Farm work, dust exposure and respiratory symptoms among farmers

OBJECTIVE: Environmental working conditions in rural areas, notably exposure to organic and mineral dusts, have been associated with increases in respiratory diseases. The objective of this study was to evaluate the prevalence of respiratory symptoms among farmers and the associations of these with occupational risk factors. METHODS: This cross-sectional study was undertaken in 1996 with 1,379 farmers from Southern Brazil. Sociodemographic and farming-production parameters were collected, as were levels of exposure to organic and mineral dusts. Respiratory symptoms were assessed by a modified version of American Thoracic Society-Division of Lung Disease questionnaire. Multiple logistic regression analysis was used in analyses, controlling for confounding factors. RESULTS: The majority (52%) of interviewees worked in activities with intense exposure to dust. Workers on farms with better economic indicators had a lower prevalence of respiratory symptoms. Poultry workers showed more symptoms of chronic respiratory disease (OR=1.60; 95% CI: 1.05-2.42). Farmers exposed to high concentrations of dust had more than 70% higher risk of asthma symptoms (OR=1.71; 95% CI: 1.10-2.67) and chronic respiratory disease symptoms (OR=1.77; 95% CI: 1.25-2.50). CONCLUSIONS: The rural workers studied herein were exposed to high levels of organic and mineral dusts. Those exposed to higher dust concentrations, such as poultry workers, showed an increased risk of work-related respiratory symptoms. The implementation of respiratory protection programs is recommended, emphasizing workers involved with poultry production.     

Exposure-response relationships between lifetime exposure to residential coal smoke and respiratory symptoms and illnesses in Chinese children

Data collected in a large epidemiologic study were analyzed to examine respiratory health effects of residential coal use in 7058 school children living in the four Chinese cities of Chongqing, Guangzhou, Lanzhou, and Wuhan. A Scenario Evaluation Approach was used to develop two exposure variables, heating coal smoke and cooking coal smoke. Estimated lifetime exposures to heating coal smoke and cooking coal smoke were both classified into four-level ordinal scales, as follows: no reported exposure (control); lightly exposed; moderately exposed; and heavily exposed. Zero-one dummy variables were constructed for each exposure level other than the control level (total six variables). These variables were entered into the analytical model. We tested for exposure-response relationships using logistic regression models, while controlling for other relevant covariates, including an indicator variable of ambient air pollution levels. We observed monotonic and positive exposure-response relationships of exposure to heating coal smoke with modeled odds ratios (ORs) of phlegm, cough with phlegm, and bronchitis. Other health outcomes were not associated with such exposure in a monotonic exposure-response pattern. However, ORs for cough, wheeze, and asthma were all higher in the exposed groups than in the control group. We observed no consistent associations between cooking coal smoke and the examined health outcomes. We conclude that exposure to heating coal smoke could have adverse effects on children's respiratory symptoms and illnesses in these four Chinese cities.     

Indoor exposure to environmental tobacco smoke and dampness: respiratory symptoms in Sardinian children--DRIAS study

Indoor exposures at home, environmental tobacco smoke (ETS) and mould/dampness adversely affect respiratory health of children. Disturbi Respiratori nell’Infanzia e Ambiente in Sardegna (DRIAS) (Respiratory Symptoms in children and the Environment in Sardegna, Italy) aims at relating the prevalence of respiratory and allergic symptoms to indoor exposures in Sardinian children.DRIAS, a cross-sectional investigation of respiratory symptoms/diseases, used a modified version of ISAAC questionnaire, included 4122 children attending 29 primary schools in the school year 2004-2005.If both parents smoke the prevalence for current wheeze and current asthma is almost doubled in comparison with never smokers, for persistent cough and phlegm a role is suggested when only mother smokes. Among mothers smoking in pregnancy, the prevalence of current wheeze and current asthma is increased. Exposure to ETS and family atopy have a joint effect resulting in an almost tripling of prevalence for current wheeze and more than four times for current asthma. Exposure to “dampness” (mould or dampness) both during the first year of life and currently is associated with increased prevalence of current wheeze, persistent cough or phlegm and current rhino-conjunctivitis; if exposure is only during the first year of life a doubling or more of prevalence is observed for current wheeze, current asthma, and persistent cough or phlegm.DRIAS results add evidence to the causal role of childhood exposure to ETS in the development of respiratory symptoms (cough, phlegm, and wheezing) and asthma. The joint effect of ETS and family atopy is corroborated. The results strengthen the evidence for a causal association between “dampness” and respiratory health, pointing to its possible independent role in causing asthma, a long-lasting exposure entails a doubled prevalence for both asthmatic and bronchitis 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.     

