Biomedical subjects

Edward L Petsonk

Publications and source records attributed to Edward L Petsonk.

8 recordsLinked to original sources

PubMed2006

Case definitions for chronic obstructive pulmonary disease.

The objective of this study was to evaluate the definitions for classification of chronic obstructive pulmonary disease (COPD) recommended by the American Thoracic Society (ATS) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Using data from the U.S. population-based third National Health and Nutrition Examination Survey (NHANES III), we compared the number of individuals in the U.S. population who met definitions of airflow obstruction based on the fixed ratio of FEV /FVC < 0.70 criterion and on the ATS lower 95% confidence limit (lower limits of normal LLN) criterion. Further, we evaluated the definitions in the context of physician-diagnosed obstructive airways diseases and respiratory symptoms. In comparison to the FEV1/FVC < LLN and FEV1 < 100% predicted definition, the fixed ratio-based definition for mild COPD underestimates airflow obstruction by 29% in 20-49-year-olds and overestimates it by 58% in 50-80-year-olds. In comparison to the FEV1/FVC < LLN and FEV1 < LLN definition, the fixed ratio-based definition for moderate COPD underestimates airflow obstruction by 31% in 20-49-year-olds and overestimates it by 37% in 50-80 year olds. Based on our estimation, approximately 0.9 million (26%) of symptomatic individuals out of the 3.6 million U.S. adults aged 20-49 years who have airflow obstruction (FEV1/FVC < LLN and FEV1 < LLN definition) may have undiagnosed respiratory disease. In conclusion, using the FEV1/FVC < 0.70 criterion will substantially under-diagnose airway obstruction in younger individuals and substantially over-diagnose COPD in older individuals.

Adult↗

PubMed2006

Longitudinal limits of normal decline in lung function in an individual.

OBJECTIVES: The objectives of this study were to propose a method of calculating longitudinal limits of normal decline (LND) in forced expiratory volume in 1 second to identify individuals with an excessive decline in lung function and to compare the method with other published LND methods. METHODS: We used longitudinal data from 11 workplace-based spirometric monitoring programs conducted from 1987 to 2001 on 12,729 workers to evaluate effectiveness of each LND method in identifying a "true" excessive decline in forced expiratory volume in 1 second defined using two criteria: slope >60 mL/year or >90 mL/year estimated over 5 or more years of follow up. RESULTS: In comparison to the LND proposed by the American College of Occupational and Environmental Medicine, the proposed method had 5.0 to 2.7 times higher sensitivity over years 1 through 5 for the >60-mL/yr criterion. CONCLUSIONS: The proposed LND method was more effective than the other methods for identifying excessive declines.

Adult↗

PubMed2006

Interpreting periodic lung function tests in individuals: the relationship between 1- to 5-year and long-term FEV1 changes.

STUDY OBJECTIVE: Spirometry is performed to monitor lung health, but variability between tests can hinder recognition of excessive FEV(1) declines. We sought to describe the relationship between FEV(1) changes over 1 to 5 years and FEV(1) declines over longer terms, using 21,821 test results from 1,884 workers who participated in an annual health monitoring program at a chemical plant between 1973 and 2003. METHODS: Test results from workers with five or more valid results over > or = 10 years were included in our analysis (mean initial worker age, 35 years; range, 18 to 62 years; 91% male; 35% current smokers and 41% nonsmokers). For each worker, long-term FEV(1) slopes (milliliters per year) were calculated by simple linear regression using all available results and compared to changes in FEV(1) between two tests over 1 to 5 years, expressed in both milliliters and percentage of initial value. RESULTS: Long-term (mean, 18 years; range, 10 to 30 years) slopes averaged - 29.1 mL/yr (- 27, - 29, and - 37 mL/yr for male never-smokers, former smokers, and current smokers, and - 20, - 26, and - 27 mL/yr for female never-smokers, former smokers, and current smokers, respectively). Excessive short-term and long-term declines were defined by lower fifth percentile values. Individuals with abnormal short-term declines were found to be 3 to 18 times more likely to ultimately show excessive long-term declines; with the strength of the association increasing with the length of the short-term testing interval. Better test operating characteristics resulted if abnormal short-term FEV(1) change was based on percentage change (ie, percentage per year) rather than absolute change (ie, milliliters per year). CONCLUSIONS: Our findings provide guidance for interpreting periodic spirometry results from individuals exposed to respiratory hazards.

Adolescent↗

PubMed2005

[Early change of pulmonary ventilation in new coal miners].

