Assessment of Metal Concentrations and Associations with Pulmonary Function among Children with Asthma in Chicago, Illinois

Individuals living in areas with the potential for elevated metal exposure from industrial sources may have reduced pulmonary function. We evaluated cross-sectional associations of toenail concentrations of 17 metals within a community area of residence and asthma control in 75 children, and pulmonary function measures [forced expiratory volume in one second (FEV1; liters), forced vital capacity (FVC; liters), FEV1 to FVC ratio (FEV1:FVC), and mid-exhalation forced expiratory flow rate (FEF 25–75%; liters/second)], in a subsample of 39 children with diagnosed asthma in Chicago, Illinois. Linear regression models were used to estimate adjusted regression coefficients and standard errors (SE) for the associations between ≥ median versus <median metal exposures and natural log-transformed (ln) pulmonary function test parameters. Toenail levels of cadmium, cobalt, iron, manganese, and vanadium were higher among children residing near an industrial corridor than those in a comparison community. Copper concentrations were inversely associated with lnFEV1 (β = −0.10, SE = 0.04, p = 0.01), lnFEV1:FVC (β = −0.07, SE = 0.03, p = 0.02) and lnFEF 25–75% (β = −0.25, SE = 0.09, p = 0.01); manganese concentrations were inversely associated with lnFEV1 (β = −0.11, SE = 0.04, p = 0.01), lnFEV1:FVC (β = −0.07, SE = 0.03, p = 0.02), and lnFEF 25–75% (β = −0.28, SE = 0.10, p = 0.004), and vanadium concentrations were inversely associated with lnFEV1 (β = −0.08, SE = 0.04, p = 0.05) and lnFVC (β = −0.07, SE = 0.03, p = 0.03). Nickel and copper were associated with uncontrolled asthma (OR = 6.8; 95% CI 2.0, 22.8 and OR = 4.6; 95% CI 1.0, 21.0, respectively). These data suggest that selected metal exposures may be associated with impaired pulmonary function parameters and reduced asthma control among children with preexisting asthma.

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Effects of Low-dose Clarithromycin Added to Fluticasone on Inflammatory Markers and Pulmonary Function among Children with Asthma: A Randomized Clinical Trial

Allergy & Rhinology ◽

10.2500/ar.2016.7.0168 ◽

2016 ◽

Vol 7 (3) ◽

pp. ar.2016.7.0168 ◽

Cited By ~ 4

Author(s):

Kong-Sang Wan ◽

Yu-Cheng Liu ◽

Che-Sheng Huang ◽

Yu-Mao Su

Keyword(s):

Nitric Oxide ◽

Pulmonary Function ◽

Eosinophil Count ◽

Forced Expiratory Volume ◽

Study Group ◽

Total Ige ◽

Specific Immunoglobulin ◽

Children With Asthma ◽

Forced Expiratory Flow ◽

Pulmonary Volume

Background Macrolides exert anti-inflammatory and immunomodulatory effects beyond their purely antibacterial action, as demonstrated by several bronchial inflammatory disorders, including asthma. Methods Fifty-eight children with newly diagnosed mild persistent asthma were selected by using the Global Initiative for Asthma guidelines and were randomly divided into the study (group I) (n = 36) and control (group II) (n = 22) groups. Mycoplasma pneumonia-specific immunoglobulin G and -specific immunoglobulin M antibody levels of each participant were measured by enzyme-linked immunosorbent assay. Clarithromycin 5 mg/kg daily and placebo were given to groups I and II, respectively, for 4 weeks. All of the children had maintenance inhaled corticosteroid (fluticasone propionate, one puff twice [50 fig/puff] daily). Forced expiratory volume in 1 second, forced expiratory flow at 25–75% of the pulmonary volume, exhaled nitric oxide value, total IgE level, absolute eosinophil count, and eosinophilic cation protein value were measured at baseline and at the end of the treatment. Results There are significantly increased forced expiratory volume in 1 second and forced expiratory flow at 25–75% of the pulmonary volume levels and decreased exhaled nitric oxide values after the 4-week clarithromycin treatment. The study group also had a decreased peripheral blood absolute eosinophil count and eosinophilic cation protein level, but not for the total IgE level, after the treatment. Conclusion Four weeks of sub-antimicrobial doses of clarithromycin may improve pulmonary function and decrease eosinophilic inflammation in children with asthma.

