2015年长三角地区三城市大气污染对成人急性呼吸系统疾病及症状的影响

目的了解长三角地区大气污染对成人急性呼吸系统疾病及症状的影响。方法 2015年9—11月,在长三角地区的上海、苏州和南京三个城市的4个调查点随机整群抽取4144名年龄大于18岁的常住居民进行问卷调查,同时收集距离调查点最近的环保监测站点的每日PM_(2.5)、NO_2、O_3、CO、SO_2等5种大气污染物的浓度数据,采用Logistic回归模型分析排除了其他因素的影响后大气污染对成人急性呼吸系统疾病及症状的影响。结果成人近两周急性呼吸系统疾病患病率为0.99%,近两周呼吸系统症状发生率较患病率高,为3.88%。家里使用跟空气污染相关的化学品(OR=2.339,95%CI 1.156～4.734)、过敏(OR=4.857,95%CI 2.279～10.350)是成人近两周急性呼吸系统疾病患病的危险因素;从事的岗位存在有毒化学品、高温等职业有害因素(OR=1.796,95%CI 1.220～2.644)、有呼吸系统疾病家族史(OR=2.670,95%CI 1.865～3.823)、过敏(OR=3.703,95%CI 2.395～5.725)是成人近两周呼吸系统症状发生的危险因素。此外,在排除其他因素的影响后发现,近两周PM_(2.5)的平均暴露水平既是成人近两周患急性呼吸系统疾病患病的危险因素(OR=1.014,95%CI 1.000～1.028),也是成人近两周呼吸系统症状发生的危险因素(OR=1.025,95%CI 1.018～1.033)。结论长三角地区大气污染可能会使成人近两周急性呼吸系统患病和症状的发生风险增加。     

宁波市江北区小学生呼吸系统疾病与生活居住环境关系研究

目的 调查宁波市江北区小学生呼吸系统疾病患病情况,分析生活居住环境和行为习惯对患病率的影响。方法 2019—2021年采用整群抽样方法,对宁波市江北区监测点小学三年级全体学生进行问卷调查,应用logistics回归模型分析小学生呼吸系统疾病的影响因素。结果 资料完整并纳入分析1 144名小学生,近1年内呼吸系统疾病患病率为44.49%。Logistic回归分析显示,有呼吸系统疾病家族史（OR=2.28, 95%CI:1.37～3.82）、过敏史（OR=5.63, 95%CI:4.22～7.51）、居住地100m内垃圾站（OR=1.96,95%CI:1.07～3.59）和近1年内购置大件家具（OR=1.81,95%CI:1.11～2.94）是小学生呼吸系统疾病的危险因素,女生（OR=0.71, 95%CI:0.55～0.92）和重污染天气总是佩戴口罩（OR=0.53,95%CI:0.35～0.80）是小学生呼吸系统疾病的保护因素。结论 性别、呼吸系统疾病家族史、过敏史、居住地100 m内垃圾站、近1年购置大件家具、重污染天气佩戴口罩等是宁波市江北区小学生呼吸系统疾病的影响因素。     

台州市小学生呼吸系统疾病与生活居住环境的关系研究

【目的】了解浙江省台州市小学生生活居住环境与患呼吸系统疾病的关系,探讨与小学生呼吸系统疾病相关的生活居住环境因素。【方法】2018、2019年的11月15日—12月31日,采用整群随机抽样法选择台州市某小学二～五年级小学生1 044人进行问卷调查,分析小学生生活居住环境与患呼吸系统疾病之间的关系。【结果】共完成有效问卷调查1 044人,近1年患过呼吸系统疾病的学生共224人,占21.5%。多因素logistic回归分析显示,家居100 m内有垃圾站(OR=2.522,95%CI:1.105～5.752)、家庭内有被动吸烟(OR=1.781,95%CI:1.234～2.571)、家庭内使用空气污染型化学品(OR=1.915,95%CI:1.396～2.627)是台州市小学生患呼吸系统疾病的危险因素。【结论】应在小学生的日常生活中对呼吸系统疾病的危险因素加以预防,降低小学生呼吸系统疾病的患病率。     

