA is associated with an increased risk of HACSCs, highlighting the urgent need to improve outpatient care for OA patients.

scholarly journals Seasonal Changes in Lung Function in a Farming Population

2000 ◽  
Vol 7 (4) ◽  
pp. 320-325 ◽  
Author(s):  
Ambikaipakan Senthilselvan ◽  
James A Dosman ◽  
Karen M Semchuk ◽  
Helen H McDuffie ◽  
Allan J Cessna ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Seasonal Changes ◽  
Pesticide Exposure ◽  
Respiratory Health ◽  
Longitudinal Design ◽  
Winter Season ◽  
Occupational Exposures ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Farm Residents

OBJECTIVE:To assess the changes in respiratory health from winter to summer seasons in a rural population.DESIGN:A longitudinal design was used in the study.SETTING:A population-based study was conducted as part of the Environmental Pesticide Exposure and Human Health component of the Prairie Ecosystem Study (PECOS) in southwestern Saskatchewan.PATIENTS:In the winter season, 358 patients participated in the study. Of these patients, 234 returned for the second assessment during the summer season. After excluding 34 children aged 17 years and under, 200 adult patients were available for analysis.MEASUREMENTS:Questionnaires were used to obtain information on demographic factors, smoking habits, occupational and environmental exposures, and respiratory conditions. Pulmonary function measurements were obtained using a volume displacement spirometer.RESULTS:Mean ages (± SD) of the 106 men and 94 women participating in the study were 50.1±13.3 and 49.0±13.1 years, respectively. Mean percentage changes in maximal midexpiratory flow rate from winter to summer assessments indicated an improvement for town residents and a decline for farm residents. Mean percentage changes in the ratio of forced expiratory volume in 1 s to forced vital capacity indicated an improvement for town residents who were not engaged in farming, and increasing declines for town residents engaged in farming, farm residents not engaged in farming and farm residents engaged in farming.CONCLUSIONS:Seasonal changes occurred in measurements of pulmonary function between winter and summer seasons; these changes may be related to the environmental or occupational exposures experienced by the participants during the study.

scholarly journals Dietary and supplemental antioxidant and anti-inflammatory nutrient intakes and pulmonary function

2013 ◽  
Vol 17 (9) ◽  
pp. 2081-2086 ◽  
Author(s):  
Tze Pin Ng ◽  
Mathew Niti ◽  
Keng Bee Yap ◽  
Wan Cheng Tan
Keyword(s):  
Pulmonary Function ◽  
Fruits And Vegetables ◽  
Dairy Product ◽  
Population Based ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Pulmonary Risk ◽  
Anti Inflammatory

AbstractObjectiveA limited but growing body of evidence supports a significant role of antioxidant and anti-inflammatory micronutrients in pulmonary health. We investigated the associations of dietary and supplemental intakes of vitamins A, C, E and D, Se and n-3 PUFA with pulmonary function in a population-based study.DesignPopulation-based, cross-sectional study and data analysis of fruits and vegetables, dairy products and fish, vitamins A, C, E and D, Se and n-3 PUFA supplemental intakes, pulmonary risk factors and spirometry.SubjectsChinese older adults (n 2478) aged 55 years and above in the Singapore Longitudinal Ageing Studies.ResultsIn multiple regression models that controlled simultaneously for gender, age, height, smoking, occupational exposure and history of asthma/chronic obstructive pulmonary disease, BMI, physical activity, and in the presence of other nutrient variables, daily supplementary vitamins A/C/E (b = 0·044, se = 0·022, P = 0·04), dietary fish intake at least thrice weekly (b = 0·058, se = 0·016, P < 0·0001) and daily supplementary n-3 PUFA (b = 0·068, se = 0·032, P = 0·034) were individually associated with forced expiratory volume in the first second. Supplemental n-3 PUFA was also positively associated with forced vital capacity (b = 0·091, se = 0·045, P = 0·045). No significant association with daily dairy product intake, vitamin D or Se supplements was observed.ConclusionsThe findings support the roles of antioxidant vitamins and n-3 PUFA in the pulmonary health of older persons.

scholarly journals Maternal smoking behaviour across the first two pregnancies and small for gestational age birth: Analysis of the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the South of England

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260134
Author(s):  
Elizabeth J. Taylor ◽  
Pia Doh ◽  
Nida Ziauddeen ◽  
Keith M. Godfrey ◽  
Ann Berrington ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Smoking ◽  
Population Based ◽  
Smoking Behaviour ◽  
Adverse Birth Outcomes ◽  
Full Sample ◽  
Healthcare Data ◽  
Increased Risk ◽  
Never Smokers