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The influence of HIV infection and antiretroviral treatment on pulmonary function in individuals in an urban setting in sub-Saharan Africa

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v22i1.1312 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Oda E. Van den Berg ◽

Erica J. Shaddock ◽

Sarah L. Stacey ◽

Charles Feldman ◽

Roos E. Barth ◽

...

Keyword(s):

Hiv Infection ◽

Pulmonary Function ◽

Antiretroviral Treatment ◽

Forced Expiratory Volume ◽

Mediating Effect ◽

Urban Setting ◽

Sub Saharan Africa ◽

Linear Regression Models ◽

Cross Sectional ◽

Hiv Negative

Background: With the roll-out of antiretroviral treatment (ART), the life expectancy of people with HIV and, hence, morbidity from non-communicable diseases, including pulmonary diseases, have increased.Objectives: This research study aims to investigate whether HIV infection and ART use are associated with pulmonary function, given the high frequency of pulmonary infections, including tuberculosis (TB), associated with HIV.Method: Adults living with HIV (ART-naïve, on first- or second-line ART), and age and sex matched HIV-negative controls were included in a cross-sectional study in Johannesburg, South Africa. Spirometry was performed to determine lung function, measuring the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC) and the FEV1/FVC ratio before (pre), and after (post), short-acting bronchodilator. The association of HIV infection and ART use with pulmonary function was analysed using linear regression models, adjusting for age, gender, body surface area (BSA), employment, education, smoking and TB.Results: Overall, 548 participants (62% women) were included with a mean age of 38 (standard deviation [s.d.] 9.5) years. No effect of HIV or ART on post-FEV1 was observed in adjusted analysis. Additional adjustment for TB resulted in a higher post-FEV1 in participants on ART compared with HIV-negative participants, whereas TB was associated with a lower FEV1. No effect of HIV and ART on post-FEV1/FVC was observed.Conclusion: HIV infection and ART use were not associated with reduced pulmonary function in this urban African population. Tuberculosis showed a mediating effect on the association between HIV, ART and pulmonary function.

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

Public Health Nutrition ◽

10.1017/s1368980013002590 ◽

2013 ◽

Vol 17 (9) ◽

pp. 2081-2086 ◽

Cited By ~ 17

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.

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IMPACT OF OBESITY ON PULMONARY FUNCTIONS AMONG YOUNG NON-SMOKER HEALTHY FEMALE OF SHAH ALAM, MALAYSIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i10.27234 ◽

2018 ◽

Vol 11 (10) ◽

pp. 465

Author(s):

Aniruddha Bhattacharjee ◽

Ariitharan A/l Thygoo ◽

Subramanian Rammohan

Keyword(s):

Pulmonary Function ◽

Flow Rate ◽

Inverse Correlation ◽

Forced Expiratory Volume ◽

Female Students ◽

Control Group ◽

Contributing Factors ◽

Cross Sectional ◽

Pulmonary Functions ◽

Healthy Female

Objectives: The sedentary lifestyle, physical inactivity, and unhealthy diet of Malaysian female have become important contributing factors to the rise of obesity. Studies on pulmonary function in relation to obesity are very few in Malaysia. Therefore, the study was aimed to evaluate the effect of obesity on pulmonary functions among young adult healthy female students of Shah Alam, Malaysia.Methods: A cross-sectional comparative study was conducted in a total of 100 (50 obese and 50 non-obese) adult non-smoker healthy female students aged 18–25 years. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FEV1 as a percentage of FVC (FEV1/FVC%), maximum midexpiratory flow rate (FEF 25–75%), and peak expiratory flow rate (PEFR) were measured using a computerized spirometer. Body weight, height, waist circumference (WC), and hip circumference (HC) were measured.Results: The mean FVC (L), FEV1 (L), FEV1/FVC ratio, FEF 25–75% (L/s), and PEFR (L/s) of obese group were marginally lower than non-obese control group, but the differences were not statistically significant. WC and waist–hip ratio exhibited significant (p<0.05) inverse correlation with all pulmonary function measurements except FEV1/FVC%. However, body mass index had no significant correlation with any spirometric variables in studied obese females.Conclusion: There was no significant effect of obesity on pulmonary functions in the studied Malaysian females. However, abdominal obesity had more impact on the impairment of pulmonary functions than overall relative obesity.