石家庄市居民慢性阻塞性肺疾病检出情况及影响因素研究

目的探讨石家庄市居民慢性阻塞性肺疾病检出情况及影响因素。方法2021年9—12月采用整群随机抽样方法抽取石家庄市3个社区,对抽中社区的所有居民进行问卷调查和肺功能检查。利用描述流行病学方法分析社区人群慢性阻塞性肺疾病患病现状。应用单、多因素方法分析影响慢性阻塞性肺疾病发生的危险因素。结果共2348名居民完成问卷调查和肺功能检查,其中男1205人,占51.32%,女1143人,占48.68%,年龄31~76岁。共有146例检出慢性阻塞性肺疾病,检出率为6.22%,其中轻度69例,占47.26%,中度54例,占36.99%,重度23例,占15.75%,未检出极重度者。检出来的症状分布中,以咳嗽及咳痰的比例较高,分别为52.05%(76例)和49.32%(72例)。多因素Logistic回归分析结果显示年龄≥40岁(OR=1.705、1.936)、男性(OR=3.404)、居住在农村(OR=2.469)、偶尔或经常吸烟(OR=1.592、1.800)、有职业粉尘接触史(OR=2.179)、有哮喘家族史(OR=3.164)、有慢性阻塞性肺疾病家族史(OR=5.170)、有呼吸道反复感染史(OR=3.414)是石家庄市居民慢性阻塞性肺病患病的影响因素。结论石家庄市居民的慢性阻塞性肺疾病患病情况不容乐观,且危险因素众多。重点针对中老年、吸烟、农村、有各种相关家族史的男性高危人群开展早期筛查和采取针对性干预措施,有助于对居民慢性阻塞性肺疾病进行防控。     

肺癌危险因素的病例对照研究

目的分析肺癌患病的危险因素,为预防控制肺癌提供依据。方法采用病例对照研究方法,选取2015年1月—2017年6月绍兴市461例新发肺癌病例为病例组,采用频数匹配法选取与病例年龄、性别构成相近且同地居住的600名正常居民为对照组;通过问卷调查收集人口学特征、慢性病家族史、既往疾病史和行为因素资料,采用Logistic回归模型分析肺癌患病的危险因素。结果多因素Logistic回归分析结果显示,调整性别、年龄后,有恶性肿瘤家族史(OR=6.606,95%CI:3.439～12.689)、有肺部疾病患病史(OR=2.836,95%CI:1.208～6.659)、生活和工作紧张程度一般/紧张(OR=2.485,95%CI:1.830～3.376)、每周食用新鲜蔬菜天数5天(OR=3.116,95%CI:2.470～3.930)和现在吸烟/偶尔吸烟/已戒烟(OR=6.029,95%CI:3.716～9.783)是肺癌患病的危险因素。进一步分析吸烟与肺癌患病的关联显示,调整年龄、性别、恶性肿瘤家族史、肺部疾病患病史、生活和工作紧张程度及每周食用新鲜蔬菜天数后,与已戒烟≥10年相比,10年是肺癌患病的危险因素(OR=4.751,95%CI:2.404～9.386)。结论恶性肿瘤家族史、肺部疾病患病史、生活和工作中紧张程度高、每周食用新鲜蔬菜天数5天和吸烟是肺癌患病的危险因素。     

唐山市农村地区慢性阻塞性肺疾病危险因素病例对照研究

目的 分析唐山市农村地区慢性阻塞性肺疾病(COPD)的危险因素.方法 以唐山市农村地区40岁以上人群COPD流行病学调查中确诊的190例(男120例、女70例)患者作为病例组,按性别相同、年龄±5岁的条件从每位患者的邻居中选取两名健康者作为对照组(男240例、女140例),进行1:2匹配的病例对照研究,应用条件Logistic回归进行危险因素分析.结果 单因素分析结果显示,职业性粉尘或化学物质暴露(OR=4.738,95%CI:3.045～7.371)、吸烟(OR=3.973,95%CI:2.749～5.742)、吸烟指数(OR=3.751,95%CI:2.602～5.407)、低体重(OR=2.785,95%CI:2.018～3.844)和呼吸疾病家族史(OR=2.231,95%CI:1.434～3.472)与COPD的关联具有统计学意义(P＜0.05).多因素分析结果显示,职业性粉尘或化学物质暴露(OR=4.997,95%CI:3.033～8.234)、吸烟(OR=3.311,95%CI:1.175～9.327)、低体重(OR=2.479,95%CI:1.732～3.547)和呼吸疾病家族史(OR=2.217,95%CI:1.311～3.750)为COPD的危险因素(P＜0.05).结论 职业性粉尘或化学物质暴露、吸烟、低体重和呼吸疾病家族史是唐山市农村地区人群患COPD的危险因素.     