Association between exposure to workplace secondhand smoke and reported respiratory and sensory symptoms: cross-sectional study

The purpose of this work was to assess the relation between exposure to secondhand smoke (SHS) at work and reported respiratory and sensory symptoms. A cross-sectional telephone survey of 382 nonsmoking indoor workers in Victoria, Australia was used. After controlling for potential confounders, exposure to SHS at work for part of the day was significantly associated with an increased risk of wheeze (OR = 4.26), frequent cough (OR = 2.26), sore eyes (OR = 3.77), and sore throat (OR = 2.70). Among workers who had not experienced a cold in the past 4 weeks, we found strong dose-response relationships between increasing levels of exposure to SHS at work and morning cough, frequent cough, sore eyes and sore throat, and a positive relationship for wheeze. These findings provide compelling evidence that nonsmoking indoor workers are adversely affected by exposure to SHS at work and underline the importance of workplace smoke-free policies in protecting the health of workers.     

Small bakeries--a cross-sectional study of respiratory symptoms, sensitization and dust exposure.

This cross-sectional study investigated the prevalence of respiratory symptoms and sensitization to dust components in 224 individuals in 18 small bakeries in Scotland. Each work practice in the bakeries was characterized by an assessment of dust exposure and assigned to a category with either a direct exposure to flour dust of an indirect exposure to flour dust. We found that work-related respiratory symptoms were significantly associated with specific IgE to wheat flour and amylase but not to exposure category (except for nasal/eye symptoms). However, specific IgE to wheat flour was significantly associated with exposure category. There was a higher prevalence of immunological sensitization, reporting of work-related respiratory symptoms and exposure to dust than in other studies and of the 144 personal dust sample results taken, 21 (14.6%) of the total exceeded 10 mg/m3, the substantial dust concentration as outlined by the COSHH Regulations. Follow-up of those with work-related asthma symptoms (questionnaire response) was inconclusive of the work-relatedness of their symptoms, although it did confirm respiratory morbidity.     

Secondhand smoke exposure and respiratory symptoms among casino, club, and office workers in Victoria, Australia

OBJECTIVE: To examine the association between smoke-free policies, exposure to secondhand smoke (SHS) at work, and self-reported respiratory and sensory symptoms of workers. METHOD: Ninety-one nonsmoking workers recruited from three workplaces with varying smoking policies completed a telephone-administered questionnaire and provided saliva samples (before and after usual work shift) for cotinine analysis. RESULTS: Mean before-after shift saliva cotinine per hour worked was significantly higher among club (0.42 ng/mL/hr worked) than casino workers (0.18 ng/mL/hr worked) (P < 0.001), club than office workers (0.03 ng/mL/hr worked) (P < 0.001), and casino than office workers (P < 0.001). Casino and club workers reported similar levels of respiratory morbidity and were more likely to have sore eyes (odds ratio [OR] = 5.5, P < 0.01) and a sore throat (OR = 4.3, P < 0.05) compared with office employees. CONCLUSION: Air-conditioning interventions reduce, but fail to eliminate, exposure of hospitality workers to SHS. Such exposure is associated with measurable increases in the risk of respiratory symptoms.     

