Postal survey on asthma, chronic bronchitis and respiratory symptoms among adult Estonians and non-Estonians (FinEsS-study)

BACKGROUND: According to the data of the population census held in Estonia in 1989, the resident population consisted of 61.5% Estonians and 38.5% non-Estonians, the majority of them being Russians--30.3%. The aim of this study was to investigate the prevalence of asthma, chronic bronchitis and respiratory symptoms among the adults in these ethnic groups. METHODS: The study was a postal survey, similar in design to parallel studies currently in progress in Finland, Estonia and Sweden (FinEsS). RESULTS: The prevalence of physician-diagnosed asthma was 2.0%, being similar in men and women and in both Estonians and non-Estonians. The prevalence of physician-diagnosed chronic bronchitis was 10.5%. Compared with the non-Estonian population, the prevalence was much lower among Estonians (7.9% vs. 13.5%, p<0.001). Such a difference in prevalence was observed in all age groups. The high prevalence of chronic bronchitis in non-Estonians could be related to more extensive smoking habits, smoking indoors and probably ETS exposure. The defined OR between non-Estonians vs. Estonians after correcting for the influence of smoking habits, area of domicile, age, gender, and socioeconomic group was 1.30. A similar pattern of differences between Estonians and non-Estonians was observed in respiratory symptoms. CONCLUSION: This study revealed that the prevalence of physician-diagnosed asthma in Estonians and non-Estonians was the same. Physician-diagnosed chronic bronchitis was more frequent in non-Estonians than in Estonians. A significant difference was determined in the prevalence of respiratory symptoms, especially among those common to chronic bronchitis. The differences remained significant after correction for possible confounders.     

An interview study to estimate prevalence of asthma and chronic bronchitis

A questionnaire of respiratory symptoms and diseases completed by 6610 adults in 3 age cohorts (35–36 y; 50–51 y and 65–66 y) in northern Sweden was followed-up by interview and lung function testing of 1243 subjects with asthmatic or bronchitic symptoms and 263 subjects assessed from the postal questionnaire as being healthy. We report the results of this follow-up study.According to the criteria used, 292 subjects (5.1% of the original study sample) were diagnosed as having asthma. Out of the 1243 subjects 334 (5.9% of the original study population) were diagnosed as having chronic bronchitis.However, examination of the 263 subjects who were healthy according to the postal questionnaire showed that elderly smokers, in particular, under-reported bronchitic symptoms; taking this into account, the prevalence of chronic bronchitis is estimated to be of the order of 9%. Diagnostic difficulties were noted in 70 subjects (corresponding to 1.2% of the original study sample) in whom asthma or chronic bronchitis were strongly suspected. Further investigation of these subjects was considered necessary. In this cross-sectional study, FEV₁ <80% of predicted values was found in 36% of subjects diagnosed as having asthma and in 31% of those with chronic bronchitis. Among subjects with attacks of breathlessness and wheezing, diagnostic criteria often used for asthma in questionnaire studies, 70% were diagnosed as having asthma. Of those with chronic productive cough, 62% were diagnosed as having chronic bronchitis. We consider that trained nurses provide reliable data that may be used in epidemiological surveys of obstructive lung diseases.     

