To assess whether working in an industrial harbor where an oil tank exploded was associated with more airway symptoms and lower lung function in men 1.5 years later.
In a cross-sectional study of 180 men, 18 to 67 years old, airway symptoms and lung function among men who worked in the industrial harbor at the time of the explosion was compared with those of working men with residence more than 20 km away. Regression analyses are adjusted for smoking, occupational exposure, atopy, recent infection, and age.
Exposed men had significantly more upper (ORirritated nose = 2.89 [95% confidence interval = 1.31 to 6.37]) and lower (ORdyspnea uphill = 3.79 [95% confidence interval = 1.69 to 8.46]) airway symptoms, and some indication of more reversible airway obstruction than unexposed workers.
Men working in an area with an oil tank explosion had more airway symptoms and indication of more airway obstruction 1.5 years after the event.
Oil tanks containing a mixture of hydrocarbons, including sulphuric compounds, exploded and caught fire in an industrial harbour. This study assesses airway symptoms and lung function in the nearby population 1½ years after the explosion.
A cross-sectional study included individuals =18 years old. Individuals living 20 km away formed a control group. A questionnaire and spirometry tests were completed by 223 exposed individuals (response rate men 70%, women 75%) and 179 control individuals (response rate men 51%, women 65%). Regression analyses included adjustment for smoking, occupational exposure, atopy, infection in the preceding month and age. Analyses of symptoms were also adjusted for stress reactions related to the accident.
Exposed individuals experienced significantly more blocked nose (odds ratio 1.7 [95% confidence interval 1.0, 2.8]), rhinorrhoea (1.6 [1.1, 3.3]), nose irritation (3.4 [2.0, 5.9]), sore throat (3.1 [1.8, 5.5]), morning cough (3.5 [2.0, 5.5]), daily cough (2.2 [1.4, 3.7]), cough >3 months a year (2.9 [1.5, 5.3]) and cough with phlegm (1.9 [1.2, 3.1]) than control individuals. A significantly increasing trend was found for nose symptoms and cough, depending on the proximity of home address to explosion site (daily cough, 3-6km 1.8 [1.0, 3.1],
Assess if people who lived or worked in an area polluted after an oil tank explosion had persistent respiratory health impairment as compared to a non-exposed population 5.5 years after the event.
A follow-up study 5.5 years after the explosion, 330 persons aged 18-67 years, compared lung function, lung function decline and airway symptoms among exposed persons (residents 20 km away). Also men in the exposed group who had participated in accident related tasks (firefighting or clean-up of pollution) were compared with men who did not. Data were analysed using Poisson regression, adjusted for smoking, occupational exposure, atopy and age.
Exposed men who had participated in accident related tasks had higher prevalence of lower airway symptoms after 5.5 years (n?=?24 [73%]) than non-exposed men (28 [48%]), (adjusted relative risk 1.51 [95% confidence interval 1.07, 2.14]). Among men who participated in accident related tasks FEV1 decline was 48 mL per year, and 12 mL among men who did not (adjusted difference -34 mL per year [-67 mL, -1 mL]), and at follow-up FEV1/FVC ratio was 71.4 and 74.2% respectively, (adjusted difference -3.0% [-6.0, 0.0%]).
Residents and workers had more airway symptoms and impaired lung function 5.5 years after an oil tank explosion, most significant for a group of men engaged in firefighting and clean-up of pollution after the accident. Public health authorities should be aware of long-term consequences after such accidents.
Psychological factors such as anxiety and depression are prevalent in patients with asthma. The purpose of this study was to investigate the relationship between respiratory symptoms and psychological status and to estimate the importance of psychological status in comparison with other factors that are known to be associated with respiratory symptoms. This study included 2270 subjects aged 20-44 (52% female) from Sweden, Iceland, and Norway. Each participant underwent a clinical interview including questions on respiratory symptoms. Spirometry and methacholine challenge were performed. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Eighty-two percent of the subjects reported no anxiety or depression whatsoever, 11% reported anxiety, 2.5% depression and 4% reported both anxiety and depression. All respiratory symptoms, such as wheezing, breathlessness and nightly symptoms, were more common, at a statistically significant level, in participants who had depression and anxiety, even after adjusting for confounders (ORs 1.33-1.94). The HADS score was the most important determinant for nightly symptoms and attacks of breathlessness when at rest whereas bronchial responsiveness was the most important determinant for wheezing, and breathlessness when wheezing. The probability of respiratory symptoms related to HADS score increased with increasing HADS score for all respiratory symptoms. In conclusion, there is a strong association between respiratory symptoms and psychological status. There is therefore a need for interventional studies designed to improve depression and anxiety in patients with respiratory symptoms.
The oral cavity is united with the airways, and thus poor oral health may affect respiratory health. However, data on the interaction of periodontal and respiratory health is limited. We aimed to evaluate whether periodontal health status, assessed by the Community Periodontal Index (CPI), was related to lung function among young and middle-aged adults in two Norwegian cohorts.
