The ß(2)-adrenergic receptor (ADRB2) is an important regulator of airway smooth muscle tone. We tested the hypothesis that three functional polymorphisms in the ADRB2 gene (Thr164Ile, Gly16Arg and Gln27Glu) are associated with reduced lung function, asthma or chronic obstructive pulmonary disease (COPD). We first genotyped 8,971 individuals from the Copenhagen City Heart Study for all three polymorphisms. To validate our findings, we genotyped an additional 53,777 individuals from the Copenhagen General Population Study for the Thr164Ile polymorphism. We identified 60,910 Thr164Ile noncarriers, 1,822 heterozygotes and 16 homozygotes. In the Copenhagen City Heart Study, the Thr164Ile genotype was associated with reduced forced expiratory volume in 1 s (FEV(1)) % predicted (trend p = 0.01) and FEV(1)/forced vital capacity (FVC) (p = 0.001): Thr164Ile heterozygotes had 3% and 2% reduced FEV(1) % pred and FEV(1)/FVC, respectively, compared with noncarriers. The odds ratio for COPD in Thr164Ile heterozygotes was 1.46 (95% CI 1.05-2.02). In the Copenhagen General Population Study, the Thr164 genotype associated with reduced FEV(1) % pred (p = 0.04) and FEV(1)/FVC (p
Division of Respiratory Medicine, Center for Medicine and Clinical Research, Kuopio University Hospital, Kuopio, Finland. Electronic address: Margit.Pelkonen@kuh.fi.
The present study examines how trends in the prevalence of asthma during the past three decades associate with hospitalization and mortality during the same period.
Altogether 54?320 subjects aged 25-74 years were examined in seven independent cross-sectional population surveys repeated every five years between 1982 and 2012 in Finland. The study protocol included a standardized questionnaire on self-reported asthma, smoking habits and other risk factors, and clinical measurements at the study site. Data on hospitalizations were obtained from the Care Register for Health Care, and data on mortality from the National Causes of Death register.
During the study, the prevalence of asthma increased - especially in women. In asthmatic compared with non-asthmatic subjects, hospitalization was significantly higher for all causes, respiratory causes, cardiovascular causes and lung cancer. In addition, particularly in asthmatic subjects, mean yearly hospital days in the 5-year periods after each survey diminished. In asthmatic subjects, the decrease in yearly all-cause hospital days was from 4.45 (between 1982 and 1987) to 1.11 (between 2012 and 2015) and in subjects without asthma the corresponding decrease was from 1.77 to 0.60 (p?
The purpose of this study was to investigate the risk of transitional cell carcinoma among subjects with an intake of acetaminophen, aspirin, some other drugs and with some intercurrent diseases. The source person-time ('study base') included subjects living in Stockholm in 1985-1987. The study included 325 subjects with a transitional cell carcinoma of the urinary tract and 393 controls randomly selected from the source person-time. Data were obtained by a postal questionnaire supplemented by a telephone interview. A relative risk (with a 95% confidence interval) of 1.6 (1.1-2.3) was obtained after an intake of acetaminophen, adjusted for age, aspirin, gender and smoking. Conversely, a 30% decrease in risk was obtained after an intake of aspirin. No details in the exposure substantiated the finding for acetaminophen. The inherent validity problems of observational studies, and the weak evidence in this and previous studies of the association between acetaminophen and transitional cell carcinoma, makes available epidemiological evidence insufficient to regulate the use of this commonly ingested analgesic. Increased risks were, in addition, found for tetracyclines, nitrofurantoin and a history of allergic asthma and a decreased risk found for rheumatic symptoms. The findings stress the nonepidemiological data concerning the potential carcinogenicity of acetaminophen and may be a foundation for future research of some other drugs and diseases.
To investigate racial/ethnic differences in acute asthma among adults presenting to the emergency department (ED), and to determine whether observed differences are attributable to socioeconomic status (SES).
Prospective cohort studies performed during 1996 to 1998 by the Multicenter Airway Research Collaboration. Using a standardized protocol, researchers provided 24-h coverage for a median duration of 2 weeks per year. Adults with acute asthma were interviewed in the ED and by telephone 2 weeks after hospital discharge.
Sixty-four North American EDs.
A total of 1,847 patients were enrolled into the study. Black and Hispanic asthma patients had a history of more hospitalizations than did whites (ever-hospitalized patients: black, 66%; Hispanic, 63%; white, 54%; p
The APHEA 2 project investigated short-term health effects of particles in eight European cities. In each city associations between particles with an aerodynamic diameter of less than 10 microm (PM(10)) and black smoke and daily counts of emergency hospital admissions for asthma (0-14 and 15-64 yr), chronic obstructive pulmonary disease (COPD), and all-respiratory disease (65+ yr) controlling for environmental factors and temporal patterns were investigated. Summary PM(10) effect estimates (percentage change in mean number of daily admissions per 10 microg/m(3) increase) were asthma (0-14 yr) 1.2% (95% CI: 0.2, 2.3), asthma (15-64 yr) 1.1% (0.3, 1.8), and COPD plus asthma and all-respiratory (65+ yr) 1.0% (0.4, 1.5) and 0.9% (0.6, 1.3). The combined estimates for Black Smoke tended to be smaller and less precisely estimated than for PM(10). Variability in the sizes of the PM(10) effect estimates between cities was also investigated. In the 65+ groups PM(10) estimates were positively associated with annual mean concentrations of ozone in the cities. For asthma admissions (0-14 yr) a number of city-specific factors, including smoking prevalence, explained some of their variability. This study confirms that particle concentrations in European cities are positively associated with increased numbers of admissions for respiratory diseases and that some of the variation in PM(10) effect estimates between cities can be explained by city characteristics.