Ambient air pollution and chronic respiratory morbidity in Delhi

The authors conducted a cross-sectional study among residents of Delhi to determine the role of ambient air pollution in chronic respiratory morbidity in Delhi. The authors selected a random, stratified sample (N = 4,171) of permanent residents who were 18+ y of age and who lived near 1 of the 9 permanent air quality monitoring stations in the city. Air-quality data for the past 10 y were obtained; data were based on the differences in total suspended particulates, and the study areas were categorized into lower- and higher-pollution zones. A standardized questionnaire was administered, clinical examination was carried out, and spirometry followed. The authors assessed chronic respiratory morbidity by (a) prevalence of chronic respiratory symptoms (i.e., chronic cough, phlegm, breathlessness, and wheezing) and airway diseases (i.e., chronic obstructive pulmonary disease/chronic bronchitis and bronchial asthma); and (b) lung function results in asymptomatic nonsmoking subjects in the two pollution zones. A multiple logistic regression identified the determinants of chronic symptoms. Smoking, male sex, increasing age, and lower socioeconomic status were strong independent risk factors for occurrence of chronic respiratory symptoms. In the comparison of nonsmoking residents of lower- and higher-pollution zones--stratified according to socioeconomic levels and sex--chronic cough, chronic phlegm, and dyspnea (but not wheezing) were significantly more common in the higher-pollution zone in only some of the strata. Furthermore, prevalence rates of bronchial asthma, chronic obstructive pulmonary disease, and chronic bronchitis among residents in the two pollution zones were not significantly different. Nonetheless, lung function of asymptomatic nonsmokers was consistently and significantly better among both male and female residents of the lower-pollution zone.     

本溪市大气污染与急慢性呼吸系统疾病的关系

目的 灯一溪市大气污染治理。方法 于１９９４年和１９９５年连续二年调查室外大气污染对呼呼统健康的影响,经对市内５个衡区２５岁以上成中呼吸系统症状生咳 、气短、突发性喘息）三种疾病（慢性支气管炎,慢性阻塞性疾患及上呼吸道感染）以内外多种暴露的流行病学调查,用多因素Ｌｏｇｉｓｔｉｃ回归分析,调整了年龄、性别、文化程度、职业、室内煤及吸烟状况后,得出室外大气污染和一呼吸系统疾病的联系。结果 ６种呼吸系统     

Ambient Air Pollution and Chronic Respiratory Morbidity in Delhi

The authors conducted a cross-sectional study among residents of Delhi to determine the role of ambient air pollution in chronic respiratory morbidity in Delhi. The authors selected a random, stratified sample (N = 4,171) of permanent residents who were 18+ y of age and who lived near 1 of the 9 permanent air quality monitoring stations in the city. Air-quality data for the past 10 y were obtained; data were based on the differences in total suspended particulates, and the study areas were categorized into lower- and higher-pollution zones. A standardized questionnaire was administered, clinical examination was carried out, and spirometry followed. The authors assessed chronic respiratory morbidity by (a) prevalence of chronic respiratory symptoms (i.e., chronic cough, phlegm, breathlessness, and wheezing) and airway diseases (i.e., chronic obstructive pulmonary disease/chronic bronchitis and bronchial asthma); and (b) lung function results in asymptomatic nonsmoking subjects in the two pollution zones. A multiple logistic regression identified the determinants of chronic symptoms. Smoking, male sex, increasing age, and lower socioeconomic status were strong independent risk factors for occurrence of chronic respiratory symptoms. In the comparison of nonsmoking residents of lower- and higher-pollution zones—stratified according to socioeconomic levels and sex—chronic cough, chronic phlegm, and dyspnea (but not wheezing) were significantly more common in the higher-pollution zone in only some of the strata. Furthermore, prevalence rates of bronchial asthma, chronic obstructive pulmonary disease, and chronic bronchitis among residents in the two pollution zones were not significantly different. Nonetheless, lung function of asymptomatic nonsmokers was consistently and significantly better among both male and female residents of the lower-pollution zone.     

Comparison of allergic diseases,symptoms and respiratory infections between Finnish and Russian school children

