Study on the relationship of air pollution to respiratory disease in schoolchildren.

Respiratory symptoms and ventilatory functions were measured in fourth and fifth grade school children living in two areas that differ in air pollution but are comparable with respect to social and demographic factors.Children living in the high polluted area showed a higher prevalence of cough during the day or at night, which is assumed to be due to the difference in pollution level.Mean ventilatory function in the children from both areas did not differ. In both areas mean PEFR (peak expiratory flow rate) and mean FEV (forced expiratory volume) of children with symptoms were lower than in children without.Depending on the criteria used prevalence figures for chronic respiratory disease ranged between 5,3–12,7% in the high polluted and 3,3–9,8% in the low polluted area.     

甘肃省民勤县小学生呼吸系统疾病和症状的家庭影响因素分析

目的了解民勤县小学生呼吸系统症状和疾病影响因素,以利于保护儿童健康。方法于2016年4月至5月,采用随机整群抽样的方法选取民勤县3~6年级小学生1 966名为研究对象,采用美国流行病学标准问卷(ATS-DLD-78-C)进行呼吸系统症状和疾病调查并进行影响因素的logistic回归分析。结果 1 966名小学生感冒时咳嗽、不感冒时咳嗽、持续咳嗽、感冒时咳痰、不感冒时咳痰、持续咳痰、喘鸣的发生率分别为63.9%、12.0%、8.6%、39.0%、9.8%、4.0%、10.6%,男生持续咳嗽、持续咳痰发生率高于女生(P0.05);反复呼吸道感染、肺炎、哮喘、气管/支气管炎、过敏性鼻炎患病率分别为5.5%,1.9%,0.7%,7.0%,5.5%,反复呼吸道感染患病率与年龄呈负相关(P0.05);logistic回归分析显示过敏史、家族史、被动吸烟、豢养宠物、大件新家具、地毯、冬春季开窗通风、煤炉取暖增加儿童发生呼吸系统症状和疾病的危险性,与父母同住是保护性因素(P0.05)。结论多种家庭相关因素影响民勤县小学生呼吸系统健康。     

哮喘和咳嗽变异性哮喘儿童肺常规通气功能比较

目的 通过比较哮喘与咳嗽变异性哮喘儿童的肺常规通气功能,探讨其临床意义。 方法 选择2010年5-11月就诊于河北省儿童医院呼吸科门诊,确诊为哮喘或咳嗽变异性哮喘的患儿80例,分为:1)哮喘急性发作组(A组)33例,平均年龄(7.96±2.12)岁;2)哮喘缓解组(B组)27例,平均年龄(7.97±1.91)岁;3)咳嗽变异性哮喘组(C组)20例,平均年龄(8.03±2.18)岁;同时随机选择同期正常健康体检儿童30例,作为对照组(D组),平均年龄(8.58±2.11)岁。测定用力肺活量(FVC)、一秒钟用力呼气容积(FEV1)、最大呼气峰流速(PEF)、用力呼气25%流速(FEF25)、用力呼气50%流速(FEF50)、用力呼气75%流速(FEF75)、最大呼气中期流速(MMEF75/25)等7项指标。 结果 A、B、C三组患儿各项肺功能指标均低于D组儿童(B、C组除外PEF、FEF50、FEF75),且A组各项肺功能指标均明显低于B和C组; 但B、C两组患儿差异无统计学意义。 结论 肺常规通气功能检测可以评价哮喘与咳嗽变异性哮喘患儿的气道阻塞程度,对于诊断及病情评估有重要意义。     

Prevalence of respiratory symptoms and diseases in schoolchildren living in a polluted and in a low polluted area in Israel

Second and fifth grade schoolchildren living in two communities with different levels of air pollution were studied. The parents of these children filled out ATS-NHLI health questionnaires. The prevalence of reported respiratory symptoms and pulmonary diseases was found to be significantly higher among children growing up in the polluted community (Ashdod) as compared with the low-pollution area (Hadera). Logistic models fitted for the respiratory conditions which differed significantly between both areas of residence also included background variables that could be responsible for these differences. Relative risk values, which were calculated from the logistic models, were in the range of 1.47 for cough without cold to 2.66 for asthma for children from Ashdod, as compared with 1.00 for children from Hadera.     