OBJECTIVE: To study the early effects of coal dust on lung function in new underground coal miners. METHODS: Two hundred and eighty-seven male miners were selected from new employees at the Xuzhou Mining Group Company as study group, and 132 male students at a mining technical school were selected as control. Data collection included: individual demographic parameters, family medical history, occupational history, and smoking history, measurement of dust concentrations in work areas, and lung function tests. This prospective cohort study took place over 3 years during which time total dust and respirable dust concentrations in the new coal miners' work areas were measured twice each month. For both miner and student groups, FVC and FEV(1) were tested initially before dust exposure, and then 15 times over the 3 years. RESULTS: The average total dust and respirable dust concentrations in the miners' work areas were 23.8 mg/m(3) and 8.9 mg/m(3) respectively, which greatly exceeded national health criteria. During the first year of dust exposure, the miners's average FVC was higher than that of the controls (5.19 L vs 4.92 L, P < 0.01). During the 2nd and 3rd year the difference in average FVC between miners and control group was not significant (5.14 L vs 5.12 L, P > 0.05). Before dust exposure, the miners' FEV(1) was significantly higher than that of the control group (4.48 L vs 4.28 L). In the miners group, FEV(1) declined rapidly during the first year following dust exposure (from 4.48 L to 4.25 L), and in the 2nd and the 3rd year the average FEV(1) of the miners was significantly lower than that of controls (4.34 L vs 4.56 L, P < 0.01), although there were some fluctuations during the follow-up period. Overall, the average FEV(1) of miners group showed a significant decline during the study. There were significant correlations between FVC or FEV(1) and age, height, weight, and smoking. The three-year total loss of FVC and FEV(1) in smoking miners (154 ml, 184 ml) were greater than in non-smoking miners (83 ml, 91 ml). CONCLUSION: There are apparent effects of coal dust on lung function in new underground coal miners, with FEV(1) being more impacted than FVC. Smoking may aggravate the effect of dust exposure on reducing lung function.

Adolescent↗

PubMed2004

Symptom onset in the first 2 years of employment at a wood products plant using diisocyanates: some observations relevant to occupational medical screening.

BACKGROUND: Questionnaires are essential tools for medical screening, but their role in monitoring workers at increased risk of occupational asthma (OA) remains indeterminate. METHODS: Employees who were at a newly established wood products plant without previous exposure to methylene diphenyl diisocyanate (MDI) completed an initial questionnaire and from one to four follow-up questionnaires during a 2-year period. Onset of symptoms in 132 workers was assessed by exposure groups and modeled using generalized estimating equations. RESULTS: Onset of attacks of dyspnea with wheeze, attacks of dyspnea or cough at rest, and chest tightness were significantly associated with MDI exposure after controlling for age, smoking, and wood dust exposure. Onset of cough on most days was significantly related to smoking and dust. Onset of phlegm production was significantly related to both MDI and dust exposure. CONCLUSIONS: Onset of certain symptoms is significantly associated with MDI exposure. Early detection of MDI-associated health effects using a short screening questionnaire appears feasible.

Adult↗

PubMed2004

Repeated measures of FEV1 over six to twelve months: what change is abnormal?

Monitoring change in FEV1 (deltaFEV1) is useful for assessing adverse respiratory effects in an individual, but high variability impedes reliable recognition of accelerated decline. The American Thoracic Society (ATS) recommends a > or =15% year-to-year FEV1 decline for clinical significance. To evaluate the applicability of this criterion in health monitoring programs, we examined the mean, lower 5th percentile, and lower 5% cutoff value of deltaFEV1 determined from 2 tests at 6- and 12-month intervals using data obtained with ATS-recommended equipment and procedures in 389 white male workers, each with 3 to 11 spirometry tests over 5 years. Results indicate that when healthy working males perform spirometry according to ATS standards, a yearly decline in FEV1 greater than 8% or 330 mL should not be considered normal, whereas the 15% ATS criterion could be appropriate in clinical settings.

Adult↗

PubMed2002

Health effects associated with medical glove use.

Adverse reactions to medical gloves represent an important public health issue. Accordingly, there is increasing interest in understanding the information reported to the US Food and Drug Administration (FDA) describing health effects associated with the use of medical gloves. This article provides a retrospective analysis and summary of health effects associated with medical glove use reported to the FDA. The FDA's medical device adverse event databases were searched via computer using keywords to identify reports of reactions associated with any type of medical glove. Demographic and clinical information abstracted from these reports was used to perform frequency and trend analyses. The reported medical glove-related events, including the noted trends in reporting, suggest the need for further study and continued monitoring of such reports.

Adult↗

PubMed2002

Work-related asthma and implications for the general public.

Asthma has been increasing over the last two decades in the United States. The onset of asthma has also been increasingly reported as a result of occupational exposures to over 350 different agents. Work-related asthma (WRA) has become the most frequently diagnosed occupational respiratory illness. Epidemiologic studies from the United States reported WRA incidence rates of 29-710 cases per million workers per year and suggest that 10-25% of adult asthma is work related. Much can be learned about asthma in the general population from investigations of asthma in the workplace. Surveillance of WRA continues to highlight an important role for low molecular weight chemical sensitizers, as well as high molecular weight antigens. Additionally, recent reports implicate mixed exposures, including commercial cleaning solutions, solvents, and other respiratory irritants, as well as contamination in nonindustrial environments, including schools and offices. Investigations of WRA have demonstrated a clear dose-related increase in sensitization and symptoms for exposures to both chemical and protein sensitizers. High proportions of exposed working groups can be affected. Skin exposures may affect the likelihood of individuals developing respiratory symptoms. Atopy increases the risk of sensitization and illness from workplace exposure to antigens but not to chemical sensitizers. Irritant exposures can act as adjuvants among individuals exposed to sensitizing substances, increasing the proportion who become sensitized. Atopy might also be a result of irritant exposures in some persons. Occupational asthma often has important long-term adverse health and economic consequences but can resolve completely with timely control of exposures. Detailed study of such asthma "cures" may prove useful in understanding factors that influence asthmatic airway inflammation in the general population.

Allergens↗