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Biomedical subjects

F Kauffmann

Publications and source records attributed to F Kauffmann.

At least 55 records · Page 3Linked to original sources

Occupational exposures estimated by means of job exposure matrices in relation to lung function in the PAARC survey.

OBJECTIVES: The aim of this analysis of the French Cooperative PAARC (Pollution Atmosphérique et Affections Respiratoires Chroniques) survey, was to test whether occupational exposures to dusts, gases, or chemical fumes or to specific hazards, estimated by job exposure matrices, were related to a decrease in forced expiratory volume in one second (FEV1). METHODS: The most recent occupation was recorded in adults, aged 25-59, from non-manual worker households. Analysis was restricted to 10,046 subjects whose occupation was encountered at least 10 times in the study and who performed good FEV1 tracings. From occupational title, exposures to dusts, gases, and chemical fumes, and to specific hazards were classified in three categories (no, low, and high) with a British, a French, and an Italian job exposure matrix. Specific hazards were analysed for the British and French job exposure matrices for the same 42 specific dusts, gases, and chemical fumes. To limit spurious associations, a selection of seven hazard groups and 12 specific hazards was set before the start of the analysis. Based on the consistency of the relations according to sex and the British and French job exposure matrices, associations of age, height, city, and smoking adjusted FEV1 score with occupational exposures were classified as very likely, possible, or unlikely. RESULTS: For the three job exposure matrices and both sexes clear exposure-response relations between the level of exposure to dusts, gases, and chemical fumes, and a decrease in FEV1 were found. Associations with FEV1 were classified as very likely for known hazards such as organic dusts and textile dusts, and not previously recognised hazards such as polycyclic aromatic hydrocarbons (PAHs) and detergents, and as possible for solvents, waxes and polishes, and diesel fumes. Associations found for PAHs and solvents were confirmed by the Italian job exposure matrix. Associations remained significant in women, but not in men, after adjustment for educational level. CONCLUSIONS: Hypotheses have been generated for exposure to detergents, PAHs, and solvents, but they need to be interpreted with caution before replication. Significant associations found for known risk factors with a decrease in FEV1 are arguments for the validity of the matrices. Despite the expected limitations of job exposure matrices, these results encourage further work to improve exposure assessment by job exposure matrices.

Adult↗

Longitudinal observations of serum IgE and skin prick test response.

The objective of the study was to assess skin prick test and IgE changes in a working population surveyed 5 yr apart and to determine whether age and smoking habits modify these changes. SPTs were performed on 223 subjects by the same method and common allergens (a mixture of grass pollens and a mixture of 95% house dust and 5% house dust mite). IgE measurements were done in duplicate by the same technique at each survey. A SPT-positive response at the first survey was highly predictive of a positive value at the second survey. The prevalence of positive SPT significantly increased in 5 yr (from 17.5 to 24.7%). A strong correlation was observed between IgE levels 5 yr apart (r = 0.92), and the IgE level appeared very stable. The initial IgE level was significantly greater among the converters than in consistently negative subjects (92.3 versus 30.1 IU/ml). Conversely, the initial IgE level was lower for the reverters than in consistently positive subjects (36.8 versus 97.0 IU/ml). In SPT negatives, non- and exsmokers had a greater decrease in IgE than current smokers (p = 0.06). IgE level appears to be a good predictor of SPT changes for both conversion and reversion. The IgE level appears very stable in midadulthood, which suggests that the adult environment may play a small effect in IgE level.

Adult↗

Heart rate variability during sleep in infants with bronchopulmonary dysplasia. Effects of mild decrease in oxygen saturation.

We sought to determine whether abnormal heart rate modulation by the autonomic nervous system occurs in patients with severe bronchopulmonary dysplasia (BPD) in relation to sleep stages and mild changes in arterial oxygen saturation SaO2. On 10 oxygen-dependent 7- to 29-month-old infants with BPD, polygraphic recordings, including heart and respiratory rate and body movement detection, were performed. Heart rate variability was evaluated in high (HF), mid, and low (LF) frequency bands. Parameters were analyzed in two ranges of SaO2: normal range, (SaO2 greater than 95%), and mild decrease in (SaO2, values of 90 to 94%). In contrast to what is normally observed, LF at normal SaO2 was less marked in rapid eye movement, (REM) sleep than in non-rapid eye movement (NREM) sleep stage 2. A mild decrease in SaO2, as compared with a normal SaO2 value, was associated with: (1) a heart and respiratory rate acceleration, (2) a decrease in HF in REM sleep (p < 0.02); (3) an increase in LF in NREM sleep stage 2 (p < 0.02), intensifying the change observed in a normal SaO2 level. These data show that a mild decrease in SaO2 increases modifications of autonomic control observed in infants with severe BPD.

