Lung Function and Symptoms of Exposure to the Volcanic Eruption in the Canary Islands: First Follow-Up of the ASHES Study.

INTRODUCTION: Exposure to gases and particulate matter released during volcanic eruptions can prove harmful to population health. This paper reports the preliminary results of the ASHES study, aimed at ascertaining the respiratory health effects of the 2021 volcanic eruption in La Palma Island (Spain) on the adult population without previous respiratory disease. METHODS: Ambispective cohort study on the healthy adult population. Three exposure groups were considered: Group 1, high exposure; Group 2, moderate exposure; and Group 3, minor or no exposure. We carried out a descriptive analysis of symptoms during and after the eruption, as well as measure lung function after the eruption (through forced spirometry and diffusing capacity of carbon monoxide). RESULTS: The analysis included 474 subjects: 54 in Group 1, 335 in Group 2, and 85 in Group 3. A significant increase in most symptoms was observed for subjects in the groups exposed during the eruption. After the eruption, this increase remained for some symptoms. There seems to be a dose-response relationship, such that the higher the exposure, the higher the odds ratio. A prebronchodilator FEV1/FVC ratio<70% was observed in 13.0% of subjects in Group 1, 8.6% of subjects in Group 2, and 7.1% of subjects in Group 3. CONCLUSIONS: This study is the first to report a dose-response relationship between exposure to volcanic eruptions and the presence of symptoms in adults. Furthermore, there is a tendency toward obstructive impairment in individuals with higher exposure.

A longitudinal and multidesign epidemiological study to analyze the effect of the volcanic eruption of Tajogaite volcano (La Palma, Canary Islands). The ASHES study protocol.

INTRODUCTION: Volcanic eruptions emit gases and particulate matter into the atmosphere which, if inhaled, can have an impact on health. The eruption of the volcano situated in the Cumbre Vieja Nature Reserve (La Palma, Canary Islands, Spain) affords a unique opportunity to study the effect of such a phenomenon on health. The aim of the proposed study is to assess the short-, medium- and long-term respiratory health effects of exposure to volcanic emissions from the eruption in three different population groups. METHODS: We propose to undertake a multidesign study: an ambispective cohort study to analyze the effect of the eruption on the general population, the highly exposed population, and the childhood population; and a pre-post quasi-experimental study on subjects with previously diagnosed respiratory diseases. The information will be collected using a personal interview, biologic specimens, air pollution data, data from medical records, respiratory tests and imaging tests. The study has an envisaged follow-up of five years, to run from the date of initial recruitment, with annual data-collection. This study has been approved by the Santa Cruz de Tenerife Provincial Research Ethics Committee (Canary Island Health Service) on March 10, 2022. CONCLUSIONS: This study will make it possible to advance our knowledge of the effect a volcano eruption has on population health, both short- and long-term, and to assess the potential respiratory injury attributable to volcanic eruptions. It may serve as a model for future studies of new volcanic eruptions in the coming years.

Significado clínico de las micobacterias ambientales aisladas en muestras respiratorias en pacientes con silicosis y sin silicosis / Clinical Significance of Environmental Mycobacteria Isolated From Respiratory Specimens of Patients With and Without Silicosis

Objetivo: Describir las diferencias clínicas, funcionales y radiográficas de la enfermedad respiratoria por micobacterias ambientales (MA) en pacientes con silicosis y sin silicosis. Método: Estudio observacional retrospectivo en pacientes a los que se les había aislado una micobacteria no tuberculosa en el laboratorio de Microbiología del hospital de O Meixoeiro (CHU de Vigo) desde enero 2007 hasta diciembre 2013. Se diferenció a los pacientes según presentaran o no silicosis y enfermedad pulmonar por MA utilizando los criterios de la American Thoracic Society. Resultados: Se identificaron 156 casos con aislamiento respiratorio de al menos una especie de MA. El 71% eran varones, de los cuales 40 (25,6%) tenían silicosis. En 60 pacientes (38,5%), el 62,5% del grupo de silicosis y el 30,2% del grupo sin silicosis, se cumplían los criterios microbiológicos recomendados por la American Thoracic Society siendo las especies más comunes Mycobacterium avium complex, Mycobacterium genavense y Mycobacterium chelonae. En 34 pacientes (22,7%), 14 del grupo de silicosis y 20 del grupo sin silicosis, se cumplían los criterios de la American Thoracic Society de enfermedad pulmonar por MA. Se realizó tratamiento en 24 casos, con mayores niveles de erradicación bacteriológica en el grupo sin silicosis. Conclusiones: En nuestros pacientes el antecedente de silicosis se relacionó con mayor incidencia de enfermedad por MA. La especie causante de la mayor parte de los casos de de enfermedad en nuestro medio por MA es Mycobacterium avium complex, seguido de Mycobacterium genavense. Los pacientes con silicosis presentaron menores niveles de curación tras el tratamiento

