Acute lower respiratory disease.
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Disease↗
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[Influence of atmospheric contamination on respiratory diseases].
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Air Pollution↗
[Fungi of the upper respiratory tract and the incidence of chronic respiratory diseases in workers of gypsum industry. I].
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Candida↗
Modern trends in the surgery of respiratory disease.
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Humans↗
Respiratory symptoms and FEV1 as predictors of hospitalization and medication in the following 12 years due to respiratory disease.
The predictive value of cough, mucus hypersecretion, breathlessness, chronic bronchitis and forced expiratory volume in one second (FEV1) for hospitalization and medication were examined in a random population sample of 876 men, 46-69 yrs of age. All of the men were examined in 1974 with interview and lung function tests. Information on hospitalization in the period 1977-1986 was obtained from the Danish National Patient Register, and information on drug usage was obtained from 567 men in a questionnaire survey ultimo 1985. FEV1 was a strong predictor of both hospitalization and medication. Respiratory symptoms were good predictors of hospitalization due to either respiratory disease in general (odds ratios 2.56-3.29), or chronic obstructive pulmonary disease (COPD), (odds ratios 4.16-5.75). They contained predictive values in addition to that provided by FEV1. Respiratory symptoms were good predictors of medication for airway obstruction, relative risks 3.56-4.70, and/or airway disease in general, relative risks 2.67-4.69. After controlling for FEV1, cough was still significantly associated with treatment for airway disease in general and both cough, mucus hypersecretion and chronic bronchitis were significantly associated with treatment for airway obstruction. We conclude that apart from FEV1, respiratory symptoms are independent predictors of hospitalization and medication due to respiratory disease.
Aged↗
Influenza and other actue respiratory diseases in the Czech Socialist Republic, 1969-1974.
Since 1969, the incidence of acute respiratory diseases (ARD) in the Czech Socialist Republic of Czechoslovakia has been monitored by a special programme based on reports from 85 district epidemiological centres. In this paper, the incidence of ARD in three age groups, together with the incidence of complications and death rates, are presented for each season during the period 1969-1974. The significance of epidemiological observations and laboratory investigations relating to influenza and other ARD agents, such as parainfluenza viruses, adenoviruses, rhinoviruses, RS virus, coronaviruses, and Mycoplasma pneumoniae, is discussed.
Adolescent↗
Upper respiratory disease in deployed U.S. Navy shipboard personnel.
A study was conducted to determine the risk of upper respiratory disease among deployed U.S. Navy shipboard personnel. Between January and June 1989, a Patient Encounter Form was used to collect disease information from 10 U.S. Navy ships. Patients with a diagnosis of upper respiratory infection (URI) on initial sick-call visit were used in this study. Information on time spent in various ports and time at sea for each of the 10 ships was also collected. A classification scheme was developed to permit daily estimates of URI rates and to indicate whether the ship was in port or at sea. Of 967 cases of URI, 64.4% occurred while at sea, with an average daily rate of 0.5/1,000 crew members; 35.4% of the cases occurred while in port, with an average daily rate of 0.4/1,000 crew members. There was an increase in URI rates after 9 days at sea or in port. These data suggest that there are defined periods of increased transmission of upper respiratory infections aboard ships, both at sea and in port.
Humans↗
Respiratory disease in tungsten carbide production workers.
We carried out a medical and environmental survey to evaluate respiratory disease at two tungsten carbide (TC) production plants. The study population of 290 subjects (19.2 percent of the total work force) was chosen to focus on those with the greatest potential exposures to cobalt, a binding agent which is probably the cause of interstitial fibrosis and airways disease in TC workers. We found peak air concentrations of cobalt exceeding 500 micrograms/m3 during many major steps in TC production. Nine subjects at plant A and two at plant B had interstitial infiltrates. Two of these nine from plant A had restriction (total lung capacity less than 80 percent of predicted). A lung biopsy specimen in one showed interstitial fibrosis. Two nonsmokers at plant A and one nonsmoker at plant B had obstructive defects. These results suggest that interstitial and obstructive lung disease occur in TC workers in association with elevated peak air concentrations of cobalt.
Adult↗
[Safety of herbal medicinal drugs in acute respiratory diseases of children].
For children, the use of herbal medicinal drugs for treatment of acute respiratory diseases is widespread. After many decades or centuries of experience they are assumed to be safe, but the scientific proof is still rather weak for most of them. The few studies performed so far, are often not available, as they are usually not published in peer-reviewed journals. The postmarketing surveys and observational studies of recent years, which are presented in the following article, however, do not reveal any new unknown risk.