Respiratory health of plywood workers occupationally exposed to formaldehyde

This study was undertaken to enlarge our understanding of the adverse health effects of formaldehyde exposure in the workplace and community environment. The respiratory health status of 186 male plywood workers was evaluated by spirometric tests, respiratory questionnaires, and chest x-rays. Area concentrations of formaldehyde were measured in the work environment and found to range from 0.28 to 3.48 ppm. The average personal exposure was to 1.13 ppm of formaldehyde. Exposure to formaldehyde was associated with decrements in the baseline spirometric values, i.e., forced expiratory volume in 1 sec (FEV1.0), forced expiratory volume/forced vital capacity (FEV/FVC), and FEF25%-75%, and with several respiratory symptoms and diseases, including cough, phlegm, asthma, chronic bronchitis, and chest colds. The results of the study support the hypothesis that chronic exposure to formaldehyde induces symptoms and signs of chronic obstructive lung disease.     

Respiratory findings in livestock farmworkers.

In this cross-sectional study, the prevalence of acute and chronic respiratory symptoms and lung function were investigated in 236 (169 male and 67 female) livestock farmworkers raising domestic animals, including cattle and horses. The prevalence of acute and chronic respiratory symptoms was recorded by administering a modified version of the British Medical Research Council questionnaire on respiratory symptoms. Lung function was measured by recording the maximum expiratory flow-volume curves from which the forced vital capacity, the one-second forced expiratory volume, and the maximum expiratory flow rates at 50% and the last 25% were measured. There was a significantly higher prevalence of almost all chronic respiratory symptoms in farmers compared with controls: highest among men for chronic cough (27.2%) and highest among women for dyspnea (28.3%). Typical symptoms of occupational asthma were diagnosed in 3.6% of the male and 1.5% of the female livestock farmers. A logistic regression analysis performed on chronic respiratory symptoms of livestock workers indicate significant effects of smoking (P < 0.001) on all symptoms except occupational asthma. A large number of male and female livestock farmworkers complained of acute work-related symptoms: highest for dry cough (52.2%) and shortness of breath (44.9%). Lung function data among these workers demonstrated a trend toward lower lung function in general. Multivariate analysis of lung function parameters indicate significant effects of length of employment and smoking in male and length of employment in female livestock farmworkers. The data suggest that employment in livestock farming may be associated in a dose-dependent manner with the development of acute and chronic respiratory symptoms and lung function changes.     

The South Karelia Air Pollution Study: changes in respiratory health in relation to emission reduction of malodorous sulfur compounds from pulp mills.

The authors assessed the health effects of emission reduction of malodorous sulfur compounds in a prospective cohort study with a controlled natural experiment. A total of 810 subjects (83%) participated in the follow up: 316 from the severely polluted, 306 from the moderately polluted, and 188 from the nonpolluted communities. In the severely polluted community, the annual ambient air concentration of total reduced sulfur compounds decreased from 11 microg/m3 to 6 microg/m3. Compared with the nonpolluted community, the relative decrease in acute respiratory infections, adjusted for a change in smoking habits, was 0.53 episodes/person-year (95% confidence interval = 0.22, 0.83) in the severely polluted community and 0.36 episodes/person-year (95% confidence interval = 0.06, 0.66) in the moderately polluted community. In addition, the frequency of nasal symptoms (p = .004) and cough (p = .037) decreased significantly. The results are consistent with the hypothesis that exposure to malodorous sulfur compounds increases the risk of acute respiratory infections and symptoms of the respiratory tract.     

