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1.
Rev Saude Publica ; 54: 133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33331527

RESUMO

OBJECTIVE: To explore the association of occupational pesticide exposure with acute and mental health symptoms. METHODS: Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios. RESULTS: Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment. CONCLUSIONS: Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.


Assuntos
Depressão/induzido quimicamente , Fazendeiros , Cefaleia/induzido quimicamente , Exposição Ocupacional/estatística & dados numéricos , Praguicidas/envenenamento , Praguicidas/toxicidade , Envenenamento/epidemiologia , Doenças Respiratórias/induzido quimicamente , Taquicardia/induzido quimicamente , Adolescente , Adulto , Agricultura , Brasil/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Família , Feminino , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Prevalência , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/epidemiologia , Taquicardia/epidemiologia , Adulto Jovem
2.
Pediatr Ann ; 49(12): e532-e536, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33290571

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the identified cause of coronavirus disease 2019 (COVID-19), continues unabated. This fact, coupled with recurrence of COVID-19 in areas where it had been controlled, highlights the critical need for a safe and effective vaccine to prevent and mitigate this novel virus. The spike protein of SARS-CoV-2 is important in its lifecycle as well as in the development of immunity after human infection. This has prompted the selection of this antigen as a focus in developing COVID-19 vaccines. This article provides (1) a summary of the host immune responses to SARS-CoV-2 infection, (2) the vaccine platforms being used with COVID-19 vaccine candidates undergoing, or about to undergo, Phase III clinical trial testing, and (3) an overview of the key criteria necessary for COVID-19 vaccine efficacy and safety. In addition, the unique concept of vaccine-enhanced disease will be discussed. [Pediatr Ann. 2020;49(12):e532-e536.].


Assuntos
/imunologia , Anticorpos Antivirais/análise , Anticorpos Antivirais/imunologia , Anticorpos Facilitadores , Desenvolvimento de Medicamentos , Humanos , Parcerias Público-Privadas , RNA/imunologia , Proteínas Recombinantes/imunologia , Doenças Respiratórias/induzido quimicamente , Glicoproteína da Espícula de Coronavírus/imunologia , Replicação Viral/imunologia
4.
Ann Agric Environ Med ; 27(3): 418-426, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955225

RESUMO

INTRODUCTION AND OBJECTIVE: Burning coal and firewood generates toxic emissions that are associated with respiratory illness, cardiovascular disease, and even death. The aim of the study is to evaluate the association between county-level prevalence of household coal and firewood use and health outcomes, including total, respiratory, and cardiovascular mortality, as well as total and respiratory hospitalization rates. MATERIAL AND METHODS: The ecological study included data on the use of household coal and firewood in 139 counties obtained from the 2015 Chilean National Socio-economic Characterization Survey. Total, respiratory, and cardiovascular mortality, as well as total and respiratory hospitalization rates, were obtained from the Department of Health Statistics. Poisson models with robust error variance, Pearson linear correlation coefficients, and scatterplots were used to explore associations between household coal and firewood use and morbidity-mortality, stratifying by geographic zone. RESULTS: Total, respiratory, and cardiovascular mortality and total and respiratory hospitalization rates were 5.7 per 1,000, 552 per 100,000, 157 per 100,000, 92.5 per 1000, and 8.8 per 1000 inhabitants, respectively. The median prevalence of coal use for residential cooking, heating, or water heating was 3.64%, while the median prevalence of firewood combustion was 12%. In southern counties, age- and gender-adjusted respiratory mortality increased 2.02 (95% CI: 1.17-3.50), 1.5 (95% CI: 1.11-1.89), and 1.76-fold (95% CI: 1.19-2.60) for each percentage increase in household coal and firewood use for heating, cooking and heating water, respectively. CONCLUSIONS: The prevalence of household coal and firewood used for heating and cooking was positively correlated with respiratory mortality and hospitalization in southern zone counties.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Doenças Cardiovasculares/mortalidade , Carvão Mineral/efeitos adversos , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Doenças Respiratórias/mortalidade , Madeira/efeitos adversos , Doenças Cardiovasculares/induzido quimicamente , Chile/epidemiologia , Culinária , Feminino , Calefação , Humanos , Masculino , Doenças Respiratórias/induzido quimicamente
5.
Cent Eur J Public Health ; 28(3): 202-207, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997476

