Factors affecting work productivity and activity impairment among chronic obstructive pulmonary disease patients.

Chronic obstructive pulmonary disease (COPD) can negatively affect patients' employment and work-life activities with a significant indirect economic impact. The current study aimed to measure unemployment, work productivity, activity impairment, and their associated factors among COPD patients. A cross-sectional study was conducted in the Chest outpatient clinic, Mansoura University Hospital, Egypt. COPD patients completed an interviewer-administered questionnaire including sociodemographic, occupational data, clinical history, medical research council (mMRC) dyspnea scale, the COPD assessment test (CAT), and work productivity and activity impairment Questionnaire (WPAI-COPD). A total 140 patients were included in the study and 22.1% of them gave up their jobs because of their COPD. Due to COPD, the mean percentage of daily activity impairment was 39.8 among all patients. The mean percentages of absenteeism, presenteeism, and overall work impairment among the 84 working patients were 0.07, 24.4, and 24.5. The CAT score was the significant predictor of all components of WPAI. In conclusion, COPD causes early retirement, high work productivity loss, and impaired daily activities. Higher CAT scores and increased disease severity significantly increase absenteeism, presenteeism, overall work, and activity impairment. Thus, timely diagnosis of COPD with appropriate management can help improve outcomes and lower the disease burden and economic impact.

Protective role of Nrf2 in zinc oxide nanoparticles-induced lung inflammation in female mice and sexual dimorphism in susceptibility.

BACKGROUND: Zinc oxide nanoparticles (ZnO-NPs) are currently employed in various products such as rubber, paint, and cosmetics. Our group reported recently that Nrf2 protein provides protection against pulmonary inflammation induced by ZnO-NPs in male mice. The current study investigated the effect of Nrf2 deletion on the lung inflammatory response in female mice exposed to ZnO-NPs. METHODS: An equal number of female Nrf2-/- mice and female Nrf2+/+ mice (24 each) were allocated into three equal groups, and each was exposed to ZnO-NPs at either 0, 10 or 30 µg ZnO-NPs/mouse through pharyngeal aspiration. Bronchoalveolar lavage fluid (BALF) and lungs were examined 14 days later to determine the number of inflammatory cells, the protein level, and for scoring inflammation histopathologically. The mRNA levels of Nrf2-dependent antioxidant enzymes and proinflammatory cytokine in lung tissue were also measured. RESULTS: Exposure to ZnO-NPs increased all types of BALF cells and lung inflammation scores in both of female Nrf2-null (Nrf2-/-) and wild-type (Nrf2+/+) mice, and Nrf2 deletion enhanced ZnO-NPs-induced increase in the number of eosinophils in BALF. Exposure to ZnO-NPs dose-dependently increased the level of oxidized glutathione (GSSG), and mRNA levels of proinflammatory cytokines/chemokines; KC, MIP-2, IL-6, IL-1ß and MCP-1 only in wild-type mice. Nrf2 deletion decreased total glutathione levels and basal mRNA levels of SOD1 and NQO1, and increased the basal mRNA level of above proinflammatory cytokines/chemokines. Nrf2 deletion enhanced ZnO-NPs-induced downregulation of GcLc, GR and TGF-ß and upregulation of HO-1 and TNF-α. Taken together with our previous results in male mice, our results showed a lower susceptibility of females to lung tissue inflammation, relative to males, irrespective of Nrf2 deletion, and that enhancement of ZnO-NPs-induced upregulation of HO-1 and TNF-α and downregulation of GcLc, GR and TGF-ß by deletion of Nrf2 is specific to female mice. CONCLUSION: We conclude that Nrf2 provides protection in female mice against increase in BALF eosinophils, probably through down-regulation of proinflammatory cytokines/chemokines and upregulation of oxidative stress-related genes. The study also suggests lower susceptibility to lung tissue inflammation in female mice relative to their male counterparts and the synergistic effects of Nrf2 and exposure to ZnO-NPs on mRNA expression of GcLc, GR, HO-1, TGF-ß or TNF-α in female mice.

Psychological distress among Egyptian physicians during COVID-19 pandemic.

OBJECTIVE: The current study's main objective was to measure the prevalence of psychological distress and its associated factors among Egyptian physicians during the COVID-19 pandemic. Perceived stressors and coping strategies were also explored. METHODS: A cross-sectional study on 714 physicians was carried out using an online administered questionnaire. The questionnaire included sociodemographic and occupational data, data related to the current pandemic, Kessler psychological distress scale, and the brief resilient coping scale. Multivariable logistic regression analysis was performed to identify significant predictors. RESULTS: About 50% of physicians had severe psychological distress. Among studied physicians, the significant predictors were being female, having a pre-existing illness, having an elderly family member, and being in close contact with a case (AOR 1.6, 1.6, 1.4 and 1.7, respectively). Meanwhile, significant occupational predictors were less experienced and frontline physicians (AOR 2.0 and 1.8, respectively). The most distressful concern was fear for families and personal health and safety, while religious coping was the most effective coping strategy. CONCLUSION: During the current pandemic, Egyptian physicians have a high prevalence of psychological distress. Frontline, low-experienced, female, previously ill physicians are more likely to have severe psychological distress. Therefore, psychological preparedness and psychological support services should be implemented and made easily accessible during pandemics.