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Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study

Wellcome Open Research ◽

10.12688/wellcomeopenres.15460.1 ◽

2019 ◽

Vol 4 ◽

pp. 168 ◽

Cited By ~ 5

Author(s):

Harriet Mpairwe ◽

Pius Tumwesige ◽

Milly Namutebi ◽

Marble Nnaluwooza ◽

Tonny Katongole ◽

...

Keyword(s):

Asthma Control ◽

Asthma Management ◽

Cross Sectional Study ◽

P Value ◽

Asthma Diagnosis ◽

Sectional Study ◽

Asthma Control Test ◽

Cross Sectional ◽

Children With Asthma ◽

Control And Management

Background: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among schoolchildren with asthma in urban Uganda, to assess the level of asthma control and management. Methods: Schoolchildren aged 5-17 years were enrolled, asthma was diagnosed by the study medical team. Asthma control was assessed using the Asthma Control Test and the childhood Asthma Control Test. Data on previous asthma management was obtained using interviewer-led questionnaires. Data were analysed using multiple linear and multiple logistic regression. Results: We enrolled 561 children with asthma, of whom only 56% had ever had an asthma diagnosis. We categorised asthma as well-controlled (55.5%), partly-controlled (29.5%) and poorly-controlled (15.0%). Poor asthma control was associated with increasing age (adjusted regression coefficient [95% confidence interval], p-value: -1.07 [-1.20, -0.94], p<0.0001), concurrent allergic rhinitis (-1.33 [-2.28, -0.38], p=0.006), and city residence in early life (-1.99 [-3.69, -0.29], p=0.06). Regular use of inhaled asthma medication in the last 12 months was very low; 18.1% for salbutamol and 6.7% for inhaled corticosteroids. The main barriers to inhaled asthma medication use were lack of prescription (47.6%) and inaccurate diagnosis (38.8%). Increased inhaler use was associated with tertiary education of the fathers (adjusted odds ratio [95% confidence interval], p-value: 5.19 [2.39-11.28], p<0.0001), city residence in early life (4.66 [1.79-12.43], 0.002) and an asthma diagnosis prior to enrolment (11.39 [6.35-20.43], p<0.0001). Conclusions: This study confirms that children with asthma in Uganda generally have inadequate asthma control, which is attributable to poor asthma management. This could be improved through re-training of medical workers and patient education, and by increasing availability and affordability of essential asthma medications.

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Pattern of Pulmonary Function Test in Patients with Severe Mitral Stenosis

Bangladesh Critical Care Journal ◽

10.3329/bccj.v2i2.24078 ◽

2015 ◽

Vol 2 (2) ◽

pp. 57-59

Author(s):

Umme Salma Khan ◽

Abdullah Al Shafi Majumder ◽

AKM Monwarul Islam ◽

Fazle Rabbi Mohammed

Keyword(s):

Pulmonary Function ◽

Pulmonary Function Test ◽

Mitral Stenosis ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Female Ratio ◽

Function Test ◽

Male Female Ratio ◽

Restricted Type ◽

Impaired Pulmonary Function

Background: The deterioration in lung function in mitral stenosis correlates with the severity of stenotic valves. A correlation is noted between vital capacity and the severity of dyspnoea in patients with mitral stenosis. This study tried to evaluate the pattern of pulmonary function test in patient with severe mitral stenosis.Materials & Methods: This study involving 56 patients of severe mitral stenosis was performed in a referral cardiovascular center at Dhaka, Bangladesh from January to September, 2011. Colour doppler echocardiography and pulmonary function test were performed in each cases. Forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC and peak expiratory flow (PEF) rate was assessed from pulmonary function test. Finally, pattern of pulmonary function test in severe mitral stenosis was assessed.Results: Amomg 56 patients, 46 were female with a male female ratio 1: 0.22 and the mean age of patients was 28.76 ± 7.2. Among patients with severe mitral stenosis, mean FEV1 (%) was 60.18 ± 13.054. Minimum FVC (%) was 26, maximum was 90 with mean 53.80 ± 12.313. The PEF varied from 150 to 330 L/minute with mean 223.75 ± 62.3251. In current study, out of 56 patients, 2 cases had obstructive type and rest of the patients had restricted type of airway on pulmonary function.Conclusion: The brief results of this study reveal that severe mitral stenosis is associated with impaired pulmonary function, usually presenting restrictive airway pattern.Bangladesh Crit Care J September 2014; 2 (2): 57-59

