Assessment of Peak Expiratory Flow Rate in Spice Mill Workers - A Cross-Sectional Study

Background: Numerous industries have researched the effects of occupational dust and particles on respiratory function. The continuous exposure to dispersed particles causes respiratory ailments in spice mill workers. Spice dust exposure is linked to a systemic inflammatory response, including respiratory irritation. Spice dust is finely divided solid particles and a form of respirable dust this is the leading cause of occupational disease. Allergies and asthma have been linked to spice mill workers. Objective: To study the effect of spice dust exposure on expiratory function and to compare the peak expiratory flow rate of spice mill workers and normal adults across age groups and gender Method: 186 subjects in Mumbai region, 93 spice mill workers and 93 normal adults were selected as per inclusion and exclusion criteria. PEFR was measured in all the participants using a mini Wright peak flow meter. Result: The statistical analysis showed that there is a significant difference in the peak expiratory flow rates of spice mill workers. However, intergroup analysis between age groups showed that there was not much difference in the PEFR values for the age group 40-50 when compared with normal. The reason could be less number of participants available for the study. Also, the gender-wise comparison showed statistically significant difference in male and female PEFR values. Conclusion: The present study concluded that peak expiratory flow rate was significantly reduced in spice mill workers when compared to normal adults of same age. Key words: PEFR, spice mill workers, spice dust, allergies.

Voluntary Cough Effectiveness and Airway Clearance in Neurodegenerative Disease

Purpose: Voluntary cough dysfunction is highly prevalent across multiple patient populations. Voluntary cough has been utilized as a screening tool for swallowing safety deficits and as a target for compensatory and exercise-based dysphagia management. However, it remains unclear whether voluntary cough dysfunction is associated with the ability to effectively clear the airway. Method: Individuals with neurodegenerative disorders performed same-day voluntary cough testing and flexible endoscopic evaluations of swallowing (FEES). Participants who were cued to cough after exhibiting penetration to the vocal folds and/or aspiration with thin liquids during FEES met inclusion criteria. One-hundred and twenty-three trials were blinded, and the amount of residue before and after a cued cough on FEES was measured with a visual analog scale. Linear and binomial mixed-effects models examined the relationship between cough airflow during voluntary cough testing and the proportion of residue expelled. Results: Peak expiratory flow rate ( p = .004) and cough expired volume from the entire epoch ( p = .029) were significantly associated with the proportion of aspiration expelled from the subglottis. Peak expiratory flow rate values of 3.00 L/s, 3.50 L/s, and 5.30 L/s provided high predicted probabilities that ≥ 25%, ≥ 50%, and ≥ 80% aspirate was expelled. Accounting for depth of aspiration significantly improved model fit ( p < .001). Conclusions: These findings suggest that voluntary cough airflow is associated with cough effectiveness to clear aspiration from the subglottis, although aspiration amount and depth may play an important role in this relationship. These findings provide further support for the clinical utility of voluntary cough in the management of dysphagia.

Value of Peak Expiratory Flow Rate in Evaluating Cough Ability in Patients Undergoing Lung Surgery

Introduction. Postoperative ineffective cough is easy to occur after thoracic surgery, and it is also a risk factor for postoperative pulmonary complications (PPCs). Objectives. To explore the value of peak expiratory flow rate (PEF) in evaluating cough ability in patients undergoing lung surgery and evaluate the effectiveness of chest wall compression during the expiratory phase by PEF. Methods. From September 2020 to May 2021, the researchers collected the data of patients who underwent lung surgery. Eventually, 153 patients who met the criteria were included, 102 cases were included in the effective cough group and 51 cases were included in the ineffective cough group. The receiver working curve (ROC curve) was used to analyze whether PEF could evaluate cough ability. At the same time, the researchers collected the pulmonary function data of the first 30 patients of the ineffective cough group while compressing the chest wall during the expiratory phase to evaluate the effectiveness of chest wall compression. Results. The area under the curve (AUC) of postoperative PEF to evaluate the postoperative cough ability was 0.955 (95% CI: 0.927–0.983, P < 0.001 ). The values of PEF (127.17 ± 34.72 L/min vs. 100.70 ± 29.98 L/min, P < 0.001 , 95% CI: 18.34–34.59) and FEV1 (0.72 (0.68–0.97) L vs. 0.64 (0.56–0.82) L, P < 0.001 ) measured while compressing the chest wall were higher than those without compression. Conclusions. PEF can be used as a quantitative indicator of cough ability. Chest wall compression could improve cough ability for patients who have ineffective cough.

Estimation of peak expiratory flow rate in young Indians.