Acute Disease↗
Association of interleukin-8 with inflammatory and innate immune components in bronchoalveolar lavage of children with chronic respiratory diseases.
BACKGROUND: The host inflammatory response and innate immunity play a complex role in respiratory diseases. METHODS: We evaluated the levels of inflammatory mediators and antibacterial proteins in children who required bronchoscopy and bronchoalveolar lavage fluid (BALF) for clinical indications such as chronic tracheostomy (n=15) and chronic suppurative lung disease (n=8). RESULTS: Our results suggested the presence of interleukin-1beta (IL-1beta) and IL-8 as major inflammatory mediators in BALF samples. The level of the antibacterial protein sIgA was higher than lactoferrin and lysozyme. BALF IL-8 levels significantly correlated with the presence of IL-1beta, IL-6, IL-10, IL-16, sIgA and lysozyme. BALF IL-8 levels did not correlate with the levels of immunomodulatory and anti-inflammatory clara cell 10 kDa protein (CC10) or lactoferrin. CONCLUSION: This study suggests that patients with high levels of BALF IL-8 could potentially have high levels of IL-6, IL-10, IL-16, lysozyme and sIgA. Evaluating the inflammatory mediators (IL-8) in relation to other BALF protein components provides insight into understanding the role of inflammatory mediators in the regulation of host defense and the response to lung inflammation and injury.
Biomarkers↗
Epidemiology of chronic non-specific respiratory diseases.
The current state of research into the epidemiology of chronic non-specific respiratory diseases (CNSRD) is reviewed. Recommendations are made on the definitions of CNSRD for use in epidemiological studies, and various aspects of the etiology and natural history of CNSRD are identified as requiring further investigation. The need for standardization of investigative methods is emphasized. Since smoking is such an important factor in the etiology of CNSRD, it is recommended that efforts be made to discourage children from taking up the habit.
Chronic Disease↗
[Medical outcomes and antimicrobial compliance according to the Chilean Society of Respiratory Diseases guidelines for hospitalized patients with community acquired pneumonia].
BACKGROUND: The Chilean Society of Respiratory Diseases (SER) developed guidelines for the empirical treatment of community acquired pneumonia (CAP). AIM: To evaluate the degree of adherence to antibiotic treatment recommended by SER guidelines and its influence on medical outcomes. PATIENTS AND METHODS: We prospectively evaluated 453 consecutive immunocompetent adults (mean age +/- SD: 69 +/- 19 years) hospitalized for CAP. Patients were stratified according to the Pneumonia Severity Index (PSI), and initial antibiotic regimen was classified as being consistent or inconsistent with the SER guidelines. Rate of medical complications, switch therapy rate, length of stay (LOS), and 30 days mortality were compared between those treated consistently or inconsistently with the SER guidelines. RESULTS: Adherence to SER guidelines was 46%. Patients treated consistently with the SER guidelines were older (mean age +/- SD: 72 +/- 16 v/s 65 +/- 20 years), had more comorbidities (84 v/s 69%) and a higher proportion belonged to the high-risk PSI categories (69 v/s 49%). There were no significant differences in medical complication rate, switch therapy rate or LOS between both groups. Adherence to SER guidelines did not affect mortality after adjusting for PSI and for prognostic factors associated with 30 days mortality by multivariate analysis. CONCLUSIONS: The degree of adherence to antibiotic treatment recommended by SER guidelines was moderate and they were applied mainly in patients with high risk CAP. This fact can explain the lack of evidence of improved medical outcome in patients treated according to SER guidelines.
Adolescent↗
Evaluation of the ATS respiratory diseases questionnaire among French-speaking silicon carbide workers.
The American Thoracic Society (ATS) respiratory disease questionnaire for adults was translated by two fluently bilingual Quebec health professionals into simple, everyday French easily understood by an adult population of varying age and educational background. After independent assessment by professional translators, it was field-tested on 165 silicon carbide production workers. Responses to the ATS cough questions were significantly related to those obtained by a semiquantitative estimate of cough frequency. ATS questions on cough and phlegm were significantly associated with the physical sign of productive cough on request. A significant association was found between answers to questions on mild or moderate breathlessness and self-evaluation of breathing on a linear scale. Workers with cough, wheeze, or breathlessness had significantly lower percent-predicted FEV1, and FEV1 decreased as the severity of breathlessness increased. Highly significant, dose-dependent associations with current cigarette smoking habit were found for cough, phlegm and wheeze. Significant, dose-dependent associations with phlegm, wheeze and mild breathlessness also occurred with exposure to sulfur dioxide. All of these relationships are similar to findings from studies of English-speaking populations. Minor problems with the original English ATS questionnaire were discovered on translation, and suggestions for improvements were made. Preliminary experience with this French translation suggests that it is a useful, comparable version of the English ATS questionnaire.