Periodontal health status and lung function were measured among 656 participants in the Norwegian part of the European Community Respiratory Health Survey (ECHRS III) and the RHINESSA offspring study. Each participant was given a CPI-index from 0 to 4 where higher values reflect poorer periodontal status. The association between CPI and lung function was estimated with linear regression adjusting for age, gender, smoking, body mass index, exercise, education, use of antibiotics, inhaled medication and corrected for clustering within families.
Participants with CPI 3-4 had significantly lower FEV1/FVC ratio compared to participants with CPI 0, b (95% CI) = -0.032 (-0.055, -0.009). Poorer periodontal health was associated with a significant decrease in the FEV1/FVC ratio with an adjusted regression coefficient for linear trend b (95% CI) = -0.009 (-0.015, -0.004) per unit increase in CPI. This negative association remained when excluding asthmatics and smokers (-0.014 (-0.022, -0,006)).
Poorer periodontal health was associated with increasing airways obstruction in a relatively young, healthy population. The oral cavity is united with the airways and our findings indicate an opportunity to influence respiratory health by improving oral health.
Cites: J Oral Microbiol. 2010 Dec 21;2:null PMID 21523216
There are few studies on predictors of smoking cessation in general populations. We studied the smoking cessation rate in relation to several potential predictors, with special focus on respiratory and cardiovascular disease.
Smokers (n = 4636) from seven centres in Northern Europe, born between 1945 and 1973, who answered a questionnaire in 1999-2001 (the RHINE study) were followed up with a new questionnaire in 2010-2012. Altogether 2564 answered the questionnaire and provided complete data on smoking. Cox regression analyses were performed to calculate hazard ratios (HRs).
A total of 999 subjects (39%) stopped smoking during the study period. The smoking cessation rate was 44.9/1000 person-years. Smoking cessation was more common with increasing age, higher education and fewer years of smoking. Asthma, wheeze, hay fever, chronic bronchitis, diabetes and hypertension did not significantly predict smoking cessation, but smokers hospitalized for ischaemic heart disease during the study period were more prone to stopping smoking (HR 3.75 [2.62-5.37]).
Successful smoking cessation is common in middle-aged smokers, and is associated with few smoking years and higher education. A diagnosis of respiratory disease does not appear to motivate people to quit smoking, nor do known cardiovascular risk factors; however, an acute episode of ischaemic heart disease encouraged smoking cessation in our study population.
A cohort pattern has been demonstrated for ulcer mortality and perforation, pointing to a role of early life factors, while only a period-related decrease has been observed in elective ulcer surgery, which reflects uncomplicated ulcer. The aim of this article was to study whether the susceptibility to peptic ulcer disease is determined early in life, as reflected in a cohort pattern consistent for all ulcer manifestations. The subjects were all patients treated surgically for peptic ulcer (perforations 1962-1990; bleedings 1971-1990; elective surgery 1971-1990) and all deaths from peptic ulcer (perforations and other ulcer deaths 1951-1989) in Iceland. Age-specific incidence and mortality were analyzed graphically by year of birth (cohort) and by year of event (period). The effects of cohort and period on incidence and mortality were analyzed by Poisson regression. Ulcer perforation and bleeding, operative incidence, and mortality, showed a rise and subsequent fall in successive generations, with the highest risks observed in the subjects born after the turn of the 20(th) century. This was confirmed by statistical analyses showing highly significant cohort effects (P
Studies using mothers' self-reported information on birth and pregnancy characteristics are common, but the validity of such data is uncertain. We evaluated questionnaire data from the RHINE III study on reproductive health provided by 715 mothers from Bergen, Norway, about their 1629 births between 1967 and 2010, using the Medical Birth Registry of Norway (MBRN) as gold standard. Validity of dichotomous variables (gender, preterm birth [42 weeks' gestation], induction of labour, forceps delivery, vacuum delivery, caesarean section, were assessed by sensitivity, specificity, positive and negative predictive values (PPV and NPV) and Cohen's kappa. Paired t-test, Pearson's correlation coefficient and Bland-Altman plots were used to validate birthweight, stratified by mother's level of education, parity, birth year and child's asthma status. Child's gender and caesarean section showed high degree of validity (kappa = 0.99, sensitivity and specificity 100%). Instrumental delivery and extremely preterm birth showed good agreement with sensitivity 75-92%. Preterm birth and induction of labour showed moderate agreement. Post-term delivery was poorly reported. The validity appeared to be independent of recall time over 45 years, and of the child's asthma status. Maternally reported birth and pregnancy information is feasible and cheap, showed high validity for important birth and pregnancy parameters, and showed similar risk-associations compared to registry data.
Cites: Indoor Air. 2008 Apr;18(2):84-9218333988
Cites: BMC Pulm Med. 2014 Apr 16;14:6324739530
Cites: BMJ. 1991 Sep 21;303(6804):671-51912913
Cites: Am J Epidemiol. 1997 Jan 1;145(1):58-678982023