Electronic cigarette use and respiratory symptoms in the French population-based Constances cohort.

BACKGROUND: Knowledge about the consequences of electronic cigarette (EC) use on respiratory health is still limited. We aimed to assess whether EC use is associated with the occurrence of asthma symptoms and chronic bronchitis among the French adult population, with a specific focus on never combustible cigarettes (CC) smokers. We further investigated whether the association differed in men and women. METHODS: Constances is a population-based cohort of adults aged 18-69 years at inception. We analyzed baseline data collected in 136,276 participants recruited in 2015-2019. Associations of current and former EC use with respiratory symptoms (asthma symptom score and chronic bronchitis) were assessed, controlling for CC smoking, cannabis use, demographics, education and body mass index (BMI). RESULTS: Increased frequencies of respiratory symptoms were observed in both current and former EC users (for the asthma symptom score, adjusted mean score ratio (aMSR): 1.34 [95 % confidence interval: 1.28-1.41] and 1.39 [1.33-1.45], respectively; for chronic bronchitis, adjusted prevalence ratio (aPR): 1.27 [1.19-1.36] and 1.40 [1.32-1.48], respectively). Among never CC smokers, ever EC use was associated with an increased asthma symptom score in both men and women (aMSR = 1.44 [1.09-1.90] and 1.36 [1.01-1.83], respectively), and with a higher prevalence of chronic bronchitis only in women (aPR = 1.97 [1.27-3.05]). CONCLUSION: EC use is associated with symptoms of asthma and chronic bronchitis, independently of CC smoking and cannabis use. The fact that these associations are observed among individuals who have never smoked tobacco adds further evidence of the deleterious effects of EC on respiratory health.

Exposure to ambient air pollution and chronic bronchitis: Findings from over 6.6 million adults in northwestern China.

BACKGROUND: Ambient air pollution increases the risk of respiratory mortality and morbidity, but evidence concerning effects of air pollution on chronic bronchitis (CB) is scarce. This study aimed to evaluate the associations of a set of air pollutants with the burden of CB, and to explore potential modifiers on the associations. METHODS: In 2020, a total of 6,556,440 adults living in the Northwestern region of China were recruited. The Space-Time Extra-Trees model was employed to assess the annual average concentrations of six air pollutants for the three years (2017-2019) before 2020 , and subsequently allocated to the participants based on the latitude and longitude of their home addresses. We investigated the associations between the levels of various air pollutants and the odds of CB using generalized linear mixed models, and conducted multiple sensitivity analyses and subgroup analyses. RESULTS: The odds of CB displays an approximately linear association with particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), particulate matter with aerodynamic diameter ≤10 µm (PM10), while it shows a non-linear relationship with gaseous pollutants. In the adjusted model, the odds ratios and 95% confidence intervals for CB per 10 µg/m3 increase in PM2.5, PM10, and sulfur dioxide (SO2) were 1.297 (1.262-1.332), 1.072 (1.064-1.080), and 2.587 (2.186-3.063), respectively. Furthermore, several additional sensitivity analyses demonstrated the stability of these associations. Subgroup analyses found that the aforementioned associations were greater among participants aged below 50 years old and those who smoked and had no leisure time exercise. CONCLUSION: Long-term exposure to ambient air pollutants may increase the odds of CB, especially among younger people and those with unhealthy lifestyles.

An investigation of the risk factors of chronic obstructive pulmonary disease in natural population-based cohorts in China - a nested case-control study.

Background: Chronic obstructive pulmonary disease (COPD) has become one of the most significant chronic diseases in China. According to conventional wisdom, smoking is the pathogenic factor. However, current research indicates that the pathophysiology of COPD may be associated with prior respiratory system events (e.g., childhood hospitalization for pneumonia, chronic bronchitis) and environmental exposure (e.g., dust from workplace, indoor combustion particles). Dyspnea, persistent wheezing, and other respiratory symptoms further point to the need for pulmonary function tests in this population. Reducing the burden of chronic diseases in China requires a thorough understanding of the various factors that influence the occurrence of COPD. Methods: Using a cohort from the natural population, this study used nested case-control analysis. We carried out a number of researches, including questionnaire surveys and pulmonary function testing, in the Northwest and Southeast cohorts of China between 2014 and 2021. After removing any variations in the baseline data between patients and control subjects using propensity score matching analysis, the risk factors were examined using univariate or multivariate regression. Result: It was discovered that prior history of chronic bronchitis, long-term wheezing symptoms, and environmental exposure-including smoking and biofuel combustion-were risk factors for COPD. Dyspnea, symptoms of mobility limitation, organic matter, and a history of hospitalization for pneumonia at an early age were not significant in the clinical model but their incidence in COPD group is higher than that in healthy population. Discussion: COPD screening effectiveness can be increased by looking for individuals with chronic respiratory symptoms. Smokers should give up as soon as they can, and families that have been exposed to biofuels for a long time should convert to clean energy or upgrade their ventilation. Individuals who have previously been diagnosed with emphysema and chronic bronchitis ought to be extra mindful of the prevention or advancement of COPD.