Adult↗
Mortality from non-malignant respiratory disease in the fibreglass manufacturing industry.
OBJECTIVES: To investigate the question of whether there is an association between workplace exposures and sociodemographic factors and mortality from non-malignant respiratory disease excluding influenza and pneumonia (NMRDxIP) among workers in a fibreglass wool manufacturing facility. METHODS: A case-control study with cases and controls derived from deaths recorded from the Kansas City plant in the Owens Corning mortality surveillance system. The cases are defined as decedents with NMRDxIP as the underlying cause of death. Matched, unadjusted odds ratios (ORs) were used to assess any association between NMRDxIP and cumulative exposure history and sociodemographic factors individually. Matched, adjusted ORs were obtained by conditional logistic regression to estimate the effect of any one variable while controlling for the effect of all the others. RESULTS: Results of the unadjusted analysis, considering variables one at a time, yielded no significant associations between NMRDxIP and any of the exposure or sociodemographic variables. The smoking OR was substantially increased (OR 5.09; 95%CI 0.65 to undeterimed). Also, there were no significant variables in a conditional logistic regression analysis in which all variables were simultaneously adjusted. ORs for respirable glass fibres were below unity at all concentrations of exposure in the adjusted analysis. For respirable silica there was no consistent relation across all exposure levels. The ORs increased through the first three exposure concentrations but decreased for the highest exposure. However, ORs although not significant, are greater than unity for all respirable concentrations of silica exposure. CONCLUSIONS: The findings for Kansas City show no association between respirable glass fibres and NMRDxIP. The adjusted ORs for all exposures to respirable fibres were less than unity. On the other hand, the ORs for silica exposures were all above unity although there was no clear dose-response relation and none of the ORs were significant. Exposures for all substances considered were very low. Further, given the number of cases and controls, the statistical power to detect relatively small increases in risk, if any increase truly exited, was relatively low. The ORs for exposures to silica were all above unity although there was no clear dose-response relation and none of the ORs were significant. These raised ORs for silica suggest that continued surveillance would be prudent.
Asbestos↗
[Respiratory diseases in European farmers-II. Part of the European farmers' project].
BACKGROUND: The aim of the European Farmers' Project was to estimate the prevalence of respiratory diseases in farmers across Europe. Furthermore, risk factors for respiratory symptoms in different parts of agricultural production should be assessed. METHODS: In the first part of the study, 7496 farmers from four European countries answered a written questionaire. Of these, 229 were visited at their farms in the second part of the survey. On site, spirometry, allergy tests, as well exposure measurements were performed. RESULTS: Farmers with animal production had a significantly lower prevalence of allergic diseases than the general population. In contrast, the prevalence of chronic phlegm was higher in animal farmers. Organic dust toxic syndrome (ODTS) was a major predictor of chronic bronchitis. It was indicated that allergens found in the working environment could be transfered to the living environment of the farmer. Poor ventilation as well as high temperatures inside the animal buildings were shown to have a negative impact on respiratory symptoms and lung function parameters. CONCLUSION: Animal farmers are at high risk of chronic bronchitis. Intervention studies on the efficacy of different types of ventilation are now warranted. Furthermore, prospective studies on the associaton between ODTS and COPD should be done.
Adult↗
Risks of respiratory disease in the heavy clay industry.