Background Little is known about differences in allergic and respiratory diseases between the Finnish and Russian populations. Methods We conducted a population-based cross-sectional study to compare the occurrence of allergic diseases and respiratory infections among school children in the towns of Imatra in Finland and Svetogorsk in Russia on either side of the common border. The study population consisted of 512 Finnish and 581 Russian school children aged 7–16 years (response rate 79%). We used multiple logistic regression analysis to calculate odds ratios adjusting for age and gender. Results The prevalences of asthma (6.7 vs. 3.9%, adjusted odds ratio (OR) 1.54, 95% confidence interval (CI 0.87–2.71), allergic rhinitis (15.2 vs. 8.8%, OR 1.81, 1.22–2.68), allergic conjunctivitis (4.7 vs. 3.2%, 1.33, 0.70–2.53), and atopic dermatitis (10.5 vs. 5.9%, 1.78, 1.12–2.83) were substantially higher among school children in Imatra compared to those in Svetogorsk, but the symptoms were more severe among allergic Russian children. Tonsillitis (adjusted OR 0.11, 95% CI 0.07–0.17), sinusitis (0.39, 0.24–0.63), bronchitis (0.41, 0.27–0.62) and pneumonia (0.19, 0.04–0.90) occurred less frequently in the Finnish children, whereas otitis media (2.37, 1.55–3.62) and common cold (4.07, 3.12–5.31) were more frequent in Finland. Conclusions Allergic diseases are more common in Finnish than Russian school children, but the symptoms are more severe among allergic Russian children. Respiratory infections are in general more frequent in Russian children. “Western” lifestyle habits, differences in diagnostic procedures and environmental factors, and availability of health care and medications are discussed as possible explanations for the observed differences.     

Non-responders to a postal questionnaire on respiratory symptoms and diseases

Only few data have been published about non-responders in epidemiological studies on respiratory diseases. The aim of this study was to examine the characteristics of the non-responders and the reasons for non-response in a survey of respiratory health. All 9132 subjects, born 1925–1926, 1940–1941, 1955–1956 and 1970–1971 and living in eight representative areas in Norrbotten, Sweden, were invited to a prevalence study on asthma, chronic bronchitis and respiratory symptoms. The response rate was 85%. A sample of the non-responders from the cross-sectional postal questionnaire study was contacted by telephone and interviewed using the same questionnaire as had been used in the postal survey. Of the 1397 non-responders a stratified sample of 182 subjects were selected for this study and 144 agreed to participate. The response rate was increasing by increasing age. The main reason for non-response was that the subjects had forgotten to mail the questionnaire, lack of interest or lack of time. There were significantly higher proportions of current smokers and manual workers among the non-responders. The prevalence rates of wheezing, long-standing cough, sputum production, attacks of breathlessness, asthma and use of asthma medicines were significantly higher among the non-responders compared with the responders according both univariate and multivariate logistic regression analyses, in which the influences of age, sex, smoking habits, socio-economic group and area of domicile were taken into account. The prevalence of respiratory symptoms and diseases was slightly underestimated in the postal survey.     

Self reported respiratory symptoms and diseases among hairdressers.

OBJECTIVES: Hairdressers are exposed to many irritative and allergenic substances capable of causing occupational respiratory symptoms and diseases. The self reported prevalence of respiratory symptoms and diseases was studied, and the risks among hairdressers compared with saleswomen was estimated. METHODS: A cross sectional prevalence study of respiratory symptoms and diseases was carried out among hairdressers and supermarket saleswomen, with a computer assisted telephone interview method (CATI). The study population comprised all the female hairdressers and supermarket saleswomen aged 15-54 years in the Helsinki metropolitan area, Finland. Disproportionate random samples of female hairdressers and sales-women were drawn from the trade union membership registers. The interviews were carried out between February and April 1994. A response rate of 80.5% (355/440) was obtained for hairdressers and 82.2% (583/709) for saleswomen. Atopy, smoking, chronic illnesses, type of work, working hours, working conditions, personal and professional use of hair products, and the use of personal protective devices were assessed. The outcome variables were self reported symptoms of the upper and lower respiratory tract. These were used to define chronic bronchitis, and asthma, laryngitis, and allergic rhinitis diagnosed by a physician. RESULTS: There was a considerable difference in the prevalence of chronic bronchitis; 6.8% in hairdressers versus 1.9% in saleswomen. The odds ratio (OR) adjusted for age, smoking, and atopy for chronic bronchitis indicated an increased risk of chronic bronchitis (OR 4.8, 95% confidence interval (95% CI) 2.2 to 10.1). No association was found between work as a hairdresser and asthma, laryngitis, and allergic rhinitis. Also the prevalence of rhinitis, rhinitis with eye symptoms, cough with phlegm, dyspnoea, and dyspnoea accompanied by cough was increased among hairdressers. The corresponding adjusted risk ORs were 1.7 (95% CI 1.3 to 2.3) for rhinitis, 1.9 (95% CI 1.4 to 2.6) for rhinitis with eye symptoms, 1.4 (CI 1.1 to 1.9) for cough with phlegm, 1.5 (95% CI 1.0 to 2.2) for dyspnoea, and 1.6 (95% CI 1.0 to 2.7) for dyspnoea with cough. CONCLUSIONS: Our results indicate an increased prevalence of upper and lower respiratory symptoms among hairdressers. Allergenic and irritative chemicals in hairdressing are likely candidates explaining the difference found between the hairdressers and controls. Work related reasons should be considered when a hairdresser presents with airway symptoms. Preventive actions are needed to improve the working conditions and personal protection.     

