Prevalence of self-reported respiratory disease symptoms among veterinarians in the Southern Netherlands

In June 1991, 831 veterinarians registered in the Southern Netherlands were mailed a questionnaire to obtain details of work practice and health problems. One hundred fifty-two veterinarians were not eligible (retired or not working regularly), 497 practitioners returned a complete questionnaire (73% response rate). The purpose was to assess the prevalence of respiratory disease symptoms (RDS) and to compare the prevalence of RDS between occupational specialties and with a group of swine farmers. The professional specialty of each veterinarian was grouped as: small-animal practice (17%), large-animal practice (51%), mixed-animal practice (14%), and other practice (i.e., government, industry) (18%). Adjusted for age, gender, smoking, history of atopy, and use of respiratory protective devices, large-animal practitioners had a two times higher odds of chronic cough (OR = 1.8, 95% CI 1.1-2.8) or chronic phlegm production (OR = 2.1, 95% CI 1.1-3.7) and a three times higher odds of chest wheezing (OR = 2.8, 95% CI 1.3-6.3) than veterinarians with another specialty. Modelling the occurrence of RDS in veterinarians with exposure variables indicated that working more than 20 hr per week in swine confinement buildings increased the odds of occurrence of chronic cough and chronic phlegm production approximately three times, in addition to a significant effect of smoking. Besides a significant effect of smoking and history of atopy, no exposure variables other than occupation were associated with occurrence of asthmatic attacks in swine farmers and large-animal practitioners. Large-animal practitioners had a two times higher odds of asthmatic attacks (OR = 1.8, 95% CI 1.1-2.9) than swine farmers. Large-animal practitioners have a considerably higher proportion of symptoms like cough, phlegm production, a stuffed up nose, sneezing, and tearing eyes than small-animal practitioners during, and 4–8 hr after, working with animals. © 1996 Wiley-Liss, Inc.     

Smoking habit, respiratory symptoms and lung function in young adults

Background: Smoking is the primary cause of deterioration inforced expiratory volume (FEV₁) and the development of chronicobstructive lung disease. This study assessed the independentassociation of smoking with respiratory symptoms and lung functionin young adults who took part in the European Community RespiratoryHealth Survey (ECRHS–I). Methods: Cross-sectional multi-centresurvey of a general population of young adults aged 20(44 yearsin the ECRHS(I conducted in five Spanish centres. Several groupswere created in an exclusive and descendent manner from thesubjects who completed the questionnaire in accordance withhow they had answered the questions: asthma-related symptoms;chronic bronchitis symptoms; minor respiratory symptoms; chroniccough; and no respiratory symptoms. Among a subset of the population,forced spirometry tests were performed. Linear and logisticalregression models were used to assess the relationship of smokingin the presence of symptoms and its impact on lung function,adjusted by other important variables. Results: The prevalenceof respiratory symptoms was higher among smokers. After adjustingfor geographical area, total IgE, age, sex, and FEV₁, smokingwas associated with an increased risk of chronic bronchitisand other respiratory symptoms. These risks increased with increasingnumber of cigarettes smoked per day. A deterioration of FEV₁and the FEV₁/FVC ratio was also directly associated with thenumber of cigarettes smoked per day. Conclusion: Even amongyoung adults, smoking confers a high risk of developing a numberof respiratory symptoms and the deterioration of the ventilatoryfunction.     

The health impact of smoking in manual and non-manual social class men and women: a test of the Blaxter hypothesis

Blaxter has hypothesized that harmful behavioral habits like smoking have a greater impact on health in the non-manual than in the manual social classes, possibly because other adverse exposures have a more important role in the manual social classes. However, the outcome measure used was a composite measure of physiological indices of morbidity and the relevance of this to other health problems is uncertain. We have therefore investigated the effect of smoking on mortality, to test whether the risk of death associated with smoking differs between manual and non-manual social classes. Data on 6831 men and 7993 women, aged 45-64 when screened in the Renfrew and Paisley study, a large prospective observational study in the West of Scotland, have been analyzed. All cause mortality rate ratios for smokers compared with never smokers have been calculated within manual and non-manual social classes. Although the age adjusted rate ratios are slightly higher among the non-manual men and women (2.19 [1.83-2.61] versus 1.92 [1.71-2.17] for non-manual and manual men respectively, and 1.75 [1.54-1.99] versus 1.65 [1.50-1.82] for non-manual and manual women), this difference between social classes is not statistically significant (p-values for test of difference 0.26 and 0.47 for men and women respectively). When additionally adjusted for other risk factors, cardiorespiratory symptoms and deprivation, this picture remained the same (p-values for test of difference are 0.41 and 0.50 for men and women respectively). Similar results were found when the cohort was divided by deprivation categories rather than social classes or when smoking related mortality rather than mortality from all causes was used as the outcome measure. We therefore conclude that the health impact of smoking is similar in each socio-economic group. The relative health improvement consequent on smoking cessation is thus similar in different socio-economic groups.     