RESUMO

OBJECTIVE: Nanomaterials consist of particles smaller than 100 nm - nanoparticles (NPs). Their nano dimensions allow them to penetrate through various membranes and enter into the bloodstream and disseminate into different body organs. Massive expansion of nanotechnologies together with production of new nanoparticles which have not yet been in contact with living organisms may pose a potential health problem. It is therefore necessary to investigate the health impact of NPs after experimental exposure. Comparison of the effect of TiO2 and NPs Fe3O4 in Wistar rats at time intervals 1, 7, 14 and 28 days was performed by studying the cytotoxic effect in the isolated inflammatory cells from bronchoalveolar lavage (BAL). METHODS: Wistar rats were intravenously (i.v.) given a suspension of NPs TiO2 or Fe3O4 (coated by sodium oleate) via the tail vein. After time intervals of 1, 7, 14 and 28 days, we sacrificed the animals under anaesthesia, performed BAL and isolated the cells. The number of animals in the individual groups was 7-8. We examined the differential count of BAL cells (alveolar macrophages - AM, polymorphonuclear leukocytes - PMN, lymphocytes - Ly); viability and phagocytic activity of AM; the proportion of immature and polynuclear cells and enzymes - cathepsin D - CAT D, lactate dehydrogenase - LDH and acid phosphatase - ACP. RESULTS: We found that TiO2 NPs are relatively inert - without induction of inflammatory and cytotoxic response. Exposure to nanoparticles Fe3O4 induced - under the same experimental conditions - in comparison with the control and TiO2 a more extensive inflammatory and cytotoxic response, albeit only at 1, 7 and 14 days after injection. CONCLUSIONS: The results suggest that TiO2 and Fe3O4 nanoparticles used in our study were transferred from the bloodstream to the respiratory tract, but this effect was not observed at 28 days after i.v. injection, probably due to their removal from the respiratory tract.


Assuntos
Óxido Ferroso-Férrico/toxicidade , Nanopartículas Metálicas/toxicidade , Doenças Respiratórias/induzido quimicamente , Titânio/toxicidade , Administração Intravenosa , Animais , Óxido Ferroso-Férrico/administração & dosagem , Nanopartículas Metálicas/administração & dosagem , Ratos , Ratos Wistar , Titânio/administração & dosagem
6.
Toxicol Lett ; 334: 14-20, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32949622

RESUMO

Air pollution is known to trigger and exacerbate many respiratory diseases. The interaction between respiratory microbiome and host plays a significant role in maintaining airway immune homeostasis and health. Emerging evidence has revealed the associations of disturbances in the airway microbiome with air pollution and respiratory disease. However, respiratory microbiome has been an undervalued player in progressions of respiratory disease caused by air pollution. In this review, we summarize the current research advances with respect to the effects of air pollution on respiratory microbiome, then discuss the underlying mechanisms of air pollution induction of dysbiosis in respiratory microbiota and its links to respiratory diseases. This work may be helpful to deepening understanding the relationships between exposure, microbiome and airway disease and discovering new preventive and therapeutic strategies for air pollution-mediated respiratory disease.


Assuntos
Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Microbiota/efeitos dos fármacos , Material Particulado/toxicidade , Sistema Respiratório/efeitos dos fármacos , Doenças Respiratórias/induzido quimicamente , Humanos , Exposição por Inalação/efeitos adversos , Sistema Respiratório/microbiologia , Doenças Respiratórias/microbiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-32948054

RESUMO

Increasing artisanal and small-scale gold mining (ASGM) in developing countries has raised health concerns in mining communities. A preliminary health survey was conducted in Thabeikkyin Township, Mandalay Region, Myanmar, in February 2020 to assess the health conditions of an ASGM community. Respiratory function and other clinical assessments were evaluated in miners and non-miners, and participants' hair was analyzed for heavy metals. Respiratory function of miners was similar to that of non-miners. However, miners' respiratory function declined with longer mining activity duration. In total, 3 out of 18 miners showed neurological signs and symptoms of chronic mercury intoxication. The median concentration of the hair mercury was significantly higher in miners than non-miners (P = 0.01), and 9 out of 18 miners and 2 out of 11 non-miners showed the warning level of mercury. We found that, despite an association between declining respiratory function and length of time mining, only a minority of miners showed clinical features of chronic mercury intoxication. Further clinical surveys with a larger sample size are necessary to determine the broader health status of this community. In addition, clinical indicators such as pulmonary function tests are recommended as additional criteria for the diagnosis of mercury intoxication.