Bronchopulmonary Dysplasia↗

[Smoking by the 11-16 years old in the Yvelines department in 1990].

Smoking and its risk factors were studied in 1990 on a representative sample of 2,514 pupils in Yvelines by auto-questionnaire. A similar enquiry had been carried out in 1983 with the same methodology. It was noted that between 1983 and 1990, there was a diminution in the prevalence of smoking from 15.4 to 7.6 per cent in the young in Yvelines. Amongst those young people of French nationality, the prevalence of smoking passed from 16 to 9 per cent in boys and from 17 to 12 per cent in girls aged between 11 and 16. This diminution of prevalence affected both brothers, sisters, and best friends whether male or female. The proportion of youth who had never smoked was significantly increased. In 1990, age and smoking habits of best male or female friend had a relationship which was independent of other factors with smoking in the two sexes. In girls, religious practice and (just within the limits of significance) the attitude of parents, and in boys the absence of one parent from the home, were also linked to smoking habits. The evolution of risk factors was discussed, particularly comparing the two studies of 1983 and 1990. All health education should take account of the phenomenon of "youth groups" as initiation occurs early, health education should be made early, at primary school level.

Adolescent↗

Heart rate and heart rate variability during sleep in small-for-gestational age newborns.

To assess the influence of intrauterine growth retardation on heart rate (HR) and HR variability during sleep, we performed polygraphic recordings in 10 small-for-gestational age (SGA) and 16 appropriate-for-gestational age (AGA) newborns. Both groups were clinically and neurologically normal and were at 37 to 41 wk conceptional age. RR intervals were analyzed using the short-time Fourier transform in three frequency bands: 1) high frequency, with a period 3-8 heartbeat; 2) mid frequency, with a period 10-25 heartbeat; and 3) low frequency, with a period 30-100 heartbeat. In both active and quiet sleep, SGA newborns significantly differed from AGA newborns by having a shorter RR interval (p < 0.01) and lower amplitude of HR variability in all bands (p < 0.05) except low frequency in quiet sleep. Quiet sleep differed from active sleep by having a longer RR interval (p < 0.05), higher high-frequency variability (p < 0.02) in both SGA and AGA newborns, and lower low-frequency variability (p < 0.005 for AGA newborns). Our data give evidence of clear modifications of both sympathetic and parasympathetic HR control in the at-risk SGA population. Similarity of between-state characteristics suggests maintained CNS control of HR in SGA as well as in AGA newborns. We speculate that between-group HR and HR variability differences may be related to augmented metabolic rate in SGA compared with AGA newborns.

Basal Metabolism↗

Heart-rate variability in low-risk prematurely born infants reaching normal term: a comparison with full-term newborns.

To investigate the influence of prematurity and postnatal age on the maturation of the autonomic nervous system function, we analysed heart-rate and heart-rate variability in twelve prematurely born infants (< 37 weeks gestational age) reaching the conceptional age of 37-41 weeks. These neonates were compared with sixteen 37-41 week conceptional age newborns (< 10 days postnatal age). Heart-rate variability was analysed by spectral analysis of interbeat intervals using Short-Time Fourier Transform. We found that during both active and quiet sleep, the durations of RR-intervals were shorter and the amplitude of heart-rate variability in different frequency bands was lower in prematures reaching term than in newborns of the same conceptional age (P < 0.001). Between-state comparison showed differences in both groups. In both groups, low-frequency heart-rate variability was higher in active sleep than in quiet sleep. Between-state differences of RR-intervals and high-frequency heart-rate variability were present only in newborns (P < 0.01). Discrimination between newborns and prematures reaching term, based on RR-intervals and heart-rate variability, was correct in both sleep states with errors between 7 to 16%. However, in both newborns and prematures reaching term, between-state discrimination showed less reliable results, especially for quiet sleep discrimination with 24% (in PRT) and 20% (in NB) of errors. Our results, especially information given by factor analysis, suggest that the differences between newborns and prematures reaching term, concerning RR-interval and heart-rate variability, may be related to a changed balance between the sympathetic and parasympathetic nervous systems with a diminished parasympathetic component of heart rate control in prematures reaching term, as compared to newborns.

Discriminant Analysis↗

Sleep, snoring and smoking in high school students.