Personal protective equipment (PPE) use and its relation to accidents among construction workers.

BACKGROUND: The construction industry is characterized by a high prevalence of accidents and injuries. Inadequate risk management measures, including failure to use or incorrect use of personal protective equipment (PPE) may significantly increase the risk of accidents. OBJECTIVES: The main objectives of the current study were to measure the prevalence of PPE use and accidents and their associated factors among construction workers. METHODS: A cross-sectional field study with an analytic component was carried out on 384 workers from different sites in Port-Said, Egypt, using an interview administered questionnaire. The questionnaire included sociodemographic and occupational data, practice of PPE use and accident analysis. RESULTS: About 60% of workers use PPE during work. Main reasons for non-use are discomfort, lack of knowledge on how to use it and poor fit. Occupational accidents in the last 12 months were reported by 64.3% of workers. The main accident types were: being hit by falling objects, falls from height, and tool related accidents. Safety training was the significant independent predictor of PPE use (AOR=2.0). However, age, marital status, smoking, safety training, and PPE use were also significant independent predictors of accidents (AOR=2.4, 3.1, 0.5, 0.5, and 0.2; respectively). DISCUSSION: Among construction workers, PPE utilization is low with significant relation to safety training while occupational accidents are common and significantly related to safety training and PPE use. Therefore, safety training should be provided, and PPE use should be enforced at construction sites.

Role of Nrf2 in inflammatory response in lung of mice exposed to zinc oxide nanoparticles.

BACKGROUND: Zinc oxide nanoparticles (ZnO-NPs) are widely used in many industrial sectors and previous studies have reported that exposure of the lungs to ZnO-NPs induces both acute and/or chronic pulmonary inflammation, but the exact mechanism underlying such response remains elusive. This study investigated the role of nuclear factor-erythroid 2-related factor (Nrf2) in pulmonary inflammation induced by exposure to ZnO-NPs using Nrf2 null (Nrf2-/-) mice. METHODS: Twenty-four male Nrf2-/- mice and thirty male wild type C57BL/6 J mice were divided into three groups of eight and ten each respectively, and exposed once to ZnO-NPs at 0, 10, 30 µg/mouse by pharyngeal aspiration. At 14 days after the exposure to ZnO-NPs, bronchoalveolar lavage fluid (BALF) and lungs were collected to quantify protein level and the number of inflammatory cells. The mRNA levels of Nrf2-dependent antioxidant enzymes and inflammatory cytokines in lung tissue were measured. RESULTS: Exposure to ZnO-NPs dose-dependently increased the number of total cells, macrophages, lymphocytes and eosinophils in BALF both in Nrf2-/- mice and wild type mice, but the magnitude of increase was significantly higher in Nrf2-/- mice than wild type mice. The number of neutrophils in BALF increased in Nrf2-/- mice, being accompanied by marginal trend of increase in mRNA expression of MIP-2, neutrophil chemoattractant, but such changes were not observed in wild type mice. Exposure to ZnO-NPs did not dose-dependently increase mRNA level of Nrf2-dependent antioxidant enzymes both in Nrf2-/- mice and wild type mice. CONCLUSION: Pharyngeal aspiration of ZnO-NPs induced infiltration of inflammatory cells in the lung of mice, but minimally induced Nrf2-dependent antioxidant enzymes. The results suggest that Nrf2 play a role in negative regulation on ZnO-NP exposure-induced neutrophil migration, but does not demonstrate that the regulation is through suppression of oxidative stress.

Copper Oxide Nanoparticles Reduce Vasculogenesis in Transgenic Zebrafish Through Down-Regulation of Vascular Endothelial Growth Factor Expression and Induction of Apoptosis.

The present study investigated the effects of exposure to metal oxide nanoparticles on vasculogenesis/angiogenesis using transgenic zebrafish. The study also examined the potential mechanisms involved in those effects using human umbilical vein endothelial cells (HUVEC). TG (nacre/fli1:EGFP) zebrafish were exposed to nano-sized titanium dioxide (TiO2), silica dioxide (SiO2), and copper oxide (CuO) particles at 0.01, 1 and 100 µg/ml concentrations from 1 to 5 dpf (day-post-fertilization). Angiogenesis was evaluated morphologically at the end of exposure. Exposure to CuO nanoparticles reduced the number of transversely-running subintestinal vessels in TG zebrafish. Exposure to CuO nanoparticles down-regulated the expression of vascular endothelial growth factor (VEGF) and VEGF receptor in endothelial cells sorted by Fluorescence Activated Cell Sorter (FACS). Exposure of HUVEC to CuO nanoparticles reduced cell viability and increased apoptotic index in a dose-dependent manner. The results suggested that CuO nanoparticles inhibit vasculogenesis through reduction of VEGF expression and induction of apoptosis.