Assuntos
Exposição Ambiental/efeitos adversos , Poluentes Ambientais/toxicidade , Mercúrio/toxicidade , Mineradores/psicologia , Mineração , Exposição Ocupacional/análise , Doenças Respiratórias/epidemiologia , Feminino , Ouro , Avaliação do Impacto na Saúde , Humanos , Masculino , Mianmar/epidemiologia , Testes de Função Respiratória , Doenças Respiratórias/induzido quimicamente
8.
Toxicol Appl Pharmacol ; 407: 115238, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-32950532

RESUMO

Menthol is widely used in tobacco products. This study compared the effects of menthol on human bronchial epithelium using submerged cultures, a VITROCELL® cloud chamber that provides air liquid interface (ALI) exposure without solvents or heating, and a Cultex ALI system that delivers aerosol equivalent to that inhaled during vaping. In submerged culture, menthol significantly increased calcium influx and mitochondrial reactive oxygen species (ROS) via the TRPM8 receptor, responses that were inhibited by a TRPM8 antagonist. VITROCELL® cloud chamber exposure of BEAS-2B monolayers increased mitochondrial protein oxidation, expression of the antioxidant enzyme SOD2, activation of NF-κB, and secretion of inflammatory cytokines (IL-6 and IL-8). Proteomics data collected following ALI exposure of 3D EpiAirway tissue in the Cultex showed upregulation of NRF-2-mediated oxidative stress, oxidative phosphorylation, and IL-8 signaling. Across the three platforms, menthol adversely effected human bronchial epithelium in a manner that could lead to respiratory disease.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Mentol/efeitos adversos , Doenças Respiratórias/induzido quimicamente , Aerossóis , Antioxidantes/metabolismo , Cálcio/metabolismo , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Citocinas/metabolismo , Humanos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Proteômica , Espécies Reativas de Oxigênio/metabolismo , Mucosa Respiratória/efeitos dos fármacos , Canais de Cátion TRPM/biossíntese , Canais de Cátion TRPM/efeitos dos fármacos
10.
Public Health ; 186: 20-27, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32750505

RESUMO

OBJECTIVES: In 1984, nearly 500,000 inhabitants of Bhopal city, India, were exposed to toxic gases that leaked from a nearby pesticide manufacturing plant. In 1985, four cohorts were established to assess the long-term health impact of exposure, namely, mild, moderate, severely exposed and unexposed groups. The self-reported morbidity data of these cohorts were collected by follow-up cross-sectional surveys at regular intervals over the last 35 years. The present study aimed to analyse the long-term trend of chronic (duration of symptoms >3 months) respiratory morbidity in the four cohorts, stratified by age groups. STUDY DESIGN: The design of this study is a longitudinal analysis of cross-sectional respiratory morbidity data. METHODS: Chronic respiratory morbidity data within the cohorts were analysed at 5-year intervals (first recorded data from 1986). Based on age at the time of exposure, subjects were stratified into four age groups: children (aged <10 years), teenagers (aged ≥10 to <20 years), younger adults (aged ≥20 to <40 years) and older adults (aged ≥40 years). RESULTS: During the first decade, after exposure to the toxic gases, chronic respiratory morbidity in children and teenagers was high (up to 9.1%), which declined thereafter. Progressively increasing chronic respiratory morbidity was observed in both the younger and older adult age groups within all cohorts during the initial 5-10 years after exposure. Respiratory morbidity in both the younger and older adult age groups remained high for 15-20 years and thereafter recorded a declining trend. The highest respiratory morbidity observed during this study in the younger and older adult age groups was 38.6% and 59.5%, respectively; these values were both recorded in the severely exposed cohort. CONCLUSIONS: Exposure to toxic gases released during the Bhopal gas disaster has resulted in chronic respiratory morbidity of the exposed population; this morbidity has continued over decades. The age of the individuals at the time of exposure and exposure severity were crucial determinants of the long-term trend of respiratory morbidity.