Prevalence of respiratory symptoms among wheat flour mill workers in Ibadan, Nigeria

BACKGROUND: While investigations into occupational health problems of various groups of workers have been conducted in Nigeria, so far, very little attention has been paid to the health status of workers in the grain industry. The prevalence of respiratory symptoms among wheat flour mill workers and control groups in a medium size industrial setting in Nigeria was studied. METHODS: The study employed a cross-sectional analytical design. Data were collected using structured interviews, work-site observations, and physical examination. Respondents consisted of 91 flour-millers, 30 matched internal controls from the maintenance unit of the same flour mill factory, and 121 matched external controls. RESULTS: Fifty-four percent of the flour-millers reported at least one respiratory symptom compared with 30% of the internal controls (P < 0.05) and 19% of the external controls (P < 0.001). Most symptoms were significantly more prevalent among the flour-millers compared with control subjects, and this trend was more evident amongst non-smokers than ex-smokers. CONCLUSIONS: The study concluded that wheat flour mill workers in Nigeria, like grain workers elsewhere, were at an increased risk of developing both pulmonary and non-pulmonary symptoms compared with control subjects. The result has implications for improved dust control measures in the grain industry in Nigeria.     

Work-related respiratory symptoms and lung function in New Zealand mussel openers

Our objectives were to measure the prevalence of work-related and nonwork-related respiratory symptoms in a group of New Zealand mussel openers who open green-lipped mussels, and to relate these to demographic factors, work history, smoking history, and pulmonary function measurements. A cross-sectional study of respiratory symptoms and lung function was performed on 224 New Zealand mussel openers (99.6% of the study population) at nine work sites. In addition, peak expiratory flow (PEF) change across-shift was measured at one work site in 19 workers. The mean age of all mussel openers was 33.4 years and the mean duration of mussel opening was 5.0 years; 25% were male, 54.7% were current smokers, and 13.9% were ex-smokers. The reported symptom prevalences were: any wheeze, 35%; work-related wheeze, 23%; any chest tightness, 30.5%; work-related chest tightness, 20.2% (work-related symptoms were defined as symptoms improving on rest days or worse at work). Seventy-two mussel openers (32.3%) answered positively to at least 1 of 4 questions concerning work-related symptoms. The mean predicted FEV₁ (SD) for this group was 74.3% (14.5), and the mean predicted FVC (SD) was 79.2% (16.0). Nineteen workers completed serial PEF, and the mean percentage change was +1.5% at 7 hr, but 8 workers had falls ranging between 1.1–14% after either 1 or 7 hr of work. Duration of mussel opening of greater than 2 years, but less than 7 years (OR = 2.29; 95% CI, 1.07–4.91), and duration of mussel opening greater than 7 years (OR = 3.72; 95% CI, 1.52–9.11), were significant predictors of work-related respiratory symptoms. Female sex (OR = 1.73; 95% CI, 0.83–3.60) was also associated with the presence of work-related symptoms. No relationship was found with measured hygiene parameters or cleaning agents used. In conclusion, duration of work as a mussel opener was associated with the presence of work-related respiratory symptoms, after adjustment for age, sex, and smoking habit. There were marked abnormalities in mean FEV₁ and FVC, although no consistent changes across working shift were noted. Am. J. Ind. Med. 34:163–168, 1998. © 1998 Wiley-Liss, Inc.     

Social class,anxieties and mothers' foodwork

In the context of concerns about childhood obesity, mothers are placed at the forefront of responsibility for shaping the eating behaviour and consequently the health of their young children. This is evident in a multitude of diverse sites such as government reports, health promotion materials, reality TV shows and the advice of childcare nurses and preschools. These sites produce a range of resources available to mothers to draw on to constitute themselves as mothers in terms of caring for their children's health. Drawing on a qualitative study of mothers recruited through three Australian preschool centres, this article examines how the working‐class and middle‐class mothers of preschool‐aged children engage with knowledge about motherhood, children and health and how those engagements impact on their mothering, their foodwork and their children. We argue that, unlike the working‐class mothers pathologised in some literature on obesity, these working‐class mothers demonstrated a no‐nonsense (but still responsibilised) approach to feeding their children. The middle‐class mothers, on the other hand, were more likely to engage in practices of self‐surveillance and to demonstrate considerable anxieties about the appropriateness of their practices for their children's current and future health.     