The relationship between snoring, sleep and smoking was investigated in young students from a survey by self-administered questionnaire on sleep habits, conducted in high schools in the educational district of Lyons (France). Our sample consisted of 11,417 boys and 13,265 girls between 15 and 20 years of age. We found that 28.4% of girls and 38.8% of boys reported that they snored. In both sexes, snoring was associated with short (<7 h) and long (>10 h) sleep length, nocturnal awakenings and daytime sleepiness. Smoking was a risk factor for snoring. Multiple logistic regression showed that the odds-ratio for habitual snoring increased when tobacco consumption increased from a 1.30 (moderate smokers) to 2.26 (heavy smokers) in girls and from 1.38 to 2.09 in boys. This dose-effect relationship between smoking and snoring suggests that a substantial proportion of snoring cases is attributable to tobacco consumption in young students.

Journal Article↗

Heart rate variability in normal sleeping full-term and preterm neonates.

To assess maturation of the Autonomic Nervous System (ANS) and sleep states, Heart Rate Variability (HRV) was studied in 24 healthy sleeping newborns, aged from 31 to 41 weeks, conceptional age (CA). Spectral analysis of the interbeat interval (RR) signal, was performed by Short-Time Fourier Transform, in three frequency bands: high (HF), of purely vagal origin, mid (MF), and low (LF), vagal and sympathetic, thus allowing evaluation of both branches of the ANS, observed in Active Sleep (AS = REM Sleep) and in Quiet Sleep (QS = nREM Sleep). Principal Component Analysis, Discriminant Analysis, and hypothesis tests were used to investigate the evolution of spectral variables and their relation with sleep states. HF, MF, LF, and mean RR all increased with age; the differences from the premature to the full-term group, were more marked, as a whole, in AS than in QS. HF showed the highest increase from the premature (31-36 weeks CA) to the intermediate (37-38) group, whereas LF showed equal differences from the premature to the intermediate, and from the intermediate to the full-term (39-41) groups. These results suggest a steep increase in vagal tone at 37-38 weeks CA, with stability afterwards, and a more regular increase in sympathetic tone from 31 to 41 weeks CA.

Analysis of Variance↗

Personal factors related to the perception of occupational exposure: an application of a job exposure matrix.

Whether certain personal characteristics influence the perception of exposure to dusts, gases or fumes was assessed in 6803 men and 6765 women drawn from nonmanual worker households in seven French cities. Factors modifying the strength of the association between two estimates of exposure (here a job exposure matrix estimate and exposure reported by the subjects) are potential recall determinants of exposure. This association was significantly stronger in men than in women, suggesting a better perception of exposure in men. The strength of the association between both estimates of exposure increased significantly among men according to educational level. Smoking habits had no effect on the perception of exposure. The perception of exposure did not vary significantly according to respiratory symptoms in women. In men, subjects without chronic cough or chronic bronchitis had a significantly higher perception of exposure than the others, but no difference was shown for wheezing, dyspnoea or asthma.

Adult↗

Relation of serum elastin peptide concentration to age, FEV1, smoking habits, alcohol consumption, and protease inhibitor phenotype: an epidemiological study in working men.

BACKGROUND: In clinical investigations elastin peptide concentration has been proposed as one potential marker of lung elastin degradation. No epidemiological study has yet confirmed this hypothesis. METHODS: The relation of elastin peptide concentration to some factors closely related to pulmonary emphysema (age, smoking habits, FEV1 alpha protease inhibitor (PI) phenotype) and to alcohol consumption was examined in an epidemiological study of 310 working men. The elastin peptides used for obtaining antibodies and as reference in an ELISA assay were prepared from chemically hydrolysed elastin. RESULTS: The elastin peptide concentration significantly decreased with age from 2.92 (1.54) micrograms/ml among subjects younger than 30 years to 2.18 (1.14) micrograms/ml among subjects older than 50. Elastin peptide concentration did not differ with smoking habits and was clearly unrelated to FEV1. A lower elastin peptide concentration was observed in all groups of subjects with a protease inhibitor phenotype other than PI MM (PI FM, IM, MP, MS, MZ, and S phenotypes). CONCLUSIONS: The results cast doubts on the usefulness of the elastin peptide concentration as a marker of lung destruction in middle aged, predominantly healthy men. Blood elastin peptide concentration may reflect both elastin degradation and resynthesis. The results of this analysis suggest that several factors (age, alcohol consumption, non-PI MM phenotype) may be associated with decreased resynthesis of lung elastin. Further studies, conducted in various age groups and including estimates of the degree of lung destruction, are needed to unravel the mechanisms underlying lysis and resynthesis of lung elastin.