Assuntos
Vazamento Acidental em Bhopal , Exposição Ambiental/efeitos adversos , Gases/efeitos adversos , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/mortalidade , Adolescente , Adulto , Criança , Estudos Transversais , Desastres/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Feminino , Intoxicação por Gás/epidemiologia , Humanos , Índia/epidemiologia , Isocianatos/envenenamento , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Morbidade , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
11.
Environ Health ; 19(1): 62, 2020 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503565

RESUMO

BACKGROUND: Nyamulagira and Nyiragongo are active volcanoes situated close to Goma (North Kivu, Democratic Republic of Congo). These volcanoes are among the most prolific sources of volcanic SO2 pollution on earth. OBJECTIVE: We investigated the possible spatiotemporal relationships between volcanic degassing represented by eruptive emissions of SO2 that occurred between 2000 and 2010, and the incidence of acute respiratory symptoms (ARS) in populations living in areas up to more than 100 km from the volcanoes. METHODOLOGY: The total flux of SO2 emitted during eruptions since 2000 and the average spatial distribution of the volcanic plume (2004-2008) were based on publicly available remote sensing data. The monthly numbers of adults and children reporting acute respiratory symptoms were extracted from health data collected routinely by selected local health centres and hospitals between 2000 and 2010. The monthly numbers of persons with ARS recorded during or after eruptions were compared with those recorded before eruptions, using negative binomial regression models allowing the calculation of incidence rate ratios (IRR) and their 95% confidence intervals. We first compared years with and without eruptions and then considered shorter time-windows (months). RESULTS: In the investigated area, ARS were the second most frequent cause of medical visits (12.2%, n = 3.2 million cases), after malaria (32.3%, n = 8.4 million cases). SO2 emissions gradually increased 30 to 50 times in 2010 compared to 2002. Taking 1999 as a reference, the IRR for ARS increased three-fold between 2000 [0.9 (0.8, 1.1)] and 2009 [2.8 (2.2, 3.7)]. Although the incidence of ARS appeared to increase after some eruptions, especially in areas close (< 26 km) to the volcanoes, we did not find a consistent temporal association between the yearly incidence of ARS and volcanic eruptions when considering the entire observation period. When we analysed shorter time-windows (6 months in the year preceding an eruption), we observed increased ARS incidences in eruptive months, except in 2010. IRRs were increased for centres situated close to volcanoes (< 26 km) in 2001 and 2002. CONCLUSION: ARS incident cases increased over the years in populations living around the Nyamulagira and Nyiragongo volcanoes, but we found no consistent evidence for an association between the yearly incidence of ARS and volcanic eruptions or the intensity of SO2 emissions, possibly because of interference with man-made events, including massive population displacements caused by insecurity in the area. Nevertheless, some evidence was found for increased incidence of ARS following eruptions, especially in areas close to volcanoes. Assessing personal, ground level exposure to SO2 and particulates with adequate controlling for confounding, such as viral and other infections, could clarify the contribution, if any, of volcanic emissions of SO2 to the high burden of respiratory diseases in this region.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Exposição Ambiental/efeitos adversos , Doenças Respiratórias/epidemiologia , Dióxido de Enxofre/efeitos adversos , Erupções Vulcânicas/efeitos adversos , República Democrática do Congo/epidemiologia , Humanos , Incidência , Doenças Respiratórias/induzido quimicamente , Análise Espaço-Temporal
12.
Environ Res ; 188: 109619, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32531523