Maternal smoking, social class and outcomes of pregnancy

Exposure to tobacco during pregnancy is an important risk factor for infant health. Recently the prevalence of smoking during pregnancy has declined in our area. The objective of this study was to analyse the association between several social variables and the fetal exposure to smoking, as well as the association between maternal smoking and some adverse gestational outcomes. Data collection was cross-sectional. The study population were women in the city of Barcelona (Catalonia, Spain) delivering a child without birth defects. The sample corresponded to the controls of the Birth Defects Registry of Barcelona, 2% of all pregnancy deliveries in the city from 1994 to 2003 (n = 2297). Information sources were hospital records and a personal interview of mothers. The analysis measured first the association between independent variables (instruction level, social class, occupation, nationality, planned pregnancy, parity, hospital funding and smoking status of the mother's partner) with two dependent variables: smoking at the initiation of pregnancy and quitting during pregnancy. Second, the persistence of smoking over pregnancy and all independent variables were studied with three variables indicating adverse outcomes of pregnancy: low gestation, low birthweight and intrauterine growth restriction (IUGR). Finally, the joint association between the persistence of smoking over pregnancy and social class taken as independent variables was determined with the three variables indicating adverse outcomes of pregnancy. Logistic regression models were fitted, adjusting for maternal age. Results are presented as odds ratios with their 95% confidence intervals. The prevalence of smoking at the onset of gestation was 41%, and 40% of these women quit during pregnancy, so that 25% delivered as active smokers. Fewer women with higher educational levels and from families with non-manual jobs smoked, as did immigrants, those planning pregnancy and women whose partner did not smoke. Smoking immigrants quit more frequently than nationals, as did those planning pregnancy, primiparae, and women whose partner did not smoke. Low gestation, low birthweight and IUGR were more frequent among smokers and women with a manual occupation, but manual occupation lost its significance when adjusting for smoking. The association between smoking and adverse results was higher for IUGR. In conclusion, the prevalence of smoking and quitting during pregnancy varied according to social factors. The influence of social factors on the outcome of pregnancy was mediated strongly by smoking in a country that provides access to health care free of cost. A priority in reducing inequalities in health is to help women from manual work backgrounds quit smoking.     

The influence of gender, social circumstances and smoking on survival: the Renfrew and Paisley study

The present study aimed to compare survival to age 75 between men and women, by social circumstances and smoking behaviour. A 20 year follow up was carried out of a large representative cohort of Scottish men and women in the Renfrew and Paisley study, and was combined with Scottish mortality statistics. 6831 men and 7993 women aged 45-64 y at time of examination (between 1972 and 1976) were considered. Combining the estimates from the Renfrew and Paisley study with those from Scottish mortality statistics for men and women younger than 45 y of age, it was calculated that 28% of the male smokers and 44% of the male never smokers in disadvantaged social circumstances will have survived to age 75 y, compared with 46% and 56% of the female smokers and never smokers respectively. In more privileged social circumstances, 41% of the male smokers and 62% of the male never smokers will have survived to age 75 y, compared with 56% and 70% of the female smokers and never smokers respectively. The difference between male smokers in low social classes and female never smokers in high social classes is 42% in absolute terms (28% vs 70%), which gives an indication of the combined influence of gender, social circumstances and smoking on survival. These results show that gender, social circumstances and smoking are important determinants of mortality which have led to substantial differences in survival. The influence of additional factors related to mortality could usefully be compared to these to put their effects into perspective.     

Social capital, the miniaturization of community and cannabis smoking among young adults

OBJECTIVES: The impact of social participation, trust and the miniaturization of community, i.e. the combination of high social participation and low trust, on cannabis smoking was investigated. METHODS: The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons aged 18-80 years, of which 3,978 persons aged 18-34 years were included in this study, answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the association between the social capital variables and ever having experienced cannabis smoking. The multivariate analysis was performed to investigate the importance of possible confounders (age, country of origin and education) on the differences in having experienced cannabis smoking according to social participation, trust and their four combination categories. RESULTS: Cannabis smoking is not associated with social participation, but positively associated with low trust among both men and women, and the miniaturization of community, i.e. the combination of high social participation and low trust, among men. CONCLUSIONS: This study suggests that the miniaturization of community, i.e. the combination of high social participation and low levels of generalized trust of other people, may enhance the experience of cannabis smoking.     