Incense Use and Cardiovascular Mortality among Chinese in Singapore: The Singapore Chinese Health Study

Background: Incense burning is common in many parts of the world. Although it is perceived that particulate matter from incense smoke is deleterious to health, there is no epidemiologic evidence linking domestic exposure to cardiovascular mortality.Objective: We examined the association between exposure to incense burning and cardiovascular mortality in the Singapore Chinese Health Study.Methods: We enrolled a total of 63,257 Singapore Chinese 45–74 years of age during 1993–1998. All participants were interviewed in person to collect information about lifestyle behaviors, including the practice of burning incense at home. We identified cardiovascular deaths via record linkage with the nationwide death registry through 31 December 2011.Results: In this cohort, 76.9% were current incense users, and most of the current users (89.9%) had burned incense daily for ≥ 20 years. Relative to noncurrent users, current users had a 12% higher risk of cardiovascular mortality [multivariable adjusted hazard ratio (HR) = 1.12; 95% CI: 1.04, 1.20]. The HR was 1.19 (95% CI: 1.03, 1.37) for mortality due to stroke and 1.10 (95% CI: 1.00, 1.21) for mortality due to coronary heart disease. The association between current incense use and cardiovascular mortality appeared to be limited to participants without a history of cardiovascular disease at baseline (HR = 1.16; 95% CI: 1.07, 1.26) but not linked to those with a history (HR = 1.00; 95% CI: 0.86, 1.17). In addition, the association was stronger in never-smokers (HR = 1.12; 95% CI: 1.02, 1.23) and former smokers (HR = 1.19; 95% CI: 1.00, 1.42) than in current smokers (HR = 1.05; 95% CI: 0.91, 1.22).Conclusions: Long-term exposure to incense burning in the home environment was associated with an increased risk of cardiovascular mortality in the study population.Citation: Pan A, Clark ML, Ang LW, Yu MC, Yuan JM, Koh WP. 2014. Incense use and cardiovascular mortality among Chinese in Singapore: The Singapore Chinese Health Study. Environ Health Perspect 122:1279–1284; http://dx.doi.org/10.1289/ehp.1307662     

Alcohol,housing, and smoking in relation to respiratory symptoms

An evaluation of the relative effects of housing standards, alcoholic beverage consumption, and tobacco smoking on the appearance of respiratory symptoms in the adult population in older residential districts in Central Copenhagen indicates that regular daily intake of alcoholic beverage, especially beer consumption, and residence in damp and cold dwellings have more bearing on these symptoms than tobacco smoking. Within these limitations coughing in the morning, phlegm production, and wheezing in the chest were correlated to the smoking. The results are based on 881 interviews comprising 109 questions of medical, hygienic, social, and housing conditions. The evaluation of the results is primarily based on the use of a statistical structure search program identifying and ranking predictors for the health of the different population groups.     

Relation of occupational exposure to respiratory symptoms and asthma in a general population sample: self-reported versus interview-based exposure data

The objective of this study was to examine how the consistency of self-reported exposure to dust or gas, asbestos, and quartz varied between subjects with and those without respiratory symptoms and asthma in a Norwegian community sample () in 1987-1988. Exposure characterization obtained in a structured work history interview was used as the "gold standard." The authors also wanted to assess how the exposure-disease relation differed when the exposure was based on self-reported versus interview-obtained data. The prevalence of self-reported exposure to dust or gas, asbestos, and quartz was 28%, 5%, and 4%, respectively. The sensitivity of the self-reported exposure data varied from 21% to 64% and was higher in those with than in those without the respiratory disorders. The specificity varied from 78% to 100% and was lower in those with than in those without the respiratory disorders. The sex-, age-, and smoking-adjusted odds ratios of the respiratory disorders in those with exposure to dust or gas and to asbestos were only slightly reduced when misclassification was taken into account. The corresponding numbers for exposure to quartz were halved and lost their statistical significance when the misclassification was allowed for. In this general population sample, the self-reported occupational, airborne exposure data were differentially misclassified by disease status.     