Adverse effects of low-level air pollution on the respiratory health of schoolchildren in Hong Kong

To evaluate the respiratory effects of long-term exposure to air pollution, schoolchildren (ages 8 to 12 years) from two districts in Hong Kong with contrasting air quality were studied. Parents of 1660 children completed questionnaires on respiratory symptoms, and 1294 children had their ventilatory function tested with a spirometer. After adjustment for relevant covariates, children living in the more polluted district had increased odds ratios for frequent cough (1.74), frequent sputum (1.87), chronic sputum (1.84), and doctor-diagnosed asthma (1.98). Children of both sexes in the more polluted district had significantly poorer lung function, and the differences among girls were more marked. The study provides additional evidence for the adverse effects of long-term exposure to relatively low-level air pollution.     

Respiratory Health of Plywood Workers Occupationally Exposed to Formaldehyde

This study was undertaken to enlarge our understanding of the adverse health effects of formaldehyde exposure in the workplace and community environment. The respiratory health status of 186 male plywood workers was evaluated by spirometric tests, respiratory questionnaires, and chest x-rays. Area concentrations of formaldehyde were measured in the work environment and found to range from 0.28 to 3.48 ppm. The average personal exposure was to 1.13 ppm of formaldehyde. Exposure to formaldehyde was associated with decrements in the baseline spirometric values, i.e., forced expiratory volume in 1 sec (FEV_(1.2) forced expiratory volume/forced vital capacity (FEV/FVC), and FEF_25%-75%, and with several respiratory symptoms and diseases, including cough, phlegm, asthma, chronic bronchitis, and chest colds. The results of the study support the hypothesis that chronic exposure to formaldehyde induces symptoms and signs of chronic obstructive lung disease.     

孟鲁司特联合沙美特罗治疗重度哮喘的效果

目的观察分析孟鲁司特联合沙美特罗治疗重度哮喘患者的效果。方法选取医院(在2014年1月-2019年12月期间)收治的86例重度哮喘患者,按照数字随机表法分为试验组(应用孟鲁司特联合沙美特罗治疗方法)和对照组(单纯应用沙美特罗治疗方法),每组均为43例。采用统计学分析两组重度哮喘患者的临床症状(肺部啰音、咳嗽、呼吸困难以及喘息等)消失时间、治疗总有效率、治疗前后的肺功能指标(1 s用力呼气量、用力呼气峰流速、用力呼气量占肺活量比值)。结果两组重度哮喘患者治疗前肺功能指标(1 s用力呼气量、用力呼气峰流速、用力呼气量占肺活量比值)比较,差异无统计学意义(P>0.05),治疗后试验组重度哮喘患者的肺功能指标(1 s用力呼气量、用力呼气峰流速、用力呼气量占肺活量比值)明显高于对照组(P<0.05);试验组重度哮喘患者的临床症状(肺部啰音、咳嗽、呼吸困难以及喘息等)消失时间明显短于对照组(P<0.05),试验组重度哮喘患者的治疗总有效率明显高于对照组(P<0.05)。结论孟鲁司特联合沙美特罗治疗重度哮喘患者的效果显著。     

Respiratory symptoms and lung function in furriers

Forty women who had been occupationally exposed in the fur coat manufacturing industry were studied. The mean age was 30 years; mean duration of exposure was 14 years. A group of 31 females who did not work in the furrier industry also was included in the study as the control group. A higher prevalence of all chronic respiratory symptoms was found among furriers when compared with controls; these differences were statistically significant for nasal catarrh (p less than 0.05) and sinusitis (p less than 0.01). Among the furriers, the highest prevalence of respiratory symptoms was recorded for chronic cough in 20 workers (50.0%), followed by sinusitis in 12 (30.0%), dyspnea in 10 (25.0%), and nasal catarrh in 8 workers (20.0%). Among the furriers, two (5.0%) had symptoms characteristic of occupational asthma. Most of the symptomatic furriers complained of acute symptoms during their work shifts. Statistically significant mean reductions in lung function over the work shift were recorded in furriers for forced vital capacity (FVC), -4.1%; one-second forced expiratory volume (FEV1), -5.2%; and flow rate at 50% vital capacity (FEF50%), -6.3%. Furriers demonstrated significantly lower mean Monday preshift measurements for FVC and flow rate at 25% (FEF25%) (p less than 0.05) when compared with those predicted. Preshift administration (by spinhaler) of 40 mg disodium cromoglycate in three workers reduced the intensity of acute respiratory symptoms and diminished the reductions in ventilatory capacity over the work shift. Data from six additional male workers demonstrated similar findings for symptoms and lung function. Our data suggest that furriers are at risk of developing both acute and chronic respiratory symptoms as well as ventilatory capacity impairment as a result of occupational exposure.     