广州市居民健康相关行为及影响因素分析

目的 探讨广东省广州市居民健康相关行为及影响因素,为今后开展城市社区居民健康教育提供参考依据.方法 采用按性别定额抽样的方法,对广州市422名15岁～的居民进行健康相关行为(吸烟、饮酒、体育锻炼、主动获取卫生保健知识)的问卷调查,其中社区居民200名,医院门诊患者222名.用χ~2检验和非条件Logistic回归进行影响因素分析.结果 本调查吸烟者11.85%;饮酒者6.2%;常参加体育锻炼者59.72%;主动获取保健知识者66.10%.Logistic回归分析表明,在控制混杂因素后,性别是影响吸烟(OR=19.68,95%CI=7.37～52.60)、饮酒(OR=7.84,95%CI=2.61～23.59)、主动获取卫生保健知识(OR=2.05,95%CI=1.34～3.15)的主要因素;文化程度是影响吸烟(OR=0.42,95%CI=0.21～0.83)、体育锻炼的主要因素(OR=2.09,95%CI=0.31～0.73);在业状况是影响体育锻炼(OR=0.61,95%CI=1.02～2.62)和主动获取卫生保健知识(OR=1.77,95%CI=1.08～2.90)的主要因素.结论 本次调查对象健康行为与性别、文化程度、是否在业因素有关.     

农村中老年吸烟人群COPD发病危险因素分析

目的通过对农村中老年吸烟人群慢性阻塞性肺疾病(COPD)患病率和危险因素进行调查,旨在明确农村中老年吸烟人群COPD发病的危险因素,从而为预防和干预提供依据。方法采用分阶段整群抽样的方法抽取浙江省江山市辖区内1 098名农村吸烟中老年人进行COPD发病的危险因素调查,分别进行单因素和多因素Logistic回归分析。结果农村中老年吸烟人群的COPD患病率(11.38%)显著高于农村中老年不吸烟人群(6.57%)和城镇中老年吸烟人群(7.49%),且差异有统计学意义(P0.05);农村中老年吸烟人群COPD患病率在性别、年龄、吸烟种类、饮酒、每年吸烟支数、呼吸道疾病家族史、呼吸道疾病个人史、是否经常下厨和有害气体或粉尘接触史等方面差异有统计学意义(P0.05);多因素Logistic回归分析结果提示:较大的年龄、吸旱烟、年吸烟支数较多、呼吸道疾病家族史、呼吸道疾病个人史、经常下厨和有害气体或粉尘史是导致COPD发生的危险因素(OR=1.759、3.213、2.432、1.686、2.652、1.593和1.419,P0.05)。结论农村中老年吸烟人群的COPD发患病率较高,较大的年龄、吸旱烟、年吸烟支数较多、呼吸道疾病家族史、呼吸道疾病个人史、经常下厨和有害气体或粉尘史是导致农村中老年吸烟人群COPD发生的危险因素,应针对性地采取预防和干预措施。     