RESUMO

The aim of this study consists of investigating the effects of the SO2, PM10, inorganic chemical elements and black carbon (BC) present in fine particulates on the acute outcomes of respiratory diseases in children up to 12 years of age living in Brazilian urban area in the southern hemisphere during the winter (2013) and summer (2013-2014) months. SO2 and PM10 concentration data were obtained from six air quality monitoring stations spatially distributed in the area. PM2.5 samples were collected at the same locations with a MiniVol sampler over a 24-h period on alternating days. The PM2.5 components were analysed using the energy dispersive X-ray fluorescence and reflectance techniques. Hospital care and admission events due to acute respiratory diseases (n = 8,987) of the coded groups JJ00-JJ99 of the International Code of Diseases (ICD-10) were obtained from three hospitals (one public and two private hospitals). To quantify the association of acute respiratory disease events with pollutant concentrations, a generalized additive model (GAM) with a Poisson distribution was applied. The results showed a greater risk of acute respiratory events due to exposure to SO2 with a relative risk of 1.28 (95% CI: 1.22-1.34) and to PM10 with a risk of 1.14 (95% CI: 1.09-1.20) on the day of exposure (lag 0). The chemical constituents present in the fine particles with the highest risk for acute respiratory diseases were Si with a risk of 1.22 (95% CI: 1.15-1.29), S with a risk of 1.09 (95% CI: 1.06-1.12), Ti with a risk of 1.09 (95% CI: 1.01-1.17), BC with a risk of 1.07 (95% CI: 1.03-1.11), Se with a risk of 1.03 (95% CI: 0.96-1.10) and Ni with a risk of 1.03 (95% CI: 0.96-1.10).


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Transtornos Respiratórios , Doenças Respiratórias , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Brasil/epidemiologia , Criança , Humanos , Incidência , Material Particulado/análise , Material Particulado/toxicidade , Transtornos Respiratórios/induzido quimicamente , Transtornos Respiratórios/epidemiologia , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/epidemiologia
13.
Environ Health ; 19(1): 63, 2020 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503633

RESUMO

BACKGROUND: There have been no studies of air pollution and mortality in Lima, Peru. We evaluate whether daily environmental PM2.5 exposure is associated to respiratory and cardiovascular mortality in Lima during 2010 to 2016. METHODS: We analyzed 86,970 deaths from respiratory and cardiovascular diseases in Lima from 2010 to 2016. Estimated daily PM2.5 was assigned based on district of residence. Poisson regression was used to estimate associations between daily district-level PM2.5 exposures and daily counts of deaths. RESULTS: An increase in 10 µg/m3 PM2.5 on the day before was significantly associated with daily cardiorespiratory mortality (RR 1.029; 95% CI: 1.01-1.05) across all ages and in the age group over 65 (RR 1.04; 95% CI: 1.005-1.09) which included 74% of all deaths. We also observed associations with circulatory deaths for all age groups (RR 1.06; 95% CI: 1.01-1.11), and those over 65 (RR 1.06; 95% CI 1.00-1.12). A borderline significant trend was seen (RR 1.05; 95% CI 0.99-1.06; p = 0.10) for respiratory deaths in persons aged over 65. Trends were driven by the highest quintile of exposure. CONCLUSIONS: PM2.5 exposure is associated with daily cardiorespiratory mortality in Lima, especially for older people. Our data suggest that the existing limits on air pollution exposure are too high.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Doenças Cardiovasculares/mortalidade , Exposição Ambiental/efeitos adversos , Material Particulado/efeitos adversos , Doenças Respiratórias/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/induzido quimicamente , Criança , Pré-Escolar , Cidades , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Doenças Respiratórias/induzido quimicamente , Adulto Jovem
14.
Environ Geochem Health ; 42(10): 3317-3331, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32367271