Airway disease caused by phenolic (phenol-formaldehyde) resin exposure.

A standardized respiratory questionnaire and pulmonary function tests, including measurement of forced vital capacity (FVC), one-second forced expiratory volume (FEV1.0), and maximum expiratory flow rate at 50% FVC (MEF50%), were administered to five groups of employees in a filter-manufacturing plant to determine the acute and chronic effects of exposure to phenolic resin fumes. Employees exposed for more than five years had lower FEV1.0/FVC and MEF50%/FVC ratios than a group that had smoked more but that had never been consistently exposed to resin fumes. The existence of chronic airway obstruction was also evident by a slight excess of chronic cough and sputum production in the exposed groups. However, in spite of the high proportions of subjects reporting acute respiratory symptoms, we found only small decreased in pulmonary function during the workday and workweek.     

Height and lung function in preadolescent children of Kuwaitis and European origin: a pilot survey on health effects of gas cooking in the Middle East.

Spirometric testing, including forced vital capacity (FVC), forced expiratory volume in .5 s (FEV0.5), FEF25-75%, and peak expiratory flow resistance (PEFR), was conducted among 130 10-y-old children (67 Kuwaitis, 63 Europeans) who lived with their parents in the same area in Kuwait city. Lung function of children who lived in houses with gas stoves were compared with those who lived in homes supplied with electric cookers. The FEV0.5 for children who lived in households with gas stoves was significantly lower (average difference, 94 ml; p = .05; corrected to height and sex). Other lung function indices, i.e., FVC, FEF25-75%, and PEFR, were also lower but, after accounting for confounders, were not statistically significant. Children from households that were equipped with gas cookers were approximately 3 cm shorter than children who lived in homes with electric cookers. These findings suggest that children who live in a very hot and dry climate--even with efficient air conditioning systems--are susceptible to the same environmental hazards to which children from other climatic zones are exposed. This susceptibility may be more pronounced before or at the onset of puberty.     

Long-term residence in areas of high ozone: associations with respiratory health in a nationwide sample of nonsmoking young adults [dsee comments]

Few studies have examined the respiratory effects of multiyear ozone exposures in human populations. We examined associations between current respiratory health status and long-term ozone exposure histories in 520 Yale College (New Haven, CT) students who never smoked. Questionnaires addressed current respiratory symptoms, respiratory disease history, residential history, and other factors. The symptoms of cough, phlegm, wheeze apart from colds, and a composite respiratory symptom index (RSI) were selected as outcome measures. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), forced expiratory flow rate between 25 and 75% of FVC (FEF(25-75)), and forced expiratory flow rate at 75% of FVC (FEF(75)) were obtained by forced expiration into spirometers. Ozone exposure was treated as a dichotomous variable, where subjects were assigned to the high-exposure group if they lived for 4 or more years in a U.S. county with 10-year average summer-season daily 1-hr maximum ozone levels [greater/equal to] 80 ppb. Lung function and respiratory symptoms were analyzed by multiple linear and logistic regression on ozone exposure, controlling for covariates. Lung function was lower in the group with high ozone exposures: differences were statistically significant for FEV(1) [-3.1%; 95% confidence interval (CI), -0.2 to -5.9%] and FEF(25-75) (-8.1%; CI, -2.3 to -13.9%), and nearly so for FEF(75) (-6.7%; CI, 1.4 to -14.8). Gender-specific analyses revealed stronger associations for males than for females. The symptoms of chronic phlegm, wheeze apart from colds, and RSI were increased in the ozone-exposed group, with odds ratios of 1.79 (CI, 0.83-3.82), 1.97 (CI, 1.06-3.66), and 2.00 (CI, 1.15-3.46), respectively. We conclude that living for 4 or more years in regions of the country with high levels of ozone and related copollutants is associated with diminished lung function and more frequent reports of respiratory symptoms.     