淮安市沿淮河居民食管癌及癌前病变影响因素的多元有序logistic回归分析

目的探讨淮安市沿淮河居民食管癌及癌前病变发病的危险因素,为食管癌的防治提供依据。方法采用整群抽样方法抽取洪泽、金湖两地食管癌高发区居民作为研究对象,进行危险因素问卷调查,对问卷调查评价出的高危人群进行碘染色内镜筛查,并取活检组织进行病理诊断,依据病理诊断标准分为不同病变等级,并采用多元有序logistic回归对食管癌及癌前病变影响因素进行分析。结果该研究共收集参加碘染色内镜筛查居民4 001例,对照组(内镜检查正常)3 042例,轻中度异常增生组746例,重度异常增生及以上组213例。单因素分析结果显示,食管癌及癌前病变的发生与学历、饮用水来源、吸烟、饮酒、水果食用频率、肉类食用频率、腌制食品食用频率、油炸食品食用频率、性格类型、胃十二指肠溃疡、食管炎、胃肠炎疾病史和肿瘤家族史有关,有统计学意义(P0.05,P0.01)。多因素有序logistic回归分析结果表明,吸烟(OR=1.22,95%CI:1.02~1.46)、饮酒(OR=1.38,95%CI:1.14~1.68)、经常吃腌制食品(OR=1.76,95%CI:1.47~2.13)、经常吃油炸食品(OR=2.10,95%CI:1.41~3.15)、胃十二指肠溃疡疾病史(OR=1.57,95%CI:1.28~1.93)、食管炎疾病史(OR=1.44,95%CI:1.07~1.92)、胃肠炎疾病史(OR=1.46,95%CI:1.24~1.73)、肿瘤家族史(OR=2.70,95%CI:2.32~3.15)是食管癌及癌前病变发生的独立危险因素。结论淮安市沿淮河居民食管癌及癌前病变发生受遗传因素、膳食结构、生活方式及多因素共同影响,建议采取综合措施,积极改变不良的生活方式,对于高危人群,应该积极参加筛查,做到早诊早治。     

广州市小学生呼吸系统疾病生活居住环境影响因素调查

研究学龄儿童呼吸系统疾病的生活居住环境相关影响因素,为呼吸系统疾病的预防与控制提供依据.方法 于2014-2015年用分层整群随机抽样的方法,选择广州市某小学三~五年级共1 016名小学生进行问卷调查.分析呼吸系统疾病与学龄儿童个体特征、家庭社会经济状况、父母疾病史以及家庭室内外环境等因素的关系.结果 多因素非条件Logistic回归分析结果显示,性别(OR=1.52,95%CI=1.18~ 1.96)、生活居住周围100 m内有臭水沟(OR=1.66,95%CI=1.02~2.71)、生活居住周围100 m内有垃圾站(OR=1.45,95%CI=1.04~2.03)及使用驱蚊剂习惯(OR=1.69,95%CI=1.26~2.26)可增加呼吸系统疾病的发生风险(P值均<0.05).结论 家庭居住环境因素对学龄儿童的呼吸系统健康有一定程度的影响.     

Remission of chronic urticaria in the course of house dust mite immunotherapy—Mere coincidence or something more to it?

It has been hypothesised that house dust mite is as a causative and/or deteriorating factor in some cases of chronic urticaria. In this report we describe two patients with the history of respiratory house dust mite allergy and chronic urticaria, which resolved in the course of house dust mite immunotherapy. Basing on literature and our own experiences, we can only speculate that some patients suffering from mite-induced respiratory allergy and concomitant chronic urticaria may benefit additionally from allergen immunotherapy, manifesting as the withdrawal or alleviation of urticaria symptoms.     

Occupational exposure, environmental pollution and chronic respiratory symptoms in Vietnam

Since the introduction of the market economy in 1986, Vietnam has been in the process of rapid economic development. However, the current state of affairs in the industries is very profit-oriented and due consideration is not given to the occupational health services and environmental health. In order to investigate the relationship among occupational exposure to dust/chemicals (toxic gases/fume), environmental pollution and chronic respiratory symptoms in Vietnam, the questionnaire standardized by the American Thoracic Society was applied to 1,562 subjects living in the Quang Ninh area and its surroundings, North Vietnam. Chronic respiratory symptoms such as cough, phlegm, wheezing and breathlessness appeared from the questionnaire. According to the results of multiple logistic regression analyses, among current non-smokers, the odds ratios of chronic respiratory symptoms with a history of occupational exposure to dust, living in polluted district and age were over unity. Especially for cough, significantly higher odds ratios were observed among those with the history of occupational exposure to dust: 2.248 (95% confidential interval: 1.642-3.077). Among current smokers, the odds ratios of chronic respiratory symptoms with the history of occupational exposure to dust were over unity. These results indicate that the history of occupational exposure to dust, living in polluted area and age cause non-smokers to have chronic respiratory symptoms, and also that the history of occupational exposure to dust affect the current smokers.     