1998 Quebec Social and Health Survey: determinants of chronic respiratory diseases

In the course of the "1998 Health and Social Survey", questions were included to verify the prevalence of chronic respiratory diseases and also of wheezing. The objectives of this study were 1) to verify the prevalence of wheezing and its validity as an indicator of chronic respiratory diseases in Québec; and 2) to examine the relationship between chronic respiratory diseases and some of their potential determinants. A total of 30,386 individuals participated in the study. For all ages, the prevalence of wheezing was 5.4%. It was associated with asthma, allergies, chronic bronchitis and emphysema. A low familial income and tobacco smoking were associated with wheezing, asthma, chronic bronchitis and emphysema. Passive smoking was associated with wheezing whereas the presence of carpets was associated with wheezing and asthma. Between 32 and 48% of families with an asthmatic or an allergic member modified their dwelling to alleviate respiratory problems. The prevalence of wheezing documented here was lower than in anglosaxon countries. This result could be explained by a cultural factor (the French translation or the perception of wheezing). This study emphasizes the role of reducing tobacco smoking in the prevention of chronic respiratory diseases.     

Respiratory symptoms and obstructive lung diseases in iron ore miners: Report from the obstructive lung disease in northern Sweden studies

This is a population-based study on the prevalence of respiratory symptoms assessed by a mail questionnaire. The objective was to examine if work in an iron mine increased the risk of airway symptoms or obstructive diseases. The exposed group consisted of 114 previous or current male miners. Referents, 2472 males from the province, had never been employed by the mining company or worked as miners. Age, smoking and a family history of asthma were considered as possible confounders. The miners had an increased risk for respiratory symptoms (OR=2.2, 95% CI=1.4–3.1) including recurrent wheeze (OR=2.4, 95% CI=1.5–3.9), longstanding cough (OR=1.8, 95% CI=1.0–3.2), and for physician-diagnosed chronic bronchitis (OR=2.2, 95% CI=1.0–4.5). Attacks of shortness of breath and asthma manifestations were similar between miners and referents. Higher risks in miners were found particularly among the non-smokers for physician-diagnosed chronic bronchitis (OR=9.2, 95% CI=3.0–28) and for symptoms as well. A family history of asthma was less common among miners (9.2% vs. 17%, p < 0.05). We conclude that miners in a modern underground iron mine had an increased risk of respiratory symptoms. In contrast to other studies, this increased risk was particularly found in non-smokers. A family history of asthma may be an important confounder in occupational studies of respiratory diseases.     