RESUMO

This study aims to investigate the relationship between the number of hospitalized cardiovascular and respiratory patients and the average concentration of criteria air pollutants, including NO2, SO2, CO, O3 and PM10 in Ahvaz in the period of 10 years (2007-2017). Data on referrals and the number of hospitalized cardiovascular and respiratory patients and also on air pollutants are obtained through Hospital Information System and air quality monitoring stations including Department of Environment Protection Station, Naderi Square Station, University Square Station and the Meteorological Organization Station. The data were analyzed by SPSS version 4 and Poisson distribution regression model to evaluate the effects of each pollutant and the rate of hospitalization. In this study, confidence interval and the significance level are considered at 95% and 5%, respectively. Changes in air pollution indices and number of patients with cardiovascular diseases were evaluated using Excel, Stata and ARIMA models. Based on the results of Poisson regression analysis, there was a significant relationship between the average concentration of NO2, O3, CO and SO2 and hospitalization of patients with cardiovascular disease, with a confidence level of less than 5%. This was the case with NO2 more than other pollutants. Furthermore, there was a significant relationship between the average concentrations of NO2, CO and O3 and the hospitalization rate of patients with respiratory problems and a confidence level of 5%. The effect of NO2 was also higher here. Due to the results, NO2, CO, and O3 had a significant direct correlation with cardiovascular and respiratory rates. The effect of NO2 has been higher than other pollutants. In the study of time intervals of patients with cardiovascular, the results of time-interval analysis indicate the relationship between cardiovascular clients with the "t" time of 7 days earlier and NO2 as a pollutant. The results of this analysis also revealed the relationship between respiratory patients at the time "t" up to 7 days before and O3.


Assuntos
Poluentes Atmosféricos/análise , Doenças Cardiovasculares/epidemiologia , Hospitalização/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Doenças Cardiovasculares/induzido quimicamente , Humanos , Incidência , Irã (Geográfico) , Doenças Respiratórias/induzido quimicamente
15.
Occup Environ Med ; 77(5): 316-323, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31974293

RESUMO

OBJECTIVES: To examine associations between occupational exposures to rubber dust, rubber fumes and N-nitrosamines and non-cancer mortality. METHODS: A cohort of 36 441 males aged 35+ years employed in British rubber factories was followed-up to 2015 (94% deceased). Competing risk survival analysis was used to assess risks of dying from non-cancer diseases (respiratory, urinary, cerebrovascular, circulatory and digestive diseases). Occupational exposures to rubber dust, rubber fumes, N-nitrosamines were derived based on a population-specific quantitative job-exposure matrix which in-turn was based on measurements in the EU-EXASRUB database. RESULTS: Exposure-response associations of increased risk with increasing exposure were found for N-nitrosomorpholine with mortality from circulatory diseases (subdistribution hazard ratio (SHR) 1.17; 95% CI 1.12 to 1.23), ischaemic heart disease (IHD) (SHR 1.19; 95% CI 1.13 to 1.26), cerebrovascular disease (SHR 1.19; 95% CI 1.07 to 1.32) and exposures to N-nitrosodimethylamine with respiratory disease mortality (SHR 1.41; 95% CI 1.30 to 1.53). Increased risks for mortality from circulatory disease, IHD and digestive diseases were found with higher levels of exposures to rubber dust, rubber fumes and N-nitrosamines sum, without an exposure-dependent manner. No associations were observed between rubber dust, rubber fumes and N-nitrosamines exposures with mortality from asthma, urinary disease, bronchitis, emphysema, liver disease and some digestive diseases. CONCLUSIONS: In a cohort of rubber factory workers with 49 years of follow-up, increased risk for mortality from circulatory, cerebrovascular, respiratory and digestive diseases were found to be associated with cumulative occupational exposures to specific agents.


Assuntos
Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/mortalidade , Nitrosaminas/efeitos adversos , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/mortalidade , Borracha/efeitos adversos , Adulto , Doença Crônica/mortalidade , Poeira/análise , Monitoramento Ambiental/métodos , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias , Nitrosaminas/análise , Exposição Ocupacional/análise , Fatores de Risco , Borracha/análise , Análise de Sobrevida , Reino Unido/epidemiologia
16.
Chemosphere ; 247: 125913, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31962222