Assessment of respiratory symptoms and asthma prevalence in a U.S.-Mexico border region

The authors studied children who were 10-12 yr of age and who resided in sister cities in a U.S.-Mexico border region to determine the prevalence of asthma and respiratory symptoms. The relationship of symptoms to ambient levels of particulate matter less than 10 microm in diameter (PM10), and to several indoor environmental conditions, was assessed. The study was conducted in the border cities of Ambos Nogales (Nogales, Arizona [United States], and Nogales, Sonora [Mexico]). At the beginning of the 11-wk study, during the autumn of 1996, 631 students and their parents completed baseline questionnaires. While in school, the children completed daily symptom diaries and daily peak expiratory flow maneuvers. PM10 values and daily temperatures were also measured. The authors found that the prevalence of self-reported asthma among 5th-grade students was comparable on both sides of the border (i.e., 7.6% on the Arizona side and 6.9% on the Sonora side). Wheezing was a frequent complaint (29.5-35.6%), as was cough (16.8-29.6%). Smoking in the home was common on both sides of the border, and it was associated with a greater occurrence of self-reported asthma and respiratory complaints. Increased respiratory symptoms were also associated with increased ambient PM10 levels. The prevalence of respiratory symptoms such as wheezing and frequent cough among all children in this study, combined with the limitations inherent in self-reporting, suggest that asthma may actually be more prevalent than has been previously reported.     

空气污染对交通警察呼吸系统影响

目的了解沈阳市空气污染暴露对交通警察呼吸系统影响, 为职业健康保护提供科学依据。方法通过问卷调查132名男性交通警察(外勤组79名, 内勤组53名)基本情况、呼吸道症状及肺功能相关指标, 比较2组呼吸系统健康状况。结果外勤组咳嗽、咳痰、气短、连续打喷嚏、鼻干燥、咽喉不适等呼吸系统不适症状发生率分别为64.56%、50.63%、35.44%、25.32%、48.10%和69.62%, 均高于内勤组的22.64%、28.30%、16.98%、9.43%、26.42%和32.08%(P<0.05);外勤组的肺功能指标肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气量(FEV1.0)、呼气峰值流速(PEF)及实测值/预计值分别为(82.27±14.57)%、(84.63±15.97)%、(88.70±11.34)%、(72.62±21.20)%, 均低于内勤组的(94.25±12.28)%、(93.51±14.25)%、(96.64±12.33)%、(82.94±20.61)%(P<0.05);外勤组阻塞性和限制性通气功能障碍发生率分别为1.89%和7.55%, 明显高于内勤组的15.19%和20.25%(P<0.05)。结论空气污染暴露严重危害交通警察呼吸系统健康。     

继发于上呼吸道感染的长期咳嗽患儿肺功能与嗜酸性粒细胞的关系

目的探讨继发于上呼吸道感染（URI）的长期咳嗽惠儿肺功能与嗜酸性粒细胞的关系。方法收集24例继发于URI的长期咳嗽患儿作为观察组．用视觉模拟法对其咳嗽程度进行评分。并测定其肺功能,检测外周血及诱导痰的嗜酸性粒细胞（EOS）含量：另收集22例健康儿童作为对照。结果①咳嗽症状评分：长期咳嗽组患儿的VAS评分明显高于对照组（P〈0．05）。②肺功能：长期咳嗽组患儿第一秒用力呼气容积（FEV,）及1秒率均低于对照组;支气管激发试验结果显示两组FEV,下降率无统计学差异（P=0．083）;支气管舒张试验结果显示观察组FEV,增加率均明显高于对照组;观察组24h内最高呼气流量波动率明显低于对照组（P〈0．05）。（3）EOS检测：观察组外周血及痰液EOS计数及比例明显高于对照组。结论嗜酸性粒细胞浸润是继发于上呼吸道感染长期咳嗽患儿气道的一个重要特征,并且与肺功能受损密切相关。     