安徽省40岁及以上人群慢性呼吸道症状流行及慢性阻塞性肺疾病认知现状

目的了解安徽省≥40岁人群慢性呼吸道症状流行及慢性阻塞性肺疾病(COPD)相关知识知晓现状,为防控COPD提供参考。方法于2015年1-6月,采用多阶段分层整群随机抽样方法在安徽省5个COPD监测点抽取2996名≥40岁常住居民为研究对象,进行问卷调查,内容包括人口学资料、呼吸道症状、吸烟情况、慢性非传染性呼吸系统疾病名称、肺功能检查、COPD危险因素和症状的知晓情况,COPD疾病名称知晓途径等。采用SAS 9.4软件进行Rao-Scottχ²检验和基于复杂抽样设计的logistic回归分析。结果安徽省≥40岁居民中慢性呼吸道症状总流行率为11.6%,慢性咳嗽、慢性咳痰、喘息和呼吸困难的流行率分别为3.2%、3.9%、2.3%和6.8%。既往或现在吸烟者的慢性咳嗽率、慢性咳痰率和喘息率均高于从不吸烟者,差异均有统计学意义(P<0.01)。研究对象对COPD疾病名称知晓率为5.4%,对慢性支气管炎、肺气肿、哮喘疾病名称知晓率分别为61.4%、58.9%和61.8%;男性慢性支气管炎、肺气肿和哮喘的疾病名称知晓率均高于女性,差异均有统计学意义(P<0.01);既往或现在吸烟者对慢性支气管炎、肺气肿和哮喘的名称知晓率均高于从不吸烟者,差异均有统计学意义(P<0.01)。调查对象对COPD相关知识知晓率为2.9%,肺功能检查知晓率为2.1%。不同性别、吸烟状况者对COPD疾病名称、COPD相关知识和肺功能检查知晓率的差异均无统计学意义(P>0.05)。COPD疾病名称知晓途径主要为电视(33.0%)、亲戚朋友(29.8%)、医院或医生(26.1%)。在知晓COPD疾病名称者中,分别有55.9%、53.7%、52.7%的居民认为慢性咳嗽、气短或呼吸困难、咳痰是COPD的主要症状,72.3%的居民认为吸烟是COPD的危险因素。结论安徽省≥40岁人群中慢性呼吸道症状流行率较高,但居民对COPD相关知识知晓率较低,需加强COPD健康促进和健康教育,提高COPD的防控意识。     

Respiratory symptoms and pulmonary function of workers exposed to cork dust, toluene diisocyanate and conidia

A cross-sectional study on suberosis was conducted to determine the prevalence of respiratory symptoms and the level of pulmonary function, and their relationships within job categories of exposure to cork dust, toluene diisocyanate (TDI) resin bonding and conidia, among cork workers. Exposure-response relationships, with confounders taken into account, showed specific associations between cork dust and chronic bronchitis, TDI and asthma, and conidia and symptoms of hypersensitivity pneumonitis. Workers exposed to these risk factors had reduced mean spirometric values. A significant correlation between a decrease in pulmonary function and length of exposure was found for the workers exposed to cork dust. These results strongly suggest that suberosis, as hitherto described, might in fact be comprised of three different diseases with different etiologic risk factors, ie, respiratory hypersensitivity from exposure to conidia, asthma from exposure to TDI, and chronic obstructive pulmonary disease from exposure cork dust.     

Residential proximity to large airports and potential health impacts in New York State

Objective This study assessed whether residents living near commercial airports have increased rates of hospital admissions due to respiratory diseases compared to those living farther away from these airports. Methods This cross-sectional study included all residents living within 12 miles from the center of each three airports (Rochester in Rochester, LaGuardia in New York City and MacArthur in Long Island). We obtained hospital admission data collected by the NYS Department of Health for all eligible residents who were admitted for asthma, chronic bronchitis, emphysema, chronic obstructive pulmonary disease and, for children aged 0–4 years, bronchitis and bronchiolitis during 1995–2000. Exposure indicators were distance from the airport (≤5 miles versus >5 miles) and dominant wind-flow patterns from the airport (>75th percentile versus ≤75th percentile), as well as their combinations. Results Increased relative risks of hospital admissions for respiratory conditions were found for residents living within 5 miles from the airports (1.47; 95% CI 1.41, 1.52 for Rochester and 1.38; 95% CI 1.37, 1.39 for LaGuardia) compared to those living >5 miles. We did not find positive associations between wind-flow patterns and respiratory hospital admissions among the residents in any airport vicinity. No differences were observed for MacArthur airport using either exposure measure. Conclusion There is the suggestion that residential proximity to some airports may increase hospital admissions for respiratory disorders. However, there are many factors that could influence this association that may differ by airport, which should be measured and studied further.     