煤烟型大气污染对成人呼吸系统疾病及其症状影响的研究

采用环境流行病学方法调查了太原市 3个不同程度大气污染研究区成人的呼吸系统疾病和症状以及相关影响因素。结果表明 ,成人呼吸系统症状的标化发生率和疫区的标化患病率均为重度污染区 >中度污染区 >相对清洁区 (P <0 0 5 ) ,出现呼吸系统症状和疾病的危险性 ,重、中污染区分别是相对清洁区的1 8倍和 2 1倍、1 3倍和 1 8倍 ,经多因素Logistic回归分析 ,在调整了年龄、性别、职业、吸烟、家庭燃料、家族史等因素后 ,燃煤产生的LNSO2 、LNTSP、LNPM1 0 、LNPM2 5 每增加一个单位 ,成人呼吸系统症状发生的危险性分别增加 1 39倍、1 71倍、1 6 7倍和 1 79倍 ,慢性阻塞性肺部疾病患病的危险性分别增加 1 31倍、1 5 3倍、1 5 1倍和 1 6 8倍。提示煤烟型大气污染对成人呼吸系统症状和疾病的发生已产生一定程度的影响。     

宜昌市儿童哮喘的危险因素分析

目的 分析影响宜昌市儿童哮喘发病的危险因素, 为预防儿童哮喘的发生和急性发作提供指导。方法 采用分层随机整群抽样的方法, 在宜昌市抽取10 456名儿童进行初筛问卷调查, 筛选出疑似哮喘儿童, 对其再次发放哮喘儿童调查问卷进一步调查确诊, 同时选取与哮喘儿童数量相近, 性别、年龄相匹配的非哮喘儿童进行病例对照研究。结果 个人药物过敏史、过敏性鼻炎、湿疹史以及一级亲属哮喘或过敏史;家居环境中墙面涂有油漆、用煤炭取暖、做饭、霉斑现象、装修史、家属吸烟以及用毛毯做被褥;3个月以内添加辅食、1岁以内使用抗生素均是影响宜昌市儿童哮喘发病的危险因素。结论 对于有个人或家属过敏性疾病史的儿童, 家长应尽量避免家庭环境中过敏原的暴露, 积极避免危险因素可防止哮喘的发生或减少其急性发作的次数。     

青岛地区儿童哮喘影响因素病例对照研究

目的探讨儿童哮喘的影响因素。方法应用1：1配对的病例一对照研究方法，采用问卷调查方式，调查300对病例和对照儿童，并分析有关的暴露因素。结果单因素Logistic回归分析结果显示，有17个因素与儿童哮喘有关联，包括父亲呼吸系统疾病史、母亲呼吸系统疾病史、家庭收入情况、特应性体质、急性呼吸道感染史、食肉习惯、海产品摄入量、是否有泡沫制品、是否装修过、厨房排烟方式、排烟效果、是否饲养宠物、家族哮喘病史、家族过敏性鼻炎史、父母食物过敏史、父母粉尘过敏史、首次发病后是否经过系统治疗。多因素Logistic回归分析显示，7个因素进入主效应模型，其中父亲有呼吸系统疾病史（OR=3．771，95％CI：1．533～9．278）、家庭低收入（OR=I．503，95％CI：1．258～1．795）、特应性体质（OR=3．788，95％CI：2．368～6．058）、喜食肥肉（OR=2．042，95％CI：1．481～2．815）、家族哮喘病史（OR=I．710，95％CI：0．988～2．958）、家族过敏性鼻炎史（OR=I．991，95％CI：1．234～3.211）是儿童哮喘的危险因素，饲养宠物（OR=0．443，95％CI：0．265～0．739）是保护因素；回归系数分别为1．327，0．407，1．332，0．714，0．536，0．689，-0．814。结论儿童哮喘是遗传和环境双重因素共同作用导致的一种复杂疾病。     