INTRODUCTION: Peak expiratory flow rate (PEFR) is commonly used to monitor the progression of respiratory diseases as it gives good information about the status of airways. A good amount of research is going across the world to establish a local prediction equation. The joint task force of the American thoracic society and European Respiratory Society has promoted research in this regard. In India, data derived from the Caucasian population are still used for PEFR. OBJECTIVE: To verify the relationship between PEF levels and the variables age, sex, anthropometric and body surface area, and establish the regression equation for young Indian adults. METHODS: A cross-sectional observational study was conducted in 15-25 years aged 1000 subjects from the Metropolitan region of Mumbai. Pearson’s correlation coefficient was used to understand the relation of anthropometric parameters and PEFR. Multivariate regression analysis was done for establishing a prediction equation (Alpha 5%). RESULTS: Age and all anthropometric parameters were correlated with PEFR. The mean PEFR of the male population was 515 ml/sec, whereas, for females, it was 399 ml/sec, for PEFR highest correlation was observed with BSA (.696) followed by weight (.667), height (.630), age (.504) whereas BMI shown lowest correlation coefficient (.445). PEFR had the best significance with age, BSA, Height, and BMI. It had less significance with weight. In females, PEFR had the best significance with Height, weight, BMI, and Age. CONCLUSION: Gender-wise differences exist in PEFR. Hence gender-specific equations are needed for the estimation of PEFR.

EFFECT OF ONE MONTH DIAPHRAGMATIC BREATHING ON PEAKEXPIRATORY FLOW RATE AND BREATH HOLDING TIME

Practice of yoga based relaxation techniques has been associated with various physiological changes in our body. The long term practice of these techniques has been reported to improve the pulmonary functions. However, the study on effects of short term diaphragmatic breathing on lung functions is yet lacking. Therefore, the present analytical study was conducted to find the changes in pulmonary functions after practising diaphragmatic breathing for one month among (n=40; 20 males and 20 females) 1st year MBBS students aged between 18-20 years. Peak expiratory flow rate (PEFR) and breathe holding time (BHT) was recorded in these subjects before and after one month of practising diaphragmatic breathing. There was a significant increase in both PEFR and BHT after 1month of diaphragmatic breathing manoeuvre depicting the beneficial of diaphragmatic breathing on pulmonary functions. Key words: Yoga; Pulmonary functions; Peak Expiratory Flow Rate; Breath Holding Time

1507A cross sectional study on respiratory morbidity among traffic police personnel in Hyderabad, Telangana

Background Occupational hazards cause early deaths to millions of people worldwide and result in avoidable morbidity that adversely affect the quality of life. The problem of air pollution is also addressed in two of the Sustainable Development Goals (SDGs) – SGD3 and SDG11. Traffic police are one of the worst sufferers because they are continuously exposed to the toxic pollutants emitted from the automobiles. Methods A community based cross-sectional study was carried out from June 2016 to October 2017 among traffic police personnel of Hyderabad district, Telangana. The study was done with a sample size of 270. Data collection was done using a standardized pretested structured schedule developed using ATS-DLD questionnaire, Peak Expiratory Flow Rate (PEFR) measurements and spirometry for lung volumes. Results The average roadside working hours per day for the study participants was 6 hrs per day. The prevalence of respiratory morbidity was found to be 29.85%. Chronic phlegm, chronic cough and chronic wheeze was reported in 18.99%, 13.17%, 2.32% respectively. Respiratory morbidity was significantly associated with age, duration of occupation related exposure to air pollution and the Air Quality Index of workplace (p &lt; 0.05). Around 29% showed obstructive pattern Peak Expiratory Flow Rate (PEFR). Around 68% had FEV1 less than 80% predicted. Conclusions The respiratory morbidity may be attributed to the harmful effects of air pollution due to vehicular exhaust. Key messages Respiratory morbidity among traffic police personnel in Hyderabad warrants implementation of preventive measures.

Comparison between Effect of Balloon Blowing Exercise (BBE) in Semi-Fowler (45 Degree), Upright & 90/90 Bridge with Ball Position on Peak Expiratory Flow Rate in Healthy Individuals

Purpose: This study was conducted to investigate the Comparison between effects of balloon blowing exercise (BBE) in Semi Fowlers (45 degree), Upright & 90/90 Bridge with ball position on Peak expiratory flow rate in healthy individuals. Participants & Method: Participants were randomly assigned in respective groups to perform the balloon blowing activity. The exercise programs were conducted 30 minutes per day, 5 times a week for 4 weeks, Peak expiratory flow rate was measured with mechanical equipment called Peak Expiratory Flow Meter before and after the exercise program period. Results: Effectiveness of Semi fowlers position for Balloon blowing activity is significantly more than that of Upright and 90/90 Bridge Position with Ball on Peak expiratory flow rate pre and post values(p<0.005). Conclusion: With accordance to objectives, Comparison of Peak expiratory flow rate values in pre & post exercise in three positions shows that there is improvement of group A(Semi fowlers position)> Group C(90/90 Bridge with ball position)>Group B(Upright position) Keywords: Peak expiratory flow rate (PEFR), Balloon blowing exercise (BBE), Semi fowlers position, Upright position, 90/90 Bridge will ball position.