Airway responsiveness to methacholine,respiratory symptoms,and dust exposure levels in grain and flour mill workers in eastern france

Our goal was to assess the relation between dust exposure levels and the respiratory health status of workers in grain and flour mills in eastern France. We studied 118 male workers from 11 mills and 164 unexposed male controls. Dust concentration was measured by personal sampling methods. Outcome variables included respiratory symptoms, routine pulmonary function tests, and indices of airway responsiveness to methacholine. A great within- and between-area variability of inhalable dust concentration was found in all mills. A dose-response relationship was observed between dust exposure levels and chronic respiratory symptoms, suggesting that exposure to grain and flour dust may lead to chronic bronchitis. A significant relation was found between dust exposure and airway hyper-responsiveness; this finding is important since it has been hypothesized that the latter abnormality may lead to or be a predisposing factor in subsequent chronic, irreversible airflow obstruction.     

Occupational exposure to second hand smoke and respiratory and sensory symptoms: A cross-sectional survey of hospital workers in Egypt

Objective

Exposure to Second Hand Smoke (SHS) has been associated with an increased risk of respiratory symptoms, upper and lower respiratory tract diseases and an increased risk of asthma and chronic obstructive pulmonary disease. The majority of cases of mortality and morbidity is attributable to exposure of adults to SHS and is related to cardiovascular diseases and lung cancer. In Egypt, comprehensive smoke-free laws exist, however, in many workplaces they are poorly enforced consequently exposing workers to the detrimental health hazards of SHS. We aimed at determination of workplace exposure to Second Hand Smoke (SHS) and its association with respiratory and sensory irritation symptoms in hospital workers in Port-said governorate in Egypt.

Material and Methods

A cross-sectional face to face survey was conducted by the use of a standardised questionnaire among 415 adult hospital workers; representing 50% of all employees (81% response rate); recruited from 4 randomly selected general hospitals in Port-said governorate in Egypt.

Results

All hospitals employees reported exposure to SHS — on average 1.5 (SD = 2.5) hours of exposure per day. After controlling for potential confounders, exposure to SHS at work was significantly associated with an increased risk of wheezes (OR = 1.14, p < 0.01), shortness of breath (OR = 1.17, p < 0.01), phlegm (OR = 1.23, p < 0.01), running and irritated nose (OR = 1.14, p < 0.01) as well as a sore, scratchy throat (OR = 1.23).

Conclusions

These findings point out that workplace exposure to SHS is evident in hospitals in Port-said governorate and that workers are adversely affected by exposure to it at work. This underlines the importance of rigorous enforcement of smoke-free policies to protect the workers’ health in Egypt.     

Health effects of dust storms: subjective eye and respiratory system symptoms in inhabitants in Mongolia

The cross-sectional study described here aimed to investigate potential health effects associated with dust storms in Mongolia. The authors surveyed the subjective symptoms of the eyes (e.g., bloodshot eyes) and respiratory system (e.g., coughing) among inhabitants in different living environments (urban and desert) immediately after a dust storm. The subjects studied lived either in an urban area (n = 36 residents), or a desert area (n = 87 nomads). Information concerning eye and respiratory system symptoms was obtained by face-to-face household interviews. Multiple logistic regression analysis was performed on the relationships between the subjective symptoms and the different living environments adjusting for age, gender, and smoking status. The occurrence of lacrimation, an eye symptom, was higher among the desert area participants compared to those residing in the urban area. Results suggest that the occurrence of eye lacrimation is related to dust storms.     

Lung function, respiratory symptoms, and mortality: results from the Busselton Health Study