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Use of Complementary and Alternative Medicine in Children with Asthma

Canadian Respiratory Journal ◽

10.1155/2010/682142 ◽

2010 ◽

Vol 17 (4) ◽

pp. 183-189 ◽

Cited By ~ 26

Author(s):

Vanessa Torres-Llenza ◽

Sanjit Bhogal ◽

Michael Davis ◽

Francine M Ducharme

Keyword(s):

Asthma Control ◽

Persistent Asthma ◽

Preschool Age ◽

Multivariable Logistic Regression Analysis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Asian Ethnicity ◽

Children With Asthma ◽

Cam Use ◽

Complementary And Alternative

BACKGROUND: Because of the potential risk of interaction with, and underuse of, conventional medications, it is important to document the prevalence of the use of complementary and alternative medicines (CAMs) in asthmatic children.OBJECTIVE: To ascertain the prevalence and type of CAMs, and to identify factors associated with their use.METHODS: A cross-sectional survey of children who presented to the Asthma Centre of The Montreal Children’s Hospital (Montreal, Quebec) between 1999 and 2007 was conducted. At the initial consultation, parents completed a questionnaire inquiring, in part, about CAM use. Computerized health records provided information regarding patient characteristics and their condition.RESULTS: The median age of the 2027 children surveyed was 6.1 years (interquartile range 3.3 to 10.5 years); 58% were male and 59% of children had persistent asthma. The prevalence of CAM use was 13% (95% CI 12% to 15%). Supplemental vitamins (24%), homeopathy (18%) and acupuncture (11%) were the most commonly reported CAMs. Multivariable logistic regression analysis confirmed the association of CAM use with age younger than six years (OR 1.86; 95% CI 1.20 to 2.96), Asian ethnicity (OR 1.89; 95% CI 1.01 to 3.52), episodic asthma (OR 1.88; 95% CI 1.08 to 3.28) and poor asthma control (OR 1.98; 95% CI 1.80 to 3.31).CONCLUSION: The prevalence of reported CAM use among Quebec children with asthma remained modest (13%), with vitamins, homeopathy and acupuncture being the most popular modalities. CAM use was associated with preschool age, Asian ethnicity, episodic asthma and poor asthma control.

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Secondhand tobacco smoke exposure and pulmonary function: a cross-sectional study among non-smoking employees of bar and restaurants in Santiago, Chile

BMJ Open ◽

10.1136/bmjopen-2017-017811 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017811 ◽

Cited By ~ 1

Author(s):

Javiera Parro ◽

Paulina Aceituno ◽

Andrea Droppelmann ◽

Sthepanie Mesías ◽

Claudio Muñoz ◽

...

Keyword(s):

Pulmonary Function ◽

Cross Sectional Study ◽

Tobacco Smoke Exposure ◽

Cumulative Exposure ◽

Outcome Variable ◽

Linear Regression Models ◽

Cross Sectional ◽

Urine Cotinine ◽

Secondhand Tobacco Smoke ◽

Shs Exposure

IntroductionThe workplace remains a significant source of secondhand smoke (SHS) exposure. This pollutant is known to be associated with respiratory and cardiovascular problems, but its effects on specific pulmonary function parameters remain largely unexplored. The objectives of this study were to measure SHS exposure among non-smoking employees of bar and restaurants in Santiago, Chile and to evaluate the effects of such exposure on pulmonary function.MethodsCross-sectional design. The study sample included non-smoking workers from 57 restaurants and bars in Santiago, Chile. The outcome variable was pulmonary function and the exposure variables were urine cotinine concentration, a biomarker for current SHS exposure, and years of SHS exposure in the workplace as proxy of chronic exposure. Personal and occupational variables were also recorded. Data analysis was performed using linear regression models adjusted by confounders.ResultsThe median age of the workers was 35 years and the median employment duration at the analysed venues was 1 year. Workers in smoking facilities reported greater SHS exposure (36 hours per week) than workers in smoke-free locations (4 hours per week). Urine cotinine levels were inversely correlated with forced vital capacity, but the finding was not statistically significant (β=−0.0002; 95% CI −0.007 to 0.006). Years of exposure to SHS showed to be significantly associated with forced expiratory flow25/75(β=−0.006; 95% CI −0.010 to −0.0004).ConclusionThese findings suggest that cumulative exposure to SHS at work may contribute to deterioration of pulmonary function in non-smoking employees.