OBJECTIVES: Little information is available on the quantitative risks of respiratory disease from quartz in airborne dust in the heavy clay industry. Available evidence suggested that these risks might be low, possibly because of the presence in the dust of other minerals, such as illite and kaolinite, which may reduce the harmful effects of quartz. The aims of the present cross sectional study were to determine among workers in the industry (a) their current and cumulative exposures to respirable mixed dust and quartz; (b) the frequencies of chest radiographic abnormalities and respiratory symptoms; (c) the relations between cumulative exposure to respirable dust and quartz, and risks of radiographic abnormality and respiratory symptoms. METHODS: Factories were chosen where the type of process had changed as little as possible during recent decades. 18 were selected in England and Scotland, ranging in size from 35 to 582 employees, representing all the main types of raw material, end product, kilns, and processes in the manufacture of bricks, pipes, and tiles but excluding refractory products. Weights of respirable dust and quartz in more than 1400 personal dust samples, and site histories, were used to derive occupational groups characterised by their levels of exposure to dust and quartz. Full size chest radiographs, respiratory symptoms, smoking, and occupational history questionnaires were administered to current workers at each factory. Exposure-response relations were examined for radiographic abnormalities (dust and quartz) and respiratory symptoms (dust only). RESULTS: Respirable dust and quartz concentrations ranged from means of 0.4 and 0.04 mg.m-3 for non-process workers to 10.0 and 0.62 mg.m-3 for kiln demolition workers respectively. Although 97% of all quartz concentrations were below the maximum exposure limit of 0.4 mg.m-3, 10% were greater than this among the groups of workers exposed to most dust. Cumulative exposure calculations for dust and quartz took account of changes of occupational group, factory, and kiln type at study and non-study sites. Because of the importance of changes of kiln type additional weighting factors were applied to concentrations of dust and quartz during previous employment at factories that used certain types of kiln. 85% (1934 employees) of the identified workforce attended the medical surveys. The frequency of small opacities in the chest radiograph, category > or = 1/0, was 1.4% (median reading) and seven of these 25 men had category > or = 2/1. Chronic bronchitis was reported by 14.2% of the workforce and breathlessness, when walking with someone of their own age, by 4.4%. Risks of having category > or = 0/1 small opacities differed by site and were also influenced by age, smoking, and lifetime cumulative exposure to respirable dust and quartz. Although exposures to dust and to quartz were highly correlated, the evidence suggested that radiological abnormality was associated with quartz rather than dust. A doubling of cumulative quartz exposure increased the risk of having category > or = 0/1 by a factor of 1.33. Both chronic bronchitis and breathlessness were significantly related to dust exposure. CONCLUSIONS: Although most quartz concentrations at the time of this study were currently below regulatory limits in the heavy clay industry, high exposures regularly occurred in specific processes and occasionally among most occupational groups. However, there are small risks of pneumoconiosis and respiratory symptoms in the industry, although frequency of pneumoconiosis is low in comparison to other quartz exposed workers.
Adolescent↗
[Chronic non-specific respiratory disease with reference to 926 cases].
This study has been compiled from the hospital records of 926 patients with chronic non-specific respiratory disease, i.e. asthma, chronic bronchitis and emphysema. The aims of the study were to ascertain the role of age, allergy, family history, cigarette smoking, social class and occupation in the genesis of these diseases, and to investigate aggravating factors and the morbidity associated with these diseases. Asthma was found to occur in the younger age groups, allergy and family history being the outstanding aetiological factors in this disease. In chronic bronchitis the age factor is not decisive, and the influence of allergy, family history and the smoking of cigarettes is evenly distributed. Emphysema occurs mainly in later life, although 2 cases of younger onset with alpha1-antitrypsin deficiency were noted. In this disease, allergy and family history appear to be of lesser aetiological importance than the smoking of cigarettes. The majority of patients in all diagnostic categories fell into social group III (skilled workers) and most did work not associated with dust. In each diagnostic category, a certain number of patients were found in whom the factors of allergy, family history, cigarette smoking and general atmospheric pollution did not play a part. In these patients the possible role of the microclimate at the place of work is emphasised and warrants further study. The high prevalence, especially of asthma and chronic bronchitis, among housewives is stressed. Aggravating factors, i.e. humidity, irritating substances, temperature variations, dust, and type and locality of work, are shown to influence the symptomatology of asthma, bronchitis and emphysema. These diseases have a high associated morbidity, resulting in the loss of working days and in early retirement for the sufferers.
Absenteeism↗
[Passive smoking and respiratory diseases. Current data].
Smoking is now unanimously recognised as a pathological factor and a major carcinogen. It is estimated that it is responsible for around 10% of the overall mortality in France or more than 50,000 deaths per year and in the United States for around 15% of the overall mortality or 300,000 deaths per year. There has been recent evidence that the risk linked to the inhalation of tobacco smoke does not appear only in active smokers, but also in all subjects who are involuntarily exposed to tobacco smoke. We have here planned a general review of the epidemiological studies which have looked for an association between passive exposure to tobacco and respiratory disease. In children, an increase in symptoms and respiratory infections has been observed, as well as a slowing down in pulmonary growth. In adults the effect of involuntary exposure to tobacco smoke seems above all to be carcinogenic. It is estimated that there is a 25% increase in the risk of bronchial cancer in a non smoker married to a smoker when compared to the risk observed in a non exposed non smoker. Thus the disastrous effect of smoking appears without any threshold.
Adult↗