PURPOSE: This study examines the association between lung function [percentage predicted FEV, (forced expiratory volume in 1 s)] and respiratory symptoms (asthma, bronchitis, wheeze, dyspnea) and mortality from all causes; coronary heart disease, stroke, cancer, and respiratory disease in a cohort of 2,100 men and 2,177 women in the Busselton Health Study followed for 20-26 years for mortality. METHODS: A total of 840 men and 637 women died during the follow-up period, and Cox proportional hazards regression was used to assess the relationships between risk factors and mortality. RESULTS: Lung function was significantly and independently predictive of mortality from all causes, coronary heart disease, cancer, and respiratory disease in both men and women, and of mortality from stroke in women. There was evidence that, among men, the association was stronger in current and former smokers as compared to those who never smoked. After adjustment for age, smoking, lung function, coronary heart disease, blood pressure, treatment for hypertension, total cholesterol, body mass index, and alcohol consumption, dyspnea was significantly related to total mortality in men and women and to respiratory disease mortality in men, and asthma was significantly related to respiratory disease mortality in women. CONCLUSIONS: Lung function is associated with mortality from many diseases independent of smoking and respiratory symptoms. Although most respiratory symptoms are associated with smoking and lung function, after controlling for smoking and lung function, only dyspnea is associated with mortality from nonrespiratory causes.     

Coffee, tea, and incident type 2 diabetes: the Singapore Chinese Health Study

BACKGROUND: Increasing coffee intake was inversely associated with risk of type 2 diabetes in populations of European descent; however, data from high-risk Asian populations are lacking as are data on tea intake in general. OBJECTIVE: We investigated the prospective associations between intakes of coffee, black tea, and green tea with the risk of type 2 diabetes in Singaporean Chinese men and women. DESIGN: We analyzed data from 36 908 female and male participants in the Singapore Chinese Health Study aged 45-74 y in 1993-1998 who had multiple diet and lifestyle measures assessed and then were followed up between 1999 and 2004. We used Cox regression models to investigate the association of baseline coffee and tea intakes with incident type 2 diabetes during follow-up, with adjustment for a number of possible confounding or mediating variables. RESULTS: In multivariate models participants reporting > or =4 cups of coffee/d had a 30% reduction in risk of diabetes [relative risk (RR): 0.70; 95% CI: 0.53, 0.93] compared with participants who reported nondaily consumption. Participants reporting > or =1 cup of black tea/d had a suggestive 14% reduction in risk of diabetes (RR: 0.86; 95% CI: 0.74, 1.00) compared with participants who reported 0 cups/d, and we observed no association with green tea. CONCLUSION: Regular consumption of coffee and potentially black tea, but not green tea, is associated with lower risk of type 2 diabetes in Asian men and women in Singapore.     

被动吸烟与家养宠物对儿童哮喘及哮喘样症状影响

目的 探讨被动吸烟与家养宠物对儿童哮喘及哮喘样症状的交互效应。方法 采用整群随机抽样方法在广西百色市随机抽取6所小学,采用国际统一的标准问卷美国胸腔协会(ATS)调查表对所选学校的所有儿童进行有关被动吸烟、饲养宠物以及哮喘及哮喘样症状等情况调查。结果 广西百色市3 473名儿童中,持续咳嗽、持续咳痰、哮喘、哮喘现患、喘鸣现患的发生率分别为11.52%(400/3 473)、6.68%(232/3 473)、7.63%(265/3 473)、2.04%(71/3 473)、4.15%(144/3 473),17.71%(615/3 473)的儿童目前家中饲养宠物,目前暴露环境烟雾的比率高达39.48%(1 371/3 473);在调整了儿童的年龄、性别、父母文化程度等混杂因素后,多因素非条件logistic回归分析表明,与既不被动吸烟又不家养宠物的儿童比较,单纯暴露被动吸烟或家养宠物可使儿童患有持续咳嗽的风险分别增高28%(OR=1.28,95%CI=0.98~1.66)和8%(OR=1.08,95%CI=0.73~1.61),而同时暴露于这2个因素使儿童患有持续咳嗽的危险性增加155%(OR=2.55,95%CI=1.85~3.51);暴露于被动吸烟和家养宠物对儿童持续咳嗽影响的交互效应有统计学意义(χ²=5.50,P=0.019),但对哮喘及其他哮喘样症状影响的交互效应均无统计学意义(P>0.05)。结论 被动吸烟与家养宠物均可增加儿童患有哮喘及哮喘样症状的风险,且两者对儿童持续咳嗽的影响存在明显交互效应。