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Factors affecting spirometry reference range in growing children

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.6.1212 ◽

2019 ◽

Vol 35 (6) ◽

Author(s):

Sara Sadiq ◽

Nadeem Ahmed Rizvi ◽

Fahad Khalid Soleja ◽

Muaz Abbasi

Keyword(s):

Reference Range ◽

Forced Expiratory Volume ◽

P Value ◽

Strong Positive Correlation ◽

Linear Regression Models ◽

Factors Affecting ◽

Independent Variables ◽

Creative Commons ◽

Forced Expiratory Flow ◽

Expiratory Flow

Objectives: To find out the association of weight, height and age with spirometry variables and to generate a regression equation by taking weight as an independent variable beside age and height among children and adolescents of Karachi. Methods: A modified form of ISSAC questionnaire was used. The spirometry variables recorded were Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1/FVC, Peak expiratory flow rate (PEF), Forced expiratory flow between 25% and 75% expired volume (FEF25-75). A person’s correlation coefficient among boys and girls were calculated for all spirometry variable considering age, height and weight as independent variables. The linear regression models were calculated. Results: The results reported a linear correlation of lung function variables with all three independent variables (i.e. p-value = 0.000), in which age and height manifested a strong positive correlation while weight reported a moderately significant correlation. All spirometry variables such as FVC, FEV1, PEF and FEF25-75 reported a significant coefficient of dependency and coefficient of correlation individually with age, height and weight. Conclusion: It is concluded that beside age, height and weight both also have significant correlation with lung volumes so these should be taken into account when using spirometry as a diagnostic test. doi: https://doi.org/10.12669/pjms.35.6.1212 How to cite this:Sadiq S, Rizvi NA, Soleja FK, Abbasi M. Factors affecting spirometry reference range in growing children. Pak J Med Sci. 2019;35(6):1587-1591. doi: https://doi.org/10.12669/pjms.35.6.1212 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Serum 25-hydroxyvitamin D levels and lung function in adults with asthma: the HUNT Study

European Respiratory Journal ◽

10.1183/09031936.00069714 ◽

2014 ◽

Vol 45 (4) ◽

pp. 1019-1026 ◽

Cited By ~ 15

Author(s):

Tricia L. Larose ◽

Arnulf Langhammer ◽

Yue Chen ◽

Carlos A. Camargo ◽

Pål Romundstad ◽

...

Keyword(s):

Allergic Rhinitis ◽

Lung Function ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Health Study ◽

Linear Regression Models ◽

Cross Sectional ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Hunt Study

The association between vitamin D status and lung function in adults with asthma remains unclear.We studied this cross-sectional association and possible modification by sex and allergic rhinitis in 760 adults (aged 19–55 years) with self-reported asthma in the Nord-Trøndelag Health Study. Serum 25-hydroxyvitamin D (25(OH)D) level <50 nmol·L−1was considered deficient. Lung function measurements included forced expiratory volume in 1 s (FEV1) % predicted, forced vital capacity (FVC) % predicted and FEV1/FVC ratio. Multiple linear regression models were used to estimate adjusted regression coefficients (β) and 95% confidence intervals.44% of asthma adults had serum 25(OH)D levels <50 nmol·L−1. Its associations with lung function measures seemed to be modified by sex and allergic rhinitis (p<0.03 for three-way interaction term). Overall, a serum 25(OH)D level <50 nmol·L−1was not associated with lung function measurements in subjects with allergic rhinitis in this asthma cohort. In men with asthma but without allergic rhinitis, however, a serum 25(OH)D level <50 nmol·L−1was significantly associated with lower FEV1/FVC ratio (β=−8.60%; 95% CI: −16.95%– −0.25%).Low serum 25(OH)D level was not associated with airway obstruction in most asthma adults with the exception of men with asthma but without allergic rhinitis.

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