[The role of exposure to airborne pollutants in the workplace on the prevalence and severity of chronic respiratory disease in Italy]. / Il ruolo dell'esposizione a inquinanti aerodispersi nel luogo di lavoro sulla prevalenza e gravità della malattia respiratoria cronica in Italia.

OBJECTIVES: occupational exposure to vapours, gases, dusts and fumes (VGDF) plays an important role in the development and exacerbation of respiratory diseases. The aim of this study is to evaluate the possible association of occupational exposure to airborne pollutants and chronic respiratory diseases. DESIGN: multicase-control study. SETTING AND PARTICIPANTS: cases of chronic respiratory diseases and controls from the Italian multicentric study Gene Environment Interaction in Respiratory Diseases (GEIRD). MAIN OUTCOME MEASURES: the occurrence of rhinitis, asthma, chronic bronchitis/chronic obstructive pulmonary disease (COPD), asthma severity, spirometry data, exhaled nitric oxide (FeNO) were examined in relation to chronic and acute occupational exposures to airborne pollutants using multiple regression models. RESULTS: 2,943 subjects were enrolled in the study. Regularm exposure to VGDF was associated with a higher prevalence of chronic bronchitis/COPD (OR 1.40, 95%CI 0.98-1.99), especially in those also having asthma (OR 1.80, 95%CI 1.14-2.85), a lower prevalence of remittent asthma (OR 0.53, 95%CI 0.29-0.96) and, in those with asthma, an increased activity of the disease (severity score) (OR 1.77, 95%CI 1.20-2.60). No associations were observed between occupational exposure and prevalence of rhinitis, spirometry and FeNO data. Finally, an association was found between acute exposure to airborne pollutants (occupational and non-occupational) and the respiratory diseases investigated, in particular active asthma and asthma associated chronic bronchitis/BPCO. CONCLUSIONS: these data confirm a significant role of occupational exposure to airborne pollutants on respiratory health, underlying the importance of workplace exposure prevention, in particular for more susceptible subjects, as those with respiratory diseases.

Axial Spondyloarthritis after bariatric surgery: a 7-year retrospective analysis

Abstract Background: In recent decades, obesity has become a public health problem in many countries. The objective of this study was to evaluate the main joint and extra-articular manifestations related to spondyloarthritis (SpA) after bariatric surgery (BS) in a retrospective cohort. Methods: Demographic, clinical, laboratory and imaging data from nine patients whose SpA symptoms started after a BS have been described. Modified New York (mNY) criteria for ankylosing spondylitis (AS) and the Assessment of Spondyloarthritis International Society (ASAS) criteria for axial (ax-SpA) and peripheral (p-SpA) spondyloarthritis were applied. Results: The mean weight reduction after BS was 49.3 ±21.9 kg. The BS techniques were Roux-en-Y gastric bypass (n =8; 88.9%) and biliopancreatic diversion with duodenal switch (n = 1; 11.1%). Four (44.4%) patients had no axial or peripheral pain complaints before BS, while the other four (44.4%) had sporadic non-inflammatory back pain that had been attributed to obesity. One patient (11.1%) had persistent chronic back pain. In all nine cases, patients reported back pain onset or pattern (intensity or night pain) change after BS (mean time 14.7 ± 18 months). In addition, 8 of them (88.9%) were human leukocyte antigen (HLA)-B27 positive. All nine patients could be classified according to ASAS criteria as ax-SpA and five (55.6%) patients were classified as AS, according to the mNY criteria. Conclusion: Our data highlight a temporal link between SpA onset symptoms and the BS, suggesting a possible causal plausibility between the two events.