Work-related respiratory disorders among Finnish farmers

Several research projects on work-related respiratory diseases have been conducted in Finland. One of the largest, "Farmers' Occupational Health Programme," was conducted by the Social Insurance Institution of Finland during 1973-1983 in cooperation with Kuopio Regional Institute of Occupational Health and the National Board of Health. The main objective of the program was to develop a model for occupational health services for farmers. As a part of the program, postal surveys were conducted in 1979 and 1982. The surveys allowed an analysis of both the prevalence and the mean annual incidence of asthma, farmer's lung, and chronic bronchitis as well as of background variables related to the diseases. More than every tenth farmer suffered from these respiratory diseases. The occurrence of chronic bronchitis (the most common disease) was, in general, related to farming types in which grain crops (including animal feeds) were handled. Chronic bronchitis was most prevalent among farmers who worked in piggeries, implying a combined effect of grain dusts, dusts of animal origin, and development of the disease. Atopy predisposed to and had an additive effect with smoking on chronic bronchitis.     

Occupational obstructive airway diseases in Germany

In industrialized countries, occupational asthma caused by allergens and irritants due to workplace exposure is increasing. More than 8,000 such claims were made in Germany (10.5% of all decided occupational disease claims) in 1995; 1,900 were confirmed (6.5% of all confirmed claims). The legal basis and the occupational disease-related regulations of trade-assigned statutory accident insurance institutions (‘Berufsgenossenschaften’) in Germany are described. Hitherto, three occupational disease categories for obstructive airway disorders existed: due to sensitizing agents, due to chemical-irritative or toxic agents, and due to isocyanates. Approximately 40% of accepted claims for occupational asthma and rhinitis result from exposure to flour. Ongoing changes in the recognition of work-related airway disease symptoms account for differences in the incidence and prevalence as reported over the years. Recently, chronic obstructive bronchitis and/or emphysema of hard coal miners have been included in the German list of occupational diseases. Am. J. Ind. Med. 33:454–462, 1998. © 1998 Wiley-Liss, Inc.     

Correlation between autopsy findings for chronic obstructive airways disease and in-life disability in South African gold miners

Objectives: In South Africa chronic obstructive airway disease (COAD), which could be due to working in a dusty atmosphere in scheduled mines or works, is a compensatable disease. Miners are compensated for in-life respiratory disability and for findings at autopsy of COAD, which includes emphysema, bronchitis assessed by mucus gland hyperplasia in the main bronchus, and bronchiolitis assessed by goblet cell metaplasia. The question arises as to whether the autopsy findings correlate with in-life impairment. The objectives of the study were: (1) to determine whether autopsy COAD outcomes relate to lung function and to respiratory symptoms and signs; and (2) to quantify the individual contributions of emphysema, bronchiolitis and bronchitis to lung function impairment. Methods: On 724 gold miners, pathological findings of COAD – emphysema, bronchitis and bronchiolitis – were related to lung function measurements and respiratory symptoms and signs observed within 5 years prior to death. Results: Emphysema diagnosed at autopsy was the main determinant of airflow impairment. The emphysema score categories 0–5, 5–35, 35–65 and >65 were associated with decreased forced expiratory volume in 1 s, expressed as percentage predicted (FEV₁%) as follows: 78.8%, 66.2%, 52.0% and 46.0%, respectively. The score was also associated with increasing frequency of dyspnoea. After adjustment for emphysema, the bronchitis and bronchiolitis were not related to significant lung function loss, and in subjects without emphysema, the presence of moderate or marked bronchitis was associated with a mild impairment only. Bronchitis at autopsy was associated with increased frequency of rhonchi, sputum and cough, whereas bronchiolitis was associated with increased sputum only. Silicosis found at autopsy was associated with some obstructive and restrictive lung function impairment. Tobacco smoking was associated with all the COAD outcomes. Received: 5 May 1999 / Accepted: 11 December 1999     