Social class inequalities in childhood mortality and morbidity in an English population

The objective of this study was to examine the association between social class of the head of household at the time of birth and mortality and morbidity during the first 10 years of life in a cohort of all 117 212 children born to women who both lived, and delivered in hospital, in Oxfordshire or West Berkshire during the period 1 January 1979 to 31 December 1988. Logistic regression was used to estimate social class gradients, with odds ratios (OR), for mortality during the early neonatal period, late neonatal period, post-neonatal period, post-infancy period and throughout the first 10 years of life. Logistic regression was also used to estimate social class gradients, with ORs, for hospital admission rates for 16 broad groups of diseases during years 0-3, 4-6, 7-10 and throughout the first 10 years of life. Poisson regression was used to estimate social class gradients, with effect sizes, for overall hospital admission rates during years 0-3, 4-6, 7-10 and throughout the first 10 years of life. The study revealed a significant social class gradient in mortality during the first 10 years of life (adjusted OR for each decrement in social class category 1.08; [95% confidence interval 1.03, 1.14]). The study also revealed a significant adjusted social class gradient in hospital admission rates for 14 of the 16 groups of diseases during the first 10 years of life. For the majority of these, the social class gradients had attenuated somewhat by the later childhood years. However, the social class gradient persisted throughout the first 10 years of life for diseases of the respiratory system (1.07 [1.05, 1.08]), diseases of the digestive system (1.06 [1.04, 1.09]), and injury and poisoning (1.07 [1.06, 1.09]). In addition, a significant adjusted social class gradient was found in overall hospital admission rates for each age group studied. This study suggests that there are significant social class inequalities in a wide range of adverse child health outcomes.     

Genetic variation of human respiratory syncytial virus among children with fever and respiratory symptoms in Shanghai,China, from 2009 to 2012

Human respiratory syncytial virus (HRSV) of genus Pneumovirus is one of the most common pathogens causing severe acute lower respiratory tract infection in infants and children. No information on the genotype distribution of HRSV is available in East China (e.g. Shanghai). From August 2009 to December 2012, 2407 nasopharyngeal swabs were collected from outpatient children with fever and respiratory symptoms in Shanghai. HRSV infection was determined using a multiplex RT-PCR assay. The second hypervariable region (HVR2) of G protein gene of HRSV was amplified and sequenced from HRSV positive samples. Genotypes were characterized by phylogenetic analyses. Of 2407 nasopharyngeal samples, 184 (7.6%) were tested as HRSV positive. From 160 positive subjects with sufficient nasopharyngeal samples, 69 HVR2 sequences were obtained by RT-PCR and sequencing. Three HRSV epidemic seasons were observed from August 2009 to December 2012, and an extreme outbreak of HRSV occurred in the 2009–2010 epidemic season. A genotype shift of predominant HRSV strains from B group in the 2009–2010 epidemic season to group A in the subsequent epidemic seasons was observed. Ten HRSV genotypes, including four group A genotypes NA1, NA3, NA4, and ON1, and six group B genotypes BA9, BA10, SAB4, CB1, BAc, and BA?, were detected in Shanghai. Seven genotypes (NA1, BA9–10, SAB4, CB1, BAc and BA?) were found in the 2009–2010 epidemic season. The co-circulation of multiple genotypes was associated with the extreme outbreak of HRSV among children with fever and respiratory symptoms in the 2009–2010 epidemic season.     

Social interactions and smoking: evidence using multiple student cohorts,instrumental variables,and school fixed effects

In this paper, I use a social interactions framework to detect whether individual smoking decisions are influenced by classmate smoking decisions. There are several large challenges in addressing this question, including the endogeneity of school (and thus classmates) through residential location choices, ‘third factors’ such as school-level unobservables that influence individual and classmate choices simultaneously, and the difficulty of the identification of parameters in empirical models of social interactions. In order to address these issues, I use an instrumental variables/fixed effects methodology that compares students in different grades within the same high school who face a different set of classmates and classmates' decisions. Preferred specifications suggest that increasing the proportion of classmates who smoke by 10% will increase the likelihood an individual smokes by approximately 3 percentage points. I compare these results with previous findings that are unable to use school fixed effects and/or use potentially invalid instruments and find that the current results suggest smaller social interactions in adolescent smoking decisions than some previous work. Copyright © 2009 John Wiley & Sons, Ltd.     