Respiratory effects of exposure to low levels of concrete dust containing crystalline silica

BACKGROUND: Dusts containing crystalline silica are generated in mining, construction, glass, granite and concrete production industries. The association between exposure to low levels of concrete dust containing crystalline silica and reduction in lung function, was evaluated in a cross-sectional study. METHODS: The study was carried out among 144 concrete workers, from two factories, with exposure assessment of respirable dust and silica by personal samplers. Results of respiratory questionnaires and standardized measurements of lung function were compared with the results in a control population. Multiple linear regression analysis was used in selecting factors that predict (age and standing height standardized residual) lung function. RESULTS: The average concentration of respirable dust in both factories was 0.8 mg/m(3) and 0.06 mg/m(3) for respirable silica. The average silica content of the dust was 9%. The average cumulative dust exposure was 7.0 mg/m(3) year and cumulative silica exposure was 0.6 mg/m(3) year. Significant associations between exposure to concrete dust and a small lung function (FEV(1)/FVC ratio, MMEF) loss were found, independent of smoking habits and of a history of allergy. CONCLUSIONS: Our results indicate that, concrete workers with chronic obstructive pulmonary symptoms and/or work-related lower respiratory symptoms are at risk of having a reduction in lung function (FEV&(1)/FVC ratio) outside the 5th percentile of the external reference population, and therefore, of mild chronic obstructive pulmonary disease, at respirable concrete dust levels below 1 mg/m(3) with a respirable crystalline silica content of 10% (TWA, 8 hr).     

Levels of endotoxin in 390 Swedish homes: determinants and the risk for respiratory symptoms in children

Endotoxins are microbiological agents which ubiquitously exist in an indoor environment, and are believed to be causal agents for a number of diseases. This study investigated the indoor levels and determinants of endotoxins and their impact on asthma and allergy diseases among Swedish pre-school children. House dust samples from 390 homes of 198 case children with asthma and allergy and 202 healthy control children were collected in the Dampness Building and Health (DBH) study. House dust endotoxin levels in the child's bedroom and living rooms ranged from 479-188,000 EU/g dust and from 138-942,000 EU/g dust, respectively. Pet-keeping and agricultural activities were significantly associated with the higher endotoxin concentration levels in indoor dust. Endotoxins in theindoor environment did not associate to asthma and allergy diseases in the children. However, we found an association between endotoxins and the presence of disease symptoms in the sub-group of families without indoor pets.     

Respiratory impairment in Brazilian foundry workers exposed to sand

OBJECTIVE: Foundries date back to the 16th century in Brazil and still constitute a strong economic activity today. Workers are at risk of respiratory diseases due to various exposures such as polycyclic aromatic hydrocarbons, pyrolysis degradation products, mineral dust, organic dust, resin, and isocyanates. We evaluate respiratory morbidity among workers in foundries using sand. METHODS: Six foundries with sand molding operations were selected. Length of exposure in years was utilized as a surrogate for exposure. The medical evaluation consisted of a respiratory symptoms questionnaire, occupational history, spirometry, and chest X-rays. Additionally, workers exposed to resins and a control group underwent bronchial provocation tests. RESULTS: A sample of 598 male workers with a mean age of 36.5 years (SD = 10.0) was analyzed. The mean length of exposure was 10.1 years (SD = 7.4). The overall prevalence of pneumoconiosis was 4.5%. Chronic bronchitis (CB) and X-ray profusion were significantly related to the quartiles of length of exposure (trend tests: P = 0.0055 and P < 0.001, respectively). There was a significant risk of having an abnormal FVC and FEV(1) with the presence of pneumoconiosis (OR = 4.63 CI 1.40-13-23, OR 3.34 CI 1.03-9.26, respectively). Workers exposed to resins compared with controls showed no differences in relation to spirometry, respiratory symptoms and bronchial reactivity. CONCLUSIONS: There were significant associations between length of exposure CB and prevalence of profusion 1/0 or above. There was also a significant association for pneumoconiosis versus and abnormal FVC and FEV(1). Foundry workers currently exposed to resins did not show an excess of respiratory symptoms, abnormal spirometry or increased bronchial reactivity.     