Maternal smoking is established to cause adverse birth outcomes, but evidence considering maternal smoking change across successive pregnancies is sparse. We examined the association between self-reported maternal smoking during and between the first two pregnancies with the odds of small for gestational age (SGA) birth (<10th percentile) in the second infant. Records for the first two pregnancies for 16791 women within the SLOPE (Studying Lifecourse Obesity PrEdictors) study were analysed. This is a population-based cohort of prospectively collected anonymised antenatal and birth healthcare data (2003–2018) in Hampshire, UK. Logistic regression was used to relate maternal smoking change to the odds of SGA birth in the second infant. In the full sample, compared to never smokers, mothers smoking at the start of the first pregnancy had higher odds of SGA birth in the second pregnancy even where they stopped smoking before the first antenatal appointment for the second pregnancy (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.10, 2.03]). If a mother was not a smoker at the first antenatal appointment for either her first or her second pregnancy, but smoked later in her first pregnancy or between pregnancies, there was no evidence of increased risk of SGA birth in the second pregnancy compared to never smokers. A mother who smoked ten or more cigarettes a day at the start of both of her first two pregnancies had the highest odds of SGA birth (3.54 [2.55, 4.92]). Women who were not smoking at the start of the first pregnancy but who subsequently resumed/began smoking and smoked at the start of their second pregnancy, also had higher odds (2.11 [1.51, 2.95]) than never smokers. Smoking in the first pregnancy was associated with SGA birth in the second pregnancy, even if the mother quit by the confirmation of her second pregnancy.

scholarly journals Is asthma associated with COVID-19 infection? A UK Biobank analysis

2021 ◽  
pp. 00309-2021
Author(s):  
Caroline J. Lodge ◽  
Alice Doherty ◽  
Dinh Bui ◽  
Raisa Cassim ◽  
Adrian J. Lowe ◽  
...  
Keyword(s):  
Lung Function ◽  
Early Onset ◽  
Age At Onset ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Asthma Medication ◽  
Positive Test ◽  
Uk Biobank ◽  
Increased Risk ◽  
Health Related

BackgroundThe relationship between asthma and COVID-19 risk is not clear and may be influenced by level of airway obstruction, asthma medication, and known COVID risk factors. We aimed to investigate COVID-19 risk in people with asthma.MethodsWe used UK Biobank data from all participants tested for SARS-CoV-2 (n=107 412 (17 979 test positive)). Baseline questions at baseline defined ever asthma and asthma medications. Baseline Forced Expiratory Volume in the first second (FEV1) was categorized into quartiles. Logistic regression modelled relationships between asthma, and asthma categories (age at onset, medications, FEV1 quartiles), and risk of SARS-CoV-2 positive test. We investigated modification by sex, ethnic group, smoking, and BMI.ResultsThere was a reduced risk of a positive test associated with with early-onset asthma (<13 years), (OR 0.91(95% CI 0.84, 0.99). This was found for early-onset asthmatics in males (OR 0·87 [95% CI: 0·78, 0·98]), non-smokers (0·87 [0·78, 0·98]), overweight/obese (0.85 [0.77, 0.93]), and non-Black participants (0·90 [0·82, 0.98]). There was increased risk amongst early onset asthmatics in the highest compared to lowest quartile of lung function (1.44 [1.05, 1.72]).ConclusionAmongst males, non-smokers, overweight/obese, and non-Black participants, having early-onset asthma was associated with lower risk of a SARS-CoV-2 positive test. We found no evidence of a protective effect from asthma medication. Early-onset asthmatics of normal weight and with better lung function may have lifestyle differences placing them at higher risk. Further research is needed to elucidate the contribution of asthma pathophysiology and different health-related behaviour, across population groups, to the observed risks.

scholarly journals Metabolome-defined obesity and the risk of future diabetes and mortality

2021 ◽  
Author(s):  
Filip Ottosson ◽  
Einar Smith ◽  
Ulrika Ericson ◽  
Salvatore Di Somma ◽  
Paola Antonini ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Population Based ◽  
Normal Weight ◽  
Plasma Metabolites ◽  
Italian Population ◽  
Related Risk ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Future Diabetes

Background Obesity is a key risk factor for type 2 diabetes, however, up to 20% of patients are normal weight. Our aim was to identify metabolite patterns reproducibly predictive of BMI, and subsequently to test if lean individuals who carry an obese metabolome are at hidden high risk of obesity related diseases, such as diabetes. Methods We measured 109 metabolites in fasted plasma samples of 7663 individuals from two Swedish and one Italian population-based cohort. Ridge regression models were used to predict BMI using the plasma metabolites. Individuals with a predicted BMI either more than 5 kg/m2 higher (overestimated) or lower (underestimated) than their actual BMI were characterized as outliers and further investigated for obesity related risk factors and future risk of diabetes and mortality. Results The plasma metabolome could predict BMI in all cohorts (r2 = 0.48, 0.26 and 0.19). The overestimated group had a BMI similar to individuals correctly predicted as normal weight, similar waist circumference, were not more likely to change weight over time but had a 2 times higher risk of future diabetes and an 80 % increased risk of all-cause mortality. These associations remained after adjustments for obesity-related risk factors and lifestyle parameters. Conclusions We found that lean individuals with an obese metabolome, have an increased risk for diabetes and all-cause mortality compared to lean individuals with a healthy metabolome. Metabolomics may be used to identify hidden high-risk individuals, in order to initiate lifestyle and pharmacological interventions.

Sign in / Sign up

Export Citation Format

Share Document