A population-based study on welding exposures at work and respiratory symptoms

In the first European Community Respiratory Health Survey (ECRHS I), an excess asthma risk was associated with high exposure to gases and fumes, mineral and biological dusts. In a 9-year follow-up study (ECRHS II), the aim was to study if welding at work increases the risk of asthma symptoms, wheeze and chronic bronchitis symptoms. The study also aimed to identify specific welding risk factors. In a random population sample of individuals from 22 European centres in 10 countries, 316 males reported welding at work during the follow-up period. These individuals responded to a supplemental questionnaire about frequency of welding, use of different methods and materials, welding environment and respiratory protection. Cumulative exposure to welding fumes for the follow-up period was estimated by using a database on welding fume exposures. Log-binomial regression models were used to estimate prevalence ratios (PR) with 95% confidence intervals (CIs) for prevalence of asthma symptoms or asthma medication, wheeze and chronic bronchitis symptoms in relation to welding methods and welded materials as well as estimated cumulative welding fume exposure compared to an external reference group. In the study population of 316 males, 62% performed welding <1 h day(-1), 23% 1-3 h day(-1) and 15% >4 h day(-1). Welding was a common task in many occupations and only 7% of the individuals actually called themselves welders and flame cutters, while the largest groups doing welding worked in construction or were motor, agricultural and industrial mechanics and fitters. Welding at work was not associated with an increased prevalence of asthma symptoms or wheeze but there was an association with chronic bronchitis symptoms (PR = 1.33, 1.00-1.76). Using assigned cumulative exposure in tertiles showed that the lowest exposed tertile had the highest PR of bronchitis symptoms. Chronic bronchitis symptoms was significantly higher in those frequently welding in galvanized steel or iron (PR = 2.14, 1.24-3.68) and in those frequently manual welding stainless steel (PR = 1.92, 1.00-3.66). There was also an increase in the prevalence of wheeze in individuals welding painted metal (PR = 1.66, 0.99-2.78; PR = 1.83, 0.90-3.71). Welding with manual metal arc technique <1 day week(-1) showed a prevalence risk of 1.69 for wheeze (CI = 1.16-2.46). In conclusion, the present study shows an association between welding in galvanized material and stainless steel and chronic bronchitis symptoms. There was also an increased prevalence of wheeze and welding in painted metal. The results support that welding in coated material is a respiratory hazard underscoring the importance of preventive actions.     

Prävalenz von somatischen Erkrankungen bei Kindern und Jugendlichen in Deutschland

In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which was conducted from 2003 to 2006, data on acute/infectious and chronic diseases were collected from a population-based sample of 17,641 subjects aged 0 to 17 years. The annual prevalence rates among acute diseases vary widely. Children and adolescents are most frequently affected by acute (infectious) respiratory conditions. 88.5 % of the surveyed children and adolescents experienced at least one episode of common cold within the last 12 months. Among the other acute respiratory infections, bronchitis and tonsillitis were the most frequently encountered conditions with 19.9 % and 18.5 %, respectively. The 12-month prevalence of otitis media and pseudocroup was 11 % and 6.6 %, respectively. 1.5 % of the children and adolescents experienced an episode of pneumonia. Apart from respiratory infections, gastrointestinal infections were very frequently stated as reasons for acute illness. Furthermore, 12.8 % of the children and adolescents experienced a herpetic infection, 7.8 % a conjunctivitis and 4.8 % a urinary tract infection. Lifetime prevalence rates of infectious diseases were as follows: pertussis 8.7 %, measles 7.4 %, mumps 4.0 %, rubella 8.5 %, varicella 70.6 %, scarlet fever 23.5 %. The various chronic somatic diseases in children and adolescents had different lifetime prevalence rates. Most frequently, children and adolescents were affected by obstructive bronchitis (13.3 %), neurodermatitis/atopic eczema (13.2 %) and hay fever (10.7 %). Scoliosis and asthma had been diagnosed by a doctor in 5.2 % and 4.7 % of subjects aged 0-17 years, respectively. The lifetime prevalence rates of the remaining diseases varied between 0.14 % for diabetes mellitus and 3.6 % for convulsions/epileptic fits. For the first time ever, these survey results provide nationwide representative information on the prevalence rates of acute/infectious and chronic diseases in children and adolescents which is based on a population-representative sample.     