Objective: To describe the clinical, functional and radiographic differences of respiratory disease caused by environmental mycobacteria (EM) in patients with and without silicosis. Method: Retrospective, observational study in patients with nontuberculous mycobacteria isolated in the Hospital Meixoeiro (University Hospital of Vigo) microbiology laboratory between January 2007 and December 2013. Patients were grouped according to the presence or absence of silicosis and mycobacterial lung disease, using American Thoracic Society criteria. Results: In 156 cases, at least one species of EM had been isolated from the respiratory culture. A total of 71% were identified in men, 40 (25.6%) of whom had silicosis. Sixty patients (38.5%) met American Thoracic Society microbiological criteria: 62.5% of the silicosis group and 30.2% of the non-silicosis group. The most common species were Mycobacterium avium complex, Mycobacterium genavense and Mycobacterium chelonae. American Thoracic Society criteria for environmental mycobacterial disease were met in 34 (22.7%) patients: 14 in the silicosis group and 20 in the non-silicosis group. Treatment was administered in 24 cases, with better bacteriological eradication levels in the non-silicosis group. Conclusions: In our series, a history of silicosis was related with a higher incidence of environmental mycobacterial disease. The causative species in the majority of cases in our setting wasMycobacterium avium complex, followed by Mycobacterium genavense. Patients with silicosis showed lower cure rates after treatment

Clinical Significance of Environmental Mycobacteria Isolated From Respiratory Specimens of Patients With and Without Silicosis.

OBJECTIVE: To describe the clinical, functional and radiographic differences of respiratory disease caused by environmental mycobacteria (EM) in patients with and without silicosis. METHOD: Retrospective, observational study in patients with nontuberculous mycobacteria isolated in the Hospital Meixoeiro (University Hospital of Vigo) microbiology laboratory between January 2007 and December 2013. Patients were grouped according to the presence or absence of silicosis and mycobacterial lung disease, using American Thoracic Society criteria. RESULTS: In 156 cases, at least one species of EM had been isolated from the respiratory culture. A total of 71% were identified in men, 40 (25.6%) of whom had silicosis. Sixty patients (38.5%) met American Thoracic Society microbiological criteria: 62.5% of the silicosis group and 30.2% of the non-silicosis group. The most common species were Mycobacterium avium complex, Mycobacterium genavense and Mycobacterium chelonae. American Thoracic Society criteria for environmental mycobacterial disease were met in 34 (22.7%) patients: 14 in the silicosis group and 20 in the non-silicosis group. Treatment was administered in 24 cases, with better bacteriological eradication levels in the non-silicosis group. CONCLUSIONS: In our series, a history of silicosis was related with a higher incidence of environmental mycobacterial disease. The causative species in the majority of cases in our setting was Mycobacterium avium complex, followed by Mycobacterium genavense. Patients with silicosis showed lower cure rates after treatment.

Exposición a contaminantes ambientales y enfermedad respiratoria. Un foco de atención en el año 2009 / Exposure to Environmental Contaminants and Respiratory Disease. Spotlight on the Year 2009

La inhalación mantenida de agentes contaminantes presentes en el aire que respiramos es una causa frecuentede enfermedad respiratoria. De forma clásica, esta relación exposición-enfermedad se ha concretadoen el lugar de trabajo y como causa de enfermedades específi cas, como la neumoconiosis y el asmaocupacional. Sin embargo, cada vez es mayor la evidencia que indica la asociación entre exposición laboraly otras afecciones respiratorias tan prevalentes como la enfermedad pulmonar obstructiva crónica y elcáncer de pulmón. Además, el efecto de la contaminación también se observa fuera del lugar de trabajo, elaire de las ciudades puede contribuir a aumentar la morbilidad y la mortalidad por enfermedades respiratoriascrónicas. A continuación, se revisan algunos de los artículos publicados durante el año 2009 que incidenen algunos aspectos relacionados con las enfermedades respiratorias de origen laboral y medioambiental(AU)

The continued inhalation of contaminants present in the air that we breathe is a common cause ofrespiratory disease. Classically, this exposure-disease relationship has been proved in the workplace and asa cause of specifi c diseases such as pneumoconiosis and occupational asthma. However, there is increasingevidence indicating an association between occupational exposure and other more prevalent respiratorydiseases such as Chronic Obstructive Pulmonary Disease and lung cancer. The effect of contamination isalso observed outside the workplace. The air in cities can contribute to increasing the morbidity andmortality due to chronic respiratory diseases. Some articles published during the year 2009 that have abearing on aspects associated with respiratory diseases of occupational or environmental origin arereviewed below(AU)

[Update in respiratory disease and environmental exposure: an invisible relationship]. / Actualización en enfermedad respiratoria y exposición ambiental: una relación invisible.