The effect of domestic factors on respiratory symptoms and FEV1

This study was conducted to determine whether indoor air pollution factors affected respiratory function and symptoms in 1357 non-smoking Caucasian children. Interviews were conducted to determine: exposure to pets and to gases, vapours and dusts from hobbies; the use of gas stoves; fireplaces, air conditioners and humidifiers; type of heating systems; and the number of residents, and the number of smokers in the home. The forced expiratory volume in one second (FEV1) was obtained from maximum expiratory flow volume curves, and symptoms from the application of a standardized questionnaire. Indoor pets and the use of fireplaces and humidifiers had no consistent relationships with FEV1 when considered individually or in combination with the other factors. Hobbies, the use of gas stoves, the absence of air conditioning, the use of hot water heating, crowded homes, and the presence of smokers in the home all had negative relationships with FEV1. The largest effect on lung function was observed in children from homes with hot water heating systems, whereas the smallest effect was observed in children with smokers in the home. Children who lived in homes with hot water heating systems with no air conditioning had mean FEV1 of up to 0.4 litres lower than did their counterparts who lived in homes with forced air heating and air conditioning. Pets, heating systems, cooking fuel, crowding and passive smoking showed no consistent effects on the reporting of any of the symptoms. Girls who were exposed to the emissions from indoor hobbies reported more phlegm, wheeze and dyspnoea.     

Effects of environment and passive smoking on the respiratory health of children.

A cross-sectional survey was conducted to evaluate the possible effects of outdoor air pollution and of parental smoking on the respiratory health of children. A total of 3092 primary schoolchildren living in two polluted areas (an industrial town, Civitavecchia, and the city of Rome) and in a rural area, were chosen. A self-administered questionnaire was filled in by the parents of 2929 children (94.2%). A broad spectrum of respiratory symptoms and illnesses were taken as outcome variables. The frequency of most outcome variables was higher among children from the polluted areas than among those growing up in the non-polluted area (e.g. asthma: odds ratio (OR) = 1.4 for Civitavecchia, OR = 1.3 for Rome). Exposure to any passive smoking increased OR of having night cough (OR = 1.8), snoring (OR = 1.4), and respiratory infections during the first 2 years of life (OR = 1.3). A further increase in risk was observed in children whose mothers smoked or if both parents were smokers (asthma, OR = 1.5). When the separate and joint effects of the two exposures were studied, the patterns of OR did not suggest synergism between the two factors. The study indicates that both air pollution and passive smoking cause an increase in respiratory symptoms in children, although there would seem to be no additional effects of the two exposures together.     

Airway Disease Caused by Phenolic (Phenol-Formaldehyde) Resin Exposure

? A standardized respiratory questionnaire and pulmonary function tests, including measurement of forced vital capacity (FVC), one-second forced expiratory volume (FEV_1.0), and maximum expiratory flow rate at 50% FVC (MEF50%), were administered to five groups of employees in a filter-manufacturing plant to determine the acute and chronic effects of exposure to phenolic resin fumes. Employees exposed for more than five years had lower FEV_1.0/FVC and MEF50%/FVC ratios than a group that had smoked more but that had never been consistently exposed to resin fumes. The existence of chronic airway obstruction was also evident by a slight excess of chronic cough and sputum production in the exposed groups. However, in spite of the high proportions of subjects reporting acute respiratory symptoms, we found only small decreases in pulmonary function during the workday and workweek.