Pulmonary function abnormality and respiratory tract irritation symptoms in epichlorohydrin-exposed workers in Taiwan

BACKGROUND: Epichlorohydrin (ECH) is a strong irritant of the eyes, respiratory tract, and skin. The aims of this study were to examine the dose-response relationship between observed abnormal pulmonary function tests and respiratory tract irritation symptoms among epichlorohydrin-exposed workers in Taiwan. METHODS: A total of 167 workers were randomly selected from a resin synthesis factory. Sixty-six air samples were taken to determine ECH concentration in the workplace. Demographic data, work history, smoking status, and respiratory tract irritation symptoms were gathered by a standard self-administered questionnaire. Pulmonary function tests were also performed. RESULTS: There were 13 of 41 (31.7%) abnormal mean mid-expiratory flow (MMEF) among the high-ECH-exposed workers, 11 of 38 (29%) among the low-ECH-exposed workers, and 4 of 59 (6.8%) among non-ECH-exposed workers. There was a significant linear trend between ECH exposure and the prevalence of small airway abnormalities (P = 0.007) after adjusting for other factors. There was also a significant dose-response relationship of respiratory tract irritation symptoms (cough, phlegm, chest tightness, and dyspnea) among the ECH-exposed workers. CONCLUSIONS: This study suggests that obstructive lung abnormalities and small airway lung damage are associated with ECH exposure. The study also suggests that exposure to very low concentrations (<0.2 ppm) causes significant higher prevalence of respiratory tract irritation symptoms. Causal inferences from the findings cannot be made from this cross-sectional study and further longitudinal studies are needed to better clarify the nature of the observed associations.     

Social class,dementia and the fourth age

Research addressing social class and dementia has largely focused on measures of socioeconomic status as causal risk factors for dementia and in observed differences in diagnosis, treatment and care. This large body of work has produced important insights but also contains numerous problems and weaknesses. Research needs to take account of the ways in which ageing and social class have been transformed in tandem with the economic, social and cultural coordinates of late modernity. These changes have particular consequences for individual identities and social relations. With this in mind this article adopts a critical gaze on research that considers interactions between dementia and social class in three key areas: (i) epidemiological approaches to inequalities in risk (ii) the role of social class in diagnosis and treatment and (iii) class in the framing of care and access to care. Following this, the article considers studies of dementia and social class that focus on lay understandings and biographical accounts. Sociological insights in this field come from the view that dementia and social class are embedded in social relations. Thus, forms of distinction based on class relations may still play an important role in the lived experience of dementia.     

徐州市2008年15岁及以上常住居民吸烟与被动吸烟现状调查

目的 了解徐州市不同人群吸烟现状,为开展控烟工作提供依据.方法 于2008年6-12月采用多阶段分层随机抽样方法 ,选择具有代表性的样本,对15岁及以上常住居民,采用统一调查问卷进行调查.结果共调查44 686人,其中城市10 295人(23.04%),农村34 391人(76.96%);男性21 524人(48.17%),女性23 162人(51.83%).15岁及以上人群吸烟率、现在吸烟率、常吸烟率、重型吸烟率、平均每日吸烟量、戒烟成功率、复吸率及被动吸烟率分别为22.45%、21.40%、15.49%、9.49%、15.09支、4.68%、5.91%和14.12%.城乡居民的吸烟率、现在吸烟率、常吸烟率差异无统计学意义(P>0.05);戒烟成功率、被动吸烟率城市高于农村(P<0.05);复吸率、重型吸烟率、平均每日吸烟量农村高于城市(P<0.05).男性吸烟率、现在吸烟率、常吸烟率、重型吸烟率、复吸率、平均每日吸烟量比例均高于女性(P<0.05).戒烟成功率、被动吸烟率女性高于男性(P<0.05).该人群吸烟者中主要吸有过滤嘴香烟(85.17%).不同文化程度、职业、经济收入的人群吸烟率比较,经X~2检验,差异均有统计学意义(P<0.05).结论 徐州市居民中吸烟率仍然很高,应采取有针对性的措施,有效地控制烟草的流行.