RESUMO

Emerging epidemiologic studies suggested that particulate matter (PM) was a risk factor for the incidence of chronic kidney disease (CKD). However, few studies were conducted to examine whether PM was associated with cause-specific deaths in the CKD progression. This study aimed to estimate the association between fine particulate matter (PM2.5) and a spectrum of deaths among CKD patients. We took leverage of the Elderly Health Service cohort (n = 66,820), a large Hong Kong elderly cohort followed up till 2010. A total of 902 CKD incident patients in the cohort were identified during the follow-up period. We estimated yearly PM2.5 at the residential address for each CKD patient based on a satellite-based spatiotemporal model. We used Cox proportional hazards models with attained age as the underlying timescale to assess the association between long-term exposure to PM2.5 and cause-specific mortality among CKD patients. A total of 496 patients died during the follow-up, where 147 died from cardiovascular disease, 61 from respiratory disease and 154 from renal failure. The mortality hazard ratio (HR) per interquartile-range increase in PM2.5 (4.0 µg/m3) was 1.97 (95% confidence interval (CI): 1.34 to 2.91) for ischemic heart disease (IHD) among CKD patients, and was 1.42 (95%CI: 1.05 to 1.93) for CKD among those patients concomitantly with hypertension. Associations were not of statistical significance between PM2.5 and mortality hazard ratios of all-cause, stroke, and pneumonia among CKD patients. Our findings suggest that long-term exposure to PM2.5 may contribute to the CKD progression into ischemic heart diseases.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Material Particulado/química , Insuficiência Renal Crônica/mortalidade , Idoso , Poluição do Ar/efeitos adversos , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Estudos de Coortes , Exposição Ambiental/análise , Feminino , Hong Kong/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Material Particulado/análise , Modelos de Riscos Proporcionais , Insuficiência Renal Crônica/induzido quimicamente , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/epidemiologia , Fatores de Risco
17.
Artigo em Inglês | MEDLINE | ID: mdl-31991627

RESUMO

There is a discussion in Europe about the dominant role of air pollution for health effects, most researchers claim that the particulate matter is responsible for inflammatory processes in the respiratory system, while others underline the role of nitrogen dioxide. The aim of the study was to assess the risk related to NOx, NO2 and PM2.5 concentration increase and daily outpatient visits or hospitalization due to bronchitis and asthma exacerbation in the entire population of Silesian Voivodeship, Poland. To assess the relationship between daily pollutants concentrations and the number of outpatient visits or hospitalizations due to bronchitis and asthma (available in the regional registry), the multivariable log-linear Poisson regression model was used. Results were presented by relative risk (RR) of health outcomes related to the increase in pollutant concentration by unit (interquartile range). Obtained results confirmed a statistically significant association between outpatient visits and hospitalizations due to bronchitis and asthma exacerbation and daily nitrogen oxides concentrations in Silesian voivodeship, Poland. The strongest relationship was observed in the case of NO2 and outpatient visits due to bronchitis, e.g., RR = 1.434 (1.308-1.571) for exposure expressed by the 50-day moving average concentration. In the case of hospitalizations, the health effect was lagged a few days in relation to the increase in exposure.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Asma/epidemiologia , Bronquite/epidemiologia , Hospitalização/estatística & dados numéricos , Dióxido de Nitrogênio/efeitos adversos , Smog/efeitos adversos , Asma/induzido quimicamente , Bronquite/induzido quimicamente , Europa (Continente) , Humanos , Exposição por Inalação/efeitos adversos , Material Particulado , Polônia/epidemiologia , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/epidemiologia
18.
Toxicol Lett ; 319: 168-174, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31698045

RESUMO

Sulfur mustard and related vesicants are cytotoxic alkylating agents that cause severe damage to the respiratory tract. Injury is progressive leading, over time, to asthma, bronchitis, bronchiectasis, airway stenosis, and pulmonary fibrosis. As there are no specific therapeutics available for victims of mustard gas poisoning, current clinical treatments mostly provide only symptomatic relief. In this article, the long-term effects of mustards on the respiratory tract are described in humans and experimental animal models in an effort to define cellular and molecular mechanisms contributing to lung injury and disease pathogenesis. A better understanding of mechanisms underlying pulmonary toxicity induced by mustards may help in identifying potential targets for the development of effective clinical therapeutics aimed at mitigating their adverse effects.