Significant contributions have been made in the past year on different aspects of occupational/environmental respiratory disease. In the case of neoplastic diseases associated with asbestos inhalation, the areas of most interest have been in the search for tumour markers, the importance of the determination of asbestos fibre deposits in biological samples, and new therapeutic schemes in malignant pleural mesothelioma. A consensus article has been published on occupational asthma, in which some clinical evidenced-based recommendations are established, directed at the diagnosis and management of work-related asthma. As regards hypersensitivity-induced pneumonitis, the clinical and evolutionary aspects of this disease have been described in a large series of 86 patients with pigeon-fancier lung. There have also been interesting studies published this year that emphasise the need to take an occupational history in patients with respiratory symptoms in order to look for a causal or synergic relationship with smoking. Finally, the results of studies have been published which were directed at elucidating the role of urban contamination, mainly caused by road traffic, in the deterioration of lung function. A recent study showed that it would be possible to achieve a significant reduction in urban mortality attributed to urban contamination by reducing the levels of PM 2.5. They conclude that more restrictive standards need to be adopted in Europe to protect the health of the population, which coincides with the proposal by the World Health Organisation.

Actualización en enfermedad respiratoria y exposición ambiental: una relación invisible / Update in Respiratory Disease and Environmental Exposure: an Invisible Relationship

En el último año, se han producido contribuciones relevantes en diferentes aspectos de la patología laboral/ambiental respiratoria. En el caso de las enfermedades neoplásicas asociadas a la inhalación de asbesto,las áreas de interés más recientes se sitúan en la búsqueda de marcadores tumorales, la importancia de ladeterminación del depósito de fibras de amianto en muestras biológicas y en los nuevos regímenes terapéuticosen el mesotelioma pleural maligno. En el asma relacionada con el trabajo, se ha publicado un artículode consenso en el que se establecen unas recomendaciones basadas en evidencias clínicas, dirigidas aldiagnóstico y el manejo del asma relacionada con el trabajo. En referencia a las neumonitis por hipersensibilidad,en una amplia serie de 86 pacientes con pulmón del cuidador de aves se describen las característicasclínicas y evolutivas de esta patología. En este año se han publicado además interesantes estudios queenfatizan la necesidad de realizar una historia laboral en los pacientes con síntomas respiratorios para sospecharuna relación causal o sinérgica con el tabaco. Finalmente, se han publicado resultados de diferentestrabajos dirigidos a elucidar el papel de la contaminación urbana, principalmente derivada del tráfico rodado,en el deterioro de la función pulmonar. Un estudio reciente demuestra que sería posible obtener unasignificativa reducción de la mortalidad atribuida a la contaminación urbana, reduciendo los niveles de PM2,5, y concluye que en Europa es necesario adoptar estándares más restrictivos para proteger la salud delos ciudadanos, coincidiendo con la propuesta de la Organización Mundial de la Salud(AU)

Significant contributions have been made in the past year on different aspects of occupational/environmental respiratory disease. In the case of neoplastic diseases associated with asbestos inhalation,the areas of most interest have been in the search for tumour markers, the importance of the determinationof asbestos fibre deposits in biological samples, and new therapeutic schemes in malignant pleuralmesothelioma. A consensus article has been published on occupational asthma, in which some clinicalevidenced-based recommendations are established, directed at the diagnosis and management of workrelatedasthma. As regards hypersensitivity-induced pneumonitis, the clinical and evolutionary aspects ofthis disease have been described in a large series of 86 patients with pigeon-fancier lung. There have alsobeen interesting studies published this year that emphasise the need to take an occupational history inpatients with respiratory symptoms in order to look for a causal or synergic relationship with smoking.Finally, the results of studies have been published which were directed at elucidating the role of urbancontamination, mainly caused by road traffic, in the deterioration of lung function. A recent study showedthat it would be possible to achieve a significant reduction in urban mortality attributed to urbancontamination by reducing the levels of PM 2.5. They conclude that more restrictive standards need to beadopted in Europe to protect the health of the population, which coincides with the proposal by the WorldHealth Organisation(AU)

Normativa del asma ocupacional / Guidelines for Occupational Asthma

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