Risco aumentado de sintomas respiratórios e bronquite crônica em mulheres que utilizam biocombustíveis na Nigéria / Increased risk of respiratory symptoms and chronic bronchitis in women using biomass fuels in Nigeria

OBJETIVO: Determinar a associação de sintomas respiratórios e bronquite crônica com o uso de biocombustíveis entre mulheres habitantes de áreas rurais do estado de Ekiti, sudoeste da Nigéria. MÉTODOS: De janeiro a junho de 2009, realizou-se um estudo transversal com uma amostra de 269 mulheres adultas. Um questionário adaptado do European Community Respiratory Health Survey foi aplicado para a obtenção de dados sobre características sociodemográficas, tipo de combustível utilizado para a preparação de alimentos, sintomas respiratórios e história de tabagismo. Todas as participantes foram convidadas a realizar espirometria. RESULTADOS: Das 269 mulheres no estudo, 161 (59,9 por cento) utilizavam biocombustíveis para a preparação de alimentos. As mulheres que utilizavam biocombustíveis relataram mais sintomas respiratórios que aquelas que não os utilizavam - tosse (13,7 por cento vs. 3,7 por cento); sibilância (8,7 por cento vs. 2,8 por cento); dor no peito (7,5 por cento vs. 1,9 por cento); falta de ar (11,8 por cento vs. 6,5 por cento); sintomas nasais (9,3 por cento vs. 4,6 por cento); e bronquite crônica (10,6 por cento vs. 2,8 por cento). A análise multivariada por regressão logística confirmou que o uso de biocombustíveis está associado às seguintes variáveis: tosse (OR = 4,82; p = 0,01); bronquite crônica (OR = 3,75; p = 0,04); sibilância (OR = 2,22; p = 0,23); dor no peito (OR = 3,82; p = 0,09); falta de ar (OR = 1,54; p = 0,35); e sintomas nasais (OR = 2,32; p = 0,20). Todos os parâmetros espirométricos avaliados (VEF1, CVF, VEF1/CVF e PFE) foram menores nas mulheres que utilizavam biocombustíveis do que naquelas que não os utilizavam. CONCLUSÕES: Nossos resultados enfatizam a necessidade de se substituir o uso de biocombustíveis nos domicílios pelo de um tipo de combustível atóxico, como eletricidade ou gás.

OBJECTIVE: To determine whether respiratory symptoms and chronic bronchitis are associated with the use of biomass fuels (BMFs) among women residing in rural areas of the Ekiti State, in southwestern Nigeria. METHODS: From January to June of 2009, we carried out a cross-sectional study including 269 adult women. To collect data on sociodemographic status, type of fuel used for cooking in the household, respiratory symptoms, and smoking history, we used a questionnaire adapted from the European Community Respiratory Health Survey. All of the participants were invited to undergo spirometry. RESULTS: Of the 269 women in the study, 161 (59.9 percent) used BMFs for cooking. The proportion of women who reported respiratory symptoms was greater among those using BMFs than among those using a non-BMF-cough (13.7 percent vs. 3.7 percent); wheezing (8.7 percent vs. 2.8 percent); chest pain (7.5 percent vs. 1.9 percent); breathlessness (11.8 percent vs. 6.5 percent); nasal symptoms (9.3 percent vs. 4.6 percent); and chronic bronchitis (10.6 percent vs. 2.8 percent). Multivariate logistic regression analysis revealed that the use of BMFs was associated with the following variables: cough (OR = 4.82; p = 0.01); chronic bronchitis (OR = 3.75; p = 0.04); wheezing (OR = 2.22; p = 0.23); chest pain (OR = 3.82; p = 0.09); breathlessness (OR = 1.54; p = 0.35); and nasal symptoms (OR = 2.32; p = 0.20). All of the spirometric parameters evaluated (FEV1, FVC, FEV1/FVC ratio, and PEF) were lower in the women using BMFs than in those using a non-BMF. CONCLUSIONS: Our results underscore the need for women using BMFs in their households to replace them with a nontoxic type of fuel, such as electricity or gas.

Prevalência de sintomas respiratórios e fatores associados: estudo de base populacional em adultos de Lages, Santa Catarina, Brasil / Prevalence of respiratory symptoms and associated factors: a population-based study in adults from Lages, Santa Catarina State, Brazil

Realizou-se estudo transversal de base populacional em Lages, Santa Catarina, Brasil, para estimar a prevalência de sintomas de bronquite crônica, falta de ar e chiado no peito e os fatores associados em adultos de 20-59 anos de idade (n = 2.051). Processo de amostragem através de conglomerados e análise de regressão de Poisson foram realizados. As prevalências de bronquite crônica, falta de ar e chiado no peito foram de 5 por cento, 35,7 por cento e 20,2 por cento, respectivamente. Análises ajustadas mostraram presença de bronquite crônica associada à baixa escolaridade, fumar dez ou mais pacotes de cigarros ao ano e internação por problemas de pulmão na infância. Falta de ar associou-se ao sexo feminino, baixa escolaridade e renda familiar, pardos e amarelos, história de internação por problemas de pulmão na infância, ser fumante e trabalhar com poeira ou pó. Presença de chiado no peito associou-se ao sexo feminino, baixa escolaridade e renda familiar, pardos e pretos, história de internação por problemas de pulmão na infância, ser fumante e trabalhar com poeira ou pó. Particularidades do clima e das atividades laborais devem ser consideradas no planejamento das ações em saúde.