Airway hyperresponsiveness, prevalence of chronic respiratory symptoms, and lung function in workers exposed to irritants.

The association between occupational exposure to airway irritants and the prevalence of chronic respiratory symptoms and level of lung function, and whether these associations were modified by airway hyperresponsiveness, smoking, and a history of allergy were studied in 668 workers from synthetic fibre plants. Respiratory symptoms were recorded with a self administered Dutch version of the British Medical Research Council questionnaire, with additional questions on allergy. Airway responsiveness was measured by a 30 second tidal breathing histamine challenge test. On the basis of job titles and working department, the current state of exposure of all workers was characterised as (1) no exposure, reference group; (2) white collar workers; (3) SO2 HCl, SO4(2); (4) polyester vapour; (5) oil mist and vapour; (6) polyamide and polyester vapour; (7) multiple exposure. Workers exposed to airway irritants were not simultaneously exposed to airborne dust. Airway hyperresponsiveness (AHR), defined as a 20% fall in forced expiratory volume in one second (FEV1) at < or = 32 mg/ml histamine, was present in 23% of the subjects. The association between exposure groups and prevalence of symptoms was estimated by means of multiple logistic regression; the association with level of lung function (forced vital capacity (FVC), FEV1, maximum mid-expiratory flow rate (MMEF)) was estimated by means of multiple linear regression. Both methods allow simultaneous adjustment for potential confounding factors. The exposure groups were associated with a higher prevalence of chronic respiratory symptoms. Lower prevalence of symptoms was found for workers exposed to SO2, HCl, and SO4(2-), most likely due to pre-employment selection procedures. Current smoking, AHR, and a history of allergy were significantly associated with a higher prevalence of chronic respiratory symptoms, independent of each other, and independent of irritant exposure. The association between exposure and prevalence of symptoms was greater in smokers than in ex-smokers and non-smokers. This difference was most clearly seen in the polyester vapour and polyamide and polyester vapour group. No modification of the association between exposure groups and prevalence of symptoms by airway hyperresponsiveness could be shown. The exposure groups were not significantly associated with a lower level of lung function. Adjustment for chronic respiratory symptoms did not change the results. There were no indications of a possible interaction between exposure and AHR, current smoking, or a history of allergy on lung function. Workers of the polyester vapour and the oil mist and vapour group with >10 years of exposure had a lower FEV1 (beta = -295 and -358 ml) and significantly lower MMEF (beta = -1080 and -1247 ml/s; p < 0.05) than the reference group. The number of workers of both group were, however, small (n = 10 and n = 13 respectively). More investigations between low level exposure to irritant and respiratory health.     

Lung Function and Respiratory Symptoms in Male Palestinian Farmers

ABSTRACT

In a cross-sectional study of 250 farmers aged 22 to 77 years, of whom 36.4% are smokers, the authors aimed at describing lung function and respiratory symptoms and to estimate associations with exposures to pesticides and dust. Lung function was measured using a spirometer. Respiratory symptoms and exposure levels were self-reported based on a modified standardized questionnaire. Mean forced vital capacity (FVC) was 4.20 L (SD = 0.93 L), 95.51% of predicted as compared to European standards. Mean forced expiratory volume in one second (FEV₁) was 3.28 L (SD = 0.80 L), 91.05% of predicted. The authors found high symptom prevalences: 14.0% for chronic cough; 26.4% for wheeze; and 55.2% for breathlessness. There was no clear association between exposure to pesticides or dust and lung function or between such exposures and respiratory symptoms. However, a significant association was found between smoking and respiratory symptoms such as chronic cough, cough with phlegm, and wheezes. The lack of farm exposure associations could be due to improvement in farmers’ awareness to pesticides hazards as well as regulations of pesticide import, or because of inherent problems with the experimental design. Farmers who kept animals and poultry seem to have less respiratory symptoms and better lung function.