Adult↗

Frequency and correlates of the saw-tooth pattern of flow-volume curves in an epidemiological survey.

The object of this report was to assess the possibility of identifying saw-tooth patterns on flow-volume curves in men aged 28 to 58 years. We studied the frequency of these patterns and their relationships with two indirect signs of UAO increase in FEV1/PEF and FEF50%/FIF50% ratios--as well as with clinical and functional data. Twenty-six of the 360 subjects surveyed, ie, 7.2 percent, had flow oscillations in the inspiratory and/or expiratory part of flow-volume curves, corresponding to the definition of the saw-tooth pattern. We observed significant relationships between the saw-tooth pattern and the mean FEV1/PEF ratio. In 97 subjects, the proportion of those with saw-tooth patterns was 13.4 percent, and the mean FEF50%/FIF50% ratio was 1.53 in those with the pattern vs 1.07 in those without it. These results show that the saw-tooth pattern was not rare in these men.

Adult↗

Total circulating IgE and FEV1 in adult men. An epidemiologic longitudinal study.

Epidemiologic data relating total circulating immunoglobulin E (IgE), an objective marker of allergy, to cross-sectional and longitudinal FEV1 as well as to methacholine bronchial hyperresponsiveness were obtained from 310 French adult men surveyed five years apart. Skin prick test responses to common aeroallergens, IgE level, and bronchial hyperresponsiveness were assessed at the end of the follow-up. IgE level was not associated with PD20 to methacholine. Cross-sectionally, age and height-adjusted FEV1 score was inversely related to total IgE level (regression coefficient of FEV1 score on Log[IgE] beta = -.20; p = 0.02). Stratified analysis showed that IgE level was associated with FEV1 score only in nonsmokers (beta = -0.52; p less than 0.001), an association that remained after exclusion of asthmatics. Longitudinally, five-year FEV1 decline was related to IgE in nonsmokers (regression coefficient of FEV1 decline on Log[IgE] beta = 19.9; p = 0.03) and exsmokers (beta = 18.9; p = 0.06) but not in current smokers. The relationship persisted, even if with lesser significance, among exsmokers after exclusion of asthmatics (beta = 17.2) and further exclusion of skin prick test-positive men (beta = 18.8). Whether IgE production also reflects factors other than allergy, possibly nonallergic inflammation, needs further investigations.

Adult↗

Relationship of upper airways disorders to FEV1 and bronchial hyperresponsiveness in an epidemiological study.

Associations of upper airways disorders (UAD) with forced expiratory volume in one second (FEV1) and bronchial methacholine response were studied, taking smoking habits into account. We used epidemiological data drawn from a population of 324 men, aged 27-58 yrs. Lower FEV1 level was related to hay fever (p = 0.01), usual (p = 0.01) and chronic (p = 0.02) rhinitis and common cold on the day of examination (p = 0.04). Allowance for the major potential confounding factor, tobacco smoking, showed similar results. Bronchial methacholine response was heightened in men reporting hay fever compared to those without (p = 0.01) but also in men reporting chronic rhinitis (p = 0.06), a group which did not exhibit skin prick test positivity more often than other subjects. Exclusion of asthmatics and taking into account smoking and skin prick test positivity yielded mostly similar results. Our data support the hypothesis of an association between lung impairment, as assessed by lower FEV1 and bronchial hyperresponsiveness to methacholine, and different types of UAD, allergic or not.

Adult↗

In utero exposure to parental smoking, cotinine measurements, and cord blood IgE.

The relationship between parental smoking and cord blood IgE has been studied in a survey conducted in 99 unselected newborn infants with a sensitive tests for IgE and cotinine as a biologic marker to validate smoking data. For both cord blood cotinine and maternal urine continine creatinine ratio (CCR), significantly higher levels were observed for smokers compared to nonsmokers. Furthermore, among nonsmokers, passive smokers had significantly higher cotinine levels than true nonsmokers, which demonstrates that cord blood may be used to assess active as well as passive maternal smoking. No association was observed in this study between cord blood IgE and maternal smoking assessed by questionnaire (geometric means of cord blood IgE levels were 0.11 IU/ml for newborn infants of smoking mothers and 0.12 IU/ml for newborn infants of nonsmoking mothers). The same observations were drawn from the analysis of cord blood IgE and cotinine levels, with correlation coefficients of -0.005 for cord blood CCR and 0.003 for maternal CCR. Additional studies are needed to determine whether maternal smoking is causally related to cord blood IgE and by which mechanisms.

Cotinine↗