A cross-sectional population-based study was conducted in Lages, Santa Catarina State, Brazil, in order to estimate the prevalence of symptoms of chronic bronchitis, breathlessness, and wheezing and associated factors in a sample of adults 20 to 59 years of age (n = 2,051). The study employed a cluster sample design and Poisson regression analyses. Prevalence rates for chronic bronchitis, breathlessness, and wheezing were 5 percent, 35.7 percent, and 20.2 percent, respectively. The adjusted analysis showed chronic bronchitis associated with low schooling, smoking, and hospital admissions due to respiratory illness during childhood. Breathlessness was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Wheezing was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Public health planners should consider climatic factors and work activities when developing activities to prevent respiratory diseases.

Manifestações respiratórias e doenças de vias aéreas: prevalência e fatores de risco em suinocultores de Braço do Norte, Santa Catarina / Respiratory manifestations and respiratory diseases: prevalence and risk factors among pig farmers in Braço do Norte, Brazil

OBJETIVO: Descrever a prevalência de sinais e sintomas de doença respiratória, avaliar as características do confinamento e identificar potenciais fatores de risco nos suinocultores do município de Braço do Norte, Santa Catarina. MÉTODOS: Um estudo do tipo observacional, de caráter exploratório, com delineamento transversal, em que a coleta de dados foi através de entrevistas e realização de espirometrias. Foram investigados o histórico laborativo, as condições do ambiente e trabalho, a saúde respiratória e o hábito tabágico. Como medida de risco foi utilizada a razão de chances da exposição, ao comparar suinocultores expostos e não expostos aos fatores de interesse de acordo com presença de sinais e sintomas de doença respiratória. RESULTADOS: A prevalência das manifestações de sintomas e sinais respiratórios foi de 84,3 por cento, de asma brônquica foi de 5,6 por cento e de bronquite crônica naqueles acima de 40 anos foi 5,1 por cento. Apenas 2,6 por cento dos suinocultores utilizavam equipamentos de proteção específica para o aparelho respiratório. Manifestações respiratórias entre os suinocultores mostraram-se associadas ao baixo nível socioeconômico, baixa escolaridade, tabagismo, uso de fogão a lenha e uso de desinfetantes. Havia uma aparente associação entre tempo e intensidade de trabalho e os achados de uma menor prevalência de manifestações respiratórias. CONCLUSÃO: O 'fenômeno saúde do trabalhador' pode explicar a associação entre tempo/intensidade de trabalho e a menor prevalência de manifestações respiratórias. Entretanto, o evidente comprometimento do aparelho respiratório entre os suinocultores e a baixa adoção de medidas de proteção específica nesta população apontam para a necessidade de um programa de controle da exposição e regulamentação dos fatores ambientais.

OBJECTIVE: To describe the prevalence of signs and symptoms of respiratory disease among pig farmers in Braço do Norte, Santa Catarina, Brazil, evaluating the characteristics of swine confinement buildings and identifying potential risk factors. METHODS: An exploratory, cross-sectional, observational study involving interviews and pulmonary function tests (spirometry). Aspects related to job history, work conditions, and environment, as well as to respiratory status and smoking, were evaluated. Odds ratios were used to estimate the chances of exposure when comparing pig farmers according to the signs and symptoms of respiratory disease. RESULTS: The prevalence of clinical signs and symptoms of respiratory disease was 84.3 percent, clinical manifestations of bronchial asthma were detected in 5.6 percent of the farmers evaluated, and chronic bronchitis was diagnosed in 5.1 percent of the workers over the age of 40. Only 2.6 percent used specific individual respiratory protection devices. Respiratory disease was positively associated with low socioeconomic level, low level of education, smoking, the use of wood stoves, and the use of disinfectants. Work load and length of employment were both apparently associated with a lower prevalence of respiratory disease. CONCLUSION: The association between duration of employment and lower prevalence of respiratory disease can be attributed to the healthy worker effect. However, the evident respiratory impairment among pig farmers and the limited use of personal protective equipment draw attention to the need to implement a program to monitor exposure and regulate environmental factors.