Assuntos
Alquilantes/toxicidade , Substâncias para a Guerra Química/toxicidade , Compostos de Mostarda/toxicidade , Doenças Respiratórias/induzido quimicamente , Animais , Humanos , Pulmão/patologia , Lesão Pulmonar/induzido quimicamente , Lesão Pulmonar/tratamento farmacológico , Lesão Pulmonar/patologia , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/tratamento farmacológico , Fibrose Pulmonar/patologia , Doenças Respiratórias/tratamento farmacológico , Doenças Respiratórias/patologia
19.
Toxicol Lett ; 320: 73-79, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31811912

RESUMO

INTRODUCTION: Choking agent exposure, among them chlorine gas, occurs in household or industrial accidents, chemical warfare and terrorist attacks. AIMS: Review of published animal and human data regarding the history, pathophysiology, clinical effects and management of chlorine exposure. PATHOPHYSIOLOGY: Highly soluble agents cause quick upper respiratory tract symptoms. Chlorine gas has a medium solubility, also causing delayed lower airway symptoms, mainly due to its oxidizing potential by releasing hypochlorous and hydrochloric acid, but also by interacting with Transient Receptor Potential channels. SYMPTOMS: Eyes may show conjunctival injection, abrasions and corrosions. Burns of the oronasal mucosa and trachea can occur. Dyspnea, bronchospasm and possible retrosternal pain occur frequently. Glottis edema or laryngospasm are acute life-threatening emergencies. Chlorine gas can cause toxic pneumonitis, lung edema and acute respiratory distress syndrome (ARDS). MANAGEMENT: General management includes physical examination, pulse oximetry and arterial blood gases. Eyes should be irrigated, humidified oxygen and inhalative bronchodilators administered. An EKG, cardiac enzymes and complete-blood-count should be obtained if there is retrosternal pain. Routine chest x-ray is not recommended - except if pulmonary edema is suspected. Laryngoscopy should be performed if glottis edema is suspected. Sodium bicarbonate inhalation after chlorine gas inhalation is discussed controversially. Mechanical ventilation with continuous-positive-airway-pressure or intubation/tracheotomy with high positive-end-expiratory-pressure may be necessary. Glucocorticoids for prevention of pulmonary edema should be applied restrictively. Prophylactic antibiotics are not recommended. In severe ARDS, extracorporeal membrane oxygenation (ECMO) can be considered. CONCLUSION: Treatment is mainly symptom oriented. New and promising therapies are in development.


Assuntos
Acidentes Domésticos , Acidentes de Trabalho , Queimaduras Químicas/terapia , Substâncias para a Guerra Química/envenenamento , Cloro/envenenamento , Queimaduras Oculares/terapia , Doenças Respiratórias/terapia , Animais , Queimaduras Químicas/etiologia , Queimaduras Químicas/história , Queimaduras Químicas/fisiopatologia , Substâncias para a Guerra Química/história , Cloro/história , Queimaduras Oculares/induzido quimicamente , Queimaduras Oculares/história , Queimaduras Oculares/fisiopatologia , História do Século XX , História do Século XXI , Humanos , Exposição por Inalação/efeitos adversos , Exposição Ocupacional/efeitos adversos , Prognóstico , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/história , Doenças Respiratórias/fisiopatologia , Medição de Risco
20.
Arch Environ Occup Health ; 75(2): 88-97, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30896376

RESUMO

Exposure to pesticides via inhalation might impair lung function and develop further severe respiratory symptoms and diseases. Thus, the purpose of the study was to compare lung function between pre- and post-pesticide spraying seasons among male sprayers. The study also evaluated the association of lung function changes and other factors with respiratory symptoms. The follow-up study was conducted on 58 male sprayers. The subjects were interviewed and measured lung function before and after pesticide spraying season. The results found that forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow rate in the post-spraying season were significantly lower than in the pre-spraying season. With regard to respiratory symptoms, cough symptoms were associated with changes in FEV1/FVC [odd ratio (OR) = 1.29, 95% confidence interval (CI) = 1.01-1.67)] and smoking status (OR = 12.95, 95%CI = 1.35-124.34). Phlegm symptoms were also associated with changes in FVC (OR = 2.07, 95%CI = 1.01-4.25) and FEV1 (OR = 0.41, 95%CI = 0.18-0.91). The study provides evidence that pesticide spraying may increase risks for significant alteration of lung function and respiratory symptoms.


Assuntos
Fazendeiros/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Praguicidas/efeitos adversos , Doenças Respiratórias/epidemiologia , Adulto , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Prevalência , Testes de Função Respiratória , Doenças Respiratórias/induzido quimicamente , Fatores de Risco , Estações do Ano , Tailândia/epidemiologia
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