Vapor, dust, and smoke exposure in relation to adult-onset asthma and chronic respiratory symptoms: the Singapore Chinese Health Study

Occupational factors contribute to a significant fraction of respiratory disease and symptoms. The authors evaluated the role of occupational exposures in asthma, chronic bronchitis, and respiratory symptoms in the Singapore Chinese Health Study, a population-based cohort of adults aged 45-74 years at enrollment in 1993-1998. Information on occupations and occupational exposures was collected at enrollment for 52,325 subjects for whom respiratory outcomes were obtained via follow-up interviews in 1999-2004. Exposure to dusts from cotton, wood, metal, minerals, and/or asbestos was associated with nonchronic cough and/or phlegm (odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.08, 1.30), chronic bronchitis (OR = 1.26, 95% CI: 1.01, 1.57), and adult-onset asthma (OR = 1.14, 95% CI: 1.00, 1.30). Cotton dust was the major contributor to respiratory symptoms. Vapor exposure from chemical solvents, dyes, cooling oils, paints, wood preservatives, and/or pesticides was associated with nonchronic cough or phlegm (OR = 1.14, 95% CI: 1.03, 1.27), chronic dry cough (OR = 1.55, 95% CI: 1.19, 2.01), and adult-onset asthma (OR = 1.34, 95% CI: 1.15, 1.56). Chemical solvents, cooling oils, and pesticides were the major contributors to respiratory symptoms. These data support the role of occupational exposures in the etiology of respiratory illness in a population-based cohort in Singapore with a low prevalence of atopic illness.     

Work related distal airway obstruction in an agricultural population.

OBJECTIVE--To assess the prevalence of distal airway obstruction and its risk factors in agricultural areas. METHODS--A cross sectional study of respiratory symptoms and lung function was performed among French farmers and their spouses (1122 subjects) who came for preventive medicine examinations. They answered a respiratory questionnaire and performed pulmonary function tests on a portable spirometer. Diagnoses of chronic bronchitis were made on the basis of reported chronic respiratory symptoms. Airway obstruction was determined from predicted values. Odds ratio (OR) and linear regression coefficients were calculated after stratification by smoking and history of cardiac and other respiratory diseases. RESULTS--Of respiratory symptoms prevalence of chronic cough was 8.47%, and chronic bronchitis 7.66%. Prevalence of distal airway obstruction was 11.4%, and overall airflow obstruction 3.2%. Smokers were 20.2% men, and 5.7% women. Linear regressions showed high association between pack-years in smokers or exsmokers and forced expiratory volume in one second/forced vital capacity (FEV1/VC) and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75). In non-smokers without any history of cardiac or respiratory diseases, age and the size of farms had the highest correlations with these variables. OR for distal airway obstruction was 2.1 in subjects > 50 years old v the younger ones and 3.02 in the smaller farms v the larger ones. CONCLUSION--After stratification by smoking and history of cardiac and respiratory diseases, distal airway obstruction is present in agricultural areas. The age, and the size of farm are the highest respiratory risk factors in non-smokers.