The objective of the study was to evaluate the risk of asthma in children who had undergone an adenoidectomy, an operation frequently performed on children with glue ear or recurrent otitis media. Two surveys were carried out, a nation-wide questionnaire returned by 483 individuals (survey A) and a survey of hospital discharge records involving 1616 children who had undergone an adenoidectomy and 161 control children who had undergone probing of the nasolacrimal duct due to congenital obstruction (survey B). The questionnaire (survey A) showed that an adenoidectomy before the age of 4 years was associated with asthma (OR 3.19, 95% CI 1.25; 8.13) and with allergy to animal dust (OR 2.50, 95% CI 1.27; 4.95). In survey B, asthma diagnosis was retrieved from the national asthma register. It showed also that adenoidectomy at an early age was associated with an increased risk of asthma (OR 6.74, 95% CI 2.99; 15.2). There was an association between asthma and adenoidectomy, even before adenoidectomy had actually been performed. The risk of asthma was highest among children who had had adenoidectomy because of recurrent otitis media. The observed association between an adenoidectomy and asthma may be explained by an underlying factor predisposing to both recurrent otitis media and asthma.
Asthma risk is increased after bronchiolitis in infancy. Recent studies have suggested that the risk may be dependent on the causative virus. The aim of the study was to evaluate the asthma risk in adolescence in subjects hospitalized for rhinovirus or respiratory syncytial virus (RSV) bronchiolitis in infancy.
At the median age of 16.5 years, a questionnaire was sent to 96 study subjects hospitalized for bronchiolitis at
AIM: This paper is a report of a study to determine the demographic, personal, interpersonal and illness factors associated with asthma quality of life (QOL), as self-reported by adolescents from the United States of America (USA) and Iceland. BACKGROUND: Asthma affects 12% of children in the USA and an estimated 9% in Iceland. Limited research has addressed asthma QOL for adolescents. METHODS: This cross-sectional exploratory study included adolescents with asthma (n = 15 from the USA; n = 15 from Iceland), aged 13-17 years, primarily recruited from paediatric practices in central Kentucky, USA and Reykjavik, Iceland. Data were collected in 2006. Adolescents in the USA (47% male) had a mean age of 14.1 years (sd = 1.5); Icelandic adolescents (73% male) had a mean age of 15.1 years (sd = 1.4). Participants completed questionnaires measuring sociodemographic and asthma characteristics, degree of limitations due to asthma, self-rated health, depressive symptoms and asthma QOL. Multiple regression was used to determine predictors of asthma QOL. RESULTS: Gender was statistically significantly associated with QOL. The difference in QOL between adolescents in the USA and Iceland was not statistically significant. Statistically significant predictors of higher asthma QOL were a better rating of overall health (P
Recent studies have stressed the influence of other viruses than respiratory syncytial virus (RSV) in the development of asthma in later childhood after bronchiolitis in infancy. However, the virus-specific prognosis until adulthood has remained obscure, due to lack of sufficiently long follow-up studies. The aim of the present study was to evaluate adult respiratory morbidity after bronchiolitis in infancy, focused on cases not caused by RSV.
A total of 54 children hospitalized for bronchiolitis at age
Adult asthma and traffic exposure at residential address, workplace address, and self-reported daily time outdoor in traffic: A two-stage case-control study.
Most epidemiologic studies use traffic at residential address as a surrogate for total traffic exposure when investigating effects of traffic on respiratory health. This study used GIS (Geographical Information Systems) to estimate traffic exposure, not only on residential, but also on workplace address, in addition to survey questions on time spent in traffic during commuting or other daily activities.The aim was to investigate 1) if there is an association between traffic exposure and prevalence of adult asthma and asthma symptoms, and 2) if so, does this association become stronger using more complete traffic exposure information.
This study was conducted in two stages: A first cross-sectional survey in Southern Sweden 2004 (n = 24819, 18-80 years, response rate 59%) was followed by a case-control study in 2005 to obtain more detailed exposure and confounder information (n = 2856, asthmatics and controls (1:3), 86% response rate). In the first survey, only residential address was known. In the second survey, questions about workplace addresses and daily time spent in traffic were also included. Residential and workplace addresses were geocoded and linked with GIS to road data and dispersion modelled outdoor concentrations of NOx (annual mean, 250 × 250 m resolution).
Living within 50 m of a road (measured by GIS) with traffic intensity of >10 cars/minute (compared with no road within this distance) was associated with an increased prevalence of asthma, (OR = 1.8, 95% CI = (1.1-2.8), and with asthma symptoms last 12 months. No statistically significant effects were seen for traffic exposure at workplace address, daily time spent in traffic, or commuting time to work, after adjustment for confounders. A combined total exposure estimate did not give a stronger association with asthma prevalence or asthma symptoms.
Traffic exposure at close proximity to residential address showed association with asthma prevalence and asthma symptoms last 12 months, among adults in southern Sweden. The associations were not stronger when accounting for total traffic exposure. This could reflect exposure misclassfication at workplace address and for other daily time in traffic, but also that residential address remains the main determinant for traffic exposure among adults.
Notes
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